cDNA cloning of a novel amphiphysin isoform and tissue-specific expression of its multiple splice variants

Amphiphysin, an SH3-domain containing protein concentrated in nerve terminals, is believed to be involved in the synaptic vesicle recycling. We have cloned cDNAs of a novel isoform of amphiphysin (amphiphysin II) by exploiting sequence information for homologous ESTs deposited in databases. At least 9 different subtypes of the isoform with 50-60% amino acid identity to the human amphiphysin were identified by a conventional library screening and PCR amplification of cDNA libraries. Each subtype probably represents a splice variant of a single gene transcript. Analysis of mRNA expression in various tissues by RT-PCR showed that the isoform is ubiquitously distributed. The expression spectrum of the isoform subtypes, however, is significantly different in several tissues examined, suggesting that they are involved in the regulation of endocytic processes that are unique to each cell type.

Inhibitory role of prolactin in the downregulation of testicular follicle-stimulating hormone receptors in mice

Previous studies have shown that follicle-stimulating hormone (FSH) reduced its own receptors (downregulation) in the testis of adult mice. In the present study, we further examined the effect of prolactin (PRL) on the downregulation of testicular FSH receptors using hypophysectomized adult mice. FSH binding per testis increased after hypophysectomy, reaching a peak 5-10 days after the operation, and decreased thereafter. Hypophysectomized mice were given s.c. injections of 100 micrograms ovine PRL (NIADDK-oPRL) and/or 2 micrograms ovine FSH (NIADDK-oFSH) twice daily for 5 or 10 days beginning from 5 or 10 days after hypophysectomy. The 5-day treatment with a combination of oPRL and oFSH maintained the level of testicular FSH binding that was decreased by the treatment with oFSH alone, while the 5-day treatment with oPRL alone did not influence the testicular FSH binding. The change in the FSH binding per Sertoli cell was comparable to that in the binding per testis. A similar result was obtained by the 10-day treatment. Therefore, PRL was suggested to have an inhibitory role in the downregulation of testicular FSH receptors by FSH in adult mice.

Expression of a betaine aldehyde dehydrogenase gene in rice, a glycinebetaine nonaccumulator, and possible localization of its protein in peroxisomes

Betaine aldehyde dehydrogenase (BADH) catalyzes the last step in the plant biosynthetic pathway that leads to glycinebetaine. Rice plants (Oryza sativa L.), albeit considered a typical non-glycinebetaine accumulating species, have been found to express this enzyme at low levels. This observation evokes an interest in phylogenic evolution of the enzyme in the plant kingdom. It is reported here that rice plants possess the ability to take up exogenously added betaine aldehyde through the roots and convert it to glycinebetaine, resulting in an enhanced salt-tolerance of the plants. A gene encoding a putative BADH from the rice genome was also cloned and sequenced. The gene was found to contain 14 introns, and the overall nucleotide sequence of the coding region is c. 78% identical to that of the barley BADH cDNA. Cloning of a partial BADH cDNA from rice was accomplished by reverse transcription-polymerase chain reaction (RT-PCR). The nucleotide sequence of the cloned fragment was found to be identical to the corresponding exon regions of the rice genomic BADH gene. The deduced amino acid sequences of rice and barley BADH both contain a C-terminal tripeptide SKL, a signal known to target preproteins to microbodies. This localization was confirmed by an immuno-gold labeling study of transgenic tobacco harboring barley cDNA, which showed BADH protein inside peroxisomes. Northern blot analysis revealed that the level of BADH mRNA is salt-inducible.

Expression of a betaine aldehyde dehydrogenase gene in rice, a glycinebetaine nonaccumulator, and possible localization of its protein in peroxisomes

Betaine aldehyde dehydrogenase (BADH) catalyzes the last step in the plant biosynthetic pathway that leads to glycinebetaine. Rice plants (Oryza sativa L.), albeit considered a typical non-glycinebetaine accumulating species, have been found to express this enzyme at low levels. This observation evokes an interest in phylogenic evolution of the enzyme in the plant kingdom. It is reported here that rice plants possess the ability to take up exogenously added betaine aldehyde through the roots and convert it to glycinebetaine, resulting in an enhanced salt-tolerance of the plants. A gene encoding a putative BADH from the rice genome was also cloned and sequenced. The gene was found to contain 14 introns, and the overall nucleotide sequence of the coding region is c. 78% identical to that of the barley BADH cDNA. Cloning of a partial BADH cDNA from rice was accomplished by reverse transcription-polymerase chain reaction (RT-PCR). The nucleotide sequence of the cloned fragment was found to be identical to the corresponding exon regions of the rice genomic BADH gene. The deduced amino acid sequences of rice and barley BADH both contain a C-terminal tripeptide SKL, a signal known to target preproteins to microbodies. This localization was confirmed by an immuno-gold labeling study of transgenic tobacco harboring barley cDNA, which showed BADH protein inside peroxisomes. Northern blot analysis revealed that the level of BADH mRNA is salt-inducible.

Inhibitory role of opioid peptides in the regulation of aggressive and sexual behaviors in male Japanese quails

We have recently isolated three opioid peptides, i.e., Met- and Leu-enkephalins and Met-enkephalin-Arg6-Phe7, from the avian brain. Furthermore, electrophysiological studies have shown that the dominant effect of these enkephalins on preoptic and hypothalamic neurons is an inhibition of neuronal activities in the male Japanese quail. The hypothalamus and preoptic area are known to be involved in the control of male reproductive behaviors, such as aggressive and sexual behaviors. To determine the functional role of opioid peptides in these reproductive behaviors, therefore, the present study was undertaken using adult males of the Japanese quail. We examined behavioral changes following an injection of naloxone (0.2, 2.0, and 20.0 nmol), a nonselective opioid receptor antagonist, or D-Ala2-Met5-enkephalinamide (DALA; 0.2, 2.0, and 20.0 nmol), a selective delta opioid receptor agonist, into the preoptic and anterior hypothalamic regions. Naloxone treatment showed a significant increase in the frequency of several aggressive actions and the effect was dose dependent. In contrast, DALA treatment significantly decreased the frequency of aggressive actions in a dose-dependent manner. Similar significant effects of these two drugs were observed in the sexual behavior. These findings provide the first evidence for the role of opioid peptides in the reproductive behaviors in the bird and suggest an inhibitory action of opioid to evoke the behaviors.

Comparison of accelerated hyperfractionated radiotherapy and conventional radiotherapy for supratentorial malignant glioma

Between 1988 and 1993, 71 patients with glioblastoma or anaplastic astrocytoma were treated either with accelerated hyperfractionation radiotherapy (1.5 Gy twice daily to a total dose of 69 Gy, n = 35) or with conventional fractionation radiotherapy (1.8 Gy daily to 64.8 Gy, n = 36). Two patients in each group did not complete radiotherapy, leaving 67 evaluable. All patients received the chemotherapeutic regime ACNU intraarterially (50 mg/m2) or intravenously (100 mg/m2) prior to and after radiotherapy. Between 1990 and 1992, 19 patients also received intravenous interferon-beta (3 x 10(6) U, three times weekly) during radiotherapy. The median survival time was 14.5 months for the accelerated hyperfractionation group and 14 months for the conventional fractionation group. The median time to progression was 12 months for the accelerated hyperfractionation group and 9.5 months for the conventional fractionation group. There was no significant difference in either survival (P = 0.89) or progression-free survival (P = 0.25) between the accelerated hyperfractionation and conventional fractionation groups. Interferon therapy was associated with poorer survival. Brain necrosis developed in four out of 10 patients receiving accelerated hyperfractionation radiotherapy plus interferon-beta, but in none of nine patients receiving conventional fractionation radiotherapy plus interferon (P = 0.033). In conclusion, our study failed to demonstrate any possible benefit of accelerated hyperfractionation radiotherapy for malignant glioma. The incidence of brain necrosis may be increased by combining accelerated hyperfractionation radiotherapy and interferon-beta.

Primary testicular non-Hodgkin's lymphoma: a clinical study and review of the literature

Non-Hodgkin's lymphoma (NHL) of the testis is a rare disease, and treatment outcome is generally poor. In this retrospective study, we investigated treatment results for testicular NHL in an attempt to develop an effective treatment policy for this disease. The survival rate and characteristics were retrospectively analyzed in eight patients with NHL of the testis who were treated between 1969 and 1991 at Kyoto University Hospital, Department of Radiology. Four patients were at stage IEA, one at stage IIEA, and three at stage IVEA. Of the eight testicular lymphomas, six were classed as intermediate grade lymphomas and two as high-grade lymphomas according to the Working Formulation. All of the eight patients received orchiectomy. Six patients received combined chemotherapy and radiation therapy as the primary treatment for the disease. One patient each was treated with radiation therapy alone or combination chemotherapy alone. The 5-year overall and disease-free survival rate was 45 and 33%, respectively. Even though almost all of the patients had received combination chemotherapy, high incidence of relapse in the central nervous system (CNS) was observed. Prophylactic treatment against such recurrence may be necessary to improve the treatment outcome of patients with testicular NHL.

Immunohistochemical characterization of the suprachiasmatic nucleus and the intergeniculate leaflet in the hereditary bilaterally microphthalmic rat

Immunohistochemical observation was performed in the suprachiasmatic nucleus (SCN) and the intergeniculate leaflet (IGL) of hereditary bilaterally microphthalmic rats without the optic nerve on both sides. In the microphthalmic rats, volume of the SCN reduced to ca. 70% of the normal and numbers of the vasoactive intestinal polypeptide (VIP)-like immunoreactive (lir) neurons were significantly decreased. Although the arginine vasopressin (aVP)- and the VIP-lir neurons distributed in the dorsomedial and the ventrolateral part of the SCN, respectively, as reported in the normal one, somatostatin-lir neurons, localizing mainly in a border area between the dorsomedial and the ventrolateral region of the normal SCN, were shifted to the ventral part of the SCN in the microphthalmic rats. The ventral part of the SCN was covered with neuropeptide Y (NPY)-lir fibers in both normal and mutant rats. The IGL was hardly delineated cytologically in the lateral geniculate nucleus (LGN) of the mutant rats. NPY-lir neurons were found in the dorsal part of the ventral LGN, in contrast to their even distribution in the normal IGL. These findings suggest that the IGL-SCN tract remains in the hereditary microphthalmic rats without the retinal projections.

Demonstration, localization, and development of galanin receptors in the quail oviduct

We recently isolated an oviposition-inducing peptide that was identified as avian galanin from the oviducts of the Japanese quail. Avian galanin was localized in neural fibers distributed in muscle layers in the uterine and vaginal oviduct regions, and potentiated spontaneous contractions of the uterus and vagina. To elucidate whether an oviposition-inducing effect of avian galanin is due to the direct action on the oviduct, therefore, a specific binding site for avian galanin was determined in the functional quail oviduct in this study. The binding of [125I]iodoavian galanin was primarily located in the oviduct as well as the brain. The galanin binding was specifically inhibited as a function of the concentrations of both avian and rat galanins. The specific binding of avian galanin to the quail oviduct was temperature dependent and reached the maximum level for 1 h at 20 degrees C. In several regions of the oviduct, a higher level of specific galanin binding was observed only in the uterus and vagina. In contrast, the specific binding was low in the isthmus and negligible in the magnum. A similar localization was evident in the functional chicken oviduct. The Scatchard plot analysis of the binding of avian galanin to the uterine preparation revealed that the dissociation constant (Kd) was 0.249 (95% confidence interval, 0.192-0.356) nM, and the number of binding sites was 1.13 (0.99-1.36) fmol per mg tissue, respectively. During development, the galanin-binding sites were apparent in the quail oviduct at 3 weeks of age and the number of binding sites markedly increased between 3 weeks and 3 months of age. However, there was no significant change in the Kd value in the developing quail oviduct. This is the first demonstration of the presence of galanin receptors in the reproductive tract, such as the uterine and vaginal oviduct. The present results suggest that the number of galanin receptors in the oviduct increases during development and that galanin acts directly on the mature uterus and vagina to induce their contractions. This mechanism may be essential to the avian oviposition.

Widespread pruritic plaques in a patient with subacute cutaneous lupus erythematosus and hypocomplementemia: response to dapsone therapy

We describe a patient with subacute cutaneous lupus erythematosus, widespread pruritic papulosquamous plaques, and hypocomplementemia. Skin biopsy specimens revealed liquefaction degeneration and colloid bodies and dyskeratotic cells in basal and suprabasal layers. An immunofluorescence study revealed deposits of IgG, IgM, and C3 at the dermalepidermal junction in a bandlike pattern, and particulate IgG deposition in the basal and suprabasal layers. Treatment with prednisolone (15 mg/day), chloroquine phosphate (200 mg/ day), cyclosporine (5 mg/kg daily), and gold (10 mg/day) failed to reduce pruritic plaque formation, and pulse methylprednisolone therapy led to only a transient remission. Clinical exacerbations correlated with a decrease in complement levels. The disease was successfully controlled with dapsone (75 mg/day) and prednisolone (25 mg/day).

Localization of galanin and its binding sites in the quail brain

Avian galanin was first isolated from the chicken intestine, and subsequently we isolated the same peptide from the quail oviduct. Galanin is known to be a multifunctional peptide in the neuroendocrine system in mammals, while little information is available for the galanin action in the central nervous system in birds. In the present study, therefore, we examined the presence and the localization of galanin and its binding sites in the quail brain. The binding of [125I]iodo-avian galanin to brain tissues specifically inhibited as a function of the concentrations of unlabeled avian galanin. In all of the observed brain regions, the number of galanin-binding sites when compared on the basis of unit weight was maximal in the interbrain including the preoptic and hypothalamic regions and minimal in the cerebellum. The Scatchard plot analysis of the galanin binding to the interbrain revealed that the apparent equilibrium constant of dissociation (Kd) was 0.281 (95% confidence interval, 0.234-0.351) nM, suggesting the presence of a single class of high-affinity binding sites. Although galanin-like immunoreactivity was found in several restricted regions throughout the brain, the most intense immunoreaction was present in the diencephalic region. Abundant immunoreactive cell bodies and/or fibers were localized in several preoptic and hypothalamic nuclei, i.e., the nucleus preopticus medialis (POM), the nucleus paraventricularis (PVN), the nucleus periventricularis hypothalami (PHN) and the nucleus infundibuli (IN), that are known to be involved in the control of reproductive behaviors as well as the pituitary hormone secretion. A substantial number of immunoreactive cell bodies and/or fibers was further observed within the septal nuclei in the telencephalon and several mesencephalic nuclei including the nucleus intercollicularis (ICo) involved in the control of vocalizations. These results suggest that avian galanin may act as an important factor to modulate the some reproductive behaviors and/or the pituitary hormone secretion in the bird.

Subdomain structure of the matrix attachment region located within the mouse immunoglobulin kappa gene intron

Using the matrix attachment region (MAR) derived from Ig kappa gene intron, we assessed the importance of internal subregions required for the specific binding to the nuclear matrix. Relative affinities of MAR subfragments were compared in an in vitro binding reaction with isolated matrix. Cleavage at the near-centric MboII site generated two subfragments retaining a significant binding affinity. Dimerization of these subfragments greatly increased the affinity. Only a partial segment (130 bp) of the 3' fragment was necessary to restore the binding. The dimerization effect was lost when the monomer units were separated by nonMAR spacers of 500 bp <. This bipartite organization of Ig kappa MAR could be a general feature of AT-rich MARs, regardless of their genomic locations.

An oviposition-inducing peptide: isolation, localization, and function of avian galanin in the quail oviduct

It is well established that avian oviposition is regulated, at least partly, by a neurohypophysial hormone, arginine vasotocin, and ovarian hormones, prostaglandins, are regulated through mechanisms of the induction of uterine contractions. Although abundant nerves are terminated in the musculature in the uterine and vaginal oviduct regions, limited information is available on the neuronal control mechanism of avian oviposition. To identify the oviduct factor that plays an important role in the induction of oviposition as a neurotransmitter or a neuromodulator, a study was conducted to isolate the bioactive substance involved in the vaginal and uterine contractions from mature oviducts of the Japanese quail. Acetic acid extracts of 200 quail oviducts were forced through disposable C-18 reversed-phase cartridges, and then the retained material was subjected to the reversed-phase and cation-exchange HPLC purifications. A purified bioactive substance showed a single peak on the reversed-phase HPLC and was further subjected to amino acid sequence analysis and molecular weight presumption. The substance was identified as avian galanin, which was previously isolated from chicken intestine. The synthetic peptide enhanced contractions of both the vagina and the uterus in a manner similar to the native peptide, and the threshold concentrations were 10(-9) - 10(-8) M in the vagina and 10(-10) - 10(-9) M in the uterus. An intraperitoneal injection of the synthetic peptide significantly evoked quail oviposition during 5 min after injection. Immunohistochemical analysis with the anti-galanin serum revealed that abundant immunoreactive fibers were distributed in muscle layers of the vagina and the uterus. The immunoreaction examined in these regions was completely inhibited by preincubation of the antibody with synthetic peptide. These results suggest that avian galanin in the oviduct evokes oviposition through mechanisms of the induction of uterine and vaginal contractions. This peptide may contribute as a neurotransmitter or a neuromodulator to avian oviposition.

Successful treatment of livedo vasculitis with beraprost sodium: a possible mechanism of thrombomodulin upregulation

BACKGROUND

Livedo vasculitis is thought to be a thrombogenic disorder. We demonstrated that thrombomodulin (TM) expression on the endothelial cells in livedo vasculitis was markedly reduced, while blood tests of coagulation and fibrinolytic activities were within the normal range.

OBJECTIVE

Since prostacyclin (PGI2) upregulates the TM expression of endothelial cells, we tried a PGI2 analogue for the treatment of livedo vasculitis.

METHOD

Four patients with livedo vasculitis were started on a regimen of beraprost sodium (120 micrograms daily). Additional intake of low-dose aspirin was combinated with a maintenance dose of beraprost sodium (60 micrograms daily).

RESULT

All 4 patients experienced a clinical improvement with a combination therapy with beraprost sodium and low-dose aspirin.

CONCLUSION

We propose that PGI2 analogue therapy is useful for the treatment of livedo vasculitis, since the drug upregulates TM expression in this disorder.

Versatility of the thin groin flap

The groin flap is one of the most usable flaps. It provides a large amount of skin coverage with an easily concealed donor site. However, when the flap is used to reconstruct areas of the neck, hand, or foot, a secondary procedure for defatting is usually necessary. Thinner flaps are thought to be more useful in these areas. We present an anatomical study of the thin groin flap, including its dissection and defatting, and 12 clinical cases using the thin groin flap for neck (n = 7), foot (n = 4), and scalp (n = 1) reconstruction. The largest successful flap measured 13 x 30 cm. Eight flaps survived completely, two had partial necrosis, and two had total necrosis. Complications were thought to be caused by dissection around the pedicle. Meticulous dissection and thinning are required to create the thin groin flap. Excellent aesthetic results requiring no secondary defatting procedures are possible with this new thin groin flap.

Non-Hodgkin's lymphoma of the thyroid. A clinical study of twenty-two cases

Non-Hodgkin's lymphoma (NHL) of the thyroid gland is a rare disease. In the present study, the survival rate and characteristics were retrospectively analyzed in 22 patients with stage IE and IIE thyroid NHL treated with radiotherapy with or without combination chemotherapy. Seventeen NHL had histological evidence of lymphoma of mucosa-associated lymphoid tissue (MALT) type. The 5-year survival rate was 85% in all patients, with 100% and 63% respectively, for stage IE and stage IIE patients. The highly significant factor correlated with decreased determinate survival was concomitant stridor.

Phylogenetic analysis of phospholipase C genes from Clostridium perfringens types A to E and Clostridium novyi

The phylogenetic interrelationships between strains of 5 toxin types (A to E) of Clostridium perfringens were examined by analysis of differences in the nucleotide sequences of phospholipase C genes (plc genes) among 10 strains, including 3 strains for which the plc gene sequences have been previously reported. A plc gene was also cloned from a Clostridium novyi type A strain and sequenced to analyze the interspecies diversity of plc genes. Phylogenetic trees constructed by the neighbor-joining method revealed that the phylogeny of C. perfringens strains is not related to toxin typing, in agreement with the results of a comparative genome mapping study by Canard et al. (B. Canard, B. Saint-Joanis, and S. T. Cole, Mol. Microbiol. 6:1421-1429, 1992). Various C. perfringens phospholipase C enzymes were purified from cultures of Escherichia coli cells into which the encoding plc genes had been cloned. All of the enzymes showed the same specific activity. On the other hand, the level of plc transcripts differed greatly (up to 40-fold) from one C. perfringens strain to another. No significant difference in the nucleotide sequence of the plc promoter region was observed for any of the plc genes. These results suggest that the variation in phospholipase C activity among different strains is not due to mutation in the plc coding region but to that in an extragenic region. The evolution of C. perfringens phospholipase C is discussed on the basis of similarities and differences between clostridial plc genes.

Isolation and characterization of opioid peptides in the avian brain

Neuropeptides are supposed to be implicated in the regulation of hormone as well as nonhormone dependent behavioral processes in birds. Previous immunohistochemical studies have suggested that in birds opioid pentapeptides, Met- and Leu-enkephalins, may be present in the brain including the regions that regulate sex hormone dependent behaviors, such as reproductive behaviors. To determine biochemically the presence of opioid peptides in the avian brain, a study was conducted to isolate these peptides from Japanese quails and zebra finches. Acetic acid extracts of the quail and finch brains were respectively forced through disposable C-18 reversed-phase cartridges, and then the retained material was subjected to the cation-exchange and reversed-phase high performance liquid chromatographic (HPLC) purifications. All of the purified substances showed a single peak on the reversed-phase HPLC and these substances enhanced spontaneous contractions of the avian rectum. The purified bioactive substances were further subjected to amino acid sequence analysis and were characterized as peptides with the following sequences: Tyr-Gly-Gly-Phe-Met, Tyr-Gly-Gly-Phe-Leu, and Tyr-Gly-Gly-Phe-Met-Arg-Phe. These three peptides were identical with opioid pentapeptides, Met- and Leu-enkephalins, and a heptapeptide, Met-enkephalin-Arg6-Phe7, which had been previously isolated from mammalian species. This is the first direct demonstration of the presence of opioid peptides in the avian brain and confirms previous immunohistochemical findings suggesting a functional role for the opioid peptide in neural mechanisms of avian reproductive behavior.

Effects of opioid peptides on the electrical activity of preoptic and hypothalamic neurons in the quail brain

We have recently isolated three opioid peptides, i.e., Met- and Leu-enkephalins and Met-enkephalin-Arg6-Phe7, from the avian brain. In the present study, therefore, effects of these endogenous opioid peptides on the electrical activity of preoptic and hypothalamic neurons of the adult male Japanese quail were examined using a brain slice preparation. All of the three opioid peptides inhibited the spontaneous firing activities of subsets of neurons in the preoptic area and the paraventricular nucleus in the hypothalamus. Threshold concentrations for the inhibitory action were between 10(-7) and 10(-6) M in Met- and Leu-enkephalins and approximately 10(-6) M in Met-enkephalin-Arg6-Phe7, respectively. In a few cells in these brain areas, however, Leu-enkephalin rather potentiated the spontaneous activities, resulting in an increase of firing rates or a decrease of interburst intervals. The inhibitory effect of Met-enkephalin was completely blocked by naloxone, an opioid receptor antagonist, but not affected by bicuculline, a gamma-aminobutyric acid A (GABAA) receptor antagonist. These results suggest that there are functional opiate receptors in subsets of preoptic/hypothalamic neurons and that one of their main physiological functions in these areas is an inhibition of neuronal activities. Because these brain regions are considered to be involved with the regulation of a variety of male reproductive behaviors, opioid peptides may regulate some reproductive behavior through the mechanism that provokes such an inhibition.

Developmental expression of APEX nuclease, a multifunctional DNA repair enzyme, in mouse brains

Expression of the mammalian major apurinic/apyrimidinic (AP) endonuclease (designated as APEX nuclease, or HAP1, APE or Ref-1 gene product) during mouse brain development was investigated by in situ and northern blot hybridizations. The enzyme is known to be a redox factor (Ref-1) stimulating DNA binding activity of AP-1 binding proteins such as Fos and Jun as well as a multifunctional DNA repair enzyme having 5' AP endonuclease, DNA 3' repair diesterase, 3'-5' exonuclease and DNA 3'-phosphatase activities. In the embryonic and postnatal development, APEX mRNA was expressed at high levels in the proliferative zone of various brain regions, with showing temporal and spatial changes. Its expression decreased in association with brain development to the basal expression level which was observed even in adulthood, with the exception of its expression in the hippocampal formation. The growth-dependent expression of APEX gene suggests that it has some roles on cell proliferation and/or differentiation in developmental brain. Its expression on the hippocampal formation became significant from postnatal day 7 and then increased. The pyramidal and granule cell layers expressed it at a higher level than most other brain regions at postnatal day 21. The developmental change of APEX gene expression was not necessarily associated with the changes of expression of c-fos and c-jun genes measured by northern blot hybridization. However, the present results suggested that APEX/Ref-1 gene product can interact with AP-1 binding proteins in brain, especially in the hippocampal formation, to regulate some brain functions by redox-activation.

Involvement of muscle by malignant lymphoma: MR and CT appearances

OBJECTIVE

The purpose of this study is to investigate the CT and MR findings of muscular involvement by malignant lymphoma and identify the CT and MR features that may assist in their diagnosis.

MATERIALS AND METHODS

Magnetic resonance imaging was performed on four patients (five lesions) with pathologically proven non-Hodgkin lymphoma using a 1.5 T unit (Cases 1, 2, and 4) and a 0.5 T scanner (Case 3). Computed tomography scans were carried out on three patients (Cases 1, 3, and 4).

RESULTS

The lesions that extended along muscle fascicles with preserved fat planes looking like swelling of the muscle were of slightly hyper- to isointensity relative to uninvolved muscles on T1-weighted images, of hyperintensity on T2-weighted images, and of low or isodensity on CT. Microscopically, lymphoma cells were seen clustering among normal and atrophic muscle fibers in a biopsy specimen of one patient. The lesions enhanced relatively homogeneously after Gd-DTPA injection. In three cases, vessels were coursing through the lesion on MRI and in two cases on enhanced CT.

CONCLUSION

Magnetic resonance imaging proved useful to show the extension of involvement of muscular lymphoma compared with CT. The diagnosis of infiltration of muscle by lymphoma is entertained when a lesion of relatively homogeneous intensity and density extends along the muscle fascisles without obliteration of the fat planes and especially when vessels are identified within the lesion.

Avian neurosteroids. II. Localization of a cytochrome P450scc-like substance in the quail brain

We have recently demonstrated that the avian brain as well as the peripheral steroidogenic glands produces pregnenolone, the main precursor of steroid hormones, on the basis of biochemical studies. Therefore, the immunohistochemical and Western immunoblotting analyses with a polyclonal antibody directed against the purified bovine adrenal cytochrome P450scc, which is involved in pregnenolone formation, was undertaken to investigate the localization of a cytochrome P450scc-like substance in the brain of adult male Japanese quails. P450scc-like immunoreactive cells were distributed in several telencephalic, diencephalic and mesencephalic regions. An intense immunoreaction was observed in somata of Purkinje cells and in the dendrites extending through the cerebellar molecular layer. Clusters of immunoreactive cell bodies were also detected in the hyperstriatum accessorium (HA), the ventral portions of both the archistriatum and the corticoid area, the preoptic area (POA), the anterior hypothalamus (AHy) and the dorsolateral thalamus (DL). Preadsorbing the antibody with cytochrome P450scc resulted in a complete absence of P450scc-like immunoreactivity in all of positively stained cells. On Western immunoblotting with the P450scc antibody, a P450scc-like substance was present in homogenates of the several brain regions that contain immunohistochemically stained cells. Immunohistochemical experiments using both antibodies against P450scc and the glial fibrillary acidic protein (GFA), a specific marker of glial cells, indicated that many HA cells contained both P450scc-like and GFA-like immunoreactivities. However, no immunoreactivity for GFA was observed in Purkinje cells and the cells localized in the ventral portion of the corticoid area, despite the presence of P450scc-like immunoreactivity. These results confirm our previous findings of pregnenolone biosynthesis and suggest the presence of a P450scc-like substance in both neuronal and glial cells of the quail brain.

Avian neurosteroids. I. Pregnenolone biosynthesis in the quail brain

The present study was carried out to determine steroid biosynthesis from cholesterol in the brain of adult male Japanese quails. As an initial step of the experiments, the concentrations of pregnenolone, dehydroepiandrosterone and their sulfate esters in the brain and plasma extracts were measured by specific radioimmunoassays (RIAs). To exclude the possibility that these steroids in the brain are derived from peripheral steroidogenic glands, hypophysectomized and sham-operated birds were used in this experiment. The pregnenolone concentration was much larger in the brain than in the plasma in these two groups. Hypophysectomy led to decreases in the plasma and brain pregnenolone concentrations, but the change in the brain was less pronounced than that in the plasma. Although pregnenolone sulfate ester, dehydroepiandrosterone and its sulfate ester were also detected in brain extracts, those levels were low in both hypophysectomized and sham-operated birds. The biochemical demonstration of cholesterol metabolism was further conducted in intact mitochondria. When mitochondrial fractions obtained from the whole brain were incubated with cholesterol at 37 degrees C, the pregnenolone level in mitochondria increased as a function of incubation time. Finally, Western immunoblot analysis using a purified IgG with polyclonal antibodies against the purified bovine adrenal cytochrome P450scc was performed after SDS-gel electrophoresis of homogenates of the hypothalamus and preoptic area. A protein recognized the antibody as a band of electrophoretic mobility in the proximity of reference bovine P450scc. These results suggest that the brain produces pregnenolone from cholesterol in adult male Japanese quails. Most accumulation of pregnenolone in the brain may be independent of the peripheral endocrine gland system.

Cloning, sequence analysis, and chromosomal assignment of the mouse Apex gene

APEX nuclease (Apex gene product) is a mammalian multifunctional DNA repair enzyme possibly involved in the repair of apurinic/apyrimidinic (AP) sites and single-strand DNA breaks with 3' termini blocked by nucleotide fragments and also in transcriptional regulation via redox activation of the AP-1 transcription factors. We cloned a 15-kb DNA fragment containing the Apex gene from a mouse leukocyte genomic library and determined a 4-kb stretch of its nucleotide sequence, including the complete sequence of the mouse Apex gene. The gene consists of 5 exons and 4 introns spanning 2.21 kb, and the boundaries between exons and introns follow the GT/AG rule. Two major and one minor transcription initiation sites were assigned to positions +1 and +24 and position +14, respectively, by a combination of ribonuclease protection, primer extension, and 5' RACE analyses. Position +1 is located 312 nucleotides upstream from the ATG initiation codon. The translation initiation and termination sites are located in exon II and exon V, respectively. The sequenced 5' flanking region (1.32 kb) lacks a typical TATA box, but contains a CAAT box and putative binding sites for several transcription factors, such as ATF, NF-IL6, Sp1, and AP2. The 0.8-kb region from position -410 (5' flanking region) to position +386 (intron II) contains a CpG island. The Apex gene locus was mapped to mouse chromosome 14C2-D1 using in situ hybridization.

Esophageal cancer treated with radiotherapy: impact of total treatment time and fractionation

PURPOSE

Local control rate and survival rate of esophageal cancer treated with radical radiation therapy (RT) were analyzed with special respect to total treatment time and fractionation.

METHODS AND MATERIALS

Between 1979 and 1992, 88 patients with Stages I-III esophageal cancer were treated radically with RT at Kyoto University Hospital and Wakayama Red Cross Hospital. Of the 88 patients, 52 patients were treated with conventional fractionation (1.7-2.0 Gy/day, five times/week), and the remaining 36 patients were treated with accelerated hyperfractionation (AHF). In 1989, we started AHF regimen for esophageal cancer. Daily fractionations were 2.0 Gy and 1.2 Gy (field-in-field), or 1.5 Gy and 1.5 Gy at 5- to 6-h interval. Most of the patients treated with AHF received the total radiation dose of 64-68 Gy. Twenty-seven patients were treated with intraluminal brachytherapy (IBT) as boost therapy following external RT. Fourteen patients were treated with IBT following AHF.

RESULTS

The median of treatment time of AHF was approximately 2 weeks shorter than that of conventional fractionation. Local control rate at 1 year were 47% for AHF, which was significantly higher than that for conventional fractionation (22%, p < 0.05). The improvement of local control by AHF was responsible for a trend to an improved cause-specific survival (p = 0.07). Local control rates at 1 year were plotted as a function of total treatment time. The slope of the linear regression line was -2.3 +/- 0.5% per day (p < 0.025) for patients treated with external RT alone, indicating a 2.3% per day loss in local control. Pretreatment and treatment parameters were evaluated in a multivariate analysis for the end point of local control. T stage (T1, 2 vs. T3, 4; p = 0.003) and fractionation schedule (p = 0.03) were independent of prognostic significance. Patients could tolerate the AHF well, although esophageal stenosis was noted frequently as a late toxicity.

CONCLUSION

Accelerated hyperfractionation was the most important treatment-related variable in this patient population. Total treatment time may have a significant impact on the treatment outcome for esophageal cancer.

Three-dimensional treatment planning for maxillary cancer using a CT simulator

PURPOSE

The results of three-dimensional treatment planning using a computed tomography simulator were evaluated in patients with maxillary cancer.

METHODS AND MATERIALS

Treatment planning was done in 25 patients using an x-ray simulator and plain x-ray films (1979-1982, group 1) in 34 patients using an x-ray simulator and computed tomography films (1983-1987, group 2), in 24 patients using a computed tomography simulator (1988-1992, group 3). The number of patients with Stage IV disease increased in the order of group 1 to group 3.

RESULTS

The average radiation field was smallest in group 3 (66.5 cm2) followed by group 2 (67.4 cm2) and group 1 (72.9 cm2). A radiation dose of more than 30 Gy to the lens of the effected side was delivered to 13% of group 3, 44% of group 2, and 44% of group 1. The dose to the lens on the uneffected side was zero in 56% of group 1, 74% of group 2, and 96% of group 3. A long-term decrease in visual activity on the effected side occurred in 11% of group 3, 32% of group 2, and 44% of group 1. However, a significant increase in survival was only noted between groups 1 and 2, because the three population of patients were different.

CONCLUSION

The three-dimensional treatment planning results in a better treatment than two-dimensional treatment planning as measured by complication rates and field sizes.

Differential changes in the activities of multiple protein kinase C subspecies in the hippocampal-kindled rat

In previous studies we demonstrated that the membrane-associated protein kinase C (PKC) activities in the right and left hippocampus (HIPP) of rats kindled from the left HIPP increased significantly 4 weeks and 4 months after the last seizure compared with those in matched control rats. In this study, we investigated the long-lasting effect of HIPP-kindling on the membrane-associated activities of PKC subspecies in the bilateral HIPP 1 and 4 weeks after the last generalized kindled seizure had occurred. The membrane-associated activities of PKC subspecies were found to be subject to differential regulation. The activity of the alpha-subspecies was unchanged, whereas the respective activities of the beta- and gamma-subspecies in the kindled group increased significantly, compared with the controls, one (21%, P < 0.0001 for the beta-subspecies, and 23%, P < 0.001 for the gamma-subspecies) and 4 weeks (19%, P < 0.02 for the beta-subspecies, and 19%, P < 0.05 for the gamma-subspecies) after the last seizure. There were no significant differences in cytosolic PKC activity between the control and kindled groups for any subspecies examined at either time after the last seizure. These results suggest that activation of the PKC beta- and gamma-subspecies may play an important role in the enduring seizure susceptibility associated with kindling.

Annular elastolytic giant cell granuloma: response to cyclosporin A

A case of annular elastolytic giant cell granuloma with a good response to cyclosporin A is reported. A 62-year-old man developed multiple annular patches on the trunk with elevated and indurated borders. Biopsy specimens from the border showed granulomatous inflammation in the mid dermis with phagocytosis of elastic fibers by giant cells. Biopsy specimens from the center showed dense collagen formation without inflammation. Immunological investigation of perivascular infiltrating cells in the lesions revealed a predominance of CD4+ cells over CD8+ cells. Our case showed a good response to cyclosporin A (5 mg/kg/day) for eight weeks. There were no adverse effects and no recurrences for one month after discontinuation of cyclosporin A.

Differential expressions of the topoisomerase II alpha and II beta mRNAs in developing rat brain

Distributions of the topoisomerase II alpha and II beta mRNAs were examined in the developing rat brain, by in situ hybridization with isoform-specific oligonucleotide probes. Intense signals for the topoisomerase II alpha mRNA were detected in the ventricular zone of each brain region at embryonic day 13-15 (E13-E15), and in the external granular layer of the cerebellum at postnatal day 7-14 (P7-P14). Thereafter, the signals rapidly decreased in levels and eventually disappeared from respective regions. Administration of bromodeoxyuridine (BrdU) into embryos at E13 showed that the topoisomerase II alpha mRNA was expressed in the BrdU-incorporated region and its ventricular side of the neural wall, suggesting that transcription of this isoform occurs in neurons from S-phase through M-phase. On the other hand, the topoisomerase II beta mRNA was distributed throughout the brain from E13 through P21, irrespective of the ventricular and mantle zones. Signal levels of the topoisomerase II beta mRNA were much stronger during early developmental stages than at mature stages in various brain regions. The characteristic and differential spatio-temporal expressions suggest that the topoisomerase II alpha is involved in the proliferation, while the topoisomerase II beta is closely related to differentiation and maturation of neurons.

Detection of endogenous albumin as an index of blood parenchymal border alteration

We used a microdialysis technique to establish a method to detect sequential changes in disruption of the blood parenchymal border. Twelve cats were divided into two groups; one group underwent occlusion of the middle cerebral artery for 60 minutes, the other a cold injury model. Microdialysis probes were implanted bilaterally into the white matter, and dialysates were collected successively at 30 minute intervals for 6 hours in the occlusion model and 4 hours in the cold injury model. Regional cerebral blood flow was measured simultaneously using the hydrogen clearance method. The water content of the white matter was measured using specific gravity. The proteins in the dialysate were analyzed using electrophoresis with silver stain, and, with densitometric analysis, the density of the 66.2 kDa band was quantified as albumin. The ratio of this density to the preoperative density was defined as the "albumin index." On the side of the lesion in the cold injury model, this index significantly increased 3 hours after the cold injury compared with the contralateral side, and a correlation between the water content and this index was observed. The albumin index was believed to indicate the severity of disruption of the blood parenchymal border.

Photoperiodic regulation of follicle-stimulating hormone binding to gonads and of plasma gonadotropin concentrations in Indian weaver birds

Previous studies showed that changes of gonadal weight and of follicle-stimulating hormone (FSH) receptor number in response to fluctuations in natural environmental conditions are smaller in female than in male Indian weaver bird (Ploceus phillippinus). Therefore, we studied whether the response to artificial photoperiodic changes differs between the sexes. Birds were transferred to short-day (SD) photoperiods during the breeding phase (June). Other birds were subjected to long-day (LD) photoperiods during the nonbreeding phase (December). Exposure to SD for 10 weeks induced a marked testicular weight decrease. Similarly, FSH binding per unit testicular weight as well as per two testes decreased after SD exposure. The influence of photoperiodic manipulations on the ovarian weight was much smaller than that on the testicular weight. SD exposure did not alter FSH binding either per unit ovarian weight or per ovary. Plasma gonadotropin concentration significantly decreased in both sexes subjected to SD environment. On the other hand, exposure to LD significantly increased testicular weight. LD exposure slightly increased ovarian weight, but the increase was statistically not significant. FSH binding per unit testicular weight markedly increased 10 weeks after transfer to LD. The total FSH binding per two testes showed a parallel change with the testicular weight. However, there was no significant increase in FSH binding per unit ovarian weight during 10 weeks of LD exposure. Although LD exposure for 10 weeks significantly increased the total FSH binding per ovary, the rate of increase was much smaller than that in the testes. The plasma gonadotropin level in both sexes was increased by LD exposure. Scatchard plot analyses of FSH binding indicated that FSH binding changes were due to changes in binding site number. These results suggest that photoperiod regulates FSH receptor numbers particularly in the testis. Such an effect is manifested by marked changes in the testicular weight under different photoperiodic conditions in the subtropical bird.

Molecular cloning of partial cDNAs for rat DNA topoisomerase II isoforms and their differential expression in brain development

cDNA segments for DNA topoisomerase II were amplified from rat brain RNA after reverse transcription by the polymerase chain reaction, using degenerate oligonucleotide primers deduced from the conserved regions of topoisomerase II of higher eukaryotes. The cDNA product from a successful amplification was homogeneous in length but heterogeneous in sequence. Restriction mapping of the cloned cDNA fragments revealed that they consisted of two distinct sequence groups. DNA sequencing of representative clones from each group, designated A and B, showed that they are highly homologous to cDNAs of human topoisomerase II isoforms, alpha and beta, respectively. Northern blot analysis indicated that the transcript level for rat topoisomerase II alpha was high in embryonic brain and in the cerebellum of 2-day newborns, followed by rapid decrease to a undetectable level at 4 weeks after birth. In contrast, rat topoisomerase II beta transcript was present throughout the embryonic and postnatal stages. In the developing cerebellum, cells expressing topoisomerase II alpha were confirmed exclusively to the outer mitotic zone of the external granular layer, whereas the transcript of topoisomerase II beta was detected over the entire cortical region. These results clearly indicate that the isoform alpha is expressed only in proliferating cells. The differential expression of topoisomerase II isozymes was also observed among developed tissues. Therefore, the isozymes are most likely to be involved in the following different physiological processes: topoisomerase II alpha in cell proliferation, and topoisomerase II beta in some processes unrelated to cell proliferation.

Activity gel and activity blotting methods for detecting DNA-modifying (repair) enzymes

Zymographical methods (activity gel, overlay gel, activity blot and activity blotting) for detecting DNA-modifying (repair) enzymes are reviewed. Emphasis is put on the novel activity blotting method in which DNA repair enzymes electrophoresed on a gel are blotted and detected on a damaged DNA-fixed nylon membrane. Its practical procedures, including a non-radioactive detection procedure, and representative results are also described.

Identification and characterization of a nuclear scaffold protein that binds the matrix attachment region DNA

The association of nuclear DNA with the nuclear matrix (scaffold) is mediated by defined segments of DNA called matrix association region (MAR). By using a plasmid harboring a portion of the Ig kappa gene within which MAR had been located, we searched for proteins recognizing MAR in the nuclear scaffold components electrophoretically separated and blotted onto a membrane. In the presence of nonspecific competitor DNA, the labeled plasmid selectively bound to a protein with apparent molecular weight of 120,000 (designated SP120). The protein was purified directly from SDS-polyacrylamide gels and renatured by a guanidine hydrochloride procedure. The DNA region in the plasmid responsible for the binding to the solubilized SP120 coincided with the 365-base pair HindIII-HinfI fragment that had been identified as MAR. In solution, SP120 exhibited a cooperative mode of interaction with the end-labeled MAR fragment. Measurement of relative affinities of MAR subfragments to SP120 showed that the whole region is required for efficient binding. This is consistent with the minimal length for MAR estimated thus far by in situ mapping experiments. The MAR derived from another gene, fushitarazu, also bound specifically to SP120. Immunostaining of whole cells and isolated nuclei with a monoclonal antibody raised against SP120 indicated that the protein is localized in a nuclear skeletal structure. These results suggest the involvement of SP120 in the MAR-mediated anchorage of nuclear DNA to the nuclear scaffold.

Detection and analyses by gel electrophoresis of cisplatin-mediated DNA damage

DNA damage induced by cis-diamminedichloroplatinum (II) (cisplatin: cis-DDP), an anticancer drug, was studied in vitro by monitoring the drug-induced conformational change of pUC18 plasmid DNA, the sensitivity to some restriction enzymes of the damaged DNA and the sequence-dependent termination of DNA synthesis caused by cisplatin. Closed circular, superhelical pUC18 DNA was treated at 37 degrees C for 16 h with various concentrations of cisplatin. Cisplatin-dose-dependent conformational change due to unwinding of the treated DNA was detected by agarose gel electrophoresis. To analyze the base-specificity of the cisplatin damage, the measurement for sensitivity of cisplatin-treated DNA to various types of restriction enzyme and sequence gel analysis of the treated DNA were conducted. The results suggested that cisplatin attacked preferentially the sequence of GG > AG > GNG in the order. In the present assay condition, the cisplatin/DNA nucleotide ratios required for the DNA damage detection were roughly 0.025 for the conformational analysis, 0.001 or more for the restriction enzyme analysis, and less than 0.001 for the sequence gel analysis. By using the present method, it was demonstrated that the cisplatin-mediated DNA damage was inhibited by NaCl, KCl, CaCl2 or MgCl2 at their nearly physiological concentrations, and by reducing agents such as thiourea and 2-mercaptoethanol in the reaction mixture.

Annual changes in the binding of follicle-stimulating hormone to gonads and plasma gonadotropin concentrations in Indian weaver birds inhabiting the subtropical zone

In birds, annual changes in gonadal weight are much more pronounced in the male than in the female. To analyze the mechanism inducing such a sex difference in the gonadal responsiveness to natural environmental conditions, we measured annual changes in the binding of follicle-stimulating hormone (FSH) to the gonads and the plasma gonadotropin concentration in adult Indian weaver birds inhabiting the subtropical zone. The binding of FSH was highly specific for mammalian FSHs and located primarily in the gonad. The testicular weight and FSH binding showed marked changes during the annual breeding cycle. The testicular weight was maximal in the breeding phase (June, 1987) and minimal in the nonbreeding phase (December, 1987). FSH binding per unit testicular weight was greatest in the nonbreeding phase, while the total FSH binding per two testes was maximal in the breeding phase and minimal in the regressive phase (October, 1987). In contrast, the changes in the ovarian weight and FSH binding to the ovary were less pronounced than those in the testis. Although FSH binding per unit ovarian weight showed a peak in the nonbreeding phase, there was no significant change in the total FSH binding per ovary during the year, indicating the presence of a clear sex difference in the total FSH binding. Scatchard plot analyses of the binding suggested that the dissociation constant (Kd) ranged from 0.35 to 1.53 nM regardless of sex and season and that the changes in FSH binding were due to changes in the number of binding sites. Plasma FSH and luteinizing hormone (LH) levels markedly changed during the year in both sexes. Both FSH and LH levels were maximal in the breeding phase and minimal in the nonbreeding phase regardless of sex, although the rate of change in either hormone tended to be greater in the male than in the female.

Induction of interdigitating reticulum cell-like differentiation in human monocytic leukemia cells by conditioned medium from IL-2-stimulated helper T-cells

Monocytic leukemia (MoL) cells were obtained from the peripheral blood of a patient in whom the leukemic cells infiltrating various lymphoreticular organs exhibited features intermediate between interdigitating reticulum cells (IDC) and ordinary phagocytic macrophages, whereas the leukemic cells in the peripheral blood were essentially monocytic and lacked such features. Peripheral blood CD4+ T-cells were established as an interleukin-2-dependent T-cell line. When the MoL cells were exposed for a few days to conditioned medium from the T-cell line, they extended several dendritic cytoplasmic projections and became intensely positive for HLA-DR antigen, cytoplasmic S-100 beta protein, and CD1 antigen. Functionally, the conditioned medium significantly down-regulated Fc-mediated and Fc-independent phagocytic activities, and the levels of lysosomal enzymes such as lysozyme and nonspecific esterase in the MoL cells. Moreover, the conditioned medium significantly up-regulated the accessory cell function of the MoL cells as measured by the primary allogenic mixed leukocyte reaction (MLR). Furthermore, the conditioned medium significantly down-regulated the expression of CD14 antigen. Biochemical analysis indicated that the factor responsible for these changes is a protein which is distinct from known human cytokines and whose molecular weight is approximately 31 kDa. These findings suggest that IDC are closely related the monocytic lineage and that helper T-cells play an important role in constructing the microenvironment of T-lymphoid tissues which is necessary for the differentiation and maturation of IDC.

Coagulation-fibrinolysis system and markers of collagen metabolism in lung cancer

BACKGROUND

Evidence suggests that the fibrinolysis system and peritumoral connective tissue play important roles in tumor spread.

METHODS

In this study, the authors evaluated the following parameters in 30 consecutive patients with lung cancer: thrombin-antithrombin complex (TAT), cross-linked fibrin split products D-dimer (DD), plasmin-alpha 2-antiplasmin inhibitor complex (PAP), and two antigens related to connective tissue, the aminoterminal propeptide of type III procollagen (PIIIP) and the 7S domain of type IV collagen (7S-collagen).

RESULTS

Each parameter was increased significantly in the patients with cancer compared with the control subjects. Except for PIIIP, their concentration in blood was elevated to a significantly greater extent in the patients with distant metastases. The PAP concentration correlated well with the plasma concentration of TAT (r = 0.5; P < 0.01) and DD (r = 0.9; P < 0.0001). There was also a strong correlation between the serum concentrations of PIIIP and 7S-collagen (r = 0.7; P < 0.001). In patients with localized disease, DD levels were correlated significantly with those of PIIIP (Spearman rank-order correlation [rs] = 0.6; P < 0.025) and 7S-collagen (rs = 0.6; P < 0.01). In the group with disseminated metastases, there was a significant inverse relationship between serum PAP concentrations and serum concentrations of 7S-collagen (rs = -0.6; P < 0.025).

CONCLUSIONS

These results confirm the presence of a subclinical chronic activation of the parameters of intravascular clotting-fibrinolysis and alterations in the extracellular matrix of patients with lung cancer. These parameters may be useful as indicators of the clinical progression of malignant disease, particularly of lung cancer.