Effects of eicosanoid synthesis inhibitors on the in vitro growth and prostaglandin E and leukotriene B secretion of a human breast cancer cell line

We investigated the effects of cyclooxygenase and lipoxygenase inhibitors on a human breast cancer cell line (MDA-MB-231) in culture. Indomethacin (INDO), piroxicam, esculetin, and nordihydroguaiaretic acid (NDGA) significantly suppressed cell growth, although piroxicam caused significant suppression only at high concentrations. Esculetin and NDGA caused significantly reduced secretion of leukotriene B (LTB), while INDO and piroxicam caused significantly reduced secretion of prostaglandin E (PGE). Consequently, cell growth was significantly correlated with the LTB concentration when the cells were treated with esculetin or NDGA, whereas it was significantly correlated with the PGE concentration when they were treated with INDO or piroxicam. Therefore, MDA-MB-231 cell growth in vitro was independently associated with both the PG and LTB concentrations.

Adenolipoma of the thyroid gland

A rare case of adenolipoma (thyrolipoma) of the thyroid gland is reported. Previously reported cases are reviewed and the pathogenesis of this unusual thyroid lesion is discussed.

Defective lymphoid development in mice lacking expression of the common cytokine receptor gamma chain

The common gamma chain (gamma c) of the IL-2, IL-4, IL-7, IL-9, and IL-15 receptors is defective in humans with XSCID. Mice lacking gamma c expression had hypoplastic thymuses; the thymocytes responded to gamma c-independent mitogens, but not gamma c-dependent stimuli. Splenic T cells were diminished at 3 weeks of age, but CD4+ T cells markedly increased by 4 weeks. B cells were greatly diminished in contrast with the situation in XSCID. NK cells, gamma delta intestinal intraepithelial lymphocytes, dendritic epidermal T cells, peripheral lymph nodes, and gut-associated lymphoid tissue were absent. These findings underscore the importance of gamma c in lymphoid development. Moreover, differences in humans and mice lacking gamma c expression indicate species-specific differences in the roles of gamma c-dependent cytokines or in the existence of redundant pathways. These mice provide an important model for studying the pathophysiology provide an important model for studying the pathophysiology of and gene therapy for human XSCID.

[Comparison of low-dose cytosine arabinoside and aclarubicin in combination with granulocyte colony-stimulating factor to intermediate-dose cytosine arabinoside and mitoxantrone with or without etoposide in the treatment of relapsed acute myeloid leukemia]

We used a new chemotherapy regimen for the treatment of 18 consecutive patients with relapsed AML. The regimen consisted of low-dose cytosine arabinoside (Ara-C), low-dose aclarubicin and concurrent use of G-CSF (CAG regimen). Fifteen out of 18 patients (83%) achieved complete remission (CR). Median CR duration and median survival were 6 months and 15 months, respectively. These results were similar to those of previously reported salvage therapies for relapsed AML including intensive chemotherapy consisting of intermediate-dose Ara-C and sequential mitoxantrone with or without etoposide (MC/MEC), which we previously adopted. Myelosuppression and non-hematological toxicities were apparently lower and less frequent compared to MC/MEC. The CAG regimen seems promising for the treatment of relapsed AML with its low toxicity contributing to a high quality of life for the patient.

Missense mutation in exon 7 of the common gamma chain gene causes a moderate form of X-linked combined immunodeficiency

Clinical and immunologic features of a recently recognized X-linked combined immunodeficiency disease (XCID) suggested that XCID and X-linked severe combined immunodeficiency (XSCID) might arise from different genetic defects. The recent discovery of mutations in the common gamma chain (gamma c) gene, a constituent of several cytokine receptors, in XSCID provided an opportunity to test directly whether a previously unrecognized mutation in this same gene was responsible for XCID. The status of X chromosome inactivation in blood leukocytes from obligate carriers of XCID was determined from the polymorphic, short tandem repeats (CAG), in the androgen receptor gene, which also contains a methylation-sensitive HpaII site. As in XSCID, X-chromosome inactivation in obligate carriers of XCID was nonrandom in T and B lymphocytes. In addition, X chromosome inactivation in PMNs was variable. Findings from this analysis prompted sequencing of the gamma c gene in this pedigree. A missense mutation in the region coding for the cytoplasmic portion of the gamma c gene was found in three affected males but not in a normal brother. Therefore, this point mutation in the gamma c gene leads to a less severe degree of deficiency in cellular and humoral immunity than that seen in XSCID.

Encircling method of trigeminal nerve decompression for neuralgia caused by tortuous vertebrobasilar artery: technical note

BACKGROUND

Surgical treatment of trigeminal neuralgia caused by dolichoectatic vertebrobasilar artery presents a difficult problem because of the immobility and the stiffness of the atherosclerotic vessel walls.

METHODS AND RESULTS

A patient with trigeminal neuralgia was treated by a new method of vascular decompression. Preoperative studies demonstrated a dolichoectatic vertebrobasilar artery, and compression of the trigeminal nerve by the artery was confirmed during surgery. The fifth nerve was mobilized away from the artery using a ring-shaped piece of silicone rubber. Postoperatively, the facial pain completely resolved without complication.

CONCLUSIONS

Trigeminal neuralgia due to nerve compression by tortuous vertebrobasilar artery was successfully treated by an encircling method of vascular decompression.

Anaplastic thyroid carcinoma producing the granulocyte colony stimulating factor (G-CSF): report of a case

We report herein the unusual case of a 60-year-old woman with an anaplastic thyroid carcinoma which produced granulocyte colony stimulating factor (G-CSF). She presented with large neck masses, respiratory difficulty, and a high fever. Laboratory examinations revealed marked leukocytosis of 43,200/mm3 with 85% granulocytes and an elevated G-CSF level of 67 pg/dl. Total thyroidectomy with bilateral node dissection and tracheostomy was performed, and a histological diagnosis of large-cell anaplastic thyroid carcinoma was confirmed. Immunohistochemical examination with a polyclonal antibody against G-CSF stained the tumor cells. Although the respiratory difficulty, fever, and marked granulocytosis subsequently improved, she died 1 month after undergoing surgery due to metastatic mediastinal disease.

A case of an intra-atrial tumor thrombus from hepatocellular carcinoma (HCC), first indicated by 67Ga-citrate scintigraphy

We encountered a very rare case of an intra-atrial tumor thrombus from hepatocellular carcinoma (HCC). Conventional XCT and US gave evidence of HCC. In nuclear medicine studies performed incidentally, the first study with 99mTc-phytate liver scintigraphy showed 2 SOLs and evidence of chronic liver disease, and the second study with 67Ga-citrate scintigraphy demonstrated 2 hot lesions within the liver parenchyma, and also another unexpected hot area just above the left lobe of the liver, seemingly beyond the diaphragm. When echocardiography was performed, in addition to ECG, because the patient began to complain of dyspnea, an oblong mass lesion was detected within the right atrium. Reexamination with XCT and angiography clearly proved the existence of an intraatrial tumor thrombus. These results indicate the need for routine examination by echocardiography for HCC patients complaining of dyspnea.

[Apoptosis and cell growth fraction in normal, dysplastic and neoplastic squamous epithelium of uterine cervix]

To assess the transformation of cellular characteristics during a neoplastic change in uterine cervical epithelium, the populations of cells in apoptosis as well as proliferating cycle were examined in normal cervical epithelium, dysplastic change, carcinoma in situ and invasive carcinoma. The percentage of apoptotic cells (%DNA Fr.) decreased with the neoplastic change and was significantly lower in the carcinoma in situ group than in the dysplasia group. Conversely, the percentage of cells in the proliferating cycle (%GF) increased with the neoplastic change and was significantly higher in the dysplasia group than in the normal group. The ratio of %DNA Fr. to % GF was more than 1.0 in the normal group and dysplasia group, but it was less than 1.0 in the carcinoma in situ group and invasive carcinoma group. No significant correlation between %DNA Fr. and %GF was found. These results suggested to us that the decrease in apoptosis may reflect the atypical change in cervical epithelial cells during their neoplastic change, and the proliferative activity in neoplastic lesion was found when the cervical epithelium with dysplastic change was transformed to the carcinoma in situ.

Nursing in Japan: caregivers of elderly family members with dementia

1. The difficulties that caregivers of elderly family members suffering from dementia confronted are divided into five categories: incomprehensible situations, strange behavior, deterioration of dementia, trouble or inconvenience caused by demented behavior, and remarks vis-a-vis support network. 2. The considerable differences among caregivers of elderly persons suffering from dementia, in terms of problems faced and methods of coping, existed in beginning and awakening stages. 3. Nurses must assess which stages of the developmental process families are going through to implement effective nursing interventions that vary between the two stages.

Gastric ulcer healing and basic fibroblast growth factor: effects of lansoprazole and famotidine

We examined the effects of lansoprazole and famotidine on gastric basic fibroblast growth factor (bFGF) levels and ulcer healing in patients with gastric ulcer. Sixteen patients with active gastric ulcer were divided into two groups and received treatment with lansoprazole 30 mg/day or famotidine 40 mg/day. They were examined endoscopically at 2, 4, and 8 weeks to measure gastric bFGF levels at the ulcer margin and to assess ulcer healing. Helicobacter pylori infection was determined by a rapid urease test. The two groups were comparable with regard to age, male:female ratio, H. pylori infection rates, and bFGF levels. During treatment, bFGF levels did not change significantly in the famotidine group, whereas they increased by a factor of 2.2 to 2.6 in the lansoprazole group. Cumulative healing rates were also significantly lower in the famotidine group than in the lansoprazole group. These results indicate that lansoprazole increases tissue bFGF levels and promotes gastric ulcer healing in humans.

A Case with Breast Cancer under the Nipple Who Underwent Breast Conserving Treatment

Although breast conserving treatment (BCT) had become the standard therapy for early breast cancer, breast removal is still recommended for patients with a tumor beneath the nipple or with Paget's disease. We have employed transposition of a latissimus dorsi myocutaneous (LD-MC)flap after wide local excision of a tumor with the nipple-areola complex. A new nipple-areola complex was reconstructed on the LD-MC flap after breast irradiation. Utilizing reconstructive techniques, BCT will likely become the treatment of choice for more patients with early breast cancer.

Human 5-lipoxygenase associates with phosphatidylcholine liposomes and modulates LTA4 synthetase activity

A Ca2+ and a phosphatidylcholine (PC) as stimulatory factors to human 5-lipoxygenase (5-LO) were assessed to examine aspects of the regulatory mechanism of 5-LO. In the presence of Ca2+ (1 microM or less), PC liposomes distinctly stimulated the dual activities of 5-LO for the production of 5-HPETE from arachidonate and for its subsequent conversion to LTA4. At the same concentration of Ca2+, 5-LO was found to bind to PC liposomes. As with 5-LO activities, the binding was dependent on the range of Ca2+ concentration. The conversion ratios of 5-HPETE to LTA4 were dependent on PC liposome concentration and reached a maximum of 50% conversion. Among the four cell membrane lipids examined, PC liposomes demonstrated the highest conversion ratio of 5-HPETE to LTA4 by 5-LO. Most of the arachidonate added to the reaction mixture localized in PC liposomes. These results confirm that the intracellular increase of Ca2+ concentration causes 5-LO to associate with the cell membrane and perform an interfacial reaction. They also suggest that this binding of 5-LO to the cell membrane enhances the subsequent conversion from 5-HPETE to LTA4.

Sarcoidosis of the thyroid gland manifested initially as thyroid tumor

A rare case of a patients with sarcoidosis of the thyroid gland, who was preoperatively diagnosed as having thyroid carcinoma and who had no other clinical features of sarcoidosis, is reported. Thyroidectomy specimen revealed numerous noncaseating, epithelioid granulomas in the thyroid tissue. Mycobacteria, fungi and foreign body material were not identified. Similar granulomas were also found in the lymph nodes and muscular tissue adjacent to the thyroid gland and parathyroid gland After the diagnosis of sarcoidosis of the thyroid, systemic examination failed to reveal any involvement in other sites, including lung, eye and skin. This case demonstrated that sarcoidosis can manifest initially as a thyroid tumor with no other evidence of disease.

Simple surgical correction of Stahl's ear

We describe a simple method of correction of the Stahl's ear deformity. The deformed portion of the auricular cartilage is cut into tiny pieces and put back into the abnormal area. The helix and the scapha are then moulded into a normal ear shape and maintained in position with a tie-over bolster. A gutta-percha splint is used for a further month. Over a 3-year period, 6 Stahl's ear deformities in 5 patients were treated with this procedure. All patients were followed up for at least 1 year. We believe that this procedure can be applied to other partial auricular deformities as well.

Characterization of an antisense Inr element in the eIF-2 alpha gene

We recently discovered an opposing initiator promoter (Inr) downstream of the sense promoter region of the eIF-2 alpha gene (Silverman, T., Noguchi, M., and Safer, B. (1992) J. Biol. Chem. 267, 9738-9742). By reverse transcriptase/polymerase chain reaction analysis of G0 and activated (G1) T-lymphocyte RNAs, overlapping sense and antisense transcripts are now identified. Sense transcription of the eIF-2 alpha gene proceeds from left to right to generate alpha-mRNA; antisense transcription proceeds from right to left to generate RNA, having a sequence complementary to eIF-2 alpha mRNA. Upstream indicates a position 5' relative to the transcription start site. Using DNase I footprint analysis and EMSA, we have found a potential cis-regulatory sequence immediately upstream of the Inr which binds a 43-kDa protein. In addition to conferring protection against DNase I (+457 to +474), the factor also generates hypersensitive sites directly over the Inr (+447 to +457). Insertion of the Inr footprint region into a luciferase reporter gene construct increases expression 150-fold. While mutation of the Inr conserved sequence decreases luciferase activity by 50%, mutation of the 43-kDa factor binding site inhibits luciferase activity by 20%. Sense orientation of the Inr footprint region decreases activity by 80%. The 43-kDa Inr-associated binding protein may be involved in allowing access of RNA polymerase II transcription complexes ot the initiation site of this TATA-less gene. A model for the regulation of eIF-2 alpha expression involving the rapid degradation of dsRNA generated by the relative activities of the two overlapping and opposing promoters is proposed.

Interaction of IL-2R beta and gamma c chains with Jak1 and Jak3: implications for XSCID and XCID

Interleukin-2 (IL-2) signaling requires the dimerization of the IL-2 receptor beta.(IL-2R beta) and common gamma (gamma c) chains. Mutations of gamma c can result in X-linked severe combined immunodeficiency (XSCID). IL-2, IL-4, IL-7 (whose receptors are known to contain gamma c), and IL-9 (whose receptor is shown here to contain gamma c) induced the tyrosine phosphorylation and activation of the Janus family tyrosine kinases Jak1 and Jak3. Jak1 and Jak3 associated with IL-2R beta and gamma c, respectively; IL-2 induced Jak3-IL-2R beta and increased Jak3-gamma c associations. Truncations of gamma c, and a gamma c, point mutation causing moderate X-linked combined immunodeficiency (XCID), decreased gamma c-Jak3 association. Thus, gamma c mutations in at least some XSCID and XCID patients prevent normal Jak3 activation, suggesting that mutations of Jak3 may result in an XSCID-like phenotype.

Prognostic factors in breast-cancer and their controversies (review)

The status of the axillary lymph nodes (AX) is widely accepted as the most significant prognostic factor in breast cancer. Nevertheless, there are large differences in the clinical outcomes of patients with the same AX status, which suggest that we should seek further prognostic variables. At present, several biologic factors, such as DNA ploidy, c-erbB-2 expression, EGFR, p53 alteration, and HPA staining, have been proposed. However, their value as prognostic indicators remains undetermined. Whether these factors are independent prognostic factors, or merely related to other variables, such as AX metastasis, is unclear. A clear need for a new biologic markers to serve as more reliable prognostic factors exists.

Effects of phenobarbital on drug metabolizing enzyme activities and other biochemical parameters in rats with DL-ethionine-induced liver injury

Phenobarbital (PB) was orally administered once at a dose of 100 mg/kg to the liver injury model rats treated with DL-ethionine (ET), and the effects of PB on the liver drug metabolizing enzymes (DME) were chiefly examined. Liver weight, liver microsomal protein content, liver aniline 4-hydroxylase (ANH) activity, and aminopyrine N-dimethylase (AMD) activity were markedly increased in the ET-treated rats receiving PB. These findings suggested the induction of DME in the liver. However, the induction pattern of each enzyme was different. AMD activity at 48 hr after dosing of PB in the ET-treated rats was increased in the same degree as that in the control (normal). Whereas, ANH activity at 48 hr after dosing in the ET-treated rats was higher than that in normal rats. Liver lactate dehydrogenase (LDH) activity at 48 hr after dosing in the ET-treated rats was markedly increased, but such induction was not seen in normal rats. These findings indicates that DME in the liver is induced by PB treatment in the ET-treated rats as well as in normal rats, and that the ET-treated rats have a function of physiological adaptation similar to that in normal rats. The induction pattern of liver or serum enzymes in the ET-treated rats receiving PB was different from that in normal rats. Furthermore, the induction pattern of these enzymes in the ET-treated rats receiving PB was different from that in the normal rats, which may be attributed to the difference of localization in liver cells of these enzymes affected by PB.

Two cases of urogenital malignancies in male patients undergoing maintenance haemodialysis

We report two cases of urogenital malignancies, prostatic cancer in a 72-year-old man and urinary bladder carcinoma in a 50-year-old man, that developed during maintenance haemodialysis. The former patient responded to hormonal therapy with diethylstilboestrol and is still alive on maintenance haemodialysis, but the latter patient did not respond to treatment, being past cure in the far advanced stage. There are few clinical symptoms suggesting the existence of urogenital malignancies in dialysis patients and screening methods such as urine cytology or roentgenology must be restricted because of extremely reduced urine volume. However, the high incidence of urogenital malignancies in such patients is well recognized. Screening examinations with ultrasonography and/or CT scan following digital rectal examination or testing for serum prostate-specific antigen should be performed at least every 6 months.

[Advances in pathobiological research on lung carcinoma]

Histological examination revealed that many peripheral type papillary adenocarcinomas appear to develop from atypical adenomatous hyperplasia (AAH), which can be called adenoma or in situ adenocarcinoma, and progress stepwise. Molecular-biologically, loss of heterozygosities of 3, 11 and 17 chromosomes, point mutation of ras oncogene and p53 anti-oncogene, amplification of myc oncogene, and overexpression of erbB2 oncogene are related to lung cancer development. Especially, ras and p53 gene abnormalities are closely associated with poor prognosis of lung adenocarcinoma. Future molecular-biological examinations should focus on AAH and/or early stage adenocarcinoma of the lung, in order to clarify the gene abnormality at the early stage of lung carcinogenesis.