Papyriflavonol A, a new prenylated flavonol from Broussonetia papyrifera

A new prenylated flavonol, papyriflavonol A, was isolated from the root barks of Broussonetia papyrifera. The structure of this compound was elucidated as 5,7,3',4'-tetrahydroxy-6,5'-di-(gamma,gamma-dimethylallyl)-flavonol (1) by spectroscopic analysis.

Two imported cases of cutaneous larva migrans

Cutaneous larva migrans (CLM) is a rare serpiginous cutaneous eruption caused by accidental penetration and migration in the skin with infective larvae of nematode that normally do not have the human as their host. Although CLM has a worldwide distribution, the infection is most frequent in warmer climates. More recently, they have been increasingly imported from the tropics or subtropics by travelers. We experienced two patients who had pruritic serpiginous linear eruption in their skin for a few weeks after traveling to the endemic areas (Brazil and Thailand, respectively). After the treatment with albendazole, the skin lesions resolved with post-inflammatory hyperpigmentation. We report herein two cases of cutaneous larva migrans successfully treated with albendazole.

Surgery and prognostic factors for gastric stromal tumor

Morphologic studies of gastric stromal tumors (GSTs) indicate that mitotic counts (MCs) and tumor size are major discriminants predictive of biologic behavior. The purpose of this study is to improve the understanding of GST behavior, including the prognostic factors and surgical treatment of GSTs. A retrospective analysis (1990--1997) of the clinical course for 116 patients with GSTs was completed, with a median follow-up of 43 months. Tumors were categorized as malignant GSTs (n = 17) when the MC was > 5/50 high-power fields (HPF) and the size > 5 cm or as benign GSTs (n = 99) when the MC was < or = 5/50 HPF and the size < or = 5 cm, MC < or = 5/50 HPF and size > 5 cm, or MC > 5/50 HPF and size < or = 5 cm. None of 99 benign tumors recurred or metastasized, whereas 7 of 17 malignant tumors recurred. MCs had a close correlation with tumor size. Immunohistochemical studies using CD34, smooth muscle actin, S-100 protein, and synaptophysin have shown positive rates of 61%, 33%, 14%, and 3%, respectively. Smooth muscle actin reactivity was more common in the benign tumors (p = 0.046) and synaptophysin reactivity in the malignant tumors (p = 0.010). Univariate analysis showed that the following clinicopathologic factors were potentially related to poor survival of patients: (1) MC > 5/50 HPF (p = 0.0001); (2) severe pleomorphism (p = 0.0062); (3) necrosis (p = 0.0173); (4) marked cellularity (p = 0.0112); (5) presence of ulceration of overlying gastric mucosa (p = 0.0091); (6) tumor size > 5 cm (p = 0.0195); and (7) exogastric growth pattern (p = 0.0344). Tumors with MC > 5/50 HPF and size > 5 cm were found to be strong indicators of an unfavorable prognosis. The type of surgery and tumor site did not affect the prognosis of the patients.

Insulin-like growth factor-1 protects H9c2 cardiac myoblasts from oxidative stress-induced apoptosis via phosphatidylinositol 3-kinase and extracellular signal-regulated kinase pathways

Oxidative stress plays a critical role in cardiac injuries during ischemia/reperfusion. Insulin-like growth factor-1 (IGF-1) promotes cell survival in a number of cell types, but the effect of IGF-1 on the oxidative stress has not been elucidated in cardiac muscle cells. Therefore, we examined the role of IGF-1 signaling pathway in cell survival against H2O2-induced apoptosis in H9c2 cardiac myoblasts. H2O2 treatment induced apoptosis in H9c2 cells, and pretreatment of cells with IGF-1 suppressed apoptotic cell death. The antiapoptotic effect of IGF-1 was blocked by LY294002 (an inhibitor of phosphatidylinositol 3-kinase) and by PD98059 (an inhibitor of extracellular signal-regulated kinase (ERK)). The protective effect of IGF-1 was also blocked by rapamycin (an inhibitor of p70 S6 kinase). Furthermore, H9c2 cells stably transfected with constitutively active PI 3-kinase (H9c2-p110*) and Akt (H9c2-Gag-Akt) constructs were more resistant to H2O2 cytotoxicity than control cells. Although H2O2 activates both p38 mitogen-activated protein kinase (MAPK) and c-Jun N-terminal kinase (JNK), IGF-1 inhibited only JNK activation. Activated PI 3-kinase (H9c2-p110*) and pretreatment of cells with IGF-1 down-regulated Bax protein levels compared to control cells. Taken together, our results suggest that IGF-1 transmits a survival signal against oxidative stress-induced apoptosis in H9c2 cells via PI 3-kinase and ERK-dependent pathways and the protective effect of IGF-1 is associated with the inhibition of JNK activation and Bax expression.

Localized multiple glomus tumors of the face and oral mucosa

We describe a 54-year-old patient with an unusual localization of localized multiple glomus tumors. She had several nodules on the left mandibular area, lower lip, and anterior part of the buccal mucosa. A biopsy taken from the left mandibular area showed cystically dilated vessels lined by endothelial cells and a few outer layers of glomus cells in the dermis to subcutis. Localized multiple glomus tumors are rare, and both their facial and oral mucocal localization are extremely rare.

High thoracic midline dorsal column myelotomy for severe visceral pain due to advanced stomach cancer

OBJECTIVE

To report the results of high thoracic midline dorsal column myelotomy in eight consecutive patients who experienced severe visceral pain caused by advanced stomach cancer.

METHODS

Eight patients were transferred from the department of general surgery because of failed pain control after an operation and chemotherapy for advanced stomach cancer. Preoperatively, the pain was not controlled with strong opiates. The patients' neurological status was normal. Their general conditions varied from 50 to 80 on the Karnofsky scale. Under general anesthesia, patients received high thoracic midline dorsal column myelotomies after T1 or T2 laminectomy.

RESULTS

Five of the eight patients exhibited favorable outcomes after surgery. The remaining three did not experience preoperative pain but developed new pain at a different site. One patient exhibited a posterior column sign and paresthesia below the level of the myelotomy without motor deficit and analgesia. Two patients exhibited transient paresthesia below the T6 level, but the paresthesia improved after administration of corticosteroids. There was no mortality related to the procedure.

CONCLUSION

Controlling visceral pain resulting from advanced cancer is very difficult, although various surgical procedures have been tried. Poorly localized, deep and diffuse visceral pain is more difficult to manage than well-localized somatic pain. Dorsal column myelotomy at a high thoracic cord level effectively controls severe abdominal pain and should be considered as a new palliative operation for patients with severe visceral pain.

The influence of gastrectomy on the change of bone metabolism and bone density

OBJECTIVES

Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers.

METHODS

Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected.

RESULTS

Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p < 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p < 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups.

CONCLUSION

We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.

Realization of sinc waves in ultrasound imaging systems

It is known that the transmit pulse waveforms of a limited-diffraction beam in a linear array transducer should be varied according to transducer element location, dictating the use of sophisticated hardware. In order to overcome this disadvantage while achieving the same field response, we propose a method of synthesizing limited-diffraction beams by combined signal processing of pulsed plane waves propagating in distinct directions over several consecutive insonification time intervals. The method is capable of achieving both higher transmit power and better lateral resolution over a larger depth of field. Although its field response is not uniform throughout the imaging points, this is not a major problem since the response is quite uniform within a region of interest. The proposed method requires the use of multiple insonifications for transmit focusing, and, therefore, can be applied in imaging slowly-moving or still objects. Both simulation and experimental results corroborate its superiority in terms of the lateral resolution at all imaging depths.

Purification and characterization of a second type thioredoxin peroxidase (type II TPx) from Saccharomyces cerevisiae

A yeast peroxidase that reduces H2O2 and alkyl hydroperoxides with the use of reducing equivalents provided by thioredoxin was identified previously and named thioredoxin peroxidase (TPx) [Chae, H. Z., Chung, S. J., and Rhee, S. G. (1994) J. Biol. Chem. 269, 27670-27678]. A second type thioredoxin-dependent peroxidase, named type II TPx, has now been purified from yeast, and several peptide sequences have been obtained. Using those sequences, the corresponding cDNA has been identified from the GenBank database. Comparison of the predicted sequence of 176 amino acids of type II TPx with that of the 195 residues of TPx, now renamed type I TPx, revealed no substantial homology except for a short segment preceding Cys62 of type II TPx. Kinetic characterization of the reactions catalyzed by type I and II TPxs revealed that type I preferentially reduces H2O2 rather than alkyl hydroperoxides, whereas type II shows the reverse specificity. Type II TPx contains three cysteine residues at positions 31, 62, and 120. Experiments with mutant proteins in which these three cysteine residues were replaced individually with serine suggest that Cys62-SH constitutes the site of oxidation by peroxides and that the oxidized Cys62 reacts with the Cys120-SH group of another type II TPx molecule to form an intermolecular disulfide linkage. The formed disulfide can then be reduced by thioredoxin, but not by glutathione. Thus, type II TPx mutants lacking Cys62 or Cys120 showed no detectable TPx activity, whereas mutation of Cys31 had no effect on TPx activity. An antioxidant function of type II TPx in intact cells was demonstrated by the observation that Escherichia coli cells overexpressing wild-type protein were less sensitive to inhibition of growth by alkyl hydroperoxides than were control cells or cells overexpressing the mutant protein lacking Cys62.

A case of leukemia cutis

We report a case of leukemia cutis with atypical skin manifestations, presented with generalized various sized dark brownish to erythematous patches with plaques on the whole body of a 42-year-old man. Skin lesions developed 6 months ago and had no signs of itching or tenderness. He complained of sustaining fevers with abdominal discomfort. Laboratory findings showed elevation of leukocyte count and peripheral blood smear revealed 86% of lymphocyte. Histologic examination showed diffuse infiltration of abnormal cells that appeared to be leukemic in nature.

Figurate purpuric eruptions on the trunk: acetaminophen-induced rashes

A 23-year-old man had recurrent erythematous purpuric patches in a transverse-linear arrangement on his back and arms. One week prior to a recent episode, he took acetaminophen for 3 days. Four months earlier, he developed the same purpuric lesions at/around the same anatomical site when he took acetaminophen for pain-relief. A biopsy specimen showed capillaritis and extravasation of erythrocytes in the papillary dermis. A provocation test with acetaminophen confirmed these lesions as drug-induced rashes. The uncommon topographic and morphologic features of the purpuric lesion in this patient might be considered as an unusual expression of pigmented purpuric dermatosis caused by acetaminophen.

High-Tc superconductors in the two-dimensional limit:

The free modulation of interlayer distance in a layered high-transition temperature (high-Tc) superconductor is of crucial importance not only for the study of the superconducting mechanism but also for the practical application of high-Tc superconducting materials. Two-dimensional (2D) superconductors were achieved by intercalating a long-chain organic compound into bismuth-based high-Tc cuprates. Although the intercalation of the organic chain increased the interlayer distance remarkably, to tens of angstroms, the superconducting transition temperature of the intercalate was nearly the same as that of the pristine material, suggesting the 2D nature of the high-Tc superconductivity.

Prognostic impact of splenectomy on gastric cancer: results of the Korean Gastric Cancer Study Group

The relation between splenectomy and survival time after curative total gastrectomy for gastric cancer was reviewed retrospectively on 492 patients treated at nine hospitals between 1989 and 1993. Altogether 260 patients underwent splenectomy, and 232 patients did not. A univariate analysis revealed that the survival time of patients with splenectomy was significantly less than those without splenectomy (p = 0.0265). In a subgroup of our patients stratified to adjust for the stage of disease, there was no significant difference between the survival rates. Splenectomy remained insignificant according to the multivariate analysis using Cox's proportional-hazard regression. The splenectomy group was associated with more risk factors (e.g., T3/T4 tumors, positive nodes, stage greater than III, large tumor size) that are powerful predictors of death due to gastric cancer. In a separate multivariate analysis after eliminating those who had a T4 tumor invasion or a N2 nodal positivity from the analysis (or both), splenectomy again remained insignificant. In conclusion, we could not find any beneficial effect of splenectomy in gastric cancer patients in this retrospective multivariate analysis. We can presume that splenectomy cannot increase the survival rate so long as the splenectomy group has more risk factors than the nonsplenectomy group. Therefore randomized prospective clinical trials using more precise criteria to indicate the need for splenectomy are needed to assess whether splenectomy is beneficial.

Prognostic significance of lymph node metastasis in advanced carcinoma of the stomach

This study attempted to clarify the prognostic factors in advanced gastric cancer, with special reference to lymph node metastasis. It was a retrospective study of 401 patients with stage III and IV gastric cancer operated on during the 5 years from 1988 to 1993. A significant relationship was found between the 5-year survival rate and (1) the ratio of the number of metastatic lymph nodes to the total number of dissected lymph nodes (ratios of 1-15, 16-30 and 31 per cent or more were associated with a 5-year survival rate of 81, 23 and 17 per cent respectively), (2) stage N1 or N2 of the Union International Contra la Cancrum tumour node metastasis classification (58 and 27 per cent respectively) and (3) the number of metastatic lymph nodes (1-3, 4-7 and 8 or more were associated with a 5-year survival rate of 67, 49 and 32 per cent respectively). Multivariate survival analysis using Cox's proportional hazard model was applied to these three forms of lymph node status. Among these three variables, the ratio of the number of metastatic lymph nodes to the total number of dissected lymph nodes was the most meaningful prognostic factor.

Inhibition of metal-catalyzed oxidation systems by a yeast protector protein in the presence of thioredoxin

A protector protein from Saccharomyces cerevisiae specifically prevents the inactivation of enzymes caused by a thiol/Fe3+/O2 metal-catalyzed oxidation system but not by an ascorbate/Fe3+/O2 system. Ascorbate/Fe3+/O2-mediated damage of enzymes could be prevented by the protector protein only in the presence of reduced thiol. We demonstrate that two proteins from yeast, thioredoxin plus another protein having properties similar to that expected to thioredoxin reductase, when presented with NADPH and the yeast protector protein prevented inactivation of E. coli glutamine synthetase by the ascorbate/Fe3+/O2 system. This system also removes hydrogen peroxide effectively. We also demonstrate evidence suggesting that the NADPH-dependent thioredoxin system reactivates protector protein by reversible disulfide-dithiols exchange.

Inhibition of metal-catalyzed oxidation systems by a yeast protector protein in the presence of thiol

A protector protein from Saccharomyces cerevisiae prevented the inactivation of enzyme and oxidative damage to protein and DNA caused by a thiol/Fe3+/O2 metal-catalyzed oxidation (MCO) system but not when thiol was replaced by ascorbate. In the presence of a reduced thiol such as dithiothreitol and reduced glutathione, however, the protector protein prevented inactivation of E. coli glutamine synthetase against a MCO system comprised of ascorbate and Fe3+. The protector protein also inhibited the fragmentation of protein, incorporation of carbonyl groups into protein, strand breaks in pBluescript plasmid DNA, and the formation of 8-hydroxydeoxyguanosine in calf thymus DNA when induced by either the thiol/Fe3+ system or the ascorbate/Fe3+ system supplemented with dithiothreitol. These results suggest that antioxidant activity of protector protein against a MCO system requires thiol as a reducing equivalent to restore its catalytic activity.

Strand breaks in DNA induced by a thiol/Fe(III)/O2 mixed-function oxidase system and its protection by a yeast antioxidant protein

Strand breaks can be produced in pBluescript plasmid DNA and calf thymus DNA by a mixed-function oxidase (MFO) system comprised of Fe3+, O2, and dithiothreitol as an electron donor. Superoxide dismutase does not block this damage whereas a 27-KDa yeast antioxidant protein specifically inhibits strand breaks in DNA induced by the dithiothreitol MFO system. In contrast, this protein does not inhibit strand breaks in DNA induced by an ascorbate MFO system although catalase inhibits damage in DNA caused by both MFO systems. Based on the specificity of this protein, we propose that the antioxidant protein functions as a sulfur radical scavenger.