Near-haploidy in a malignant sacrococcygeal teratoma

Cytogenetic analysis of a malignant sacrococcygeal teratoma in an adult patient revealed near-haploid (77%), near-diploid (19%), and polyploid (4%) cells. The near-haploid cells had a karyotype of 25,XX,der(5)t(5;7)(p15;p13),+7,der(9)t(6;9)(p21;q34),r(17)(p13q25) . In the near-diploid and polyploid cells identical copies of the structural chromosomal changes were found. Although some of the anomalies observed appear unique to this case, a common breakpoint in chromosome 6 was previously reported as specific in a subgroup of extragonadal germ cell tumors of adults.

Evolution of residual levels of six pesticides during elaboration of red wines. Effect of wine-making procedures in their dissappearance

The effect of wine-making procedures on the concentrations of six pesticides (chlorpyrifos, penconazole, fenarimol, vinclozolin, metalaxyl, and mancozeb) in red wines has been studied. During maceration stage (4 days), the percentage remaining of chlorpyrifos, penconazole, and metalaxyl was approximately 90%, whereas that of fenarimol, vinclozolin, and mancozeb is somewhat smaller (74-67%). The residual levels found in pressed must were </=20%, except for metalaxyl (69%). From the whole concentration of chlorpyrifos in must, 85% is eliminated from the racking step; clarification (bentonite plus gelatin) eliminates 43% of the product found in the decanted wine, and with filtration, all of the residue is eliminated. Penconazole and mancozeb are retained on the lees in proportions of 43 and 31%, respectively. The eliminated percentage of vinclozolin after racking is 29%, whereas clarification and filtration reduce its proportion in the wine to 33 and 28%, respectively. Finally, fenarimol and metalaxyl are eliminated in smaller proportion with the realization of these processes.

Expression of type I interferon receptor and its relation with other prognostic factors in human neuroblastoma

Expression of type I interferon receptor (IFN-R) has been found in several normal tissues and in malignant neoplasms, mainly those with epithelial differentiation. In order to analyze the immunohistochemical expression of type I IFN-R we studied 79 cases of neuroblastoma. Results of expression of type I IFN-R were statistically correlated with histopathology, stage, bcl-2 and PCNA expression, N-myc amplification and apoptosis. We found expression of type I IFN-R in 54/79 cases showing statistical correlation with bcl-2 expression (P=0.017) and favourable histopathology (P=0.015). The overexpression found in ganglion cells suggests that IFN-R could be involved in the pathway of neuroblastoma differentiation. Moreover, the expression of type I IFN-R in stage 4 cases (12/20), even with N-myc amplification (6/8), opens new possibilities for therapeutic management in advanced cases that do not respond to any chemotherapeutic protocol.

[Usefulness of ultrasonography and computerized tomography in predicting resectability of pancreatic carcinoma]

BACKGROUND

Surgical resection is the only curative treatment of pancreatic carcinoma (PC). An accurate assessment of the extension of PC is mandatory to select appropriate patients to this therapeutic option. This study was aimed at assessing the usefulness of abdominal ultrasonography (US) and computed tomography (CT) to establish tumoral staging and to predict tumor resectability.

PATIENTS AND METHODS

Between January 1990 and December 1995, 84 PC patients were submitted to surgical procedures (potentially curative resection in 30%, biliodigestive anastomosis in 51% and exploratory laparotomy in 13%). Preoperative staging was carried out by means of abdominal US and/or CT. Definitive staging was established according to surgical findings, using the TNM classification.

RESULTS

Accuracy of preoperative evaluation with regard to tumoral staging was 65%, being underestimated in 29 (35%) patients. This underestimation was mainly due to lesions in stage I. In addition, preoperative staging predicted tumor unresectability with a 50% sensitivity and a 83% specificity.

CONCLUSIONS

US and CT have a good specificity in the staging and unresectability prediction of pancreatic cancer. However, their usefulness is limited by their low sensitivity.

Type I interferons: expression and signalization

Type I interferon (IFN-A and IFN-B) genes encode a large family of multifunctional secreted proteins involved in antiviral defence, cell growth regulation and immune activation. These cytokines, as a consequence of their biological activities, have been established as effective therapeutic molecules for malignant and viral diseases. Virus infection is the main inducer leading to transient expression of type I IFN (A and B) and the antiviral response appears to proceed through a two-step pathway requiring, first, induction of type I IFN gene expression and, second, transcriptional activation by the synthesized IFN proteins, binding to their specific cell surface receptors, of a large number of genes. The proteins they encode are responsible, in part, for the pleiotropic multiple biological activities of the IFN. In this two-step pathway, the virus-induced IFN genes and the IFN-stimulated gene (ISG) expression seem to share common factors. Even if IFN-A genes are structurally related and very often coordinately induced in virus-infected cells, differences in the expression of the individual IFN-A messenger RNAs of the multigenic IFN-A gene family are observed in human as well as in murine cells, reflecting, in a particular cell type, the transcriptional activity of the corresponding promoter regions. Important studies on interferon regulatory factors and ISG factors have been made in the last decade. However, some factors involved in IFN-A gene regulation remain to be identified. Our goal has been to review the factors involved in the control of the type I IFN gene expression to understand the mechanisms of induction and repression of their transcription and to explain the properties of these cytokines through their signal transduction pathway.

Transcriptional repression of type I IFN genes

Transcriptional regulation is a consequence of the combination of both activation and repression for establishing specific patterns of eukaryotic gene expression. The regulation of the expression of type I interferon (IFN-A and IFN-B) multigene family is controlled primarily at the transcriptional level and has been widely studied as a model for understanding the mechanisms of stable repression, transient virus induction and postinduction repression of the genes. The positive and negative regulatory elements required for this on/off switch have been defined within a complex 5' upstream region of their transcription start site. The differential expression pattern of type I IFN genes is thought to involve both substitutions in the virus responsive element (VRE) and presence or absence of negatively acting sequences surrounding the VRE. In this review we discuss several mechanisms of negative regulation due to the existence of common or specific elements in the IFN-B and IFN-A genes and we summarize recent studies on transcriptional repressors that bind to these promoters.

Study of bcl-2 protein expression and the apoptosis phenomenon in neuroblastoma

BACKGROUND

Prognosis in neuroblastoma is based upon several clinical factors such as age, tumoral staging and other genetic factors like N-myc oncogene amplification or deletion of the short arm of chromosome 1 (del 1p). Recent reports indicate that bcl-2 protein expression is associated with a poor outcome in patients with neuroblastoma.

MATERIALS AND METHODS

We present a study of 80 cases from the files of the Spanish neuroblastoma study group (N-II-92) analysing bcl-2 protein expression by means of immunohistochemical methods and its relation with other parameters such as histopathology, PCNA expression, N-myc amplification and DNA study of apoptosis.

RESULTS

We found a statistical correlation between bcl-2 protein expression and unfavourable histopathology, N-myc amplification and PCNA nuclear staining. An inverse relation between bcl-2 staining and apoptosis was detected.

CONCLUSIONS

Based on present findings it can be concluded that the determination of bcl-2 protein provides prognostic information when associated with other biological factors involved in neuroblastomas.

Translocation (X;18) in a biphasic synovial sarcoma with morphologic features of neural differentiation

The authors report a recurred neoplasm showing distinctive histologic, immunophenotypic, and ultrastructural features characteristic of biphasic synovial sarcoma with neural differentiation. The features include areas with a growth pattern of densely packed spindle cells in irregularly intersecting, broad fascicles, diffuse vimentin and HBA 71 immunoreactivity, expression of S-100 protein, and other neural markers. Moreover, areas with glandular structures and cellular expression of cytokeratin and epithelial membrane antigen were noted. Additionally, areas of neural-like growth pattern were positive for neuron-specific enolase, HNK-1, and protein gene product 9.5. Furthermore, cytogenetic analysis, two-color interphase fluorescence in situ hybridization, and reverse transcription polymerase chain reaction demonstrated the reciprocal translocation between chromosomes X and 18 associated with the different subtypes of tumor cells. The establishment and characterization of the tumor cell line are detailed. This cell line retains the distinct morphologic and genetic characteristics of the original biphasic synovial sarcoma with neural differentiation.

Simulation of the conformation and dynamics of a double-helical model for DNA

We propose a partially flexible, double-helical model for describing the conformational and dynamic properties of DNA. In this model, each nucleotide is represented by one element (bead), and the known geometrical features of the double helix are incorporated in the equilibrium conformation. Each bead is connected to a few neighbor beads in both strands by means of stiff springs that maintain the connectivity but still allow for some extent of flexibility and internal motion. We have used Brownian dynamics simulation to sample the conformational space and monitor the overall and internal dynamics of short DNA pieces, with up to 20 basepairs. From Brownian trajectories, we calculate the dimensions of the helix and estimate its persistence length. We obtain translational diffusion coefficient and various rotational relaxation times, including both overall rotation and internal motion. Although we have not carried out a detailed parameterization of the model, the calculated properties agree rather well with experimental data available for those oligomers.

Molecular alterations of the RB1, TP53, and MDM2 genes in primary and xenografted human osteosarcomas

We report the status of the RB1, TP53, and MDM2 genes in human osteosarcomas and cell lines established from surgical specimens and transplanted into athymic naked mice. By using reverse transcriptase-polymerase chain reaction (RT-PCR) as a prescreening technique and posterior sequencing, we observe new mutations in the RB1 gene, notably a duplication in tandem of exons 3 through 6. TP53 mutations appear in codons most frequently mutated in osteosarcomas. We have not seen MDM2 gene amplification in any reported case. These molecular alterations appear in different osteosarcomas not simultaneously present in the same tumor sample. A link has been described between these three genes in the pathways that control the cell cycle and the tumoral progression, but their functions are probably independent in the development of osteosarcomas. TP53 mutations appear in adult patients, whereas RB1 alterations occur mostly in younger patients.

Acute pancreatitis after long-term 5-aminosalicylic acid therapy

Acute pancreatitis is a known, although rare, complication of mesalamine treatment. This complication typically appears within the first days or weeks after initiation of therapy. We describe two cases of acute pancreatitis that occurred after long term mesalamine therapy for ulcerative colitis. A rechallenge, performed in both patients, confirmed the diagnosis of mesalamine-induced pancreatitis. These case reports provide evidence that 5-aminosalicylic acid may induce acute pancreatitis after long term treatment.

Silencer activity in the interferon-A gene promoters

Interferon-A (IFN-A) differential gene expression is modulated by a complex interplay between cis-acting DNA elements and the corresponding specific trans-regulating factors. Substitutions in the proximal virus-responsive element of the interferon-A (IFN-A) promoters contribute to their differential gene expression. The 5' distal silencing region in the weakly virus-inducible murine IFN-A11 gene has been previously delimited. DNase I footprinting experiments and transient gene expression assays demonstrate identical silencing activity in equivalent regions of the genes for IFN-A11 and IFN-A4 promoters. A minimal 20-mer distal negative regulatory element (DNRE) in both promoters is necessary and sufficient for the silencing and a region in the highly inducible IFN-A4 promoter located between the silencer and the virus-responsive element overrides the silencer activity. Mutations in the central region of the DNRE, causing derepression, also altered the formation of one of the two major DNA-protein complexes. One of these contains a protein related to or identical to the high mobility group I(Y) proteins, while the other complex contains a major protein present in uninduced and virus-induced cells with a molecular mass of 38 kDa, which may be related to the silencer activity. Similar DNREs are present in other virus-uninducible IFN-A promoters, and these data suggest that a common silencer may mediate the transcriptional repression in different genes of this family.

Effect of Wine-Making Practices on the Concentrations of Fenarimol and Penconazole in Rosé Wines

The changes in and influence of the anti-powdery-mildew fungicides fenarimol and penconazole were studied in the production and quality of rosé wines made with Monastrell grapes grown in the Jumilla wine-producing region in SE Spain. Fungicide concentrations were estimated by gas-liquid chromatography with electron-capture detection. Fermentation was retarded more by penconazole than by fenarimol; in both cases, the slowdown was directly proportional to fungicide concentration. However, the mature wine contained normal concentrations of residual sugars; other enological parameters (pH, volatile acidity, intensity of color and hue) were not significantly affected. Thirty-four days after the start of the experiment, 67% of fenarimol and 52% of penconazole, with respect to the smaller amount initially added (1 mg/liter), were found in the finished wine. The calculated half-life times were 45 and 59 days for penconazole and fenarimol respectively. Different wine-making techniques (racking, clarification, and filtration) had no decisive influence on the removal of fungicide residues from the must, although they eliminated slightly more penconazole than fenarimol.

[The usefulness of the timeliness of endoscopic sphincterotomy in severe acute pancreatitis of biliary origin]

There are evidence indicating that endoscopic retrograde cholangiopancreatography with sphincterotomy (ERCP+S) reduces the rate of complications in patients with severe acute biliary pancreatitis (ABP). The aim of this study was to analyze our experience in the treatment of severe ABP with ERCP+S and compare the evolution of the patients treated early (3 days or less following admission) with those treated late (after the 3rd day). A retrospective review of the clinical histories of the 16 patients with severe ABP treated with ERCP+S over the last two years is presented, analyzing their clinical features on admission and evolution. Biliary stones or biliary sludge was observed in 11 cases (69%). Nine patients had undergone early, and 7 late, ERCP+S. The patients of the latter group presented a greater number of complications during evolution than the former group (43% vs 0%; p = 0.025). The mortality of the patients of the late ERCP+S was also greater although without statistical significance (28.6% vs 0%; p = 0.15). No complication secondary to ERCP+S was detected. These findings confirm the fact that ERCP+S performed early in severe ABP significantly reduces the number of complications and is associated with a lower mortality.

[Massive pleural effusion secondary to pancreatic-pleural fistula as first manifestation of chronic pancreatitis. Report of three cases]

Patients with chronic pancreatitis develop massive pleural effusion in less than 1% and its frequency as the first clinical manifestation of the disease is unknown. Three patients with massive pleural effusion and dyspnea which led to the diagnosis of chronic pancreatitis are referred. The patients were 28, 37 and 41 years old, they were hard-drinking and they came to the hospital because of quick and progressive dyspnea, with hypoxemia and hypocapnia. Two patients had right and one left pleural effusion. The thoracothentesis gave 10, 9 and 3.5 l of serohematic liquid rich in pancreatic enzymes. All cases showed tomographic changes of chronic pancreatitis and pancreatic pseudocysts. Only in one of them the link between the pseudocyst and pleural effusion through a fistula in the right support of the diaphragm could be identified. The different therapeutic possibilities are discussed. Pancreatopleural fistula diagnosis should be considered in patients with massive fast pleural effusion and a history of high alcohol intake. High levels of pancreatic enzymes in the pleural liquid confirm the diagnosis.

Conservative pancreatic resection in patients with obstructive chronic pancreatitis

The purpose of this paper is to present the results of our experience in using a conservative pancreatic resection approach in a certain group of patients suffering from chronic pancreatitis. From January 1988 to December 1995, 110 patients underwent surgical therapy for chronic pancreatitis at the Hospital Clinic of the University of Barcelona. In 35 patients with an inflammatory mass at the pancreatic head, pylorus-preserving duodeno-pancreatectomy was performed. Forty male patients with localized focal pancreatitis at the body or tail underwent distal pancreatectomy and drainage of the pancreatic remnant. In 30 patients with pancreatic ducts greater than 7 mm in diameter, side-to-side pancreaticojejunostomy was carried out. Five patients could not be included in any of these three categories because of their particular characteristics. In all cases, resolution of the symptoms was achieved at the mean follow-up of 18 months (range 12 to 21 months). No patient showed a deterioration of glucose homeostasis, and exocrine dysfunction was not observed. Patients with obstructive chronic pancreatitis by inflammatory cystic mass, short strictures or intraductal stones located in the central pancreas or uncinate process may be surgically managed with conservative pancreatic resection or extraction of the stones from the Wirsung duct. The jejunal interposition and pancreaticojejunal anastomosis achieved pain control without any deterioration of the endocrine or exocrine function.

Bipolar (neural and myoblastic) phenotype in cell lines derived from human germ cell tumours of testis

Non-seminomatous germ cell tumours of the testis (NSGCT) form a heterogeneous group of neoplasms. Cell lines derived from NSGCT may provide useful data concerning the biology of neoplasic precursor germ cells, differentiation of tumour stem cells and the relationship between various tissue components of these tumours. Four NSGCT were studied, two mixed tumours composed of teratocarcinoma, yolk sac and trophoblastic elements, and two malignant teratomas with a massive neuroectodermal component, equivalent to primary neuroectodermal tumours (PNET) of the testis. The explanted tumours gave rise to various cell populations, including epitheloid cells, flattened large cells, spindle cells and tear drop cells of neuroblastic type. Ultrastructurally, cultured cells expressed various degrees of neural and muscular differentiation: neurosecretory granules, intermediate filaments of glial nature, and filaments resembling Z-bands. Cultured cells showed the expression of several neural and muscular markers, including neurofilaments, cytokeratin, actin, desmin, neuron-specific enolase, glial fibrillary acidic protein and HNK-1. In addition, three cases expressed HBA-71 antigen and two expressed MyoD1 protein. All cases were aneuploid, and an isochromosome 12p, i(12p), was detected in three cases. Myoblastic and neural cells are the predominant tumour cells that grow in vitro, independent of the nature and composition of the primary germ cell tumour. A histogenetic relationship between germ cell tumours and small round cell tumours of childhood is suggested.

Activation of TRK genes in Ewing's sarcoma. Trk A receptor expression linked to neural differentiation

Trk receptors have been identified by immunohistochemical methods in primitive neuroectodermal tumor (PNET)/Ewing's sarcoma (ES). However, the presence of different members of the Trk family of receptors in PNET/ES has not been specified. We have examined whether Trk A, B, and C receptors are specifically expressed in ES both with and without features of neural differentiation. Ten ES tumors (five primary tumors of bone and five extraosseous tumors transplanted into nude mice) were investigated for expression of Trk receptors by immunohistochemistry and reverse transcription-polymerase chain reaction. One primary ES and the five grafted ES tumors exhibited signs of neural differentiation; the remaining four primaries were undifferentiated ES. Other tumor types were analyzed as controls; they included three neuroblastomas (NB), two lymphomas, and single cases of pheochromocytoma (PHEO), schwannoma (SCHW), osteosarcoma, and carcinoma of breast, colon, and kidney. Trk receptors were detected in paraffin-embedded tumor tissue sections by means of a pan-Trk polyclonal antibody raised against the 14 carboxy-terminal residues of gp140trk, and trk A, B, and C transcripts were specifically detected by polymerase chain reaction-based amplification on cDNAs derived from tumor RNA with MuLV reverse transcriptase. Reactivity to the pan-Trk antibody was exhibited by six ES tumors, the three NBs, and the single PHEO and SCHW cases; immunoreactivity was restricted to differentiated tumors, in the case of ES. Tumor types positive for immunostaining were also distinguished by containing transcripts of TRK genes. However, the trk A, B, and C expression pattern of ES differed from that of NBs, PHEO, and SCHW. Transcripts of trk A, B, and C were detected in seven, four, and one case of ES, respectively, and in five, two, and five cases of NB, PHEO, and SCHW, respectively. Interestingly, all differentiated ES tumors contained trk A transcripts. Tumors of neuroectodermal phenotype and/or derivation were thus characterized by a distinct consensus expression pattern: trk A+/B-/C+ for differentiated ES and trk A+/B-/C+ for NB-PHEO-SCHW. These results indicate that the TRK gene family is frequently activated in ES; they also suggest that Trk A receptor is a feature of ES with neural differentiation, whereas Trk B and C receptors seem to be present in undifferentiated ES.

Late outcome after acute pancreatitis: functional impairment and gastrointestinal tract complications

Functional and morphologic changes that take place in the pancreatic gland after an episode of acute pancreatitis have been the subject of discussion among experts in recent years. At the present time there are enough studies to support the fact that for a certain time if not permanently after acute pancreatitis a variable number of patients continue to show morphologic pancreatic changes in the pancreas and exocrine functional impairment. These changes are clearly seen to be related to the severity and alcoholic etiology of the pancreatitis. There are also indications of possible progression from acute alcoholic pancreatitis to chronic pancreatitis, related to severity and recurrence. It is more probable that it is the first instance of pancreatitis in a pancreas that has previously suffered asymptomatic alcohol-induced impairment. The vascular and gastrointestinal tract complications that make a late appearance after acute pancreatitis, although infrequent, on occasion confronts the patient with a high risk of mortality, especially in cases of perforation and hemorrhage.

Ultrasonographic study of pancreatic cysts in autosomal dominant polycystic kidney disease

Pancreatic cysts are an uncommon extrarenal clinical feature of autosomal dominant polycystic kidney disease (ADPKD). The prevalence of pancreatic cysts, sonographically assessed in ADPKD and in the different typs of ADPKD (PKD1 and PKD2) has not been reported. We have studied 173 ADPKD patients and 160 non-affected family members and found a prevalence of pancreatic cysts, of 9% in ADPKD patients over 30 years of age. The presence of pancreatic cysts was related to the increasing age, to the female sex and to the type of ADPKD, found exclusively in PKD1 patients. No complications related to pancreatic cysts were recorded. Pancreatic cysts are an unusual feature of ADPKD and do not appear to contribute to morbidity or mortality.

Identification of distal silencing elements in the murine interferon-A11 gene promoter

The murine interferon-A11 (Mu IFN-A11) gene is a member of the IFN-A multigenic family. In mouse L929 cells, the weak response of the gene's promoter to viral induction is due to a combination of both a point mutation in the virus responsive element (VRE) and the presence of negatively regulating sequences surrounding the VRE. In the distal part of the promoter, the negatively acting E1E2 sequence was delimited. This sequence displays an inhibitory effect in either orientation or position on the inducibility of a virus-responsive heterologous promoter. It selectively represses VRE-dependent transcription but is not able to reduce the transcriptional activity of a VRE-lacking promoter. In a transient transfection assay, an E1E2-containing DNA competitor was able to derepress the native Mu IFN-A11 promoter. Specific nuclear factors bind to this sequence; thus the binding of trans-regulators participates in the repression of the Mu IFN-A11 gene. The E1E2 sequence contains an IFN regulatory factor (IRF)-binding site. Recombinant IRF2 binds this sequence and anti-IRF2 antibodies supershift a major complex formed with nuclear extracts. The protein composing the complex is 50 kDa in size, indicating the presence of IRF2 or antigenically related proteins in the complex. The Mu IFN-A11 gene is the first example within the murine IFN-A family, in which a distal promoter element has been identified that can negatively modulate the transcriptional response to viral induction.

Effects of ethanol feeding and malnutrition on collagen synthesizing and degrading enzymes in rat pancreas

This study was performed to delineate the combined effects of a low-fat diet and chronic ethanol ingestion on collagen metabolism in rat pancreas. Rats fed a very low-fat diet (5% of total calories as lipid) for 12 weeks developed malnutrition as judged by weight loss (-33% of the initial body weight) and low serum albumin and amylase levels. The pancreas of malnourished rats showed increased collagenase activity with respect to animals fed a 35% lipid diet (p < 0.05). Hydroxyproline content was higher in the pancreas of malnourished rats and collagenase activity correlated well with hydroxyproline content (r = 0.57, p = 0.0013). Ethanol feeding for 12 weeks, regardless of the nutritional state of the rats, did not change the synthesis and degradation rates of collagen in the pancreas. The present study suggests that malnutrition may have profound effects on collagen metabolism.

Serum amino-terminal propeptide of type III procollagen levels in chronic pancreatitis

The severity of pancreatic fibrosis, a characteristic feature of patients with chronic pancreatitis (CP), can be assessed only by direct histologic analysis of pancreatic tissue. Since serum levels of the amino-terminal type III procollagen propeptide (PIIIP) can reflect the degree of fibrogenic activity in several diseases associated with fibrosis, the current study was aimed at investigating whether PIIIP are increased in chronic pancreatitis, the relationship between PIIIP and pancreatic fibrogenic activity, and the influence of pancreatectomy, pancreatic exocrine function, and duration of disease on PIIIP levels. Serum PIIIP was measured in 18 patients with CP (15 without liver disease and three with cholestasis) and in 21 healthy controls. The effect of pancreatectomy on PIIIP was evaluated in seven patients, in whom PIIIP was measured immediately before and 2 months after surgery. Prolylhydroxylase (PHase) activity as an index of pancreatic fibrogenesis was evaluated in pancreatic tissue from 11 patients who had undergone subtotal pancreatectomy and from 11 organ donors. The bentiromide (BT)-PABA test as an index of exocrine pancreatic function was measured in all patients. PIIIP was significantly higher in patients who had or had not undergone pancreatectomy (17.3 +/- 4.0 and 25 +/- 11.4 ng/ml, respectively) than in controls (12.3 +/- 3.1 ng/ml) (p < 0.001). PIIIP decreased significantly after pancreatectomy (before, 32.0 +/- 9.3 ng/ml; after, 18.4 +/- 4.8 ng/ml; p = 0.005). PHase was significantly higher in patients (773 +/- 250 cpm/mg protein) than in controls (405 +/- 121 cpm/mg protein) (p < 0.001). PIIIP was correlated with pancreatic PHase (r = 0.7, p = 0.001) but not with BT-PABA or with the duration of the disease. In conclusion, serum PIIIP levels are increased in patients with CP and reflect the severity of pancreatic fibrogenic activity. No relationship between the serum PIIIP levels and the pancreatic exocrine function and duration of disease was found.

Effects of prolonged ethanol intake and malnutrition on rat pancreas

Nutritional factors, especially the protein and fat content of the diet, may change pancreatic morphology after ethanol induced injury. This study was performed to delineate the combined effects of a low fat diet and longterm ethanol ingestion on the rat pancreas. Male Sprague-Dawley rats were maintained with five different diets for 12 weeks and the pancreas removed on the day they were killed. Rats fed a very low fat diet without ethanol (5% of total calories as lipid) developed malnutrition, pancreatic steatosis, and reduction in zymogen granules content. Animals fed a 35% lipid diet with ethanol also developed pancreatic steatosis but changes in zymogen granules content were not detected. Both malnutrition and longterm ethanol consumption increased pancreatic cholesterol ester content, and their effects were additive. Pancreatic steatosis was accompanied with hypercholesterolaemia. Amylase, lipase, and cholesterol esterase content were reduced in malnourished rats; but longterm ethanol ingestion, regardless of the nutritional state, increased lipase content and decreased amylase. It is suggested that high serum cholesterol concentrations and increased pancreatic lipase activity could cause accumulation of cholesterol esters in acinar cells. Fat accumulation in the pancreas has been reported as the earliest histopathological feature in alcoholic patients and may be responsible for cytotoxic effects on the acinar cells at the level of the cell membrane. Although it is difficult to extrapolate results in this animal study to the human situation, the results presented in this work might explain the higher incidence of pancreatitis is malnourished populations as well as in alcoholic subjects that is reported in dietary surveys.

Aprotinin inhibits unspecific degradation of collagen in rat and human pancreas

CONCLUSION

Addition of aprotinin in human and rat pancreatic extracts inactivates nonspecific proteases that completely degrade collagen.

BACKGROUND

We sought to clarify the relative roles of collagenase and nonspecific proteases in the breakdown of collagen by the pancreas.

METHODS

The degradation of [3H] collagen fibrils by pancreatic extracts to small fragments of low molecular weight was determined by SDS-electrophoresis and autoradiography. Aprotinin (0.14 mg/mL) was added to inhibit nonspecific protease activity.

RESULTS

Rat and human pancreas extracts contained a high collagenolytic activity that was demonstrated to be the result of the combined action of collagenase and other pancreatic proteases. Seventy percent of the total collagenolytic activity in rat pancreas extracts was inhibited by aprotinin. The same aprotinin concentration had no effect on two commercially available collagenases. The electrophoretic pattern obtained from [3H] collagen treated with rat and human pancreatic extracts containing aprotinin confirmed the presence of a true specific collagenase in the pancreas.

Immunohistochemical detection of the type I interferon receptor in human fetal, adult, and neoplastic tissues

We have used the monoclonal antibody IFNaR3 that recognizes the alpha subunit of the type I interferon (IFN) receptor to study the expression of this receptor in a large series of normal human adult and fetal tissues, as well as in a large number of tumors of diverse origin. Among fetal tissues (8-20 weeks) the type I IFN receptor was expressed in liver, striated muscle, epidermis, renal tubules, choroid plexus of the CNS, and epithelia of different origins (bronchial, gastrointestinal, and pancreatic). Adult tissues showed a similar pattern that includes epithelia from salivary ducts, genital tract, bladder, breast, as well as germinal centers of lymph nodes, tonsils, and spleen. The study of a large series of tumors revealed that the type I IFN receptor is expressed in most, but not all, melanomas, bladder, kidney, small bowel, lung, and breast adenocarcinomas. The majority of lymphomas, sarcomas, and endocrine tumors proved negative. These results support the concept that the type I IFN receptor is rather ubiquitously expressed in normal and malignant epithelial tissues. More interestingly, the expression of the type I IFN receptor was not detected in all tumors, raising the question of whether some cases may fail IFN alpha therapy due to the lack of receptor expression. This report demonstrates that the IFNaR3 monoclonal antibody can be used for receptor detection in paraffin-embedded sections and it could represent a useful tool in the search for correlations between IFN alpha response and receptor expression in different diseases.

Laparoscopic treatment of acute biliary pancreatitis

Laparoscopic cholecystectomy (LC) has become the standard treatment of gallstones. Application of LC in certain complications of biliary stones such as acute biliary pancreatitis (ABP) is not well defined. 10-30% of patients with ABP present associated bile duct stones, and the realization of a preoperative ERCP has been routinely proposed. Nevertheless, this examination may be unnecessary in most patients.

AIM

To investigate the applicability of laparoscopic surgery for treatment of ABP.

MATERIALS AND METHODS

Between Jan-1992 and June-1995, 368 patients were prospectively evaluated for LC, 274 for indications other than ABP. (Group I, LC) and 91 as a consequence of ABP. (Group II, ABPxL). ERCP was indicated when ultrasonography showed a dilated bile duct (> 8 mm) or when the liver function test (LFT) presented high scores. Age, sex, operative time, incidence of bile duct stones, postoperative stay and morbimortality were evaluated.

RESULTS

The two groups were well matched for age, sex and associated medical risk factors. There were no differences in the operative time, conversion rate or postoperative morbidity (10% vs 10%). ERCP was performed in 25 patients in Group II and bile duct stones were found in 12 cases. In all cases an intraoperative cholangiography was performed, and in 6 patients, bile duct stones were removed by laparoscopic means. Three patients were converted to open surgery on finding duct stones which could not be treated by laparoscopic means. Mean postoperative stay was significantly longer in Group II than in Group I. In two cases, pancreatic pseudocyst was attempted with a laparoscopic approach.

CONCLUSIONS

Definitive treatment of ABP could be accomplished effectively by laparoscopy, with selective indication of ERCP.

Mesenteric panniculitis presenting as fever of unknown origin

A 40-yr-old man was admitted for fever of unknown origin. Mesenteric panniculitis was suspected as a result of ultrasonography, computed tomography, and nuclear magnetic resonance findings, and that diagnosis was confirmed by laparoscopy with retroperitoneal mass biopsy. Mesenteric panniculitis is a rare disease characterized by an inflammatory process of the mesenteric adipose tissue. Abdominal pain, weight loss, and abdominal mass are the most frequent symptoms. High fever and leukocytosis are uncommon. To the best of our knowledge, only two reports of mesenteric panniculitis presenting as fever of unknown origin have been described previously, with no cases published in the English literature. In the case reported, steroid therapy was started with initial improvement. Despite the temporary addition of azathioprine and the maintenance of the prednisone treatment, no further improvement has been achieved. Two years and 5 months after admission, the patient presents intermittent episodes of fever and muscle pain.

The treatment of advanced neuroblastoma. Results of the Spanish Neuroblastoma Study Group (SNSG) studies

The Spanish Neuroblastoma Study Group has conducted a study on advanced neuroblastoma (N-I-87), which included 33 stage III and 60 stage IV neuroblastoma children more than 1 year of age, enrolled between October 1987 and April 1992. They were staged according to Evans and treated with induction chemotherapy (IC) consisting of 3 courses of cyclophosphamide-doxorubicin alternating with 3 of high-dose cisplatin-teniposide. Evaluation after IC and surgery demonstrated an overall response rate of 88% for stage III and 69% for stage IV. In the latter, complete responses and good partial responses were 33 and 14%, respectively. After surgery, children received maintenance chemotherapy (all stage III except 2 and 30 stage IV) or autologous bone marrow transplantation (ABMT) (11 stage IV), the distribution was not randomised. Probability of survival at 5 years was 0.60 +/- 0.12 for stage III and 0.24 +/- 0.07 for stage IV. A significant difference in survival at 5 years was found between "good responders" and "non-responders" to initial chemotherapy.

Collagenolytic activity in human pancreatic tissue with different degrees of fibrosis

The present study was designed to establish a valid method for expressing collagenolytic activity in pancreatic tissue with different degrees of fibrosis. Collagenolytic activity was measured in pancreatic tissue of control and alcoholic chronic pancreatitis (CP) patients and data were expressed as percent digestion/mg tissue or as percent digestion/mg protein obtaining different results. The values were 18.4 +/- 4.7% digestion/mg tissue in the control group, and 8.4 +/- 3.2% digestion/mg tissue in the chronic pancreatitis group (p < 0.001). When collagenolytic activity was expressed as percent digestion/mg protein, measured by the Bradford assay, the values of the control group were 190.2 +/- 69.0% digestion/mg protein, and those of chronic pancreatitis patients were 187.2 +/- 61.7% digestion/mg protein (p = ns). Protein determination in pancreatic tissue of control and CP patients was seen to be influenced by the method assayed. Protein content per mg of fresh tissue, measured by the methods of Lowry, Bradford, and Bradford-SDS, were similar and twofold higher in controls than in CP samples. However, the Kjeldahl assay showed that protein content per mg of dry tissue was the same in both groups. The high degree of fibrosis in the pancreas of CP patients (60.2 +/- 28.0%) with regard to controls (4.7 +/- 1.8%) (p < 0.001) and the low response of collagen proteins to the Lowry and Bradford assays could explain the differences observed in protein content of human samples.(ABSTRACT TRUNCATED AT 250 WORDS)

Developmental control of IFN-alpha expression in murine embryos

The expression of IFN-alpha transcripts was investigated in murine embryos, fetuses, and fetal annexes in mid and late pregnancy. We have shown by Northern blot analysis, reverse transcription-polymerase chain reaction, and in situ hybridization the presence of IFN-alpha transcripts in mouse placenta, fetus, and newborn. From the 14th day of gestation until birth, a typical IFN-alpha transcript (1.2 kb) is found in the fetus. A transcript of larger size (2.2 kb) appears near birth and is present in the newborn mouse. Fetal annexes between the 10th and 21st days of gestation also express IFN-alpha. From the 10th day until birth, the 1.2-kb IFN-alpha mRNA species is present, as well as unusually large transcripts: 4 and 7 kb. To localize IFN-alpha transcripts, in situ hybridization was performed, using 35S-IFN-alpha antisense RNA probe in comparison with the sense RNA probe. The tissue pattern of IFN-alpha transcription in fetuses shows a clear labeling of many epithelia, such as skin, ependyme, and intestine glandular epithelium. A possible relation with cellular differentiation is discussed.

Aggregated IgE mimic interleukin-3-induced histamine synthesis by murine hematopoietic progenitors

Similar to interleukin-3 (IL-3), IgE acts on murine bone marrow cells by inducing histamine production. This effect does not result from degranulation of histamine-containing cells, but from histamine synthesis, as assessed by the following findings. (1) The histamine content of freshly isolated bone marrow cells is too low to account for the increase in extracellular histamine levels. (2) Neither IL-3 nor IgE induced histamine production in the presence of the specific inhibitor of histidine decarboxylase (HDC), the histamine-forming enzyme. (3) Both the enzymatic activity and the mRNA expression of HDC were enhanced in response to IL-3 or IgE. Artificial aggregation or formation of IgE immune complexes augmented ther effect on histamine synthesis, indicating that the aggregated form is responsible for this biologic activity. Yet, it is apparently not mediated by Fc epsilon RI because their cross-linkage by dinitrophenyl bovine serum albumin after presensitization with IgE did not induce histamine production by hematopoietic progenitors. Among other aggregated isotypes tested, only IgG2a and, to a lesser extent, IgG1 had a consistent but lower effect, whereas IgM and IgA were completely inactive. The target cells of IL-3 and IgE in terms of histamine synthesis do not belong to mature bone marrow populations, especially mast cells. They copurify with hematopoietic progenitors in the low-density layers of a discontinuous Ficoll gradient where they represent around 5% of the cells, as determined by in situ hybridization. This percentage remained the same, regardless of whether the cells were stimulated by IgE or IL-3 alone or by a combination of both, suggesting a common responder cell. In accordance with this notion, histamine-producing cells could not be distinguished from each other on the basis of density, size and internal structure, or rhodamine (Rh) retention. Finally, the effect of IgE is not caused by the induction of IL-3 because anti-IL-3 antibodies did not abrogate the effect of IgE.

HYDRO: a computer program for the prediction of hydrodynamic properties of macromolecules

HYDRO is a program for the calculation of sedimentation and diffusion coefficients, rotational relaxation times, and intrinsic viscosities of rigid macromolecules of arbitrary shape that are represented by bead models. Actually, HYDRO contains various FORTRAN callable subroutines that can be linked to the user's own programs to account for variability of shape or flexibility. Some hints are given for the use of HYDRO in various situations.

Immunohistochemical detection of P-glycoprotein in Ewing's sarcoma and peripheral primitive neuroectodermal tumors before and after chemotherapy

The authors evaluated P-glycoprotein expression in a total of 35 cases of Ewing's sarcoma and peripheral primitive neuroectodermal tumors (PNET). Fifteen cases had matched tumors before and after treatment. The 20 unmatched tumors included 14 pretreatment PNETs and Ewing's sarcomas and 6 posttreatment Ewing's sarcomas. Two antibodies, C219 and JSB-1, were used. Immunoreactivity was almost exclusively membranous. Variability in the number of positive cells and in staining intensity was noted within individual tumors. Among the 15 matched tumors, 7 were positive for P-glycoprotein before treatment; 6 of these remained positive after treatment. Four of the 8 that were negative for P-glycoprotein before treatment became positive after treatment. Of the unmatched tumors, 9 of 14 pretreatment and 3 of 6 posttreatment tumors were positive. When relapse-free survival time, based on the presence or absence of P-glycoprotein positivity in pretreatment tumor samples, was evaluated in this group, no significant difference was found (P2 = .92); however, the numbers are too small to draw definitive conclusions. The high incidence of positive primary tumors suggests that P-glycoprotein expression is probably intrinsic in Ewing's sarcoma and PNET and not necessarily induced by therapy.

Comparison of Ewing's sarcoma of bone and peripheral neuroepithelioma. An immunocytochemical and ultrastructural analysis of two primitive neuroectodermal neoplasms

Ewing's sarcoma of bone (ESB) and peripheral neuroepithelioma (PN) are frequently considered to be different tumors. Some researchers have suggested that PN is morphologically a neuroectodermal Ewing's sarcoma. We sought to determine the extent of neuroectodermal features in conventional ESB on direct patient material (25 cases) and to compare these tumors with a similar group of readily diagnosed PNs (10 cases). Light microscopic, ultrastructural, and immunophenotypic parameters were assessed and compared for both groups. The avidin-biotin complex method was used. All tumors were antigenically intact since all stained for vimentin or at least one marker. Neuroectodermal antigens (neuron-specific enolase, Leu-7 [HNK-1], neurofilament 200 kd, and S100) were found in nine of 10 cases of PN and in 17 of 25 cases of ESB. In ESB, an atypical light microscopic appearance correlated with the presence of neuroectodermal features in most cases, but neuroectodermal phenotype was more frequent (68%) than morphological evidence of neuroectodermal differentiation (36%). These data support the concept that ESB and PN are both peripheral primitive neuroectodermal neoplasms, differing only in extent of neuroectodermal phenotype and morphological differentiation.

Hydrodynamic properties of a double-helical model for DNA

The translational and rotational diffusion coefficients of very short DNA fragments have been calculated using a double-helical bead model in which each nucleotide is represented by one bead. The radius of the helix is regarded as an adjustable parameter. The translational coefficient and the perpendicular rotation coefficient agree very well with experimental values for oligonuclotides with 8, 12, and 20 base pairs, for a single value of the helical radius of about 10 A. We have also calculated a nuclear magnetic resonance relaxation time in which the coefficient for rotation about the main axis is involved. As found previously with cylindrical models, the results deviate from experimental values, indicating that the internal motion of the bases has a remarkable amplitude. An attempt to quantify the extent of internal motions is presented.

Acute necrotizing pancreatitis: a multicenter study

A multicenter study of acute necrotizing pancreatitis (ANP) classified in accordance with the Balthazar criteria (grades D and E), has been performed in 12 teaching hospitals. A total of 233 patients were reviewed, and the mortality rate was 26.6%. The most common etiology was biliary pancreatitis (45.5%). Among the complications, shock, renal insufficiency, pulmonary insufficiency and hemorrhagic gastritis were associated with a mortality rate of 51-66%. Diffuse fluid collections were associated with a higher mortality rate (26.8%) than localized fluid collections (14.5%). In 106 patients with gallstone pancreatitis, early surgery was performed in 17, and 5 patients (29.4%) died. No mortality was observed in 32 patients with delayed surgery. Sphincterotomy was performed in 13 patients, and 4 (30.7%) died. Early surgery (necrosectomy and closed peritoneal lavage) was undertaken in 75 patients, with a mortality rate of 39%. In conclusion, the morbidity and mortality rates of ANP can be improved with proper monitoring, adequate supportive care and the judicious use of surgery based on clinical and morphological findings.

Role of zinc in the process of pancreatic fibrosis in chronic alcoholic pancreatitis

Zinc acts as a cofactor in many enzymatic processes, including collagen synthesis. The observation of increased activity of prolylhydroxylase (PHase), an enzyme that takes part in the synthesis of collagen, in zinc-depleted liver tissue suggests that zinc deficiency is associated with hepatic collagen deposition. The pancreatic zinc content in chronic alcoholic pancreatitis (CAP) is still unknown. The objectives of this study were (a) To assess zinc concentrations in the pancreatic tissue in CAP; (b) to establish a possible relation between pancreatic zinc content, fibrosis, and PHase activity; and (c) to evaluate the relation between serum and pancreatic zinc levels. Sixteen surgical specimens of pancreatic tissue from patients with CAP were analyzed; control pancreatic samples from 11 organ donors were also studied. Zinc concentration, PHase activity, and the amount of fibrous tissue were assessed in the pancreatic tissue of each individual. The amount of fiber deposited in the pancreas in CAP was 68.4 +/- 19.8%, and that of the control group, 5 +/- 2% (p < 0.001). PHase activity in CAP was 754 +/- 230 cpm/mg of protein and that of the control group was 405 +/- 151 cpm/mg of protein (p < 0.001). The amount of pancreatic zinc in the former was 15.0 +/- 9.7 micrograms/g of tissue and that of the latter was 28.1 +/- 18.1 micrograms/g of tissue (p = 0.023). Serum zinc levels were similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Patterns of differentiation in extraosseous Ewing's sarcoma cells. An in vitro study

BACKGROUND

In vitro, tissue culture-associated differentiation assays have facilitated the identification of multiple tumor-cell types.

METHODS

We have investigated the capability of differentiation of three extraosseous Ewing's sarcoma cell lines toward a neural and muscular direction by in vitro stimulation with dibutyryl cyclic adenosine-monophosphate (db cAMP) and 5-azacytidine, respectively.

RESULTS

Elongation of cytoplasmic processes and increase of neural markers chromogranin, S-100 protein, and glial fibrillary acidic protein were observed after db cAMP treatment of these lines and neurosecretory granules as well as myelin figures were demonstrated ultrastructurally. These results support the existence of several pathways of neural differentiation in vitro--neuroblastic, Schwannian, and central glial--in stages of maturation more advanced than those previously reported in Ewing's sarcoma of bone. The cell lines showed no definitive myoblastic differentiation after 5-azacytidine treatment.

CONCLUSIONS

These data suggest that these three extraosseous Ewing's sarcoma cell lines configurate a heterogeneous group of tumors with respect to capability of differentiation into the neural lineage, arrested at more advanced stages of neural crest development than Ewing's sarcoma of bone and without capability of myoblastic differentiation with 5-azacytidine.

[Isolated rectal Kaposi's sarcoma]

We report a case of isolated rectal Kaposi's Sarcoma in a homosexual man with active Human Immunodeficiency Virus infection. Although gastrointestinal tract affection is not infrequent, it is usually associated with the existence of skin lesions. A few cases of noncutaneous gastrointestinal Kaposi's Sarcoma have been described, but no one affecting only the rectum. This is a diagnostic possibility in patients with Human Immunodeficiency Virus infection and rectal symptoms.

[Changes in the pancreatic and respiratory functions in cystic fibrosis. The influence of the time of the evolution of the disease]

BACKGROUND

Cystic fibrosis is the most frequent congenital disease in Caucasian and is transmitted by recessive autosomic inheritance. It is characterized by affection of different glands of exocrine secretion, particularly the pancreas and the lung. The aim of this study was to analyze the degree of alteration of pulmonary and pancreatic exocrine function in a group of patients with cystic fibrosis in relation to the time of disease evolution.

METHODS

Twenty-one patients between 9 and 31 years of age were studied; 11 with an evolution of lower than or equal to 158 months and 10 with an evolution of higher than 158 months (median of the total patients). To study pancreatic exocrine function the BT-PABA test immunoreactive serum trypsin test were used. To evaluate respiratory function FEV1, FVC, FEV1/FVC ratio and PaO2 were used.

RESULTS

The results obtained demonstrated that in the group with a lower time of evolution the diagnosis had been carried out at earlier ages (17 +/- 17 months versus 84 +/- 60 months; p = 0.002) and presented a significantly more altered pancreatic exocrine function (BT-PABA: 13 +/- 12% versus 35 +/- 23%; p = 0.013). However, respiratory function was altered in the group with longer time of evolution (FEV1: 68 +/- 20% versus 36 +/- 23%; p = 0.003; FVC: 74 +/- 9 versus 52 +/- 25%; p = 0.013; FEV1/FEV: 77 +/- 19 versus 50 +/- 9%; p < 0.001; PaO2: 84 +/- 16 versus 58 +/- 11%; p < 0.001).

CONCLUSIONS

Pancreatic exocrine function is most intensely affected in patients diagnosed with cystic fibrosis at earlier and with shorter times of evolution while patients who have the longest time of evolution and who were diagnosed later in life presented greater changes in respiratory function.

An improved Bradford protein assay for collagen proteins

A modification of the protein determination method of Bradford adapted for collagen-rich samples is described. The use of Coomassie-based protein determination methods is limited by the great variation in colour yield obtained for different proteins. This is especially important in samples containing significant amounts of collagen where direct application of the methods of Lowry and Bradford results in underestimated values. Addition of small amounts of sodium dodecyl sulphate (SDS) (0.0035%) to the diluted solutions of Coomassie Brilliant Blue G used as dye reagent in the Bradford colorimetric assay caused a 4-fold increase in the colour response of three collagen proteins (Col I, III and IV) and a decrease in absorbance for various non-collagen proteins. The presence of SDS in the reagent did not result in a significant metachromatic shift of the collagen-dye complexes. This simple modification in the preparation of the reagent for the Bradford assay allows similar response curves to be obtained for collagen and non-collagen proteins, making the modified assay of potential use for protein determination in collagen-rich samples such as pancreatic extracts.

dbl oncogene expression in childhood tumors and tumor cell lines

We studied the expression of the dbl oncogene in the total RNA obtained from a wide spectrum of childhood tumors, including Ewing's sarcomas, peripheral neuroectodermal tumors (PNET), esthesioneuroblastomas, neuroblastomas, retinoblastomas, rhabdomyosarcomas, osteosarcomas, and synovial sarcomas. Material was obtained from primary tumors, nude mice xenografts, and tumor cell lines. Following the Northern blot technique, a single band of 2.8 kb was found in each analyzed case. Induction of neural differentiation in Ewing's sarcoma, peripheral PNET, and neuroblastoma cell lines with dibutyryl cyclic AMP did not change the expression of the dbl oncogene. We conclude that the wide expression of the dbl oncogene in these childhood tumors reduces its value as a molecular marker for their differential diagnosis; on the other hand, the dbl oncogene does not appear to be an essential molecular factor in the process of neuroectodermal differentiation of small round cell tumors of childhood.

Ursodeoxycholic acid treatment of primary hepatolithiasis in Caroli's syndrome

Congenital cystic dilation of the intrahepatic bile ducts (Caroli's syndrome) is a rare cause of chronic cholestasis and hepatolithiasis in young adults. Long-term prognosis is poor even with surgical drainage. We treated twelve patients who had Caroli's syndrome and intrahepatic stones with ursodeoxycholic acid (UDCA), 10-20 mg/kg daily. The duodenal bile of these patients contained cholesterol crystals, which suggests that the stones were cholesterol rich. UDCA led to sustained clinical remission, return to normal liver function, and dissolution of intrahepatic stones on ultrasound in all patients (nine partial, three complete) after 48 (range 12-114) months' follow-up. Litholytic therapy is indicated for intrahepatic stones in Caroli's syndrome.