Female reproduction in mice lacking the prostaglandin F receptor. Roles of prostaglandin and oxytocin receptors in parturition

Female mice lacking the receptor for prostaglandin F2 alpha (FP) do not deliver fetuses at term, although these can be successfully rescued by cesarean section. No induction of oxytocin receptor mRNA is found in the uterus of these mice, and they show no uterine contraction on intravenous administration of oxytocin. Furthermore, a decline in serum progesterone levels during the periparturition period is not observed in these animals. Ovariectomy at day 19 of pregnancy restored induction of the oxytocin receptor and caused successful delivery in these animals. These results indicate not only the essential role of luteolytic PGF 2 alpha action in natural parturition but also the importance of oxytocin receptor induction in this process.

Microsatellite instability as a potential marker for poor prognosis in adult T cell leukemia/lymphoma

Microsatellite instability (MSI) represents a replication error resulting from the dysfunction of mismatch repair gene products. In this study, MSI was analyzed in 18 patients with various subtypes of adult T cell leukemia/lymphoma (ATL/L). Using six different microsatellite loci, we defined MSI as positive when replication errors were observed in at least two loci. The MSI was positive in four cases (22.2%)with acute type ATL, who tended to show more prognostically unfavorable factors and shorter overall survival. These results suggest that genomic instability may be associated with tumor progression rather than the development of ATL/L itself. In addition, the presence of the MSI at initial presentation could appear to warrant consideration as an additional prognostically unfavorable factor.

Prosaposin prevents programmed cell death of rat cerebellar granule neurons in culture

Prosaposin, the precursor of sphingolipid activator proteins (saposin A-D), has been reported to be a neurotrophic factor in vitro and in vivo. Prosaposin mRNA is transiently expressed at a high level in developing cerebellum during the period of granule cell proliferation and maturation, suggesting its significance during development of cerebellum. Here we investigated the neuroprotective effect of prosaposin on cerebellar granule neurons, exposing primary cerebellar granule cells to low K+ which induced programmed cell death. Prosaposin rescued mature cerebellar granule neurons in a bimodal manner. A similar neuroprotective effect was obtained using TX14(A), a 14-mer neurotrophic peptide derivative of prosaposin. An additive neuroprotective effect was observed between BDNF and TX14(A), but not between IGF-1 and TX14(A). Prosaposin rescued 60% of nifedipine sensitive cerebellar granule neurons as well as IGF-1, while BDNF did not. Furthermore, the neuroprotective action of prosaposin was inhibited by LY294002, a specific inhibitor of PI 3-kinase. These findings indicated that prosaposin had a trophic effect upon newborn cerebellar granule cells and that the neuroprotective action was similar to that of IGF-1 rather than BDNF. Prosaposin may play a role in cerebellar development during programmed cell death of cerebellar neurons.

Granulocyte-macrophage colony-stimulating factor expressed in T cells mediates immunity against herpes simplex virus type 1 encephalitis

A model of herpes simplex virus type 1 (HSV-1) infection was developed in rats to study systemic immune responses elicited by intravitreous inoculation of the virus. HSV-1 inoculation led to distinct granulocyte-macrophage colony-stimulating factor (GM-CSF)-producing memory T cells, which did not develop in rats inoculated with either HSV-1 intraperitoneally or inactivated HSV-1 intravitreously. On subsequent intraperitoneal viral boosting, systemic GM-CSF production was elicited as a secondary immune response that caused neutroeosinophilia. To examine the role of GM-CSF in anti-herpetic immunity, cytokine-producing and -nonproducing rats were intravitreously challenged with HSV-1, which causes lethal encephalitis. Only intravitreously primed rats were protected upon production of GM-CSF. Furthermore, pretreatment with recombinant GM-CSF protected unimmunized rats against the encephalitis. It is thus strongly suggested that the production of GM-CSF leads to anti-HSV-1 immunity against the transneuronal spread of challenged HSV-1 within the visual system.

Cytotoxic effect of accelerated carbon beams on glioblastoma cell lines with p53 mutation: clonogenic survival and cell-cycle analysis

PURPOSE

The cytotoxic effect of high-LET carbon beams was analysed on p53 mutant and wild-type glioblastoma cell lines.

MATERIALS AND METHODS

Three glioblastoma (U251MG, TK-1, A-172) cell lines, one medulloblastoma (ONS-76) and one fibroblast cell line (NB1RGB) were used. U251MG and TK-1 have mutated p53, A-172, ONS-76 and NB1RGB have wild-type p53. Gamma-ray and 290 MeV/u carbon mono-peak beams with average LET values of 20, 40, 81 and 105keV/microm were used. Cytotoxicity was measured by clonogenic survival assay and DNA histograms were analysed by flow cytometry.

RESULTS

The RBE values for carbon beams at D10 ranged from approximately 1.5-1.7 (20keV) to 2.9-3.1 (105keV). Although p53 mutants were more resistant than wild-types for all radiation qualities, carbon beams yielded a higher RBE in p53 mutants than in wild-types. Alpha values were significantly smaller in p53 mutants than wild-types for gamma- and 20 keV/microm radiations, while no significant difference was noticed for LET greater than 40 keV/microm. A G1 block was noticed after irradiation with gamma-rays and carbon beams of 20 and 40keV/microm in p53 wild-types. A more pronounced G2 block occurred in p53 mutants than wild-types in proportion to LET up to 105 keV/microm.

CONCLUSION

Accelerated carbon beams can yield higher RBE in gamma-resistant glioblastoma cell lines with p53 mutations. High-LET irradiation induces not only disappearance of the p53-dependent G1 block but also a greater G2 block in glioblastoma cell lines.

Microsatellite instability is rare in the clinical course of myelodysplastic syndrome studied with DNA from fresh and paraffin-embedded tissues

Microsatellite instability (MSI) has been reported to occur in various types of malignant neoplasms. We performed a polymerase-chain-reaction-based assay for MSI between the initial and the most recently available ("latest") samples from 23 patients with myelodysplastic syndrome (MDS). Of these patients, 15 were informative at more than three microsatellite loci. Seven patients showed an increase in leukemic cells while 8 patients did not during the interval between the two analyses. Only 1 of the patients, who had refractory anemia with excess blasts, which changed to acute myelogenous leukemia, showed microsatellite alteration at the analysis times. Among all 23 patients, two alterations were detected in the 42 informative paired samples that showed an increase in leukemic cells (4.8%), while none was detected in the 59 paired samples without such an increase. In total, therefore only two alterations were detected among 101 informative paired samples (2%). This indicates that MSI is rare in the clinical course of MDS irrespective of disease status, and is consequently not a critical genetic event for disease progression in most MDS patients.

Prevention of hyperlipidemic acute pancreatitis during pregnancy with medium-chain triglyceride nutritional support

CONCLUSION

A combination of diet therapy, nutritional support with medium-chain triglycerides (MCT), and well-planned preterm Cesarean delivery on demand is an effective measure to prevent gestational hyperlipidemic pancreatitis and leads to successful childbirth.

BACKGROUND

Prevention and therapy of gestational hyperlipidemic pancreatitis are important, although difficult, because the condition carries a high maternal and fetal morbidity and mortality.

RESULTS

We describe a 32-yr-old female with lipoprotein lipase-deficient familial hypertriglyceridemia who had recurrent episodes of acute pancreatitis. The third episode occurred with worsened hyperlipidemia 7 yr earlier at 32 wk of her first pregnancy and resulted in fetal death. The fourth and fifth episodes were also accompanied by marked hyperlipidemia probably caused by drug discontinuance and dietary noncompliance. She became pregnant. Serum triglyceride levels were controlled below 2000 mg/dL by strict monitoring with low-fat, low-calorie diet and MCT nutritional support. A premature but healthy infant was born by Cesarean delivery at 36 wk of gestation when the mother presented with mild abdominal pain and was found to have uterine contractions. The ensuing clinical course has been uneventful.

Detection of bcr/abl fusion transcripts by semiquantitative multiplex RT-PCR combined with a colormetric assay in Ph positive leukemia

We studied the feasibility of the clinical application of a new bcr/abl analysis system, C-TRAK t(9;22), consisting of a multiplex RT-PCR and a colormetric assay. With this system, bcr/abl transcripts could be detected in all of 24 cytogenetic Philadelphia chromosome (Ph) positive leukemia patients and in none of eight Ph negative patients. Multiple bcr/abl transcripts could be detected in three of the 24 Ph positive patients, the fusion of bcr exon 1 to abl exon 2 (e1a2 junction) dominated that of bcr exon 13 to abl exon 2 (b2a2 junction) in two cases and that of bcr exon 14 to abl exon 2 (b3a2 junction) and b2a2 dominated e1a2 in one case. This system was sensitive enough to be able to detect even one bcr/abl transcript-producing cell in 50000 bcr/abl negative background cells, thus making it suitable for semiquantitative evaluation. Minimal residual disease (MRD) was monitored in one Ph positive leukemia patient who underwent allogenic bone marrow transplantation (allo-BMT). After allo-BMT, a weak positivity of the bcr/abl transcript continued with no clinical relapse; this result was consistent with that of a conventional nested PCR assay using ethidium bromide staining. Including all the procedures for RNA extraction, it took only about 10 h to detect the bcr/abl transcripts. Our findings indicate that this bcr/abl analysis system provides a quick and sensitive method for screening bcr/abl transcripts and possibly for monitoring MRD in Ph positive leukemia patients.

Isolation of radiosensitive and radioresistant mutants from a medulloblastoma cell line

Two mutant clones, one radiosensitive (OS-3) and one resistant (OR-5), were isolated from ONS-76 after screening 2400 clones by the replica micro-well technique. These two clones exhibited significantly different radiosensitivity, with D37 values of 4.7Gy in OR-5 and 1.7Gy in OS-3. After gamma irradiation (8Gy), OR-5 exhibited greater G2 arrest than sensitive clone OS-3. Administration of 5mM of caffeine resulted in greater cell killing in OR-5 than in OS-3, with an almost complete release of G2 block. These observations support the notion that the G2 block contributes to the repair process of DNA damage after irradiation. The present results suggest that clones with a large postirradiation G2 block may show a greater reduction in radiosensitivity if the G2 block is released artificially. The study of the mutant clones described herein may provide important clues to the mechanism by which glioma cells acquire radioresistance.

Serum androgen levels in hyperthyroid women

Thyroid hormone is known to affect androgen metabolism, however, there are few studies in which alterations of androgen metabolism are simultaneously examined in patients with clinical thyroid disorders. In this study, we investigated the alterations of thyroid hormone and androgens before and during treatment in patients with hyperthyroidism. Fifteen female patients with hyperthyroidism due to Graves' disease were studied. From these patients, blood samples were obtained before treatment and at 1 month (M), 2M, 3M, 4M and 6M after beginning of treatment. Concentrations of free T4(FT4), free T3(FT3), testosterone (T), androstenedione (delta 4A), dihydrotestosterone (DHT), 5 alpha-androstane-3 alpha, 17 beta-diol(3 alpha-diol) and androsterone (AD) and sex hormone binding globulin (SHBG) were measured by radioimmunoassays (RIAs) or immunoradiometric assay (IRMA). As normal controls, ten healthy women were also studied. Before treatment concentrations of DHT (mean +/- SD: 3.35 +/- 0.78 nmol/L), 3 alpha-diol (0.78 +/- 0.11 nmol/L), AD (6.73 +/- 0.64 nmol/L) and SHBG (184.9 +/- 68.1 nmol/L) were significantly elevated compared with those of normal controls. T and delta 4A levels were not significantly different from normal values. DHT/T ratio indicating 5 alpha-reductase activity was 4.62 +/- 2.55 and significantly higher than that in normal controls. At 2 months after beginning of treatment with anti-thyroid drugs, thyroid function (FT4 and FT3) became normal and at 3 months after beginning of treatment, DHT, 3 alpha-diol, AD and DHT/T ratio decreased to normal range. SHBG level was gradually decreased, however still higher than that of the normal control group at 6 months after beginning of treatment. There was a time lag in recovery between serum androgen levels and SHBG level.

Interferon-alpha-induced thyroid dysfunction in patients with chronic active hepatitis C: a transient, reversible and self-limited dysfunction

To survey the prognoses of interferon-alpha (IFNalpha)-induced thyroid dysfunction, a total of 100 patients (49 males and 51 females) with biopsy-proven chronic active hepatitis C were studied. Either during or after IFNalpha therapy, 29 patients (33.7%) revealed suppression/elevation of thyroid stimulating hormone (TSH) or both, transient thyrotoxicosis (TSH less than 0.1 microU/ml) or transient hypothyroidism (TSH 5.0-190.95 microU/ml). However, the thyroid function normalized without supplementation of the thyroid hormone in the follow-up period. In the same period, one of the 14 control patients (7.1%) developed thyroid dysfunction. Thyroid abnormalities developed significantly more in patients with IFNalpha therapy than in those without IFNalpha therapy. The findings suggest that the occult autoimmune disorder becomes overt with IFNalpha treatment in patients with pre-existent autoimmune thyroid disease. IFNalpha-induced thyroid dysfunction is transient, reversible and self-limited. It is not necessary to discontinue IFNalpha therapy when thyroid dysfunction develops.

Fyn-kinase as a determinant of ethanol sensitivity: relation to NMDA-receptor function

Animals vary in their sensitivity to ethanol, a trait at least partly determined by genetic factors. In order to identify possible responsible genes, mice lacking Fyn, a non-receptor type tyrosine kinase, were investigated. These mice were hypersensitive to the hypnotic effect of ethanol. The administration of ethanol enhanced tyrosine phosphorylation of the N-methyl-D-aspartate receptor (NMDAR) in the hippocampus of control mice but not in Fyn-deficient mice. An acute tolerance to ethanol inhibition of NMDAR-mediated excitatory postsynaptic potentials in hippocampal slices developed in control mice but not in Fyn-deficient mice. These results indicate that Fyn affects behavioral, biochemical, and physiological responses to ethanol.

Idiopathic CD4+ T-lymphocytopenia in a non-Hodgkin's lymphoma patient

We report a case of idiopathic CD4+ T-lymphocytopenia with malignant lymphoma (diffuse large, B-cell type) for which there was no evidence of human immunodeficiency virus type 1 or type 2 infection and no other known causes of immunodeficiency. She had never suffered from any opportunistic infection until the diagnosis of malignant lymphoma was made, and the CD4+ T-lymphocytopenia persisted after complete remission of the lymphoma. As the clinical features and immune status of the patient differed from those associated with the acquired immunodeficiency syndrome (AIDS)-related syndrome, we conclude that immunodeficiency in this case did not contribute to the opportunistic infection but may have been associated with the genesis of malignant lymphoma.

Failure of parturition in mice lacking the prostaglandin F receptor

Mice lacking the gene encoding the receptor for prostaglandin F2alpha (FP) developed normally but were unable to deliver normal fetuses at term. Although these FP-deficient mice showed no abnormality in the estrous cycle, ovulation, fertilization, or implantation, they did not respond to exogenous oxytocin because of the lack of induction of oxytocin receptor (a proposed triggering event in parturition), and they did not show the normal decline of serum progesterone concentrations that precedes parturition. Ovariectomy at day 19 of pregnancy restored induction of the oxytocin receptor and permitted successful delivery in the FP-deficient mice. These results indicate that parturition is initiated when prostaglandin F2alpha interacts with FP in ovarian luteal cells of the pregnant mice to induce luteolysis.

[Transient decrease in the size of an enhanced anaplastic astrocytoma seen on magnetic resonance imaging: a case report]

We report unusual radiographic findings which were seen during the management of a patient with anaplastic astrocytoma. An enhanced region in a gyrus of the right frontal lobe was demonstrated in a 38-year-old woman who had had a generalized seizure. Following treatment with steroid- and osmotherapy, this enhanced region decreased clearly on magnetic resonance imaging (MRI). Six months later, an enhancing mass lesion appeared in the same position. After surgery, this was diagnosed as being an anaplastic astrocytoma. It is speculated that the initial enhancement was caused by transient dysfunction of the blood-brain following the seizure. In this case, the most important radiologic image was a T2-weighted image of MRI which was able to demonstrate the existence of the lesion until the time of its removal by surgery.

Cellular localization of mRNAs for prostaglandin E receptor subtypes in mouse gastrointestinal tract

Regional and cellular distribution of mRNAs for prostaglandin E (PGE) receptor subtypes was investigated in the mouse gastrointestinal tract by in situ hybridization. Strong signals for EP1 transcripts were detected in cells of the muscularis mucosae layer, especially in the body of the stomach. Intense signals for EP3 transcripts were detected in neurons of the myenteric ganglia throughout the tract. Moderate EP3 mRNA expression was also observed in fundic gland epithelial cells, except for surface mucous cells in the stomach. Expression of EP4 mRNA was moderate in surface epithelial cells of the corpus and in glands from the surface to the base of the antrum. Strong EP4 signals were observed in the epithelium in the duodenum, jejunum, and ileum. In the ileum, signals were only observed in the upper part of the villi. However, no or weak signals for EP2 transcripts were detected. These findings suggest that PGE2 modulates various gastric or intestinal functions via at least three different PGE receptors.

Brainstem arteriovenous malformation with a pedicle aneurysm treated by endovascular surgery and proton-beam radiosurgery--case report

A 39-year-old male presented with a small pontine hemorrhage and subarachnoid hemorrhage. Angiography showed a small left pontine arteriovenous malformation (AVM) associated with a small aneurysm on the pedicle feeding the AVM. The pedicle aneurysm was occluded by microcoils. The AVM was then treated by proton-beam radiosurgery. Follow-up angiography 2 years later revealed that the AVM had disappeared completely without neurological deficit. The combination of embolization and proton-beam radiosurgery was curative in this patient with a pontine AVM associated with an aneurysm on the feeding artery, showing that these techniques can be used to treat inoperable vascular lesions safely.

Expression of N-ras gene in gliomas

Expression of N-ras gene was examined by northern blot analysis in two cases of astrocytoma (grade II), four cases of glioblastoma multiforme (six samples including two recurrent tumors), and normal brain tissues. Expression of N-ras gene was only found in the two recurrent glioblastoma multiforme samples. Southern blot analysis found no significant difference in copy numbers of N-ras gene in pre- and post-recurrence samples. The histological diagnosis of the two recurrent tumors was glioblastoma multiforme at both first recurrent presentation. However, the tumors had progressed during recurrence, because of worsened histological findings, such as increased cellularity, pleomorphism, and vascularity. These tumors recurred at very short intervals. Enhanced expression of N-ras gene by disorder of transcription may be a factor in the progression of glioblastoma multiforme.

Dural cavernous angioma causing acute subdural hemorrhage--case report

A 78-year-old female presented with a nontraumatic acute subdural hematoma (ASDH) caused by hemorrhage from a cavernous angioma located on the convexity dura mater. The hematoma and angioma were removed successfully. Neuroimaging performed 2 years previously had not revealed cavernous angioma. The angioma most likely grew rapidly over the 2 year period, during which she had received oral antiplatelet medication. Nontraumatic ASDH may originate from a cavernous angioma which grows rapidly.

Correlation of histopathological factor of brain tumor and high thallium-201 uptake in single photon emission computed tomography

This study was undertaken to investigate the relationship between several histological features and the degree of TI-201 uptake in brain tumors. T1-201 SPECT was performed on 52 patients with intracranial lesions. Histological examinations were carried out to determine the gradation of tumor cell density, vascularization, small-cell density, and matrix loosening, and the presence of necrosis, atypia, mitoses, and endothelial proliferation. The histological findings were classified into three categories. While the early uptake of T1-201 depended on the degree of necrosis of glial tumor, the delayed T1-201 uptake was closely related to the degree of necrosis, tumor cell density, and small-cell density, and may thus be of value for estimating the viability and degree of malignancy of glial tumors. In the non-glial tumors, the early and delayed T1-201 uptakes were closely related to all histological parameters, with the increase of necrosis and vascularization in the tumor tissue being particularly closely related to high uptake levels.

Induction of human autologous cytotoxic T lymphocytes against minced tissues of glioblastoma multiforme

The authors induced autologous cytotoxic T lymphocytes (CTLs) directly from peripheral blood lymphocytes by preparing a coculture of minced tissue fragments of glioblastoma multiforme (GBM) with interleukins-1, -2, -4, and -6 and interferon-gamma in RHAM alpha medium containing 5% autologous plasma for 2 weeks. At the end of this period, the frequencies of CD3+, CD4+, CD8+, and CD16+ lymphocytes were 95% to 99%, 40% to 62%, 37% to 38%, and 0.2%, respectively. The lymphocytes killed 82% to 100% of the GBM cells within 48 hours at an effector-to-target cell ratio of 1.67, whereas in a separate coculture, autologous lymphokine-activated killer (LAK) cells killed only 33% of GBM cells under the same conditions. The lymphocytes showed no cytotoxicity against LAK-sensitive Daudi cells, natural killer-sensitive K562 cells or autologous fibroblasts grown from the brain tumor, although they did show slight cytotoxicities against allogeneic GBM cell lines. These results lead the authors to suggest that the lymphocyte population contains specific CTLs for autologous brain tumor cells and that these CTLs could be effective in adoptive immunotherapy to combat brain tumor.

Serum levels of six pancreatic enzymes as related to the degree of renal dysfunction

OBJECTIVES

Currently, serum total amylase, pancreatic isoamylase (P-amylase), lipase, trypsin(ogen), phospholipase A2 (PLA2), and elastase I are advocated to be useful in diagnosing pancreatic diseases. However, the most useful among the above six enzymes in patients with impaired renal function has not been fully clarified. We, therefore, studied the relation of the serum levels of the above enzymes and creatinine clearance (CrCl) in normal controls and patients with chronic renal insufficiency or failure.

METHODS

PLA2 and elastase I were assayed by RIA, trypsin(ogen) by EIA and others by activity. Subjects were 24 healthy controls and 47 patients with impaired renal function and no apparent pancreatic diseases.

RESULTS

1) Elastase I was significantly elevated only in patients with a CrCl of 10 ml/min or less, whereas others were elevated already in patients with a CrCl below 40 ml/min; 2) in 12 patients with a CrCl between 13 and 39 ml/min, lipase tended to be less frequently raised than others, except elastase I, although the difference was statistically insignificant; 3) in 28 patients with a CrCl between 40 and 74 ml/min, lipase was less frequently elevated than others, except elastase I and PLA2; 4) in seven patients with a CrCl of 10 ml/min or below, elastase I tended to be less frequently elevated than others, although the difference was statistically insignificant; and 5) the degree of elevation was within 2.5 times the upper limits of reference values in all enzymes, except trypsin(ogen) (within 4.8 times).

CONCLUSIONS

Elastase I was least vulnerable to impaired renal function followed by lipase. We, therefore, recommend combined assays of elastase I and lipase for detecting pancreatic diseases in patients with renal insufficiency. When cut-off levels are set at 2.5 times the upper limit of reference values, P-amylase or PLA2 can replace lipase.

Non-radioactive mismatch analysis to detect small mutations in human hypoxanthine-guanine phosphoribosyl transferase cDNA

We have combined a cDNA-driven PCR technique and a non-radioactive chemical-cleavage mismatch method, followed by a direct sequencing for detecting small mutations in the human hypoxanthine-guanine phosphoribosyl transferase (HPRT) gene. HPRT cDNA was synthesized by RT-PCR from 1,000 wild-type or HPRT(-) mutant cells. Wild-type cDNA was hybridized with mutant cDNA to form heteroduplexes. The resultant mismatched bases were modified and cleaved by base-specific chemicals, followed by analysis by denaturing polyacrylamide gel electrophoresis. Cleaved fragments were detected without using radioactive materials. Finally, direct sequencing of the PCR products was performed with a focus on a small limited region indicated by the mismatch analysis (focused sequencing). In this study, three small mutations in exon-3 of HPRT cDNA were detected and characterized completely with this system. As compared with the radioactive method, this system was shown to be very simple and efficient.

[Low incidence of point mutation of N-ras oncogene in human gliomas]

We examined the incidence of point mutations in codon 12 and 61 of N-ras gene in human gliomas using PCR with mismatched primers. This method detects point mutations. PCR with mismatched primers induced restriction sites in normal DNA but not in mutational DNA. Genomic DNAs were extracted from paraffin-embedded tissues and were amplified with nested PCR. Among 17 cases, point mutation has not been able to be found so far, when examined in codon 12 of N-ras gene and among 10 cases in codon 61 of N-ras gene. It can thus be said that point mutational activation of N-ras oncogene is an uncommon event in human gliomas.

Risk of gallstones following gastrectomy in Japanese men

The risk of gallstones developing after gastrectomy in middle-aged Japanese men was investigated in a study of 2,738 men aged between 48 and 56 years who underwent both gallbladder ultrasonography (US) and a barium study of the upper digestive tract. It was revealed that 61 men had gallstones, 37 had had their gallbladder removed previously, and 55 had a history of gastrectomy. The prevalence of gallstones was 3.5 times higher in the men who had previously undergone gastrectomy (7.7%) than in those who had not (2.2%) (P = 0.03). Moreover, gallstones tended to be more prevalent in those who had undergone Billroth II gastrectomy (12.5%) compared with those who had undergone Billroth I gastrectomy (5.6%); however, the difference was not significant. These results indicate that gastrectomy using either Billroth I or Billroth II reconstruction predisposes to gallstone formation. Nevertheless, it was estimated that prior gastrectomy was responsible for no more than 5% of gallstones in the study population.

[Transient cerebellar mutism after removal of a posterior fossa tumor in two cases]

We have reported the cases of two young patients who presented transient mutism in the course of recovery from removal of a cerebellar medulloblastoma. Although cerebellar symptoms were observed immediately after surgery, neither consciousness disturbance nor sensory aphasia was observed when the patients were mutic. From the analysis of serial magnetic resonance imaging (MRI). Gd-enhanced regions were noticed in the dentate nucleus and the cerebellar peduncle when mutism appeared, and they disappeared when mutism was gone. Although the mechanism of this interesting symptom is not clear, these MRI findings may indicate that focal ischemia or edema associated with surgical procedure may play a role in the appearance of this symptom.

Nuclear characterization and G2M ploidy in human brain tumors using semiautomated image analysis

We used image analysis to study nuclear morphometry and DNA content in relation to time to tumor progression in a series of 88 patients with brain tumors. Clinical follow-up was obtained for 73 patients. The patients with diploid tumors had a longer time to tumor progression than those with triploid, tetraploid, or hypertetraploid tumors. Mean SG2M-DNA indices (DIs) increased significantly with a increase in mean DIs in all tumors. The mean DIs appeared to be dependent on the number of SG2M phase cells. We conclude that tumors with hypertetraploid in G2M ploidy are highly malignant. Those tumor cells have a large nuclear size, much deformity in nuclear shape, and great proliferative potential. The G2M-tetraploid tumors showed a shorter time to tumor progression when the number of SG2M fractions was large. In contrast, the G2M-hypotetraploid tumors showed a longer time to tumor progression in comparison with other tetraploid and hypertetraploid tumors, but the difference was not significant.

Leukoencephalopathy associated with intra-arterial ACNU in patients with gliomas

Thirty cases of gliomas treated by surgery, radiotherapy and intra-arterial (IA) ACNU were reviewed with a focus on the late side-effect known as leukoencephalopathy. All cases were classified into three groups; remission (10 cases), regrowth (15 cases) and leukoencephalopathy (5 cases) from their outcome. The average total doses of IA ACNU were 49.8 mg/sqm body surface area in the remission group, 157.3 mg/sqm in the regrowth group and 203.1 mg/sqm in the leukoencephalopathy group. There were significant differences in the total IA ACNU doses between the remission group and both regrowth and leukoencephalopathy groups, while no significant differences were noticed in the dose of radiation given. There was a correlation between the total dose of IA ACNU and the occurrence of leukoencephalopathy. An autopsy of a typical case of leukoencephalopathy revealed various degrees of myelin breakdown and thickening of arterial walls, which probably manifested progressive dementia accompanied by urinary incontinence and gait disturbance.

Charged-particle mutagenesis II. Mutagenic effects of high energy charged particles in normal human fibroblasts

The biological effects of high LET charged particles are a subject of great concern with regard to the prediction of radiation risk in space. In this report, mutagenic effects of high LET charged particles are quantitatively measured using primary cultures of human skin fibroblasts, and the spectrum of induced mutations are analyzed. The LET of the charged particles ranged from 25 KeV/micrometer to 975 KeV/micrometer with particle energy (on the cells) between 94-603 MeV/u. The X-chromosome linked hypoxanthine guanine phosphoribosyl transferase (hprt) locus was used as the target gene. Exposure to these high LET charged particles resulted in exponential survival curves; whereas, mutation induction was fitted by a linear model. The Relative Biological Effect (RBE) for cell-killing ranged from 3.73 to 1.25, while that for mutant induction ranged from 5.74 to 0.48. Maximum RBE values were obtained at the LET of 150 keV/micrometer. The inactivation cross-section (alpha i) and the action cross-section for mutant induction (alpha m) ranged from 2.2 to 92.0 micrometer2 and 0.09 to 5.56 x 10(-3) micrometer2, respectively. The maximum values were obtained by 56Fe with an LET of 200 keV/micrometer. The mutagenicity (alpha m/alpha i) ranged from 2.05 to 7.99 x 10(-5) with the maximum value at 150 keV/micrometer. Furthermore, molecular analysis of mutants induced by charged particles indicates that higher LET beams are more likely to cause larger deletions in the hprt locus.

Basal ganglia germinoma with crossed cerebellar diaschisis--case report

An 8-year-old boy presented with a germinoma of the right basal ganglia manifesting as gradual onset of mild left hemiparesis. Computed tomography (CT) and magnetic resonance imaging disclosed a mass lesion in the right basal ganglia with mild right cerebral hemiatrophy. Single photon emission CT revealed decreased cerebral blood flow in both the right cerebral and left cerebellar hemispheres, or crossed cerebellar diaschisis. The histology of a specimen from a stereotactic needle biopsy was compatible with two-cell pattern germinoma. After irradiation and chemotherapy, the mass lesion disappeared completely. The clinical symptoms and crossed cerebellar diaschisis gradually improved.

[Clinical relevance of abdominal imaging examinations in malignant lymphoma]

We prospectively evaluated the clinical importance of abdominal imaging examinations (US, CT, upper gastrointestinal barium X-ray) in 233 consecutive patients who gave informed consent for the examinations. The examinations revealed intra-abdominal lesions in 99 of 233 patients. Intra-abdominal lymph nodes were most frequently affected, followed by stomach, spleen, liver, small intestine and large intestine. In Hodgkin's lymphoma, no gastrointestinal involvement was noted but one in the small intestine. Prognosis was poorer with advancing stage according to Ann Arbor classification. However, the presence or absence of intra-abdominal lesions did not influence the prognosis when patients were matched for the stage. Abdominal imaging examinations altered the bed-side staging to more advanced stages in 22 of 163 patients with stage I through stage III lymphoma, influencing prognosis as well as the decision of therapeutic modalities. These three diagnostic modalities were complementary to one another. In conclusion, every one of these abdominal imaging examinations is important for planning the management of patients with malignant lymphoma.

[Leiomyosarcoma of ileocecal mesentery--a case report]

We report a case of leiomyosarcoma whose origin was near the root of ileocecal mesentery and extended into the retroperitoneum. Preoperative imaging examination, including CT, MRI and angiography clearly displayed its origin and retroperitoneal extension. These results contributed to treatment planning.

Giant aneurysm at the junction of the left internal carotid and persistent primitive trigeminal arteries--case report

A 67-year-old female presented with an unruptured giant aneurysm at the junction of the left internal carotid artery (ICA) and the persistent primitive trigeminal artery (PTA), manifesting as progressive left abducens nerve paresis. The PTA was clipped by the left suboccipital approach. The aneurysm was then successfully thrombosed by ligation of the left ICA at the cervical portion following left superficial temporal artery-middle cerebral artery anastomosis. The left abducens nerve paresis improved postoperatively. Magnetic resonance imaging was of considerable value in the pre- and postoperative evaluation of the giant aneurysm.

Commitment reversion model of unrestricted cell growth

Through the analysis of accumulated experimental data of cell growth, a model of unrestricted cell growth is presented here. This model is based hypothetically on the cellular commitment to senescence as in the previously presented commitment theory. Cells are divided into 3 types, namely uncommitted cells, committed cells and terminal cells. The division of an uncommitted cell produces an uncommitted cell itself and a committed cell of the first generation. This committed cell goes through a limited number of cell divisions until the cells become non-dividing terminal cells. It is hypothesized that during a committed cell division, there is a very small probability that an uncommitted cell may be generated. With computer simulations, it is estimated that a committed cell of the first generation may divide around 30 times until they become non-dividing terminal cells, and that the probability of an uncommitted cell regeneration for each committed cell division may be 2(-H). This hypothesis may possibly clarify some aspects of the biological phenomena of cell growth, which can not be explained by the previous commitment theory, such as the growth pattern of cultured diploid cells, cancer initiation and promotion, and cancer progression and metastasis.

Charged-particle mutagenesis. 1. Cytotoxic and mutagenic effects of high-LET charged iron particles on human skin fibroblasts

Cytotoxic and mutagenic effects of high-LET charged iron (56Fe) particles were measured quantitatively using primary cultures of human skin fibroblasts. Argon and lanthanum particles and gamma rays were used in comparative studies. The span of LETs selected was from 150 keV/microns (330 MeV/u) to 920 keV/microns (600 MeV/u). Mutations were scored at the hypoxanthine guanine phosphoribosyl transferase (HPRT) locus using 6-thio-guanine (6-TG) for selection. Exposure to these high-LET charged particles resulted in exponential survival curves. Mutation induction, however, was fitted by the linear model. The relative biological effectiveness (RBE) for cell killing ranged from 3.7 to 1.3, while that for mutation induction ranged from 5.7 to 0.5. Both the RBE for cell killing and the RBE for mutagenesis decreased with increasing LET over the range of 1.50 to 920 keV/microns. The inactivation cross section (sigma i) and the action cross section for mutation induction (sigma m) ranged from 32.9 to 92.0 microns2 and 1.45 to 5.56 X 10(-3) microns2; the maximum values were obtained by 56Fe with an LET of 200 keV/microns. The mutagenicity (sigma m/sigma i) ranged from 2.05 to 7.99 X 10(-5) with an inverse relationship to LET.

Blocking type immunoglobulins in patients with nongoitrous primary hypothyroidism in area of iodine deficiency

We have evaluated the role of circulating serum immunoglobulins (IgG) which inhibit the growth of thyroid in the etiology of thyroid atrophy in endemic cretinism. Twenty nongoitrous cretins (13 women and 7 men, age range: 9-33) were classified on the basis of clinical criteria for cretinism in China. They were born and living in an iodine deficient area, Xinjiang, northwest China. Antimicrosomal antibody titers were negative in all serum. Nine patients (seven women and two men; age range: 11-23) were biologically primary hypothyroid. Seven subjects were of a myxedematous form and two subjects were of a mixed form. We have studied thyroid-growth inhibiting immunoglobulin (TGII) activity that was measured as an inhibitory effect of 4 mg/ml IgG on TSH-induced [3H]-thymidine incorporation into the DNA of a rat thyroid follicular cell line, FRTL5 cells. Six (five women and one man) out of the nine patients with primary hypothyroidism (66.7 percent) had TGII. We also measured other growth-blocking IgG that inhibited [3H]-thymidine incorporation into DNA stimulated by insulin-like growth factor-I (IGF-I), a growth factor working through a cAMP-independent pathway. Five (three women and two men) out of nine patients (55.6 percent) with nongoitrous primary hypothyroidism had IGF-I-blocking IgG. These results indicate that TGII plays an important role in atrophy of the thyroid in spite of increased serum TSH concentrations, and IgG which inhibits thyroid growth stimulated by IGF-I also might play a role in thyroid atrophy in some endemic cretins.(ABSTRACT TRUNCATED AT 250 WORDS)

[Amplification of L-myc oncogene in malignant meningioma. Case report]

Amplification of L-myc oncogene was noticed in a malignant meningioma originating from the right sphenoidal wing of a 54-year-old female. The patient underwent three surgical resections plus radiotherapy over a period of 11 years and then the growth rate of the tumor became much greater with a severely invasive appearance. Using Southern blot hybridization, L-myc amplification was examined on the specimen resected at the fourth operation. As a result, approximately five-fold amplification was confirmed, which has not been previously reported except for that in a small cell carcinoma of the lung. This result may suggest that L-myc amplification is responsible to some extent for the malignant transformation in this meningioma.

Isolated cerebral varix with magnetic resonance imaging findings--case report

A rare case of isolated cerebral varix of the left deep sylvian vein was discovered incidentally in an 11-year-old boy by computed tomographic scanning, magnetic resonance (MR) imaging, and cerebral angiography. MR imaging was most useful in diagnosis of cerebral varix. Review of 21 similar reported cases shows no significant in age, sex, location, or size character.

Thyroid atrophy in myxedematous endemic cretinism: possible role for growth-blocking immunoglobulins

We have examined the ability of IgGs obtained from 8 endemic cretins to inhibit TSH-stimulated thyroid cell growth in culture. Clinical and laboratory evidence for hypothyroidism was present in six subjects; the two remaining patients had borderline low serum T4, normal T3 and exaggerated TSH response to TRH. In six patients 2 mg IgG exhibited an inhibitory effect in the cellular growth expressed by a diminished incorporation of 3H-thymidine into the DNA of TSH-stimulated FRTL-5 cells (range: 26-87% inhibition). Seven patients presented clinically with thyroid atrophy of relatively small thyroid enlargements for the degree of chronic iodine deficiency that was present in the area. The remaining subject had a large multinodular goiter and IgG purified from this patient had no inhibitory effect in the FRTL-5 cellular growth. A direct relationship was noted between the degree of thyroid growth inhibition (%) and the basal serum TSH concentration. We conclude that the presence of thyroid growth inhibiting immunoglobulin may be related to the absence of thyroid growth or even thyroid atrophy in endemic cretins.

Soluble factors including proteinases released from damaged cells may trigger the wound healing process

The wound healing process is initiated as soon as tissue is injured. Herein, we demonstrate that c-fos and c-myc mRNA transcripts are promptly increased in the wounded tissue in vivo and in vitro. A buffer solution from scraped serum-starved quiescent fibroblasts, when added to resting fibroblasts, caused the increase of c-fos and c-myc mRNA among the indicator cells. Soluble factors contained in the wounding supernatant are responsible for these phenomena and we call them wounding factors. Addition of proteinase inhibitors to the culture medium drastically reduced the c-fos mRNA induction by the wounding factors. Exogenously added trypsin or thrombin mimicked the activity of wounding factors. These results suggest that wounding causes soluble factors including various proteinases to be released from the damaged cells, which trigger the adjacent cells to respond to the injury.

Differential expression of N-myc and c-src proto-oncogenes during neuronal and schwannian differentiation of human neuroblastoma cells

Neuroblastoma (NB) cells can be induced to differentiate bidirectionally into either neuronal or schwannian cells by different inducers. However, the underlying mechanisms are poorly understood. We examined the expression of N-myc and c-src genes in 3 human NB-cell lines during either neuronal or schwannian differentiation in vitro, since proto-oncogenes are considered to play a pivotal role in regulating cell proliferation and differentiation. Decreased N-myc expression and increased c-src expression were observed during neuronal differentiation by retinoic acid, polyprenoic acid (E5166) and dibutyryl cyclic AMP, whereas the expression of N-myc and c-src genes was considerably reduced during schwannian differentiation by bromodeoxyuridine, demonstrating that the expression of N-myc and c-src genes was regulated independently in the bipolar differentiation processes of NB cells. Our results suggest that enhanced N-myc expression might be closely linked to the undifferentiated phenotypes of NB cells, that c-src expression might be related to the neuronal differentiation of NB cells, and that N-myc and c-src genes might be regulated independently in the determination of the bipolar differentiation of NB cells.