Clinical experience with incidentally discovered pheochromocytoma

PURPOSE

We reviewed 17 resected pheochromocytomas comprising 7 from symptomatic patients, and 10 unsuspected and incidentally discovered tumors. We compared various parameters concerning these 2 groups and investigated the features of the incidentally discovered pheochromocytoma.

MATERIALS AND METHODS

Patient gender and age, clinical symptoms and signs, tumor localization, detection methods, findings on imaging studies, urinary catecholamine concentrations, results of metoclopramide stimulation tests, treatments at operation and tumor size were evaluated. Furthermore, we compared the clinically diverse aspects arising between the symptomatic and incidentally discovered pheochromocytomas.

RESULTS

The 24-hour urinary noradrenaline and vanillylmandelic acid levels in the incidental cases tended to be lower than those in the symptomatic cases, while 24-hour urinary dopamine was significantly less (468 +/- 221 compared to 1,558 +/- 899 microg./day, respectively). Typical symptoms of pheochromocytoma were noted in 6 patients (60%) in the incidental tumor group. The incidental cases had a markedly high false-negative rate (71%) as noted by the metoclopramide stimulation test, although the symptomatic cases had a 100% positive rate. On the other hand, the average diameter of incidental tumors was significantly larger than that of the symptomatic lesions (55.5 +/- 19.1 versus 35.9 +/- 12.1 mm., respectively).

CONCLUSIONS

Clinical signs and findings in patients with incidental tumors were weaker than those with symptomatic disease although most incidental tumors functioned. Lower urinary catecholamine values in the incidental tumors were consistent with these results. However, the surgical risk for incidental tumors was the same as that for symptomatic lesions. Therefore, patients with incidentally discovered pheochromocytomas scheduled to undergo surgery should be treated accordingly.

The value of serum carboxyterminal propeptide of type 1 procollagen in predicting bone metastases in prostate cancer

PURPOSE

Carboxyterminal propeptide of type 1 procollagen (P1CP) is believed to be a marker of new bone formation. We investigated the possible application of serum P1CP as a biochemical marker for bone metastases in patients with prostate cancer.

MATERIALS AND METHODS

Prostate specific antigen (PSA), prostatic acid phosphatase (PAP), P1CP and alkaline phosphatase were measured in 136 serum samples from 79 patients with untreated prostate cancer, 29 with stage D2 disease in remission and 28 with progressive stage D2 carcinoma.

RESULTS

Serum P1CP and alkaline phosphatase were significantly elevated in untreated patients with a positive bone scan (278.9 +/- 61.9 ng./ml. and 826.5 +/- 176.3 international units per 1., respectively) compared to those with a negative bone scan (104.2 +/- 4.2 and 200.8 +/- 9.1, respectively, p <0.05). The areas under receiver operating characteristics curves were 0.86 for P1CP, 0.87 for alkaline phosphatase, 0.88 for PSA and 0.85 for PAP. The best accuracy rates for P1CP, alkaline phosphatase, PSA and PAP to predict bone lesions were 84, 87, 86 and 84%, respectively. P1CP provided a greater specificity and positive predictive value. These serum markers correlated significantly with the extent of disease on bone scan (p <0.05). The incidence of positive serum P1CP and alkaline phosphatase decreased significantly in response to endocrine therapy in patients with bone metastasis, and increased progressively in association with progression of the tumor (p <0.05) parallel to PSA and PAP.

CONCLUSIONS

These findings suggest that serum P1CP is a useful indicator for predicting bone metastases.

Two components of transmitter release in retinal bipolar cells: exocytosis and mobilization of synaptic vesicles

Ca2+-transmitter release coupling was examined using bipolar cells with large presynaptic terminals dissociated from the goldfish retina. Presynaptic Ca2+ current (I(Ca)) was recorded under the whole-cell voltage clamp. Release of excitatory amino acid transmitter was simultaneously monitored as the current through N-methyl-D-asperate (NMDA) receptors of reporter cells or as the membrane capacitance (C(m)) change associated with exocytosis. When I(Ca) was activated by a long depolarizing pulse, a double-peaked transmitter-induced current (I(tr)) was elicited in reporter cells. The rapid component of I(tr) was evoked immediately after the onset of depolarization, and was affected only slightly by intracellularly applied Ca2+ chelators. The delayed slow component of I(tr) was elicited during depolarization once a fixed amount of Ca2+ was accumulated in presynaptic terminals, and its appearance was suppressed or retarded by Ca2+ chelators. Two components of transmitter release were also recognized by monitoring C(m) changes elicited by the activation of I(Ca). These results suggest that bipolar cells have at least two pools of synaptic vesicles; a small, immediately releasable pool and a large releasable pool. The rapid and the delayed slow components of transmitter release may reflect exocytosis and mobilization of synaptic vesicles, respectively.

Electrophysiological characterization of cultured hepatic stellate cells in rats

This study aimed to examine electrophysiological properties of cultured rat hepatic stellate cells (HSCs) using the whole cell configuration of patch-clamp technique. At least three different current components were identified. First, when the membrane was depolarized to voltages more positive than -40 mV, a transient outward K+ current was evoked. Second, membrane hyperpolarization below -60 mV evoked a sustained and inward-rectifying K+ current. The third component was a current flowing outward, which was activated when the cell was depolarized more positively than 0 mV. The channel for this current allowed Na+, K+, and Cl- to pass nonspecifically, suggesting the presence of hemi gap-junctional channel. Furthermore, a laser photobleaching technique revealed the presence of gap junctions between adjacent HSCs. A voltage-gated Ca2+ current, which is known to occur in smooth muscle cells, was searched for but was not detectable. These results suggest that membrane potential of HSCs is determined specifically by the two distinct K+ channels and by an intercellular mechanism involving gap-junctional communication.

Ca2+ -activated K+ current at presynaptic terminals of goldfish retinal bipolar cells

Properties of the Ca2+ -activated K+ current (I[K(Ca)]) were investigated in bipolar cells isolated from the goldfish retina. Pharmacological experiments and single channel current recordings demonstrated that I[K(Ca)] represented currents through BK channels, which were confined mostly to the presynaptic terminal. The ensemble noise analysis of I[K(Ca)], which was evoked following the activation of presynaptic Ca2+ current, revealed that the single channel conductance and open probability (P(o)) were approximately 50 pS ([K+]o = 2.6 mM, [K+]i = 140 mM) and 0.6 at 0 mV, respectively. To estimate [Ca2+]i at the cytosolic side of BK channels, activation of I[K(Ca)] was examined in Ca2+-loaded bipolar cells bathed in Co2+ solution. [Ca2+]i was monitored using furaptra fluorimetry. It was found that [Ca2+]i ranged between 10 and 20 microM when P(o) was 0.6. A high concentration of BAPTA ( > 20 mM) was required to suppress I[K(Ca)]. Under this condition, channel number was reduced without changing P(o). Therefore, it is likely that some BK channels are co-localized with Ca2+ channels in presynaptic terminals of retinal bipolar cells.

Molecular cloning and characterization of rab27a and rab27b, novel human rab proteins shared by melanocytes and platelets

Rabs are prenylated, membrane-bound proteins involved in vesicular fusion and trafficking. We isolated the complete cDNAs of two rab isoforms, rab27a and rab27b, from human melanoma cells and melanocytes, Rab27a is the human homolog of a rat megakaryocyte rab called ram p25. Rab27b corresponds to a small GTP-binding protein, c25KG, which was previously purified from platelets but whose cDNA had not been cloned. Sequence comparisons with known rabs indicate that rab27a and rab27b comprise a melanocyte/platelet subfamily within the rab family. In addition, rab27a was expressed in a large variety of cell and tissue types, excluding brain, and rab27b manifested itself primarily in testis. Bacterially expressed and purified rab27a and rab27b exhibited GTP-binding activity and can now be used for antibody production and studies of the substrate specificities of geranylgeranyl transferase. In addition, the expression of rab27a and rab27b in both melanocytes and platelets makes them candidates for involvement in mouse and human disorders characterized by the combination of pigment dilution and a platelet storage pool defect.

Evidence to suggest that expression of MITF induces melanocyte differentiation and haploinsufficiency of MITF causes Waardenburg syndrome type 2A

MITF (microphthalmia-associated transcription factor) encodes a transcription factor with a basic-helix-loop-helix-leucine zipper (bHLH-Zip) motif. Ectopic expression of MITF is found to convert NIH/3T3 fibroblasts into cells with characteristics of melanocytes. MITF transfectants formed foci, which superficially resembled those induced by oncogenes, but did not exhibit malignant phenotypes. Instead, they contained dendritic cells that express melanogenic marker proteins such as tyrosinase and tyrosinase-related protein 1. Such properties were not observed in cells transfected with the closely related gene, TFE3. These findings indicated that MITF is involved in melanocyte differentiation. Two mutations (C760-->T and C895-->T) in MITF are found to be associated with individuals with Waardenburg syndrome type 2 (WS2). These mutations create stop codons in exon 7 and 8, respectively, and probably result in truncated proteins lacking HLH-Zip or Zip structure. To understand how these MITF mutations cause WS2 in heterozygotes, mutant MITF proteins were generated and used for DNA-binding and luciferase reporter assays. The mutated MITF proteins lose their DNA-binding activity and fail to transactivate the promoter of the tyrosinase gene. However, these mutated proteins do not appear to interfere with the activity of wild-type MITF protein in these assays, indicating that they do not show a dominant-negative effect. These findings suggest that the phenotypes of the two WS2 families are caused by loss-of-function mutations in one of the two MITF alleles, resulting in haploinsufficiency of the MITF protein, the transcription factor necessary for normal melanocyte differentiation.

[Assessment of surgery for primary lung cancer with dissemination or malignant effusion of pleura (T4 advanced lung cancer)]

Twenty-four cases of primary lung cancer with dissemination or malignant effusion of pleura detected preoperatively or intraoperatively were surgically treated at our hospital. Mean survival time (MST) and two-year survival rate (2 YSR) were analyzed on their resected cases and non-resected cases with similar lesion. MST and 2 YSR of 19 cases with lobectomy, 5 cases with pneumonectomy including pleuropneumonectomy and 15 cases with no surgical procedure were 2.77 +/- 0.60 years, 53.4%, 1.51 +/- 0.50 years, 26.7% and 0.99 +/- 0.15 years, 6.7%. MST and 2 YSR of 13 cases with lymph node dissection under R 1 and 6 cases over R 2 on lobectomy group were 1.99 +/- 0.38 years, 37.5% and 5.66 +/- 1.71 years, 66.7%. These findings suggested that lobectomy with lymph node dissection of R 2 over may be a beneficial treatment of lung cancer with dissemination or malignant effusion of pleura.

Granulocyte colony-stimulating factor receptor expression on human transitional cell carcinoma of the bladder

Receptors for granulocyte colony-stimulating factor (G-CSFRs) have been confirmed on the cell surfaces of several non-haematopoietic cell types, including bladder cancer cells. This observation has naturally led to the hypothesis that the expression of G-CSFR on these cells may enhance their growth by G-CSF. In this study, the expression of G-CSFR was determined in both established human bladder cancer cell lines and primary bladder cancers. We studied five different human bladder cancer cell lines (KU-1, KU-7, T-24, NBT-2 and KK) and 26 newly diagnosed bladder tumours. G-CSFR mRNA expressions on cultured cell lines were determined using the reverse transcriptase polymerase chain reaction (RT-PCR) method. Furthermore, the G-CSFR binding experiments on the cultured cell lines were conducted using the Na(125)I-labelled G-CSF ligand-binding assay method. Moreover, the G-CSFR mRNA expressions on primary bladder tumour specimens were assessed using the in situ RT-PCR method. Three out of the five cultured cell lines (KU-1, NBT-2 and KK) exhibited G-CSFR mRNA signals when the RT-PCR method was used. The G-CSFR binding experiments showed an equilibrium dissociation constant (K[d]) of 490 pM for KU-1, 340 pM for NBT-2 and 103 pM for KK cells. With in situ RT-PCR, the tumour cells of 6 out of 26 primary bladder tumour specimens (23.1%) presented positive G-CSFR mRNA signals. Thus, in this study, G-CSFR expression was frequently observed on bladder cancer cells. Therefore, the clinical use of G-CSF for patients with bladder cancer should be selected with great care.

ACTH-independent bilateral macronodular adrenocortical hyperplasia caused Cushing's syndrome

A 53-year-old man who had been followed up for the treatment of hypertension presented with a bilateral adrenal mass during a screening CT scan. Other imaging studies and biochemical tests suggested Cushing's syndrome caused by a pituitary-independent and adrenal-dependent bilateral adrenal tumor. A total adrenalectomy was performed and the pathological appearance of the surgical specimen showed adrenal hyperplasia. Therefore, these findings were considered to be consistent with ACTH-independent bilateral macronodular adrenal hyperplasia (AIMAH). This tumor is quite rare and its etiology still remains controversial. We herein report this incidentally found AIMAH and also review the pertinent literature.

Resection of the caudate lobe of the liver for primary and recurrent hepatocellular carcinomas

BACKGROUND

Resection of the caudate lobe of the liver to treat malignancies has recently received attention, but long-term results after such resection for hepatocellular carcinoma have not been reported for an acceptable number of patients. This study analyzed the short- and long-term results after resection of the caudate lobe for primary and recurrent hepatocellular carcinoma in 19 patients.

STUDY DESIGN

Complete or partial resection of the caudate lobe was performed for the treatment of primary (n = 13) and recurrent (n = 6) hepatocellular carcinoma. Eleven patients had a solitary tumor only in the caudate lobe, but eight patients had tumors in other segments of the liver as well. There were 16 men and 3 women. Age ranged from 35 to 79 years, averaging 63 years. Clinicopathologic features of these cases were evaluated from various viewpoints.

RESULTS

The duration of the operation ranged from 80 to 250 minutes (mean plus or minus standard deviation; 149 +/- 47) and blood loss from 200 to 2,400 g (836 +/- 651). Four patients (21.8 percent) had postoperative complications and one (5.3 percent) died of postoperative variceal bleeding. Tumor size ranged from 1.0 to 6.0 cm, averaging 3.7 +/- 1.4. A capsule was seen around the tumor in 68.4 percent, daughter nodules in 5.3 percent, and vascular invasion in 31.2 percent. Hepatic cirrhosis was present in 15 patients and chronic hepatitis in four. The 5-year survival rate in all patients was 31.3 percent. The survival rate was significantly better in patients with primary hepatocellular carcinoma than in those with recurrent tumors (49.2 percent compared with none) because of frequent recurrence in the latter group.

CONCLUSIONS

Resection of the caudate lobe of the liver for hepatocellular carcinoma associated with chronic hepatic disease can be performed safely with a satisfactory long-term result, particularly in patients with primary tumors in this lobe.

Co-receptor-independent signal transduction in a mismatched CD8+ major histocompatibility complex class II-specific allogeneic cytotoxic T lymphocyte

The contribution of co-receptors in signal transduction upon T cell receptor (TCR)-mediated recognition of major histocompatibility complex (MHC) class II antigen by mature T lymphocytes expressing TCR derived from the apparently co-receptor-independent, I-Ak-specific allogeneic CD8+ CTL clone QM11 has been examined. Mature double-negative, CD8+ and CD4+ bulk T cell lines and clones expressing TCR(QM11) were developed from TCR(QM11) transgenic mice. All these T cells, irrespective of co-receptor expression, showed specific lytic activity on cells expressing I-Ak. Furthermore, co-receptorless mutants were obtained from a CD4+ and CD8+ clone. The responses of these co-receptorless mutants upon specific recognition of the alloantigen, as judged by cytolytic activity, granule exocytosis, lymphokine production, proliferation, and tyrosine phosphorylation of the zeta chain, were comparable to those of the original clones. Thus, the results proved the co-receptor independence of the recognition of I-Ak by TCR(QM11) and further indicated there is no indispensable unique signal transduced by co-receptors. However, when the amount of the available antigen was limited by anti-I-Ak antibody, the CD4+ T cell clone showed a remarkable resistance to the inhibition whereas the mismatched CD8+ clone was readily inhibitable. The anti-I-Ak-resistant component of the CD4+ clone showed dependency on the CD4 molecule. Taken collectively, the results indicate that the role played by a co-receptor molecule in mature T cells is purely quantitative amplification of the signal through the formation of a TCR/MHC/co-receptor ternary complex, and also indicate that the role of co-receptor molecules as TCR-independent adhesion molecules is at best minimal.

Autocrine growth induced by transferrin-like substance in bladder carcinoma cells

Ample evidence confirms that certain cancer cells have the capacity to produce multiple peptides as growth factors and that expression of their receptor may act in tumour cell paracrine and/or autocrine loop mechanisms, either by extracellular release of the growth factor or by the tumour itself. To study the possibility of an autocrine growth mechanism in bladder carcinoma, we investigated the ability of various bladder carcinoma cell lines to proliferate in serum-free medium. A rat bladder carcinoma cell line, BC47, demonstrated exponential and density-dependent growth in serum-free medium. Furthermore, conditioned medium from BC47 cells induced growth-stimulating activity for BC47 cells themselves. Purification and further characterization of this activity was performed by chromatographic methods, SDS-PAGE and N-terminal amino acid analysis. Finally, we have identified that a transferrin-like 70-kDa protein is found to be the main growth-promoting factor in this conditioned medium. In addition, specific antibodies against transferrin and the transferrin-receptor inhibit the in vitro growth of this cell line. Our data suggest that this transferrin-like factor possibly acts as an autocrine growth factor for cancer cells.

Comparative analysis of the gp120-binding area of murine and human CD4 molecules

The structural basis for the difference between human and murine CD4 molecules in binding to HIV envelope protein gp120 has been intensively studied. Eighteen mutant human CD4 molecules were produced by segmental replacement of beta strands and loops in the gp120-binding area of the molecule with corresponding murine sequences or by single amino acid substitutions. Examination of these mutant CD4 molecules for gp120 binding indicated that murine CD4 molecule does not bind gp120 for the following three reasons: (a) The loops flanking the C" strand are longer than their human counterparts, causing significant difference in local tertiary structure; (b) valin, rather than phenylalanine, which is the key amino acid for the binding occupies position 43; (c) amino acids at positions 45 and 46 are different, causing further decrease in binding affinity. Furthermore, the present study indicated that the aromatic ring of Phe43 and the negative charge of Arg59 play key roles in gp120 binding.

Constitutive production of multiple cytokines and a human chorionic gonadotrophin beta-subunit by a human bladder cancer cell line (KU-19-19): possible demonstration of totipotential differentiation

Bladder cancer cells have been shown to secrete a variety of factors that are not related to cells of urothelial origin. The histogenesis of these tumour developments is uncertain, and a variety of theories have been previously reported. In the present manuscript, we identify the factors constitutively produced by a human bladder cancer cell line (KU-19-19) that was found to produce beta human chorionic gonadotrophin (beta-hCG), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin 1alpha (IL-1alpha), interleukin 6 (IL-6) and interleukin 8 (IL-8). The cells were obtained from a case of metastatic carcinoma that was originally diagnosed to be a grade 3 (WHO classification), invasive transitional cell carcinoma of the bladder. On microscopic observation, the cultured cells exhibited an epithelial appearance with vacuole formation in their cytoplasm. Ultrastructural observations revealed relatively marked microvilli and a tight junction. Significant amounts of beta-hCG, G-CSF, GM-CSF, IL-1alpha, IL-6 and IL-8 concentrations in the supernatant from cultured cells were demonstrated by enzyme-linked immunosorbent assays, while the expression of mRNA of these marker proteins in cancer cells was also significantly exhibited by reverse transcription polymerase chain reaction (RT-PCR). In addition, the expression of G-CSF receptor and IL-6 receptor mRNA was also shown by RT-PCR. Xenograft transplantability using nude mice was observed in association with the presence of severe neutrophilia in the peripheral blood. These results indicate that this cell line appears to be an effective model for the study of transitional cell carcinoma of the bladder with multipotent differentiation potentials.

Role of reactive oxygen species in cis-dichlorodiammineplatinum-induced cytotoxicity on bladder cancer cells

This study was undertaken to investigate the intracellular induction of reactive oxygen species (ROS) by cis-dichlorodiammineplatinum (CDDP) and the augmentation of their cytotoxicity in bladder cancer cells (KU7) by enhancement of ROS generation by the glutathione (GSH) depletors buthionine sulphoximine (BSO) and diethylmaleate (DEM). CDDP-induced cytotoxicity in KU7 cells and its modulation by GSH depletors were determined using spectrophotometric measurement with crystal violet staining. The effects of GSH depletors on intracellular GSH levels were confirmed using the GSH reductase-DTNB recycling method. Intracellular ROS generation induced by CDDP with or without GSH depletors was estimated from the amount of intracellular dichlorofluorescein (DCF), an oxidized product of dichlorofluorescein (DCFH), which was measured with an anchored cell analysis and sorting system. The cytotoxic effects of CDDP (IC50 15.0 +/- 2.5 microM) were significantly enhanced by BSO (IC50 9.3 +/- 2.6 microM, P < 0.01) and DEM (IC50 10.3 +/- 0.3 microM, P <0.01). BSO and DEM produced a significant depletion in intracellular GSH levels (9.6 +/- 0.4 nmol 10(-6) cells, 17.9 +/- 1.0 nmol 10(-6) cells) compared with the controls (30.5 +/- 0.6 nmol 10(-6) cells). Intracellular DCF production in KU7 cells treated with CDDP (1.35 +/- 0.33 microM) was significantly enhanced by the addition of BSO (4.43 +/- 0.33 microM) or DEM (3.12 +/- 0.22 microM) at 150 min. These results suggest that ROS may play a substantial role in CDDP-induced cytotoxicity and that GSH depletors augment its cytotoxicity through an enhancement of ROS generation in bladder cancer cells.

Prognostic significance of proliferating cell nuclear antigen (PCNA) in squamous cell carcinoma of the esophagus

Proliferating cell nuclear antigen (PCNA) has been shown to be of prognostic significance in some gastrointestinal tumors. Immunohistochemical analysis was performed to determine whether PCNA is useful for predicting the outcome of patients with squamous cell carcinoma of the esophagus. Using a mouse monoclonal antibody, PC 10, the expression of PCNA was studied in resected squamous cell carcinomas of the esophagus from 59 patients who had undergone curative esophagectomy. None had received any preceding therapy. The proliferation rate was assessed in terms of the percentage of the PCNA-positive nuclear area relative to the total area of cancer nuclei using a cell analysis system (CAS). Clinicopathological variables including PCNA staining were assessed in relation to prognosis. Survival rate was obtained by the Kaplan-Meier method. The PCNA indices (percentage of the positive nuclear area) of the tumors varied from 4.4% to 96.2%. Among the clinicopathological variables, only tumor size (5 cm) and depth of invasion were correlated significantly with PCNA index (P<0.05). Microscopically, PCNA was stained in non-keratinized cells but not in keratinized cells. However the histological grade was not correlated with PCNA index. The survival rate was significantly worse in patients with high PCNA indices (> or = 40%) than in those with low indices (<40%) (P<0.05). However, multivariate analysis revealed that PCNA index was not an independent prognostic factor.

Mechanism for aromatase inactivation by a suicide substrate, androst-4-ene-3,6,17-trione. The 4 beta, 5 beta-epoxy-19-oxo derivative as a reactive electrophile irreversibly binding to the active site

Aromatase is a cytochrome P450 enzyme complex that catalyzes the conversion of androst-4-ene-3,17-dione to estrone through three sequential oxygenations of the 19-methyl group. Androst-4-ene-3,6,17-trione (1) is a suicide substrate of aromatase. The inactivation mechanism for steroid 1 has been studied to show that the inactivation reaction proceeds through the 19-oxo intermediate 3. To further clarify the mechanism, 4 beta, 5 beta-epoxyandrosta-3,6,17,19-tetraone (6) was synthesized as a candidate for a reactive electrophile involved in irreversible binding to the active site of aromatase, upon treatment of compound 3 with hydrogen peroxide in the presence of NaHCO3. The epoxide 6 inhibited human placental aromatase in a competitive manner (Ki = 30 microM); moreover, it inactivated the enzyme in an active-site-directed manner in the absence of NADPH (K1 = 88 microM, kinact = 0.071 min-1). NADPH and BSA both stimulated the inactivation rate without a significant change of the K1 in either case (kinact: 0.133 or 0.091 min-1, in the presence of NADPH or BSA, respectively). The substrate androst-4-ene-3,17-dione protected the inactivation, but a nucleophile, L-cysteine, did not. When both the epoxide 6 and its 19-methyl analog 4 were subjected separately to reaction with N-acetyl-L-cysteine in the presence of NaHCO3, the 19-oxo steroid 6 disappeared from the reaction mixture more rapidly (T1/2 = 40 sec) than the 19-methyl analog 4 (T1/2 = 3.0 min). The results clearly indicate that the 4 beta, 5 beta-epoxy-19-oxo compound 6, which is possibly produced from 19-oxo-4-ene steroid 3 through the 19-hydroxy-19-hydroperoxide intermediate, is a reactive electrophile that irreversibly binds to the active site of aromatase.

Inhibition of growth and induction of TGF-beta 1 in human hepatocellular carcinoma with androgen receptor by cyproterone acetate in male nude mice

BACKGROUND/AIMS

Hepatocellular carcinoma possesses androgen receptor but its true role is not known. This study aimed to investigate the effect of an anti-androgen cyproterone acetate on the growth of androgen receptor-positive hepatocellular carcinoma.

METHODS

Androgen receptor-positive human hepatocellular carcinoma cells (KYN-1/SM-10) were subcutaneously transplanted into male nude mice. When the tumor size was about 10 mm, animals were subcutaneously administered cyproterone acetate (0.1 mg/day and 0.8 mg/day) or solvent alone for 21 days. Animals were serially sacrificed for measurements of testicular weight, tumor size, and cytosolic and nuclear androgen receptor levels in tumor. Proliferating cell nuclear antigen, transforming growth factor-alpha, and transforming growth factor-beta 1 in tumor were investigated immunohistochemically, using monoclonal antibodies. Apoptotic activity was also studied by the in situ DNA nick end labeling method.

RESULTS

Cyproterone acetate depressed testicular weight, suppressed tumor growth, and decreased both cytosolic-androgen receptor and nuclear-androgen receptor levels dose-dependently. Numbers of proliferating cell nuclear antigen-positive cells were decreased transiently with the low dose but continuously with the high dose of cyproterone acetate. Transforming growth factor-alpha expression was not influenced by cyproterone acetate, but the high dose of cyproterone acetate induced higher expression of transforming growth factor-beta 1, associated with increased numbers of apoptotic tumor cells, peaking on day 3.

CONCLUSIONS

The inhibition of growth of androgen receptor-positive hepatocellular carcinoma with cyproterone acetate in male nude mice could be due to G1-phase cell cycle arrest, and to some extent apoptosis induced by increased synthesis of transforming growth factor-beta 1 in tumor, caused by the direct action of cyproterone acetate through androgen receptors, as well as decreased testosterone levels in blood due to cyproterone acetate-induced testicular atrophy.

Incidence of p53 and Ha-ras gene mutations in chemically induced rat mammary carcinomas

To determine whether p53 alterations, which are frequent in human breast cancers, are also common in rat mammary tumors, we examined 40 tumors from 24 rats treated with 7,12-dimethylbenz[a]anthracene (DMBA) and 34 tumors from 14 rats treated with N-nitroso-N-methylurea (NMU) (an N-nitroso compound). DMBA and NMU are known genotoxic mutagens. The entire coding regions of the p53 and Ha-ras genes were examined for mutations by polymerase chain reaction single-strand conformational polymorphism analysis and by direct sequencing. One of the 40 DMBA-induced mammary tumors had a p53 mutation, a single-base substitution (AGC-->GGC) at codon 307, resulting in an amino-acid change from Ser to Gly. No mutations were found in NMU-induced tumors. The incidence of Ha-ras gene mutation was 79% (27 of 34) at codon 12 in the NMU group and 23% (nine of 40) at codon 61 in the DMBA group. Thus, p53 mutation, in contrast to Ha-ras mutation, did not seem to be a prerequisite for carcinogenesis in chemically induced rat mammary tumors.

Molecular cloning of two novel rab genes from human melanocytes

We isolated the genes of two small GTP-binding proteins of the rab family from a human melanocyte cDNA library and from melanoma cells. One gene, rab30 codes for a novel rab protein of 203 amino acids with minimal homology to previously documented GTPases. The other, rab22b, appears to be an isoform of the human homologue of canine rab22. Both rab mRNAs displayed a nearly ubiquitous pattern of expression in the various tissues examined. Rab22b and rab30 were mapped to chromosomes 18 and 11, respectively.

Ectopic expression of MITF, a gene for Waardenburg syndrome type 2, converts fibroblasts to cells with melanocyte characteristics

MITF (microphthalmia-associated transcription factor) encodes a transcription factor with a basic-helix-loop-helix-zipper (bHLH-Zip) motif. MITF mutations occur in patients with Waardenburg syndrome type 2, a disorder associated with melanocyte abnormalities. Here we show that ectopic expression of MITF converts NIH/3T3 fibroblasts into cells with characteristics of melanocytes. MITF transfectants formed foci of morphologically altered cells, which resemble those induced by oncogenes, but did not exhibit malignant phenotypes. Instead, they contained dendritic cells that express melanogenic marker proteins such as tyrosinase and tyrosinase-related protein 1. Most cloned cells of MITF transfectants exhibited dendritic morphology and expressed melanogenic markers, but such properties were not observed in cells transfected with closely related TFE3 cDNA. Our findings indicate that MITF is critically involved in melanocyte differentiation.

Two necropsy cases of hypertrophic cardiomyopathy in Holstein cattle

Two cases of hypertrophic cardiomyopathy in Holstein dairy cows are presented. At necropsy, the hearts revealed proportionate hypertrophy of the entire ventricles. The cut surface showed relatively large areas of myocardial scarring scattered throughout the ventricular walls including the septum. Microscopic examination revealed marked disorganization of cardiac muscle cells, intramural coronary arteries with thickened walls and narrowed lumina, and pronounced myocardial fibrosis. These features resemble those of hypertrophic cardiomyopathy in humans, suggesting the presence of a similar primary myocardial disease in cattle.

[A case of lung adenocarcinoma: detection and resection of the metastatic lesion was managed effectively by serum CEA level]

This patient, a 53-year-old male, has had back pain and an abnormal shadow was detected in the right lung field on December 1989. He was admitted to the hospital for the further examination. On the diagnosis of lung cancer with high serum CEA level operation was performed on February 1990. As a results of pathological examination, histological type was adenocarcinoma and pathological stage was pT3N0M0 stage IIIA. After operation the serum CEA level was decreased immediately but it was gradually increased once again. And then 14 months later right adrenal metastasis was detected by abdominal CT with high serum CEA level and resection was performed. Similarly a solitary lymph node metastasis located in abdomen was detected and resected with high serum CEA level 28 months after second operation. In this case detection and resection of the metastatic lesion was managed effectively by serum CEA level. The patient had a good operative course and is alive 76 months after first operation without any evidence or recurrence.

Larvicidal activity of the symbiotic bacterium Xenorhabdus japonicus from the entomopathogenic nematode Steinernema kushidai against Anomala cuprea (Coleoptera:Scarabaeidae)

The entomopathogenicity of the symbiotic bacterium Xenorhabdus japonicus and the nematode Steinernema kushidai was determined. Phase I and II X. japonicus were cultured on an artificial medium and inoculated into the test insect or established into axenic S. kushidai populations. When 100, 1000, or 10,000 bacterial cells of phase I or II were directly injected into the hemocoels of 3rd instar cupreous chafer, Anomala cuprea, both phases in the late log period killed 100% of the larvae by the 2nd day postinoculation. However, both phases in the stationary period were less pathogenic with cupreous chafer mortality < 20 and 80% at 100 and 1000 bacterial cells/ larva, respectively. In vitro studies showed that axenic S. kushidai provided with phase I or II symbionts grew well and produced equal numbers of progeny on a dog food medium, but nematodes with no symbionts did not grow at all. Pig liver extracts added as a dietary supplement to the dog food medium completely restored growth and progeny production of the nematode with no bacterial cells. Studies were conducted with infective juveniles (IJs) harboring phase I or II or no symbionts that were applied against 3rd instar cupreous chafer larvae in compost or injected directly into their hemocoels. In the compost study, IJs harboring phase I killed 100% within 10 days. IJs with phase II or no symbionts caused low mortality of the cupreous chafer larvae at 10 days (< 20%). In the intrahemocoelic injection study, IJs harboring phase I resulted in 60% larval mortality at five nematodes/larva, and as the number of IJs injected increased, significantly higher larval mortality was obtained.

Role of proliferative activity estimated by bromodeoxyuridine labeling index in determining predictive factors of recurrence in superficial intermediately malignant bladder tumors

PURPOSE

Previous studies have shown that factors predictive of tumor recurrence include a history of the disease, multiple tumors at diagnosis, and high tumor grade and stage. Additional biological marker for predicting tumor recurrence could potentially be used in the decision making process and could alter the frequency of clinical cystoscopy. We attempted to clarify whether the tumor proliferative activity estimated by bromodeoxyuridine, which is believed to be a thymidine analogue, and deoxyribonucleic acid (DNA) ploidy status correlates well with tumor recurrence as an objective parameter.

MATERIALS AND METHODS

We evaluated 103 patients with superficial grade 2 transitional cell carcinoma of the bladder treated with transurethral resection. Mean followup plus or minus standard deviation was 49.5 +/- 11.3 months (minimum 36). Tumor specimens were obtained by transurethral cold-cup biopsy, with bromodeoxyuridine in vitro pulse labeling then performed under hyperbaric oxygen. The flow cytometric determination of the bromodeoxyuridine labeled cell index and DNA ploidy were estimated.

RESULTS

When the tumor was classified according to the bromodeoxyuridine labeled cell index the 5-year no recurrence rates were 82.0 and 27.1% for an index of less than 5.3 and more than 5.3%, respectively. Furthermore, the 5-year no recurrence rates were 75.1% for DNA diploid compared to 29.3% for DNA aneuploid tumors, respectively. Multivariate analysis using Cox's proportional hazards model showed that the most important risk factor for tumor recurrence was a bromodeoxyuridine labeled cell index of more than 5.3% (risk ratio 5.31, p < 0.001), followed by DNA ploidy (risk ratio 2.61, p < 0.05). Tumor stage, initial lesion versus recurrence and single versus multiple tumors did not influence the risk factor for tumor recurrence.

CONCLUSIONS

These data indicate that bromodeoxyuridine labeling status can be used as an objective risk factor for bladder cancer recurrence.

Analyses of loss-of-function mutations of the MITF gene suggest that haploinsufficiency is a cause of Waardenburg syndrome type 2A

Waardenburg syndrome type 2 (WS2) is a dominantly inherited disorder characterized by a pigmentation anomaly and hearing impairment due to lack of melanocyte. Previous work has linked a subset of families with WS2 (WS2A) to the MITF gene that encodes a transcription factor with a basic-helix-loop-helix-leucine zipper (bHLH-Zip) motif and that is involved in melanocyte differentiation. Several splice-site and missense mutations have been reported in individuals affected with WS2A. In this report, we have identified two novel point mutations in the MITF gene in affected individuals from two different families with WS2A. The two mutations (C760--> T and C895--> T) create stop codons in exons 7 and 8, respectively. Corresponding mutant alleles predict the truncated proteins lacking HLH-Zip or Zip structure. To understand how these mutations cause WS2 in heterozygotes, we generated mutant MITF cDNAs and used them for DNA-binding and luciferase reporter assays. The mutated MITF proteins lose the DNA-binding activity and fail to transactivate the promoter of tyrosinase, a melanocyte-specific enzyme. However, these mutated proteins do not appear to interfere with the activity of wild-type MITF protein in these assays, indicating that they do not show a dominant-negative effect. These findings suggest that the phenotypes of the two families with WS2A in the present study are caused by loss-of-function mutations in one of the two alleles of the MITF gene, resulting in haploinsufficiency of the MITF protein, the protein necessary for normal development of melanocytes.

Two long-term survivors after microwave coagulation therapy for hepatocellular carcinoma: a case report

We present two long-term survivors who underwent microwave coagulation therapy (MCT) for hepatocellular carcinoma (HCC). One patient was a 55-yr-old man having a solitary HCC of 25 mm in diameter associated with advanced liver cirrhosis. He underwent MCT instead of hepatic resection because he developed bleeding tendency during surgery. The other patient was a 78-yr-old woman having a 7 cm tumor in segment II and a 15 mm satellite lesion in segment IV. Because manipulation of the left hepatic lobe caused prolonged hypotension, only the main tumor was resected. The satellite lesion was treated with MCT. In both cases, tumors and surrounding liver parenchyma were widely coagulated. Postoperative courses were uneventful. The coagulated area shrank subsequently after surgery. Both patients are alive 39 and 55 months after MCT without tumor recurrence. This report proves that MCT is a curative treatment and an alternative to hepatic resection in selected patients with HCCs.

Role of protein phosphatase in malignant osteogenic and soft tissue tumors

The expression of the three catalytic subunits of protein phosphatase (PP) type 1 and 2A, PP1 alpha, PP1 gamma 1, and PP2AC, was examined in osteogenic tumors and soft tissue tumors by immunohistochemical analysis. The percentage of cells stained positively with antiserum against PP1 catalytic subunit isoform PP1 gamma 1, was significantly higher in malignant osteogenic tumors (chondrosarcoma, osteosarcoma, and Ewing's sarcoma) and in malignant soft tissue tumors (liposarcoma and malignant fibrous histiocytoma [M.F.H.]) than in benign tumors (osteochondroma, osteoblastoma, ossifying fibroma, enchondroma and lipoma). Furthermore, the malignant tumor lesions showed a markedly high number of cells in the S-phase fraction of the cell cycle, as compared to benign tumors. These results suggest that PP1 gamma 1 is involved in the accelerated growth of malignant tumor cells.

4-Oxygenated androst-5-en-17-ones and their 7-oxo derivatives as aromatase inhibitors

A series of androst-5-ene-4,7-diones and 4-oxygenated androst-5-enes were synthesized and tested for their ability to inhibit aromatase in human placental microsomes. All of the steroids examined inhibited the enzyme in a competitive manner. The inhibitory activity of 4beta-hydroxy-5-ene steroid 7 (Ki = 25 nM) was much more powerful than that of the parent 5-ene steroid 11 (Ki = 78 nM), whereas 4beta-acetate 8 and 4-oxo analog 5 (Ki = 90 and 120 nM, respectively) were less potent than compound 11. This indicates that a hydrogen bonding between a hydroxy group of the 4beta-ol 7 and a residue of the active site of aromatase plays an important role in its binding. The 5-en-4-one steroid 5 did not cause a time-dependent inactivation of aromatase. In contrast, 5-ene-4,7-dione 13 as well as its 19-hydroxy and 19-oxo analogs 19 and 20 caused the time-dependent inactivation only in the presence of NADPH in air with the k(inact) values ranging from 0.057 to 0.192 min(-1), although their affinities for the enzyme were not high (Ki = 430-6300 nM). The inactivation was prevented by androstenedione, and no significant effect of L-cysteine on the inactivation was observed in each case. These results suggest that oxygenation at C-19 would be at least in part involved in the inactivation caused by the inhibitor 13.

Clinical application of flow cytometry to urological malignancies

Flow cytometric DNA analysis provides rapid, quantitative objective information regarding the biological behavior of urological malignancies. Moreover, clinical applications of the many recent advances made the flow cytometry are expected to materialize soon. For instance, flow cytometric DNA ploidy analysis for human bladder cancers may provide a significant diagnostic and prognostic potential. Also, flow cytometric DNA analysis of irrigation specimens produces a higher sensitivity than conventional cytology for detecting bladder cancer. However, there are obvious pitfalls with this approach since diploid or near-diploid tumors cannot always be recognized by DNA analysis alone. One of the most significant advantages possible with flow cytometry is its capability of analyzing simultaneously multiple parameter on single cells. The integration of the DNA content with proliferative activity should yield important information significant to the biological behavior of individual tumors. Flow cytometric DNA/bromodeoxyuridine bivariate analysis can be used as an effective adjunct to histological examination for prognostication and decision-making in treatment of bladder cancer patients. Therefore, multiparameteric flow cytometric analysis can be used to isolate specific tumor cells from mixed cell populations, and should receive even increased attention as a valuable diagnostic technique and prognostic factor. In the present review, the efficacy of flow cytometric DNA ploidy analysis integrated with cell proliferation markers is discussed.

Synthesis and structure-activity relationships of 6-substituted androst-4-ene analogs as aromatase inhibitors

Series of 6 alpha- and 6 beta-alkyl-substituted androst-4-en-17-ones (18 and 19) and their 17 beta-reduced derivatives (14 and 15)(alkyl: methyl, ethyl, n-propyl, n-pentyl, n-octyl) were synthesized and evaluated as aromatase inhibitors. Androst-4-en-17-ones having an oxygen function (hydroxy, acetoxy, or methoxy group) at C-6 alpha and C-6 beta (4 and 5) were also tested for their abilities to inhibit aromatase. All of the steroids studied inhibited human placental aromatase in a competitive manner. The inhibitory activities of the 6 alpha- and 6 beta-methyl-17-keto steroids 18a and 19a (Ki = 3.1 and 5.3 nM, respectively) as well as the 6 beta- alcohol 5a (Ki = 6.0 nM) were high, and their apparent Ki values were lower than that of the parent 6-unsubstituted 3-deoxy steroid 1 (Ki = 6.8 nM). Elongation of the methyl group decreased affinity for aromatase in relation to carbon number of the alkyl chain in each series, in which the 6 alpha- alkyl steroids 18 essentially had higher affinity for the enzyme than the corresponding 6 beta- isomers 19. The inhibitory activities of the 17 beta-hydroxy analogs 14 and 15 were less potent than those of the corresponding 17-keto steroids. The 6 alpha-ethyl compound 18b, the 6 alpha-oxygenated derivatives 4, and the 6 beta-acetoxy and 6 beta-methoxy analogs 5b and 5c were powerful inhibitors (Ki = 12-24 nM). The methyl steroids (18a and 19a) produced "type I" difference spectra upon interaction with aromatase. These results along with molecular modeling with the PM3 method suggest that compounds 18a and 19a may produce a thermodynamically stable enzyme-inhibitor complex in the hydrophobic binding pocket with a limited accessible volume. A carbonyl group at C-17 of the 6-alkylandrost-4-enes is essential for the tight binding. Moreover, the binding pocket also tolerates a polar hydroxy group at the 6 beta-position rather than at the 6 alpha-position.

Transurethral microwave thermotherapy for management of benign prostatic hyperplasia: durability of response

OBJECTIVES

The durability of clinical efficacy of transurethral microwave thermotherapy (TUMT) by Prostatron using a low-energy protocol (maximum power, 50 W) was evaluated on an outpatient basis in patients with symptomatic benign prostatic hyperplasia (BPH).

METHODS

One hundred eighteen patients were followed up for longer than 3 months (13.4 +/- 9.5 months; mean +/- SD). All evaluations were made at baseline and then 3, 6, 12, 24, and 36 months after therapy.

RESULTS

International Prostate Symptom Score (IPSS) significantly decreased from 18.2 to 10.6 at 6 months (P < 0.01), representing a mean improvement of 41% under the baseline. Peak flow rate increased from the baseline of 8.3 mL/s to 10.3 mL/s at 6 months (P < 0.01). The improvement in terms of mean values of both parameters was sustained up to 24 months. Six of 44 patients (14%) who were followed up for 31 months on average required transurethral resection of the prostate for recurring obstructive symptoms and 10 additional patients (23%) had to be treated with various drug regimens. When the clinical outcome was evaluated in terms of improvement from the baseline according to a response criteria, disease-free rates for IPSS (more than 25% improvement from the baseline) were 76% at 12 months, 77% at 24 months, and 61% at 36 months. Disease-free rate for peak flow rate (more than 2.5 mL/s from the baseline) was sustained in 44% by 12 months and in 48% by 24 months. The overall outcome of the treatment was assessed by adding scores based on both subjective and objective efficacy criteria. At 6 months, 67% of the patients were responders, and 15 of 21 (71%) remained as responders at 24 months. Patients who had estimated prostate volume smaller than 30 cc showed more marked improvement in peak flow rate (P < 0.02), and those with baseline IPSS of 20 or more showed greater reduction of IPSS (P < 0.05) at 24 months compared with each counterpart.

CONCLUSIONS

After TUMT with a low-energy protocol, satisfactory results were obtained and the improvement seems to last at least for 24 months. This low-energy protocol may be most beneficial in patients with relatively small size of the prostate.

Ultrastructural localization of G-protein GS in the lateral wall of the guinea pig cochlear duct

Immunocytochemical localization of a GTP-binding protein, Gs, in the various cells of the lateral wall of guinea pig cochlear duct was investigated using a post-embedding immunogold method with antibody raised against a synthetic decapeptide (RMHLRQYELL) encoding the C-terminus of the alpha-subunit of Gs. In the stria vascularis, labeling was observed on the basolateral membrane infoldings of marginal cells, on the juxtaposed membrane of intermediate cells, and on the cell membrane of basal cell. In contrast, no significant labeling was observed on the luminal membrane of marginal cells. Immunoreactivity also was detected on the cell membranes of various other cells. These include spiral prominence epithelial cells, fibrocytes of spiral ligament, external sulcus cells, and epithelial and mesothelial cells of Reissner's membrane. Adenylylcyclase has been functionally implicated in some of the cell types with membranes labeled in this study. The significance of these findings is briefly discussed.

Simultaneous early gastric cancer in identical twins: report of a case

We report the unusual case of identical male twins developing early gastric cancers that were found almost simultaneously. A 39-year-old man underwent a barium-swallow examination to investigate the cause of right hypochondrial discomfort; the examination revealed evidence of gastric cancer in the upper body of the stomach. A diagnosis of adenocarcinoma was confirmed by endoscopic biopsy, and a total gastrectomy was performed. Subsequent screening of the patient's asymptomatic identical twin revealed gastric cancer in the lower body of the stomach, for which distal gastrectomy with Billroth I reconstruction was performed. The histopathological types of the two cancers were similar and both had infiltrated the submucosa. The relevant etiological factors contributing to the development of gastric adenocarcinoma in these identical twins is discussed, following the case report.

Time-dependent inactivation of aromatase by 6-alkylandrosta-1,4-diene-3,17-diones. Effects of length and configuration of 6-alkyl group

Series of 6alpha- and 6beta-alkylandrosta-1,4-diene-3,17-diones (3 and 4) were synthesized and evaluated as time-dependent inactivators of aromatase in human placental microsomes to gain insights to the structure-activity relationship of varying the 6-n-alkyl substituents (C-1--C-7) to the time-dependent inactivation activity. All of the inhibitors synthesized were powerful to good competitive inhibitors of aromatase, with apparent Ki's ranging from 4.7 to 54 nM. The 6beta-ethyl (4b) and 6beta-n-pentyl (4e) compounds were the most potent among them (Ki = 4.7 and 5.0 nM for 4b and 4e, respectively). In a series of the 6alpha-alkyl steroids, the inhibitors 3a-d having C-1--C-4 at the 6-position as well as the 6 alpha-n-heptyl (3g) compounds did not. In contrast, in the 6beta-alkyl steroid series, only the methyl analog 4a inactivated aromatase in a time-dependent manner, and the other alkyl steroids having more than two carbons at C-6beta did not. The inactivations were prevented by the substrate androstenedione, and no significant effects of L-cysteine on the inactivation were observed in each case. These results along with molecular modeling with the PM3 method indicate that both length and stereochemistry of a straight alkyl substituent at the C-6 position of androsta-1.4-diene-3,17-dione (3h) play an important role in the cause of a time-dependent inactivation of aromatase. No significant correlation between affinity for the enzyme and the inactivation ability in the 6-alkylandrosta-1,4-diene-3,17-diones is observed.

Cytochrome P4502D and -2C enzymes catalyze the oxidative N-demethylation of the parkinsonism-inducing substance 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in rat liver microsomes

We have examined the oxidative N-demethylation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), a parkinsonism-inducing neurotoxin, in liver microsomes from adult Wistar and Dark Agouti (DA) rats. The oxidation of MPTP to 4-phenyl-1,2,3,6-tetrahydropyridine (PTP) in these preparations required NADPH as a cofactor and was significantly inhibited by SKF 525-A (2 mM). MPTP N-demethylation exhibited biphasic kinetics, consistent with two enzymes, a low Km system (Km1, 10.0 +/- 2.2 microM; Vmax1, 0.048 +/- 0.009 nmol/(min.mg of protein)) and a high Km system (Km2, 1180 +/- 91 microM; Vmax2, 4.80 +/- 0.75 nmol/(min.mg of protein)). We thus employed two substrate concentrations, 5 microM and 5 mM, for the low and high Km system, respectively, to assay enzyme activity in subsequent experiments. The oxidation activity was significantly decreased by pretreatment of rats with phenobarbital and beta-naphthoflavone. Furthermore, marked strain (Wistar > DA) and sex (male > female) differences were observed at low (5 microM) and high (5 mM) substrate concentrations, respectively. Reconstitution experiments with cytochrome P450BTL, which belongs to the P4502D subfamily, and P450m1 (P4502C11) demonstrated that MPTP N-demethylase occurs at concentrations of 5 microM and 5 mM. At 5 mM the male-specific P450m1 showed a remarkably high activity, over 400-fold that of P450BTL. Polyclonal antibodies against P450BTL and P450m1 effectively suppressed the activity at the low (5 microM) and the high (5 mM) substrate concentrations, respectively. These results suggest that, in the microsomal preparations used, MPTP N-demethylation is mainly mediated by P4502D enzyme(s) at lower substrate concentrations and by P4502C11 at higher substrate concentrations.

Newly developed equipment and methods in the treatment of BPH: analysis of present status

Benign prostatic hyperplasia (BPH) is the most common disease among the aged male population. A variety of symptoms are mainly caused by obstructive changes at the prostatic urethra. Transurethral resection (TURP) has been the gold standard of treatment, but new equipment and methods such as TUMT, HIFU, TUNA, and laser prostatectomy have been developed and are being tested for clinical application. Our experience with new equipment and methods show that their effectiveness has yet to be conclusively evaluated by objective parameters, while subjective improvements have been seen with less invasive treatments such as TUMT, HIFU and TUNA. Laser prostatectomy confirmed its advantages in hemostasis but comparison of each treatment is difficult because of different pathological changes created by different energy sources shown by MRI. Further studies are required to examine the new equipment and methods and for identification of the treatment of choice for BPH.

Ultrastructural localization of G-protein Gs in the organ of Corti

Immunocytochemical localization of a stimulatory GTP-binding protein Gs in the organ of Corti in the inner ear was examined with a post-embedding immunogold technique, using antibodies raised against a synthetic decapeptide (RMHLRQYELL) of the C-terminus of the alpha subunit of Gs. Immunoreactivity was strong on the membranes of supporting cells in the reticular lamina, including inner and outer pillar cells and the phalangeal process of Deiters' cells. Immunolabeling also was seen on the membranes of cell bodies of those cells which surround nerve fibers, basilar fibers, outer spiral fibers and afferent nerve endings at outer hair cells. Gold particles also labeled the membrane of inner phalangeal cells and border cells. In contrast, outer and inner hair cells were not labeled. Possible roles of Gs in the organ of Corti are discussed.

Establishment of a human cell line secreting neuron-specific enolase from a primitive neuroectodermal tumor of the retroperitoneal cavity

Primitive neuroectodermal tumor (PNET) is one of the small round cell malignancies of presumed neural crest origin for which an effective treatment has not yet been established. In the present study, a human cell line, designated KU-9, was established from a 27-year-old male patient with PNET of the retroperitoneal cavity and has been successfully maintained in nude mice and in culture. On histological examination, the primary tumor was composed of poorly differentiated small round cells arranged in clusters showing a variety of mitotic changes, and contained Homer-Wright rosettes. The histopathological appearance of the KU-9 xenografts was similar to that of the primary tumor. Electron microscopy revealed neurosecretory granules and cytoplasmic processes in the xenograft. No significant amplification of N-myc gene was observed in the KU-9 cells. The KU-9 cells showed chromosome numbers ranging from 56 to 61 with consistent structural abnormalities being add(2)(q31), +add(11)(p11.2), +add(13)(p11.1), and +del(22)(q12). Cultured KU-9 cells grew exponentially with a doubling time of about 50 h and a time-dependent increase in medium levels of neuron-specific enolase (NSE) was noted. Serum levels of NSE in KU-9 tumor-bearing nude mice were significantly elevated and a linear relationship between the serum NSE levels and the tumor NSE content or tumor volume was observed, suggesting that serum levels of NSE may reflect the PNET tumor burden and tumor extent. These results indicate that the KU-9 cell line provides a reproducible model system which could be useful in gaining some insight into the histogenesis and oncogenesis of PNET and in establishing an effective treatment for PNET.