Randomized, controlled study on adjuvant immunochemotherapy with PSK in curatively resected colorectal cancer. The Cooperative Study Group of Surgical Adjuvant Immunochemotherapy for Cancer of Colon and Rectum (Kanagawa)

A randomized, controlled trial of adjuvant immunochemotherapy with PSK (Kureha Chemical Industry Co., Tokyo, Japan) in curatively resected colorectal cancer was studied in 35 institutions in the Kanagawa prefecture. From March 1985 to February 1987, 462 patients were registered. Four hundred forty-eight of those patients (97.0 percent) satisfied the eligibility criteria. The control group received mitomycin C intravenously on the day of and the day after surgery, followed by oral 5-fluorouracil (5-FU) administration for over six months. The PSK group received PSK orally for over three years, in addition to mitomycin C and 5-FU as in the control group. At the end of February 1990, the median follow-up time for this study was four years (range, three to five years). The disease-free survival curve and the survival curve of the PSK group were better than those of the control group, and differences between the two groups were statistically significant (disease-free survival, P = 0.013; survival, P = 0.013). These results indicate that adjuvant immunochemotherapy with PSK was beneficial for curatively resected colorectal cancer.

Werner's syndrome: no difference in in vitro life span of dermal fibroblasts from proximal and distal parts of the body

Recently it has been reported that fibroblasts from distal parts of the body of a patient with Werner's syndrome grew poorly in vitro as compared with those from the proximal part of the same patient. To confirm this observation, cultures of fibroblasts from different parts of the body were set up in 2 cases of Werner's syndrome, but no significant difference in life span was observed. Fetal calf serum (FCS) and fibroblast growth factor (FGF) stimulated growth of fibroblasts from different body parts equally well. These data indicate that there is no difference in growth activity of fibroblasts from proximal and distal body parts in patients with Werner's syndrome. Moreover, the growth rate of epidermal outgrowths did not differ significantly between proximal and distal parts of these patients.

Acute intermittent porphyria and epilepsy: safety of clonazepam

A young woman with acute intermittent porphyria (AIP) and juvenile myoclonic epilepsy began to have generalized tonic-clonic seizures (GTCs) at age 13. Subsequently, she had myoclonic seizures, which were often precipitated by visual stimulation, tended to occur in the morning, and sometimes evolved into GTCs. Valproate (VPA) resulted in a worsening of latent AIP, and treatment with a combination of phenytoin (PHT), carbamazepine (CBZ), and clonazepam (CZP) led to severe neuropathy of AIP and an electrolyte imbalance. These conditions were improved by water restriction, infusion of high doses of carbohydrates, and discontinuation of all antiepileptic drugs (AEDs) except for CZP. CZP appeared to be effective both in improving GTCs and myoclonic seizures and did not induce any symptoms of AIP. CZP may be porphyrogenic but can be used safely at a low dose for treatment of epilepsy in patients with AIP.

The level of urinary epidermal growth factor is not influenced by the extent of psoriatic lesions

Epidermal growth factor (EGF) levels in the urine of 31 normal individuals and 33 psoriatic patients were measured. The amounts of urinary EGF secreted in a day by normal and psoriatic individuals were not significantly different nor were the levels of EGF in random urine specimens corrected for creatinine values. It is known that the urinary EGF content corrected for the creatinine value correlates very well with the EGF level in blood as well as in 24-h urine specimens. Our data indicate that EGF circulating in the blood may not be correlated with the extent of psoriatic lesions.

Amino acid sequence of the 8-kDa protein in photosystem I reaction center complex from a thermophilic cyanobacterium, Synechococcus elongatus

The 8-kDa protein in Photosystem I (PS I) reaction center complex was isolated from a thermophilic cyanobacterium, Synechococcus elongatus, by SDS-polyacrylamide gel electrophoresis using TRIS-Tricine buffer system. The complete amino acid sequence of the protein was determined. The 8-kDa protein consisted of 73 amino acid residues giving a calculated molecular weight of 7,472. No significant sequence homology were observed with the known other small subunits in PS I reaction center complex, except for the 6.5-kDa protein in PS I from another thermophilic cyanobacterium, S. vulcanus. The 8-kDa protein was characteristically rich in hydrophobic amino acid residues, especially the content of leucine. These suggest that the 8-kDa subunit is an intrinsic structure component in PS I core complex for stabilization of the reaction center.

Amino acid sequence of 10-kDa protein in photosystem I reaction-center complex from a thermophilic cyanobacterium, Synechococcus elongatus Naegeli

Four small subunits (14, 13, 10, and 8 kDa) of the photosystem I reaction-center complex were isolated from a thermophilic cyanobacterium Synechococcus elongatus. The complete amino acid sequence of the 10-kDa subunit was determined to consist of 80 amino acid residues giving a molecular mass of 8855.3, excluding iron and sulfur atoms, and containing two special sequences of cysteine residues, Cys-X-X-Cys-X-X-Cys-X-X-X-Cys-Pro, at residues 10-21 and 47-58, which indicates that the subunit is an apoprotein carrying two iron-sulfur centers, FA and FB, assigned as [4Fe-4S] clusters. The amino acid sequence indicated an 87.5% identity compared with those deduced from the nucleotide sequences of chloroplast gene psa C from several plants.

Amino acid sequence of the 14-kDa protein in the photosystem I reaction center complex from Synechococcus elongatus Naegeli

One of the small components (14 kDa) of the photosystem I reaction center complex was isolated from a thermophilic alga, Synechococcus elongatus. The amino acid sequence was determined. The protein consists of 137 amino acid residues, corresponding to the molecular mass of 15,319. Alignment of this sequence with the ferredoxin-binding proteins of photosystem I from other cyanobacteria and higher plants suggests the possible biologically important residues and the residues responsible for thermostability in the sequence.

Autocrine secretion of an EGF-like substance by a cell line (HSC-1) derived from a human skin squamous cell carcinoma

The presence of EGF-autocrine secretion was investigated in a cell line derived from a human squamous cell carcinoma (HSC-1). The cell line was found to secrete the epidermal growth factor (EGF)-like substance. Meanwhile, normal human and uninvolved and involved psoriatic epidermal cells did not show any evidence of EGF secretion in culture. Not was any evidence of EGF secretion observed in vitro in several malignant cell lines other than HSC-1 derived from human squamous cell carcinomas, adenocarcinoma and melanoma. The addition of EGF did not stimulate, but rather inhibited, the growth of HSC-1 cells in GIT medium as well as Dulbecco's modified essential medium with low concentrations of fetal calf serum (0.5-1%) in vitro. Overexpression of EGF receptors is known to occur in HSC-1. The results suggest that HSC-1 cells exhibit autocrine secretion of the EGF-like substance but not autostimulation in anchorage-dependent cell culture.

Discordant expression of tuberous sclerosis in monozygotic twins

A set of 20-year-old female Japanese twins, most probably monozygotic, had clinical evidence of tuberous sclerosis (TS). They were discordant for symptoms. One of the twins exhibited facial red-brown papules (adenoma sebaceum), a dorsal shagreen patch, intracerebral calcifications, angiomyolipoma in the right kidney, and hypopigmented macules; the other had only a few hypopigmented macules. Modification of TS gene expression by the effects of environmental (extrinsic) factors is suggested.

Organ culture of human scalp hair follicles: effect of testosterone and oestrogen on hair growth

Whole human scalp hair follicles were cultured. The follicles were dissected from skin pieces of normal scalp and put into 1.5 ml of incubation medium in a closed 5 ml glass tube under an atmosphere of 95% O2 and 5% CO2. The tube was rolled at 15 rpm at 36 degrees C. Remarkable hair growth was noticed for 7 to 8 days. Hair root sheaths also grew with the hair shafts. The structure of the hair bulbs was well maintained for at least 6 days, and then the hair matrix cells started to degenerate. Fetal calf serum was not essential for hair growth in vitro, but increased the growth rate slowly. Testosterone and oestrogen inhibited hair growth in vitro to a similar extent. The minimum effective doses of both hormones to suppress hair growth were around 5 ng/ml, which corresponds well to the normal plasma level of testosterone in adult males in vivo, suggesting that scalp hair growth may be critically controlled by testosterone in adult males.

Further study on gas phase acid hydrolysis of protein: improvement of recoveries for tryptophan, tyrosine, and methionine

A novel method for vapor phase acid hydrolysis of protein suitable for quantitative analysis of tryptophan is presented. The hydrolysis is carried out in vapor of a mixture made of 7 M HCl, 10% trifluoroacetic acid, and 20% thioglycolic acid in the presence of indole. Reasonably good recoveries of common amino acids, including tryptophan (above 75%), were achieved.

[Rothmund-Thomson's syndrome--a case demonstrating prominent hyperkeratosis and literature review]

A patient, 21-year-old japanese man demonstrating many of the changes seen in the Rothmund-Thomson's syndrome is presented. In particular the hyperkeratosis palmo-plantar hyperkeratosis and warty hyperkeratosis on the hand and feet are prominent clinical features in this patient. The literatures describing hyperkeratosis in the Rothmund-Thomson's syndrome are reviewed and the clinical feature as well as diagnostic value of the hyperkeratosis is discussed.

Long-term organ culture of rabbit skin: effect of EGF on epidermal structure in vitro

A method is described for maintaining the epidermal structure of normal rabbit ear skin explants in organ culture for up to 12 weeks. Split-thickness skin specimens were put in diffusion chambers made of either millipore filters or bovine collagen membranes, and then submitted to a roller tube culture at 15 rpm and 36 degrees C. The culture medium was Dulbecco's modified Eagle's medium (DMEM) supplemented with 20% fetal calf serum (FCS) + 0.4 micrograms/ml hydrocortisone. The gas used in the culture tube was air + 5% CO2. Autoradiography revealed the incorporation of [3H]-glycine into the 68-kD keratin band of explants for up to 12 weeks, indicating that normal keratinization was maintained throughout the entire culture period. The turnover time of the epidermis from basal layer to granular layer was around 7 d in both the early and late stages of culture. The addition of epidermal growth factor (EGF) to the culture caused the epidermis to become acanthotic with orthokeratosis, but with high concentrations of EGF (greater than or equal to 10 ng/ml) parakeratosis and increased proliferation of the epidermis occurred. Dexamethasone (DMS) strongly inhibited the EGF effect.

Benign infantile epilepsy with complex partial seizures

Benign infantile epilepsy with complex partial seizures is characterized by a high incidence of family history of benign childhood convulsions, normal development prior to onset, infantile onset, no underlying disorders, no neurological abnormalities, normal interictal EEGs, good response to treatment, and complete remission with normal developmental outcome. Seizures often occur in clusters, consisting of motion arrest, decreased responsiveness, staring or blank eyes mostly with simple automatisms, and mild convulsive movements associated with focal paroxysmal discharges, most frequently in the temporal area.

Cerebral infarcts and seizures in the neonate

A retrospective analysis was performed on 54 infants who suffered perinatal hypoxic-ischemic insults and came to autopsy, in an attempt to assess the association of cerebral infarcts with seizures. Fifty infants had several types of cerebrovascular lesions, including intraventricular hemorrhage (32 cases), periventricular leukomalacia (24), ischemic neuronal necrosis (18), pontosubicular necrosis (12), cerebral infarct (9), and cerebellar hemorrhage (7). Of these infants, nine had electroencephalographic seizures. Among a variety of cerebrovascular lesions, cerebral infarcts represented the single lesion most highly correlated with seizures. The incidence of seizures in infants with cerebral infarcts (44%) was significantly higher than with other types of vascular lesions.

[Suspected germ cell tumor in bilateral basal ganglia with progressive dystonia]

We report an 11-year-old boy with left pyramidal signs followed by progressive dystonia, mental deterioration, bradykinesia and bradyarthria. Evaluation included a CT scan which showed bilateral lesions in the basal ganglia, and an elevated serum B-HCG. Those findings suggested a germ cell tumor. The patient was treated with radiation therapy with improvement in neurologic deficits, decreased size of the lesions on CT and a decline in serum B-HCG. The clinical response to radiation treatment is compatible with a germ cell tumor.

[Surgical treatment of massive pulmonary embolism--the time of the operation and its effectiveness]

The records of 6 patients undergoing pulmonary embolectomy for massive pulmonary embolism (MPE) at Kurume University Hospital during 17 years were reviewed to determine the management of surgery. The patients consisted of 2 men and 4 women. The patients' ages ranged from 29 to 68 years (mean age, 49.3 years). The records showed that one patient died of brain death after operation and the others survived. All the patients complained of chest pain, anterior chest discomfort and dyspnea. Sudden syncope was observed in 2 patients. Artificial mechanical ventilation was performed preoperatively on 3 patients. Right ventricular load was demonstrated on electrocardiograms and ultrasonograms. Pulmonary angiograms were attempted on two patients and one of them had cardiac arrest during this examination. MPE was suspected by perfusion defect of 50% to 80% of pulmonary vasculature demonstrated on lung perfusion scintigram in 4 patients. Open pulmonary embolectomy with cardiopulmonary bypass (CPB) was performed on all patients using crystalloid cardioplegia and topical cooling. Intraoperative pulmonary angiograms were performed in 4 patients to prevent residual thromboemboli. Since most thromboemboli originate below the level of the vena cava, acute double ligation of the vena cava just below the renal vein was performed to control recurrent embolism. Oral anticoagulant, warfarin, was administered for 3 months after embolectomy as prophylaxis against postoperative recurrent embolism. It is our opinion that an aggressive attitude toward pulmonary embolectomy on CPB is necessary to save lives of MPE patients. This surgical procedure is very easy and safe.

[Left atrial thrombosis after mitral valve replacement]

Thrombosis of the left atrium is a rare but troublesome complication of the mitral valve replacement (MVR). In our series of MVR, seven patients had thrombus formation of the left atrium late after MVR. These seven cases (LAT group) are compared with 53 cases (no LAT group), who are picked up randomly and have no thrombus of the left atrium after MVR, concerning to some risk factors. And the result is that the left atrial volume shows a significant difference between two groups among the risk factors. We consider that the cases with enlarged left atrium have a high risk of thrombus formation after MVR and so they also need a plication of the left atrium at the primary operation.

Human squamous cell carcinoma from skin: establishment and characterization of a new cell line (HSC-5)

A new cell line, designated as HSC-5 and derived from human skin squamous cell carcinoma (SCC), has been established in vitro and maintained proliferative in continuous tissue culture for over two years. The cells grow in a monolayer in vitro and have anaplastic epithelioid features. The doubling time was about 35 hr at the 30th passage. Chromosome analysis showed hypotetraploidy with a modal number of 76. A trial of transplantation of the cultured cells into nude mice was not successful. Analysis of cytokeratins from HSC-5 by two-dimensional gel electrophoresis revealed polypeptides No. 5, 8, 13, 18 and 19. The cell line is available to other investigators.

[Three cases with electrocardiographic changes suggesting myocardial infarction]

We had three cases that showed electrocardiographic changes suggesting myocardial infarction during or soon after operation. All cases were elderly for open abdominal operation complicated with carcinoma or infection. They were different from typical myocardial infarction in progress of electrocardiographic changes, increase of myocardial enzyme, autopsy and so on. Kuramoto et al. reported in some cases myocardial infarction could not be recognized at autopsy in spite of electrocardiographic changes suggesting myocardial infarction during gastric operation of the elderly, and they advocated an idea of "reversible myocardial infarction". These three cases were also thought to be consistent with this disorder.

Characteristics of cytokeratins from stratum corneum of palms

We have examined cytokeratins from stratum corneum (s. corneum) of the palm and back of hands by biochemical techniques which characterize cytokeratin No. 9 (CK9). By two-dimensional gel electrophoresis, cytokeratins from s. corneum of the palm (PSC) were resolved into three spots (designated as CK-A, CK-B and CK-C by us), and cytokeratins from s. corneum of the back of hands (BSC) were resolved into two spots (CK-A and CK-C). The results of polypeptide mapping and the spot positions in two-dimensional gels suggest that CK-A, CK-B and CK-C are degraded products derived from CK1/2, CK9 and CK10/11 in living keratinocytes of epidermis, respectively. While the spots of CK-A and CK-B were prominent and the spot of CK-C was very weak in PSC, the spots of CK-A and CK-C were prominent and the spot of CK-B was not detected in BSC. In filament reconstitution in vitro, cytokeratins from PSC formed intermediate-sized filaments similar to those commonly observed using cytokeratins from whole epidermis. In contrast, cytokeratins from BSC formed only short filaments and small granules. In order to examine this difference in detail, polypeptides were eluted electrophoretically from gel slices containing spots. Addition of eluted CK-B to cytokeratins from BSC promoted the formation of intermediate-sized filaments similar to those from PSC. Furthermore, although the mixture of eluted CK-A and CK-C did not form intermediate-sized filaments, the combination of CK-A and CK-B alone did form them.(ABSTRACT TRUNCATED AT 250 WORDS)