Clinical implication of expression of progesterone receptor form A and B mRNAs in secondary spreading of gynecologic cancers

This study was designed to determine the clinical implication of expression of progesterone receptor form A (PR-A) and B (PR-B) mRNAs in secondary spreading of gynecologic cancers. Approximately equal expression of PR-A and PR-B mRNAs was designated as type AB and dominant expression of PR-B mRNA as type B. Alteration from type AB to type B in the metastatic cancers occurred in 3/8 cases of uterine endometrial cancers, 2/8 cases of uterine cervical cancers, and 2/8 cases of ovarian cancers. Other cancers revealed type B regardless of primary or metastatic status. Thus, all metastatic cancers studied revealed type B. These results suggest that transcription of PR-A mRNA may be damaged, which might lead to uncontrolled overexpression of PR-B mRNA in metastatic lesion, and that the type B status could reveal a highly malignant phenotype in these three gynecologic cancers.

Acetylcholinesterase (ACE) staining shows the abnormal innervation of a pulled-through rectum in a case of repaired anorectal malformation

Abnormal innervation of the anorectum was noted in relation to anal incontinence in a case of repaired high-type anorectal malformation (ARM). A ten-year-old boy presented with anal incontinence after reconstructive surgery of ARM with a recto-urethral fistula. An anorectal manometrical examination revealed both an adequate tonus of the anal sphincter muscles and the absence of rectoanal reflex relaxation. And a barium enema showed a narrow region in the rectosigmoid colon, which was similar to that of Hirschsprung's disease (HD). Furthermore, an acetylcholinesterase (ACE) histochemical study of the rectal suction biopsies revealed an increased number of ACE-positive nerve fibers in the lamina propria mucosae and muscularis mucosae of the pulled-through colon. At the same time, however, some ganglia cells were also observed in the submucosa of the affected rectosigmoid colon and these cells could not be found in HD. Although the mechanism by which the abnormally innervated parasympathetic nerve fibers arose in the pulled-through colon remains unclear, this neuronal abnormality is considered to be the cause of anal incontinence in this case.

Rhabdomyosarcoma of the urachus. A case report

BACKGROUND

Rhabdomyosarcoma of the urachus is extremely rare, and only two cases have been reported. Cytologic, histologic, immunochemical and electron microscopic findings in embryonal rhabdomyosarcoma of the urachus are presented.

CASE

Embryonal rhabdomyosarcoma of the urachus developed in a 2-year-old boy. Imprint smears prepared prior to a histologic examination for a rapid report contained many malignant cells isolated or in clusters in a myxoid background. They were uniformly small, with round to oval nuclei and scant cytoplasm, and immunohistochemically positive for desmin and alpha-sarcomeric muscle actin but negative for myoglobin. This tumor was diagnosed cytologically as embryonal rhabdomyosarcoma because of its skeletal muscle origin and because of its similarity to one of the so-called small round cell tumors of childhood. Histologic examination confirmed the cytologic diagnosis.

CONCLUSION

Cytologic, histologic and electron microscopic findings were identical to those described previously for embryonal rhabdomyosarcoma at other sites. In immunochemical examinations, cytologic samples fixed in ethanol are more useful than histologic ones fixed in formalin. Then, in order to differentiate poorly differentiated rhabdomyosarcoma from other small round cell tumors in children, desmin and alpha-sarcomeric actin, rather than myoglobin, are recommended.

Expression of E-cadherin and alpha- and beta-catenin mRNAs in ovarian cancers

To know the biological role of the adherens junction, mainly consisting of E-cadherin and alpha- and beta-catenins, associated with invasion and metastasis of ovarian cancers, we studied the expressions of E-cadherin and alpha- and beta-catenin mRNAs in the cancers in comparison with those in normal counterparts. The integral expression of E-cadherin and alpha- and, beta-catenin mRNAs was suppressed in the metastatic lesions of advanced ovarian cancers, while it was not in the primary tumors. Therefore, the suppressed expression of main adhesion molecules in the adherens junction might contribute to adherens junctional dysfunction, which might lead to the acquirement of invasiveness and metastatic potential by advanced ovarian cancers as one of the rate-limiting steps.

Plausible novel therapeutic strategy of uterine endometrial cancer with reduction of basic fibroblast growth factor secretion by progestin and O-(chloroacetyl-carbamoyl) fumagillol (TNP-470; AGM-1470)

To know the potential of growth, invasion and metastasis of endometrial cancer associated with neovascularization, the effects of sex steroids and O-(chloroacetyl-carbamoyl) fumagillol (TNP-470; AGM-1470) on basic fibroblast growth factor (FGF) expression and secretion and its mRNA expression were investigated in well-differentiated endometrial cancer cell line Ishikawa and in undifferentiated endometrial cancer cell line AN3 CA. Basic FGF expression and secretion and its mRNA expression in Ishikawa cells, but not in AN3 CA cells, were increased by estrogen, while progesterone diminished the estrogen-induced increases. TNP-470 reduced the levels regardless of estrogen treatment in AN3 CA cells. Therefore, basic FGF secretion may be inhibited by progestin in differentiated cells, and by TNP-470 in undifferentiated cells. Since endometrial cancer consists of differentiated and undifferentiated cells as heterogeneity, a combination therapy for endometrial cancer with progestin and TNP470 might be effective.

Antiestrogenic compounds inhibit estrogen-induced expressions of basic fibroblast growth factor and its mRNA in well-differentiated endometrial cancer cells

1. The levels of basic fibroblast growth factor (FGF) expression and secretion and its messenger ribonucleic acid (mRNA) expression in well-differentiated endometrial cancer (Ishikawa) cells were significantly increased by estradiol. 2. This increase was significantly inhibited by tamoxifen, progestins (progesterone, medroxyprogesterone acetate [MPA], and 17 alpha-hydroxyprogesterone), and to some extent danazol, but not by terahydrocortisol and hydrocortisone. 3. Estrogen might stimulate the basic FGF secretion of endometrial cancer cells, at least for neovascularization, and antiestrogenic compounds may inhibit the estrogen-induced event.

Expression of estrogen receptor wild type and exon 5 splicing variant mRNAs in normal and endometriotic endometria during the menstrual cycle

Expression of estrogen receptor exon 5 splicing variant (ER-E5SV) mRNA contributes to dominant positive properties and metastatic potential of gynecological cancers. Therefore, in endometriotic endometria, which conserve implantation and tumor-like spreading potentials, the expression of ER-E5SV and estrogen receptor wild type (ER-WT) mRNA was analyzed, to investigate the biological implications. Estrogen receptor wild type mRNA in normal endometria was downregulated after ovulation, but not in endometriotic endometria. Therefore the wild type cascade in endometriotic endometria might be partly disorganized. The level of ER-E5SV mRNA in endometriotic endometria was lower than that in normal endometria, regardless of the stage in the menstrual cycle. However, there was no significant difference in the ratio of ER-E5SV to ER-WT mRNA in both normal and endometriotic endometria. On the other hand, the level of ER-E5SV mRNA in both normal and endometriotic endometria did not vary during the menstrual cycle. The dominant positive behavior of ER-E5SV might be masked by the functional cascade of ER-WT in normal endometria, but not in endometriotic endometria. This status might result in an incomplete response to endogenous steroids, and contribute to implantation and spreading potentials of endometriosis.

Expression of E-cadherin and alpha- and beta-catenin mRNAs in uterine cervical cancers

To show the mRNA expressions of E-cadherin and alpha- and beta-catenin-which mainly compose the adherens junction-associated with invasion and metastasis of uterine cervical cancers, we studied the expression of E-cadherin and alpha- and beta-catenin mRNAs in cancers in comparison with normal counterparts. The integral expression of E-cadherin and alpha- and beta-catenin mRNAs was suppressed in the metastatic lesions of advanced uterine cervical cancers, while it was not in the primary tumors. Therefore, the suppressed expression of main adhesion molecules in the adherens junction might contribute to adherens-junctional dysfunction, which might lead to invasiveness and metastatic potential of advanced uterine cervical cancers as one rate-limiting step.

Expression of basic fibroblast growth factor and its mRNA in advanced uterine cervical cancers

To know the potential of growth, invasion and metastasis of uterine cervical cancer cells associated with neovascularization, the expression of basic fibroblast growth factor (FGF) and its mRNA in uterine cervical cancers and normal uterine cervices as controls were determined by enzyme-linked immunosorbent assay (ELISA) and reverse transcription-polymerase chain reaction-Southern blot (RT-PCR-SB), respectively. Then, the relations between the expression and the histological grading and clinical staging in cervical cancers were analyzed. The levels of basic FGF and its mRNA were significantly higher in advanced primary uterine cervical cancers, regardless of histological type. Therefore, this status might contribute to the acceleration of growth, invasion, and metastasis with neovascularization in advanced uterine cervical cancers.

Comparative study on expression of plasminogen activator inhibitor 1 and its mRNA in endometrial cancers and normal endometria

The effects of the endocrine milieu on growth, invasion and metastasis, associated with neovascularization of endometrial cancer, the expression of plasminogen activator inhibitor 1 (PAI-1), and its mRNA in endometrial atypical hyperplasia and cancer, and normal endometria as controls were determined in premenopausal and postmenopausal women. In premenopausal women, the levels of PAI-1 and its mRNA in normal endometria were significantly higher than in endometrial atypical hyperplasia and cancer. On the other hand, in postmenopausal women, the results were reversed. There was no difference in the expression of PAI-1 and its mRNA in the various histological grades and clinical stages in endometrial cancers, while the expression of PAI-1 in other cancers increased during tumor progression. In our previous study, the expression of PAI-1 and its mRNA in well-differentiated endometrial cancer cell lines was dependent upon estrogen and progesterone. This might be partially related to the endocrine milieu, especially in endometrial atypical hyperplasia and well-differentiated endometrial cancer, which seems to be dependent on sex steroids. Therefore, endometrial cancer of any histological grade and clinical stage might maintain PAI-1 expression in both premenopausal and postmenopausal women, which may modulate, at least in part, growth, invasion and metastasis associated with neovascularization of endometrial cancer.

Expression of estrogen receptor exon 5 splicing variant (ER E5SV) mRNA in gynaecological cancers

Estrogen receptor exon 5 splicing variant (ER E5SV) mRNA has been found in tumours and the corresponding normal tissues, being transcriptionally active without ligand binding. Therefore, the expression of ER E5SV mRNA in gynaecological cancers was studied. The presence of ER E5SV mRNA was demonstrated in the normal ovary, uterine endometrium and cervix and their corresponding cancers. The ratio of ER E5SV/ER WT mRNA expression increased in some cases of metastatic tumour, but did not decrease in any case. Relative overexpression of ER E5SV mRNA might contribute to dominant positive properties and metastatic potential. Therefore, detection of ER E5SV mRNA abundance might be a useful indicator of metastatic potency in gynaecological cancers.

Potent immunosuppressants, 2-alkyl-2-aminopropane-1,3-diols

Several immunosuppressants, ISP-I [(2S,3R,4R)-(E)-2-amino-3,4-dihydroxy-2-(hydroxymethyl)-14-oxoeicos++ +-6-enoic acid, myriocin = thermozymocidin] and mycestericins A-G, were isolated from culture broths of Isaria sinclairii and Mycelia sterilia, respectively. In order to investigate structure-activity relationships, extensive modifications of ISP-I were conducted, and it was established that the fundamental structure possessing the immunosuppressive activity is a symmetrical 2-alkyl-2-aminopropane-1,3-diol. The tetradecyl, pentadecyl, and hexadecyl derivatives prolonged rat skin allograft survival in the combination of LEW donor and F344 recipient and were more effective than cyclosporin A. Among them, 2-amino-2-tetradecylpropane-1,3-diol hydrochloride, ISP-I-55, showed the lowest toxicity. ISP-I-55 is a promising lead compound for the development of effective immunosuppressants for organ transplantations and for the treatment of autoimmune diseases.

Determination of absolute configuration and biological activity of new immunosuppressants, mycestericins D, E, F and G

Mycestericins D, E, F and G were isolated from the culture broth of Mycelia sterilia ATCC 20349 as potent immunosuppressants. Mycestericins F and G were identical with dihydromycestericins D and E, respectively. Their absolute configurations were determined by use of the modified MOSHER'S method and by comparison of the CD spectra of their benzoate derivatives with those of synthetic analogs. Mycestericins D, E, F and G suppressed the proliferation of lymphocytes in the mouse allogeneic mixed lymphocyte reaction.

The relationship between the adenine nucleotide metabolism and the conversion of the xanthine oxidase enzyme system in ischemia-reperfusion of the rat small intestine

The time course of the energy metabolism after reperfusion, the relationship between the conversion of xanthine dehydrogenase to xanthine oxidase (D-to-O conversion) during ischemia, and the changes of the energy metabolism after reperfusion were studied using an ischemia-reperfusion model in the small intestine of the rat. The rat jejunum underwent an occlusion of the superior mesenteric artery and vein for either 30 minutes (group 1, n = 6) or 90 minutes (group 2, n = 6) with collateral interruption, and then it was reperfused. The contents of the adenine nucleotides in the small intestine of the rat were measured by high-performance liquid chromatography (HPLC) before ischemia, and 30, 60, and 90 minutes of ischemia, as well as 30, 60, 120, and 180 minutes after reperfusion. The recovery level of adenosine triphosphate (ATP) in group 1 (6.05 +/- 0.80 mumol/g dry weight) 30 minutes after reperfusion was significantly higher than that in group 2 (2.28 +/- 1.12 mumol/g dry weight) (P < .001). In addition, the ATP content after reperfusion in group 2 did not change from 30 to 180 minutes after reperfusion. The D-to-O conversion during ischemia in group 1 was not significantly greater than that before ischemia; however, that of group 2 did increase significantly during ischemia (P < .005). These results suggest that the tissue damage from ischemia-reperfusion injury after reperfusion under 90 minutes' ischemia is accomplished within the first 30 minutes after reperfusion. Therefore, the ATP level at 30 minutes after reperfusion may be useful for the evaluation of intestinal viability. Thus, the conversion of the xanthine oxidase enzyme system might play an important role in the expression of ischemia-reperfusion injury.

Prevalence of skin neoplasms among the atomic bomb survivors

About 7,000 atomic bomb (A-bomb) survivors from Hiroshima and Nagasaki who participate in the Radiation Effects Research Foundation (RERF) Adult Health Study (AHS) were examined to define the relationship between skin neoplasms and exposure to ionizing radiation. Careful clinical inspection of the skin was undertaken to detect not only skin cancer but precancerous lesions such as senile keratosis. Five cases of basal cell carcinoma, five cases of senile keratosis and one case of Bowen's disease were confirmed histologically among 5955 A-bomb survivors for whom Dosimetry System 1986 (DS86) dose estimates are available. The relationship between the combined prevalence of skin cancer and precancerous lesions and DS86 dose was examined together with other factors that might affect skin neoplasms including occupational exposure to ultraviolet (UV) rays, age, sex and city. The prevalence of basal cell carcinoma and senile keratosis increased as the DS86 dose increased. The prevalence of skin cancer and senile keratosis among persons engaged in work involving frequent exposure to UV rays was higher than among those who were not engaged in such work. Sex and city were not significantly related to those skin diseases. Odds ratios of skin neoplasm for a 1-Gy dose, occupational exposure to UV rays and age at time of examination (in 10-year increments) are 1.7, 5.9 and 1.9, respectively.

Ability of Ovarian Steroids to Regulate the Expression of the Fibroblast Growth Factor Family in Fibroblasts Derived from Uterine Endometrium

Uterine endometrial neovascularization during the menstrual cycle is regulated by a basic fibroblast growth factor (FGF) in the endometrium, consisting of endothelial and stromal cells. Acidic FGF (FGF-1), basic FGF (FGF-2) and hst-1 (FGF-4) proteins also possess angiogenic potency in vivo. Therefore, it is important to improve our understanding of the role of stromal cells in FGF supply for endometrial neovascularization. In this study, we determined FGF-1, -2, and -4 mRNA and FGF-2 by reverse transcription-polymerase chain reaction-Southern blot analysis, and enzyme-linked immunosorbent assay, respectively, in fibroblasts derived from uterine endometria as a substitute for stromal cells. Experimental results indicate that estradiol significanlty increases the levels of intracellular and secreted FGF-2 and its mRNA expression in the FGF family in the fibroblasts. Moreover, progesterone reduces the estradiol-induced increase. Therefore, endometrial neovascularization might be partially regulated by stroma-derived FGF-2 under the influence of sex steroids through a paracrine cell-to-cell interaction. Copyright 1996 S. Karger AG, Basel

Management of traumatic pancreatic pseudocysts in children

Eight children with pancreatic injuries after blunt abdominal trauma are presented. One patient with pancreatitis without complications was treated successfully with medication; seven (87.5%) developed pseudocysts, which resolved spontaneously with conservative treatment in four cases (57.1%). Non-resolving pseudocysts in 3 patients finally required surgical intervention. Pseudocysts that resolve spontaneously and those that require surgical intervention can be distinguished. The two groups showed different time sequences in both serum amylase values and pseudocyst size. Analyses of these clinical data revealed three factors with significant predictive value. On the basis of these findings, a new management strategy for traumatic pancreatic pseudocysts in children is proposed. The cyst is likely to resolve spontaneously in cases showing any two or more of the following factors: (1) cyst presentation after day 6; (2) maximum serum amylase below 1,600 IU/l; and (3) serum amylase below 600 IU/l on day 20. However, early surgical intervention is required in the presence of two or more of the following: (1) cyst presentation before day 4; (2) maximum serum amylase above 1,900 IU/l; or (3) serum amylase above 1,200 IU/l on day 20.

The occurrence of macrophage-like cholera toxin uptake cells in the intestinal villi of suckling rats

An oral administration of cholera toxin (CT. 10m g) caused diarrhea in infant rats ranging in age from 1 to 14 days. After administration of the toxin a time sequence study was carried out using highly sensitive immunohistochemical procedures. CT was exclusively incorporated into a type of macrophage-like (ML) phagocytic cell. These cells were identified within the intestinal epithelium of rats suffering choleraic diarrhea. After 2 hrs cells taking up the toxin markedly increased in number and were found in both the mucosa and the lamina propria mucosae. After 4 hrs a small number of ML cells containing CT were still present in the mucosal epithelium, but were no longer observed in the lamina propria. Two kinds of monoclonal antibodies against rat macrophages were used to gain a clue as to the cytological characteristics of ML cells. ED1- or ED2-positive macrophages were demonstrable in the lamina propria and submucosa of the small intestines from control rats. In CT-treated rats a considerable number of cells positive for CT and ED1, or CT and ED2 antisera, were found within the epithelial cell layer and the lamina propria of intestinal villi. It is suggested that many ML cells responsive to CT, if not all, are ED1 and ED2 macrophages and are resident in the villous lamina propria where they can migrate to uptake CT in the intestinal lumen. CT B-subunit and heat-labile toxin (LT) B'-subunit from a mutant strain Escherichia coli were given to the rats in order to know the onset mechanism of toxin uptake. It seems likely that the toxin receptor, GM1 ganglioside, participates in the initiation of CT-uptake mechanism. A possible role of the intestinal ML cells was discussed.

Complete disruption of the main pancreatic duct: a case successfully managed by percutaneous drainage

The authors report on a 7-year-old boy who sustained blunt abdominal trauma on a bicycle handlebar. A large traumatic pancreatic pseudocyst developed, for which percutaneous external drainage under ultrasound guidance was performed. Both the catheter fistulogram and endoscopic retrograde cholangiopancreatogram showed complete disruption of the main pancreatic duct. During continuous external drainage, the pseudocyst disappeared. The drainage flow decreased gradually and ceased. The patient is well, with normal endocrine and exocrine pancreatic functions, 2 years after discharge.

Prune-belly syndrome in a female, complicated by intestinal malrotation after successful antenatal treatment of hydrops fetalis

The authors report a female case of prune-belly syndrome having an antenatal sonographic diagnosis of hydrops fetalis and treated prenatally with transplacental digitalis administration. The findings of this case suggest that the clinical entity includes various phenotypes or aberrants having different origins.

Extralobar pulmonary sequestration mimicking cystic adenomatoid malformation in prenatal sonographic appearance and histological findings

An infant girl with extralobar pulmonary sequestration (PS) composed of congenital cystic adenomatoid malformation (CCAM)-like structure is presented. Initially, the antenatal sonographic findings indicated CCAM. The macroscopic findings of the resected specimen were compatible with extralobar PS; however, the microscopic findings showed cystic structure mimicking type II CCAM. The combination of PS and CCAM is rare, and it is likely that the embryological origin is common to both. There is confusion in the classification of these two congenital anomalies. In this report, the histological and sonographic findings of PS and CCAM are discussed.

STT10, a novel class-D VPS yeast gene required for osmotic integrity related to the PKC1/STT1 protein kinase pathway

We report the genetic and biochemical properties of a staurosporine (ST)- and temperature-sensitive mutant, stt10, of Saccharomyces cerevisiae. The stt10 mutant shows an osmoremedial phenotype in a medium with 1 M sorbitol. ST sensitivity of the stt10 mutant was suppressed by overexpression of PKC1/STT1, showing the genetic interactions of STT10 with the PKC1/STT1 pathway. The nucleotide sequence of STT10 predicts a hydrophilic protein composed of 577 amino acids that possesses 20-25% sequence similarity with yeast Slp1/Vam5p, Sec1p and Sly1p, and nematode Unc-18. The stt10 deletion mutant is viable and shows a typical class-D vacuolar protein sorting defective (vps) phenotype. Vacuoles from stt10 cells have a normal vacuolar H(+)-ATPase activity, but are defective in vacuolar acidification. Genetic studies of yeast mutants carrying delta stt10, delta bck1, stt1/pkc1 or stt4 have revealed that their functions are phenotypically related to maintenance of cellular osmotic integrity.

Limited capacity for tolerization of CD4+ T cells specific for a pancreatic beta cell neo-antigen

Mice transgenic for SV40 T antigen (Tag) under control of the rat insulin promoter (RIP) develop two alternative immunological phenotypes: tolerance or autoimmunity towards Tag. We utilized the T cell receptor (TCR) genes expressed in a Tag-specific CD4+ cell from an autoimmune RIP-Tag mouse to generate two lines of TCR transgenic mice in which either 10% or 90% of peripheral T cells express the transgenic TCR. When cross-bred to the tolerant RIP1-Tag2 line, mice from the low frequency TCR line showed partial deletion of peripheral Tag-specific T cells and nonresponsiveness of those that remained. In contrast, crossbred mice in which transgenic T cells comprised a majority of the T cell population were nontolerant both in vivo and in vitro. Thus, tolerization of CD4+ T cells specific for a rare self-antigen may fail if too many autoreactive T cells develop.

Immunohistochemical demonstration of enteric nervous distribution after syngeneic small bowel transplantation in rats

BACKGROUND

Small bowel transplantation causes a disturbance of the enteric neural networks after complete extrinsic denervation.

METHODS

The morphologic changes in the enteric nervous system after transplantation were immunohistochemically investigated in jejunal isografts at 10 days, 100 days, and 400 days after transplantation.

RESULTS

No remarkable differences were revealed concerning the antibodies for general neural markers, vasoactive intestinal polypeptide, substance P, somatostatin, or galanin between controls and isografts. Identical differences were detected in the distribution of nerve fibers containing calcitonin gene-related peptide and catecholamines. In the isografts a partial reduction of calcitonin gene-related peptide-immunopositive fibers was shown. A complete elimination of catecholaminergic nerves was seen in the isografts at 10 and 100 days; however, a sparse distribution of catecholaminergic nerves was observed in the 400-day isograft.

CONCLUSIONS

Most intrinsic neural elements are preserved; however, the extrinsic, sympathetic, and sensory nerves are completely disrupted as a consequence of transplantation. Reinnervation of extrinsic nerve fibers could occur in the transplanted small intestine.