Prognostic value of cyclin E and p53 expression in gastric carcinoma

BACKGROUND

Cyclins and wild-type p53 are prime cell cycle regulators and may be involved in tumorigenesis. Cyclin E is a late G1 cyclin and its abnormalities have been reported in several cancers. The authors investigated the correlation between cyclin E expression and progression of gastric carcinoma.

METHODS

The expression of cyclin E and p53 proteins was investigated retrospectively in 116 patients with gastric carcinoma. Immunohistochemical staining of the paraffin sections was performed using monoclonal antibodies to cyclin E and p53.

RESULTS

The total cyclin E positive rate was 44.0% (51 of 116) of all cases, 26 of which were strongly positive. Strong cyclin E expression frequently was observed in deeply invasive tumors, tumors with lymph node metastasis, and tumors of advanced stage. The incidence of p53 expression was higher in the cyclin E positive tumors than in the other tumors. With regard to prognosis, patients whose tumors had both strong positivity for cyclin E and positivity for p53 had significantly poorer prognosis. In multivariate analysis, the combined variable of cyclin E and p53 was an independent prognostic indicator together with serosal invasion and tumor size.

CONCLUSIONS

These data suggest the cyclin E expression correlates with p53 expression and may contribute to the progression of gastric carcinoma. The combined variable of cyclin E and p53 expression could be a useful prognostic indicator in patients with gastric carcinoma.

Complete inhibition of spontaneous pulmonary metastasis of human lung carcinoma cell line EBC-1 by a neutrophil elastase inhibitor (ONO-5046.Na)

We previously reported that EBC-1, a non-small cell lung cancer (NSCLC) cell line, produces immunoreactive neutrophil elastase (NE). In the present study, we examined the effects of ONO-5046.Na, a specific NE inhibitor, on the in vivo growth and spontaneous pulmonary metastasis of EBC-1 transplanted into severe combined immunodeficiency (scid) mice. In control mice, EBC-1 tumors inoculated subcutaneously grew steadily throughout 8-week observation period. The daily intraperitoneal injection of ONO-5046.Na (50 mg/kg/day) from day 1 completely suppressed the tumor growth. When ONO-5046.Na treatment was initiated 14 days after EBC-1 inoculation, it also caused a significant delayed growth of this cell line. Furthermore, ONO-5046.Na treatment completely inhibits the appearance of metastatic foci in lung at 8 weeks not only when it was administered from day 1 but also when treatment was initiated 14 days after tumor inoculation, when solid tumors started to grow. The weight of the mice treated with ONO-5046.Na was similar to that of the control mice at 8 weeks, and they appeared as healthy as the control mice during the treatment. These results indicated that a NE inhibitor, ONO-5046.Na, inhibited both primary and metastatic growth of NSCLC with no marked side effects.

Effects of intravenously administered C-type natriuretic peptide in humans: comparison with atrial natriuretic peptide

We have previously reported that C-type natriuretic peptide (CNP), the third member of the natriuretic peptide family, is produced in vascular endothelial cells and suggested that CNP might be a local regulator of vascular tone and growth. To evaluate the biological actions of CNP as compared with human atrial natriuretic peptide (hANP), we intravenously administered synthetic CNP (0.43 nmol/kg) and alpha-hANP (0.43 and 0.043 nmol/kg) to healthy humans. The experiments were done on different days in the same five healthy volunteers (31+/-1 yr old). CNP injection caused a transient but significant decrease in both systolic and diastolic blood pressure (-4.3+/-1.3, -4.1+/-1.0 mmHg) with a significant increase in heart rate (+7.6+/-2.6 bpm), and exerted significant diuretic and natriuretic activities (+130+/-80%, +160+/-100% over the basal level). These effects of CNP (0.43 nmol/kg) were comparable to, or less than, those of alpha-hANP (0.043 nmol/kg). CNP injection also significantly suppressed aldosterone secretion (22% reduction as compared with the basal level). Our results demonstrate that intravenously-administered CNP acts as a natriuretic peptide with less potency than ANP.

Expression of natriuretic peptide system during embryonic stem cell vasculogenesis

The natriuretic peptide family consists of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), and C-type natriuretic peptide (CNP). We have elucidated that CNP is synthesized by endothelial cells. We have also shown that CNP secretion is potently suppressed by vascular endothelial growth factor (VEGF). In the present study, we examined the developmental gene expression of the natriuretic peptide system with the expression of VEGF and endothelial cell-specific receptor tyrosine kinases (RTKs), which expression is necessary for vasculogenesis, using embryoid bodies (EB) as an in vitro model for vascular development. When mouse embryonic stem (ES) cells were cultured in suspension culture, ES cells spontaneously differentiated into EB on day 4 and then into cystic EB (day 10). The VEGF gene transcript was detected early, on day 4. The expression of Flk-1, and flt-1 (the two VEGF receptors) and also of tie-2, which is crucial for blood island formation, was detected as early as day 4, and also on days 8 and 21. In contrast, the expression of flt-4, the receptor for VEGF-C, and tie-1, was first detected on day 21. Along with the developmental expression of these markers of differentiation for endothelial cells, the gene expression of CNP and its specific receptor, ANP-B receptor, was detected on days 4, 8, and 21. In contrast, the gene expression of BNP, which acts as a cardiac hormone, and the gene expression of the ANP-A receptor, which is specific to ANP and BNP, was first detected on days 8 and 21, respectively. These results indicate the distinct role of CNP in the natriuretic peptide family and the close linkage of CNP expression and endothelial cell differentiation, suggesting a possible role of CNP in vasculogenesis.

Significance of ventricular myocytes and nonmyocytes interaction during cardiocyte hypertrophy: evidence for endothelin-1 as a paracrine hypertrophic factor from cardiac nonmyocytes

BACKGROUND

In cardiac hypertrophy, both excessive enlargement of cardiac myocytes and progressive interstitial fibrosis are well known to occur simultaneously. In the present study, to investigate the interaction between ventricular myocytes (MCs) and cardiac nonmyocytes (NMCs), mostly fibroblasts, during cardiocytes hypertrophy, we examined the change in cell size and gene expression of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in cultured MCs as markers for hypertrophy in the neonatal rat ventricular cardiac cell culture system.

METHODS AND RESULTS

The size of cultured MCs significantly increased in the MC-NMC coculture. Concomitantly, secretions of ANP and BNP into culture media were significantly increased in the MC-NMC coculture compared with in the MC culture (with the possible contamination of NMC <1% of MC). Moreover, in the MC culture, enlargement of MC and an increase in ANP and BNP secretions were induced by treatment with conditioned media of the NMC culture. A considerable amount of endothelin (ET)-1 production was detected in the NMC-conditioned media. BQ-123, an ET-A receptor antagonist, and bosentan, a nonselective ET receptor antagonist, significantly blocked the hypertrophic response of MCs induced by treatment with NMC-conditioned media. Angiotensin II (Ang II) (10(-10) to 10(-6) mol/L) and transforming growth factor-beta1 (TGF-beta1) (10(-13) to 10(-9) mol/L), both of which are known to be cardiac hypertrophic factors, did not induce hypertrophy in MC culture, but both Ang II and TGF-beta1 increased the size of MCs and augmented ANP and BNP productions in the MC-NMC coculture. This hypertrophic activity of Ang II and TGF-beta1 was associated with the potentiation of ET-1 production in the MC-NMC coculture, and the effect of Ang II or TGF-beta1 on the secretions of ANP and BNP in the coculture was significantly suppressed by pretreatment with BQ-123.

CONCLUSIONS

These results demonstrate that NMCs regulate MC hypertrophy at least partially via ET-1 secretion and that the interaction between MCs and NMCs plays a critical role during the process of Ang II- or TGF-beta1-induced cardiocyte hypertrophy.

Inhibition of gene expression from the human c-erbB gene promoter by a retroviral vector expressing anti-gene RNA

Anti-gene is a potent inhibitor of transcriptional promoter activity and subsequent gene expression. This property has been exploited to suppress the expression of a variety of oncogenes for regulating tumor proliferation or viral activities. In this paper, we describe a novel retroviral vector designed to express human c-erbB anti-gene RNA and to reduce the promoter activity in the cells. Mouse fibroblast NIH3T3 cells were stably transfected with an expression construct containing a truncated human c-erbB gene promoter fused to the firefly luciferase reporter gene. Infection into these cells of the c-erbB anti-gene retroviral vector targeted to the 26 bp pyrimidine-rich element in the human c-erbB gene promoter resulted in a dose-dependent decrease in the luciferase activity of the cells. Retroviral vector expressing anti-gene RNA may be useful as an alternative program of gene regulation in the cells.

Pivotal role of interleukin-8 in the acute respiratory distress syndrome and cerebral reperfusion injury

Neutrophil recruitment is one of the hallmarks of acute inflammation. A potent neutrophil chemotactic and activating factor, interleukin-8 (IL-8), has been demonstrated to be elevated in body fluids in various human diseases and experimental animal models. Recent investigations on animal disease models using blocking antibodies to IL-8 have revealed the essential involvement of IL-8 in acute inflammation. We previously reported that the administration of a neutralizing antibody against IL-8 prevented the neutrophil infiltration and neutrophil-mediated tissue injury in several animal studies. In addition, we have recently demonstrated that anti-IL-8 treatment is also effective in prevention of two models that are very relevant to clinical situations: cerebral reperfusion injury and endotoxemia-induced acute respiratory distress syndrome-like lung injury. These results further support the hypothesis that IL-8 has a pivotal role and is a novel target for therapeutic intervention in neutrophil-mediated injury.

Prediction of recurrence in histologically benign meningiomas: proliferating cell nuclear antigen and Ki-67 immunohistochemical study

BACKGROUND

Recurrence in individual patients after complete surgical removal of meningiomas cannot be predicted by histology alone because recurrence occurs even in histologically benign meningiomas.

METHODS

We investigated proliferating cell nuclear antigen (PCNA) and Ki-67 labeling indices of histologically benign meningiomas in 95 patients to assess their relationship to recurrence. The labeling index (LI) was expressed as the percentage of tumor cell nuclei immunoreactive for PCNA or Ki-67 to total tumor nuclei counted per section. The cases/specimens comprised the following two groups: (1) nonrecurrent group: 82 specimens from 82 patients without recurrence, (2) recurrent group: 28 specimens from 10 patients with recurrence.

RESULTS

Proliferative activities or aggressiveness do not always develop with every recurrence in recurrent meningiomas. The PCNA LI was significantly higher in the recurrent group (3.98% +/- 0.37%) than in the nonrecurrent group (0.71 +/- 0.13%) (p < 0.0001). The Ki-67 LI also was significantly higher in the recurrent group (3.15 +/- 0.40%) than in the nonrecurrent group (0.39 +/- 0.07%) (p < 0.0001). There was a good correlation between the PCNA LI and the Ki-67 LI (coefficient of correlation r = 0.79, p < 0.001).

CONCLUSIONS

The results of our study suggested that a PCNA or Ki-67 LI of more than 2% may represent an increased risk for recurrence; therefore, we suggest that radiotherapy or stereotactic radiosurgery should be considered, even for histologically benign meningiomas.

Alteration of E-cadherin and alpha N-catenin immunoreactivity in the mouse spinal cord following peripheral axotomy

We examined the effects of peripheral axotomy on the immunoreactivity of E-cadherin and cadherin-associated protein alpha N-catenin in the spinal cord. E-cadherin is known to be exclusively expressed in lamina II of Rexed in the spinal cord dorsal horn. This expression disappeared by day 7 after axotomy and reappeared following nerve ligature (partial axonal regeneration model) on day 63. In contrast, it remained undetectable following nerve clipping (complete degeneration model). Alpha N-catenin was diffusely stained in the gray matter, and the immunoreactivity was specifically intense in the central canal and superficial dorsal horn. The expression of alpha N-catenin in the superficial dorsal horn was similarly reduced by day 7 after axotomy, but recovered by day 63 after nerve ligature. In contrast, it remained at the reduced level after nerve clipping. The alteration of alpha N-catenin immunoreactivity showed a similar pattern consistent with that of E-cadherin. Administration of nerve growth factor (NGF) rescued the immunoreactivity of substance P, which is known to disappear after peripheral axotomy, but not influence that of both E-cadherin or alpha N-catenin. These results clearly showed that peripheral axotomy simultaneously alters the immunoreactivity of E-cadherin and alpha N-catenin in the spinal cord, suggesting a correlation in the expression of both E-cadherin and alpha N-catenin in vivo. E-cadherin-alpha N-catenin complex might be crucial for plasticity of the spinal cord dorsal horn after peripheral axotomy.

Membranous ultrastructure of human arachnoid cells

The ultrastructure of arachnoid cell membranes was investigated by conventional transmission EM and by freeze-fracture techniques in human arachnoid granulations. Arachnoid cells showed widespread membrane specialization in the granulations including the formation of desmosomes, gap junctions, tight junctions, intermediate junctions, hemidesmosome-like structures, and micropinocytotic vesicles. However, the extent of the specialization varied from portion to portion; this was clearly shown on freeze-fracture replicas. Numerous extracellular cisterns were separated by cytoplasmic bodies or slender processes, joined by these junctional complexes. Uncoated and coated vesicles were abundant along the surface of extracellular cisterns representing the pathway of CSF. Complexes of branching tight junctions were comprised of 1-50 particle strands, which formed elaborate meshworks accompanied by numerous gap junctions and desmosomes. Micropinocytotic vesicles were often concentrated in the arachnoid cell cluster up to 40 per microm2, which is equivalent to the concentration in brain capillary endothelial cells. The results of this study clearly suggest that arachnoid cells in arachnoid granulations are not only tightly adherent to form a firm structure for the passage of CSF, but that the arachnoid cells lining the CSF pathway show intense cell-cell communication and pinocytotic activity. This high transcellular activity probably reflects active transports or secretion of certain molecules by arachnoid cells.

Adenovirus-mediated gene transfer of C-type natriuretic peptide causes G1 growth inhibition of cultured vascular smooth muscle cells

We have proposed the "vascular natriuretic peptide system", in which C-type natriuretic peptide (CNP), the third member of the natriuretic peptide family, can control vascular tone and growth as an endothelium-derived relaxing peptide. We aimed at overexpression of CNP gene in vascular smooth muscle cells (SMCs) by adenovirus-mediated gene transfer to examine the growth characteristics of SMCs via the augmentation of cGMP production. Rat aortic SMCs infected with Ad.CNP, a replication-deficient adenovirus driving rat CNP cDNA, produced 162 +/- 55 fmol/mL of CNP, which was 4,000 times higher than that produced by endothelial cells. cGMP production was also augmented in Ad.CNP-infected SMCs (2200 +/- 270 fmol/10(4) cells). Accordingly, significant growth inhibition was observed in SMCs infected with Ad.CNP. The flow cytometry analysis revealed that the population of the S and G2 + M phases was reduced by 60% of the control in Ad.CNP-infected SMCs. The gene expression of ANP-B receptor, which is expressed abundantly in SMCs with the synthetic phenotype, was suppressed in Ad.CNP-infected SMCs, while the gene expression of ANP-A receptor, which is expressed predominantly in SMCs with the contractile phenotype, became detectable in Ad.CNP-infected SMCs. In addition, the gene expression of smooth muscle myosin heavy chain-2 (SM-2), which is the molecular marker of highly-differentiated SMCs, was also induced in Ad.CNP-treated SMCs. These results suggest that cGMP cascade activation induces re-differentiation of SMCs. The present study demonstrated that overexpression of CNP induced growth inhibition of SMCs at the G1 phase with possible alteration of the phenotype.

Isolation and chemical-structural determination of a novel aromatic amine mutagen in water from the Nishitakase River in Kyoto

Water samples from the Nishitakase River in Kyoto, Japan, especially taken at sites below sewage plants, show significantly high mutagenicity in the Ames test. In the present study, mutagens in the river water were adsorbed to 24 g of blue rayon, extracted, and separated by HPLC on ODS columns. Five mutagenic compounds (I-V) were isolated, and they accounted for 21%, 17%, 11%, 12%, and 6%, respectively, of the total mutagenicity of the blue rayon-adsorbed materials. With compound I obtained from adsorbate to 24 g of blue rayon as a marker, a large quantity (1.1 mg) of mutagenic compound I was isolated by Sephadex LH-20 column chromatography and HPLC on ODS columns from material adsorbed to 27 kg of blue cotton. X-ray crystal analysis was carried out with the debrominated derivative of compound I. Based on this X-ray crystallography data and the UV, mass, and 1H-NMR spectra of both the derivative and compound I, the structure of compound I was determined to be 2-[2-(acetylamino)-4-[bis(2-methoxyethyl)amino]-5-methoxyphenyl]-5-amino - 7-bromo-4-chloro-2H-benzotriazole (PBTA-1). PBTA-1 is a newly identified potent mutagen, inducing 1,200,000 revertants of Salmonella typhimurium YG1024 per microgram in the presence of S9 mix.

Prevention of cerebral edema and infarct in cerebral reperfusion injury by an antibody to interleukin-8

Reperfusion after a transient ischemia is a frequently encountered clinical condition that often causes greater tissue damage than persistent ischemia itself. Reperfusion to rabbit brain, after a transient focal ischemia, induced neutrophil infiltration and aggregation--neither of which were observed in rabbit brain rendered ischemic alone for the same time interval--thereby leading to severe brain edema and infarct. Brain tissue levels of interleukin-8 (IL-8), a potent neutrophil chemotactic cytokine (chemokine), increased significantly at 6 hours after reperfusion, but without a noticeable elevation of plasma IL-8 levels. Moreover, we detected IL-8 protein immunohistologically in the vascular wall and, to a lesser degree, in infiltrated neutrophils, suggesting a local production of IL-8 in reperfused brain tissues. Furthermore, a neutralizing anti-IL-8 antibody significantly reduced brain edema and infarct size in comparison to rabbits receiving a control antibody. These results implicate locally produced IL-8 as a pivotal mediator of cerebral reperfusion and suggest that IL-8 is a novel target for the intervention of this injury.

Coagulative and fibrinolytic activation in cerebrospinal fluid and plasma after subarachnoid hemorrhage

OBJECTIVE

Intrathecal fibrinolytic therapy has been used as one of the anticerebral vasospasm (VS) preventative therapies in patients with subarachnoid hemorrhage (SAH). However, the changes in coagulation and fibrinolysis in the blood and cerebrospinal fluid (CSF) after SAH remain unknown.

METHODS

Fifty patients with SAH caused by ruptured cerebral aneurysms were studied postoperatively to detect the serial changes of the thrombin-antithrombin III complex, active plasminogen activator inhibitor (PAI)-1, and tissue plasminogen activator (tPA)-PAI complex (tPA-PAI) activities in the plasma and CSF collected from cisternal drainage catheters.

RESULTS

The CSF levels of all parameters and plasma PAI-1 levels were significantly higher in patients with severe SAH than in those with mild SAH. There was no relationship between the CSF and plasma levels of these parameters (except the CSF levels of tPA-PAI) and the initial neurological statuses. The CSF PAI-1 levels increased to greater than 20 ng/ml near the time of the occurrence of cerebral VS, whereas they remained below 20 ng/ml in patients without VS. The CSF tPA-PAI levels showed the highest peak near the time of VS remission. The CSF PAI-1 and tPA-PAI levels were significantly lower in patients with good outcomes than in those with poor outcomes.

CONCLUSION

Both the coagulative and fibrinolytic systems were activated in the CSF and plasma after SAH in correlating to the amount of SAH clot. The intrathecal administration of fibrinolytic agents should be started early after surgery, before CSF PAI-1 levels increase, for patients with severe SAH. Patients with CSF PAI-1 levels greater than 20 ng/ml experienced high incidence of VS and poor outcomes.

Neutrophil elastase inhibitor (ONO-5046-Na) inhibits the growth of human lung cancer cell lines transplanted into severe combined immunodeficiency (scid) mice

We examined the in vivo effects of ONO-5046xNa, a specific neutrophil elastase (NE) inhibitor, on the growth of 2 non-small cell lung cancer cell lines, EBC-1 and PC-3, transplanted into severe combined immunodeficiency (scid) mice. The daily intraperitoneal injection of ONO-5046xNa (50 mg/kg/day) completely suppressed the tumor growth in EBC-1, a human squamous carcinoma cell line which produces immunoreactive NE. By contrast, in PC-3, a human adenocarcinoma cell line which is unable to produce immunoreactive NE, the ONO-5046xNa treatment caused delayed growth of the tumor. These findings suggest that ONO-5046xNa may have a clinical role in preventing the growth of human non-small cell lung cancer.

The influence of pyrimidine nucleoside phosphorylase activity on metastasis of breast cancer

The activity of pyrimidine nucleoside phosphorylase (PyNPase) was analyzed in thirty-six cases of resected breast cancer and 9 cases of resected benign breast tumor. PyNPase is an enzyme which converts 5'-DFUR to 5-FU in tumor tissue and has been reported to be identical to the platelet-derived endothelial cell growth factor (PD-ECGF) that has angiogenic activity. PyNPase activity was significantly elevated in cancer and metastatic lymph nodes compared to normal lesions of the same breast. PyNPase activity was higher in T2 and T3 breast cancer than of T1 breast cancer. Furthermore, cases of high PyNPase activity (>200 mu g FU/mg protein/h) were significantly more likely to develop distant metastasis (p<0.01) than those of low PyNPase activity. These results suggest an important role of PyNPase activity in the progression of breast cancer.

Surface strain on crown and luting cement fractures

This study investigated fractures of the cement layer between a crown and a die. Model crowns were luted on dies with zinc phosphate cement and various magnitudes of load were applied. Surface strain on the crown was measured using strain gauges. Seal was evaluated using dye penetration and tensile tests. Results showed that cement fracture affected surface strain behavior on the crown and was detected using the surface strain measurement. The dye penetration test and the tensile test could not be used to detect the cement fracture. It is suggested that the three-dimensional relative positioning between the crown and the die affected the development of the cement fracture.

Shear stress augments expression of C-type natriuretic peptide and adrenomedullin

Shear stress is known to dilate blood vessels and exert antiproliferative effects on vascular walls: these effects have been ascribed to shear stress-induced upregulation of endothelium-derived vasoactive substances, mainly nitric oxide and prostacyclin. We have demonstrated the significance of C-type natriuretic peptide (CNP) as a novel endothelium-derived relaxing peptide (EDRP) that shares a cGMP pathway with nitric oxide. Adrenomedullin is a recently isolated EDRP that elevates intracellular cAMP as prostacyclin does. To elucidate the possible role of these EDRPs under shear stress, we examined the effect of physiological shear stress on CNP mRNA expression in endothelial cells derived from the human umbilical vein (HUVECs), bovine aorta (BAECs), and murine lymph nodes (MLECs) as well as adrenomedullin mRNA expression in HUVECs. CNP mRNA was stimulated prominently in HUVECs under shear stress of 15 dyne/cm2 in a time-dependent manner (4 hours, sixfold increase compared with that in the static condition; 24 hours, 30-fold increase). Similar results were obtained in BAECs (4 hours, twofold increase; 24 hours, threefold increase) and MLECs (4 hours, threefold increase; 24 hours, 10-fold increase). Augmentation of CNP mRNA expression that was dependent on shear stress intensity was also observed (5 dyne/cm2, 2.5-fold increase of static; 15 dyne/cm2, 4.5-fold increase). Increased CNP secretion was also confirmed by the specific radioimmunoassay for CNP. Adrenomedullin mRNA expression in HUVECs increased under shear stress of 15 dyne/cm2 in a time-dependent manner (4 hours, 1.2-fold increase of static: 24 hours, threefold increase) and shear stress intensity-dependent manner (15 dyne/cm2, threefold increase compared with that at 5 dyne/cm2). These results suggest that the coordinated augmentation of mRNA expression of these novel EDRPs may constitute shear stress-dependent vasodilator and antiproliferative effects.

Single neuron responses in the monkey anterior cingulate cortex during visual discrimination

Single neuron activity was recorded from the monkey anterior cingulate cortex during operant behavior based on discrimination of rewarding, aversive, and neutral objects. Of 550 neurons recorded, 116 responded during the task; 36, during visual discrimination; 40, during bar pressing for operant responding. Of these, 26 vision-related neurons responded differentially to rewarding, aversive and neutral objects, and 11 bar press-related neurons differentiated bar pressing to avoid shock from bar pressing to obtain reward. Responses of these neurons depended on associative meaning (aversive or rewarding) of the objects since these neuronal responses were modulated by the reversal learning. The results provide neuronal bases for involvement of the anterior cingulate cortex in emotional and motivational processes.

Cervical spinal cord infarction after surgery for a pineal region choriocarcinoma in the sitting position: case report

OBJECTIVE AND IMPORTANCE

Spinal cord injury is one of several devastating complications after operation in the sitting position. Young patients exhibiting extraordinary growth spurts demonstrate a higher risk for this complication.

CLINICAL PRESENTATION

We describe a 7-year-old male patient with a pineal region choriocarcinoma in whom a cervical spinal cord infarction (C5-T1) developed as an acute complication after operation in the sitting position. Preoperatively, high serum levels of human chorionic gonadotropin (5867.7 mIU/ml) and somatomedin-C (704 ng/ml) and an extreme growth velocity in height (16 cm/yr) were noted.

CONCLUSION

It is assumed that, in addition to head flexion, the abnormal skeletal growth spurt resulting from an excessive secretion of human chorionic gonadotropin from a tumor was a possible predisposing factor for this complication. To prevent this complication, surgeons need to pay great attention to head positioning, especially in a young patient experiencing an active growth spurt.

Pituitary stalk meningioma: case report

We report a 45-year-old woman with a meningioma which was in contact with only the pituitary stalk on MRI. As the pituitary stalk has no dura mater, we suggest this tumour may have originated from the arachnoid membrane of the pituitary stalk. Though some reports have shown that meningiomas can arise from sites lacking a dural component, this is the first report of a meningioma originating from the pituitary stalk.

The role of follicular and interdigitating dendritic cells in HIV-related lymphoid hyperplasia: localization of fascin

Fascin is a 55-kDa, actin-bundling protein expressed in follicular and interdigitating dendritic cells (DCs). Because these cells play a pivotal role in the pathogenesis of human immunodeficiency virus-related lymphoid hyperplasias (HLP), we evaluated them in 49 cases by immunohistochemical localization of fascin, and we related the findings to the histologic stage of disease. Fifteen cases of early HLP revealed strong localization of fascin within DCs of hyperplastic follicles and intense staining in interdigitating DCs and their processes in the interfollicular zones. Some follicles revealed focal disruption of the fascin-positive dendritic framework. DCs were also aligned beneath the peripheral sinuses of the node. In 15 cases of progressive HLP with partial follicular involution, 3 cases revealed findings similar to those described above. Twelve cases revealed loss of follicular dendritic staining, which was moderate in five cases and marked in seven. Residual clusters of DCs remained after partial dissolution. Interfollicular dendritic staining was reduced in 13 cases, and perisinusoidal staining was reduced in 7. In late-stage HLP, staining of both follicular and interdigitating DCs was reduced or absent. Nine cases of diffuse immunoblastic or angioimmunoblastic lymphadenopathy-like proliferation had markedly reduced or absent follicular DCs, but prominent staining was present in interfollicular DCs, which formed a meshwork throughout the node in eight cases. Two cases of hyaline-vascular lymphoid hyperplasia had increased follicular DCs forming a tight syncytial network. In most cases, there was reduction of dendritic fascin-expressing cells with advanced disease and destruction of the dendritic framework of the node. Diffuse hyperplasia of fascin-positive interdigitating cells occurred in cases with angioimmunoblastic morphologic features, and cases of hyaline-vascular lymphoid hyperplasia had increased follicular dendritic histiocytes forming a tight syncytial network. Destruction of DCs and, in some cases, interdigitating cell hyperplasia might be associated with the variable clinical course of HLP.

Tumor neutrophil elastase is closely associated with the direct extension of non-small cell lung cancer into the aorta

OBJECTIVE

Neutrophil elastase (NE) is the only neutral protease that is able to degrade insoluble elastin and other extracellular matrix constituents, and thus, may be involved in tumor invasion and metastasis. Using a highly specific and sensitive enzyme immunoassay (EIA), we recently demonstrated that immunoreactive (ir)-NE is produced by non-small cell lung cancer cell lines. We have measured the ir-NE concentration in non-small cell lung cancer tumor extracts and have evaluated its association with disease stage.

METHODS

We measured the ir-NE concentration in 144 non-small cell lung cancer tumor extracts using EIA, which permits the rapid measurement of both the free and alpha1-protease inhibitor (alpha1-PI) complexed form of ir-NE. In 15 clinical T4 (cT4) patients, we also determined the concentration of free ir-NE in tumor extracts using a kit that detects only NE complexed with alpha1-PI and subtracting that value from the total NE concentration.

RESULTS

ir-NE was detected in tumor extracts from 115 of 144 patients, ranging from 0.21 to 23.35 microg/100 mg protein. When the 144 specimens were grouped according to the clinical stage of disease, the ir-NE concentration (mean+/-SE) was significantly higher in those with cT4 disease (n=15; 7.90+/-1.88 microg/100 mg protein) than in those with cT1 (n=29; 1.27+/-0.27; p<0.001), cT2 (n=64; 1.18+/-0.17; p<0.001), or cT3 disease (n=26; 1.99+/-0.38; p<0.003). There was no significant association between the ir-NE concentration and cN-factor or any other clinical features. When the ir-NE concentration in the tumor extracts of the cT4 patients was compared with respect to the tumor invasion sites, the ir-NE level was significantly higher in those with surgical T4 (sT4) disease with aortic invasion (n=4; 17.4+/-3.10) than in those who were down-staged postoperatively (n=5; 4.9+/-1.33; p=0.005) or those with sT4 disease with involvement of other sites (n=6; 4.07+/-1.83; p=0.004). Similar results were observed for the free form of ir-NE.

CONCLUSIONS

These data suggest that NE may be involved in tumor progression of non-small cell lung cancer. Since the aorta is one of the richest sources of polymeric and insoluble elastin, this enzyme may play an active role in the direct extension of the tumor into the aorta.

Prostaglandin D synthase (beta-trace) in human arachnoid and meningioma cells: roles as a cell marker or in cerebrospinal fluid absorption, tumorigenesis, and calcification process

Glutathione-independent prostaglandin D synthase (PGDS) is an enzyme responsible for biosynthesis of prostaglandin D2 in the CNS and is identical to a major cerebrospinal fluid protein, beta-trace. Although PGDS has been identified recently in rat leptomeninges, little information is available about human meninges or meningiomas. Here, we report PGDS to be expressed consistently in 10 human arachnoid and arachnoid villi and in 21 meningiomas by immunohistochemistry, Western blot, and reverse transcription (RT)-PCR analyses. In arachnoid, PGDS immunoreactivity was seen in arachnoid barrier cells but was negligible in arachnoid trabecula and pia mater. In contrast, in arachnoid villi, PGDS was seen in core arachnoid cells rather than in the cap cell cluster or arachnoid cell layer. Meningioma cells also showed intense immunoreactivity in the perinuclear region, and it was often concentrated within meningocytic whorls and around calcifying psammoma bodies. Immunoelectron microscopic data, when compared with the ultrastructure, showed that PGDS was localized at rough endoplasmatic reticulum of arachnoid and meningioma cells. Western blot showed a 29 kDa immunoreactive band indicating PGDS, but the extent of expression was variable from case to case, which was compatible with immunohistochemical data. RT-PCR revealed PGDS gene expression in all meningiomas studied, regardless of histological subtypes, and also in human arachnoid villi. Because human arachnoid and meningioma cells exclusively express PGDS, it can be considered their specific cell marker. These results show functional differences in various types of meningeal cells attributable to differences in PGDS expression.

A comparison of in vivo and in vitro strain with posterior fixed partial dentures

PURPOSE

Deformation of fixed partial dentures during function has been related to clinical failures. However, such deformation has not been measured quantitatively, and the effect on deformation of the viscoelastic behavior of peridental structures is not well understood. The purpose of this study was to determine the strain distribution of fixed partial dentures during function and to compare the biomechanical behavior of fixed partial dentures in vivo and in vitro.

MATERIAL AND METHODS

Three conventional posterior fixed partial dentures and two complete crowns were fabricated. Both in vivo and in vitro strain measurements of each of the five prostheses were recorded by a strain gauge method. A static load was produced through occlusal force in vivo and with a universal testing machine in vitro.

RESULTS

The resulting difference between the strain distribution for the two crowns in vivo and in vitro was negligible, but the whole fixed partial denture demonstrated a substantial amount of strain in vivo.

CONCLUSIONS

The results of this study suggest that serious problems with strain may occur in a long-span mandibular posterior fixed partial denture.

Opposite regulation of Gax homeobox expression by angiotensin II and C-type natriuretic peptide

Growth arrest-specific homeobox (Gax) gene was isolated from rat aorta cDNA library and its expression was largely confined to the cardiovascular tissues. Gax gene was rapidly downregulated by platelet-derived growth factor in vascular smooth muscle cells (VSMCs) and overexpressed Gax was reported to reduce the neointimal thickening after balloon injury in vivo. We have demonstrated that angiotensin II (Ang II) stimulates vascular growth. In contrast, we also reported that C-type natriuretic peptide (CNP) is secreted from vascular endothelial cells to act as a novel endothelium-derived relaxing peptide and inhibits vascular growth via cGMP cascade. In the present study, we examined the effects of Ang II and CNP on Gax gene expression in VSMCs. In quiescent rat aortic VSMCs. Gax mRNA (2 3 kb) level became negligible 6 hours after the addition of Ang II (10(-6) mol/L). The inhibitory action of Ang II on Gax mRNA expression (ED50: 10(-11) mol/L) was almost completely blocked by an AT1R antagonist, CV11974. In contrast, CNP 10(-6) mol/L augmented Gax mRNA expression to exhibit 1.8-fold increase of the control 12 hours after the stimulation. This effect of CNP was mimicked by the addition of 8-bromoadenosine 3'-5'-cyclic monophosphate. The addition of C-ANF[4-23], an atrial natriuretic peptide-C receptor-specific agonist and devoid of stimulating cGMP production, exhibited no effect on Gax mRNA expression. Simultaneous administration of Ang II and CNP revealed that CNP (10(-6) mol/L) significantly attenuated the inhibitory action of Ang II (10(-10) mol/L) on Gax mRNA expression. These results suggest that Gax is a common transcription factor involved in the signaling pathway of vascular growth for Ang II and CNP and regulates the cell cycle and/or phenotype of VSMCs for vascular remodeling in hypertension and atherosclerosis.

[Evaluation of combination chemotherapy with 5-FU and CDDP for human gastric carcinoma transplanted into nude mice]

Combined chemotherapy of 5-FU and CDDP is useful for advanced or recurrent gastric cancer. To evaluate the efficacy of this chemotherapy, using human gastric carcinoma (NSC-30) maintained in the subcutaneous (sc) space in nude mice, we designed the following four experimental groups: 1) control group, 2) 5-FU group, 3) CDDP group, and 4) combined therapy group of 5-FU and CDDP (FP group). 5-FU (150 mg/kg) was injected into the intraperitoneal space for seven days using AlZet osmotic pumps. CDDP (9 mg/kg) was injected into the intraperitoneal space at one time. The tumor growth of drug administered groups was inhibited compared with the control group, especially in the FP group. Body weight and general condition of nude mice did not differ between groups. We also measured tumor concentrations of 5-FU and thymidylate synthetase (TS) total, free, inhibition rate between 5-FU group and FP group. The tumor 5-FU concentration of FP group was slightly higher than in 5-FU group, but the TS inhibition rate was almost the same. In conclusion, this combined therapy using Alzet osmotic pump is a useful drug sensitivity test as a conventional system.

Induction of various blood-brain barrier properties in non-neural endothelial cells by close apposition to co-cultured astrocytes

Vascular endothelial cells (EC) exhibit organ-to-organ heterogeneity in their functions and morphologies. In particular, brain capillary EC have unique characteristics exemplified by the blood-brain barrier (BBB). The formation and the maintenance of BBB have been ascribed to EC responses to inductive signal(s) or factor(s) from astrocytes that encircle microvessels in the central nervous system. These EC responses were demonstrated in numerous in vivo studies, exemplified by those of Janzer and Raff (Nature 325:253, 1987) and Tout et al. (Neuroscience 55:291, 1993) showing that transplanted astrocytes induced BBB properties in non-neural vascular EC. In this study, we constructed a heterologous co-culture system, in which rat fetal brain astrocytes were cultivated on one surface of a porous membrane and human umbilical vein EC on the opposite surface. Electron microscopic examination revealed that astrocytes passed their endfeet through the pores, making contact with EC. In this system, gamma-glutamyltranspeptidase (gamma-GTP) activity in EC was found to be significantly increased by contacting astrocytes in a density- and time-dependent manner, but not when the astrocyte feeder layer was apart from EC or replaced by COS cells; astrocyte-derived extracellular matrix partially activated gamma-GTP. mRNAs for some of the representative BBB markers, including transferrin receptor, P-glycoprotein, brain-type glucose transporter (GLUT-1), and gamma-GTP were also demonstrated by reverse transcription-polymerase chain reaction to be upregulated in EC co-cultured with astrocytes. Astrocyte inductions of close membrane apposition resembling a zonula occludens and of an increase in the content of mitochondria in EC were also noted in electron micrographs. Furthermore, an increased barrier activity against inulin was conferred on EC when they were lined with astrocytes. The results obtained with this heterologous co-culture system thus indicate that through contact with their feet, astrocytes are capable of transdifferentiating non-neural EC into the brain type, endowing them with the BBB properties.

[Usefulness of the interlocking detachable coil for the repeatedly ruptured dissecting aneurysm of the vertebral artery in the acute stage]

A 44-year-old male with a repeatedly ruptured dissecting aneurysm of the vertebral artery (VA) manifesting with subarachnoid hemorrhage was successfully treated with endovascular surgery using an interlocking detachable coil (IDC). He had a dissecting aneurysm in the left VA distal to the left posterior inferior cerebellar artery (PICA). Because the dissecting aneurysm ruptured repeatedly and his clinical condition was moribund, direct surgery was not indicated. The dissecting aneurysm was embolized with an IDC and additional platinum coils. Among patients with a ruptured VA dissecting aneurysm, proximal occlusion is generally indicated. But the direct embolization of a dissecting aneurysm can be applied in cases in which the aneurysm is ruptured repeatedly in the acute stage. IDC is a useful and safe material for endovascular surgery of a ruptured VA dissecting aneurysm.

Carinal resection and reconstruction for recurrent lung cancer

A patient with a recurrent tumor in the trachea adjacent to the right main bronchus was treated by surgical resection 19 months after undergoing surgery for the primary cancer. The patient had previously undergone right upper lobectomy for T1N0M0 stage I squamous cell carcinoma. A carinal resection was performed which included 4 rings of the trachea, 2 rings of the right main bronchus, and 1 ring of the left main bronchus. Reconstruction consisted of an end-to-end anastomosis of the trachea and left main bronchus, and an end-to-side anastomosis of the right and left main bronchi. The postoperative course was uneventful, and at present the patient is healthy 12 months following reoperation.

Thoracoscopic approach to the diagnosis and treatment of diaphragmatic disorders

Thoracoscopy was used in the diagnosis and treatment of three patients with diaphragmatic disorders, including traumatic injury of the diaphragm, partial eventration of the diaphragm, and catamenial pneumothorax (endometriosis of the diaphragm). An excellent view of the diaphragm was obtained by using thoracoscopy. The diaphragmatic injury was repaired primarily, the eventration plicated, and the focal endometriosis resected. Recovery was rapid and uneventful in all three patients. Thoracoscopic surgery, although relatively new, may be an acceptable alternative to the conventional operative management of diaphragmatic disorders and may actually reduce the morbidity and mortality associated with thoracotomy.

Protective effect of leuprolide acetate on 7,12-dimethylbenz(a)anthracene (DMBA)-induced mammary carcinogenesis in rats

The anti-carcinogenic effect of TAP-144-SR biodegradable microcapsules of copoly (DL-lactic/glycolic acid) copolymer containing a potent LHRH agonist, TAP-144 (D-Leu6-(des-Gly10-NH2)-LHRH ethylamide, leuprolide acetate) was investigated in 7,12-dimethylbenz(a)anthracene (DMBA)-induced rat mammary tumours. At 50 days of age, all rats were given 20 mg doses of DMBA by gastric intubation. Rats on the Initiation Group were given a single s.c. injection of TAP-144-SR (3 mg/kg) 1 week before DMBA treatment, and rats in the Promotion Group were given repeated s.c. injections every fourth week from 1 week after DMBA treatment until the end of the experiment. In the Initiation Group, tumour incidence and multiplicity were reduced to 20.8% and 15.0% of the Control Group values, respectively. In the Promotion Group, tumour incidence and multiplicity were also reduced to 17.7% and 7.9%, respectively. It was suggested that TAP-144-SR may be a potential candidate as an agent for hormonal chemoprevention in breast cancer.

Medroxyprogesterone acetate treatment reduces serum interleukin-6 levels in patients with metastatic breast carcinoma

BACKGROUND

The serum interleukin (IL)-6 concentration was very low in patients with metastatic breast carcinoma who had received oral medroxyprogesterone acetate (MPA) treatment as compared with those who had not. Accordingly, the authors conducted a prospective study to determine whether MPA treatment reduces the serum level of IL-6 in patients with this disease.

METHODS

In 21 consecutive Japanese patients who were scheduled to receive oral MPA treatment at doses of 600, 800 or 1200 mg/day, serum concentrations of IL-6 were determined with a sensitive enzyme-immunoassay prior to the administration of MPA and again at 4 weeks after the treatment was started. In addition, plasma levels of MPA were determined by high-performance liquid chromatography (HPLC).

RESULTS

Four weeks after the oral MPA therapy was started, serum IL-6 levels decreased in all 21 patients regardless of whether or not they responded to the treatment. Although the extent of decrease in the serum IL-6 (delta IL-6) did not correlate with the daily dose of MPA, it correlated closely with the plasma MPA level in these patients. Subjective improvement in appetite and weight gain were more frequent in the delta IL-6 > 3 pg/mL group compared with the delta IL-6 < or = 3 pg/mL group (80% vs. 45% and 70% vs. 45%, respectively). Similar results were obtained for improvement in patients' sense of well-being (100% vs. 55%).

CONCLUSIONS

Oral MPA treatment reduces serum IL-6 concentration in patients with metastatic breast carcinoma, but the decrease is not associated with response to MPA. This observation may indicate a potential of this agent for producing subjective improvement.

Dynamic changes of cathepsins B and L expression in the monkey hippocampus after transient ischemia

Enzymatic activities, expressions, and the immunohistochemical localization of lysosomal cystein proteases, cathepsins B and L, were analyzed in the monkey hippocampus after transient ischemia to clarify the mechanism of delayed cornu Ammonis (CA)-1 neuronal death. By enzymatic assay, the activity of cathepsin B increased in CA-1, 24 h after the ischemic insult, while that of cathepsin L decreased. On Western blotting, the protein contents of both cathepsins B and L increased immediately after ischemia. By immunohistochemistry, cathepsins B and L were stained as coarse granules in the perikarya of control CA-1 neurons, but in postischemic CA-1 neurons they were released from lysosome granules. In contrast, in CA-2 and the remaining sectors, enzymatic activities increased after ischemia, and immunoreactivities of cathepsins B and L increased only within lysosome granules. These results suggest that cathepsins B and L may play an important role in the breakdown of certain cell proteins in the postischemic CA-1 neurons.

Expression of NF2 gene product merlin in arachnoid villi and meningiomas

Neurofibromatosis type 2 (NF2) gene encodes a novel 595 amino acid protein named merlin. Recently, Ruttledge et al demonstrated inactivation of NF2 gene in approximately 60% of sporadically occurring meningiomas. Merlin is thought to physiologically exist beneath the cell membrane, and to form a part of modulation in signal transduction, for example, information concerning contact inhibition. In NF2-related tumors, it is supposed that the mutation of merlin results in loss of this signal transduction leading to tumorigenesis. In this paper, we investigated the expression of NF2 gene product merlin in arachnoid villi and meningiomas. The immunohistochemical staining of merlin showed a striking contrast between arachnoid villi and meningiomas. In arachnoid cells, merlin was labeled in the whole cytoplasm, but not within the nuclei. In contrast, in meningiomas, immunoreactivity of merlin was mainly seen in the nuclei. These results suggest that arachnoid cells with normal merlin are capable of normal signal transduction, whereas meningioma cells with mutated merlin show impairment of signal transduction which may lead to tumorigenesis.

Possible role of the submandibular gland in the development of obesity in mice

The possible role of submandibular glands (SMG) in the development of obesity was studied in two types of genetically obese mice, ob/ob and yellow Ay: Obesity is caused by hyperplasia followed by hypertrophy in ob/ob mice and mainly by hypertrophy in Ay mice. The histological features of SMGs exhibited clear sexual dimorphism in both mice similar to lean controls. The SMGs of ob/ob mice was smaller in size and had smaller granular convoluted tubular portions than lean controls, while the SMGs of Ay mice did not differ from lean controls. Sialoadenectomy before and after development of obesity generally reduced the gain of body weights in both sexes of Ay mice but not in ob/ob mice. The content of epidermal growth factor (EGF) in the SMGs was higher in Ay mice and lower in ob/ob mice than their controls. The possible role of EGF in the SMGs in the development of obesity is discussed.

Transient brain ischaemia provokes Ca2+, PIP2 and calpain responses prior to delayed neuronal death in monkeys

To clarify the mechanism of postischaemic delayed cornu Ammonis (CA)-1 neuronal death, we studied correlations among calpain activation and its subcellular localization, the immunoreactivity of phosphatidylinositol 4,5-bisphosphate (PIP2) and Ca2+ mobilization in the monkey hippocampus by two independent experimental approaches: in vivo transient brain ischaemia and in vitro hypoxia-hypoglycaemia of hippocampal acute slices. The CA-1 sector undergoing 20 min of ischaemia in vivo showed microscopically a small number of neuronal deaths on day 1 and almost global neuronal loss on day 5 after ischaemia. Immediately after ischaemia, CA-1 neurons ultrastructurally showed vacuolation and/or disruption of the lysosomes. Western blotting using antibodies against inactivated or activated mu-calpain demonstrated mu-calpain activation specifically in the CA-1 sector immediately after ischaemia. This finding was confirmed in the perikarya of CA-1 neurons by immunohistochemistry. CA-1 neurons on day 1 showed sustained activation of mu-calpain, and increased immunostaining for inactivated and activated forms of mu- and m-calpains and for PIP2. Activated mu-calpain and PIP2 were found to be localized at the vacuolated lysosomal membrane or endoplasmic reticulum and mitochondrial membrane respectively, by immunoelectron microscopy. Calcium imaging data using hippocampal acute slices showed that hypoxia-hypoglycaemia in vitro provoked intense Ca2+ mobilization with increased PIP2 immunostaining specifically in CA-1 neurons. These data suggest that transient brain ischaemia increases intracellular Ca2+ and PIP2 breakdown, which will activate calpain proteolytic activity. Therefore, we suggest that activated calpain at the lysosomal membrane, with the possible release of biodegrading enzyme, will cause postischaemic CA-1 neuronal death.

Occult intrasacral meningocele associated with spina bifida: a case report

We present a rare case of occult intrasacral meningocele associated with spina bifida and tethered cord syndrome in a 13-year-old female. The etiology is thought to be due to a dysraphic disorder. The pertinent literature is reviewed.

Contrast-enhanced MRI of intrasellar arachnoid cysts: relationship between the pituitary gland and cyst

We recently encountered two large intrasellar arachnoid cysts extending to the suprasellar region. The intensity of the cyst contents was identical to that of the cerebrospinal fluid on both T1- and T2- weighted MRI. On contrast-enhanced MRI, the pituitary gland was compressed posteroinferiorly and flattened in the sella turcica. In this report of rare intrasellar arachnoid cysts the discussion is focused on dislocation of the pituitary gland.

Clinicopathologic evaluation of immunohistochemical E-cadherin expression in human gastric carcinomas

BACKGROUND

E-cadherin plays a crucial role in cell-cell adhesion in epithelial tissues. Recent studies have shown a correlation between decreased E-cadherin expression and cancer cell detachment.

METHODS

The expression of E-cadherin was immunohistochemically analyzed using antihuman E-cadherin antibody in 121 cases of human gastric carcinoma.

RESULTS

In noncancerous areas, the epithelial cells, including those with intestinal metaplasia, were stained positively in the plasma membrane. In contrast, E-cadherin expression of the cancer cells varied from case to case in primary and secondary sites. Tumors with a decrease in E-cadherin occurred significantly more frequently in undifferentiated adenocarcinoma (P < 0.05) and scirrhous type (P < 0.01). The rate of E-cadherin-negative tumors was higher in patients with peritoneal metastasis (P < 0.01) or in those with distant lymph node metastasis (P < 0.01), though the tumors with liver metastasis had relatively positive E-cadherin expression. Patterns of initial recurrence had similar results. Reduction or loss of E-cadherin expression correlated with shorter survival in patients after curative operation regardless of stage of disease.

CONCLUSIONS

The decreased E-cadherin expression correlates with dedifferentiation, infiltrative tumor growth, distant metastasis, and poor survival for patients with gastric carcinoma. Thus, immunohistochemical study of E-cadherin may have clinicopathologic value for patients with gastric carcinoma.

Progression in gastric carcinoma relative to the ratio of CD44 epithelial variant transcript to CD44 hematopoietic variant transcript

BACKGROUND

It has been suggested that CD44 splice variants play a role in the progression of certain epithelial cancers and non-Hodgkin's lymphoma. In this study, we investigated the epithelial variant/hematopoietic variant (E/H) ratio (the amount of the CD44 epithelial variant transcript relative to the CD44 hematopoietic variant transcript) in human gastric carcinoma compared with normal gastric mucosa.

METHODS

The ratio was determined for tumors and adjacent noncancerous mucosa from 30 gastric carcinoma patients using reverse transcription-polymerase chain reaction and Southern blotting. We also determined the tumor (T)E/H--noncancerous mucosa (N)E/H (the difference between E/H ratios of tumor tissue and adjacent noncancerous mucosa) and examined these measurements for correlations with the pathologic features of gastric carcinoma, as well as for their usefulness as an indicator of tumor progression.

RESULTS

The E/H ratio in tumor tissue was significantly higher than in adjacent noncancerous mucosa (P < 0.01). The TE/H--NE/H in patients with lymph node metastases was 0.16 +/- 0.11, compared with 0.07 +/- 0.08 in cases without lymph node metastases (P < 0.05). Significant correlations also were observed between the TE/H--NE/H and the depth of invasion, blood vessel invasion, and lymphatic vessel invasion (P < 0.03, P < 0.03, and P < 0.01, respectively).

CONCLUSIONS

Our results suggest that increases in the E/H ratio may be a useful indicator of progression in gastric carcinoma.

Progression in gastric carcinoma relative to the ratio of CD44 epithelial variant transcript to CD44 hematopoietic variant transcript

BACKGROUND

It has been suggested that CD44 splice variants play a role in the progression of certain epithelial cancers and non-Hodgkin's lymphoma. In this study, we investigated the epithelial variant/hematopoietic variant (E/H) ratio (the amount of the CD44 epithelial variant transcript relative to the CD44 hematopoietic variant transcript) in human gastric carcinoma compared with normal gastric mucosa.

METHODS

The ratio was determined for tumors and adjacent noncancerous mucosa from 30 gastric carcinoma patients using reverse transcription-polymerase chain reaction and Southern blotting. We also determined the tumor (T)E/H--noncancerous mucosa (N)E/H (the difference between E/H ratios of tumor tissue and adjacent noncancerous mucosa) and examined these measurements for correlations with the pathologic features of gastric carcinoma, as well as for their usefulness as an indicator of tumor progression.

RESULTS

The E/H ratio in tumor tissue was significantly higher than in adjacent noncancerous mucosa (P < 0.01). The TE/H--NE/H in patients with lymph node metastases was 0.16 +/- 0.11, compared with 0.07 +/- 0.08 in cases without lymph node metastases (P < 0.05). Significant correlations also were observed between the TE/H--NE/H and the depth of invasion, blood vessel invasion, and lymphatic vessel invasion (P < 0.03, P < 0.03, and P < 0.01, respectively).

CONCLUSIONS

Our results suggest that increases in the E/H ratio may be a useful indicator of progression in gastric carcinoma.

Immunohistochemical expression of the c-kit proto-oncogene product in human malignant and non-malignant breast tissues

The immunohistochemical expression of c-kit proto-oncogene product in 57 breast cancer tissues was studied using anti-c-kit proto-oncogene product antibody in comparison with 20 normal breast tissues and 58 benign breast tumours. In normal breast tissues, the c-kit proto-oncogene product was strongly expressed on cell membrane and/or cytoplasm of alveolar and ductal cells. The immunoreactive score (IRS) of c-kit proto-oncogene product in normal mammary epithelia was 6.22 +/- 2.11 (mean +/- s.d.). In benign breast diseases, the c-kit proto-oncogene product was detected heterogeneously with a reduced IRS (3.33 +/- 2.44). In breast cancer tissues, the expression of the immunoreactive c-kit proto-oncogene product was often deleted and the average IRS was significantly reduced compared to those of normal breast tissues or benign breast diseases tissues. Among benign diseases, the average IRS of intraductal papilloma was significantly reduced (1.34 +/- 1.70) and the staining intensity and pattern were found to be similar to those seen in breast cancer. The results in this study suggested that the c-kit proto-oncogene product is correlated with the growth control or the differentiation of normal breast epithelium. Also, the loss of the expression of this protein may indicate the change of the signal transduction in relation to malignant transformation in human mammary epithelium.

Local increase in polymorphonuclear leukocyte elastase is associated with tumor invasiveness in non-small cell lung cancer

The production of tumor cell proteases is implicated in tumor cell invasion and metastasis. To determine whether lung cancer cells can produce polymorphonuclear leukocyte elastase (PMN-E), we measured the concentration of immunoreactive (ir)-PMN-E in the conditioned medium of seven lines of non-small cell lung cancer cells, EBC-1, LC-1sq, LK-2, A-549, PC-3, RERF-LC-MS, and RERF-LC-OK, and three normal lung epithelial cell lines, CCD-8Lu, WI-1003, and LL-24, by using a recently developed enzyme immunoassay (EIA). We measured the concentration of ir-PMN-E in extracts of 40 non-small cell lung cancers, and evaluated its association with the clinicopathologic findings in these patients. The ir-PMN-E level in the culture medium increased with time in six of the seven lines of lung cancer cells; the exception was PC-3. No detectable ir-PMN-E was secreted into the culture medium of the three lines of normal lung epithelial cells. The ir-PMN-E was detected in tissue extracts from 34 to 40 specimens at concentrations ranging from 0.11 to 15.5 micrograms/100 mg of protein. When 40 specimens of lung cancer were categorized by clinical stage of disease, the ir-PMN-E concentration was significantly higher in stage IIIB vs stages I, II, or IIIA. Similarly, the ir-PMN-E concentration was significantly higher in stage IIIA than in stage I. Evaluation of correlations between the ir-PMN-E concentration and patient characteristics showed that the ir-PMN-E level was significantly higher in T3 and T4 tumors than in T1 or T2 tumors. Analysis of prognostic factors in a group of 101 patients with non-small cell lung cancer demonstrated that those with high ir-PMN-E had a significantly shorter overall survival vs those with a low ir-PMN-E at the cutoff point of 3.5 micrograms/100 mg of protein. Multivariate analysis showed that ir-PMN-E was a significant porgnostic factor for early death (hazard ratio, 4.04; 95% confidence interval, 1.65 to 9.95) (p = 0.005), suggesting it was an independent marker for prognosis. Results suggest that the local production of PMN-E may be involved in the tumor invasion associated with a poor prognosis in patients with non-small cell lung cancer.