MR evaluation of intrapulmonary hematoma

We report a case of circumscribed intrapulmonary hematoma, in which MR findings were useful in establishing the diagnosis. It is usually easy to make a diagnosis of intrapulmonary hematoma using conventional methods, when clinical history of trauma and regression of the mass can be observed on serial radiography. However, in this case the mass remained almost unchanged 4 months after trauma on chest radiography and CT. Magnetic resonance revealed a hyperintense mass with an even higher signal rim on T1-weighted imaging and an irregular hyperintense mass on T2*-weighted imaging. We made a diagnosis of pulmonary hematoma based on these MR findings. Follow-up chest radiography and CT taken 1 year after the injury, revealed a substantial decrease in the size of the mass, which confirmed the diagnosis. As in this case, some intrapulmonary hematomas regress very slowly or may even increase in size, and diagnosis can be difficult with conventional methods. In such cases, MRI can be helpful.

Glutathione S transferase Pi is a powerful indicator in chemotherapy of human lung squamous-cell carcinoma

We immunohistochemically investigated the expression of glutathione S transferase pi (GST- pi) and clarified the correlation between GST-pi and the results of chemosensitivity testing on the tissue of primary human squamous-cell carcinoma of the lung. The expression of GST-pi was evaluated in 105 cases and their level of chemosensitivity was estimated by the in vitro succinate dehydrogenase inhibition test for cisplatin, Adriamycin, cyclophosphamide, mitomycin C, vindesine and fluorouracil. Tumors in which 25% and more of the cells stained for GST-pi were classified as having a high GST-pi expression, while those tumors demonstrating less than 25% of the cells staining for GST-pi were considered to have a low expression GST-pi. The percentage of high GST-pi was 52% (53 of 105) while that of low GST-pi was 48% (52 of 105). No significant correlation between the expression of GST-pi and clinicopathologic factors was observed, while no significant difference in the survival of the two groups was found either. An increase in succinate dehydrogenase activity was recognized in the high-GST-pi group compared with the low-GST-pi group for each anticancer drug; however, no statistical significance was seen except for cisplatin. In the cases with adjuvant combination chemotherapy using cisplatin after a complete resection, all cases demonstrating a relapse were associated with a high GST-pi. These findings thus indicate that an overexpression of GST-pi is related to the resistance to cisplatin in human lung squamous-cell carcinoma. It is therefore important to select carefully the optimal anticancer drug for high-GST-pi cases.

Serial fetal heart rate monitoring in monozygotic twin, one of which was anencephalic

This report describes FHR patterns of monozygotic twins, one of whom was anencephalic. The recording were made from 20 to 36 weeks of gestation. Differences were observed in the FHR patterns after week 28.

Infrared/video ENG recording of positional nystagmus in subjects with peripheral vestibular disease

We performed simultaneous infrared/video and electronystagmorgraphy (ENG) recordings of eye movements in 417 patients with disequilibrium. Of that number, 54 patients with the following two criteria participated in this study: verified diagnosis of peripheral vestibular disease and the presence of positional nystagmus recorded by ENG and an infrared/ video recording system. Although horizontal nystagmus was the most common, torsional, vertical and oblique nystagmus were also demonstrated in these patients. The most striking finding was the high incidence of oblique nystagmus closely related to a significant right-left difference of the caloric response in benign positional vertigo.

Stereochemical aspects of the hydration of trans-anethole epoxide in the rat

Racemic trans-anethole epoxide [1-(4'-methoxyphenyl)-propane-1,2-oxide] was incubated with water, buffers, and rat liver microsomes and cytosol and the stereochemistry of the diols produced was determined by HPLC as their dicamphanyl esters. The diol metabolites were isolated by HPLC from the urine of rats administered [1'-14C] trans-anethole and their stereochemistry determined after derivatization to their camphanyl esters. The stereochemical course of the metabolism of trans-anethole by rat liver microsomes and cytosol is discussed.

N-ras mutation of thyroid tumor with special reference to the follicular type

Using the method of polymerase chain reaction-single strand conformation polymorphism, the point mutations of the ras oncogenes in a total of 33 thyroid tissues, including 12 follicular adenomas, 6 follicular carcinomas, 11 papillary carcinomas, and 4 undifferentiated carcinomas, were examined. The frequency of the mutation was 3% (1/33) in codon 12, 13 of Ki-ras and 18% (6/33) in codon 61 of N-ras, including 17% (2/12) in follicular adenoma, 50% (3/6) in follicular carcinoma, 0% (0/11) in papillary carcinoma and 25% (1/4) in undifferentiated carcinoma. In follicular adenoma, positivity was observed in microfollicular or trabecular subtypes. Furthermore, the mutation of ras, was examined in histologically different parts, coexisting in the same tumor in a total of four cases. Both the undifferentiated carcinoma and coexisting follicular adenoma, and both the microfollicular adenoma and trabecular nodule growing in the tumor, had the same N-ras (61) mutation. Direct sequencing analysis showed that all mutations were CAA (Gln) to CGA (Arg) transition of codon 61, except for CAA to AAA transversion in one case of follicular carcinoma. A similar genetic abnormality of N-ras genes at codon 61 between follicular adenoma and follicular carcinoma suggests that the mutation of N-ras at codon 61 might play a part in oncogenesis in follicular tumors.

Prevalence of HTLV-I/II antibodies in HIV seropositive and HIV seronegative STD patients in Vellore region in southern India

This retrospective study was designed to determine the relationship between human T-lymphotropic virus (HTLV) type-I/II infection and human immunodeficiency virus (HIV) infection among sexually promiscuous persons in southern India. Stored sera collected between 1986 and 1993 from 822 male and 488 female patients attending clinics for sexually transmitted diseases (STD), for the purpose of HIV serosurveillance, were used. They comprised 376 HIV-positive sera and 934 HIV-negative sera. They were screened for HTLV-I/II antibody by a particle agglutination test and repeatedly reactive sera were confirmed by an immunofluorescence test and a western blot test. Five (2.4%) of 212 HIV-seropositive men were confirmed positive for HTLV-I/II antibody, while none of the 610 HIV-seronegative men were positive; the difference in prevalence between HIV-seropositive and seronegative men was statistically significant (p < 0.001). Nine (5.5%) of 164 HIV-seropositive women and 3 (0.9%) of 324 HIV-seronegative women were positive for HLTV-I/II antibody (p < 0.005). All HIV-seropositives taken together, had a significantly higher prevalence of HTLV-I/II (3.7%; 14/376) compared with HIV seronegatives (0.3%; 3/934; p < 0.001). Thus, in southern India, HTLV infection, like HIV infection, is sexually transmitted, though less effectively.

Comparative mapping of the immunoglobulin C epsilon 1 gene (IGHE) in five species of nonhuman primates by fluorescence in situ hybridization

The orthologous immunoglobulin C epsilon 1 gene (IGHE) of the common chimpanzee, pygmy chimpanzee, orangutan, white-handed gibbon, and Japanese macaque was assigned to the human chromosome 14 homologue in each species and regionally mapped by fluorescence in situ hybridization to PTR15q32 (common chimpanzee), PPA15q32 (pygmy chimpanzee), PPY15q32 (orangutan), HLA17qter (white-handed gibbon), and MFU7q29 (Japanese macaque). The gene localized to the terminal region of the chromosome in each species, and so this probe provides a new telomeric DNA marker for nonhuman primates.

Plasma cell myeloma in unusually young patients: a report of two cases and review of the literature

Two cases of plasma cell myeloma in unusually young patients are reported. One was a case of multiple myeloma involving the skull and ribs in a 23-year-old woman, the other of solitary myeloma of the tibia in a 21-year-old man. Both the cases were non-secretory myeloma; however, monoclonal immunoglobulins were demonstrated by immunohistochemical studies. Plasma cell myeloma in patients below the age of 30 years is extremely rare. Our literature search disclosed 20 well-documented cases of multiple myeloma and 25 cases of solitary myeloma in patients at or below the age of 30. Plasma cell myeloma may occur in young persons, so it should be considered in the pre-biopsy differential diagnosis when bone lesions radiologically consistent with myeloma are encountered in young patients.

Chronic lymphocytic leukemia associated with nephrotic syndrome and dermatomyositis

Several types of autoimmune complications of chronic lymphocytic leukemia (CLL) have been previously reported. However, the tendency to develop autoantibodies is usually restricted to the hematopoietic system. We report a 68-year-old man who had developed dermatomyositis after ten years of chemotherapy for CLL. He also had secondary nephrotic syndrome at the onset of CLL. Subsequently, the patient died of perforation of the small intestine. The association of both nephrotic syndrome and dermatomyositis with CLL is very rare. We discuss the possibility of a casual relation.

Malignant pleurisy and intrathoracic dissemination in carcinoma of the lung: diagnostic, therapeutic and prognostic implications

Of T4 disease of lung cancer, malignant pleurisy and intrathoracic dissemination are the greatest factor preventing a cure, despite the best efforts of surgery and various adjuvant therapy modalities. Preoperative evaluation of this disease is of first importance using conventional radiology and computed tomography. Of the 43 patients who were intraoperatively diagnosed to be the disease, 8 (18%) appeared on the conventional radiology as small amounts of pleural effusion, and 9 (21%) with a interlobar pleural thickening. Based on CT findings, 16 (67%) had one or more of some disseminated nodules, interlobar pleural thickening and broad pleural indentation. In patients with T4 disease, the 5-year survival rate was 14% in patients with malignant pleurisy and/or intrathoracic dissemination, compared with the 18% in those with direct invasion to great vessels, with no significant difference. According to intrapleural instillation as postoperative adjuvant therapy, the 5-year survival rate was 25% in the patients given interleukin-2, compared with 38 months of survival time for patients prescribed doxorubicin and 33 months for those underwent exploratory thoracotomy. A more favorable prognosis of patients whose malignant pleurisy and/or intrathoracic dissemination are first found at thoracotomy can be expected when postoperative intrapleural instillation of interleukin-2 is prescribed following the resection of the intrathoracic tumors.

Epstein-Barr virus in the proliferative diseases of squamous epithelium in the oral cavity

The presence of Epstein-Barr virus was analyzed in 79 cases of oral epithelial proliferative diseases by polymerase chain reaction, in situ hybridization for Epstein-Barr virus-deoxyribonucleic acid and Epstein-Barr virus-encoded small messenger ribonucleic acid and immunohistochemistry for Epstein-Barr virus latent membrane protein. These lesions were histologically categorized as invasive squamous cell carcinoma (n = 36), carcinoma in situ (n = 10), verrucous carcinoma (n = 4), leukoplakia (n = 19), and papilloma (n = 10). Epstein-Barr virus genomes were detected in 19 squamous cell carcinoma (52.8%), four carcinoma in situ (40%), and one leukoplakia (5.3%); none of the verrucous carcinoma or papilloma cases were positive with polymerase chain reaction. By deoxyribonucleic acid in situ hybridization, positive signals were observed in the nuclei of cancer cells in 10 cases, in infiltrating lymphocytes in three, and both in one case. In patients with carcinoma in situ, only a single case was positive. In one case of leukoplakia positive signals were found in upper and middle layer squamous cells. The results by Epstein-Barr virus-encoded small messenger ribonucleic acid in situ hybridization revealed the same distribution as that by deoxyribonucleic acid in situ hybridization. Latent membrane protein was expressed only in the epithelial cells of leukoplakia but not in cases with squamous cell carcinoma and carcinoma in situ. These findings suggest that Epstein-Barr virus infection of oral squamous epithelium may be carcinogenic; alternatively, the virus may merely exist in epithelial cells of squamous cell carcinoma, carcinoma in situ, and leukoplakia as a passenger.

Structure of ascidiacyclamide as the ethanol water solvate, a cytotoxic cyclic peptide from Ascidian

The X-ray crystal structure determination of the C2H5OH.H2O solvate of ascidiacyclamide (C36H52N8O6S2), a cytotoxic cyclic peptide from marine tunicate Ascidian, revealed a C2-symmetric saddle-shaped rectangular conformation of the molecule. The water and ethanol molecules are located on the crystallographic diad axis and are held by hydrogen bonds and van der Waals contacts with the polar ring N atoms and nonpolar D-Val side-chain atoms, respectively. The molecular conformation and the interaction with solvent molecules are nearly the same as those of the compound with C2H5OH.2H2O [Ishida, In, Doi, Inoue, Hamada & Shioiri (1992). Biopolymers, 32, 131-143].

Enhancement of murine serum amyloid A3 mRNA expression by glucocorticoids and its regulation by cytokines

Macrophages are regulated by hormones, cytokines, and other substances. We examined the effects of glucocorticoids (GC) on serum amyloid A (SAA) mRNA expression using an antisense SAA3 probe, and found that dexamethasone (DEX) and triamcinolone (TC) increased SAA3 mRNA expression by macrophage cell lines in a time- and concentration-dependent manner. Both an RNA polymerase II antagonist, alpha-amanitin, and a specific GC antagonist, RU38486, inhibited the enhancement of SAA3 mRNA expression by DEX. These results show that GC lead to enhanced SAA3 mRNA transcription. Nuclear run-on experiments supported these results. Enhanced expression of SAA3 mRNA by DEX was accompanied by production of SAA3 protein. Interferon-gamma (IFN-gamma) alone showed any effect on SAA3 mRNA expression. Enhanced SAA3 expression by DEX was inhibited by treatment with IFN-gamma in a dose-dependent manner. Either transforming growth factor (TGF)-beta 1 or interleukin (IL)-4 alone showed no effect on SAA3 mRNA expression, but suppressed DEX-induced SAA3 expression. The timing of the effects of IFN-gamma and TGF-beta 1 on DEX-induced SAA3 expression differed: IFN-gamma showed its effect between 30 h before and 18 h after DEX administration, whereas TGF-beta 1 showed an effect when administered concomitantly with DEX and in the late stages after DEX administration. IL-4 mildly suppressed DEX-induced SAA3 expression when given 12 h before and after DEX administration.

Characteristic molecular packing in the crystal structure of tert-butoxycarbonyl-L-phenylalanyl-L-methionine methyl ester

The molecular conformation and association of the peptide Boc-L-Phe-L-Met-OMe have been studied in the solid state by X-ray diffraction. The peptide crystallizes in the orthorhombic system, space group P2(1)2(1)2(1), with cell parameters of a = 9.821(2), b = 25.394(6), c = 28.714(8) A, V = 7161(3) A3. The structure has been solved by direct methods and refined to a final R of 0.079 for 5464 independent reflections with Fo > or = sigma(Fo). The crystal consists of three independent molecular conformations per asymmetric unit. Respective peptide backbones adopt an extended conformation with the side-chains of Phe and Met residues being arranged below and above the backbone chains. Contrary to the sheet structure most frequently observed in the crystal packing of the extended peptide conformations, three independent molecules lie spirally along the c-axis and form a pin-wheel-like crystal packing. The sheet structures formed by two of three independent molecules are almost at right angles to the backbone of the remaining molecule. This molecular packing mode would provide a possible interaction model between the intersecting beta-sheet structure and single-strand structure of polypeptide.

Adenoid cystic carcinoma with morphological diversities--report of a case and discussion of the morphologic and immunohistochemical features

A case of adenoid cystic carcinoma (ACC) with polymorphous features and an unknown differential diagnosis was presented. It appeared, without any pain, in the right maxillary sinus of a 47 year-old man. A variety of histopathological patterns were found, including glandular, cribriform, tubular and solid ones. However, the typical features of ACC, such as cribriform pattern associated with pseudocyst and tubular formations were rather scarce. A single cell strand appearance, so-called "Indian file arrangement", and papillary cystic formation were also noted, which are often associated with polymorphous low-grade adenocarcinoma (PLGA). Immunohistochemistries of EMA, CEA and musclespecific actin showed also similar staining patterns to those of PLGA in some areas. Our case could not be regarded as PLGA; but this case with features of PLGA as well as those of ACC might suggest an entity of transitional type between ACC and PLGA.

Cathepsin B expression and laminin degradation as factors influencing prognosis of surgically treated patients with lung adenocarcinoma

We examined, immunohistochemically, tissues from primary lung adenocarcinomas. In 142 tumors, the mean overall labeling percentage of cathepsin B was 26.5 +/- 22.3 (SD). The mean labeling percentage of cathepsin B in cases with stage I disease was lower than that in cases with stages IIIA, IIIB, or IV disease (P < 0.05). Of the 115 tumors examined for laminin-positive basement membranes, 54 (47%) had a continuous pattern and 61 (53%) had a discontinuous pattern. The mean labeling percentage of cathepsin B was 35.0 +/- 24.2 in tumors with a discontinuous pattern, compared with the 21.9 +/- 16.9 in those with a continuous pattern (P < 0.01). The overall 5-year survival rates of patients with high and low cathepsin B expressions were 26% and 77%, respectively (P < 0.01), including 45% and 94% for patients with stage I disease, respectively (P < 0.01), and 15% and 60% for those with stage IIIB disease, respectively (P < 0.05). Multivariate analysis using the Cox life table regression model showed cathepsin B to be a significantly independent factor associated with death due to the disease. We conclude from this study that tumors with a discontinuous pattern of laminin have a higher percentage of cathepsin B, and the survival rate was poor for patients with a high expression of cathepsin B. Thus, cathepsin B may be useful in assessing prognosis in lung adenocarcinoma.

Effects of age and sex on sodium chloride sensitivity: association with plasma renin activity

The mechanism by which excessive NaCl intake raises blood pressure has not been fully clarified. The present study was undertaken in 87 Japanese inpatients with essential hypertension to investigate the interrelation among effects of age, sex and the renin-angiotensin system on NaCl sensitivity. After ingesting a regular NaCl diet (170 mmol/day) for one week, subjects were placed sequentially on a week of low NaCl diet (50 mmol/day) and a week of high NaCl diet (340 mmol/day). NaCl sensitivity defined as the difference in mean blood pressure between the low and high NaCl diets did not differ between genders. NaCl sensitivity was positively correlated with age and the change in PRA. The fall in PRA after NaCl loading was significantly smaller in women than in men. By multiple regression analysis, age and the change in PRA independently contributed to the change in mean blood pressure. Furthermore, the interaction between sex and the change in PRA was selected as a statistically significant variable. In conclusion, NaCl sensitivity of blood pressure is independently associated with age and the inadequate suppression of the renin-angiotensin system. Because the contribution of the change in PRA to NaCl sensitivity was greater in women than in men, the mechanism of blood pressure elevation after NaCl loading may differ between genders.

DNA-binding characterization of a novel anti-tumour benzo[a]phenazine derivative NC-182: spectroscopic and viscometric studies

NC-182 is a novel anti-tumour compound having a benzo[a]phenazine ring. Fluorescence, absorption and c.d. spectroscopy, as well as viscometric titrations, were systematically performed to investigate the interaction mode of this drug with DNA and its effect on DNA conformation, based on comparative measurements with distamycin (DNA minor-groove binder) and daunomycin (DNA-base intercalator). NC-182 was found to be a potent intercalator of DNA, especially the B-form DNA, although no specificity was observed against the base-pair. The binding of NC-182 to B-DNA behaves biphasically, depending on the molar ratio (r) of drug to DNA: NC-182 acts to render the B-form structure rigid at relatively low r value and to promote the transformation of B- to non-B forms at high r values. It was also shown that NC-182 promotes the unwinding of Z-form DNA to B-form. Viscometric, u.v. 'melting' and c.d. experiments further showed that (1) the DNA duplex structure is thermally stabilized by intercalation with NC-182 and (2) the intercalation of NC-182 into a poly(dA).2poly(dT) DNA structure thermally stabilizes the triplex structure, resulting in a melting point close to that of the duplex structure; the melting curves of triplex and duplex structures coincide at r > 0.06. These observations make a significant contribution to our understanding of the biological properties of this novel benzo[a]phenazine derivative, a new anti-tumour tumour agent against multidrug-resistant and sensitive tumours.

The enantioselective metabolism of 4-isopropenyltoluene in rabbits

4-Isopropenyltoluene (8) was administered orally to rabbits and the following four optically active metabolites, 2-(p-tolyl)propanoic acid (10), p-(1-carboxyethyl)benzoic acid (11), 2-hydroxy-2-(p-tolyl)propanoic acid (12), and 2-(p-tolyl)-1,2-propanediol (13) were isolated from urine in addition to an optically inactive metabolite, 4-isopropenylbenzoic acid (9). The enantiomeric ratios of the metabolites 10 and 11 were respectively R/S = 33:67 and 39:61 (S predominance), whereas those of the metabolites 12 and 13 possessing a tertiary hydroxyl group were R/S = 77:23 and 84:16 respectively (R predominance). The presumed metabolic pathways of 8 in rabbits leading to these metabolites are discussed.

Lack of increase in platelet Ca2+ and Na+ in deoxycorticosterone acetate-salt hypertensive rats

We have previously characterized abnormal Ca2+ handling in platelets of spontaneously hypertensive rats (SHRs). In this study, we investigated whether cellular Ca2+ metabolism and/or Na+ concentration is altered in platelets of deoxycorticosterone acetate-salt hypertensive rats (DOCA rats). The resting cytosolic Ca2+ concentration ([Ca2+]i) in platelets was significantly lower in DOCA rats than controls (54.5 +/- 1.4 vs. 61.2 +/- 2.3 nmol/l). The amplitude of the [Ca2+]i transient induced by thrombin was significantly increased in the absence, but not the presence, of external Ca2+ in DOCA rats compared with control rats. The [Ca2+]i response to 5 mumol/l ionomycin in the Ca(2+)-free buffer was greater in DOCA rats than in controls (546 +/- 23 vs. 470 +/- 18 nmol/l), indicating larger intracellular Ca2+ stores. The rate of recovery of [Ca2+]i after the peak response to thrombin was decreased in DOCA rats (79% at 0.1 U/ml and 91% at 1.0 U/ml thrombin of control rats). Cytosolic Na+ concentration ([Na+]i) in platelets was similar in DOCA and control rats. Altered Ca2+ levels are not correlated with [Na+]i in this salt-sensitive hypertensive model. Therefore, an increased [Ca2+]i is not an obligatory phenomenon in hypertension.