GM-CSF gene therapy using adenoviral vector in hamster pancreatic cancer

The aim of this study was to examine the antitumor effect of irradiated granulocyte macrophage-colony-stimulating factor (GM-CSF)-gene-transduced hamster pancreatic cancer cells and its relationship to the amount of GM-CSF produced by transduced tumor cells. Hamster pancreatic adenocarcinoma cells, HPD1NR, which spontaneously secrete 15.0+/-0.4 pg/106 cells per 24 h of GM-CSF, and HPD2NR cells, which do not secrete GM-CSF, were used. When these cells were infected with recombinant adenovirus harboring the GM-CSF gene, HPD1NR and HPD2NR secreted 624.2+/-9.9 and 157.8 +/-5.7 pg/106 cells per 24 h, respectively. Vaccination with irradiated GM-CSF-secreting HPD2NR completely protected syngeneic hamsters challenged with live parental cells. On the other hand, vaccination with irradiated HPD1NR protected 60% of hamsters from tumor development after challenge with parental cells. None of the tumor-free hamsters initially vaccinated with irradiated GM-CSF-producing HPD2NR cells developed tumor upon repeated challenge with parental cells during the entire observation period. Irradiated GM-CSF-gene-transduced hamster pancreatic cells are promising as a novel adjuvant cancer therapy after surgery for primary and metastatic pancreatic cancer. The results indicate the necessity for a therapeutic strategy for cancer based on the cytokine status of tumors.

Truncated TSG101 transcripts in human leukemia and lymphoma cell lines

Inactivation of the TSG101 gene has been shown to induce cellular transformation of NIH3T3 fibroblasts, and aberrant TSG101 transcripts have been observed not only in various human solid tumors but also in hematopoietic malignant disorders. In the present study, we performed nested reverse transcription/polymerase chain reaction (RT-PCR) analysis to identify aberrant TSG101 transcripts in 43 human leukemia and lymphoma cell lines. We could detect only a single band of the wild-type transcript with the expected size in virtually all cell lines after the first round of PCR. As in the case with various human solid tumors, the smaller TSG101 transcripts appeared in most of these cell lines after the second round of PCR. Thus, the expression level of the variant transcripts was extremely low as compared with that of the wild-type transcript, and this finding was also confirmed by Northern blot analysis. Identification of various truncated transcripts with extensive deletions in the TSG101 coding region was confirmed by means of sequencing analysis, and expression of these transcripts did not appear to be associated with a specific type of hematopoietic malignant disorder. Southern blot analysis did not indicate any gross TSG101 gene rearrangement. The truncated transcripts were also detected in normal peripheral blood leukocytes. Our results suggest that the truncated TSG101 transcripts are definitely detectable in various human leukemia and lymphoma cell lines, but do not support the notion that the variant transcripts may have a major functional relevance in the pathogenesis of human hematopoietic malignant disorder.

Involvement of lipoic acid in plasma metabolites, hepatic oxygen consumption, and metabolic response to a beta-agonist in broiler chickens

The present study was conducted to determine the role of alpha-lipoic acid (LA) in plasma metabolites, hepatic O2 consumption, and beta-adrenergic response in broilers. In Expt 1, 12-d-old female broiler chicks were divided into three dietary groups and fed on diets with or without LA (5 or 50 mg/kg) until 4 or 6 weeks of age, as a 2 x 3 factorial arrangement. The dietary LA had no effect on growth rates (body weight, abdominal fat, breast muscle, and liver). The higher level of LA increased plasma non-esterified fatty acid and decreased plasma triacylglycerol concentrations only at 6 weeks of age. A 42% increase in hepatic respiration was observed in the 4-week-old chickens given 50 mg LA/kg diet. In Expt 2, 3-d-old female broiler chicks were treated with or without dietary LA at 50 mg/kg. At 30 and 31 d old, isoproterenol (2 mg/kg body weight per h) was continuously infused into a wing vein for 2 h, and changes in plasma glucose, triacylglycerol, and non-esterified fatty acid concentrations were analysed. Isoproterenol increased plasma glucose over basal levels maximally at 60 min. Furthermore, the glucose increase in the LA-treated chickens was 35% greater than that of the controls at this time. Plasma non-esterified fatty acid and triacylglycerol concentrations were decreased by the isoproterenol infusion, regardless of LA administration. Therefore, the present study suggests that dietary LA has repartitioning effects on energy metabolism in chickens (although this depends on age-related metabolic state) and is a possible facilitator in the beta-adrenergic response of plasma glucose to a beta-agonist.

A case of Marfan syndrome in an adolescent with aortic dissection: should the recommendation for surgical intervention be changed?

We present a 15-year-old male patient with Marfan syndrome who died suddenly of aortic dissection and rupture. The commonly used criteria for elective aortic root replacement are an aortic root dimension >50 mm or an aortic dimension more than twice the normal predicted value. He did not fulfill these criteria. His ascending aortic dimension 17 days prior to his death was 48 mm and the aortic dimension to the predicted value was 1.8, although he showed progressive dilatation of the aortic root. A ratio of the ascending aortic dimension of more than 1.5 times that predicted, as proposed by Pyeritz, and a considerable increase in aortic dilatation beyond previous observations may lead to timely surgical repair.

Granulocyte/macrophage-colony-stimulating factor released by adenovirally transduced CT26 cells leads to the local expression of macrophage inflammatory protein 1alpha and accumulation of dendritic cells at vaccination sites in vivo

Antigen presenting cells (APC) play an essential role in the generation of tumor-specific immune responses. Dendritic cells are the most potent of APC, capable of activating both antigen-specific CD4+ and CD8+ T cells. Previously, we have described how vaccination of mice with irradiated tumor cells producing granulocyte/macrophage-colony-stimulating factor (GM-CSF) induces tumor-specific immunity capable of protecting mice from a subsequent tumor challenge. The present study extends these findings to examine the types of APC infiltrating vaccination sites and the chemokines responsible for their recruitment. GM-CSF released from genetically engineered tumor cells led to the local accumulation of dendritic cells in and around the vaccination site. Quantification revealed a significant ten-fold increase in the number of dendritic cells infiltrating GM-CSF-producing as opposed to beta-galactosidase-producing (control) vaccination sites. Reverse transcription/polymerase chain reaction, enzyme-linked immunosorbent assay, and immunohistochemical analysis of vaccination sites revealed that MIP-1alpha may be responsible for dendritic cell infiltration into GM-CSF-producing tissues. These findings suggest that GM-CSF may indirectly recruit dendritic cells into vaccination sites through the local production of MIP-1alpha.

Glutathione S-transferase pi immunostaining of cisplatin-resistant ovarian cancer cells in ascites

OBJECTIVE

To clarify immunohistochemically the correlation between glutathione S-transferase pi (GST pi) expression of surgically resected specimens and clinical response in ovarian cancer and to evaluate ascites cytology using GST pi staining.

STUDY DESIGN

Eighty-seven patients with ovarian cancer underwent initial debulking surgery and received cisplatin-based chemotherapy after surgery. Immunostaining for GST pi was performed on formalin-fixed sections of the patients' tumors. The cytologic slides of 24 cases were acquired for evaluation of GST pi staining.

RESULTS

Of 87 surgically resected specimens, 55 (63.2%) were GST pi positive. Twenty-five of 28 patients (89.3%) who showed no response to chemotherapy had GST pi-positive tumor cells. The predictive value of positive GST pi staining for drug resistance was 75.8% (25/33). Of 18 cases that were GST pi positive in surgically resected specimens, 17 were positive in ascites cytology. Five cases were negative in both resected specimens and ascites cytology. There was a significant correlation in the GST pi labelling index between resected specimen and ascites cytology from the same case; the correlation coefficient was .701 and P value < .001.

CONCLUSION

Overexpression of GST pi is related to resistance to cisplatin, and GST pi staining of ascites cytology can be used in pretherapeutic assessment of patients with ovarian cancer.

Inhibition of intestinal microflora beta-glucuronidase modifies the distribution of the active metabolite of the antitumor agent, irinotecan hydrochloride (CPT-11) in rats

PURPOSE

SN-38, a metabolite of irinotecan hydrochloride (CPT-11), is considered to play a key role in the development of diarrhea as well as in the antitumor activity of CPT-11. We have previously found that the inhibition of beta-glucuronidase, which hydrolyzes detoxified SN-38 (SN-38 glucuronide) to reform SN-38, in the lumen by eliminating the intestinal microflora with antibiotics, markedly ameliorates the intestinal toxicity of CPT-11 in rats. In this study we compared the disposition of CPT-11 and its metabolites in rats treated with and without antibiotics.

METHODS

Rats were given drinking water containing 1 mg/ml penicillin and 2 mg/ml streptomycin from 5 days before the administration of CPT-11 (60 mg/kg i.v.) and throughout the experiment. CPT-11, SN-38 glucuronide and SN-38 concentrations in the blood, intestinal tissues and intestinal luminal contents were determined by HPLC.

RESULTS

Antibiotics had little or no effect on the pharmacokinetics of CPT-11, SN-38 glucuronide or SN-38 in the blood, or in the tissues or contents of the small intestine, which has less beta-glucuronidase activity in its luminal contents. In contrast, antibiotics markedly reduced the AUC1-24 h of SN-38 (by about 85%) in the large intestine tissue without changing that of CPT-11, and this was accompanied by a complete inhibition of the deconjugation of SN-38 glucuronide in the luminal contents.

CONCLUSIONS

These results suggest that SN-38, which results from the hydrolysis of SN-38 glucuronide by beta-glucuronidase in the intestinal microflora, contributes considerably to the distribution of SN-38 in the large intestine tissue, and that inhibition of the beta-glucuronidase activity by antibiotics results in decreased accumulation of SN-38 in the large intestine.

Diagnosis and staging of pancreatic cancer by endoscopic ultrasound

The aim of this study was to evaluate the usefulness of and problems associated with endoscopic ultrasonography (EUS) in the diagnosis and pre-operative staging of pancreatic cancer. 96 patients suspected of having pancreatic cancer were pre-operatively examined with EUS. 37 of these 96 patients had pancreatic cancer. Results of the EUS imaging were compared with findings of histology and/or surgery, and the patient's clinical course. The sensitivity and specificity of EUS for diagnosing pancreatic cancer were 89% and 97%, respectively. EUS had excellent sensitivity regardless of tumour size or location. EUS was accurate (90%) in determining tumour size in pancreatic cancers less than 3 cm in maximum diameter, but not for tumours greater than 3 cm (30%). The accuracy of tumour (T) and nodal (N) staging were 64% and 50%, respectively. EUS is a promising method for the early diagnosis and pre-operative staging of pancreatic cancers, but requires further refinement.

Diagnosis and staging of pancreatic cancer by endoscopic ultrasound

The aim of this study was to evaluate the usefulness of and problems associated with endoscopic ultrasonography (EUS) in the diagnosis and pre-operative staging of pancreatic cancer. 96 patients suspected of having pancreatic cancer were pre-operatively examined with EUS. 37 of these 96 patients had pancreatic cancer. Results of the EUS imaging were compared with findings of histology and/or surgery, and the patient's clinical course. The sensitivity and specificity of EUS for diagnosing pancreatic cancer were 89% and 97%, respectively. EUS had excellent sensitivity regardless of tumour size or location. EUS was accurate (90%) in determining tumour size in pancreatic cancers less than 3 cm in maximum diameter, but not for tumours greater than 3 cm (30%). The accuracy of tumour (T) and nodal (N) staging were 64% and 50%, respectively. EUS is a promising method for the early diagnosis and pre-operative staging of pancreatic cancers, but requires further refinement.

Secretory carcinoma of the breast in an elderly woman: report of a case

We herein report a case of secretory carcinoma of the breast in a 73-year-old woman. Secretory carcinoma is an extremely rare tumor and demonstrates distinctive pathologic characteristics. This tumor frequently occurs in either children or adolescents, and thus has been called juvenile carcinoma. We encountered this rare tumor in an elderly woman. Aspiration biopsy cytology was performed twice, but the cytological diagnosis was not carcinoma. Such pathologic characteristics as mild atypia, the absence of hyperchromasia, and a minimal degree of pleomorphism in the tumor cells can thus lead to a cytological misdiagnosis. An excisional biopsy was performed and secretory carcinoma was finally diagnosed. Consequently, a modified radical mastectomy (Kodama's method) was performed 7 days later. We describe this very rare tumor's clinicopathologic characteristics.

p53 expression patterns in colorectal adenomas and early carcinomas: a special reference to depressed adenoma and non-polypoid carcinoma

The purpose of the present study was to investigate the role of p53 in tumor progression of colorectal adenomas and early carcinomas, while especially focusing on flat tumors (depressed adenomas and non-polypoid carcinomas). Paraffin sections of 61 pure adenomas (33 polypoid, 28 depressed), 26 carcinomas in polypoid adenoma (CIA) and 63 pure carcinomas (36 polypoid, 27 non-polypoid) were examined for immunostaining using p53 monoclonal antibody (PAb 1801). All of the carcinomas were restricted to the mucosa. The number and distribution of the p53 positive tumor cells was evaluated, and then compared with tumor growth patterns and histological features. The incidence of p53 expression in carcinomas (58% in CIA and 51% in pure carcinomas) was significantly higher than that in polypoid adenoma (27% in CIA and 21% in pure adenomas). However, the same incidence in depressed adenomas (51%) was significantly higher than in polypoid adenomas. No correlation in carcinomas was observed between p53 expression and clinicopathologic data except for age. The distribution of p53 positive cells was different between adenomas and carcinomas. There tended to be fewer p53 positive cells in adenomas, even in depressed ones, than in carcinomas and they also tended to be confined to the superficial areas in adenomas, while they were diffusely distributed in carcinomas. Interestingly, the p53 positive cells were more frequently present in the deep mucosal areas than in the superficial areas of some non-polypoid carcinomas. In conclusion, the following hypotheses are suggested: (i) the increase of p53 expression from adenoma to carcinoma supports the hypothesis of an adenoma-carcinoma sequence in a polypoid tumor; (ii) the unique p53 expression in non-polypoid carcinoma suggests the existence of another type of carcinogenesis; and (iii) depressed adenomas are thus considered to have a high potential risk of carcinoma.

Jejunal angiodysplasia confirmed by intravascular injection technique in vitro. Report of a case and review of the literature

Angiodysplasia of the small intestine is a rare but important cause of gastrointestinal bleeding. We present a 64-year-old man with repeated melena in whom the diagnosis of multiple angiodysplasia of the jejunum was suggested by angiography. The affected segment of the small intestine, in which reddish patches were detected by intraoperative endoscopy, was removed. The combined technique of injecting a dye and a water-soluble contrast medium into the resected specimen revealed areas of dilated vessels, which were diagnosed histologically as angiodysplasia. This case suggests that angiodysplasia of the small intestine can be recognized clinically before the operation and that the intravascular injection technique is useful in confirming the diagnosis in the resected specimen in vitro. We describe this case in detail and review other cases of small intestinal angiodysplasia reported in the English literature.

Involvement of beta-glucuronidase in intestinal microflora in the intestinal toxicity of the antitumor camptothecin derivative irinotecan hydrochloride (CPT-11) in rats

Irinotecan hydrochloride (CPT-11), an antitumor camptothecin derivative, causes severe forms of diarrhea clinically. We characterized CPT-11-induced diarrhea histologically and enzymologically and assessed the relationships between intestinal toxicity and the activity of the enzymes that play a key role in the major metabolic pathway of CPT-11 in rats. CPT-11 (60 mg/kg i.v. for 4 days) induced intestinal toxicity characterized by severe chronic diarrhea, loss of body weight, and anorexia. Histological damage was most severe in the cecum. The segmental difference in the degree of the damage showed good correlation with the beta-glucuronidase activity in the contents of the lumen in each case, but not with the intestinal tissue carboxylesterase activity, which converts CPT-11 to its active form (7-ethyl-10-hydroxycamptothecin). Inhibition of the beta-glucuronidase activity in the intestinal microflora by antibiotics (1 mg penicillin and 2 mg streptomycin per ml of drinking water) markedly ameliorated the diarrhea and reduced cecal damage. Analysis of CPT-11 and its metabolites in the feces indicated that antibiotics completely inhibited the deconjugation of the glucuronic conjugate of 7-ethyl-10-hydroxycamptothecin by beta-glucuronidase. It is suggested that CPT-11-induced diarrhea would be attributable to the damage to the cecum, and that the inhibition of the beta-glucuronidase activity in the intestinal microflora is a major protective effect of antibiotics.

Inhibition of UDP-glucuronosyltransferase by aglycons of natural glucuronides in kampo medicines using SN-38 as a substrate

7-Ethyl-10-[4-(piperidino)-1-piperidino]carbonyloxycamptothecin (CPT-11), a potent anticancer agent for lung and gynecological cancers, is metabolized in vivo to the active compound, 7-ethyl-10-hydroxycamptothecin (SN-38), which is subsequently conjugated to SN-38-glucuronide by UDP-glucuronosyltransferase (UDP-GT). Three purified aglycons of natural glucuronides, baicalein, luteolin and glycyrrhetic acid, inhibited UDP-GT activity towards SN-38 as a substrate. The inhibitory potencies of these aglycons toward UDP-GT were similar to that of 1-naphthol. Based on these results, together with our previous finding that the corresponding glucuronides used in the present study strongly inhibited beta-glucuronidase in gut flora, we propose that materials in Kampo (Japanese herbal) medicines containing these aglycons of natural glucuronides could be used in vivo to decrease the enterohepatic circulation of SN-38 and other drugs.

Protective effects of kampo medicines and baicalin against intestinal toxicity of a new anticancer camptothecin derivative, irinotecan hydrochloride (CPT-11), in rats

In clinical use, irinotecan hydrochloride (CPT-11; 7-ethyl-10-[4-(piperidino)-1-piperidino]carbonyloxycamptothecin), a novel antitumor agent, causes a relatively high incidence of severe forms of diarrhea. We investigated whether baicalin, an inhibitor of beta-glucuronidase, which deconjugates the glucuronide of the active metabolite of CPT-11, SN-38 (7-ethyl-10-hydorxycamptothecin), and Japanese herbal medicines (Kampo medicines) which contain baicalin can ameliorate CPT-11-induced intestinal toxicity in rats. CPT-11 (60 mg/kg i.v. once daily for 4 consecutive days) induced intestinal toxicity characterized by diarrhea, loss of body weight, anorexia and disruption of intestinal epithelium. Treatment with baicalin (25 mg/kg p.o. twice daily) or Kampo medicines (TJ-14 and TJ-114; 1 g/kg p.o. twice daily) from the day before to 4 or 10 days after the start of CPT-11 administration resulted in significantly decreased weight loss, improved anorexia and delayed onset of diarrheal symptoms. Histological examination revealed that Kampo medicine-treated animals had less damage to the intestinal epithelium and that damage was repaired more rapidly than in control rats. These results suggest that the prophylactic use of Kampo medicines (TJ-14 and TJ-114) may be of value against CPT-11-induced intestinal toxicity.

Relaxation effect of an audiovisual system on dental patients. Part 2. Palus-amplitude

Dental care services include relaxation of patients to reduce their displeasure at and tension during treatment. For this purpose, it is common to use audio or audiovisual programs, that is, to let them listen to music or watch TV. However, the former utilizes only the auditory sense, and the latter is disadvantageous in that a TV set is a rather large-scale unit. In the present study, we determined the relaxation effect of an audiovisual instrument on dental patients. The instrument, which gives virtual vision, was composed of a lightweight eyeset of the snow goggle type that has a built-in TV screen, with earphone and accessories. The relaxation effect was determined using a polygraph.

An intestinal counterpart of pyogenic granuloma of the skin. A newly proposed entity

Pyogenic granuloma is a common disease in the skin, but it is extremely rare in the gastrointestinal tract except for the oral cavity. We have seen three lesions (from three patients) of an intestinal counterpart of pyogenic granuloma and have reviewed their clinicopathologic features. Macroscopically, all three lesions revealed a polypoid growth with either a sessile or pedunculated configuration. All had an ulceration on the top. Microscopically, all these lesions were composed of a lobular proliferation of varying sizes of capillaries with an edematous stroma. Endothelial cells of the capillaries were swollen variously and in one case revealed a few mitotic figures. An inflammatory process was associated with the presence of ulcerations. Immunohistochemically, both Factor VIII-related antigen and QB-end/10(CD34) were positive only for the endothelial cells in all three cases. The characteristic macroscopic and histologic features thus allow for an early diagnosis of pyogenic granuloma in the gastrointestinal tract, which is similar to that observed in the skin.

Carcinoma of the ampulla of Vater synchronously associated with early gastric cancer--a report of two cases

We report two cases of carcinoma of the ampulla of Vater synchronously associated with early gastric cancers. The gastric lesions were diagnosed pre-operatively in one patient and at the time of examination of the resected specimen following pancreatoduodenectomy in the other. Specific problems in the diagnosis and management of these multiple primary carcinomas are discussed. Careful evaluation of the stomach prior to the surgical treatment for ampullary carcinoma is recommended.

Intraductal papillary mucinous neoplasms of the pancreas associated with so-called "mucinous ductal ectasia". Histochemical and immunohistochemical analysis of 29 cases

Twenty-nine patients (20 men, nine women; mean age, 65.9 years; range, 49-77 years) with intraductal papillary mucinous neoplasms associated with so-called "mucinous ductal ectasia" of the pancreas were studied both histochemically and immunohistochemically. These cases included six cases of hyperplasia, 13 adenomas, and 10 adenocarcinomas. The mean sizes of the hyperplasia, adenomas, and adenocarcinomas were 2.0 cm, 3.0 cm, and 4.8 cm in diameter, respectively. Tumor size correlated with the degree of cellular atypia. The proliferative rates were significantly higher in the carcinomatous epithelium with those in the hyperplastic and adenomatous epithelia. The polarity of distribution of carcinoembryonic antigen and carbohydrate antigen 19-9 were better preserved in the hyperplastic epithelia than in the carcinomatous epithelia. On the other hand, the papillary and nonpapillary hyperplastic epithelium contained mainly a neutral periodate-reactive glycoprotein with only trace amounts of sialomucins and sulphomucins. In addition, the adenomatous epithelium contained mostly sialomucins with a small amount of sulphomucins. The carcinomatous epithelium contained predominantly sulphomucin. The results of both the histological and immunohistochemical studies suggested the possibility of a sequential change from nonpapillary and papillary hyperplasia, via adenoma, to carcinoma in intraductal papillary-mucinous neoplasms associated with mucinous ductal ectasia. Moreover, these results, in combination with the histochemical findings, are considered helpful in making an appropriate preoperative diagnosis with endoscopic pancreatic ductal biopsy specimens, thus enabling the surgeon to select the most appropriate surgical procedure.

Metastasizing intramucosal gastric carcinomas. Well differentiated type and proliferative activity using proliferative cell nuclear antigen and Ki-67

BACKGROUND

Recently, endoscopic surgery for small superficial gastric carcinomas has become increasingly more challenging, and the treatment criteria remain controversial.

METHODS

To examine the metastatic potential of intramucosal gastric cancers (IMGCs), IMGCs with regional lymph node involvement (NI) were compared with IMGCs without regional lymph NI clinicopathologically. To clarify the metastatic behavior of well differentiated adenocarcinoma (W-type), immunohistochemical staining using Ki-67 and proliferating cell nuclear antigen (PCNA) monoclonal antibodies were performed.

RESULTS

Of the 943 lesions with IMGC, 21 (2.2%) were NI on histologic examination. There was no significant difference between the macroscopic classification and the incidence of NI. The sizes of the IMGCs with NI (median, 4.3 cm) were significantly larger than the IMGCs without NI (median, 2.4 cm). Among the histologic grades classified according to the predominant features, the incidence of NI in poorly differentiated adenocarcinoma (P-type) (12/304, 3.9%) was significantly higher than that in well differentiated (W-type) (6/489, 1.2%). Besides the 12 P-type IMGCs, 6 well and moderately differentiated type IMGCs contained some poorly differentiated components, totaling 18 IMGCs (86%) that were either mainly or partially P-type. Among the W-type IMGCs, the mean values of the Ki-67 and PCNA labeling indices (LI) for IMGCs with NI (Ki-67, 47.5%; PCNA, 58.3%) were higher than those of the 25 randomly selected IMGCs without NI (Ki-67, 39.2%; PCNA, 39.9%).

CONCLUSIONS

The potential for NI in IMGCs seems to be related closely to tumor size, the presence of poorly differentiated components, and, particularly in the W-type IMGC, the LI that are demonstrated immunohistochemically with Ki-67 and/or PCNA.

Risk factors related to liver metastasis in colorectal carcinoma: a multivariate analysis of clinicopathologic and immunohistochemical variables

Specimens from 48 consecutive patients undergoing surgery for colorectal carcinoma and having synchronous or metachronous liver metastases (Group 1) and those from 52 consecutive patients who had no evidence of hepatic metastases within at least 5 year after colorectal resection (Group 2) were selected and compared using a multiple logistic regression analysis. A multivariate analysis using a stepwise logistic regression revealed six independent risk factors significantly related to hepatic metastases. In addition, the following logistic regression model was obtained from this analysis. P = exp a/(1 + exp a): a = 3.524(SM-V) + 2.731(Ex-V) + 2.718(E/M) + 2.562(Lo) + 1.858(p53) + 1.941(HIR) - 4.397, where P is the probability of hepatic metastasis given six independent risk factors (E/M, Ex/M ratio; Lo, location; HIR, host inflammatory cell reaction). When the estimated probability "P" in the above logistic regression model is more than 0.55 after an examination of surgical specimens, we must consider adjuvant chemotherapy and closely monitor the patient to ensure early detection of hepatic metastases.

Proliferating cell nuclear antigen, plasma fibronectin, and liver regeneration rate after seventy percent hepatectomy in normal and cirrhotic rats

BACKGROUND

The difference in liver regeneration rate in relation to proliferating cell nuclear antigen (PCNA) and plasma fibronectin level in the cirrhotic and control liver after 70% hepatectomy were examined in the rat.

METHODS

Liver cirrhosis was induced by intraperitoneal injection of thioacetamide for 12 weeks; rats without thioacetamide administration served as controls. On the day before and days 1, 2, 3, and 7 after 70% hepatectomy, PCNA labeling index of hepatocyte, plasma fibronectin level, and percentage of the initial liver weight were determined.

RESULTS

Liver regeneration rate as expressed by percent of initial liver weight was impaired in the cirrhotic liver, and significantly lower regeneration rate was observed on days 3 and 7 after hepatectomy in the cirrhotic rats as compared with controls. PCNA labeling index was higher in the cirrhotic liver before hepatectomy. Little change of PNA labeling index was observed in the cirrhotic liver, although the index increased significantly in the control liver; significantly higher values were observed on days 1, 2, and 3, with the maximal value on day 2 after hepatectomy. The plasma fibronectin level was significantly lower in the cirrhotic rat before and after hepatectomy.

CONCLUSIONS

The results show that liver regeneration is impaired in the cirrhotic liver associated with little activation of PCNA and with lower plasma fibronectin level.

Metabolic activation of CPT-11, 7-ethyl-10-[4-(1-piperidino)-1- piperidino]carbonyloxycamptothecin, a novel antitumor agent, by carboxylesterase

We measured the plasma concentrations of 7-ethyl-10-[4-(1-piperidino)-1- piperidine]carbonyloxycamptothecin (CPT-11) and the active metabolite 7-ethyl-10-hydroxycamptothecin (SN-38), after treatment with CPT-11 to rats pretreated with bis-p-nitrophenylphosphate (BNPP) which is a specific inhibitor of carboxylesterase, and non-pretreated rats. The plasma level of SN-38 was decreased in the BNPP-pretreated group compared with these of non-pretreated group, indicating that the esterase involved in CPT-11 metabolism is a carboxylesterase. We also characterized the molecular species of carboxylesterase involved in CPT-11 metabolism using enzyme preparations purified from liver microsomes. Thirteen carboxylesterase isozyme activities towards CPT-11 were compared and guinea pig GLP1 was found to have the highest activity, while human HU1 isozyme had relatively lower activity than those of animal species. In studies on the kinetic parameters of the hydrolysis of CPT-11 by the purified carboxylesterase isozymes the highest Vmax value of the isozymes was found in human HU1 and the smallest was seen in rat RL1. The Vmax/Km for RL1 showed the largest value of 21.7 nmol/mg protein/mM.