PML-RAR alpha fusion transcripts by RNA PCR in acute promyelocytic leukemia in remission and its correlation with clinical outcome

Molecularly defined specific chromosomal translocation in leukemia allows detection of minimal residual leukemia cells by the reverse transcription-polymerase chain reaction (RT-PCR). However, the positivity of the specific fusion transcripts in chronic myelogenous leukemia and acute myelogenous leukemia with t(8;21) is reportedly not directly correlated with the predictability of relapse. We analyzed seven patients with acute promyelocytic leukemia (APL) in hematological remission for PML-retinoic acid receptor alpha (PML-RAR alpha) fusion transcripts by RT-PCR with the sensitivity level of one APL cell in 10(5) bone marrow mononuclear cells. Two of the four patients with chemotherapy-induced remission had detectable PML-RAR alpha only before treatment. In the other two patients with chemotherapy-induced remission, the PML-RAR alpha was detectable when their remission was first confirmed and became negative after consolidation chemotherapy. Two patients were resistant to chemotherapy and achieved remission by all-trans-retinoic acid; PML-RAR alpha was detectable in them for a few months during consolidation chemotherapy. Two patients whose PML-RAR alpha had become continuously positive had relapse 2 and 8 months later, but the other five patients with continuously negative or only transiently positive PML-RAR alpha remained in remission during follow-up for 11 to 35 months. These findings suggest the relevance of detectable PML-RAR alpha by RT-PCR to the predictability of relapse in acute promyelocytic leukemia.

Histological evaluation of benign prostatic hyperplasia treated by long-term administration of chlormadinone acetate (CMA)

Although the clinical effects of attempted nonsurgical treatment of benign prostatic hyperplasia have been well documented, detailed histological evaluation of the effects of treatment appears to be limited. The effect of long-term administration of an antiandrogen, chlormadinone acetate (CMA), on benign prostatic hyperplasia was evaluated with histological comparison of two biopsy specimens, one before treatment and one after treatment. Secretory epithelium showed obvious regressive changes with occasional basal cell prominence after CMA treatment. Stromal elements, however, did not show any marked changes, except for occasional edematous loosening. Scores of multiple epithelial parameters tended to be correlated with clinical improvement in urinary obstructive symptoms, especially in patients with predominant glandular hyperplasia. These results suggest that long-term administration of the potent antiandrogen CMA to inhibit dihydrotestosterone-receptor binding might be a useful therapeutic maneuver in patients with glandular hyperplasia, without any deterioration of the stromal component.

Flow-cytometric quantification in human gliomas of alpha satellite DNA sequences specific for chromosome 7 using fluorescence in situ hybridization

Cell suspensions prepared from freshly frozen tissue specimens were used to examine aberrations in the number of chromosome 7 signals in 10 human gliomas. Nuclear DNA was hybridized in vitro with an alpha satellite DNA probe specific for the centromeric regions of chromosome 7, using fluorescence in situ hybridization (FISH). The intensity of the fluorescence signal from the hybridized probe was measured, together with the nuclear DNA content, by flow cytometry. The mean probe fluorescence of all nuclei was compared to the mean copy number per nucleus found with microscopic scoring. Moreover, the mean probe fluorescence ratio of DNA aneuploid nuclei relative to DNA diploid nuclei (FISHa/FISHd) was calculated to determine how the numerical aberration of chromosome 7 signals contributes to the DNA ploidy of the sample. The results from the flow-cytometric analysis and from microscopic evaluation were compatible. One of four tumors with DNA diploidy had a higher average intensity of FISH signal and a broader coefficient of variation in FISH signal than normal brain tissue; this was shown to be due to the gain of chromosome 7 signals. Although FISHa/FISHd correlated with DNA indices (P < 0.01), there were some disparities, probably due to other complex genotypic associations involving several gains or losses of chromosomes. Thus gain of chromosome 7 in gliomas is related to both DNA ploidy change and chromosome specific gain. It is concluded that flow-cytometric quantification of FISH is useful in investigating numerical aberrations of chromosomes and nuclear DNA content simultaneously.

Enhancement of 12-O-tetradecanoylphorbol-13-acetate-induced tumor necrosis factor alpha production by phenethylphthalimide analogs

Effects of phenyl-, benzyl-, phenethyl-, and phenylpropylphthalimides on 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced tumor necrosis factor (TNF)-alpha production by human leukemia cell line HL-60 were examined. Among the four phthalimide derivatives, only phenethylphthalimide showed potent enhancing effect on TNF-alpha production.

Numerical aberrations of chromosome 17 detected by FISH with DNA-specific probe in oral tumors

Numerical aberrations of chromosomes were investigated in oral tumors by using fluorescence in situ hybridization (F1SH) with 4 chromosome centromere-specific DNA probes. The hybridization signals of the centromere sequence were easily detected and counted within interphase nuclei as well as metaphase chromosomes. The number of hybridized signals for chromosome 17 significantly increased in oral malignant tumors compared to benign tumors, which had two spots as well as normal lymphocytes. Cell lines derived from oral squamous cell carcinoma also showed numerical aberrations of chromosomes 1, 4 and 11, in addition to chromosome 17. These findings suggested that numerical aberrations of chromosomes occur during the development of malignant tumors of the oral cavity.

[Dynamics of fluoroquinolone agents in tear fluid--a comparison of the dynamic in tears of human and rabbit eyes]

We compared the dynamics of fluoroquinolones administered either systemically or locally, in the tears of human and rabbit eyes. The concentrations of locally administered ofloxacin (OFLX) in the human and rabbit tear fluid were similar. However, there was a difference between the norfloxacin (NFLX) concentrations in human and rabbit tear fluid measured after instillation. The NFLX concentrations in the tear fluid were significantly higher than the OFLX concentrations and they were retained longer with oral administration. On the other hand, the drug dynamics depended on the concentrations of the drug in the serum, and were better in the rabbit eyes than in the human eyes. Knowing the correlation of drug dynamics in rabbit and human eyes may supply useful information about drug dynamics in human eyes, and may be a useful index for clinical treatment.

[Thallium-201 single photon emission computed tomography in the evaluation of therapeutic response for brain tumors]

To evaluate the effectiveness of radiation and chemotherapy of malignant brain tumors, 201TlCl-SPECT (Tl-SPECT) was compared with CT and MRI. The subjects were 14 patients with malignant brain tumors; 12 malignant astrocytomas, 1 medulloblastoma and 1 malignant lymphoma. Tl-SPECT was performed before and immediately after the therapy. On the Tl-SPECT, count ratio (Tl-index) of tumor to normal brain tissue was measured. To evaluate the size of tumor, CT or MRI was performed before and immediately after the therapy, and 1-2 months after the therapy. The change of Tl-index immediately after therapy was compared with the change of the size of tumor. Though the change of Tl-index did not correlate with the change of tumoral size immediately after therapy, it correlated with the change of tumoral size 1-2 months after the therapy, i.e., it was thought that Tl-index reflected the change of tumoral size 1-2 months after the therapy. Tl-SPECT will be feasible for the evaluation of the effectiveness of the therapy for malignant brain tumors, because it reflects the effectiveness of the therapy earlier than CT or MRI.

Crystallization and analyses of crystals of various chemotypes of R-form lipopolysaccharides from Salmonella spp

Various chemotypes (Re, Rd2, Rd1P-, Rd1, RcP-, Rc, Rb3, Rb2, Rb1, and Ra) of R-form lipopolysaccharides (LPSs) of Salmonella spp. were crystallized by treatment with 70% ethanol containing 250 mM MgCl2, and crystals of the LPSs were observed electron microscopically and analyzed by electron diffraction and synchrotron X-ray diffraction. All the LPSs tested formed three-dimensional crystals showing very similar shapes; hexagonal plate, solid column, discoid, square or rectangular plate, lozenge plate and truncated hexangular or rectangular pyramid forms. Electron diffraction patterns from the hexagonal plate crystals of all these LPSs obtained by electron irradiation from the direction perpendicular to the basal plane showed that they consist of hexagonal lattices with the lattice constant of 4.62 A. The crystals of all the LPSs thus formed gave ring-like X-ray diffraction patterns because of their small sizes. The long-axis values were calculated from the X-ray diffraction patterns from crystals of all the LPSs in the low-angle region and they corresponded roughly to the length of the proposed primary chemical structures of the R cores of the LPSs. The volume occupied by a single molecule of all the LPSs were calculated from the molecular weights based on the proposed structures and the crystallographic data obtained by electron diffraction, X-ray diffraction, and density determination.

Delayed appearance of the catalytic activity by immunization of a rabbit compared with the hapten binding

Polyclonal antibodies catalyzing the hydrolysis of carbonate ester were generated by immunizing a rabbit with hapten(4-nitrophenyl phosphate II) conjugated to keyhole limpet hemocyanin. The hydrolytic activity of IgG purified from antisera exhibited plateu one month later than the simple hapten-binding. The affinity of IgG with substrate increased even after the hapten-binding reached plateu. These suggest a strategy to generate good polyclonal catalytic antibodies and the day to fuse spleen cell with myeloma cell to get good monoclonal catalytic antibodies.

Effects of fibroblast growth factors and related peptides on food intake by rats

The effects of acidic fibroblast growth factor (aFGF), basic FGF (bFGF), and related peptides, such as aFGF fragments, on food and water intake were investigated. Infusion of aFGF and bFGF into the third cerebral ventricle significantly suppressed food intake. The potency of aFGF was 1.5 that of bFGF in food intake inhibition. Both FGFs also suppressed water intake. Infusion of a carboxyl-terminal fragment of aFGF, aFGF-(114-140), did not affect food intake, whereas an amino-terminal fragment of aFGF, aFGF-(1-15), was significantly inhibitory. Other amino-terminal fragments, aFGF-(1-20) and aFGF-(1-29), did not affect food intake. However, [Ala16]aFGF-(1-29), in which the cysteine residue at position 16 was replaced with alanine, significantly suppressed food intake. Infusions of functional antagonists for FGFs, anti-aFGF, anti-bFGF, and anti-aFGF-(1-15) IgGs, into the lateral hypothalamus significantly increased food intake. The results suggest that: aFGF, bFGF, and some amino-terminal peptides of aFGF participate in the central regulation of food intake; the lateral hypothalamus is involved in their feeding suppression actions; and these peptides may function as physiologically relevant substances in the adult central nervous system, other than as neurotrophic factors.

Identification of S-phase cells with PC10 antibody to proliferating cell nuclear antigen (PCNA) by flow cytometric analysis

We estimated the expression of proliferating cell nuclear antigen (PCNA) in HeLa S3 cells by flow cytometry with monoclonal antibody (MAb) PC10. HeLa cells were fixed with six different fixation procedures: 15-min and 30-min acetone, 15-min acetone followed by 15-min methanol (acetone/methanol), 30-min methanol, 15-min methanol followed by 15-min acetone (methanol/acetone), and a mixture of acetone and methanol. The fixed cells were applied to MAb PC10 against PCNA and then treated with FITC. With five fixation procedures except for acetone/methanol, PCNA was expressed in almost all cells with similar shapes and different FITC intensity levels on PCNA/DNA bivariate cytograms, whereas acetone/methanol fixation allowed PCNA detection in S-phase cells with a cytogram that showed a horseshoe-like pattern with a peak level at mid-S-phase. Flow cytometric dual parameter analysis of PCNA/BrdU was carried out in HeLa cells to confirm detection of PCNA in S-phase cells with acetone/methanol fixation. The population of cells stained for both parameters, i.e., S-phase cells, was obviously discriminated from that of the non-S-phase cell in PCNA/BrdU bivariate cytograms. These results strongly suggest that PCNA used with acetone/methanol fixation would be equal to BrdU as an S-phase marker.

MRI of subperiosteal hematoma of the orbit

OBJECTIVE

The MR findings of two cases of subperiosteal hematoma of the orbit are described.

MATERIALS AND METHODS

We present two cases of subperiosteal hematoma of the orbit following minor head trauma, the first presenting with chronic progressive exophthalmos and the second with acute proptosis.

RESULTS

Both cases showed a well-defined biconvex mass with a curvilinear hypointense band in the superior portion of the orbit. In Case 1 chronic hematoma demonstrated high signal on both T1- and T2-weighted imaging, and in Case 2 acute hematoma displayed intermediate signal on T1-weighted imaging and high signal on T2-weighted imaging. Follow-up MRI in Case 2 demonstrated the typical signal changes from acute to subacute hematoma.

CONCLUSION

Subperiosteal hematoma has a characteristic appearance on MRI which is virtually diagnostic. In proper clinical settings MRI is the modality of choice for the detection and characterization of this hematoma.

Estimation of S-phase fraction in tumor tissue sections by immunohistochemical staining of PCNA

We describe a method for measuring the size of the S-phase fraction in human tumor tissue sections using an antibody to PCNA (PC10). Although treatment with Triton X-100 before fixation extracted a large amount of PCNA from the cells even in frozen tissue sections, PCNA remained exclusively in S-phase cells. Immunohistochemical staining of PCNA after the detergent treatment allowed estimation of the S-phase fraction in solid tumors. The validity of the method was directly proven by double staining of bromodeoxyuridine (BrdU) and PCNA in HeLa cells. The PCNA-positive cells were identical with BrdUrd-positive cells after the detergent treatment. In contrast, almost all HeLa cells in the exponentially growing phase were positive for PC10 without treatment with Triton X-100.

Burkitt type leukaemia associated with multiple myeloma

We describe a 77-year-old man with multiple myeloma (MM) who developed Burkitt type leukaemia (BTL) 16 months after the initial diagnosis of MM. MM was positive for CD10 with immunoglobulin (Ig) kappa, kappa Bence Jones protein (BJP) and a normal karyotype. BTL was positive for CD10, CD19, CD20 and HLA-DR with Ig mu and lambda, lambda BJP and a clonal abnormal karyotype of 46,XY,-13, t(8;14)(q24;q32),11q+,14q+, +mar. The patient died 9 d after diagnosis of BTL despite treatment with multiple agents. This is, to our knowledge, the first such case to be reported.

A cephalometric and electromyographic study of upper airway structures in the upright and supine positions

Obstructive sleep apnea (OSA) is characterized by recurrent upper airway obstruction during sleep, usually in the supine position. To investigate the relationship between upper airway size and genioglossus (GG) muscle activity, upright and supine cephalograms were obtained in 20 OSA patients and 10 symptom-free control subjects. Tongue electromyographic (EMG) recordings were obtained with surface electrodes, and pressure transducers were placed in the 10 symptom-free controls. The tongue cross-sectional area increased 4.3% (p < 0.05), and the oropharyngeal area decreased 36.5% (p < 0.01) when the OSA patients changed their body position from upright to supine. No changes were observed in the tongue area, but soft palate thickness increased (p < 0.01) when the control subjects changed from the upright to the supine position. Furthermore, the oropharyngeal cross-sectional area decreased 28.8% (p < 0.01) despite a 34% increase (p < 0.05) in resting GG EMG activity. Posterior tongue pressure increased 17% (p < 0.05) with the change from upright to supine. On the basis of these findings, we propose that body posture has a substantial effect on upper airway structure and muscle activity. This postural effect should be taken into account when assessing upper airway size in the erect posture (conventional cephalography) and in the supine position (computed tomography). The vertical and anteroposterior position of the tongue and its relationship to airway size may be more important than soft palate size in the pathogenesis of OSA.

Concentrations of alpha-tocopherol and its quinone derivative in cerebrospinal fluid from patients with vascular dementia of the Binswanger type and Alzheimer type dementia

We determined the concentrations of alpha-tocopherol (alpha-TOH) and alpha-tocopherol quinone(alpha-TQ), an oxidized derivative of alpha-TOH, in cerebrospinal fluid from patients with Alzheimer type dementia (ATD) and those with vascular dementia of the Binswanger type (VDBT). Compared with results for the controls, the VDBT patients had unaltered concentrations of alpha-TOH, but a statistically significant, 3.6-fold increase of alpha-TQ (P < 0.01) which was significantly correlated with decreases in the Mini-Mental State Examination scores (P < 0.05). In contrast, ATD patients had significantly decreased concentrations of alpha-TOH (P < 0.01), but had unaltered concentrations of alpha-TQ. These results suggest that there is greater oxidation of alpha-TOH to alpha-TQ in VDBT brain, but are inconclusive about the occurrence of peroxidation in ATD brains.

Expression cloning of a GM3-specific alpha-2,8-sialyltransferase (GD3 synthase)

A cDNA encoding a GM3-specific alpha-2,8-sialyltransferase (GD3 synthase) was obtained from an expression cDNA library of human melanoma cell line WM266-4 by enrichment of Namalwa KJM-1 cells highly expressing GD3 using an anti-GD3 antibody and a fluorescence-activated cell sorter. Selection of B-cell line Namalwa cells expressing transfected cDNAs in the presence of anti-GD3 monoclonal antibody KM641 gave a cDNA (pAMo-GD3) encoding a protein with a type II transmembrane topology as found for mammalian glycosyltransferases. The following evidence confirms that the cDNA encodes an alpha-2,8-sialyltransferase, which specifically converts GM3 to GD3. (i) Transfection of pAMo-GD3 into Namalwa KJM-1 cells leads to the appearance of GD3 and a GD3 synthase activity. (ii) Northern blot analysis revealed a correlation between the expression of this gene and GD3 in several cell lines. (iii) The putative COOH-terminal active domain of this cloned enzyme fused with protein A has been purified with IgG-Sepharose beads and has been shown to possess GD3-synthesizing activity, excluding the possibility that the cloned cDNA encodes a transacting factor inducing a GD3 synthase. The deduced primary sequence also contains the "sialyl motif" conserved among all the sialyltransferases cloned to date. The polymerase chain reaction analysis reveals that this gene is located on chromosome 12.

[An educational method of cross-sectional anatomy combined with gross-anatomic practice]

This paper proposes a method to introduce cross-sectional anatomy to the dissection programs of gross anatomy. The lecture emphasizes presenting to students useful markers of structures to understand the cross-sectional plane. The practice is to begin by preparing en bloc-resected organs. Eight planes were sliced by students as follows: the first plane through the arch of the aorta 2-3 cm below its upper border, the second through the bifurcation of the trachea and the pulmonary trunk, the third through the origin of the pulmonary trunk, the fourth through the middle of the right ventricle, the fifth through the liver 2-3 cm below its upper surface, the sixth through the portal area, the seventh through the gallbladder, the eight through the right renal hilus. The students sketched slices, identified structures with knowledge they acquired from the dissection, compared them with clinical CT and presented their observations to other students. The introduction of the cross-sectional anatomy into practice is one of multiple accesses available in the study of gross anatomy which are necessary for students to obtain a better understanding of the human structure and to increase their knowledge applicable to medicine.

Ultrastructural changes in hepatocytes, sinusoidal endothelial cells and macrophages in hypothermic preservation of the rat liver with University of Wisconsin solution

To identify subtle changes which might lead to liver failure after liver transplantation, rat livers stored at 4 degrees C in University of Wisconsin solution for 8, 16, 24, and 32 h were examined by transmission electron microscopy, scanning electron microscopy, cellular matrix maceration and freeze fracture for ultrastructural analysis. Endothelial cells exhibited aggregation of intramembrane particles (IMPs) at 8 h and produced tiny blebs accompanied by marked development of pits. As deterioration advanced, endothelial cells exposed the perisinusoidal faces of hepatocytes directly to the lumen with destruction of sieve plates. They then degraded with loss of IMPs. Macrophages followed a similar deterioration process to endothelial cells. Membranes of hepatocytes did not demonstrate aggregations of IMPs for 32 h. Rough endoplasmic reticulum (rER) lost ribosomes and smooth ER (sER) increased in amount and dilated in an irregular form. Autophagosomes appeared in the cytoplasm, engulfed cytoplasmic matrix containing intracellular organelles and became autophagic vacuoles. At 32 h bile canaliculi were filled with detached vesicles. This may be one of the causes of preservation related bile duct complications after liver transplantation.

[Effect of Oren-gedoku-to on changes in hexobarbital-induced sleeping time in chlorpromazine-treated mice]

The effects of Oren-gedoku-to on the hypnotic duration induced by hexobarbital, and on the change of this duration in chlorpromazine-treated mice were investigated. Single dose of Oren-gedoku-to (1.0 or 2.0 g/kg, p.o.) or chlorpromazine (10 mg/kg, p.o.) prolonged the hexobarbital hypnosis time. And the simultaneous dose of chlorpromazine (6.0 mg/kg, p.o.) and Orengedoku-to (1.0 g/kg, p.o.) indicated the equal effect for the administration of chlorpromazine (10.0 mg/kg, p.o.) alone. Although the mechanism of the action remains to be unknown, administration of Oren-gedoku-to in combination with chlorpromazine seems to be useful from the standpoint of alleviation of the side-effects caused by less dose.

Production of hematinic acid by the reaction of hemoglobin with phenylhydrazine: evidence for the oxidative cleavage of heme

Incubation of hemoglobin (Hb, 2 mM as heme) with phenylhydrazine (PH, 5-20 mM) under aerobic conditions produced hematinic acid (HA), one of the oxidatively degraded pyrroles derived from protoporphyrin in Hb. However, incubation with H2O2 resulted in a much lower production of HA. HA was determined by gas-liquid chromatography (GLC) after derivatization to the methyl ester. HA produced by PH was dependent on PH concentration and on incubation time. The maximal yield of HA was 18.8 x 10(-4)% in the reaction with 20 mM of PH for 2 h. Degraded compounds (not identified) other than HA derived from porphyrin were observed on TLC of the mixture after the reaction. Oxidation of ferrous ion and the globin of Hb by PH, which causes alternation of Hb, have been made on the mechanism responsible for the acquisition of the hemolytic activity of PH. Our findings regarding HA production reveal that the porphyrin of Hb is added to the sites oxidized. This is discussed in relation to the hemolysis.