Lifestyle and anti-Helicobacter pylori immunoglobulin G antibody among outpatients

Since eradication of Helicobacter pylori (H. pylori) is thought to be a preventive measure against stomach cancer, several studies have examined factors associated with the infection. This paper reports the association of the infection with lifestyle factors observed in a hospital-based case-control study. Cases were 140 anti-H. pylori IgG antibody-positive outpatients (75 males and 65 females). Controls were 52 antibody-negative outpatients (22 males and 30 females). Both groups had undergone gastroscopy at Aichi Cancer Center Hospital between February 1995 and February 1997, and lifestyle data collected on the first visit were linked to calculate odds ratios. A strong association was observed with smoking among males; age-adjusted odds ratio (OR) = 7.85, 95% confidence interval (CI), 2.03-30.4. Rice breakfast (OR = 3.74; 95% CI, 1.30-10.8) and soybean paste soup (every day vs. occasionally, OR = 5.24; 95% CI, 1.80-15.2) were also associated with antibody positivity in males, but not in females. In females, pickled Chinese cabbage (> or = 1/week vs. < or = 3/month, OR = 2.82; 95% CI, 1.06-7.48) and lettuce (> or = 1/week vs. < or = 3/month, OR = 2.90; 95% CI, 1.09-7.76) were significantly associated with positivity. Multivariate analysis gave similar estimates for the above factors. Although the association between smoking and H. pylori infection has not been detected in past studies of a general population, except one recent one, this study on outpatients suggested a possible association. Smoking may work as a cofactor disturbing incidental eradication of H. pylori by antibacterial agents administered for other reasons.

[Regional pulmonary function by 133Xe gas and 99mTc-MAA in 11 cases with lymphangiomyomatosis (LAM)]

The evaluation of the regional distribution of ventilation and perfusion was performed by 133Xe gas and 99mTc-MAA in 11 patients with LAM. We divided the lung images into six lung regions, the upper, middle, and lower lung fields of the left and right lungs, and classified the ventilation distribution pattern as one of three types according to the washout time. Prolongation of mean transit time (MTT) predominantly in the lower lung field was classified as type a, predominantly in the middle and upper lung fields as type b, and diffuse prolongation of MTT throughout the lung as type c. The classification included 16 cases of type b, four of type a, and two of type c. The 133Xe washout was predominantly delayed in the middle and upper lung fields in 73% of LAM cases. Pulmonary perfusion was reduced in the middle lung field and relatively increased in the lower lung field in comparison with healthy controls. A follow-up study of 133Xe gas lung scan was performed in three cases of type b. All the cases deteriorated and presented obstructive and restrictive disturbances without changes in the distribution pattern. These findings suggested that the washout type did not change with the progress of the stage of the disease.

[Oligomelanotic malignant melanoma in the nasal cavity diagnosed by IMP scintigraphy]

MRI, 67Ga scintigraphy, and 123I-IMP-SPECT were performed in the patient with oligomelanotic malignant melanoma in the nasal cavity which is not confirmed pathologically at first. MRI failed to diagnose the tumor as malignant melanoma. It was difficult to differentiate malignant melanoma from malignant lymphoma in 67Ga scintigraphy. The remarkable accumulation of 123I-IMP was consistent with the tumor localization in the nasal cavity. This tumor uptake was thought to be oligomelanotic or amelanotic melanoma since the accumulation was more distinctive at the delayed image and since the tumor was not visibly melanotic. Finally the tumor was confirmed to be oligomelanotic melanoma by immunohistochemical examination; which was in accordance with IMP-SPECT findings. Oligomelanotic or amelanotic melanoma occurs in nasal cavity with high frequency. We report here the oligomelanotic melanoma case where IMP-SPECT was rather useful to make a pathological diagnosis than other imaging modalities.

Dietary and lifestyle correlates of passive smoking in Hong Kong, Japan, Sweden, and the U.S.A

From epidemiologic studies in several countries, passive smoking has been associated with increased risk for lung cancer, respiratory diseases, and coronary heart disease. Since the relative risks derived from those studies are weak, i.e. relative risk less than two, we investigated whether poorer diets and less healthy lifestyles might act as confounders and be correlated with having a smoking husband on a cross-cultural basis. Characteristics of never-smoked wives with or without smoking husbands were compared between 530 women from Hong Kong, 13,047 from Japan, 87 from Sweden, and 144 from the U.S. In all four sites, wives with smoking husbands generally ate less healthy diets. They had a tendency to eat more fried food but less fruit than wives with nonsmoking husbands. Other healthy traits, e.g. avoiding obesity, dietary cholesterol and alcohol, or taking vitamins and participating in preventive screening were also less prevalent among wives with smoking husbands. These patterns suggest that never-smoked wives with smoking husbands tend to share the same less healthy dietary traits characteristic of smokers, and to have dietary habits associated with increased risk for lung cancer and heart disease in their societies. These results emphasize the need to take into account the potential confounding effects of diet and lifestyle in studies evaluating the health effects of passive smoking, especially since it is known that the current prevalence rates of smoking among men is indirectly associated with social class and education in affluent urban societies.

Changes in DNA copy number in primary gastric carcinomas by comparative genomic hybridization

We examined 33 primary gastric carcinomas using comparative genomic hybridization to detect changes in the DNA copy number and the chromosomal location of these changes. Ninety-four percent (31 of 33) showed 1 or more DNA copy number changes, such as increases at 2p23-p25 (observed in 21% of the total cases), 3q26.3-q27 (24%), 7p15 (24%), 9p22-pter (18%), and 13q22-q34 (21%) and decreases at 1p34.2-p36.2 (18%) and Y (52%). Histological examination indicated that increases at 3q26.1-q26.3 and 7p15 and decreases at 1p36.1-p36. 2 and Y were commonly observed in both differentiated and undifferentiated types. Increases at 3q27, 6q23-q25, and 7cen-p14 and decreases at 1p34.2-p35 and 17p12 were predominantly observed in the differentiated type, and increases at 2p23-pter, 9p22-pter, and 13q31-qter and a decrease at 6p21.3 were predominantly observed in the undifferentiated type. In addition, clinical staging of tumors showed that increases at 2p23-p25, 7p14-p21, 7q31-q32, and 9p22-pter and a decrease at Y were observed in early-stage tumors, whereas increases at 9q32-q33 and 15q26 were observed only in late-stage tumors. Many of the abnormalities detected in this study were not previously reported in gastric carcinomas. Our comparative genomic hybridization results indicate the presence of genetic alterations that may play some important role in the development and progression of gastric carcinomas.

Cerebral revascularization by omental free flap using contralateral superficial temporal vessels as recipient vessels: case report

BACKGROUND

Although the most common technique of cerebral revascularization is superficial temporal artery to middle cerebral artery bypass, we occasionally encounter a situation in which the ipsilateral superficial temporal artery is not available. Treatment may require several techniques including long vein graft bypass.

METHODS

A 54-year-old man experienced transient ischemic attacks, and cerebral angiography revealed occlusion of the right common carotid artery. Cerebral blood flow study revealed reduced perfusion reserve capacity of the right cerebral hemisphere. We applied an omental free flap to the brain surface using the contralateral superficial temporal vessels as recipient vessels.

RESULTS

Cerebral blood flow study revealed improvement of perfusion reserve capacity. Cerebral angiography revealed good collateral circulation from the omentum to the brain. The patient has not experienced a transient ischemic attack, following additional ligation of the occipital artery 13 months after the first operation.

CONCLUSIONS

Because an omental flap has a long pedicle and its circulation can be monitored easily, this method is safe and as effective as a long bypass graft in a patient such as ours in whom the ipsilateral superficial temporal artery is not available for anastomoses.

Cerebral revascularization using latissimus dorsi muscle free flap transfer--technical note

A method for cerebral revascularization using latissimus dorsi muscle free flap transfer is described. Latissimus dorsi muscle is harvested with thoracodorsal vessels after completion of craniotomy and exposure of superficial temporal vessels. The size of muscle belly which is harvested is dependent on the area where the revascularization is necessary. Microvascular anastomoses of superficial temporal vessels and thoracodorsal vessels are performed in end-to-end fashion. A 31-year-old male patient with moyamoya syndrome was treated by this method. Postoperative angiography demonstrated successful revascularization in the affected hemisphere, with improved perfusion reserve capacity shown by cerebral blood flow study. This type of encephalo-myo-synangiosis (with free muscle flap) is a possible method when vascular reconstruction of an extensive ischemic area which involves anterior and posterior cerebral artery territories is needed in a patient with moyamoya disease or other similar ischemic conditions.

Arterialized occipitoparietal osteocutaneous flap

We treated a case of postoperative osteomyelitis and epidural abscess in the left temporal and parietal region. The scalp and skull defect following debridement was reconstructed immediately with an arterialized occipitoparietal osteocutaneous flap that was supplied proximally by the occipital artery and distally by the superficial temporal artery. This method is one of the alternative methods for small to moderately sized skull and scalp defects in the temporal, parietal, and occipital areas without available superficial temporal artery.

An ecological study on diet/nutrition and cancer in Japan

Correlation or ecological studies may be useful in identifying cancer risk factors which are distributed relatively homogeneously within a population, but differ greatly between populations or between different periods within a given population. In Japan, the westernization of dietary habits has progressed remarkably in the last few decades and may have resulted in changes of incidence/mortality rates of diet-related diseases, especially cancer. Based on data from the National Nutritional Survey of Japan (1955-1993) and the vital statistics of Japan (1955-1993), we conducted correlation analyses between food/nutrient intake and cancer mortality. The present study on chronological correlations suggests the relationship between westernized dietary habits and mortality by cancers of the colon, breast, ovary and prostate and also the relationship between traditional Japanese dietary habits and mortality by stomach cancer. Our results suggest the importance of diet in the etiology of diet-related cancer. Further observation and analyses are needed to confirm the relationship between food/nutrient intake and cancer mortality, while also considering the consumption of tobacco and alcohol and improvement in cancer diagnostic and therapeutic techniques.

The expression of ST2 gene in helper T cells and the binding of ST2 protein to myeloma-derived RPMI8226 cells

The ST2 gene, which is specifically induced by growth stimulation, encodes interleukin-1 receptor-related proteins. Using the RT-PCR method, we found that the ST2 gene was broadly expressed in hematopoietic cell lines. It was also expressed specifically in helper T cell lines among lymphocytic cell lines. We analyzed the expression of ST2 in mouse helper T cell subsets with Northern blotting analysis. Mouse Th1 cell lines so far studied did not express ST2 mRNAs. On the other hand, one of the Th2 cell lines, D10, expressed ST2L (transmembrane form) without stimulation, while co-stimulation by PMA and A23187 induced ST2 (soluble form) mRNA. These results suggest that the ST2 gene is involved in the regulation of the immune system. IL-1 alpha, IL-1 beta, and receptor antagonist did not bind to ST2L protein, which prompted us to search for the specific ligand of ST2. The recombinant human ST2 protein was purified and labeled with FITC. The labeled human ST2 protein bound with myeloma-derived RPMI8226 cells among the various B-cell lines, indicating possible involvement of ST2 in T-cell/B-cell interaction.

Epidemiological features of first-visit outpatients in Japan: comparison with general population and variation by sex, age, and season

To evaluate the methodological issues in using first-visit outpatients as controls in epidemiological studies, the features of general lifestyles of non-cancer outpatients at Aichi Cancer Center Hospital (ACCH) were compared with those of the general population, and their variation by sex, age, and season was determined by using a self-administered questionnaire. The study included 1231 subjects randomly selected from the Nagoya electoral roll (CRG), and three groups of non-cancer ACCH outpatients living in Nagoya; 800 from the period September to December 1992 (OPG1), 2326 from January to December 1992 (OPG2), and 12,243 from January 1991 to December 1992 (OPG3). In the younger age group, the proportion of current smokers was higher in the CRG than in the OPGs. In the older age groups, the proportion of those who consumed fresh vegetables and fruit everyday was higher in the OPGs than in the CRG. For other items, the features of the OPGs were not significantly different from those of the CRG. Among the OPG3, there were differences in the features of general lifestyles between sexes and consumption of several food items varied with age. Seasonal variation, however, was only observed in the specific food items where supply varied seasonally. It was concluded that, with due consideration of age, sex, and season in the analysis, it is feasible to use non-cancer outpatients as controls in epidemiological studies.

Presence of human papillomavirus type 6f in tonsillar condyloma acuminatum and clinically normal tonsillar mucosa

An attempt was made to detect human papillomavirus (HPV) in 8 cases of oral papilloma by Southern blot hybridization. HPV type 6 was identified in a case of tonsillar condyloma acuminatum, but neither HPV type 6 nor 11 was found in the 7 other cases of squamous papilloma. The hybridization pattern of the HPV type 6 DNA after digestion with restriction enzymes revealed that the HPV was of the 6f subtype. DNA samples isolated from the condyloma acuminatum, 3 peripheral specimens of clinically normal tonsillar mucosa, a swab sample and saliva from the male patient with this tonsillar condyloma acuminatum were examined further by polymerase chain reaction (PCR). HPV type 6 DNA was detected in the tonsillar condyloma acuminatum and the 3 specimens of clinically normal tonsillar mucosa, but no HPV type 6 DNA was detectable in the normal tonsillar mucosa by Southern blot hybridization using a whole HPV DNA probe. The presence of a small amount of HPV in clinically normal tissue detectable only by PCR suggests latent infection of peripheral tissues with HPV produced from the condyloma acuminatum. Although HPV type 6 DNA was not detectable in the swab and saliva samples of this single case, further study is necessary for the clinical application of preoperative virological diagnosis by PCR using these samples.

Cerebral revascularization using omentum and serratus anterior muscle free flap transfer for adult moyamoya disease: case report

BACKGROUND

Use of the omentum in the treatment of moyamoya disease is now widely accepted, and, especially in patients with ischemic symptoms of anterior or posterior cerebral artery distribution, omental transplantation or other indirect revascularizations are indicated.

CASE REPORT

A 39-year-old man, who developed left homonymous hemianopia, was discovered to have occlusion of the distal portion of bilateral internal carotid arteries. We performed indirect revascularization with an omental flap on the left cerebral hemisphere and a serratus anterior muscle flap on the right cerebral hemisphere.

RESULTS

Subsequent clinical course was uneventful. Cerebral blood flow study and angiography revealed good collateral circulation in both the omentum and muscle flap. The collateral circulation was more developed than that arising from the omental transfer on the contralateral side at the same postoperative period.

CONCLUSIONS

This type of encephalomyosynangiosis (EMS)-EMS with free muscle flap-is as effective as that with the omental flap in adult moyamoya disease. Especially in a patient who is in need of vascular reconstruction of an extensive ischemic area, serratus anterior muscle flap transfer is one of the alternative methods.

[Survival factors in healthy aging among rural Japanese residents of Aichi]

To investigate survival factors in healthy aging among rural Japanese elderly residents, a nested case-control study was conducted. Subjects who answered questionnaires in 1985 were followed for 10 years. Cases comprised 124 men and 109 women who, in 1995, were 75 years old or over, and whose activities of daily living were active enough to cope for themselves. Controls were selected from subjects who died between 1987 and 1994. One control per case was randomly selected, and matched to each case for sex and birth-year (+/- 2 years). The survival odds ratio (sOR) was calculated by using a conditional multiple logistic regression model. An sOR greater than 1.0 was observed for frequent intake of eggs, regular daily routine, adaptability to changes, leisure time exercise and a health examination at least once within 3 years. In both men and women present or past history of heart disease, cerebrovascular disease and diabetes, family history of hypertension, and in women, smoking were negatively associated with survival. By multivariate analysis, adaptability to change in men, and regular daily routine and health examinations in women were positively associated to survival. Smoking and history of chronic disease were negatively associated with survival, in both men and women. In conclusion, it is suggested that psychological factors and recent health examinations were positively associated to survival in healthy aging, and habitual smoking and chronic disease contributed negatively to survival. These results require further careful evaluation to determine whether the factors are associated with cause or effect.

Positive and negative host factors for Sendai virus transcription and their organ distribution in rat

In vitro mRNA synthesis by Sendai virus is almost entirely dependent on the addition of cellular proteins (positive host factors), one of which could be tubulin. In this study, we investigated the distribution of host factors in various rat organs. Extracts from the brain, thymus, heart, lung, testis, ovary, and uterus all supported in vitro Sendai virus transcription, among which the highest activity was obtained with the brain extract. On the other hand, little or no activity was detected in the liver, spleen, and kidney extracts. An inverse correlation between the apparent host factor activity to stimulate mRNA synthesis and RNase activity that hydrolyzes Sendai virus mRNAs was found, except in the liver extract. However, when a transcription initiation complex was isolated and subjected to RNA chain elongation reaction, all of the extracts including those from liver, spleen and kidney, were active. Immunoblotting showed that tubulin molecules were integrated in these initiation complexes, supporting the notion that tubulin is involved in the initiation complex formation. We also identified a transcription inhibitory activity without any detectable RNase activity in the liver extract. This negative host factor seemed to act on RNA chain elongation. It is likely that Sendai virus transcription is regulated by both positive and negative regulatory factors.

International cooperative research

The Special Cancer Research Program was newly established in 1984 within the existing International Scientific Research Program of the Monbusho (Ministry of Education, Science and Culture) as a part of "the Comprehensive 10-Year Strategy for Cancer Control" which was launched by the Japanese Government in 1984. The Comprehensive 10-Year Strategy for Cancer Control ended successfully 1993 and the Second 10-Year Program was started in 1994. When the Special Cancer Research Program started in 1984, the number of projects was 12 and the number of collaborating countries was 18. Since then the numbers of projects and collaborating countries have increased year by year to 27 projects and 30 collaborating countries in 1995. The cumulative (actual) number of projects from 1984 to 1995 was 216 (62) and the total number of collaborating countries was 57. Major topics covered by the Special Cancer Research Program are; exchanges of scientific information on cancer researches in advanced countries, viruses and parasites related to carcinogenesis, carcinogens/promoters and their inhibitors in the natural environment, migrant studies on cancer, studies on the etiology and prevention of cancers of special interest, and studies on diagnosis and treatment of cancer.

Cancer consequences of the Chernobyl accident in Europe outside the former USSR: a review

The accident which occurred during the night of April 25-26, 1986 in reactor 4 of the Chernobyl nuclear power plant in the Ukraine released considerable amounts of radioactive substances into the environment. Outside the former USSR, the highest levels of contamination were recorded in Bulgaria, Austria, Greece and Romania, followed by other countries of Central, Southeast and Northern Europe. Studies of the health consequences of the accident have been carried out in these countries, as well as in other countries in Europe. This report presents the results of a critical review of cancer studies of the exposed population in Europe, carried out on the occasion of the 10th anniversary of the Chernobyl accident. Overall, three is no evidence to date of a major public health impact of the Chernobyl accident in the field of cancer in countries of Europe outside the former USSR.

[Recent trends of epidemiological studies on cancer in Japan--personal experience and view of an epidemiologist]

As the number of cancer deaths has increased, the number of cancer researchers including cancer epidemiologists has increased. Compared to the approaching methods of epidemiologic studies on cardiovascular diseases, those of cancer epidemiology are different. In cancer epidemiology a case-control study has been used most frequently, while in cardiovascular disease epidemiology a cross-sectional study with health examinations in a defined population has been used most frequently. In the latter study a cross-sectional study has been repeated periodically forming a cohort study in a model area. Only few large scale cohort studies on cancer had been conducted previously, but in recent years several large scale cohort studies on cancer have been conducted by several research groups. In recent years there is a trend that epidemiologists in cancer, cardiovascular diseases and other related areas collaborate in conducting a large scale cohort study. Chemoprevention studies on cancer have been initiated by cancer epidemiologists in recent years.

Protective factor against progression from atrophic gastritis to gastric cancer--data from a cohort study in Japan

To investigate the association between atrophic gastritis and gastric cancer and to identify the risk and protective factors for the progression of atrophic gastritis to cancer, we conducted a prospective study on 5,373 subjects with neither cancer nor resected stomach who underwent gastroscopic examination and completed a life-style questionnaire. After an average of 6 years of follow-up, 69 gastric-cancer cases were identified, 65 from the subjects without atrophic gastritis and 4 from the subjects without atrophic gastritis. The presence of atrophic gastritis increased the risk of gastric cancer 2.19-fold, the risk trend increasing with the degree and the extension of atrophy [relative risk (RR) 1.60 for mild atrophy and 2.85 for moderate and severe atrophy]. Among the subjects with atrophic gastritis, family history of gastric cancer (RR 2.27) and a preference for spicy food (RR 1.84) increased the risk and self-administered meal controls, such as portion reduction (RR 0.44) reduction of salty food (RR 0.56) and the change to the consumption of easily digested food (RR 0.57) decreased the risk of gastric cancer. The results of this study suggest that atrophic gastritis increases the risk of gastric cancer but that dietary modification prevents the progression from atrophic gastritis to gastric cancer, regardless of pre-cancerous lesions.

Protective factor against progression from atrophic gastritis to gastric cancer--data from a cohort study in Japan

To investigate the association between atrophic gastritis and gastric cancer and to identify the risk and protective factors for the progression of atrophic gastritis to cancer, we conducted a prospective study on 5,373 subjects with neither cancer nor resected stomach who underwent gastroscopic examination and completed a life-style questionnaire. After an average of 6 years of follow-up, 69 gastric-cancer cases were identified, 65 from the subjects without atrophic gastritis and 4 from the subjects without atrophic gastritis. The presence of atrophic gastritis increased the risk of gastric cancer 2.19-fold, the risk trend increasing with the degree and the extension of atrophy [relative risk (RR) 1.60 for mild atrophy and 2.85 for moderate and severe atrophy]. Among the subjects with atrophic gastritis, family history of gastric cancer (RR 2.27) and a preference for spicy food (RR 1.84) increased the risk and self-administered meal controls, such as portion reduction (RR 0.44) reduction of salty food (RR 0.56) and the change to the consumption of easily digested food (RR 0.57) decreased the risk of gastric cancer. The results of this study suggest that atrophic gastritis increases the risk of gastric cancer but that dietary modification prevents the progression from atrophic gastritis to gastric cancer, regardless of pre-cancerous lesions.

Assignment of the human ST2 gene to chromosome 2 at q11.2

The human St2 locus has been assigned to chromosome 2, using a human ST2 cDNA clone, by a human/rodent somatic cel hybrid mapping panel. The St2 locus has also been mapped to chromosome 2q11.2, using a human ST2 genomic DNA clone, by in situ hybridization. The locus is very tightly linked to the Il-1r1 locus. Together with the structural similarity of ST2 to IL-1RI, these data suggest functional relationships between these two genes.

[Early detection in the mass screening for breast cancer]

Mass screening for breast cancer has been conducted in Japan mainly by physical examination, defined as a standard method in Law of the Health Services for the Aged. Detection rate of early breast cancer by physical examination ranged between 40 and 50%. To improve the detection rate of breast cancer at the early stage, some screening trials using a film mammography were carried out in recent years. Detection rates of early breast cancer in these trials were reported to be improved largely, suggesting the effectiveness of breast cancer screening would be improved by the screening with film mammography.

The possible risk of lower-limb sclerotherapy causing an extended hypercoagulable state

The risk of thrombosis after lower-extremity sclerotherapy is still an unresolved issue. This study was conducted to investigate the influence of sclerotherapy on coagulation and fibrinolysis by examining 20 patients who underwent surgical procedures, 10 of whom were treated by surgery alone (control group), while the other 10 were given sclerotherapy using 1% hydroxypolyaetoxydodecan as polidocanol (sclerotherapy group). Sex, age, and severity of disease was comparable between the two groups. No significant difference was found in the transient elevation of acute phase proteins, C-reactive protein (CRP), or fibrinogen. Thrombin antithrombin III complex (TAT), a marker of coagulation, transiently increased following treatment. In the control group, TAT peaked 3 days after treatment, whereas in the sclerotherapy group the elevation was prolonged, peaking 7 days after treatment. Elevation of the markers of fibrinolysis, plasmin plasmin inhibitor complex (PIC) and fibrin degradation products (FDP), was slower than that of TAT, peaking 7 days after treatment in both groups, the plasma PIC being significantly enhanced 7 days after treatment in the sclerotherapy group. A significant decrease in the platelet count was observed 3 days after treatment in the sclerotherapy group. These results suggest that sclerotherapy may enhance coagulation or fibrinolysis after surgical procedures.

[Quantitative flow measurement of the vertebro-basilar circulation for positional vertigo by using 2D phase contrast technique]

Quantitative measurements of blood flow in the vertebral and basilar arteries were obtained by the 2D phase contrast (2D PC) technique. In phantom study, flow velocity measured with 2D PC correlated well with actual flow velocity. Sixty-six patients were neurologically normal and 20 had positional vertigo due to vertebrobasilar insufficiency (VBI). Mean velocities (MV) were measured by using a transverse plane in the vertebral arteries at the level of C3 and in the basilar arteries at the level of the sella floor. Volume flow rates (VFR) were calculated as the product of MV and the area of the arteries whose diameters were measured on the basis of pixel counting in the histogram of the signal intensity profile. In the normal group, MV of the left vertebral artery and MV and VFR of the basilar artery showed significant declines as age progressed. In the vertigo group, MV and VFR of the basilar artery were significantly lower than in the normal group. It is concluded that 2D PC technique appears to be fast and easy to handle without cardiac gating to assess blood flow in vessels surrounded by bone tissues.

Single stage reconstruction of scalp and skull using free muscle flap and titanium mesh in patients with epidural infection

Simultaneous scalp and skull reconstruction using free muscle flap transfer and titanium mesh was performed in two patients with postoperative intracranial infection. The postoperative course in both patients was uneventful. The transferred flap was the latissimus dorsi muscle flap in one and a combination flap with the latissimus dorsi and serratus anterior muscle in another. The titanium mesh afforded satisfactory contour with only mild foreign-body reaction and could be applied simultaneously with the free muscle flap to the infected cranial wound.

Distinct mutational spectrum of the p53 gene in lung cancers from Chinese women in Hong Kong

Accumulating evidence suggests that the p53 gene is a good target for molecular epidemiological studies to search for risk factors in carcinogenic events. The lung cancer incidence for females in Hong Kong is unusually high, ranking among the highest in the world despite a low percentage with a history of smoking. To gain insights into possible etiological risk factors responsible for this high incidence, we examined p53 mutations in 35 lung cancer specimens from Chinese females living in Hong Kong and compared them with 35 matched cases from Japanese women as well as previously reported p53 mutations in the world literature. p53 mutations in exons 5-8 were present in 20 and 31% of the Hong Kong and Japanese cases, respectively. Notably, single-base deletions within runs of identical bases were observed in 3 (43%) of the 7 mutations in the Hong Kong cases, in contrast to the absence of such mutations in the controls and the extreme scarcity in the literature, suggesting that distinct environmental and/or genetic factor(s) might be involved. Although the frequent occurrence of characteristic single-base deletions could be a reflection of mutator mutations leading to inefficient mismatch repair of slipped strand mispairings, none of the lung cancer specimens exhibited such microsatellite instabilities.

Studies on natural ST2 gene products in the human leukemic cell line UT-7 using monoclonal antihuman ST2 antibodies

Eight species of murine monoclonal antibodies against human ST2 protein, which is highly similar in protein sequence to the interleukin 1 receptor, were produced. The fusion was carried out between the murine myeloma cell line PAI and murine lymph node or spleen cells from mice immunized with the recombinant ST2 protein produced in Escherichia coli. Characterization of these monoclonal antibodies by immunoblot analysis revealed that they all reacted with recombinant, N-glycosylated ST2 protein that was secreted from COS7 cells transiently transfected with a mammalian expression vector carrying ST2 cDNA. The recombinant N-glycosylated ST2 protein could be immunoprecipitated by 5 out of 6 species of the IgG class monoclonal antibodies. Furthermore, these antibodies were also able to detect, by immunofluorescence, the membrane-bound chimeric molecule possessing an extracellular portion of human ST2 and a transmembrane and cytoplasmic portion of murine receptor type ST2L expressed on COS7 cells, indicating that these monoclonal antibodies were useful for detecting the natural membrane-bound ST2 in human cells. Combining immunoprecipitation and immunofluorescence with the aid of these monoclonal antibodies, together with the reverse transcriptase-polymerase chain reaction method, the human leukemic cell line UT-7 was demonstrated to express human ST2 mRNA and protein. The identification of the ST2 gene product in UT-7 cells may help investigators elucidate the function of the human ST2 gene.

[Physicochemical characterization and lung clearance of pertechnegas]

Pertechnegas, which is a variant of technegas, is an ultrafine carbon aerosol formed inside a technegas generator in the presence of 3% oxygen and 97% argon. The easy extractability of the pertechnegas in the phosphate buffered saline (PBS), the distribution seen in rats after intravenous injection of the pertechnegas and the results of the radiochromatography showed that the pertechnegas behaved like pertechnetate (TcO4-). In vivo study, the clearance half time (T1/2) of inhaled pertechnegas has shown no significant difference to that of TcO4- aerosol in 7 normal subjects. T1/2 of the pertechnegas was considerably faster in comparison with T1/2 of DTPA aerosol. However, T1/2 of the pertechnegas was more rapid in 6 smokers compared with T1/2 in 4 nonsmokers (p < 0.01), and was also increased in the upper lung field compared with the lower lung field (p < 0.01); these results closely correlate with those obtained with DTPA aerosol. Further study of the clearance of the pertechnegas in pulmonary diseases is required to assess clinical usefulness.

Purification and N-terminal sequence of a novel interferon-induced 100 kD protein secreted by mouse Ehrlich ascites tumor cells

Mouse Ehrlich ascites tumor cells secrete a 100 kD protein when they are stimulated by murine interferon-beta (2000 IU/ml). This 100 kD protein was purified from conditioned medium by chromatography on phenyl-Sepharose CL-4B, phosphocellulose, DEAE-Sephacel, and Vydac C4 columns and preparative sodium dodecyl sulfate-polyacrylamide gel electrophoresis. A single species of 100 kD protein was isolated, and its N-terminal sequence analysis suggested that mouse Ehrlich ascites tumor cell-derived interferon-induced 100 kD protein is a novel protein.

Epidemiology of breast cancer in Japan

The mortality and incidence of breast cancer are high in Western industrialized countries and relatively low in developing countries in Asia and other parts of the world. In Japan the mortality of breast cancer has gradually been increasing, but is still much lower compared with that of Western countries. Within Japan the mortality of breast cancer is higher in urban areas than in non-urban areas. The future estimation of cancer incidence in Japan predicts that breast cancer will become a leading cancer in the near future.

[Recent trends in cancer in Japan and the world]

In Japan, the age-adjusted mortalities of cancer of the stomach, uterus, liver (females only) and esophagus (females only) have been declining in recent years, whereas those of cancer of the lung, large intestine, pancreas, bile ducts, prostate and ovary have been increasing. The pattern of cancer among Japanese seems to be approaching that in Western countries. Although cancer screening and improvements of diagnostic and therapeutic techniques may have contributed to the changes in cancer mortality, the main reasons for these changes may be due to changes in environmental factors such as tobacco and diet. The mortalities of cancer of the stomach, bile ducts and liver are relatively high in Japan compared to those of foreign countries, while those of cancer of the breast, uterus, lung and colon are relatively low.

Vascularized omental graft to brain surface in ischemic cerebrovascular disease

The application of vascularized omental graft for the treatment of four patients with ischemic cerebrovascular disease is presented. The superficial temporal artery and vein were used as recipient vessels, and vascular anastomosis was applied in an end-to-end fashion. The distal parts of the omentum were exteriorized as monitoring segments for about 1 week. Angiography and cerebral blood flow (CBF) studies were performed in all patients postoperatively. There were no major complications, and all patients showed increases of CBF and apparent clinical improvement. It is suggested that this method is effective in selected patients with ischemic cerebrovascular disease.

The existence of a growth-specific DNA binding factor for the promoter region of mouse ST2 gene

A comparison of the 5'-flanking regions of human and mouse ST2 genes revealed the presence of two highly conserved DNA sequences. The promoter activity assay with a luciferase gene as a reporter showed that the deletion of the upstream conserved region diminished the transcriptional activity in growing BALB/c-3T3 cells. By electrophoretic mobility-shift analysis, the presence of a factor that binds to the positive regulatory region of the mouse ST2 gene was found in growing but not in quiescent BALB/c-3T3 cells. These results suggest the functional importance of this conserved region and the requirement of a binding factor for the expression of the ST2 gene.

[A case of dural arteriovenous malformation on the convexity adjacent to the superior sagittal sinus]

A case of dural arteriovenous malformation (DAVM) on the convexity adjacent to the superior sagittal sinus (SSS) was reported. A 55-year-old female was admitted to our hospital complaining of severe headache and intracranial bruit. CT scan revealed an osteolytic lesion at the right frontal bone adjacent to the SSS, and MRI showed a flow void area at the same site. Cerebral angiography detected DAVM which was fed by bilateral superficial temporal arteries and plenty of meningeal branches of the middle meningeal artery. It was drained by cortical veins to the SSS. Endovascular surgery was tried for this lesion, but it failed. After the surgical excision of DAVM, the above symptoms disappeared with no complications. The 14 cases reported in the literature were examined to characterize DAVM at this site. Average age was 47 with no age distribution. 43% of the cases had intracranial hemorrhage, subarachnoid hemorrhage (2), intracranial hemorrhage (2), intraventricular hemorrhage (1), and subdural hematoma (1). The DAVM arises most frequently at the middle third of the SSS and tends to extend to the posterior third. The symptom most frequently seen is headache, but we ought to pay attention to the possibility of progressive dementia. As for therapy, direct surgical excision is sometimes necessary if intravascular embolization ends in failure or incomplete cure.

Plasma factor triggering alternative complement pathway activation by liposomes

Several plasma components, such as complement (C) components, play a role in the clearance of liposomes from the circulation. The interactions between liposomes and the C system were investigated in this study. Multilamellar vesicle (MLV) liposomes, which were damaged by activation of the complement, became susceptible depending on the density of cetylmannoside (Man) on the liposome membrane, and activation proceeded through the alternative C pathway as observed for liposomes without Man (PC-MLV) (K. Funato et al., Biochim. Biophys. Acta 1103:198-204, 1992). In addition, the capacity of Man-modified liposomes (Man-MLV) to activate the alternative C pathway was abolished by preadsorption of plasma with Man-MLV but not with PC-MLV. The results suggest that a specific plasma factor adsorbed with Man-MLV was responsible for the augmentation of the C activation and, further, that the rapid clearance of Man-MLV from the circulation is caused by both enhanced C-mediated liposome permeability and enhanced C-mediated phagocytosis of liposomes.

Gastric damage and body weight loss in LHA-lesioned rats: effects of cytoprotective geranylgeranylacetone

We investigated the development of gastric damage and body weight (BW) loss in lateral hypothalamic area (LHA)-lesioned rats, measured 2 h and 1 and 3 days after the lesioning (experiment 1), as well as the effects of geranylgeranylacetone (GGA), a cytoprotective antiulcer agent, on these disorders (experiment 2). In experiment 1, BW of LHA-lesioned rats decreased throughout the 3-day experiment. In LHA-lesioned rats, gastric mucosal lesions appeared 1 day after lesioning in the glandular portion and persisted, whereas those in the rumenal portion appeared only after 3 days. Gastric transepithelial potential differences (PDs) of glandular portion began to decrease after 2 h and had decreased in both portions. Gastric acid output was increased transiently at 2 h but it was not high after 1 day and after 3 days was lower than that in sham-LHA-lesioned rats. In experiment 2, PDs of the rumenal decreased more in LHA-lesioned rats than in sham-LHA-lesioned rats pair fed to LHA-lesioned rats after 3 days. Three days of treatment with GGA (200 mg/kg ip) improved PDs of rumenal and glandular portions in LHA-lesioned rats and reduced lesions of the rumenal portion. Loss of BW in LHA-lesioned rats was significantly but not completely inhibited by GGA. These results indicate that disturbance to the gastric defensive mechanism plays an important role in the development of gastric lesions after LHA lesions and that the impairment of gastric functions may be a partial cause of the loss of BW in LHA-lesioned rats.

Different factors bind to the regulatory region of the Na+,K(+)-ATPase alpha 1-subunit gene during the cell cycle

Three factors that bind to the positive regulatory region (ARE) of the Na+,K(+)-ATPase alpha 1-subunit gene were shown to be present in growing BALB/c-3T3 cells as shown by the gel retardation assay pattern in which three specific complexes (C1, C2 and C3) were identified. The complexes are similar to those observed in MDCK cell nuclear extracts in which linker substitution mutations in the competitor gave parallel specific effects in both cells. During the process of the cell growth cycle, the relative mobility of C3 was altered, and the amount of C1 decreased in the G0 state. All three complexes (C1, C2 and C3) disappeared and other specific complexes with higher mobilities were alternatively observed at 6 h after serum stimulation and thereafter. The expression of the mRNA for the alpha 1-subunit gene was repressed at G0 and gradually increased after serum stimulation. These results suggest that different sets of factors are responsible for the transcription of the gene at different stages of the cell cycle.

Identification of the product of the murine ST2 gene

The murine ST2 gene is expressed in growth-stimulated BALB/c-3T3 cells. This gene encodes a protein that is similar to the extracellular portions of the interleukin-1 receptors (types 1 and 2). In this study, we prepared a polyclonal antibody against the recombinant ST2 protein produced in Escherichia coli. This antibody detected recombinant ST2 protein in the culture fluid of COS7 cells transfected with a mammalian expression vector (pEF-BOS) carrying ST2 cDNA. Using this antibody, we could detect the ST2 protein in the culture fluid of growth-stimulated BALB/c-3T3 cells, and in the medium of continuously growing cells, but not in that of growth-arrested cells. ST2 proteins produced in COS7 cells and BALB/c-3T3 cells were N-glycosylated as predicted from nine putative N-glycosylation sites in its deduced amino-acid sequence.

Effects of GABA and L-glutamate on the gastric acid secretion and gastric defensive mechanisms in rat lateral hypothalamus

The effects of administration of an inhibitory GABAergic or excitatory glutaminergic neurotransmitter into the lateral hypothalamic area (LHA) on gastric acids, an aggressive mechanism, and transepithelial potential difference (PD) and mucosal blood flow (MBF), defensive mechanisms, were examined in anesthetized rats, since lesions of LHA in these animals cause gastric mucosal damage and electrical stimulation stimulates gastric acids and antral contractions. Microinfusion of the inhibitory neurotransmitter, muscimol (GABA agonist) resulted in an increase in gastric acid secretion and in PD and MBF. The GABA antagonists picrotoxin and bicuculline methiodide, in contrast, decreased these three factors. The excitatory neurotransmitter L-glutamate induced only an increase of MBF. Thus, the GABAergic system in LHA stimulates the gastric functions, both defensive and aggressive mechanisms, while the glutaminergic system increases only a portion of the defensive system. The results suggest that there is a significant interaction between LHA and stomach functions.

Hypergastric acid secretion in rats with ventromedial hypothalamic lesions

This study was designed to investigate abnormal gastric acid secretion in ventromedial hypothalamic (VMH)-lesioned rats. Basal secretion and secretion stimulated by pentagastrin (25 micrograms/kg, IP) or histamine (2 mg/kg/h, IV) were significantly higher in VMH-lesioned rats than in sham VMH-lesioned rats. Subdiaphragmatic vagotomy and methyl atropine treatment (5 mg/kg, IV) remarkably decreased both basal (about 36-44%) and stimulated secretion (about 36-67%) in VMH-lesioned rats, but did not completely reverse it to normal. Serum insulin and glucose levels were significantly higher in VMH-lesioned rats, but serum gastrin levels were not. VMH-lesioned rats showed significantly heavier gastric dry weight; however, no difference in the mucosal layer/total layer ratio of the gastric wall and the density of the parietal cells was observed between the two groups, indicating that the total number of parietal cells might have increased in VMH-lesioned rats because the increase of gastric dry weight can be presumed to be due to increase of the gastric mucosal layer as well as total layer. These results suggest that vagal activation is one of the main contributors to hypergastric acid secretion in VMH-lesioned rats, but that other factors such as increase of parietal oxyntic cell number may also contribute.

Immunocytochemical localization of alpha-, beta I-, beta II- and gamma-subspecies of protein kinase C in the motor and premotor cortices of the rhesus monkey

We obtained evidence for the localization of alpha-, beta I-, beta II- and gamma-subspecies of protein kinase C (PKC) in the monkey motor and premotor cortices (Brodmann's areas 4 and 6). In Brodmann's area 4, the immunoreactivity for the alpha-PKC was present in horizontal and round cells in the layers I and II, and small pyramidal cells in layer III and also in the glial cells in subcortical white matter. The alpha-PKC immunopositive glial cells contained GFAP-immunoreactive product. The beta I-PKC immunoreactivity was present in the round cells in layer I and in the pyramidal cells in the layer V, including Betz cells. The beta II-PKC immunoreactivity was observed as small dots in perikarya of the small and medium-sized pyramidal cells in layers II, III, V and VI, but not in layer I. The gamma-PKC immunoreactive cell bodies were observed in layers II, III and VI, and most of the immunoreactive cells were pyramidal. Intense gamma-PKC immunoreactivity was found in the neuropils of layers I and II. Similar distributions of four PKC subspecies were seen in Brodmann's area 6, except that beta I-PKC immunoreactive Betz cells were not present. The unique localization of PKC subspecies suggested that each PKC subspecies was involved in the specific function in motor and premotor cortices of the rhesus monkey.

Effect of mass screening for breast cancer from the aspect of psychosocial assessment of the quality of life

To assess the quality of life (QOL) in patients with breast cancer receiving mass screening, a collaborative matched case-control study was conducted in nine hospitals throughout Japan. A total of 122 patients detected by mass screening (study group) and 226 patients found in out-patient clinics (control group) were assessed psychosocially on the basis of questionnaire information. The incidence of patients with early stage breast cancer was significantly higher in the study group than in the control group (P < 0.05). Chest wall pain was observed in 35.2% of the study group and in 46.5% of the control group (P < 0.05). Although control patients were more optimistic than study group patients, disturbed daily life and anxiety about recurrence were a little more frequent in the former group than in the latter. In particular, shoulder stiffness was frequently seen in the control group (P < 0.05). Early detection and information do not create anxiety in mass screening patients (P < 0.01). We should recommend mass screening to patients to detect early stage breast cancer and provide better QOL.

Presence of a novel primary response gene ST2L, encoding a product highly similar to the interleukin 1 receptor type 1

In the course of studying the ST2 gene, which was initially found to be expressed specifically at the G0/G1 transitional state in BALB/c-3T3 cells and was one of the primary response genes, we found another ST2-related mRNA, designated as ST2L, in serum-stimulated BALB/c-3T3 cells in the presence of cycloheximide. Nucleotide sequence analysis of the cloned ST2L cDNA revealed that it had an open reading frame encoding a polypeptide of 567 amino acids. A 5' region (1,028 nucleotides) of ST2L cDNA was identical with the ST2 cDNA, and a unique 3' region encoded a putative transmembrane domain of 24 amino acids and a cytoplasmic domain of 201 amino acids. The ST2 gene product is highly similar to the extracellular portion of IL-1 receptors type 1 and type 2, and the ST2L gene product shows a marked similarity with entire IL-1 receptor type 1.

Nucleotide sequence of a complementary DNA for human ST2

Human ST2 cDNA, a homologue of murine ST2 that is only expressed in growth-stimulated BALB/c-3T3 cells and a member of the primary response gene family induced by growth factors, was isolated from the cDNA library of an activated human helper T cell line, 5C10. Human ST2 has 67.6% identity in a 327 amino acid overlap to murine ST2. Furthermore, as in the case of murine ST2, human ST2 encodes a protein remarkably similar in sequence to the extracellular portion of human interleukin 1 receptor, both types 1 and 2. The expression of ST2 in human lymphocytes could trigger further investigations into its physiological role in humans.