Pathology and cellular kinetics of gallbladder with an anomalous junction of the pancreaticobiliary duct

OBJECTIVES

Anomalous junction of the pancreaticobiliary duct (AJPBD) is thought to be an important risk factor for gallbladder carcinoma in Japan. In this report, we examine histopathology and cellular kinetics of gallbladder mucosae of patients with AJPBD and the possible risk of gallbladder carcinoma.

METHODS

We examined 62 gallbladders from patients with AJPBD (group A), 16 gallbladder carcinomas from patients with AJPBD (group B), 60 gallbladder carcinomas from patients without AJPBD (group C), and six normal gallbladders from patients without AJPBD (group D). Histopathology, mucosal heights, and proliferative cell nuclear antigen-labeling index were obtained from routinely processed tissue specimens.

RESULTS

The incidence of hyperplastic changes in group A and in the noncancerous regions (NCRs) of group B was greater than in the NCRs of group C (p < 0.05). The incidence of dysplastic changes in the NCRs of group B was greater than in the NCRs of group C (p < 0.05). The mucosal heights in group A and in the NCRs of group B were higher than in the NCRs of group C (p < 0.05). A high proliferative cell nuclear antigen-labeling index was observed in group A and in the NCRs of group B, where hyperplastic changes were frequently observed.

CONCLUSIONS

These results suggest that a sequence of hyperplastic changes with a corresponding increase in cellular kinetics with progression through dysplasia to carcinoma may be important in carcinogenesis in gallbladders of patients with AJPBD. AJPBD itself may be a possible risk for gallbladder carcinoma.

Growth inhibition of human leukemic cells by WT1 (Wilms tumor gene) antisense oligodeoxynucleotides: implications for the involvement of WT1 in leukemogenesis

We have previously reported expression of WT1 in acute leukemia. To elucidate its biological significance, we examined the effect of the suppression of the WT1 expression by WT1 antisense oligomers on the growth of the leukemic cells expressing WT1. When 20 different WT1 antisense (AS) oligomers covering from the 5' cap sites of the WT1 gene to the 3' end were examined for the inhibitory effect on the growth of K562 cells expressing WT1, four WT1 AS oligomers inhibited the cell growth, whereas WT1 sense and random sequence oligomers had no effect on the cell growth of K562. Moreover, WT1 AS oligomers significantly inhibited the growth of the clonogenic cells of fresh leukemic cells in six of 14 patients with acute myeloid leukemia, in one of two patients with chronic myelogenous leukemia (CML) chronic phase, and in one of one patient with CML blastic crisis. However, these oligomers did not inhibit normal colony-forming unit-granulocyte-macrophage. Western blot analysis clearly demonstrated the significant reduction in the WT1 protein levels in the K562 and fresh leukemic cells that were treated with the WT1 AS oligomers, confirming that the inhibitory effect of the WT1 AS oligomers on the cell growth operates via the reduction in the WT1 protein levels. These results show that WT1 plays an important role in leukemogenesis.

Cholecystokinin receptor antagonist, loxiglumide, inhibits invasiveness of human pancreatic cancer cell lines

Recently, cholecystokinin has been reported to be important in regulating the growth of pancreatic cancer. We investigated the effect of loxiglumide (LXG), a cholecystokinin receptor antagonist, on the invasiveness of two human pancreatic cancer cell lines. Cells were treated with LXG for 24 h, and examined in the invasion assay. The expression and activity of MMP-9 in supernatants from cancer cells were analyzed by Western blotting and zymogram. Interestingly, the invasiveness of cancer cells and expression of MMP-9 were decreased by LXG in a dose-dependent manner. LXG may be a useful therapeutic agent against pancreatic cancer.

The expression of IL-6 and its related genes in acute leukemia

Acute myeloid leukemia (AML) blast cells frequently produce interleukin-6 (IL-6) and other cytokines such as colony-stimulating factors (CSF: G-CSF, M-CSF, and GM-CSF), tumor necrosis factor (TNF)-alpha, and IL-1. The AML blast cells that produced IL-6 alone could not form autonomous in vitro colonies, whereas the blast cells that coexpressed CSF in addition to IL-6 were able to form such colonies. This suggests that IL-6 acts as a costimulator to enhance CSF-induced clonogenicity of AML blast cells. TNF-alpha and IL-1 that are produced from the blast cells may stimulate the growth of the AML blast cells by inducing production of CSF in bone marrow stromal cells or in the blast cell population itself. Improvement of clinical manifestations by the administration of an anti-IL-6 murine monoclonal antibody in a patient with AML-M5B confirmed an important role of IL-6 in in-vivo growth of the blast cells. The mRNA expression of IL-6 and its related genes in AML and acute lymphoid leukemia (ALL) blast cells was analyzed by reverse transcriptase-polymerase chain reaction (RT-PCR). IL-6 mRNA expression was common in AML, but rare in ALL, whereas the IL-6 receptor (IL-6R) mRNA was expressed in almost all cases of AML and in more than half of the cases of ALL. In contrast, gp130 was ubiquitously expressed in both AML and ALL. A significant correlation between the levels of IL-6R expression and the responsiveness of the blast cells to exogenous IL-6 was observed. This suggests the possibility of the rapid prediction of the responsiveness of leukemic cells to exogenous IL-6 (IL-6 administration for therapy) by rapid measurement of IL-6R mRNA by RT-PCR.

Interleukin-1 alpha activates an NF-kappaB-like factor in osteoclast-like cells

We investigated the NF-kappaB transcription factor in osteoclast-like cells. Osteoclast-like cells were differentiated from mouse bone marrow cells in co-culture with mouse calvaria-derived primary osteoblasts in the presence of 1alpha,25-dihydroxyvitamin D3 and prostaglandin E2 in collagen gel-coated dishes. We enriched osteoclast-like cells from the co-cultures by Pronase treatment. When the enriched osteoclast-like cells were treated with phorbol 12-myristate 13-acetate, interleukin-1 (IL-1), calcitonin, or macrophage colony-stimulating factor, only IL-1 activated an NF-kappaB-like factor, which specifically bound to a kappaB motif DNA sequence, as detected by an electrophoretic mobility shift assay. IL-1 also activated NF-kappaB induction in osteoblasts. However, the NF-kappaB-like factor induced by IL-1-stimulated osteoclast-like cells is of smaller molecular size than the factor in osteoblasts, as shown by an electrophoretic mobility shift assay. The NF-kappaB activity of osteoclast-like cells was recognized completely by antibodies against the p50 subunit, and only partially by antibodies against the p65 subunit of NF-++kappaB. Antibodies against c-Rel, Rel B, and p52 did not recognize the NF-kappaB-like factor. These results suggest that IL-1 activates an NF-kappaB-like factor in osteoclast-like cells, which contains p50 and p65-related proteins.

Mapping of the genes encoding mouse prostaglandin D, E, and F and prostacyclin receptors

Prostaglandins and prostacyclin are metabolites of arachidonic acid and exert a variety of actions to maintain local homeostasis in the body. Their actions are mediated by cell surface receptors specific to the respective ligands. Using a panel of interspecific back-cross mice, we have mapped the prostaglandin D receptor gene (Ptgdr), prostaglandin E receptor subtype EP(1) gene (Ptgerepl), prostaglandin F receptor gene (Ptgfr), and prostacyclin receptor gene (Ptgir). Ptgdr mapped to proximal Chr 14, Ptgfr mapped to distal Chr 3, Ptgerepl mapped to middle Chr 8, and Ptgir mapped to proximal Chr 7.

Role of repeat computed tomography after emergency endoscopic retrograde pancreatography in the diagnosis of traumatic injury to pancreatic ducts

Endoscopic retrograde pancreatography (ERP) is performed on patients with pancreatic injury after abdominal trauma. To delineate pancreatic ductal injuries more accurately, we performed repeat computed tomography (CT) shortly after completion of ERP. We describe our experiences with six patients to demonstrate the feasibility and utility of this method. In our cases, the diagnosis of pancreatic ductal injury was made with certainty on the basis of the presence of extravasated contrast medium. This protocol is useful for reaffirmation of injuries noted on ERP, for diagnosis of injuries not noted on ERP, and for exclusion of injuries in patients with equivocal results of ERP. Moreover, the protocol is easy to implement because it involves only the transfer of the patient from the endoscopy to the CT suite. The technique can be used to clarify potentially confusing situations.

Targeted disruption of gp130, a common signal transducer for the interleukin 6 family of cytokines, leads to myocardial and hematological disorders

gp130 is a ubiquitously expressed signal-transducing receptor component shared by interleukin 6, interleukin 11, leukemia inhibitory factor, oncostatin M, ciliary neurotrophic factor, and cardiotrophin 1. To investigate physiological roles of gp130 and to examine pathological consequences of a lack of gp130, mice deficient for gp130 have been prepared. Embryos homozygous for the gp130 mutation progressively die between 12.5 days postcoitum and term. On 16.5 days postcoitum and later, they show hypoplastic ventricular myocardium without septal and trabecular defect. The subcellular ultrastructures in gp130-/- cardiomyocytes appear normal. The mutant embryos have greatly reduced numbers of pluripotential and committed hematopoietic progenitors in the liver and differentiated lineages such as T cells in the thymus. Some gp130-/- embryos show anemia due to impaired development of erythroid lineage cells. These results indicate that gp130 plays a crucial role in myocardial development and hematopoiesis during embryogenesis.

[Higher expression levels of alternatively spliced pX mRNA in human T lymphotropic virus type I (HTLV-I) asymptomatic carriers positive for antibodies to p40tax protein]

We cloned and sequenced complementary DNA (cDNA) of human T lymphotropic virus type I (HTLV-I) pX gene mRNA expressed in peripheral blood lymphocytes of asymptomatic carriers and searched for a possible correlation between HTLV-I pX mRNA expression levels to viral load and anti-p40tax status. Nine cDNA clones had four alternatively spliced forms of mRNA, three forms were identical to the reported cDNA sequences. One cDNA clone contained a novel splicing acceptor site, thereby indicating an unidentified form of pX mRNA, termed as pX delta 17 delta 37. These results, together with previous observations, suggest that HTLV-I has complex pattern of splicing. The expression levels of the five pX mRNAs, pX, pX delta 17, p21rex, orf II, and pX delta 17 delta 37, were examined in twenty-one asymptomatic carriers. Alternatively spliced pX mRNA species were detected in all the carriers. Semiquantitation of pX mRNAs revealed that pX and pX delta 17 were the dominant mRNA species among alternatively spliced pX mRNA. All pX mRNAs but the orf II message correlated with amounts of proviral DNA significantly (p < 0.05). The levels of proviral DNA and mRNAs were significantly higher in anti-p40tax positive carriers than in negative ones. These observations suggest that the alternatively spliced pX mRNAs are expressed ubiquitously in the peripheral blood lymphocytes of HTLV-I asymptomatic carriers with complex pattern of splicing and that the presence of anti-p40tax may be a marker for a higher viral load and viral replication levels in HTLV-I asymptomatic carriers. Our observations may explain previous finding that the carriers rate is higher in the offspring of anti-p40tax positive mothers than those of anti-p40tax negative mothers.

A cysteine protease inhibitor stored in the large granules of horseshoe crab hemocytes: purification, characterization, cDNA cloning and tissue localization

A cysteine protease inhibitor with an apparent Mr = 12,600, designated limulus (L)-cystatin, was isolated from hemocyte lysates of the Japanese horseshoe crab (Tachypleus tridentatus), using two steps of chromatography, including dextran sulfate-agarose, and carboxymethylated papain-agarose. L-cystatin inhibits amidolytic activity of papain by forming a noncovalent 1:1 complex with an equilibrium constant (Ki) of 0.08 nM. It also inhibits cathepsin L (Ki = 0.17 nM) and ficin (Ki = 0.52 nM), but not argingipain (a bacterial cysteine protease) and calpains. A cDNA for L-cystatin was isolated and the open reading frame coded for a mature protein of 114 amino acids, of which 99 residues were confirmed by peptide sequencing. L-cystatin shows significant sequence identities to members of the family 2 cystatin, such as bovine colostrum cystatin (33%) and human cystatin S (31%). Northern blotting revealed expression of the mRNA in hemocytes and slightly in heart but expression was negligible in hepatopancreas, intestine, stomach, and muscle. Immunoblotting revealed the localization to be in the large granules of hemocytes. Furthermore, L-cystatin has an antimicrobial activity against Gram-negative bacteria, which is much stronger than that of chicken egg white cystatin. These data suggest that the large granule-derived L-cystatin serves synergistically to accomplish an effective defense against invading microbes, together with other defense molecules that are released in response to external stimuli.

A new inositol 1,4,5-trisphosphate binding protein similar to phospholipase C-delta 1

We have reported that two inositol 1,4,5-trisphosphate binding proteins, with molecular masses of 85 and 130 kDa, were purified from rat brain; the former protein was found to be the delta 1-isoenzyme of phospholipase C (PLC-delta 1) and the latter was an unidentified novel protein [Kanematsu, Takeya, Watanabe, Ozaki, Yoshida, Koga, Iwanaga and Hirata (1992) J. Biol. Chem. 267, 6518-6525]. Here we describe the isolation of the full-length cDNA for the 130 kDa Ins(1,4,5)P3 binding protein, which encodes 1096 amino acids. The predicted sequence of the 130 kDa protein had 38.2% homology to that of PLC-delta 1. Three known domains of PLC-delta 1 (pleckstrin homology and putative catalytic X and Y domains) were located at residues 110-222, 377-544 and 585-804 with 35.2%, 48.2% and 45.8% homologies respectively. However, the protein showed no PLC activity to phosphatidylinositol 4,5-bisphosphate and phosphatidylinositol. The 130 kDa protein expressed by transfection in COS-1 cells bound Ins(1,4,5)P3 in the same way as the molecule purified from brain. Thus the 130 kDa protein is a novel Ins(1,4,5)P3 binding protein homologous to PLC-delta 1, but with no catalytic activity. The functional significance of the 130 kDa protein is discussed.

A cross-sectional study on nerve conduction velocities among workers exposed to carbon disulphide

We examined nerve conduction velocities (NCVs) in the ulnar nerve (motor, slower motor fiber and mixed), the peroneal nerve (motor, MCV) and the sural nerve (sensory, SCV) among 46 Japanese workers exposed to carbon disulphide (CS2, CS2-exposed group) and 28 normal control workers (group C). The subjects had not suffered from diseases or injuries of the peripheral or central nervous system. MCV in the peroneal nerve and SCV in the sural sural nerve in the CS2-exposed group were significantly reduced compared with those of group C (p < 0.05 in both), but no significant difference in NCVs of the ulnar nerve was noted between the two groups. In the two subgroups of the CS2 exposed group (currently exposed: group E n = 24; removed from exposure: group R n = 22), NCVs of group E tended to be lower than those of group R in spite of the younger age of group E. MCV in the peroneal nerve and SCV in the sural nerve in group E were significantly reduced compared with those in group C, but not significantly in group R. These findings indicate the existence of a toxic effect of CS2 exposure on the NCV, predominantly evident in the lower limbs in those workers. On removal from CS2 exposure, NCV recovery seemed to be possible.

Purification, characterization, and cDNA cloning of a 27-kDa lectin (L10) from horseshoe crab hemocytes

We separated granular components of horseshoe crab hemocytes by a combination of centrifugation on sucrose density gradient and high performance liquid chromatography, and a 27-kDa protein termed L10 was found to be a major component in the large granules (Shigenaga, T., Takayenoki, Y., Kawasaki, S., Seki, N., Muta, T., Toh, Y., Ito, A., and Iwanaga, S. (1993) J. Biochem. (Tokyo) 114, 307-316). In the present work, lectin activity of this protein and its unique primary structure were elucidated. L10 was purified by four steps of chromatography, including dextran sulfate-Sepharose CL-6B, CM-Sepharose CL-6B, Sephacryl S-200, and Mono S. At least three 27-kDa isoproteins, named L10a, L10b, and L10c, were isolated. Their amino acid compositions were almost indistinguishable, and there were no amino sugars. All the isoforms had hemagglutinating activity against human A-type erythrocytes, in a Ca(2+)-independent manner with L10b showing the highest activity. The L10b-mediated hemagglutination was inhibited in the presence of N-acetylglucosamine or N-acetylallolactosamine, and the association constant (Ka) between L10b and N-acetylglucosamine was 1.95 x 10(4) M-1. Furthermore, L10b specifically agglutinated Staphylococcus saprophyticus KD. Ultracentrifugation analysis revealed that L10b is present in monomer form in solution. A cDNA coding for an isoform of L10 was isolated from a hemocyte cDNA library. The open reading frame of the 768-base pair cDNA coded for the signal sequence of 19 residues. The mature protein had 236 residues with the calculated molecular weight of 26,757. Amino acid sequences of the peptides derived from L10c exactly corresponded to the predicted sequence of the cDNA, whereas amino acid replacements of Ile-129 to Val and His-213 to Tyr existed both in L10a and L10b, suggesting that the cDNA codes for L10c. Cysteine was absent and there were five tandem repeats with 47 amino acids in each segment with internal sequence identities of 49-68%. The entire amino acid sequences had no significant sequence similarity with other known proteins.

Human pancreatic phospholipase A2 stimulates the growth of human pancreatic cancer cell line

Phospholipase A2 (PLA2) from human pancreas, designated hPLA2-I, functions as a digestive enzyme. Interestingly, the present study demonstrated that the mature form of hPLA2-I stimulated the growth of a human pancreatic cancer cell line MIAPaCa-2, whereas the pro-form was ineffective. PLA2s from Laticauda semifasciata fraction I, Crotalus adamanteus venom, Streptomyces violaceoruber and bee venom, showed no proliferative effect to the growth of MIAPaCa-2. The Scatchard plot analysis revealed that the MIAPaCa-2 cell had a specific binding site for the mature hPLA2-I. The equilibrium binding constant (Kd) and the maximum binding capacity (Bmax) were 2.6 nM and 0.4 fmol/10(6) cells, respectively. These results suggest that the mature hPLA2-I, but not the pro-form, may function as a growth factor of pancreas carcinoma via the specific binding site.

Large-volume intraoperative peritoneal lavage with an assistant device for treatment of peritonitis caused by blunt traumatic rupture of the small bowel

The benefits of large-volume intraoperative peritoneal lavage (IOPL), with an assistant lavage device, were evaluated retrospectively in 114 patients with peritonitis caused by blunt traumatic rupture of the small bowel. Postoperative complications caused by infection were a major problem after rupture of the small bowel (46 of 114, 39.4%). Both prolongation of the interval between injury and laparotomy and rupture of the lower part of the small bowel were risk factors for postoperative complications caused by infection. Large-volume IOPL (25.2 +/- 2.1 L) with an assistant lavage device reduced the rate of complications caused by infection from 30 of 58 (51.8%) to 15 of 56 (26.8%). The volume used for IOPL was closely related to the occurrence of postoperative complications resulting from infection. No complications from infection occurred in patients who received lavage with of 28.3 +/- 2.7 L of saline, whereas complications occurred in those patients treated with a smaller volume of lavage fluid (18.0 +/- 2.5 L). Large-volume IOPL should be considered in patients with blunt rupture of the small bowel who are at risk for infection, and the assistant device for IOPL may be useful for such treatment.

Human T-lymphotropic virus type-I, and hepatitis A, B and C viruses in Nepal: a serological survey

In 1987, 676 blood samples were collected from inhabitants of the Bhadrakali and Kotyang villages in Nepal. The samples were tested for the prevalence of antibody to hepatitis A virus (anti-HAV), hepatitis B surface antigen (HBsAg), antibody to hepatitis B core antigen (anti-HBc), second-generation antibody to hepatitis C virus (anti-HCV) and antibody to human T-lymphotropic virus type-I (anti-HTLV-I). Anti-HAV was present in 99.3% of the people surveyed. The prevalence of anti-HAV reached 100% in the < 25 age group and was as high or only slightly lower in all other age groups. The prevalence of HBsAg was 0.3% and of anti-HBc 7.7%. Anti-HCV was found in 0.1% of the residents. No significant difference by gender or village was noted in the prevalence of anti-HAV, HBsAg, anti-HBc, or anti-HCV. No anti-HTLV-I-positive persons were identified. These data suggest that the prevalence of hepatitis B and C virus infections in Nepal is low in contrast to hepatitis A virus infection, and that human T-lymphotropic type-I infection may be absent in this population.

Higher expression levels of alternatively spliced pX mRNA in human T lymphotropic virus type I asymptomatic carriers positive for antibodies to p40tax protein

cDNA of human T lymphotropic virus type I (HTLV-I) pX gene mRNA expressed in peripheral blood lymphocytes of asymptomatic carriers was sequenced. One cDNA clone contained a novel splicing acceptor site, indicating an unidentified form of pX mRNA: pX delta 17 delta 37. All 21 asymptomatic carriers expressed some level of alternatively spliced pX mRNA (pX, pX delta 17, p21rex, orfII, or pX delta 17 delta 37). pX and pX delta 17 were the dominant mRNA species among the five pX mRNAs. All pX mRNAs but orfII correlated significantly with amounts of provirus DNA (P < .05). Levels of provirus DNA and pX mRNAs were significantly higher in anti-p40tax-positive carriers than in negative ones. These observations suggest that the pX mRNAs are expressed ubiquitously, with a complex pattern of splicing, and that the presence of anti-p40tax may serve as a marker for a higher virus load and viral replication levels in asymptomatic HTLV-I carriers.

A case of drug eruption caused by the crude drug Boi (Sinomenium stem/Sinomeni caulis et Rhizoma)

We report a case of drug eruption caused by the crude drug Boi. A 41-year-old female patient had been diagnosed with chronic rheumatoid arthritis in the department of internal medicine. After ingestion of a decoction of the crude drug Boi for the alleviation of arthralgia, a slight fever developed, which was followed by systemic edematous erythema with itching. HPLC showed that the main components of the crude drug Boi are sinomenine and magnoflorine. The results of patch tests were negative for all oral drugs that the patient had been taking. Oral ingestion tests showed that the patient showed positive reactions to the as-is Boi boiling-water decoction and 1/10-volume sinomenine. Based on this, the drug eruption was judged to be caused by sinomenine. It is considered the first time that the causative component of a drug eruption was confirmed by oral ingestion tests with components of a crude drug of Kampo medicine (Sino-Japanese traditional medicine).

Inositol 1,4,5-trisphosphate binding to porcine tracheal smooth muscle aldolase

A cytoskeletal fraction of porcine tracheal smooth muscle (PTSM) was found to contain > 90% of total cellular aldolase (fructose 1,6-bisphosphate aldolase, EC 4.1.2.13) activity. PTSM aldolase was purified by DEAE and inositol 1,4,5-trisphosphate (Ins(1,4,5)P3) affinity chromatography and found to react with an antibody directed against human aldolase C, but not anti-aldolase A and B. The molecular mass of native aldolase was about 138 kDa (on Sephacryl S-300); SDS-denatured enzyme was 35 kDa (comigrated with rabbit skeletal muscle aldolase). Total cellular aldolase tetramer (aldolase4) content was 34.5 pmol/100 nmol lipid P(i). Ins(1,4,5)P3) binding activity coeluted with aldolase during Sephacryl 300, DEAE, and Ins(1,4,5)P3 affinity chromatography. Ins(1,4,5)P3 bound to purified aldolase (at 0 degree C) in a dose-dependent manner over the range [Ins(1,4,5)P3] 20 nM to 20 microM, with maximal binding of 1 mol of Ins(1,4,5)P3/mol aldolase4 and a Kd of 12-14 microM. Fru(1,6)P2 and Fru(2,6)P2 displaced bound Ins(1,4,5)P3) with a 50% inhibition at 30 and 170 microM, respectively. Ins(1,3,4)P3 (20 microM) and glyceraldehyde 3-phosphate (2 mM) were also potent inhibitors of Ins(1,4,5)P3 binding, but not inositol 4-phosphate or inositol 1,4-bisphosphate (20 microM each). Aldolase-bound Ins(1,4,5)P3 may play a role in phospholipase C-independent increases in free [Ins(1,4,5)P3].