Disruption of the RB pathway and cell-proliferative activity in non-small-cell lung cancers

The pathway consisting of retinoblastoma protein (pRB), cyclin D1 and p16 (RB pathway) which is involved in the phosphorylation of pRB plays an important role in G1/S progression. The disruption of this RB pathway has been reported in several types of human neoplasm. An immunohistochemical study of 101 non-small-cell lung cancers (NSCLCs) showed loss of p16 is in 47 tumors (46.5%) and loss of pRB in 42 tumors (41.6%). In 79 of 101 NSCLCs (78.2%), the expression of p16 and pRB was complementary (p < 0.0001). Methylation of the cdkn2 gene was detected in 50% of p16-negative tumors and in 11% of p16-positive tumors. Aberrant expression of cyclin D1 was found in 45 tumors (44.5%). The cyclin-D1-positive tumors had significantly higher Ki-67 indices than the cyclin-D1-negative tumors irrespective of the tumor p16 or pRB expression. Thus, 91 (90%) of 101 NSCLCs showed disturbed expression of at least 1 of the 3 components of the RB pathway. Our results suggest that the disruption of the RB pathway plays an important role in tumorigenesis in NSCLCs and that increased cyclin-D1 expression leads to strong proliferative activity which may over-ride the suppressive effect of p16 and pRB.

Urinary excretion of aquaporin-2 in term and preterm infants

Aquaporin-2 (AQP-2) is a vasopressin-regulated water channel of the renal collecting duct and is excreted in human urine. We measured the urinary excretion of AQP-2 by radioimmunoassay in 14 term and 12 preterm infants aged 1 month. Excretion of AQP-2 was low compared with adults, and correlated significantly with urine osmolality in preterm infants. Our results demonstrate that AQP-2 water channels are expressed in the renal collecting duct of both term and preterm infants.

The ultrastructure of anionic sites in rat articular cartilage as revealed by different preparation methods and polyethyleneimine staining

The ultrastructure of anionic sites in the middle layer of rat articular cartilages was studied by two methods, the quick-freezing and deep-etching method, and the quick-freezing and freeze-substitution method. The anionic sites were visualized with a cationic tracer, polyethyleneimine. They were also compared with those revealed in tissues subjected to conventional fixation, such as pre-embedding or post-embedding. With the deep-etching method, three-dimensional meshwork structures were observed more clearly in the extracellular matrix compared with those seen in conventional ultrathin sections. In combination with polyethyleneimine staining, in which no chemical contrast was needed for visualization of anionic sites, numerous stained particles were detected around filaments in the extracellular matrix, indicating that they were anionic sites consisting mainly of proteoglycans. With the pre-embedding method and polyethyleneimine staining, the shapes of aggregated stained particles varied with different preparation procedures, including chemical fixation and contrasting. The fine meshworks were also observed with the post-embedding method and polyethyleneimine staining. It is suggested that such images of anionic sites, as revealed by the deep-etching method and the post-embedding polyethyleneimine-staining method with low-temperature dehydration, are probably closer to native states than those revealed by the conventional pre-embedding polyethyleneimine-staining method.

Neonatal intrathymic splenocyte injection yields prolonged cardiac xenograft survival

Intrathymic (i.t.) injection of allogenic cells without administration of anti-lymphocyte serum (ALS) in neonatal recipients has induced donor-specific tolerance to subsequent cardiac allografts in rats. This study examines whether similar tactics can be successfully applied to a hamster-to-rat cardiac xenotransplantation model. Lewis neonates on their first day of life underwent i.t., subcutaneous (s.c.), intraperitoneal (i.p.), or intravenous (i.v.) injections of 5 x 10(7) Golden Syrian hamster splenocytes. After six weeks, the rats underwent heterotopic cardiac transplantation of hamster hearts. Cyclophosphamide (CyP) was administered on the day before surgery and postoperatively to suppress antibody-mediated graft rejection. Rats given splenocytes with 80 mg/kg of CyP had the following graft survival times: 8 to 12 days for i.t. injection (mean, 9.4 days); 5 to 7 days for s.c. injection (mean, 6.6 days); 4 to 11 days for i.p. injection (mean, 7.4 days); and 4 to 13 days for i.v. injection (mean, 7.9 days). Only the extension of graft survival produced by i.t. injection was statistically significant in comparison with the rats given only CyP treatment (mean, 7.5 days; P < 0.05). Thus, it appears that i.t. injection of xenogenic splenocytes in neonatal recipients with administration of CyP, but without ALS, can prolong xenograft survival. This biological intervention may be most useful in pediatric xenotransplantation when combined with other immunomodulation techniques.

Morphological studies of glomeruli in obstructive kidneys by confocal laser scanning microscopy and quick-freezing replica method

Morphological changes of glomeruli in obstructive kidneys were studied by using confocal laser scanning microscopy (CLSM), and quick-freezing and deep-etching (QF-DE) method. Twenty-one rabbits were divided into three groups, consisting of control, 6-hr bilateral ureteral obstruction (BUO) and 24-hr BUO. In the experimental groups, the attenuation of cell bodies, the lengthening and stretching of major processes, the cystic formation in the cytoplasm and the fusion of foot processes were observed on conventional ultrathin sections. These changes in the 24-hr BUO group were more clearly observed than those in the 6-hr BUO group. By the CLSM, cell bodies and foot processes of podocytes in the experimental groups were more intensely immunostained with anti-alpha-tubulin antibody and phalloidin-FITC. By the QF-DE method, cytoskeletons in the podocyte cell bodies and major processes were composed of numerous intermediate filaments, but distinct changes of actin filaments and microtubules were not observed in the control and experimental groups. Considering the physiological changes in BUO, the mechanical stress appeared to be brought about by hemodynamic factors rather than the change of intratubular pressure, resembling the morphological changes in experimental animals with hyperfiltration and the homeostatic adaptation of podocytes under the BUO condition.

Poorly differentiated desmin-negative and vimentin-positive leiomyosarcoma of the stomach examined by the immunohistochemical and quick-freezing and deep-etching methods

A poorly differentiated leiomyosarcoma of the stomach in a 41-year-old woman is reported. The diagnosis was confirmed by the diffuse immunohistochemical reaction to HHF35, and the presence of focal density and caveolas in some of the tumour cells by conventional electron microscopy. Immunohistochemically, most tumour cells had an undifferentiated nature, in which negative immunostaining for desmin, alpha-smooth muscle actin, and type IV collagen, and positive immunostaining for vimentin were observed. By the quick-freezing and deep-etching (QF-DE) method, these tumour cells revealed the loss of bundled actin and myosin filaments, which constitute desmin associated structures (focal densities and dense patchy areas). Their cytoplasm had many mitochondria and other cell organelles. The intermediate filaments (IFs), which were determined to be vimentin by immunohistochemistry, were observed in the inter-organellar spaces, and connected with these cell organelles. Actin filaments formed a meshwork structure and were distributed mainly in subplasmalemmal regions. Although a basal lamina was not detected by conventional electron microscopy, basal lamina-like structures, an association between the extracellular matrices and the cell membrane, were observed. Using the QF-DE method, three dimensional ultrastructural alterations of the cytoskeleton and extracellular matrix of the leiomyosarcoma were observed.

Activation of the precursor of human stromelysin 2 and its interactions with other matrix metalloproteinases

Matrix metalloproteinases (MMP) are synthesized as inactive zymogens (proMMP) and subsequently activated by many factors to degrade the extracellular matrix (ECM). In the present study, we have examined the intermolecular activation mechanisms of proMMP by MMP-10 (stromelysin 2). ProMMP-10 was purified from the culture media of OSC-20 human oral squamous carcinoma cells stimulated with 12-O-tetradecanoylphorbol 13-acetate. The final products are partially activated (approximately 38% of the full activity) during the purification steps and contain proMMP-10 of Mr 56,000 with minor protein bands of Mr 47,000, 24,000 and 22,000. The zymogen is activated by 4-aminophenylmercuric acetate and processed to the active forms of Mr 47,000 and 24,000. The NH2-terminal sequence of the 47,000- and 24,000-Mr species is Phe82-Ser-Ser-Phe-Pro-Gly, which is identical to that of stromelysin 2. ProMMP-9 (progelatinase B) is activated by MMP-10 to its full activity and processed to the low-Mr species of Mr 81,000, 65,000, 57,000 and 55,000, the former two of which show proteolytic activity on a gelatin zymography. The NH2-terminal sequence analysis indicates that the 81,000-, 65,000- and 57,000-M, species have the identical sequence of Phe88-Gln-Thr-Phe-Glu-Gly, suggesting the cleavage of the Arg87-Phe88 peptide bond for activation and both NH2-terminal and COOH-terminal truncation in the 65,000- and 57,000-Mr forms. MMP-10 also activates proMMP-7 (promatrilysin) up to about 60% of the full activity and generates the same active species of Mr 19,000 as that obtained by activation with 4-aminophenylmercuric acetate. Incubation of proMMP-2 (progelatinase A) or proMMP-3 with MMP-10 does not result in activation of these proMMP. These results indicate that in addition to the previously reported activation of proMMP-1 (tissue procollagenase) and proMMP-8 (neutrophil procollagenase), MMP-10 can also activate proMMP-9 and proMMP-7, and suggest the possibility that MMP-10 may replace a role of MMP-3 in the ECM degradation in concert with other MMP under various pathological conditions.

[Surgical treatment for lung cancer invading thoracic aorta]

We experienced three surgical cases of lung cancer invading thoracic aorta, and discussed some problems in order to improve the surgical outcome. In the first case, the patient had a ruptured descending aortic aneurysm into a tumor of left lung. Following urgent graft replacement of descending aorta, left pneumonectomy was carried out, but the patient died of bone marrow dissemination which was probably caused by aspiration of the tumor cells on cardiopulmonary bypass. In the second case, the patient underwent resection of the left upper lobectomy combined with resections of the left subclavian artery and distal aortic arch, but died of perforation of aortic arch due to vascular injury by cross clamp. In the third case, an operation was successfully performed for lung cancer invading the aortic arch. Left upper lobectomy with associated resection of aortic arch, left subclavian and common carotid arteries was performed. Both arteries were replaced with a Gelseal Graft.

Prevention of postoperative nausea and vomiting with a combination of granisetron and droperidol

In this randomized, double-blind study, we compared the efficacy and safety of granisetron plus droperidol with each antiemetic alone for preventing postoperative nausea and vomiting (PONV) in 150 female patients scheduled for elective major gynecological surgery. Patients were randomly assigned to receive i.v. either granisetron 2.5 mg (Group G), droperidol 1.25 mg (Group D), or granisetron 2.5 mg plus droperidol 1.25 mg (Group GD) immediately before the induction of anesthesia (n = 50 in each group). A standard anesthetic technique and postoperative analgesia were used. Complete response, defined as no PONV and no administration of rescue antiemetic medication during the first 24 h after anesthesia, was 84% in Group G, 54% in Group D, and 96% in Group GD (P = 0.046 versus Group G, P = 0.001 versus Group D). No clinically important adverse effects were observed in any group. In conclusion, the combination of granisetron and droperidol is more effective than each antiemetic alone for complete response in patients undergoing general anesthesia for major gynecological surgery.

IMPLICATIONS

We compared the efficacy of granisetron plus droperidol with each antiemetic alone for the prevention of nausea and vomiting after gynecological surgery. The granisetron/droperidol combination was the most effective against these emetic symptoms.

[A case of complete mediastinal goiter located in the retrotracheal region: review on reported cases from 1986 to 1997 in Japan]

A 66-year-old man was admitted to our hospital as a result of an abnormal shadow which was observed on his chest X-ray. A chest CT scan and chest MRI revealed an upper mediastinal tumor. The tumor was located in the retrotracheal region and resected completely following a thoracotomy. Histological examination of the tumor revealed follicular adenoma of the thyroid gland. Complete mediastinal goiter is a relatively rare lesion, with only 59 cases (including our case) in Japan prior to 1997. Only two cases were reviewed, in which the tumors were located in the retrotracheal region, out of the 59 cases in Japan.

Contribution of the disulfide bond of the A subunit to the action of Escherichia coli heat-labile enterotoxin

Escherichia coli heat-labile enterotoxin (LT) consists of an A subunit and five B subunits. These subunits oligomerize into an assembled holotoxin within the periplasm. Structural analysis of LT has revealed that the A subunit interacts with the B subunit through its carboxy terminus. This indicates that the carboxy-terminal portion of the protein is required for assembly of holotoxin in the periplasm. However, it is not known whether other regions of the A subunit contribute to the assembly. The A subunit constituting the holotoxin contains a disulfide bond between Cys-187 and Cys-199. It has been observed in many proteins that the intramolecular disulfide bond is deeply involved in the function and tertiary structure of the protein. We speculated that the disulfide bond of the A subunit contributes to the assembly in the periplasm, although the bond is not a structural element of the carboxy-terminal portion of the A subunit. We replaced these cysteine residues of the A subunit by oligonucleotide-directed site-specific mutagenesis and analyzed the LTs produced by cells containing the mutant LT genes. The amount of the mutant holotoxin produced was small compared with that of the wild-type strain, indicating that the disulfide bond of the A subunit contributes to the structure which functions as the site of nucleation in the assembly. A reconstitution experiment in vitro supported the notion. Subsequently, we found that the mutant A subunit constituting holotoxin is easily degraded by trypsin and that in cells incubated with mutant LTs, the lag until the intracellular cyclic AMP begins to accumulate is longer than in cells incubated with native LTs. These results might be useful for the analysis of the interaction of LT with target cells at the molecular level.

Anti-emetic efficacy of prophylactic granisetron, droperidol and metoclopramide in the prevention of nausea and vomiting after laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled trial

This study evaluates the prophylactic anti-emetic efficacy of granisetron, droperidol and metoclopramide, for the prevention of post-operative nausea and vomiting in female patients undergoing elective laparoscopic cholecystectomy. The patients were randomly assigned to one of four groups (n = 30 for each group): granisetron 3 mg, droperidol 1.25 mg, metoclopramide 10 mg and placebo (saline). These medications were given immediately before the induction of anaesthesia. During the first 24 h after anaesthesia, the incidence of post-operative nausea and vomiting was 13, 30, 33 and 37% after administration of granisetron, droperidol, metoclopramide and placebo, respectively (P < 0.05, overall Fisher's exact probability test). No clinically important adverse effects were observed in either group. Our results suggest that granisetron is a better anti-emetic than droperidol or metoclopramide for the prevention of post-operative nausea and vomiting after laparoscopic cholecystectomy when compared with a placebo.

Recovery of post-tetanic count and train-of-four responses at the great toe and thumb

We have studied the recovery of post-tetanic count and train-of-four responses at the great toe and thumb accelerographically after the administration of vecuronium 0.2 mg.kg-1. Sixty adult patients scheduled for anaesthesia with nitrous oxide and isoflurane were studied. The times to the return of the first post-tetanic twitch were comparable at the great toe and thumb (mean (SD) times: 30.0 (6.5) min and 35.0 (8.5) min, respectively). Recovery of post-tetanic count followed similar time courses at the great toe and thumb. Also, time to the return of the first twitch of the train-of-four did not differ significantly at the great toe and the thumb (47.5 (9.6) min vs. 49.7 (10.5) min). Similarly, time to the return of the second, third and fourth twitches of the train-of-four did not significantly differ at the great toe and the thumb. However, the value of the first twitch of the train-of-four, expressed as a proportion of control twitch, was significantly higher than that at the thumb between 50 min and 110 min after the vecuronium injection, and the train-of-four ratio at the great toe was significantly higher than that at the thumb between 60 min and 100 min after the vecuronium injection.

Granisetron prevents nausea and vomiting during spinal anaesthesia for caesarean section

BACKGROUND

Nausea and vomiting during spinal anaesthesia for caesarean section are common and unpleasant complications. This study was undertaken to evaluate the efficacy of granisetron, a selective 5-hydroxytryptamine type 3 receptor antagonist, for prophylactic treatment of nausea and vomiting in parturients undergoing nonemergent caesarean section under spinal anaesthesia.

METHODS

In a randomized, double-blind, placebo-controlled trial, 100 patients, 21-38 years, received either placebo (saline) or granisetron at 3 different doses (20 micrograms.kg-1, 40 micrograms.kg-1 or 80 micrograms.kg-1) (n = 25 for each) intravenously immediately after clamping of the foetal umbilical cord. Nausea, vomiting and safety assessments were performed during spinal anaesthesia for caesarean section.

RESULTS

The treatment groups were similar with regard to maternal characteristics and operative management. The incidence of nausea and vomiting was 64%, 52%, 14% and 12% after administration of placebo and granisetron in a dose of 20 micrograms.kg-1, 40 micrograms.kg-1 and 80 micrograms.kg-1, respectively (P < 0.05; overall Fisher's exact probability test). No clinically important adverse effects were observed in any group.

CONCLUSION

Prophylactic use of granisetron in a minimum dose of 40 micrograms.kg-1 is effective for preventing nausea and vomiting during spinal anaesthesia for caesarean section.

Immunocytochemical study of lysosomal proteins with a new monoclonal antibody directed against epithelioid macrophages

A monoclonal antibody, EPI-1, was produced against macrophages in epithelioid granulomas induced in rat foot pads by muramyl dipeptide. This EPI-1 antibody reacted to lysosome-like structures in epithelioid macrophages, peritoneal and pulmonary macrophages, and also in other tissues such as liver, testes, and kidneys. Western blot analysis of epithelioid granulomas, liver, testes, and kidneys revealed the same positive band of 62 kDa. Immunoelectron microscopic study of foot pad granulomas and hepatocytes demonstrated the EPI-1 antigen located in lysosomes and autophagic vesicles, preferentially along their membranes. These findings suggest that the EPI-1 antibody may recognize a novel antigen related to lysosomal membrane proteins in macrophages and other cells, which is useful for identifying lysosomes and their related structures.

A microsatellite instability analysis in neuroblastoma based on a high resolution fluorescent microsatellite analysis

It has recently been reported that mismatch repair enzymes, which are one type of DNA repair enzymes, are the causative genes for a major group of hereditary non-polyposis colon cancers (HNPCC). Abnormalities in the mismatch repair system can be monitored by observing instability at the microsatellite loci (MSI) in cancer cells. MSI has been reported not only in tumors associated with hereditary non-polyposis colorectal cancer but also in sporadic forms of various tumors. No correlation between pediatric malignant tumors and the mismatch repair system has yet been reported. In the present study, we examined the frequency of MSI in 21 neuroblastomas, which are the most common solid tumors in childhood, using a high resolution fluorescent microsatellite analysis. MSI on five microsatellite loci was detected in none of the 21 samples. Other mechanisms independent of mismatch repair deficiency may thus play a role in both tumorigenesis and the development of neuroblastoma.

Cardiovascular responses to tracheal extubation or LMA removal in children

PURPOSE

This study was designed to investigate the cardiovascular effects related to tracheal extubation or laryngeal mask airway (LMA) removal in children.

METHODS

Sixty children, ASA physical status 1, 4-10 yr of age, undergoing minor elective surgery (inguinal hernia and phimosis) were allocated randomly to have their surgery performed with endotracheal intubation (Group ET, n = 30) or LMA (Group LMA, n = 30) and were studied for cardiovascular responses related to extubation or LMA removal. Changes in heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before and 1, 2, 3, 5, and 10 min after tracheal extubation or LMA removal when the patients were awake.

RESULTS

The maximal changes in HR, SBP and DBP were less in Group LMA than in Group ET during the observation period (HR; 12 vs 26, SBP; 14 vs 28, DBP; 9 vs 13, median, P < 0.05).

CONCLUSION

Laryngeal mask airway removal elicited less haemodynamic change than tracheal extubation in paediatric patients.

Prevention of PONV with granisetron, droperidol or metoclopramide in patients with postoperative emesis

PURPOSE

A high incidence of postoperative nausea and vomiting (PONV) has been noted in patients with a history of postoperative emesis. This study was undertaken to compare the efficacy of granisetron, droperidol and metoclopramide, in the prevention of PONV in such patients undergoing general anaesthesia for major gynaecological surgery.

METHODS

In a randomised, double-blind study, 90 female patients received 2.5 mg granisetron, 1.25 mg droperidol or 10 mg metoclopramide (n = 30 of each) i.v. immediately before induction of anaesthesia. The same standard general anaesthetic technique, which consisted of isoflurane in nitrous oxide and oxygen, was used. Nausea, vomiting and safety assessments were performed continuously during the first 24 hr after anaesthesia.

RESULTS

The incidence of PONV was 20% with granisetron, 57% with droperidol and 60% with metoclopramide (P < 0.05; overall Fisher's exact probability test). No clinically adverse events were observed in any group.

CONCLUSION

Granisetron is more effective than droperidol or metoclopramide in preventing PONV in female patients with a history of postoperative emesis.

Prevention of postoperative nausea and vomiting in female patients during menstruation: comparison of droperidol, metoclopramide and granisetron

The incidence of postoperative nausea and vomiting (PONV) is high in women during menstruation. We have compared the efficacy of droperidol, metoclopramide and granisetron in the prevention of PONV in female patients during menstruation undergoing major gynaecological surgery. In a randomized, double-blind study, 120 patients received droperidol 25 micrograms kg-1, metoclopramide 0.2 mg kg-1 or granisetron 40 micrograms kg-1 (n = 40 in each group) i.v. immediately before induction of anaesthesia. A standard general anaesthetic technique and postoperative analgesia were used throughout. There was a complete response, defined as no PONV and no administration of rescue medication, during the 24-h observation period in 45% of patients in the droperidol group, 38% in the metoclopramide group and 70% in the granisetron group (P = 0.021 vs droperidol, P = 0.003 vs metoclopramide). There was no difference in the incidence of adverse events between groups. We conclude that the prophylactic antiemetic efficacy of granisetron was superior to that of droperidol or metoclopramide for prevention of PONV in women during menstruation.

Prevention of nausea and vomiting in female patients undergoing breast surgery: a comparison with granisetron, droperidol, metoclopramide and placebo

BACKGROUND

Breast surgery is associated with a relatively high incidence of postoperative nausea and vomiting (PONV). This study was undertaken to evaluate the efficacy of granisetron, droperidol and metoclopramide for preventing PONV after breast surgery.

METHODS

In a randomized, double-blind, placebo-controlled trial, 120 female patients received granisetron 40 micrograms.kg-1, droperidol 1.25 mg, metoclopramide 10 mg or placebo (saline) (n = 30 for each) intravenously immediately before the induction of anaesthesia. A standard general anaesthetic technique was employed throughout. Postoperatively, during the first 24 h after anaesthesia, the incidence of PONV and adverse events was recorded.

RESULTS

The incidence of PONV was 17% with granisetron, 37% with droperidol, 43% with metoclopramide and 50% with placebo (P < 0.05; overall Fisher's exact probability test). The incidence of adverse events was not different among the groups.

CONCLUSION

Granisetron is highly effective for reducing the incidence of PONV in female patients undergoing breast surgery. Droperidol and metoclopramide are ineffective in this population.

[Construction of a scale for college life anxiety and its reliability and validity]

The purpose of this study are to construct the College Life Anxiety Scale for measuring the level of college students' anxiety and to examine its reliability and validity. After collecting items about the anxiety in college life, factor analysis was performed on the data obtained from 2,782 college students. The result, firstly, showed that the College Life Anxiety Scale consisting of 30 items had three factors, which were daily life anxiety, test anxiety and college maladjustment. Secondly, it was indicated that the Scale had both high test-retest reliability and internal consistency (.82 and .84, respectively). It was also suggested that the Scale had high content, clinical, and criterion-related validities. In conclusion, the College Life Anxiety Scale is well able to measure the level of college students' anxiety in their usual life.

[Anti-dermaptophyte activity of phenolic compounds in "mokusaku-eki"]

"Mokusaku-eki," a kind of pyroligneous acid, is a dark brown color solution obtained from the charcoal burner of such Quercus spp. woods as a by-product. This is used as a folk medicine in water eczema. The n-hexane fraction of this solution contained several phenolic compounds such as 4-ethyl-2-methoxyphenol (3) and 2,6-dimethoxyphenol (4), which could not be found in the fresh woods. Among these compounds, 3 has the highest anti-dermaptophyte activity against Trichophyton mentagrophytes at minimum inhibitory concentration (MIC) 150 micrograms/ml.