Cloning of cDNA encoding the common alpha subunit precursor molecule of pituitary glycoprotein hormones in the Australian lungfish, Neoceratodus forsteri

We have isolated cDNA clones encoding a putative glycoprotein hormone alpha subunit precursor molecule from a pituitary cDNA library of the Australian lungfish (Neoceratodus forsteri) by a two-step plaque hybridization technique initially using cDNA encoding the toad glycoprotein hormone alpha subunit precursor molecule as the hybridization probe. The inserts (799 bp) of two of the isolated cDNA clones contained sequences of 5' and 3' untranslated regions, including a poly(A) stretch, and the entire coding sequence of the alpha subunit precursor molecule. The deduced amino acid sequence showed that its signal peptide consists of 24 residues and its mature protein 97 residues. In the mature protein, there is an insert of one residue (Ala) just after the 9th residue. This insert is unique to the Australian lungfish among vertebrate species studied. The amino acid sequence of the mature protein shares the common, or the same-group, amino acid residues at 9 positions with tetrapod and not actinopterygian vertebrates, while only one residue is common to some teleosts and the lungfish to the exclusion of the tetrapods. The overall sequence of the mature protein of the Australian lungfish also shares more similarity with those of tetrapods (69 to 84%) than it does with teleosts (57 to 74%). These results on the relation of the alpha subunit precursor molecule between the lungfish and other vertebrates are consistent with the recent molecular phylogenetic studies suggesting a closer relationship between lungfish and tetrapods than between lungfish and teleosts. We also found that the primary structure of the lungfish alpha subunit is slightly but significantly more similar to that of homeothermic vertebrates than to that of amphibians. This may be due to specialization of the amphibian alpha subunit molecules.

Startle-induced epilepsy in a patient with epidermal nevus syndrome

Startle-induced epilepsy was observed in a 5-year-old boy with epidermal nevus syndrome. He manifested linear nevus on the face and neck, mild mental retardation, and right hemiparesis. Massive myoclonus, followed by tonic seizures, had been triggered by unexpected auditory stimuli since 3 years of age. The startle-induced seizures were the only epileptic manifestation. Interictal EEG occasionally depicted spontaneous focal spikes and waves in the left frontotemporal area, and ictal EEG depicted vertex spikes and then diffuse slow spike-and-wave complex bursts. Left frontal and perisylvian cortical atrophy and a white matter abnormality in the left frontal area were revealed by magnetic resonance imaging. Single photon emission computed tomography demonstrated diffuse low perfusion in the left cerebral hemisphere. Lower amplitude potentials in the left cerebral cortex were evident during somatosensory evoked potential evaluation. These results indicate that hemispheric dysfunction could cause startle-induced epilepsy in this patient.

Dual action of CD30 antigen: anti-CD30 antibody induced apoptosis and interleukin-8 secretion in Ki-1 lymphoma cells

CD30 is a member of the tumor necrosis factor superfamily. In this study, we examined the effect of four anti-CD30 (aCD30) antibodies (Abs) on CD30-positive anaplastic large cell lymphoma-derived cell line, Ki-JK. The aCD30 Abs suppressed [3H]thymidine (TdR) incorporation. With a TdT mediated dUTP-biotin nick end labeling method, apoptosis was detected in Ki-JK cells at day 5 after the addition of aCD30 Ab to the culture. Genistein, an inhibitor of protein tyrosine kinase, had no effect on aCD30 Ab-induced apoptosis. The aCD30 Ab simultaneously induced interleukin-8 (IL-8) secretion in the Ki-JK cells. In culture of the Ki-JK cells with aCD30 Ab for 5 days, the IL-8 concentration of the cell free-supernatant increased to 240 +/- 16 pg/ml, though the concentration was < 12.5 pg/ml without aCD30 Ab. In combination with aCD30 Ab, genistein decreased the concentration of IL-8 in day 5 supernatants. Although, doxorubicin and herbimycin-A suppressed [3H]TdR incorporation and induced apoptosis in the Ki-JK cells, they did not induce IL-8 secretion. Only aCD30 Ab-induced apoptosis was accompanied by IL-8 secretion. IL-8 mRNA was not detected in the Ki-JK cells by reverse transcription-polymerase chain reaction assay. IL-8 mRNA was detected 5 days after adding aCD30 Ab to the culture.

Hydrostatic pressure induces expression of interleukin 6 and tumour necrosis factor alpha mRNAs in a chondrocyte-like cell line

OBJECTIVES

To clarify the effect of pressure on the expressions of proteoglycan core protein and metabolism related cytokines in a chondrocyte-like cell line, HCS-2/8.

METHODS

HCS-2/8 cells were exposed to 1, 5, 10, or 50 MPa of hydrostatic pressure (HP) for two hours, and mRNA expressions of interleukin 6 (IL6) and tumour necrosis factor alpha (TNFalpha) were examined by using reverse transcription-polymerase chain reaction (RT-PCR) method with specific primer sets; and mRNA of proteoglycan core protein, stromelysin, and tissue inhibitor of metalloproteinase 1 (TIMP1) were measured with northern blotting.

RESULTS

HP exposure caused temporal morphological changes of the cells, but did not affect cellular viability, IL6 and TNFalpha mRNA expressions were not observed in the control cells under the atmospheric pressure, whereas in the cells treated with HP, pressure dependent enhancement of IL6 mRNA expression was observed between 30 minutes and four hours after HP release. TNFalpha mRNA expression also increased 30 minutes after the exposure to 50 MPa of HP and disappeared four hours later. Proteoglycan core protein mRNA levels increased between 30 minutes and four hours after the exposure to 1 or 5 MPa of HP, whereas the levels decreased after 10 or 50 MPa of HP. Stromelysin and TIMP1 mRNA signals did not respond to HP.

CONCLUSION

HP at excessively high levels induced IL6 and TNFalpha expression and reduced the expression of proteoglycan core protein, while physiological levels of HP increased the expression of proteoglycan core protein. These findings are important when considering the pathology of osteoarthritis.

Developmental regulation of polysialic acid synthesis in mouse directed by two polysialyltransferases, PST and STX

Polysialic acid is a developmentally regulated carbohydrate attached to the neural cell adhesion molecule, N-CAM, and abundant in embryonic tissues. There is increasing evidence that polysialic acid reduces N-CAM adhesion, thereby promoting neurite outgrowth and cellular mobility. It has been shown that two enzymes, polysialyltransferase, PST, and sialyltransferase X, STX, form polysialic acid on N-CAM. However, it is not known how these two enzymes contribute to polysialylation. In order to determine how the expression of PST and STX leads to polysialic acid synthesis during mouse development, the expression of PST and STX transcripts were evaluated by Northern blot analysis, competitive reverse transcription-polymerase chain reaction and in situ hybridization, and those results were correlated to the expression of polysialic acid. The results obtained by these analyses demonstrated that both PST and STX transcripts were barely detected at embryonic day 8 (E8) but increased after E9. PST and STX transcripts were present in substantial quantity between E11 and E15, coinciding with the period when maximum synthesis of polysialic acid is required. Ten days after birth, the level of STX transcript declined substantially, whereas the level of PST transcript only gradually declined and persisted in the adult brain. These results, taken together, strongly suggest that PST and STX coordinately synthesize polysialic acid during development. At the same time, they are expressed differentially in tissue-specific and cell-type-specific manners, suggesting that PST and STX may have distinct roles in development and organogenesis.

[Percutaneous positioning of port catheter in the hepatic artery for chemotherapy of metastases using the Arai technique]

INTRODUCTION

Liver metastases from colorectal, gastric and breast cancers are a very frequent event; these metastases are treated with cycles of intraarterial chemotherapy with a permanent catheter positioned in the hepatic artery or with surgical or interventional radiology techniques. We tested Arai's technique and its feasibility and evaluated the efficacy of this chemotherapy schedule.

MATERIAL AND METHODS

Four patients with liver metastases from colorectal carcinoma were treated with combined systemic and locoregional chemotherapy with a permanent catheter placed in the hepatic artery according to Arai's technique. Arai's technique consists in studying the hepatic vascularization and then redistributing hepatic flow in case of multiple hepatic arteries; the vessels in which the infusion of chemotherapies could cause toxicity are then occluded and finally a catheter is positioned in the hepatic artery with subclavian artery catheterization and the connection with a subcutaneous reservoir for injection--the port-a-cath system. We planned CT examinations to study liver morphology and radiographs of the abdomen and chest to depict the catheter position and patency, respectively.

RESULTS

The catheter was positioned correctly without any complications in all patients, as planned. We administered 37 cycles of combined systemic and locoregional chemotherapy in all. Two patients died of disease progression after 6 months but the other 2 are still alive and CT showed partial disease remission. We observed no catheter dislocation or occlusion at chest radiography and transport angiography, respectively.

CONCLUSIONS

Infusion chemotherapy in the hepatic artery from permanent catheters is widely accepted in our country and we believe that Arai's technique could be an alternative to the more classic and established surgery. The small number of our patients and the short follow-up do not permit definitive conclusions to be drawn on the clinical efficacy of this combined systemic and intra-arterial treatment.

[A case of pyelitis cystica diagnosed with utilization of ureterofiberscope]

We herein report a case of pyelitis cystica in 65-year-old woman. She was referred to our hospital in order to have a treatment for a stone in the ureter on left side. Excretory urogram showed hydronephrosis on left, and multiple, small, smooth and round filling defects in the renal pelvis on right side. ESWL was performed to the ureteral stone, and the stone was discharged completely in 4 days. Then further examinations were made for the filling defects of right renal pelvis. Nonopaque calculi were ruled out on retrograde pyelogram and CT scan. Urinary cytology from the renal pelvis was class I. Our impression was pyelitis cystica of right kidney. Under spinal anesthesia, ureterofiberscopy was performed. Multiple small cysts were observed in the pelvis and calyx, as well as cystitis cystica. Cold cup biopsy was also done and histopathological finding ws pyelitis cystica, without malignancy. We compared endoscopic findings with radiographic findings in 18 cases of pyloureteritis cystica from the Japanese literature. The radiographic findings were multiple small, in a uniform size, and round filling defects with regular contour, and the endoscopic findings were multiple white or ocher colored, half sphere or sphere shaped, and small cyst with smooth surface in 15 of 18 cases. We thought these findings were characteristic ones in pyloureteritis cystica. Endoscopy and biopsy are mandatory for diagnosis of pyeloureteritis cystica.

[Arterial redistribution of extrahepatic collaterals to the liver under temporary balloon occlusion of the proper hepatic artery]

Three patients with liver metastases receiving transarterial chemotherapy underwent embolization of extrahepatic collaterals to the liver under temporary balloon occlusion of the proper hepatic artery. Enhancement in the liver and tumors was observed at CT arteriography through the right inferior phrenic artery and was accentuated under balloon occlusion in all patients. A Cyanoacrylate-Lipiodol mixture was infused through the right inferior phrenic artery to occlude arterial communications with intrahepatic arteries. Better contrast agent distribution was obtained in all patients after embolization. It is suggested that this procedure can be effective for arterial redistribution against extrahepatic collaterals to the liver.

[Effect of lafutidine, a novel antiulcer agent, on healing and relapse of acetic acid-induced gastric ulcer in rats]

Effect of lafutidine ((+/-)-2-(furfurylsulfinyl)-N-[4-[4-(piperidinomethyl)-2-pyr idyl] oxy-(Z)-2-butenyl] acetamide, FRG-8813), a novel antiulcer agent, on the healing and relapse in acetic acid-induced gastric ulcer in rats was investigated. Lafutidine at 1, 3 or 10 mg/kg, twice daily for 10 days reduced the ulcer area in a dose-dependent manner, and the effect by 10 mg/kg of lafutidine was significant. The effect of famotidine at 1 mg/kg and cimetidine at 30 mg/kg, which have almost equal antisecretory activity to lafutidine at 10 mg/kg, on the ulcer area was not significant. Effect on the healing and relapse was assessed by endoscopy for 25 weeks after the induction of gastric ulcer. Drugs were administered twice daily for 11 weeks. Lafutidine at 3 mg/kg and famotidine at 1 mg/kg accelerated the healing, but cimetidine at 30 mg/kg did not. Cumulative relapse rate and inflammatory cell infiltration were significantly reduced in rats initially treated with lafutidine. Famotidine and cimetidine had no effect. In conclusion, lafutidine accelerated ulcer healing and prevented ulcer relapse in rats.

Transcript levels of aquaporin 1 and carbonic anhydrase IV as predictive indicators for prognosis of renal cell carcinoma patients after nephrectomy

Since failure of differentiation has been suggested to be involved in the neoplastic process and progression of tumors, we evaluated whether the transcript levels of differentiation markers of proximal renal tubular cells, from which renal cell carcinoma (RCC) arises, could be used as prognostic markers. We used Northern blot analysis to study the expression of aquaporin 1 (aqp1) and carbonic anhydrase IV (ca4) genes in 66 paired samples of primary RCC and non-tumorous kidney tissues. Poor differentiation of tumor cells and non-clear cell-subtype RCC were significantly associated with low levels of aqp1 transcripts. When patients were divided into 2 groups according to level of aqpI transcript in RCC, a low level of aqp1 was significantly associated with unfavorable outcome. Among 18 patients with metastatic RCC and 40 patients with moderately differentiated RCC, those with RCC expressing low levels of aqpl mRNA demonstrated poorer survival than those with RCC expressing relatively high levels of aqp1. Similarly, decreased expression of ca4 mRNA in RCC was associated with poor survival. On multivariate analysis, transcript levels of aqpI and stage of the tumor were the independent factors predicting disease-specific survival. Transcript levels of aqp1 may serve as a new molecular prognostic marker in patients with RCC following nephrectomy.

[Diagnoses and treatments for recurrent colon cancer]

The incidence of recurrence after curative resection in colon cancer is approximately 20%, and liver metastasis is the most common. Diagnostic modalities including recent techniques for recurrent colon cancer for example also in the liver, are not complete to point out minimal lesions. Thus, it is very hard to evaluate that recurrent lesions are localized or not. On the other hand, only regional treatments such as surgical resection and hepatic infusion chemotherapy are effective for this cancer, and the effect of systemic chemotherapy including 5-FU-LV and new agents are still now limited. From these points of view, for better management of patients with recurrent colon cancer, deeply understandings of incompleteness of imaging diagnoses and well application of local treatments are required.

[The propriety of bilateral internal thoracic artery grafting in women]

In our institution, the exclusion criteria of the bilateral internal thoracic artery (BITA) grafting include age over 70 years old, obesity, severe diabetes, renal dysfunction and poor preoperative physical activity. The objective of this study is to evaluate propriety of the use of bilateral internal thoracic artery for coronary artery bypass grafting (CABG) in women. Clinical outcome of female patients who underwent BITA grafting (group B-F; n = 50) was compared with that of female patients who underwent single internal thoracic artery grafting (group S; n = 50). In addition, clinical outcome of the male patients who underwent BITA grafting (group B-M; n = 50) was compared with that of group B-F. Between group B-F and S, the age, prevalence of obesity and that of renal dysfunction were significantly different, which was predictable because of the group selection according to the criteria. However, the prevalence of previous myocardial infarction and that of left ventricular dysfunction and the extent of coronary artery disease were not significantly different. Whereas, between group B-F and B-M, preoperative factors were not significantly different except the body size. Intraoperative technical factors, such no of grafts, aortic cross clamp time, cardiopulmonary bypass time, rate of complete revascularization, were not significantly different. In comparison of group B-F with group B-M, the site of anastomosis with arterial grafts were not significantly different. Patency rate of arterial and venous grafts two week after operation was not significantly different. Either postoperative complications, such as reoperation for bleeding, wound complication, low output syndrome, renal dysfunction etc, were not significantly different. One patient (2%) in group B-F and 1 patient (2%) in group B-M died in the hospital (p > 0.05). In summary, BITA can be a viable conduit of choice for CABG in female patients as well as that in male patients. Criteria of the use of BITA is recommended to exclude preoperative risk factors above-mentioned.

Clinical evaluation of serum prostate-specific antigen-alpha1-antichymotrypsin complex values in diagnosis of prostate cancer: a cooperative study

BACKGROUND

We studied the clinical significance of serum prostate-specific antigen bound to alpha1-antichymotrypsin (PSA-ACT) values determined with a newly developed enzyme immunoassay.

METHODS

Serum PSA-ACT values were determined in a total of 652 sera. Clinical utility for the diagnosis of prostate cancer was compared to that of Tandem-R PSA and gamma-seminoprotein (gamma-Sm). The new enzyme immunoassay is based on the use of the Stanford reference as an international standard for PSA assays.

RESULTS

Serum PSA-ACT values ranged from less than 0.10 to 1.4 ng/mL in healthy males (n = 100) while values in patients with benign prostatic hyperplasia (n = 155) averaged 3.4 +/- 3.8 ng/mL (mean +/- SD). In patients with prostate cancer, serum PSA-ACT values increased significantly with progression of the clinical stage and there were statistically significant differences between benign prostatic hyperplasia and each stage of prostate cancer except for stage A. Using BPH levels as controls (4.8 ng/mL for PSA-ACT, 7.2 ng/mL for PSA, 3.8 ng/mL for gamma-Sm, and 2.4 ng/mL for the complexed/free PSA ratio of PSA-ACT/gamma-Sm), specificity was 80%. The sensitivity of prostate cancer detection was 79% for PSA-ACT, 77% for PSA, 57% for gamma-Sm, and 46% for the ratio between PSA-ACT/gamma-Sm.

CONCLUSION

Although the determination of serum PSA-ACT showed essentially the same utility as that of PSA for the diagnosis of prostate cancer, PSA-ACT may allow prediction of the clinical stage. The PSA-ACT assay may therefore replace PSA in the detection of prostate cancer.

Large granular lymphocyte leukemia with pure red cell aplasia in a renal transplant recipient

Neoplastic disorders sometimes accompany a renal transplant. Herein, we report a large granular lymphocyte (LGL) leukemia patient with pure red cell aplasia (PRCA) after renal transplantation. A 36-year-old female was presented to our department with anemia in February 1996. She had undergone hemodialysis because of pregnancy in December 1981. She received a renal transplantation from her mother in April 1986. After the transplantation, she received cyclosporin A (CyA) at 2 mg/kg/day, mizoribine at 1 mg/kg/day, and methylprednisolone at 0.1 mg/kg/day for 8 years. In July 1995, her hemoglobin level dropped to 9.3 g/dl, and anemia developed gradually. In January 1996, her hemoglobin was 5.8 g/dl, and she was given a red blood cell transfusion. Laboratory findings were as follows: RBC 1.46 x 10(12)/L; hemoglobin 5.8 g/dl; hematocrit 17.8%; leucocytes 5.2 x 10(9)/L with 62.4% neutrophils, 34.1% lymphocytes, 2.6% monocytes; platelets 50.8 x 10(10)/L; reticulocytes 0.4%. Bone marrow aspirate smears and biopsy sections revealed normal myeloid and megakaryocyte differentiation with few erythroid precursors. The lymphocytes were of medium size with granules in the cytoplasm. More than 90% of lymphocytes were of the LGL type. Surface markers of peripheral blood mononuclear cells demonstrated increases in the CD2+, CD3+, CD4-, and CD8+ populations. A monoclonal rearrangement of T-cell receptor (TCR)-beta chain gene was found by Southern blot analysis of the mononuclear cells in peripheral blood. A diagnosis of LGL leukemia with PRCA was made. During the next 4 months, she received six red blood cell transfusions, a total of 12 U. In March 1996, the patient was treated with cyclophosphamide (1 mg/kg/day). After 1 month of treatment, serum GPT levels increased to 60 IU/l. The dose of cyclophosphamide was reduced to 0.5 mg/kg/day. Two months after initiation of the therapy, the patient developed reticulocytosis and blood transfusion was not needed thereafter. During remission, the number of CD2+, CD3+, CD4-, and CD8+ lymphocytes decreased. Large granular lymphocytes decreased to less than 10% of peripheral blood. The monoclonal rearrangement of the TCR-beta chain gene in peripheral blood disappeared.

Localization of heat shock protein in osteoarthritic cartilage

In osteoarthritic (OA) chondrocytes, expression of 70 kD heat shock protein (HSP70) is enhanced under stress. The HSP70 level is also related to OA severity in humans. In the present study, specimens of OA cartilage were obtained from 14 surgically treated female patients. Their disease severity was evaluated according to Mankin's histological/histochemical grading scores. The ratio of HSP70-positive cells was examined by using immunohistochemistry. As OA became more severe, the ratio of HSP70-positive cells increased in deeper areas from the surface, and there was a positive correlation between the grade and the ratio. Distribution of cells expressing HSP70 mRNA detected by in situ hybridization was similar to the distribution of positive cells in the immunohistochemistry. It was presumed that HSP70 plays a role in cell protection from stress, and that mechanical and biological factors which are related to the enhancement of HSP70 expression, have a considerable influence on OA progressions.

Prostate specific antigen adjusted for the transition zone volume as an indicator of prostate cancer

PURPOSE

We compared prostate specific antigen (PSA) adjusted for the transition zone volume with PSA and PSA density with regard to value in diagnosing prostate cancer in men with intermediate PSA levels of 4.1 to 10.0 ng./ml. in a community based urology practice.

MATERIALS AND METHODS

Between October 1994 and May 1996, PSA transition zone was obtained from 92 of 94 men who underwent systematic sextant biopsies and had a PSA value between 4.1 and 10.0 ng./ml. PSA transition zone, calculated by dividing the PSA value by the volume of the transition zone of the prostate, was compared with PSA and PSA density via the receiver operating characteristic (ROC) curves.

RESULTS

Of the 92 men 12 (13.0%) had prostate cancer. ROC curve analysis demonstrated that PSA transition zone and PSA density predicted the biopsy outcome significantly better than PSA (p <0.05 and p <0.01, respectively). In a subset of 59 men with normal digital rectal examination PSA transition zone predicted the biopsy outcome better than PSA density, although without significant difference. With a cutoff value of 0.3 PSA transition zone had a sensitivity of 75% and a specificity of 54%.

CONCLUSIONS

PSA transition zone is more specific than PSA in distinguishing benign from malignant disease in men with intermediate PSA levels of 4.1 to 10.0 ng./ml., especially in those with normal digital rectal examination. Further study is necessary to discuss whether PSA transition zone is superior to PSA density.

Optical illustration of glutamate-induced cell swelling coupled with membrane depolarization in embryonic brain stem slices

Using intrinsic- and voltage-sensitive dye optical recordings, we have elucidated coupling of glutamate-induced depolarization and neuronal swelling in early embryonic chick brain stem slices. Twenty-four slices were prepared from 8-day old chick embryos, and stained with a voltage-sensitive merocyanine-rhodanine dye (NK2761). The pressure ejection of glutamate to one site within the preparation evoked changes in transmitted light intensity. With 700 nm incident light, three components were identified in glutamate-induced optical changes. The first component was wavelength dependent, while the second and third components were independent of the wavelength. With reference to the action spectrum of the merocyanine-rhodanine dye and osmotic changes in optical properties, we concluded that the first component reflects glutamate-induced depolarization of the membrane, and that the second component is an intrinsic light-scattering change resulting from neural cell swelling coupled with the membrane depolarization.

Value of systematic transition zone biopsy in the detection of prostate cancer

BACKGROUND

We evaluated routine transition zone biopsies for the detection of prostate cancer.

METHODS

Systematic sextant transrectal biopsies, including 2 systematic transition zone biopsies (sextant biopsy group), were performed on 196 consecutive patients. Biopsies were based on indications from digital rectal examination and/or a serum PSA level greater than 4.0 ng/mL. During the same period, 21 patients with persistently elevated PSA levels and earlier negative systematic biopsies also had the sextant biopsy (re-biopsy group). The sextant biopsy group was compared with 124 cases in our previous cancer detection program who had systematic quadrant biopsies targeted to the peripheral zone (quadrant biopsy group).

RESULTS

Between the sextant and quadrant biopsy groups, the difference in rate of cancer detection was not significant statistically. Of the sextant biopsy group, 64 (33%) demonstrated malignancy, including 9 (4.6%) with cancer found exclusively in the peripheral zone and 55 (28%) both in the peripheral and transition zones. No cancer was found exclusively in the transition zone. Of the re-biopsy group, all 4 cancers (19%) were detected in the transition zone, 2 of them exclusively in the transition zone.

CONCLUSION

Routine transition zone biopsies did not increase the detection rate of prostate cancer. Systematic transition zone biopsies proved useful to the patients with persistently elevated PSA values and negative results in previous systematic peripheral zone biopsies.

The first exon of the rat aldolase C gene is essential for restoring the chromatin structure in transgenic mice

A 13-kb fragment of the rat aldolase C gene contains sufficient information for gene expression. Transgenic mice carrying the 13-kb fragment showed restoration of chromatin structure and tissue-specific, copy number-dependent expression. To localize the regulatory elements responsible for restoring chromatin structure, several mutated constructs were used to produce transgenic mice. Three activities were examined: recreation of DNase hypersensitive sites, restoration of methylation status, and copy number-dependent expression. Deletions of the 3'-flanking region did not affect those activities. Deletion of seven introns affected the mRNA levels but not the restoration of the chromatin structure. The insertion of the LacZ gene into the first exon of the transgene interfered with both the restoration of the chromatin structure and the copy number-dependent expression in transgenic mice. DNase I footprinting assays revealed that brain-specific factors bind to the sequence disrupted by the LacZ insertion. These results suggest that the sequence in the first exon is essential for restoring the chromatin structure of the rat aldolase C gene.

Early detection of axonal and neuronal lesions in prenatal-onset periventricular leukomalacia

The expression of beta-amyloid precursor protein (beta-APP) immunoreactivity was investigated in 16 cases of prenatal-onset periventricular leukomalacia (PVL). beta-APP positive axons were found in the early stage of prenatal PVL, which included coagulation necrosis, microglial activation, axonal swelling or astrogliosis, but were not detectable in the late stage of prenatal PVL. Furthermore, beta-APP immunoreactive neurons were also observed in the fifth layer of pyramidal neurons of the cerebral cortex, corresponding to the beta-APP positive axons in PVL. Thus, beta-APP is detected as an early sign of axonal and neuronal lesions in prenatal-onset PVL, and neuronal beta-APP in the cerebral cortex may function to repair cell damage. In addition, prenatal PVL occurred at various stages before birth.

Intermittent hepatic arterial infusion of high-dose 5FU on a weekly schedule for liver metastases from colorectal cancer

PURPOSE

We performed phase I and II studies to examine the usefulness of intermittent hepatic arterial infusion of high-dose 5-fluorouracid (5-FU) for patients with liver metastasis from colorectal cancer.

METHODS

As the phase I study, 1000, 1250 and 1500 mg/m2 of 5-FU were administered over 5 h by hepatic arterial infusion on a weekly schedule to establish the recommended dose. Based on the results of the phase I study, the phase II study was performed to confirm the efficacy of the recommended dose thus obtained.

RESULTS

In the phase I study, the dose-limiting factors of this therapy were gastrointestinal and central nervous system toxicities, and the recommended dose was judged to be 1000 mg/m2. In the phase II study, 1000 mg/m2 of 5-FU was administered over 5 h once a week on an outpatient basis, and this therapy was repeated as long as possible. The response rate was 78% (25/32), with an overall median survival time of 25.8 months (without extrahepatic lesions 25.9 months; with extrahepatic lesions 17.3 months).

CONCLUSIONS

(1) Compared with conventional continuous infusion, the advantages of this therapy were that it caused no decrease in the patient's quality of life as a result of being permanently equipped with a pump and it thus enabled more cost-effective use of the pump, (2) The phase II study on 32 patients showed that this therapy caused no serious toxicities, with a response rate of 78% and a survival time of 25.8 months, which exceeded the results with conventional continuous infusion. If the reproducibility of these results is established in further studies involving multicenter collaboration, this therapy will be able to become the standard local chemotherapy for liver metastases from colorectal cancer. (3) Important problems remaining to be solved are improvement of the technical aspects and studies of combined use with systemic chemotherapy. Furthermore, to finally determine the position of this therapy in the treatment system for liver metastasis from colorectal cancer, it is necessary to conduct comparative trials versus systemic chemotherapy, using the survival time as the end-point.