Up-regulation of CC chemokine receptor 6 on tonsillar T cells and its induction by in vitro stimulation with alpha-streptococci in patients with pustulosis palmaris et plantaris

Pustulosis palmaris et plantaris (PPP) is a tonsil-related disease; tonsillectomy is somewhat effective in treating the condition. However, the aetiological association between the tonsils and PPP has not yet been elucidated fully. Recently, some chemokines and chemokine receptors, including CC chemokine receptor (CCR) 4, CCR6 and CX chemokine receptor (CXCR) 3, have been reported to play important roles in the development of psoriasis, a disease related closely to PPP. In this study, we found that CCR6 expression on both tonsillar and peripheral blood T cells was up-regulated more intensively in PPP patients than in non-PPP patients (P < 0.001 for both), but CCR4 and CXCR3 expressions were not. In vitro stimulation with alpha-streptococcal antigen enhanced CCR6 expression significantly on tonsillar T cells in PPP patients (P < 0.05), but this was not observed in non-PPP patients. The chemotactic response of tonsillar T cells to the CCR6 ligand CC chemokine ligand (CCL) 20 was significantly higher in PPP patients than in non-PPP patients (P < 0.05). The percentage of CCR6-positive peripheral blood T cells decreased after tonsillectomy in PPP patients (P < 0.01); this decrease correlated with an improvement of skin lesions (P < 0.05, r = -0.63). The numbers of CCR6-positive cells and the expression of CCL20 were increased significantly in pathological lesions compared with non-pathological lesions in PPP skin (P < 0.01, P < 0.05 respectively). These results suggest that a novel immune response to alpha-streptococci may enhance CCR6 expression on T cells in tonsils and that CCR6-positive T cells may move to peripheral blood circulation, resulting in recruitment to target skin lesions expressing CCL20 in PPP patients. This may be one of the key roles in pathogenesis of the tonsil-related disease PPP.

Peptidergic and catecholaminergic fibers in the human corneal epithelium. An immunohistochemical and electron microscopic study

Innervation of the clinically normal human corneal epithelium was investigated utilizing immunohistochemical and electron microscopic techniques. All corneal epithelial sheets examined demonstrated neuron specific enolase (NSE: a non-specific marker for neural elements), calcitonin gene-related peptide (CGRP: a putative marker for sensory fibers), and tyrosine hydroxylase (TH: a marker for catecholaminergic nerves) immunoreactive fibers. NSE, CGRP, and TH fibers formed a dense basal epithelial plexus. The CGrp fibers tended to have beaded profiles, while TH fibers were smooth. Numerous free nerve endings originating from the basal epithelial plexus og NSE and CGRP fibers terminated throughout the thickness of epithelium. The densities of fibers in the basal epithelial nerve plexus were: NSE greater than CGRP greater than TH. Transmission electron microscopy demonstrated two types of epithelial nerve fibers, one containing large dense-core vesicles and another small dense-core vesicles. Both types contained clear vesicles. These large and small dense-core vesicle fibers appeared to correspond to the CGRP and TH immunoreactive fibers, respectively. These results provide morphological baseline data on the normal sensory and sympathetic corneal epithelial innervation.

Roles of aquaporin-3 water channels in volume-regulatory water flow in a human epithelial cell line

Membrane water transport is an essential event not only in the osmotic cell volume change but also in the subsequent cell volume regulation. Here we investigated the route of water transport involved in the regulatory volume decrease (RVD) that occurs after osmotic swelling in human epithelial Intestine 407 cells. The diffusion water permeability coefficient (Pd) measured by NMR under isotonic conditions was much smaller than the osmotic water permeability coefficient (Pf) measured under an osmotic gradient. Temperature dependence of Pf showed the Arrhenius activation energy (Ea) of a low value (1.6 kcal/mol). These results indicate an involvement of a facilitated diffusion mechanism in osmotic water transport. A mercurial water channel blocker (HgCl(2)) diminished the Pf value. A non-mercurial sulfhydryl reagent (MMTS) was also effective. These blockers of water channels suppressed the RVD. RT-PCR and immunocytochemistry demonstrated predominant expression of AQP3 water channel in this cell line. Downregulation of AQP3 expression induced by treatment with antisense oligodeoxynucleotides was found to suppress the RVD response. Thus, it is concluded that AQP3 water channels serve as an essential pathway for volume-regulatory water transport in, human epithelial cells.

Postnatal changes in expression of vesicular glutamate transporters in the main olfactory bulb of the rat

Olfactory information is initially processed through intricate synaptic interactions between glutamatergic projection neurons and GABAergic interneurons in the olfactory bulb. Although bulbar neurons and networks have been reported to develop even postnatally, much is yet unknown about the glutamatergic neuron development. To address this issue, we studied the postnatal ontogeny of vesicular glutamate transporters (VGLUT1 and VGLUT2) in the main olfactory bulb of rats, using in situ hybridization, immunohistochemistry, and their combination. In situ hybridization data showed that VGLUT1 mRNA is intensely expressed in differentiating mitral cells and smaller cells of the mitral cell layer (MCL) on postnatal day 1 (P1), and also at lower levels in small- and medium-sized cells, presumably tufted cell populations, of the external plexiform layer (EPL) from P5 onward. VGLUT2 mRNA was expressed in many MCL cell populations on P1, also in small- and medium-sized cells of the EPL at almost the same level as MCL cells between P5 and P7, and became apparently less intense in the MCL than in the EPL from P10 onward. The expression, unlike VGLUT1 mRNA, was also found in small-sized cells of the interglomerular region. In partial agreement with these data, immunohistochemical analyses demonstrated that subsets of mitral and EPL cells are stained for VGLUT1 or VGLUT2, with the former cells coexpressing both subtypes until P5. Moreover, a combined fluorescence in situ hybridization-immunohistochemical dual labeling of the P10 bulb revealed that neither VGLUT1 nor VGLUT2 mRNA is expressed in GABAergic or dopaminergic periglomerular cells, implying their expression in other periglomerular cell subclasses, external tufted cells and/or short-axon cells. Thus, the present study suggests that early in the postnatal development distinct glutamatergic bulbar neurons of rats express spatiotemporally either or both of the two VGLUT subtypes as a specific vesicular transport system, specifically contributing to glutamate-mediated neurobiological events.

Sequential pancreaticoduodenectomy after living donor liver transplantation for cholangiocarcinoma

Liver transplantation (LT) for patients with primary sclerosing cholangitis (PSC) is often contraindicated due to concomitant occurrence of cholangiocarcinoma (CC). Cases of simultaneous pancreaticoduodenectomy (PD) with LT have been sporadically reported; however, the applicability of such an invasive procedure to patients with CC has not been validated. We report here a case of sequential PD performed 44 days after a successful living donor liver transplantation (LDLT) using a left lobe graft. Although a clear pancreatic juice leakage through the drain persisted for days after surgery, the patient recovered from the complication and was discharged 32 days after the procedure. Currently, 1 year after LDLT, the patient is doing well with no evidence of recurrence. In conclusion, a sequential PD following LDLT is a safe and feasible option to treat CC complicating PSC. Long-term follow-up and accumulation of cases are necessary to evaluate the effectiveness of this procedure for this complicated disease.

Demonstration of a Marek's disease virus-specific antigen in tumour lesions of chickens with Marek's disease using monoclonal antibody against a virus phosphorylated protein

By use of monoclonal antibody against a Marek's disease virus (MDV) serotype 1-specific phosphorylated protein, MDV antigen-positive cells were demonstrated in tumour lesions of various visceral organs of chickens with Marek's disease. However, these tumour lesions did not appear to have the MDV glycoproteins gA and gB, which are considered to be late gene products of the virus genome gA and gB as well as the phosphorylated protein were detected in the feather follicle epithelium, which is a permissive site for MDV replication.

[Congenital bronchoesophageal fistula in an adult; an undiscribed mechanism of symptom tolerance]

We present a case of a congenital bronchoesophageal fistula in a 61-year-old woman. She was referred to hospital because of postprandial heart burn. Three-dimensional (3D) computed tomography (CT) demonstrated an anastomosis between her right intermediate bronchus and esophagus. In spite of direct communication between her bronchus and esophagus, she has never suffered severe infection. We visualized the orifice of fistula closed with mucosal flap in swallowing by means of a bronchofiberscope. The delay of a diagnosis was explained by symptom tolerance. Some theories as to the symptom tolerance are found in literatures, but we supposed to find an undiscribed mechanism; closure of the orifice in swallowing. The fistula was surgically closed.

[Reoperation for left main bronchial stump fistula developing after pneumonectomy]

We report the case of a 71-year-old male patient who underwent reoperation for bronchial stump fistula developing after left pneumonectomy for adenocarcinoma of the left lung (clinical stage IIB). After surgery, he developed persistent, severe cough and chest X-ray films taken on the 23rd postoperative day showed a drop in the air-fluid level in the left lung field, which, along with bronchoscopic findings, strongly suggested the bronchial stump fistula and subsequent reoperation was performed. Both superior pulmonary vein and main pulmonary artery were dissected again proximally in pericardium, and the left main bronchus was separated from the surrounding tissue. Bronchial stump was closed with a stapler as close to the carina as possible, and additional resection was performed. After reoperation, the patient had an uneventful course, and was discharged in the second postoperative week. Shorter length of bronchial stump may be the most important factor to prevent the bronchial stump fistula developing after pneumonectomy.

Effects of Bupleurum scorzoneraefolium, Bupleurum falcatum, and saponins on nephrotoxic serum nephritis in mice

ETHNOPHARMACOLOGICAL SIGNIFICANCE

Bupleuri radix is a commonly prescribed Oriental herbal medicine containing extracts of different Bupleuri species. We wished to determine whether two of these species, Bupleurum scorzoneraefolium and Bupleurum falcatum, or their active ingredients, saikosaponins a, c, and d, could prevent the development of immune-complex nephritis in nephrotoxic serum treated mice.

MATERIALS AND METHODS

Immune-complex nephritis was created in C57BL/6 mice by administration of nephrotoxic serum containing anti-basement membrane antibodies. Mice were next given one of five treatments: Bupleurum scorzoneraefolium, Bupleurum falcatum, saikosaponin a, saikosaponin c, or saikosaponin d. Proteinuria, blood urea nitrogen, creatinine, and renal histological changes were then examined.

RESULTS

Saikosaponin c almost completely prevented the development of nephritis, although immune-complex deposition was not affected. Bupleurum falcatum and saikosaponin d had a significant, although lesser effect, and Bupleurum falcatum and saikosaponin a showed no effect.

CONCLUSIONS

The mechanism of action of saikosaponin c and the reasons for the difference between the two bupleuri species should be investigated further in order to find the best way to utilize the therapeutic effect of Bupleuri radix on nephritis.

Aqueous humour levels of asymmetric dimethylarginine (ADMA) are correlated with pigment epithelium-derived factor (PEDF) in patients with uveitis

The association between the aqueous humour levels of asymmetric dimethylarginine (ADMA) and pigment epithelium-derived factor (PEDF) was evaluated. Aqueous humour levels of ADMA and PEDF were measured by high-performance liquid chromatography and enzyme-linked immunosorbent assay, respectively, in 31 uveitis samples and nine cataract control samples. Aqueous humour ADMA and PEDF levels were significantly higher in infectious and non-infectious uveitis patients than in controls (0.67+/-0.04 nmol/ml and 0.55+/-0.03 nmol/ml versus 0.43+/-0.04 nmol/ml for ADMA; 8.22+/-1.45 microg/ml and 5.22+/-0.95 microg/ml versus 1.32+/-0.22 microg/ml for PEDF). A significant positive correlation between ADMA and PEDF levels in aqueous humour was found in control and uveitis patients. These results demonstrated that the aqueous humour level of ADMA is correlated with PEDF in humans and suggest that both ADMA and PEDF in aqueous humour may be elevated in response to inflammation in uveitis.

[Preoperative assessment of myocardial ischemia in thoracic surgery for lung cancer]

BACKGROUND

Morbidity of myocardial ischemia in the thoracic surgery for lung cancer has been reported in the literatures, although, the risk of myocardial ischemia is not well identified preoperatively.

OBJECTIVES

The aim of this study was to describe the prevalence of severe coronary stenosis in the thoracic surgery for lung cancer.

METHODS

From January 2004 to December 2006, data were collected concerning 175 consecutive patients underwent lung resection for lung cancer. Prior to the surgery, we performed coronary angiography on the patients with either ischemic change in the exercise electrocardiogram (ECG) testing or comorbid conditions (current or previous smoking, hypertention, diabetes mellitus, hyperlipidemia or history of chest pain).

RESULTS

Fifty-eight (33%) patients underwent coronary angiography. Coronary stenosis was detected in 19 patients (10.9%), including 6 patients (3.4%) with severe stenosis. These 6 patients received percutaneous coronary intervention or coronary artery bypass grafting prior to the lung resection, which resulted in no incidence of perioperative myocardial ischemia. Three of 6 patients with severe stenosis were negative for ischemic changes in exercise ECG testing.

CONCLUSION

The prevalence of severe coronary stenosis is 3.4%, which is supposed to indicate the risk of perioperative myocardial ischemia in the thoracic surgery for lung cancer.

Sentinel lymph node biopsy for breast cancer

This manuscript is a brief discussion of the developments of the technology and concepts that led to modern procedures of radiotracer guided surgery of sentinel nodes (SNs) for breast cancer. The past section highlights some of the contributions by key persons involved with SN methods. The present section describes the magnitude of types of published material to date. The future section describes the major international trials and some important technical challenges yet to be solved.

Telmisartan, an angiotensin II type 1 receptor blocker, inhibits advanced glycation end-product (AGE)-induced monocyte chemoattractant protein-1 expression in mesangial cells through downregulation of receptor for AGEs via peroxisome proliferator-activated receptor-gamma activation

Interaction between advanced glycation end-products (AGEs) and their receptor (RAGE) plays a central role in diabetic nephropathy pathogenesis. Pathophysiological crosstalk between the AGEs-RAGE system and angiotensin II (Ang II) is also involved in this disease. This study investigated the role of proliferator-activated receptor-gamma (PPAR-gamma)-modulating activity on inhibition of monocyte chemoattractant protein (MCP-1) expression. Telmisartan, an Ang II type 1 receptor blocker, downregulated RAGE mRNA and inhibited superoxide generation and MCP-1 gene expression in mesangial cells; these processes were blocked by GW9662, a PPAR-gamma inhibitor. Candesartan, an Ang II type 1 receptor blocker, did not suppress AGEs-induced superoxide generation. Telmisartan and the antioxidant, N-acetylcysteine, completely inhibited AGEs-induced MCP-1 overproduction by mesangial cells. These results suggest that telmisartan inhibits AGEs-signalling to MCP-1 expression in mesangial cells by downregulating RAGE gene expression and subsequent oxidative stress generation via PPAR-gamma activation. This study has demonstrated a unique benefit of telmisartan in that it may function as an anti-inflammatory agent against AGEs via PPAR-gamma activation and may play a protective role in diabetic nephropathy.

Dural arteriovenous fistula involving the posterior condylar canal

Although dural arteriovenous fistulas (DAVFs) occur in any structure that is covered by the dura mater, DAVFs at the posterior condylar canal have not been reported. We present a DAVF that involves the posterior condylar canal and drains into the posterior condylar vein and the occipital sinus, which was treated by selective transvenous embolization. Knowledge of venous anatomy of the craniocervical junction and careful assessment of the location of the arteriovenous fistula can contribute to successful treatment.

Expression and prognostic significance of EFNB2 and EphB4 genes in patients with oesophageal squamous cell carcinoma

OBJECTIVE

Tyrosine kinases and its receptors play important roles in growth, migration, and invasion of malignant cells. Among those, there are only few reports examining the expression pattern of Eph/ephrin signalling system in oesophageal carcinoma. The prognostic importance of ephrin-B2 ligand (EFNB2) and its receptor EphB4, and its correlation with clinicopathologic characteristics are yet to be delineated in patients with oesophageal carcinoma.

MATERIALS AND METHODS

EFNB2 gene and EphB4 receptor gene were examined of mRNA specimens in 61 patients with oesophageal squamous cell carcinoma using reverse-transcriptase polymerase chain reaction. EFNB2 protein was selectively examined using an immunohistochemical analysis.

RESULTS

EFNB2 mRNA expression was detected in 38 (62.3%) and EphB4 expression was found in 44 (72.1%) out of 61 cancer tissues analysed. There was a statistically significant correlation between EFNB2 expression and number of lymph node metastasis (P<0.05), and a trend toward statistical significance for correlation between EFNB2 expression and American Joint Committee on Cancer Classification Stage (P<0.1), indicating that EFNB2 expression was up-regulated by advancement of the disease process. EFNB2 protein was strongly expressed in tumour with high mRNA EFNB2 expression and was weakly expressed in tumour with low mRNA expression in some representative tumours. The 5-year overall survival rate (23%) of patients with positive EFNB2 gene expression was significantly worse than 55% of negative expression (P<0.05). The results of multivariate analysis of prognosticators for survival showed that positive EFNB2 gene expression (P<0.01) and number of lymph node metastasis (P<0.05) were identified as significant factors indicative of a poorer survival.

CONCLUSIONS

EFNB2 gene expression may be a biological marker and a useful prognostic indicator in patients with oesophageal squamous cell carcinoma.

Cryopreservation of wild mouse spermatozoa

Spermatozoa of wild mice from China, Czechoslovakia, Denmark, India, Japan and Switzerland were frozen and stored at -196 degrees C. After thawing, intact oocytes were inseminated in vitro with relatively high motility frozen-thawed mouse spermatozoa from Czechoslovakia, Denmark and India, while oocytes with a partially dissected zona were inseminated with low motility frozen-thawed spermatozoa from China, Japan and Switzerland. Embryos developing to the 2-cell stage from oocytes fertilized with frozen-thawed spermatozoa were transferred to the oviducts of female recipients on the first day of pseudopregnancy (day when a vaginal plug was confirmed). Successful embryo development to the 2-cell stage was 46 to 67%. Offspring resulted from 17 to 51% of these transferred 2-cell embryos.

Aqueous humor levels of asymmetric dimethylarginine (ADMA) are positively associated with monocyte chemoattractant protein-1 (MCP-1) in patients with uveitis

BACKGROUND/AIMS

The aim of the study was to evaluate whether aqueous humor levels of asymmetric dimethylarginine (ADMA) are associated with monocyte chemoattractant protein-1 (MCP-1).

METHODS

Aqueous humor levels of ADMA and MCP-1 were measured by high-performance liquid chromatography (HPLC) and ELISA, respectively, in 31 uveitis samples and nine cataract control samples.

RESULTS

Aqueous humor ADMA and MCP-1 levels were significantly higher in infectious or non-infectious uveitis patients than in controls (0.67+/-0.04 nmol/ml vs 0.55+/-0.03 nmol/ml vs 0.43+/-0. 04 nmol/ml (p<0.01) and 29.0+/-11.3 ng/ml vs 4.5+/-1.2 ng/ml vs 0.47+/-0.1 ng/ml (p<0.01), respectively). A positive correlation between ADMA and MCP-1 levels in aqueous humor was found in control and uveitis patients (r = 0.33, p<0.05).

CONCLUSION

The results demonstrated that aqueous humor levels of ADMA were positively associated with MCP-1 in humans. Our present observations suggest that aqueous humor levels of ADMA may be a novel biomarker of inflammation in uveitis.

A phase II study of doxorubicin plus paclitaxel followed by weekly paclitaxel as neoadjuvant chemotherapy for breast cancer (SBCCSG-07)

11103

Background: The primary aim of this study was to estimate the rate of clinical and pathologic response to preoperative doxorubicin and paclitaxel followed by weekly paclitaxel in stage II /III breast cancer. Secondary objective included the determination of time to progression, over all survival, the rate of breast conservation surgery, feasibility and safty. Saitama breast cancer clinical study group-07 study (SBCCSG-07; CTR:UMIN000000504) Methods: Patients were treated with 50 mg/m2 of doxorubicin intravenously and 150 mg/m2 of paclitaxel both administered intravenously on day 1 every 21 days for 4 courses followed by 80 mg/m2 of paclitaxel administered intravenously on day 1 every week for 12 courses(AP-wP). The rate of pathological, clinical response and breast conserving surgery and adverse events (CTCAE ver.3.0) were analyzed in stage II /III breast cancer. Results: From December 2005 to August 2006, 40 planned patients have been enrolled. One patient canceled chemotherapy for interstitial pneumonia. 16 patients have finished their treatment, received surgery and are evaluable for response. Clinical response rate was 81.2% (50.0%CR; 31.2%PR). Stable disease and progressive disease occurred in 2 (12.5%) patients and 1 (6.3%) patient. Four patients (25%) had pathological complete response. Conclusions: Preliminary results indicate that the AP-wP regimen feasible and very active as induction chemotherapy of operable breast cancer. Updated data including evaluation of biological markers will be presented at the meeting.

No significant financial relationships to disclose.

Phase I study of YM155, a first-in-class survivin suppressant, in patients with advanced solid tumors in Japan

3536

Background: YM155 is a small molecule expected to induce apoptosis in tumor tissue by suppressing survivin. In the US, a phase I study was conducted with a 168-hr continuous infusion every 3 wks. In Japan, we conducted a similar phase I study to evaluate toxicity profile of YM155 compared with the results of the US study. Methods: The objectives were to determine the MTD, characterize the pharmacokinetics (PK) and observe anti-tumor activity. A standard 3+3 dose escalation scheme was utilized. Results: 34 pts (M/F: 24/10, median age 60, range 26 - 81) were enrolled into 6 dose cohorts [1.8 mg/m2/day (N=3), 3.6 (6), 4.8 (6), 6.0 (8), 8.0 (6), and 10.6 (5)]. 2/5 pts experienced dose-limiting toxicities (DLT) during cycle (C) 1 at 10.6 mg/m2/day (blood creatinine increased (2), lymphocyte count decreased (1)), thus the MTD was 8.0 mg/m2/day. Both pts experienced a DLT (56 yo female, 57 yo male), reached to NCI-CTC grade 2 blood creatinine level at the end of infusion. One of them developed to grade 3 blood creatinine level on day10. They recovered to grade 1 or below in 2 wks without plasma dialysis, so that they continued YM155 infusion decreased to 8.0 mg/m2/day. Renal parameters of them changed in a regular manner, as urine microalbumin increased from day 3 to 7, protein urine from day 6 to 8, and blood creatinine from day 8 to 10. As the other DLT during C1, 1/6 pt experienced AST increased at 6.0 mg/m2/day.. The most frequent AEs were: fatigue (39%), urine microalbumin present (39%), pyrexia (33%), and anemia / haemoglobin decreased (30%). At the MTD, the median YM155 clearance was 39 L/hr with a median steady state concentration of 13 ng/mL and a median terminal half-life of 20 hours. 9/33 pts showed stable disease (SD) and minor tumor shrinkage was observed in 5 of them. One pt (thyroid carcinoma) is ongoing (40 wks) and has had disappearance of pleural effusion. Another patient (malignant fibrous histiocytoma) showed tumor regression in abdominal cavity confirmed by CT scan. Conclusions: YM155, the first survivin suppressant, was well tolerated and the MTD was 8.0 mg/m2/day x 168-hr in Japan. The contribution of YM155 to the treatment of advanced solid tumors should be evaluated in further trials.

No significant financial relationships to disclose.

Novel therapeutic targets for diabetic nephropathy

Diabetic nephropathy is a leading cause of end-stage renal failure, which could account for disabilities and high mortality rates in patients with diabetes. Diabetic nephropathy seems to occur as a result of an interaction between metabolic and hemodynamic factors, which activate common pathways that lead to renal damage. Recent large prospective clinical studies have shown that intensive glucose control reduces microvascular complications effectively among patients with diabetes, and the renin-angiotensin system (RAS) is also an important target for both metabolic and hemodynamic derangements in diabetic nephropathy. High glucose, via various mechanisms such as increased production of oxidative stress and advanced glycation end products (AGEs), activation of the RAS and protein kinase C (PKC), and stimulation of the polyol pathway, elicits vascular inflammation and alters gene expression of growth factors and cytokines, thereby it might be involved in the development and progression of diabetic nephropathy. Therefore, to develop novel therapeutic strategies that specifically target these metabolic and hemodynamic derangements is desired for patients with diabetic nephropathy. In this review, we discuss the molecular mechanisms of diabetic nephropathy and review the promising therapeutic targets for this devastating disorder.

Adult-onset acute tubulointerstitial nephritis and uveitis with Fanconi syndromeCase report and review of the literature

We report a case of tubulointerstitial nephritis and uveitis (TINU syndrome) with full type Fanconi syndrome. A 32-year-old woman presented with fatigue, anorexia and weight loss. Laboratory findings showed anemia, polyclonal hypergammaglobulinemia and moderate renal dysfunction. Tubular function abnormalities were normoglycemic glucosuria, panaminoaciduria, phosphaturia and kaliuresis leading to hypokalemia. Renal tubular acidosis and hypouricemia were also evident. Serum antistreptolysin O titer was high. Ocular symptoms (bilateral anterior uveitis) emerged soon after admission. Renal biopsy showed diffuse tubulointerstitial infiltration by lymphocytes and plasma cells without granuloma. Treatment with systemic steroids was given and renal function, and ocular symptom returned to normal with 3 months. Although tubular abnormalities involving TINU syndrome has already been reported, the disease associated with full type Fanconi syndrome has rarely been seen, and systemic steroid may be beneficial in reducing the development of tubulointerstitial injury.

69 APPLICATION OF BOVINE AMNIOTIC CELLS FOR PRENATAL GENETIC DIAGNOSIS AND NUCLEAR TRANSFER

Amniotic fluid includes many cells derived from the fetus called 'amniotic cells'. Although these amniotic cells may have much potential as a reproduction or breeding source of the animals, there has been limited study of the potential applications of these cells. We examined the potential of bovine amniotic cells for biotechnological use. Bovine amniotic cells separated from amniotic fluid obtained from a slaughterhouse were prepared for use in all experiments. First, to examine the culture condition of amniotic cells, the cells were cultured in various culture media. Cytologic normality of the cultured cells was analyzed by chromosomal examination and Papanicolaou examination. Second, to examine the potential of cultured amniotic cells for prenatal genetic diagnosis, the cells were used for sexing by PCR. The coincidence of the results with the gender of the fetus from which the cells were derived was examined. Third, we used the cultured cells as donor cells for nuclear transfer, and examined the developmental ability of reconstructed embryos. The normality of the blastocysts derived from the reconstructed embryos was examined by chromosomal examination and transplantation to the recipient heifer. Bovine amniotic cells were cultured successfully in Amnio-max C-100� (GIBCO, Grand Island, NY, USA), which is marketed as culture medium for human amniotic cells. In all cases, the sex of cultured amniotic cells analyzed by PCR was coincident with that of the fetus from which the amniotic cells were derived. The frequencies of cleavage and development to the blastocyst stage of embryos reconstructed from amniotic cells were the same as those of fetal fibroblasts. There were no differences in the normality of chromosomal number between blastocysts derived from amniotic cells and fetal fibroblasts. A blastocyst derived from amniotic cells developed into a fetus after transplantation. DNA microsatellite analysis of the fetus at Day 64 was coincident with that of the fetus from which the amniotic cells were derived. These results indicate that bovine amniotic cells can be successfully cultured in vitro, and the cultured cells precisely reflect the genetic information of the fetus from which the cells were derived. The cultured cells also have developmental ability as donor cells for nuclear transfer. Amniotic cells may have the potential for effective reproduction and breeding using genetic and biotechnological sources.

A possible involvement of crosstalk between advanced glycation end products (AGEs) and asymmetric dimethylarginine (ADMA), an endogenous nitric oxide synthase inhibitor in accelerated atherosclerosis in diabetes

Endothelial dysfunction due to reduced bioavailability of nitric oxide (NO) is an early step in the course of atherosclerotic cardiovascular disease (CVD). NO is synthesized from L-arginine via the action of NO synthase (NOS), which is known to be blocked by endogenous L-arginine analogues such as asymmetric dimethylarginine (ADMA). ADMA is a naturally occurring amino acid found in plasma and various types of tissues. Recently, it has been demonstrated that plasma levels of ADMA are elevated in patients with diabetes. It has also been reported that elevated plasma levels of ADMA are associated with increased risks of nonfatal stroke and myocardial infarction in patients with early diabetic nephropathy. These findings suggest that the elevated ADMA in diabetes could contribute to acceleration of atherosclerosis in this population. In diabetes mellitus, the formation and accumulation of advanced glycation end products (AGEs) progress. There is a growing body of evidence to show that AGEs are involved in the development and progression of atherosclerosis in patients with diabetes. Since ADMA is mainly metabolized by dimethylarginine dimethylaminohydrolase (DDAH), it is conceivable that the impairment of DDAH actions by AGEs could be one possible molecular mechanism of the ADMA elevation in diabetic patients. In this paper, we would like to propose the possible ways of testing our hypotheses. Does treatment with metformin, which has a potential effect on the inhibition of glycation reactions in vivo, decrease the levels of ADMA in diabetic patients? If the answer is yes, is this beneficial effect of metformin superior to that of other anti-diabetic agents with equihypoglycemic properties? Does treatment with pyridoxamine, a post-Amadori inhibitor (so-called Amadorins) of AGE formation, also reduce the levels of ADMA and subsequently improve endothelial dysfunction in diabetic patients? Are the ADMA-lowering effects of these agents associated with an increase of DDAH expression and/or activity in endothelial cells? These clinical studies could clarify whether AGEs are involved in the elevation of ADMA in patients with diabetes via suppression of DDAH expression and/or activity, thus providing a novel molecular mechanism for accelerated atherosclerosis in diabetes.

Streptozotocin-induced partial beta cell depletion in nude mice without hyperglycaemia induces pancreatic morphogenesis in transplanted embryonic stem cells

AIMS/HYPOTHESIS

It appears that the adult pancreas has limited regenerative ability following beta cell destruction by streptozotocin (STZ). However, it is not clear if this limitation is due to an inability to respond to, rather than an absence of, regenerative stimuli. In this study we aimed to uncouple the regenerative signal from the regenerative response by using an exogenous stem cell source to detect regenerative stimuli produced by the STZ-injured pancreas at physiological blood glucose levels.

METHOD

Adult nude mice received 150 mg/kg STZ and 1x10(6) J1 mouse embryonic stem (ES) cells by i.p. injection. Permanent beta cell depletion of 50% was estimated from the ratio of beta:alpha cells in pancreata from STZ-treated mice compared with control animals after 24 days.

RESULTS

Transplanted ES cells homed to the STZ-injured pancreas and formed tumours. Immunocytochemical analysis of pancreas-associated ES tumours revealed foci containing insulin/PDX-1 double-positive and glucagon-positive/PDX-1-negative cell clusters associated with PDX-1-positive columnar lumenal epithelium and extensive alpha-amylase-positive pancreatic acini comprising approximately 0.1% of ES tumour volume.

CONCLUSIONS/INTERPRETATION

These data indicate that (1) the adult pancreas produces a milieu of regenerative stimuli following beta cell destruction, and (2) this is not dependent on hyperglycaemic conditions; (3) these regenerative stimuli appear to recapitulate the signalling pathways of embryonic development, since both exocrine and endocrine lineages are produced from PDX-1-positive precursor epithelium. This model will be useful for characterising the regenerative mechanisms in the adult pancreas.

Polyamines in renal failure

The levels of polyamines (putrescine, spermidine and spermine) and polyamine oxidase in plasma of patients with chronic renal failure were determined. The level of putrescine was increased but the level of spermine was decreased in the plasma of these patients. The patients also had increased plasma polyamine oxidase activity leading to increased degradation of spermine. As acrolein was a major toxic compound produced from spermine by polyamine oxidase, the levels of free and protein-conjugated acrolein in plasma were also measured. Acrolein levels were enhanced in plasma of patients with chronic renal failure. The accumulated acrolein found as protein conjugates was equivalent to 170 microM, which was about 5-fold higher than in plasma of normal subjects. It was found that acrolein is mainly produced by spermine oxidase in plasma. An increase in putrescine, spermine oxidase and acrolein in plasma was observed in all cases such as diabetic nephropathy, chronic glomerulonephritis and nephrosclerosis. After patients with chronic renal failure had undergone hemodialysis, their levels of plasma polyamines, spermine oxidase and acrolein returned towards normal. It is likely that acrolein produced from spermine accumulates in the blood due to decreased excretion into urine and may function as a uremic "toxin".

Utility of clinical markers to identify patients with high risk cervical dysplasia and cancer

10055

Background: The natural history of cervical neoplasias appears unpredictable with 1/3 to 1/2 of CIN lesions regressing without intervention; therapeutic targeting aids in screening and selecting patients at risk and elucidating treatment response. This study aimed at determining if a pattern of tumor suppressor, oncogene, and growth factor expression (specifically HER-2/neu, progesterone and estrogen receptors (ER/PR), p53, and Ki67) exists in the progression of cervical cancer utilizing the widely applicable process of immunohistochemistry. Methods: Paraffin sections from 128 cervical biopsy, cone, and hysterectomy specimens collected from 1/00–12/04 were obtained from the surgical pathology repository at a tertiary care center with a primarily Asian and Polynesian patient population. Levels of expression in normal, low and high grade dysplasias, and invasive carcinomas were measured via automated immunohistochemical analysis. Results: 30% of samples came from patients who smoked. Ki-67 index rose with increasing dysplastic change (17–43%) but dropped with invasive carcinomas (<17%). HER-2/neu staining occurred at greater levels in high grade lesions and invasive carcinomas but average intensity measured <1, with >2.2 being of prognostic significance because of candidacy for Herceptin therapy by breast criteria. ER/PR expression generally remained low with a penchant for parabasal cells (2–14%), and p53 levels likewise appeared minimally affected (3–5%). Conclusions: While HPV infection immortalizes cervical cells via a p53/pRb pathway, the equivocal expression of wild-type p53 across pre-invasive and more aggressive lesions suggests the involvement of other environmental toxins and genetic mutations. PR and ER play only a minor role in the development of adenosquamous carcinomas, indicating a lack of hormonal control in cervical tumor growth and proliferation. Her-2/neu, however, participates in the late events of cervical malignancy but at such levels that clinical usefulness proves questionable. Although HER-2/neu perhaps holds limited prognostic value in cervical carcinogenesis, similar molecular pathways independent of HPV need to be investigated as adjuncts to the common Pap smear.

No significant financial relationships to disclose.

Retrospective analysis of gefitinib versus docetaxel in never-smoking patients with previously treated non-small-cell lung cancer (NSCLC)

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Background: Docetaxel has been standard for second line treatment of NSCLC. In ISEL study, subgroup analyses showed significantly longer survival in the gefitinib group than the placebo group for never-smokers and Asians. It is not clear whether gefitinib has the clinical advantage in these selected patients with NSCLC. We aimed to compare the clinical benefit of gefitinib with that of docetaxel in never smoker previously treated with chemotherapy, retrospectively. Methods: We reviewed patients from August 2002 to September 2005 in Shizuoka Cancer Center. Patients with following conditions were analyzed: NSCLC, received gefitinib or docetaxel, never-smoker, not chemo-naived. We assessed the response rate, progression free survival (PFS) and over all survival for gefitinib and docetaxel respectively. Survival curves were calculated using the Kaplan Meier-method. Prognostic factors were estimated using multivariate analysis. Results: 108 patinets were selected. 69 patients were treated with gefitinib and 39 patients were treated with docetaxel. 28 patients overlapped each other. The patients treated with gefitinib following docetaxel and those with docetaxel following gefitinib were 17 and 13, respectively. 69 patients with gefitinib: the median age, 62 years (31–79); stage IIIB/IV, 14/55; ad/sq/ others, 61/3/5; PS 0/1/2/3, 19/35/13/2; prior therapy containing platinum regimen, 58. The response rate was 36%. 39 patients with docetaxel: the median age, 63 years (31–76); stage IIIB/IV, 8/31; ad/sq/others, 29/7/3; PS 0/1/2/3, 18/19/1/1; prior therapy containing platinum regimen, 34. The response rate was 10%. Gefitinib was superior in longer median PFS (148 days vs 43 days, p = 0.0002). Over all survivals were not significant between two arms. In multivariate analysis for PFS, following factors were significant: gefitinib therapy (hazard ratio 0.375, p = 0.0002); male (hazard ratio 1.854, p = 0.0011); good performance status (hazard ratio 0.450, p = 0.0057). Conclusions: Our results suggested that gefitinib therapy is very attractive for never smoker in the point of PFS. Many patients received cross-over therapies made difficult to analyze over all survival.

No significant financial relationships to disclose.

The thioredoxin system in retroviral infection and apoptosis

Human thioredoxin (TRX) was first identified in human T-cell leukemia virus type I (HTLV-I)-positive T-cell lines and is associated with the pathophysiology of retroviral infections. TRX is a vital component of the thiol-reducing system and regulates various cellular function (redox regulation). Members of the TRX system regulate apoptosis through a wide variety of mechanisms. A family of thioredoxin-dependent peroxidases (peroxiredoxins) protects against apoptosis by scavenging hydrogen peroxide. Thioredoxin 2 is a critical regulator of cytochrome c release and mitochondrial apoptosis; transmembrane thioredoxin-related molecule (TMX) has a protective role in endoplasmic reticulum (ER) stress-induced apoptosis. TRX interacts with apoptosis signal-regulating kinase 1 (ASK1) and is a sensor of oxidative stress. Thioredoxin binding protein-2/vitamin D(3) upregulated protein 1 is a growth suppressor and its expression is suppressed in HTLV-I-transformed cells. Studies of these molecules of the TRX system provide novel insights into the apoptosis associated with retroviral diseases.

Improved search for nu(mu) --> nu(e) oscillation in a long-baseline accelerator experiment

We performed an improved search for nu(mu) --> nu(e) oscillation with the KEK to Kamioka (K2K) long-baseline neutrino oscillation experiment, using the full data sample of 9.2 x 10(19) protons on target. No evidence for a nu(e) appearance signal was found, and we set bounds on the nu(mu) --> nu(e) oscillation parameters. At Deltam(2)=2.8 x 10(-3) eV(2), the best-fit value of the K2Knu(mu) disappearance analysis, we set an upper limit of sin(2)2theta(mue) < 0.13 at a 90% confidence level.

Advances in the treatment of pediatric brain tumors

Brain tumors are a heterogeneous group of neoplasms with different origins, pathobiologies, treatments and prognoses. The collective contributions from the fields of neuro-oncology, neurosurgery, radiation oncology, neurology, neuropathology, neuroradiology and molecular biology have all led to significant advances in the treatment of certain brain tumors. Ideas from these fields, under the cooperative umbrella of clinical cancer trial consortia, have been tested in large-scale studies. As a result, patient survivals have increased markedly for these tumor types. Unfortunately, there are certain brain tumors in childhood, such as the diffuse intrinsic pontine glioma and atypical teratoid rhabdoid tumor, for which survival advantages have not been found. This review will discuss the current and possible future therapies of the most common pediatric brain tumors and highlight some of the novel imaging modalities that are used pre- and intraoperatively.

Effect of long-lasting serotonin depletion on environmental enrichment-induced neurogenesis in adult rat hippocampus and spatial learning

The dentate gyrus of the hippocampal formation produces new neurons throughout adulthood in mammalian species. Several experimental statuses and factors regulating to neurogenesis have been identified in the adult dentate gyrus. For example, exposure to an enriched environment enhances neurogenesis in the dentate gyrus and improves hippocampus-dependent spatial learning. Furthermore, serotonin is known to influence adult neurogenesis, and learning and memory. However, the effects of long-lasting depletion of serotonin over the developing period on neurogenesis have not been investigated. Thus, we examined the influence of long-lasting serotonin depletion on environmental enrichment-induced neurogenesis and spatial memory performance. As reported previously, environmental enrichment significantly increased new neurons in the dentate gyrus. However, there was no improvement of the spatial learning test in adult rats in standard and in environmental enrichment housings. Intracisternal administration of the serotonergic neurotoxin, 5,7-dihydroxytryptamine, on postnatal day 3 apparently reduced serotonin content in the adult hippocampus without regeneration. This experimental depletion of serotonin in the hippocampus of rats housed in an enriched environment had no effect on spatial memory performance, but produced significant decreases in the number of bromodeoxyuridine-labeled new cells in the dentate gyrus. These findings indicate that newly generated cells stimulated by environmental enrichment are not critical for improvements in hippocampus-dependent learning. Furthermore, numbers of bromodeoxyuridine-labeled cells in the dentate gyrus of 5,7-dihydroxytryptamine-injected rats did not differ between 1 day and 4 weeks after bromodeoxyuridine injection. These data suggest that survival of newly generated dentate gyrus cells remains relatively constant under long-lasting serotonin depletion.

Search for coherent charged pion production in neutrino-carbon interactions

We report the result from a search for charged-current coherent pion production induced by muon neutrinos with a mean energy of 1.3 GeV. The data are collected with a fully active scintillator detector in the K2K long-baseline neutrino oscillation experiment. No evidence for coherent pion production is observed, and an upper limit of is set on the cross section ratio of coherent pion production to the total charged-current interaction at 90% confidence level. This is the first experimental limit for coherent charged pion production in the energy region of a few GeV.

Dichotomy of all-trans retinoic acid inducing signals for adult T-cell leukemia

We previously reported that all-trans retinoic acid (ATRA) inhibits growth in human T-cell leukemia virus type 1 (HTLV-1)-positive T-cell lines and fresh cells from patients with adult T-cell leukemia. However, the mechanism of this inhibition is not clear. In the present study, we observed that NF-kappaB transcriptional activity as well as cell growth decreased significantly in HTLV-1-positive T-cell lines in the presence of ATRA. Furthermore, we observed that ATRA reduced HTLV-1 proviral DNA, HTLV-1 genes (gag, tax, or pol mRNA) using the real-time quantitative polymerase chain reaction. SIL-2R was reduced by ATRA in both protein level (culture supernantant) and mRNA level in HTLV-1-positive T-cell lines. Interestingly, ATRA significantly inhibited RT activity similar to azidothimidine (AZT) in HTLV-1-positive T-cell lines. Moreover, AZT inhibited proviral DNA but not NF-kappaB transcriptional activity, and sIL-2R on HTLV-1; however, ATRA inhibited of NF-kappaB, proviral DNA and sIL-2R on HTLV-1. These results suggested that the decrease in sIL-2R induced by ATRA may be caused by the actions of a NF-kappaB inhibitor acting on the NF-kappaB/sIL-2R signal pathway. These results suggested that ATRA could have two roles, as a NF-kappaB inhibitor and as an RT inhibitor.

Evidence for muon neutrino oscillation in an accelerator-based experiment

We present results for nu(mu) oscillation in the KEK to Kamioka (K2K) long-baseline neutrino oscillation experiment. K2K uses an accelerator-produced nu(mu) beam with a mean energy of 1.3 GeV directed at the Super-Kamiokande detector. We observed the energy-dependent disappearance of nu(mu), which we presume have oscillated to nu(tau). The probability that we would observe these results if there is no neutrino oscillation is 0.0050% (4.0 sigma).

Cerebellar glioblastoma genetically defined as a secondary one

We report here the case of a 29-year-old woman with cerebellar glioblastma. In the present case, tumor lesions were observed in each cerebellar hemisphere. The left-side lesion was diagnosed as glioblastoma, and the right-side lesion as malignant astrocytoma by histopathology. Immunohistochemistry revealed that the tumor cells of the left-side lesion was positive for p53, whereas epidermal growth factor receptors (EGFR) were negative in tumor cells from both sides. Genetic alterations were investigated using a genome DNA microarray (GenoSensor Array 300), which has led us to define this tumor as a secondary glioblastoma. The clinical presentation and genetic findings of this relatively rare entity are discussed.

[Pulmonary thromboembolism after thoracoscopic pulmonary wedge resection; report of a case]

We encountered a case of acute pulmonary embolism after lung cancer surgery. The case was a 64-year-old female. She was admitted to our hospital with an abnormal shadow on chest X-ray. There was a past history of hypopituitarism medicated with steroids. Chest computed tomography (CT) demonstrated ground glass attenuation shadow measuring 10 mm in the left upper lobe. She underwent left thoracoscopic pulmonary wedge resection due to bronchioloalveolar cell carcinoma. Postoperatively, the patient suddenly complained of chest pain and dyspnea the day after surgery. Chest CT showed left and right pulmonary arterial thromboembolism. Thrombolytic and anticoagulation therapy with urokinase and heparin sodium were immediately started. Venography demonstrated thrombus located in the vein of the bilateral lower leg region. We inserted an inferior vena cava filter to prevent aggravation of pulmonary embolism. After 11 days, CT showed completed thrombolysis in the bilateral pulmonary artery. The patient was discharged on the 25th postoperative day, and has been followed with anticoagulation therapy.