Identification of the full-length KIAA0591 gene encoding a novel kinesin-related protein which is mapped to the neuroblastoma suppressor gene locus at 1p36.2

The distal region of a short arm of chromosome 1p is frequently deleted in many human cancers including neuroblastoma (NBL), in which it has been narrowed down to the smallest region of overlap between D1S244 and D1S214 (approximately 7 cM). During the search for the candidate tumor suppressor genes mapped within the region, we found the KIAA0591 gene which encoded a new human kinesin-related protein with a homology to human axonal transporter of synaptic vesicles (ATSV). The kinesin is an intracellular motor protein and often associated with neuronal differentiation and survival. Here we identified a complete open reading frame of the KIAA0591 gene by screening a cDNA library derived from human substantia nigra. The KIAA0591 protein contains a possible pleckstrin homology (PH) domain at its carboxy-terminus. However, it did not possess a force-generating motor domain which is well conserved among kinesin superfamily members (KIFs). Northern blot analysis demonstrated that KIAA0591 mRNA was preferentially expressed in both adult and fetal brains, kidney, skeletal muscle and pancreas. KIAA0591 was expressed in favorable NBLs at higher levels than in unfavorable NBLs, although RT-PCR SSCP analysis showed no mutation within the coding region of the KIAA0591 gene, when 8 neuroblastoma tissues and 15 neuroblastoma-derived cell lines were examined. Thus, the full-length KIAA0591 gene may be a novel member of human KIF superfamily which lacks motor domain and might function as a tumor suppressor in an epigenetic but not a classic Knudson's manner.

[Left Sylvian fissure meningioma in a one-year-eight-month old child]

We report a case of a Sylvian fissure meningioma in a one-year-eight-month old child who experienced the onset of a convulsive seizure. He had no neurological deficit and no developmental disorders. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large left temporal tumor which was well enhanced and without dural attachment. Angiography revealed a slight tumor stain in the left Sylvian fissure supplied by branches of the internal carotid artery. Total removal of the tumor was performed, and we found that the tumor had no dural attachment, but was strongly attached to the M2 segment of the left middle cerebral artery. Pathological examinations revealed it to be a fibrous meningioma without malignancy. This is the youngest case among the reported five pediatric deep Sylvian meningiomas. Introducing this case, we discuss the clinical features of pediatric meningiomas.

Gamma Knife radiosurgery for pituitary adenomas

Ninety-two patients with pituitary adenomas have been treated during the last 5 years. Sixty-three of these patients had more than 6 months follow-up, and they form the basis of this report. Eighteen had non-functioning adenomas (NFA), and 36 had functioning adenomas (FA). The mean marginal dose was 22.5 Gy (NFA 19.5 Gy, FA 23.9 Gy). Control of tumor growth was achieved in 92%. A significant decrease of excessive hormone production was seen in 75.6%, and the endocrinopathy normalization rate was 26.7%. Post-radiosurgical complications were seen in 4.7%.

Expression of cadherin and CSF dissemination in malignant astrocytic tumors

Cadherins are Ca2+-dependent cell adhesion molecules that play an important role in tissue construction and morphogenesis in multicellular organisms. Because in recent years there have been reports of cadherin involvement in tumor metastasis, we conducted an immunostain for E-cadherin and N-cadherin monoclonal antibodies in paraffin-embedded surgical specimens of primary and recurrent lesions in 13 cases of glioblastoma and nine cases of anaplastic astrocytoma. No expression of E-cadherin was detected in the tumor cells. On the other hand, expression of N-cadherin was observed in malignant astrocytic tumor cells, but the N-cadherin positive rate tended to be less at the time of recurrence. Decreased expression of N-cadherin was detected at the time of recurrence in 11 of the 13 cases in the glioblastoma group. Cerebrospinal fluid (CSF ) dissemination and extracranial metastasis were observed in nine (81.8%) of these 11 patients. Therefore, we tried to analyze the clinical backgrounds and the N-cadherin positive rates by statistics. We concluded that decreased expression of N-cadherin at the time of recurrence correlates with dissemination in malignant astrocytic tumors.

[Immunohistochemical evaluation of intracranial recurrent meningiomas: correlation of topoisomerase II alpha expression and cell proliferative potential]

Most of meningiomas belong to benign tumor. But inspite of Simpson grade I surgical resection, it had been reported that a part of these cases recurred after initial operation. In discussing tumor recurrence in meningioma, it is important to evaluate not only the extent of surgical resection and malignancy but also cell proliferative potential, which had been studied immunohistochemically by using BudR, PCNA and MIB-1. Recently, it is known that topoisomerase (Topo) II alpha expression becomes remarkable in tumorigenesis. The correlation with cell proliferative potential has been reported. In this paper we evaluated the relationship of cell proliferative potential and tumor recurrence immunohistochemically by using Topo II alpha and MIB-1 monoclonal antibody in the 21 recurrent cases of meningiomas and hemangiopericytomas. As a result, mean Topo II alpha staining index (SI) and MIB-1 SI initial surgical resection were 2.29% and 3.41%, respectively, at recurrence these SIs had risen at 4.3% and 6.25%, respectively. As to the interval from initial surgical resection to recurrence, in the cases which recurred under 3 years Topo II alpha SI and MIB-1 SI were 3.13% and 5.00%, on the other hand, in the cases which recurred later than 3 years were 1.16% and 1.30%, respectively. Topo II alpha SI and MIB-1 SI 1 of former cases were higher than latter cases. Furthermore good correlation between the Topo II alpha SI and MIB-1 SI was found. It is concluded that Topo II alpha expression was as well available for the marker of cell proliferative potential and for one of the predicting factors for tumor recurrence in meningioma and hemangiopericytoma as MIB-1 SI.

Detection of mammosomatotrophs in paraffin-embedded specimens of various pituitary adenomas

BACKGROUND

There are various classification systems for pituitary adenomas based on whether mammosomatotroph cells, which simultaneously express both prolactin (PRL) and growth hormone (GH), can be found. Until the present, the identification of such cells required special techniques and could not be performed in paraffin-embedded specimens. This hindered large-scale studies for detection of mammosomatotrophs in various pituitary adenomas and, as a result, such classification has remained controversial. To establish a methodology for the detection of mammosomatotrophs in paraffin-embedded specimens and to propose a more logical classification for pituitary adenomas, the authors conducted this retrospective study.

METHODS

We performed double immunofluorescence staining of PRL and GH in paraffin-embedded specimens of various pituitary adenomas with subsequent observation with a confocal laser-scanning microscope.

RESULTS

Mammosomatotrophs were found in four of the 10 GH-secreting adenomas and one of the 10 clinically nonfunctioning adenomas. However, mammosomatotrophs were not identified in all 10 cases of prolactinoma.

CONCLUSIONS

This is the first report in the literature that successfully demonstrates the presence of mammosomatotrophs in routine paraffin-embedded pituitary adenomas. The new methodology is important for future study of the function and role of these cells. A large-scale study for mammosomatotrophs in various pituitary adenomas with this method and a more logical classification of pituitary adenomas are proposed.

Primary central nervous system T-cell lymphoma. Case report

A 46-year-old male presented with a rare primary non-Hodgkin's lymphoma of the central nervous system of T-cell lineage, localized primarily in the right parietal region. There was no evidence of acquired immunodeficiency syndrome. Biopsy of the tumor allowed immunohistochemical confirmation of the diagnosis. Irradiation and chemotherapy were given, and the patient has remained well for 24 months. The clinical manifestations, management, and outcome of T-cell lymphoma are very similar to those of B-cell lymphoma.

[Lymphoplasmacyte-rich meningioma: a report of three cases and a review of the literature]

We report three patients (a 36-year-old man, a 41-year-old woman, and a 22-year-old man) with lymphoplasmacyte-rich meningioma who manifested characteristics on radiological and blood examinations. Two were hospitalized with gradual deterioration of hemiparesis and one with general convulsive seizure. Radiological examination revealed typical meningiomas of convexity in two and that of falx in one. Two of the patients showed large perifocal edema. Anemia was found in one patient and an elevated level in the zinc sulfate turbidity test was noted in all cases. Abnormal findings in laboratory examination improved quickly, whereas perifocal edema remained for six months after tumor removal. The tumors were histologically confirmed to be meningioma with massive infiltrates of plasma cells and lymphocytes. Seventeen cases of lymphoplasmacyte-rich meningioma that have been reported to date including our three cases were reviewed.

[Clinical evaluation of intraoperative radiotherapy using photon radiosurgery system for brain tumors]

The photon radiosurgery system is a miniature X-ray generator that can be placed stereotactically and intraoperatively into intracranial tumors to deliver a single fraction of high-dose interstitial irradiation. This battery-powered device produces low energy X-ray photons in a spherical and symmetrical pattern at the probe tip. Dose rates of up to 200 cGy/Mim are possible, allowing for the administration of 15 Gy to a lesion 3 cm in diameter in less than 1 hr. Background exposure is minimal, and no special shielding of the patient or health care personnel is required. Thirty-nine patients with brain tumor were treated in this method. There were no adverse effects. During the follow-up period of 1-30 months, 3 cases with 5 metastatic brain tumors died about 8 months after this treatment. Five recurrent cases of 21 malignant gliomas died about 4 months after treatment. Interstitial radiotherapy using photon the radiosurgery system promises to be a useful treatment for brain tumors.

Expression and role of cadherins in astrocytic tumors

Cadherins are Ca(2+)-dependent cell adhesion molecules that play an important role in tissue formation and morphogenesis in multicellular organisms. In recent years, there have been reports of cadherin involvement in tumor invasion and metastasis. Twenty-two surgical specimens and some cultured cells were studied by immunohistochemical staining. No significant difference was observed in the patients with anaplastic astrocytoma, whereas decreased expression of N-cadherin was detected at the time of recurrence in those with glioblastoma. In these groups, cerebrospinal fluid dissemination was found, and contralateral cerebral metastases and extracranial metastases were observed. We conclude that decreased N-cadherin expression at the immunohistochemically demonstrated time of recurrence correlates with tumor invasion and dissemination of cerebrospinal fluid.

Involvement of 5-hydroxytryptamine7 receptors in inhibition of porcine myometrial contractility by 5-hydroxytryptamine

1 5-Hydroxytryptamine (5-HT; 1 nM - 100 microM) concentration-dependently inhibited the amplitude and frequency of spontaneous contractions in longitudinal and circular muscles of the porcine myometrium. The circular muscle (EC50; 68-84 nM) was more sensitive than the longitudinal muscle (EC50; 1.3-1.44 microM) to 5-HT. To characterize the 5-HT receptor subtype responsible for inhibition of myometrial contractility, the effects of 5-HT receptor agonists on spontaneous contractions and of 5-HT receptor antagonists on inhibition by 5-HT were examined in circular muscle preparations. 2 Pretreatment with tetrodotoxin (1 microM), propranolol (1 microM), atropine (1 microM), guanethidine (10 microM) or L-NAME (100 microM) failed to change the inhibition by 5-HT, indicating that the inhibition was due to a direct action of 5-HT on the smooth muscle cells. 3 5-CT, 5-MeOT and 8-OH-DPAT mimicked the inhibitory response of 5-HT, and the rank order of the potency was 5-CT>5-HT>5-MeOT>8-OH-DPAT. On the other hand, oxymethazoline, alpha-methyl-5-HT, 2-methyl-5-HT, cisapride, BIMU-1, BIMU-8, ergotamine and dihydroergotamine had almost no effect on spontaneous contractions, even at 10-100 microM. 4 Inhibition by 5-HT was not decreased by either pindolol (1 microM), ketanserin (1 microM), tropisetron (10 microM), MDL72222 (1 microM) or GR113808 (10 microM), but was antagonized by the following compounds in a competitive manner (with pA2 values in parentheses): methiothepin (8.05), methysergide (7.92), metergoline (7.4), mianserin (7.08), clozapine (7.06) and spiperone (6.86). 5 Ro 20-1724 (20 microM) and rolipram (10 microM) significantly enhanced the inhibitory response of 5-HT, but neither zaprinast (10 microM) nor dipyridamole (10 microM) altered the response of 5-HT. 6 5-HT (1 nM - 1 microM) caused a concentration-dependent accumulation of intracellular cyclic AMP in the circular muscle. 7 From the present results, the 5-HT receptor, which is functionally correlated with the 5-HT7 receptor, mediates the inhibitory effect of 5-HT on porcine myometrial contractility. This inhibitory response is probably due to an increase in intracellular cyclic AMP through the activation of adenylate cyclase that is positively coupled to 5-HT7 receptors.

[A case of giant cell-rich gliosarcoma]

We report a case of gliosarcoma with numerous giant cells resembling ganglion cells and having clear nucleoli. A 75-year woman was admitted to our hospital suffering from progressive left hemiparesis and ambulatory disturbance of one week's duration. CT and MRI studies showed ring enhancement on a clear margin mass in the right parieto-occipital lobe. The mass was totally removed macroscopically. Her left hemiparesis had improved and self walk came to be possible. But the tumor was regrowthed during next two months and she died for three months and a week. The gross and microscopic appearances of the tumors showed the double structure. The surface of the tumor was well enhanced and consisted of soft, gray, and easily bleeding tissue. The central core, however, was poorly enhanced and consisted of hard, yellow, non-bleeding tissue. Macroscopically, the central area included numerous giant ganglion-like cells which were negative for GFAP but positive for EMA in the cytoplasm. These giant cells had abundant collagen fibers and were surrounded by such fibers. Microscopic findings of the surrounding area included numerous spindle shaped cells which were positive for GFAP and vimentin. The origins of giant cells or tumor tissues have long been discussed, but no consensus has yet been obtained. Therefore, we speculated as to the origin in our patient based on immunohistochemical study and the findings of electronmicroscopy. We concluded, in sharp contrast to the old theory of one origin, epithelial tissue of a hamartomatous nature existed initially, followed by the growth of malignant tissue of a reactive astrocytic tumor with a sarcomatous component.

Spontaneous regression of primary intracranial germinoma. A case report

BACKGROUND

Testicular seminomas are well known to regress spontaneously at a higher incidence than other tumors. To date, there have been no reports of spontaneous regression of an intracranial germinoma, although these tumors are histologically identical to testicular seminomas.

METHODS

The authors present a patient with a primary intracranial germinoma that regressed spontaneously.

RESULTS

A 21-year-old man was admitted to the study facility with acute onset of headache and vomiting. He had a 3-year history of polydipsia and polyuria. Computed tomography (CT) demonstrated a large tumor in the third ventricle, accompanied by hydrocephalus. He underwent ventriculoperitoneal shunt placement on the second day of hospitalization. A CT scan obtained on the fifth postoperative day demonstrated a remarkable decrease in tumor size. Because serial magnetic resonance imaging (MRI) demonstrated a gradual decrease in tumor size, tumor resection was not performed at that time. The patient was discharged and followed with MRI. The tumor continued to regress for more than 2 months. The patient was readmitted due to tumor regrowth, confirmed by MRI 4 months after the initial admission, despite the absence of symptom exacerbation. Two weeks later, the suprasellar portion of the tumor was resected through a right frontotemporal craniotomy. The histopathologic diagnosis was a germinoma. No concurrent tumors were found on whole body examination. The residual tumor gradually regressed after conventional radiation therapy and there has been neither tumor recurrence nor metastasis to date.

CONCLUSIONS

Although the precise cause of the transient partial regression is unknown, this case indicates that, like their testicular counterparts, intracranial germinomas may on occasion spontaneously regress.

[Management of increased intracranial pressure in metastatic brain tumor]

Metastatic brain tumors generally accompany huge peripheral edema, and half of the cases have multiple lesions. Thus, one must manage the increased intracranial pressure (IICP). Ideally, local control of the tumor progression by surgical removal with radiation or radiosurgery is the best method to reduce IICP. We usually use a glyceol or steroids as medical treatment. Steroids are effective for peripheral edema, and we have used them for inoperable patients over the long term. One should estimate the condition of the primary lesion, systemic metastasis, and intracranial lesion in order to determine the therapy to assure patients the best quality of life.

Tumor cell counting using an image analysis program for MIB-1 immunohistochemistry

A cell counting method for MIB-1 immunohistochemistry, using an image analysis program, NIH Image, on a personal computer, has advantages over manual cell counting by microscopy. MIB-1 slides were photographed at a magnification of x 50 on 24 x 36 mm color films and the photographs were then enlarged to adequate size for observation. The MIB-1-positive cells, on the enlargements, were marked with a white pen, and negative cells with a black pen. Subsequently, the image of an enlargement was converted into data that can be processed by the program using a flatbed image scanner. Threshold levels were adjusted according to the respective white and black markings, and the program automatically counted the number of MIB-1-positive and negative tumor cells. Our method has the following significant advantages: Once cells had been marked and the image converted into the NIH Image data, the cell count process was completed within a few minutes; in contrast to manual microscopic cell counting, count overlapping or cells missed by the observer are eliminated; overlapping nuclei could be separated by the marking procedure; our method required no elaborate and costly image analysis system. The present method may be recommended to researchers undertaking cell kinetic studies utilizing immunohistochemical methods.

Correlation between MR image characteristics and histological features of acoustic schwannoma

We retrospectively studied 21 cases of histologically proven acoustic shwannomas with an emphasis on the correlation of their magnetic resonance imaging (MRI) findings and histological features. All cases were of low signal intensity in the T1W MRI. In the T2W MRI, 9 of them were of homogeneous high signal intensity (Hom-HSI-T2) and 12 of them were of heterogeneous high signal intensity (Het-HSI-T2). The cases of Hom-HSI-T2 were generally associated with capsular enhancement, and were usually cystic tumors with high vascularities and mainly Antoni A tissues. On the contrary, the cases of Het-HSI-T2 were generally associated with homogeneous enhancement, and were usually solid tumors with low vascularities and various tissue components.

Demonstration of activin in normal pituitary and in various human pituitary adenomas by immunohistochemistry

Inhibins and activins have been known to modify the secretion of various pituitary hormones. To study whether inhibins and activins are present in human pituitary tissues, immunohistochemical studies with antisera to activin A and inhibin alpha subunit were performed on 9 human pituitary adenoma tissue specimens and one sample of normal pituitary tissue adjacent to one adenoma. Activin immunoreactivities were demonstrated in the cytoplasms of one GH and one PRL and two non-functioning adenomas and one normal pituitary tissue, but they were negative in one PRL, one ACTH, one FSH and two non-functioning adenomas. Thus, the presence and absence of activin in the same type of adenoma in regard to hormone production, suggested that the difference in immunostaining simply reflected the difference in the activin concentration. In contrast to this, inhibin alpha subunit immunoreactivity was not found in any of the tissues studied. These data suggested a local synthesis of activin in the normal pituitary as well as various kinds of pituitary adenoma tissues and its local role in the human pituitary gland.

Inhibin alpha, beta A and beta B subunit messenger ribonucleic acid levels in cultured rat pituitary: studies by a quantitative RT-PCR

Recent studies have demonstrated that inhibins and activins both play not only endocrine roles but also local regulatory roles in gonadotoropin secretion. There has been controversy as to the subtype of rat pituitary inhibin/activin. We studied the levels of inhibin alpha, beta A and beta B subunit mRNAs by a quantitative reverse transcription-polymerase chain reaction (RT-PCR) and the changes in their levels by adding inhibin alpha, beta A and beta B mRNA antisense oligonucleotides and inhibin A, activin A or GnRH to cultured rat anterior pituitary cells. This study demonstrated the level of 3 mRNAs to be 1.6 x 10(-2), 0.75 and 3.4 x 10(-2) molecules/cell with a molar ratio of 1:50:2. A stimulatory role for activin B in FSH secretion was suggested as beta B mRNA antisense oligonucleotide decreased FSH secretion. The beta B mRNA level tended to be decreased by the addition of activin A, but the decrease was not statistically significant. GnRH did not affect alpha and beta B mRNA levels when administered singly. The level of beta A mRNA was not changed by any of the above treatments. In conclusion, the presence of inhibin alpha, beta A and beta B subunit mRNAs in the rat anterior pituitary with the greatest abundance of beta A was demonstrated by using RT-PCR. Activin B or activin AB may play important roles in FSH secretion in an autocrine or a paracrine fashion, and activin A may play an indirect role in FSH secretion.

MIB-1 staining index and peritumoral brain edema of meningiomas

BACKGROUND

Growth rates and tumor aggressiveness of meningiomas are thought to be closely related to brain edema development. However, histopathologic data alone are not consistently accurate predictors of the behavior and clinical course of a meningioma.

METHODS

The authors examined 57 histologically proven intracranial meningiomas to identify factors, including growth fractions determined by MIB-1 immunostaining, that may influence the development of meningioma-associated peritumoral brain edema. There were 54 benign, 2 atypical, and 1 anaplastic meningiomas. The MIB-1 staining index (SI) percentage was defined as the number of MIB-1 positive cells divided by the total number of tumor cells in a 1.037-square millimeter area on the slide. The extent of peritumoral brain edema was determined using preoperative magnetic resonance imaging. The extent of edema was classified as Grade 0,1, or 2 (GR0, GR1, or GR2), in order of increasing severity.

RESULTS

The MIB-1 SIs of the 57 cases ranged from 0.06-6.8% (median, 0.80%). There were 26 GR0, 20 GR1, and 11 GR2 edema cases. The MIB-1 SI rose in order of increasing edema severity. There was a statistically significant correlation between the MIB-1 SI and the extent of brain edema (P<0.0001), and also between the tumor size and the extent of brain edema (P=0.001). Meningothelial and atypical/anaplastic meningiomas were associated with peritumoral brain edema more often than any other subtype (P<0.005).

CONCLUSIONS

Growth fractions, as determined by MIB-1 immunostaining, rise with increasing severity of peritumoral brain edema, indicating a close relationship between tumor aggressiveness and edema development.

Inhibin alpha and beta A subunit messenger ribonucleic acids expression in human pituitary adenomas: studies by quantitative reverse transcription-polymerase chain reaction

Inhibin alpha and beta A subunit messenger ribonucleic acid (mRNA) levels were measured quantitatively by reverse transcription-polymerase chain reaction (RT-PCR) in human pituitary adenomas. The inhibin alpha subunit mRNA levels were undetectably low in cultured adenoma tissues, but beta A mRNA were 0.383 +/- 0.074 in 3 GH adenomas, 0.672 +/- 0.140 in 3 prolactinomas and 0.957 +/- 0.414 molecules/cell in 3 non-functioning adenomas. The addition of 10(-8) M activin A decreased the beta A mRNA levels within 4 h in 1 of 3 GH adenomas, 2 of 3 prolactinomas and 2 of 3 non-functioning adenomas, though the decreases were not statistically significant. The results showed an abundance of beta A subunit mRNA compared with alpha subunit mRNA in all human pituitary adenomas and a local role for activin in its own production through inhibin beta A mRNA subunit expression.