Antinociceptive mechanism of the aconitine alkaloids mesaconitine and benzoylmesaconine

We explored the possible role of the specific regions in the brain stem on the antinociceptive actions of mesaconitine (MA) and benzoylmesaconine (BM) by the microinjection of MA and BM into nucleus reticularis paragigantocellularis (NRPG), nucleus raphe magnus (NRM), and periaqueductal gray (PAG). MA microinjected into NRPG, NRM, or PAG elicited a dose-dependent antinociceptive action, whereas BM injected into NRM or PAG elicited a dose-dependent antinociceptive action but not in NRPG. The NRM appeared to be the most sensitive region among the three tested locations.

Reconstruction of stenotic external auditory canal with a postauricular chondrocutaneous flap

A case of stenosis of the external auditory canal secondary to a burn injury was reconstructed with a chondrocutaneous postauricular flap. Advantages of this technique include the use of a single flap to reconstruct the whole circumference of the canal, the fact that a chondrocutaneous flap is more likely to prevent restenosis than a skin flap alone, and the fact that reconstruction with an axial-pattern flap is more reliable than reconstruction with a random-pattern flap.

The prognostic significance of epidermal growth factor receptor expression in breast cancer

The association between epidermal growth factor receptor (EGFR) expression, clinicopathological variables, silver-stained nuclear organizer region (Ag-NOR) counts, and patient survival was determined in 93 patients with operable breast cancer. The EGFR expression was found to be significantly associated with the presence and number of axillary lymph node metastases (P = 0.0429), but not with age, menopausal status, tumor size, histologic type or grade, or Ag-NOR counts. In a univariate analysis, a significant difference was also observed in the survival of patients stratified by tumor size (P = 0.0091), histologic grade (P = 0.0352), axillary lymph node metastases (P = 0.0001), and EGFR expression (P = 0.0263). However, a multivariate analysis revealed that axillary lymph node metastases was the only strong independent predictor of survival (P < 0.0001). When axillary lymph node metastases were excluded from the Cox model, the EGFR expression tended to be an independent prognostic factor (P = 0.0558). The results of this study thus indicate that the prognostic value of EGFR expression is limited because the EGFR expression is significantly associated with axillary lymph node metastases.

Comparative effects of piroxicam and esculetin on incidence, proliferation, and cell kinetics of mammary carcinomas induced by 7,12-dimethylbenz[a]anthracene in rats on high- and low-fat diets

We investigated the effects of piroxicam, a cyclooxygenase inhibitor, and esculetin, a lipoxygenase inhibitor, on 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary carcinogenesis in female rats. Seven days after receiving a 5-mg dose of DMBA, rats were fed either a high-fat (20% soybean oil) or low-fat (0.5% soybean oil) diet. One third of the rats received diets containing 0.01% piroxicam and one third received diets containing 0.03% esculetin. Esculetin significantly inhibited mammary tumorigenesis and tumor proliferation in the rats fed the high-fat and the low-fat diets. Piroxicam had no inhibitory effect. Our findings indicate that DMBA-induced mammary tumorigenesis is affected by lipoxygenase products rather than by cyclooxygenase products.

Reappraisal of internal mammary lymph node dissection in selected patients with invasive breast cancer

We performed a new type of en bloc extended radical mastectomy (EXT) as a clinical trial in 118 patients from 1980 through 1985. A variety of conventional radical mastectomies (RDL) were also undertaken in 105 patients from 1973 through 1985. In this retrospective study, univariate and multivariate analyses were performed to compare the results of EXT and RDL. The univariate analysis showed that the 10-year survival rates for the EXT and the RDL groups were 86% +/- 3.3% and 77% +/- 4.2%, respectively (P = 0.073 with the Cox-Mantel test). For the subgroups stratified according to the status of axillary lymph node involvement, the EXT was significantly better in patients with one to three metastatic axillary lymph nodes (P = 0.016). The adjusted Cox regression analysis revealed that the favorable results of EXT were most encouraging in the patients with one to three metastatic axillary lymph nodes (P = 0.058). Therefore, it is suggested that an EXT may be more advantageous than RDL in selected patients with resectable invasive breast cancer.

Immunohistochemical demonstration of thyrotropin (TSH)-receptor in normal and diseased human thyroid tissues using monoclonal antibody against recombinant human TSH-receptor protein

We performed an immunohistochemical analysis of TSH-receptor in normal and diseased human thyroid tissues using a monoclonal antibody (T3-356) against the C terminal region of human TSH receptor. In normal human thyroid tissues, a positive staining was observed exclusively along the basal cell surface of the flattened follicular cells. In the tissues from adenomatous nodules, adenomas, and papillary carcinomas, a positive staining was also found along the basal cell surface of the follicular cells. In addition, a considerable cytoplasmic staining was observed. The apical and lateral cell surfaces of the follicular cells showed no staining. The foci of squamous cell metaplasia of papillary carcinomas, anaplastic carcinoma, and medullary carcinoma did not show a positive staining. In Graves' thyroids, the positive staining was also observed along the basal cell surface of the follicular cells. The staining was obviously intense in the Graves' thyroids, and the most intense staining was noted in the foci of papillary projection of the columnar follicular cells. These findings indicate that TSH receptor is preserved essentially in the basal cell surface of the thyroid follicular cells in neoplastic conditions and that the amount of TSH receptor protein is increased in Graves' thyroid.

Radioimmunodetection of cancer of gastrointestinal tract and liver metastasis with I-131 anti-CEA and I-131 anti-CA19-9 monoclonal antibody cocktail (IMACIS-1)

We evaluated the intravenous infusion of a cocktail of I-131 anti-CEA and anti-CA19-9 monoclonal antibody F(ab')2 (IMACIS-1) in patients with gastrointestinal neoplasm and liver metastases in order to assess its efficacy in detecting the presence of cancer. Seven patients with primary or recurrent gastrointestinal cancer in whom liver metastases were also detected were studied. Accumulation of radioactivity in the primary tumor was seen in only one patient. Visualization of the liver metastases was achieved in all patients. Thus detection of liver metastasis was better than in primary or recurrent tumors. While tumor visualization was most often seen in the 3 day image, optimal visualization of the tumor was seen at 5-7 days. There was no correlation between the serum concentration of CEA or CA19-9 and the visualization of tumors. Serum kinetics of I-131 IMACIS-1 showed biexponential components with a 1st phase T1/2 of 5.0 hours and 2nd phase T1/2 of 34.7 hours. The mean whole body (I-131) half-life determined from the whole-body scans was 1.95 days. The mean urinary excretion of I-131 in 7 days was 85%. This value agreed closely with total radioactivity retention detected by scanning. This series of studies demonstrated the potential utility of a cocktail of antibodies consisting of an anti-CEA and an anti-CA19-9 monoclonal F(ab')2.

Immunohistochemical Detection of p53 and c-erbB-2 Proteins: Prognostic Significance in Operable Breast Cancer

We examined the associations of p53 expression and/or c-erbB-2 expression with Ag-NOR counts and clinicopathologic variables in 111 breast cancer patients, and assessed whether expression of either p53or c-erbB-2 would be useful prognostic indicators. There was no significant association between p53 expression and c-erbB-2 expression, but p53 expression and c-erbB-2 expression, especially in combination, were shown to be significantly associated with Ag-NOR counts and axillary lymph node metastasis. Although p53 expression and c-erbB-2 expression were significant prognostic factors by univariate analysis, they did not appear to be independent prognostic factors by multivariate analysis, in which nodal status was introduced using the Cox model. When nodal status was excluded from the model, however, concurrent p53 and c-erbB-2 expression did have a significant prognostic value. Therefore, it was suggested that concurrent p53 and c-erbB-2 expression provides valuable prognostic information for breast cancer patients in whom axillary lymph node dissection has not been performed.

Unique T cell differentiation markers: gangliosides with cholera toxin receptor activity on murine fetal thymocytes

Cholera toxin B subunit receptors (CTBR; gangliosides GM1a and GM1b-GalNAc-Gal) and GM1b-type gangliosides were examined during T cell development in BALB/c mice by FACS or TLC immunostaining. Sixty-two percent of CD4-8- early fetal thymocytes express CTBR [58% low affinity (GM1a+), 4% high affinity (GM1a2+)] at 13 days gestation (Day 13); GM1a2+ was expressed preferentially on Thy-1+ fetal thymocytes after Day 13. GM1a2+ Thy-1+ cells increased from 4% on Day 13 to 95% on Day 17. Surface GM1a2+ decreased beginning on Day 15 while GM1b-GalNAc-Gal (and CD4 and CD8) increased. GM1b-type+ cells increased from 8% on Day 13 to 51% on Day 17 and then decreased to 16% at 4 weeks; few asialo GM1+ cells (< 5%) are seen during gestation. Thus, synthesis of GM1a- and GM1b-type series was active until Days 15 and 17, respectively, and then was suppressed; GM1b-GalNAc-Gal was synthesized from GM1b following Gestational Day 15. GM1a- and GM1b-type identify immature T cells in mice, while GM1b-GalNAc-Gal identifies mature T cells.

The relationship of p53 protein and lymph node metastases in invasive breast cancer

The p53 expression in invasive breast cancers from 106 patients was correlated with clinicopathological variables to ascertain its usefulness for estimating prognosis. The p53 expression was significantly associated with the number of axillary lymph node metastases and the presence of internal mammary lymph node metastases; however, it was not associated with age, menopausal status, histologic type, or tumor size. Although p53 expression was a significant prognostic factor according to univariate analysis, it did not appear to be an independent prognostic factor according to multivariate analysis. Thus, the prognostic power of p53 expression is likely to be weak and therefore probably of limited clinical value. Nevertheless, the number of patients in our study was small, and we believe that an investigation of a larger series of patients is indicated.

Presacral epidermal cyst found in an adult male with a high CEA content: report of an unusual case

A 63-year-old Japanese man presented with constipation, having noticed flat stools for several years. Digital examination of the rectum, followed by barium enema, colono-fiberscopy, computed tomography (CT), and magnetic resonance imaging (MRI) revealed an oval mass located between the retrorectal and presacral space without any mucosal lesion. This mass had narrowed the rectal lumen by compressing the rectum anteriorly. Although the plasma levels of the tumor markers were within the normal range, those of the tumor contents were elevated with a carcinoembryonic antigen (CEA) of 118 ng/mL, while the alpha-fetoprotein (AFP) value was 1 ng/mL. The tumor was completely extirpated through an abdominal incision, and there has been no evidence of recurrence thus far. Histological examination showed that the tumor wall was made of keratinized stratified squamous epithelium without any cutaneous adnexal structure, and hence it was diagnosed as an epidermal cyst. CEA was identified in these benign epithelial cells by immunoperoxidase staining using a monoclonal antibody. To the best of our knowledge, there have been only four other cases with a presacral epidermal cyst documented in the Japanese literature, all of whom were female. Our patient is the first reported case of an adult male with a presacral epidermal cyst.

Interfacial kinetic reaction of human 5-lipoxygenase

The kinetics of human 5-lipoxygenase were investigated in the presence of Tween 20 using a continuous spectrophotometric assay. Using the mixture at a constant molar ratio of arachidonate/Tween 20 at pH 8.0, the steady-state velocity on a varied arachidonate concentration did not follow simple Michaelis-Menten-type kinetics and double-reciprocal plot analysis gave hyperbolic curves. However, by introducing the concept of a local pH change, it was possible to analyze the kinetics as simple Michaelis-Menten type. The concept of a local pH change implies that when utilizing an acidic and amphiphilic substance as a substrate, such as arachidonate, the medium around the substrate is acidified with an increased concentration of substrate. This concept was explained rationally by two experiments. Consequently, the data were transformed according to a local pH change and analyzed according to a dual phospholipid model as has been proposed for phospholipase A2 [Hendrickson, H. S. and Dennis, E. A. (1984) Kinetic analysis of the dual phospholipid model for phosphalipase A2, J. Biol. Chem. 259, 5734-5739]. It is concluded that 5-lipoxygenase performs an interfacial reaction in the arachidonate/Tween 20 mixed micelles in the same manner as phospholipase A2. The values of Km were almost constant (about 0.07 molar fraction), even when arachidonate molar ratios were changed in the surface of the mixed micelles. The values for Ks (the association constant of the enzyme to the micelle interface) ranged over 0.21-0.48 microM. The Vmax was 25.76 mumol.min-1.mg-1. This concept of a local pH change could be used extensively with enzymes which utilize both amphiphilic and acidic substances as substrates.

[Reconstructive surgery in breast cancer operation]

We reported our experience with immediate breast reconstruction after partial or total mastectomy. In patients who underwent breast conserving surgery (BCT), an immediate transposition of adipose tissue with latissimus dorsi muscle vascular pedicle was carried out with the aim of improving cosmetics after wide excision. In those who received modified radical mastectomy, immediate breast reconstruction (MIBR) using a transverse abdominomyocutaneous flap or latissimus dorsi myocutaneous flap was carried out. Although either BCT or MIBR was performed at the patient's request, reconstructive surgery thus plays an important role in breast cancer operation.

The ter primordial germ cell deficiency mutation maps near Grl-1 on mouse chromosome 18

A single recessive gene, ter (teratoma), causes germ cell deficiency and a high incidence of congenital testicular teratomas in the 129/Sv-ter strain of the mouse. Linkage analyses between the ter gene and 36 marker genes of 19 chromosomes were performed with matings between the C57BL/6J-ter congenic strain and four inbred strains. Results showed that the ter gene was linked to D18Mit9, D18Mit14, and D18Mit17 on Chromosome (Chr) 18. Gene order estimated on the basis of recombination distance (in centimorgans) was [centromere-D18Mit14-5.1 (cM)-ter-0 (cM)-D18Mit17-23.8 (cM)-D18Mit9]. D18Mit17 is the microsatellite DNA of the Grl-1 (glucocorticoid receptor-1) locus. We conclude that the ter gene is closely linked to Grl-1 on Chr 18 and is a new mutation involving the developmental modification of primordial germ cells in mice.

[Case report of sister with Duane's syndrome and PGA, or myasthenia gravis]

We report a case of polyglandular autoimmune syndrome (PGA) complicated by Duane's syndrome. The patient was 44-year-old female with marked limitation of abduction in the left eye, lethargy, nonhomogeneous facial pigmentation, goiter, and oligomenorrhea. A diagnosis of chronic thyroiditis was first made to explain the patient's symptoms. Laboratory examinations were performed. Plasma ACTH level was high and plasma cortisol was low, and there was no response to the ACTH stimulation test. The presence of primary adrenocortical deficiency was confirmed. Moreover, primary gonadal failure was also present, and the diagnosis of PGA type II was made. The patient's elder sister had myasthenia gravis which is a condition known to occur with PGA type II. Therefore, the sister was also suspected to have PGA type II, as the syndrome can occur in family members. However, since she had been receiving large doses of steroids for her myasthenia gravis, laboratory findings were inconclusive. Duane's syndrome, which is characterized by congenital oculomotor disturbance, was also seen in the sister. It is still unknown whether the familial occurrence of Duane's syndrome has a genetic basis. There have been reports of congenital disorders occurring in combination with autoimmune diseases. Further investigation into the relationship between congenital anomalies and autoimmune diseases is necessary.

Nuclear immunoreaction of p53 protein in soft tissue sarcomas. A possible prognostic factor

BACKGROUND

Tumor suppressor gene p53, located on the short arm of chromosome 17, frequently mutates in various types of cancers and plays a critical role in the multiple stages of carcinogenesis. However, there is little information about the clinicopathologic significance of alterations of the p53 gene in soft tissue sarcomas (STS).

METHODS

Because it is known that nuclear accumulation of p53 protein correlates closely with the presence of mutations in the p53 gene, immunohistochemical detection of this protein was performed. A polyclonal antibody (RSP-53) raised against synthetic human p53 peptide was used to detect nuclear accumulation of the protein. Pathologic specimens of 96 patients with STS were collected from the surgical pathology files of the National Cancer Center Hospital and examined.

RESULTS

Nuclear accumulation of p53 protein was detected in 31 (32.3%) patients. The percentage of patients with a positive immunoreaction was high in patients with malignant schwannoma (100%), rhabdomyosarcoma (71.4%), and synovial sarcoma (50.0%), whereas it was low in patients with liposarcoma (13.6%) and 0% in those with fibrosarcoma. It was closely associated with the histologic grade of malignancy (grade 1, 12.0%; grade 2, 30.8%; grade 3, 44.4%) and the patient's age (younger than 40 years, 46.9%; 40 years of age or older, 25.0%). Both overall and metastasis-free survival rates were significantly lower for patients with a nuclear p53 immunoreaction than for those without it.

CONCLUSIONS

The nuclear p53 immunoreaction is considered a marker of tumor aggressiveness and appears to be a useful prognostic factor for STS.

Inhibitory effects of purified eicosapentaenoic acid and docosahexaenoic acid on growth and metastasis of murine transplantable mammary tumor

We studied the effects of purified linoleic acid, eicosapentaenoic acid(EPA) and docosahexaenoic acid (DHA) on mammary tumor MM48 the transplanted into C3H/He mice. The growth of the primary tumor was significantly inhibited in EPA- and DHA-treated groups as compared with control and/or linoleic acid-treated groups (p < 0.05). The number of metastatic tumors in the lungs tended to be inhibited in the EPA- and DHA-treated groups and promoted in the linoleic acid-treated group, as compared with the control group, but not to a statistically significant extent. The EPA-treated group survived significantly longer than the control group (p = 0.002), while the DHA-treated group survived longer than the control group although the difference was not significant (p = 0.070). However, there was no significant difference between EPA- and DHA-treated groups on primary tumor growth, number of lung metastases or survival time of animals.

Evaluation of spinal bone changes in patients with chronic renal failure by CT and MR imaging with pathologic correlation

To investigate bone changes in patients with chronic renal failure (CRF), bone mineral density (BMD) and T1 relaxation times were measured with CT and MR imaging and the results were correlated to histology. Excised lumbar vertebrae from 25 autopsy cases of CRF (18 males and 7 females), including 12 cases in which the patients had been receiving hemodialysis were examined. BMD and T1 relaxation time values were associated with specific histologic findings for cellularity, trabeculae, and peritrabecular fibrosis. Three vertebrae with low BMD showed increased hematopoietic marrow content, a finding not observed in primary osteoporosis. The vertebrae with osteosclerosis showed prolonged T1 relaxation time, which was due to increased amount of hematopoietic marrow, and the presence of thickened or many small irregular trabeculae or peritrabecular fibrosis. These findings may be useful in the evaluation of bone changes in patients with CRF.

A review of 79 thymomas: modification of staging system and reappraisal of conventional division into invasive and non-invasive thymoma

A clinicopathological study of surgically resected thymomas was performed using Masaoka's staging and modified Masaoka's staging systems, and the utility of these two staging systems was compared. The modification enabled adjustment for the disproportion in the number of cases between Stage I and Stage II. Analysis of survival rates, according to the tumor stage, indicated that the old classification should be reappraised, that is, division into non-invasive and invasive thymomas, although staging may contribute to the indication for postoperative radiotherapy, especially for Stage II disease. Analysis of the cases showed a wide spectrum of aggressiveness, varying from cases showing slow progression with a relatively favorable prognosis, such as the spindle cell type, to cases with rapid progression leading to tumor death in a relatively short time, such as the epithelial cell predominant and polygonal cell type. The pathological stage at the time of first surgical resection would reflect the degree of aggressiveness of thymoma in many instances. Therefore, not only staging the tumor extent but also grading of its aggressiveness are needed in order to predict the prognosis of patients with thymoma. For the latter, histology and cytopathology are helpful.

Healing of the rabbit medial collateral ligament following an O'Donoghue triad injury: effects of anterior cruciate ligament reconstruction

The effects of healing time and anterior cruciate ligament reconstruction on healing of the medial collateral ligament and stability of the knee joint were evaluated in a rabbit model of an O'Donoghue triad injury (rupture of the medial collateral ligament with removal of the anterior cruciate ligament and part of the medial meniscus). At time 0 and at 6 and 12 weeks postoperatively, the anterior-posterior translation and varus-valgus rotation of the knee, the structural properties of the femur-medial collateral ligament-tibia complex, and the mechanical properties of the substance of the medial collateral ligament were evaluated. Although anterior-posterior translation increased significantly with time, we could not demonstrate a significant temporal effect on varus-valgus rotation. The ultimate load, elongation at failure, and energy absorbed to failure improved with time. In addition, with time, failure of the complex occurred more often in the ligament substance than at the osseous insertion. Because healing time did not affect the cross-sectional area or modulus of the medial collateral ligament, the improved structural properties of the complex resulted not from improvements in the mechanical properties of the tissue but rather from healing of the tibial insertion site. By 12 weeks, the reconstructed knees had only minor signs of osteoarthrosis on the tibiofemoral surfaces; this is in contrast to the findings in anterior cruciate ligament-deficient knees in our earlier study. Additionally, at 12 weeks, the stiffness of the complexes from the reconstructed group was 1.3 times that of the anterior cruciate ligament-deficient group (p < 0.05), and te ultimate load had increased by a factor of 1.6 (p < 0.05). Our findings demonstrate that reconstruction of the anterior cruciate ligament in the rabbit helps to stabilize the joint, improves healing of the medial collateral ligament, and may decrease the incidence of early-onset osteoarthrosis after an O'Donoghue triad injury.

Immunohistochemical demonstration of thyroid peroxidase (TPO) in human thyroid tissues from various thyroid diseases

Human thyroid peroxidase (hTPO) was detected immunohistochemically in 61 normal, benign and malignant thyroid tissues with a monoclonal antibody (38E) against hTPO using paraffin-embedded sections. Thyroid peroxidase was expressed intensely not only in tissues from Graves disease and hyperfunctioning adenomas, but also in those from carcinomas, adenomas and Hashimoto's thyroiditis. The staining pattern of TPO in the follicular cells was a diffuse and fine granular one in the normal thyroids, Graves' thyroids and adenomas, but abnormal coarse granular deposits of TPO were characteristically identified in most of the papillary carcinomas and Hashimoto's thyroiditis. These coarse granular deposits of TPO suggested that qualitative or structural changes in the TPO molecule are present in carcinomas and Hashimoto's thyroiditis. Consequently, these qualitative changes in TPO may be responsible for the lack of biochemically measured TPO activity in these diseases. This finding may also be useful in distinguishing between benign and malignant thyroid tumors.

Antigen-specific human monoclonal antibodies from mice engineered with human Ig heavy and light chain YACs

We describe a strategy for producing human monoclonal antibodies in mice by introducing large segments of the human heavy and kappa light chain loci contained on yeast artificial chromosomes into the mouse germline. Such mice produce a diverse repertoire of human heavy and light chains, and upon immunization with tetanus toxin have been used to derive antigen-specific, fully human monoclonal antibodies. Breeding such animals with mice engineered by gene targeting to be deficient in mouse immunoglobulin (Ig) production has led to a mouse strain in which high levels of antibodies are produced, mostly comprised of both human heavy and light chains. These strains should provide insight into the adoptive human antibody response and permit the development of fully human monoclonal antibodies with therapeutic potential.

Surgically curable "early" adenocarcinoma in the periphery of the lung

To define surgically curable "early" adenocarcinoma in the periphery of the lung, we examined histopathologic prognostic factors in 56 cases of stage I mucinous, nonmucinous, and sclerosing bronchioloalveolar carcinomas less than 2 cm in diameter. The death rate 5 years after surgery was only 1.8%, but the recurrence rate within 5 years after surgery was 8.9%. In addition, there were two cases of recurrence more than 5 years after surgery. Vascular invasion (p < 0.05) and mitotic index (p < 0.01) were the most important determinants of prognosis, and there was no recurrence or death in cases showing grades 1 and 2 collagenization in fibrotic foci. These results indicate surgically curable stage I adenocarcinomas to be less than 2 cm in diameter and without vascular invasion, with a low mitotic index and grade 1 or 2 fibrotic scarring, although the significance of nuclear atypia as a prognostic factor remains to be clarified. It may be possible to improve the cure rate by postoperative adjuvant chemotherapy for "early" adenocarcinoma with vascular invasion, high mitotic index, higher scar grade, and probably a high degree of nuclear atypia.

A Mechanism of Lithium Storage in Disordered Carbons

High-resolution electron microscopy and lithium-7 nuclear magnetic resonance measurements were carried out for a disordered carbon material, prepared by heat treatment of polyphenylene, in which lithium was stored electrochemically. The nuclear magnetic resonance spectrum suggests the existence of Li(2) covalent molecules in the carbon material. This extra covalent site of lithium storage promises extraordinarily high energy density for secondary batteries.