Tissue-specific activation of tumor marker glutathione transferase P transgenes in transgenic rats

By means of transgenic rats, we have recently shown that the GPEI enhancer of the glutathione transferase P (GST-P) gene, which has two one-base-missmatched AP-1 sites locating palindromically with three-base spacing in between, is sufficient for conferring tumor-specific activation of the gene in vivo. It is noted that there is another consensus AP-1 site near the promoter of this gene. By using seven independent transgenic rats, bearing distinct areas of the GST-P gene that are connected to the chloramphenicol acetyltransferase (CAT) coding sequence, we analyzed CAT expression in various tissues (brain, lung, liver, kidney, spleen) in these transgenic rats. We found that the ECAT gene, which has sufficient of the upstream regulatory region (approx. 2.9 kb) of the gene containing GPEI, is trans-activated in the kidney and lung of transgenic rats in a similar manner to endogenous GST-P. When either the GPEI core sequence or the AP-1 site near the promoter is deleted, CAT expression decreases to almost background level. Substitution of the GPEI core or the AP-1 site near the promoter to this silent construct (5CATGPEIcore) reconstituted CAT expression in the transgenic rats. In these rats, CAT was expressed in the brain and lung rather than in the kidney, showing a somewhat different pattern from the endogenous GST-P. In the brain tissue of the 5CATGPEIcore transgenic rat, CAT was demonstrated in the glia cells, which is consistent with endogenous GST-P expression. These results suggest that a relatively long upstream region (approx. 2.9 kb) is required for tissue-specific expression of the GST-P gene and that GST-P expression in the brain may be regulated differently from its expression in other organs.

Identification of an enhancer responsible for tumor marker gene expression by means of transgenic rats

The glutathione transferase P (GST-P) gene is known for its specific expression during chemical hepatocarcinogenesis of the rat and is used as a tumor marker for hepatocellular carcinoma. We have shown recently that the upstream 2.9-kb region of the GST-P gene is sufficient for conferring tumor-specific expression of the gene in vivo (S. Morimura et al., Proc. Natl. Acad. Sci. USA, 90: 2065-2068, 1993). To further identify crucial sequence elements regulating the unique expression of this gene, we have established six independent lines of transgenic rats bearing distinct areas of the GST-P gene that are connected to the chloramphenicol acetyltransferase coding region and analyzed changes of the chloramphenicol acetyltransferase activity during the course of chemical hepatocarcinogenesis. We demonstrate here that the enhancer, glutathione transferase P enhancer I, that is located 2.5 kb upstream of the GST-P gene is required and sufficient for its tumor-specific expression of the gene among other controlling elements. This approach to transgene expression could be used to define other enhancers, the activity of which is dependent on cellular changes such as carcinogenesis, development, and differentiation.

Functions of milk protein gene 5' flanking regions on human growth hormone gene

Fragments containing 5' flanking regions of four bovine milk protein genes--alpha lactalbumin (b alpha LA), alpha S1 casein (b alpha S1CN), beta casein (b beta CN), kappa casein (b kappa CN)--and mouse whey acidic protein (mWAP) gene were prepared by PCR and ligated to human growth hormone (hGH) gene. These recombinant DNAs were microinjected into rat embryos to produce transgenic rats, and the functions of the 5' regions to direct secretion of hGH in the milk were tested. Although milk was obtained only in 5 of 19 mWAP/hGH rat lines, more than two-thirds of the rats carrying the other four DNAs produced milk. More than 80% of the lactated rats carrying b alpha LA/, b beta CN/, and mWAP/hGH, and 33% of the lactated b alpha S1CN/hGH rats secreted detectable amounts of hGH (> 0.05 microgram/ml) in the milk. In some rats, the hGH concentrations in the milk were comparable to or more than that of the corresponding milk protein in bovine milk. The ranges of hGH concentrations in the milk of b alpha LA/, b beta CN/, b alpha S1CN/, and mWAP/hGH rats were 1.13-4,360 micrograms/ml, 0.11-10,900 micrograms/ml, 86.8-6,480 micrograms/ml, and 6.87-151 micrograms/ml, respectively. HGH was also detected in the sera of these rats, and some abnormalities of growth and reproduction were observed. All but one virgin mWAP/hGH rat secreted up to 0.0722 microgram/ml of hGH in the serum, and more than half of them showed abnormal fat accumulations at their abdomen.(ABSTRACT TRUNCATED AT 250 WORDS)

[Treatment of unresectable non-small cell lung cancer (NSCLC) with carboplatin and chronic daily administration of oral etoposide]

CBDCA has only modest activity against NSCLC, but it is less toxic than cisplatin (CDDP). And CB DCA has a proven synergistic effect with etoposide. On the other hand, etoposide is schedule dependent and when give daily peros has activity against several tumors. So we conducted a trial to evaluate the efficacy of a combination of CBDCA and chronic daily administration of oral etoposide for previously untreated unresectable NSCLC. The treatment schedule consisted of CBDCA 400 mg/m2 on day 1 and chronic daily administration of oral etoposide of 50 mg/day/body for 21 consecutive days every 28 days. Twenty-nine of 36 enrolled patients were eligible. The response rate was 27.6% (95% confidence interval: 11.1-43.9%). The median survival time was 405 days. The primary toxicity was myelosuppression: leukopenia, neutropenia, anemia and thrombocytopenia of Grade 3 or 4 were 14.7%, 29.4%, 26.5%, and 5.9%, respectively. No bleeding episodes or toxic death were observed. Nonhematologic toxicity was slight, and there was no severe gastrointestinal toxicity. This combination was effective against NSCLC with tolerable toxicity and an "easily tolerated outpatient regimen".

Effect of chlorpromazine on mouse ambulatory activity sensitization caused by (+)-amphetamine

The development of sensitization to the ambulation-increasing effect of (+)-amphetamine (2.5 mg kg-1) was found to be dose-dependently inhibited when 1 or 2 mg kg-1 chlorpromazine was administered concomitantly, and the sensitization to (+)-amphetamine was almost completely suppressed when co-administered with 4 mg kg-1 chlorpromazine. Following a challenge dose of 2.5 mg kg-1 (+)-amphetamine, mice pretreated with (+)-amphetamine alone or with (+)-amphetamine plus 1 or 2 mg kg-1 chlorpromazine showed similar marked enhancement of the sensitization. However, mice that had been given (+)-amphetamine plus 4 mg kg-1 chlorpromazine displayed only slight enhancement of the effect compared with the activity level in saline-pretreated mice.

[Malignant lymphoma following operation and chemotherapy of small cell lung carcinoma]

A 57-year-old man was admitted with systemic lymphadenopathy. He had undergone resection for small cell lung carcinoma and received chemotherapy 6 years previously. A specimen of swollen lymph nodes showed malignant lymphoma. Surface marker analysis revealed the lymphoma to have the same characteristics as lymphoblastic lymphoma (LBL). He received combination chemotherapy, but marked resistance was recognized. His condition deteriorated rapidly and died. Having the characteristics of LBL on lymphoma at an older age and severe drug-resistance suggests that this lymphoma might have been a second malignancy due to preceding chemotherapy.

[Pharmacodynamics and therapeutic usage of recombinant human erythropoietin (SNB-5001) in animal models]

In mice, SNB-5001 released reticulocytes dose-dependently. In rats, rabbits and dogs given the same doses of SNB-5001, each dose-response curve of hemopoiesis almost showed parallelism. SNB-5001 induced nearly the same extent of hemopoiesis in these animals. After the hemopoiesis caused by SNB-5001, reticulocytes decreased within a week in both rats and dogs, but numbers of red blood cells (RBC) were higher than each control group for over 2 weeks in rats and for over 3 weeks in dogs. In polycythemic rats given excessive doses (200-5000 U/kg) of SNB-5001, blood volume increased, but blood pressure did not change. In the renal anemic rats produced by partial nephrectomy, dose-related and cumulative hemopoiesis were observed in both groups given SNB-5001 with different administration schedules (once a day for a week or once a week for 3 weeks). In the phrebotomized rats, SNB-5001 accelerated the recovery from the anemia induced by phrebotomy when given in a large quantity (6 ml/rat) and prevented the progressive anemia induced by intermittent phlebotomies when given in a small quantity (1 ml/rat x 3). SNB-5001 also improved the anemia caused by chronic inflammation in rats. However, increases of hemoglobin and hematocrit were smaller than that of RBC. Those results were caused by impaired release of iron from the reticuloendothelial system.

Serum calcium increases the incidence of arrhythmias during acetate hemodialysis

We investigated the occurrence of arrhythmias during maintenance acetate hemodialysis (HD) using a 24-hour continuous electrocardiogram recording system. Three of 22 patients showed augmented increases in both ventricular premature beats and supraventricular premature beats during HD. When we changed the dialysate from one with a Ca2+ concentration of 1.75 mmol/L (3.5 mEq/L), to one with a Ca2+ concentration of 1.25 mmol/L (2.5 mEq/L), the elevation of serum Ca2+ concentration during HD was abolished and the increases in both ventricular premature beats and supraventricular premature beats were significantly decreased. The elevation of serum Ca2+ concentration during HD might induce either extracellular or intracellular increase in Ca2+ concentration in the heart and elicit either reentry- or triggered-activity types of arrhythmias during HD. The present results indicate that the dialysate with a lower Ca2+ concentration is advisable to use in patients with underlying cardiac diseases.

Sensitization to ambulation-increasing effects of cocaine after repeated administration in mice--roles of dose and interval of administration as well as experimental environments

Effects of 5 subcutaneous injections of cocaine (COC) at 10, 20 or 40 mg/kg at intervals of 1 to 7 days were investigated by placing mice individually into tilting activity cages (20cm in diameter and 18 cm height). A progressive enhancement of the ambulation-increasing effect was noted for 3 to 4 hrs after each administration, showing marked sensitization (reverse tolerance). The enhancement of the effect progressed rapidly and the maximum sensitization was observed after the 3rd to 4th administration of 10 to 20 mg/kg at intervals of 3 to 7 days. The peak effect of the enhancement was of short duration. Sensitization lasted for at least one month. However, 40 mg/kg of COC produced stereotyped behaviors concurrent with preconvulsive signs which were also enhanced by serial administration. In contrast, pretreatment with COC in a narrow environment (glass jar, 5.5 cm in diameter and 15 cm height) did not cause the enhancement to the ambulation-increasing effect of the drug. Cross-sensitization was observed from COC to methamphetamine.

[Evaluation of chemotherapy of unresectable non-small cell lung cancer]

For this evaluation, a comparison was made of survival of 34 patients with non-small cell lung cancer who had undergone chemotherapy (Group B) with that of 38 patients without this chemotherapy (Group A). Group B had received neither radiotherapy for primary lesions nor bronchial artery infusion of anticancer drugs, and the chemotherapeutic regimen was CDDP + VDS or CDDP + VDS + MMC chemotherapy. MST of this group was significantly longer than that of Group A (4.5 months vs 7.3 months. P less than 0.01), but the PS features of the two groups differed significantly. A comparison was thus made of survival for PS 1-2 cases in both groups (Group A: 17 cases, Group B: 27 cases). MST of group A and B were 6.8 and 9.8 months, respectively (P less than 0.05). The efficacy of the treatment for prolonging survival in terms of age, sex, PS, histology, T factor, N factor and M factor was evaluated by multivariate analysis using the proportional hazard model of Cox. The results obtained indicated the chemotherapy significantly prolonged survival.

Comparison of sensitization to ambulation-increasing effects of cocaine and methamphetamine after repeated administration in mice

The effects of repeated (5 times) subcutaneous administration of cocaine (10, 20 or 40 mg kg-1) and methamphetamine (1, 2 or 4 mg kg-1) at 3-4 day intervals have been compared in mice placed individually into tilting activity cages. A progressive enhancement of the ambulation-increasing effect was noted for 3-4 h after each administration, indicating that sensitization occurred. This occurrence and the existence of an optimal dose producing sensitization were similar for both drugs. However, enhancement of the effect after cocaine progressed rapidly and maximum sensitization was observed earlier than after methamphetamine administration. Moreover, the higher doses of cocaine (40 mg kg-1) caused stereotypies concurrent with preconvulsive signs of short duration that were enhanced by serial administration. In contrast, methamphetamine caused a more progressive enhancement, but stereotypies with no preconvulsive signs were produced by the higher dose (4 mg kg-1). The respectively, effective doses for the development of enhancement suggested that cocaine was less potent than methamphetamine in producing sensitization. Cross-sensitization occurred between both drugs. Thus, sensitization to cocaine was distinct from that to methamphetamine due to differences in its rapidity, intensity, and the presence or absence of preconvulsive changes.

[Mitral flow dynamics in patients with hemodialysis: assessment with pulsed Doppler echocardiography]

We investigated transmitral flow dynamics before (B) and after (A) hemodialysis (HD). Pulsed Doppler echocardiography was performed in 15 patients (10 males and 6 females, with a mean age of 51) with neither valvular disease nor heart failure. After HD, systolic and diastolic pressure declined significantly to [156 +/- 27----135 +/- 24mmHg (p less than 0.01) and 84 +/- 16----75 +/- 15mmHg (p less than 0.02)] respectively. However, heart rate did not change. Doppler derived indexes were peak early filling velocity (E), peak filling during atrial contribution (A), early filling time velocity integral (IE), atrial time velocity integral (IA), and percent atrial contribution [IA/(IE + IA) x 100] (%A) There was a positive correlation between E and peak systolic stress (r = 0.437, p less than 0.05). Conclusion; In HD, early diastolic filling is dependent on preload. It is necessary to consider preload when diastolic function is assessed.

Renal anemia in polycystic kidney disease mouse

DBA/2FG-pcy mice developed the chronic renal failure by the progressive polycystic formation at five months old. Their bilaterally enlarged kidneys occupied about 15% of the body weight. It was about 9 times larger than the normal kidney of DBA/2N mice. A large number of various-sized cysts appeared in cortex and medulla of bilateral light-yellow kidneys of sponge-like shape. Blood urea nitrogen and creatinine increased. Red blood cells (746 +/- 39 x 10(4)/mm3), hemoglobin (8.8 +/- 0.4 g/dl) and hematocrits (31.1 +/- 1.5%) were lower than those of normal control mice. Serum erythropoietin level and reticulocytes did not increase. In addition, the treatment with exogenous erythropoietin improved the anemia in DBA/2FG-pcy mice. It was suggested that the anemia in DBA/2FG-pcy mice was due to the disorder of erythropoietin production caused by the progressive polycystic formation in kidneys.

Chronic intracerebroventricular infusions of endothelin elevate arterial pressure in rats

We investigated the effects of intracerebroventricular infusions of endothelin on cardiovascular and endocrinological responses using conscious, unrestrained rats. Chronic intracerebroventricular infusions of endothelin, 10 pmol/h for 7 days, elevated arterial pressure significantly on days 5, 6 and 7 of the infusion, compared with intracerebroventricular infusions of the vehicle. Heart rate decreased from day 1 of the infusion of endothelin until the end of the experiment. The urinary excretion of norepinephrine increased on day 3 and epinephrine increased on days 3, 4 and 5 of endothelin infusion. The urinary excretion of arginine vasopressin increased on day 5, 6 and 7 of the infusion. These findings suggest that chronic intracerebroventricular infusions of endothelin elicit elevations in arterial pressure and that the initiation of blood pressure rises can be related to sympathetic activation although the actual role for the pressor responses has been played by the released arginine vasopressin.

Intracerebroventricular infusions of insulin increase vasopressin release in rats

1. The role of cerebral insulin or insulin-like immunoreactive substance (ILI) on arginine-vasopressin (AVP) release using rats was investigated. Feeding rats with a high salt diet for 4 weeks significantly decreased the contents of ILI in both the hypothalamus and pituitary gland. Intracerebroventricular infusions of insulin (4 and 40 micrograms/min for 30 min) increased plasma AVP concentrations dose-dependently without hypoglycaemia, but decreased hypothalamic and pituitary contents of AVP. 2. These results indicate that ILI in the brain may play a role in the secretion of AVP, and that this mechanism could be operated to control a water-sodium balance.

Intracerebroventricular injections of endothelin increase arterial pressure in conscious rats

We investigated the possible effects of endothelin (ET) on the central regulation of arterial pressure by injecting ET intracerebroventricularly (ICV) into conscious rats. ICV injections of ET caused dose-dependent elevation of arterial pressure and increase of heart rate. The first reaction was abolished by bunazosin, an alpha 1-adrenergic blocker, injected intravenously. However, the increase in arterial pressure and heart rate caused the rats, injected with ET ICV, to roll to the left on their long axis for 20-30 min, followed by prolonged sedation. Furthermore, the pressor responses and tachycardia were significantly attenuated by the ICV pretreatment with nicardipine, a calcium channel blocker, and nicorandil, a nitrate derivative, respectively. These results suggest that ET may elevate the intracellular Ca2+ concentration ([Ca2+]i) of sympathetic nerve activity regulatory neurons of the brain, leading to an accelerated outflow of sympathetic nerve activity and cause the elevation of arterial pressure.

[Estimating the quality of life in childhood cancer survivors from parent questionnaires]

Multidisciplinary clinical research on childhood cancer has achieved a marked improvement in survival rate during the last two decades. Due to the increase of long-term survivors, the survey of quality of life (QOL) of cured children is essential. But methods to estimate QOL of children have not been established. We attempted to estimate the QOL of surviving patients from the responses to a questionnaire filled out by their parents. The total number of patients treated at the National Children's Hospital from 1965-1987 was 937, of which 296 patients are still surviving. Among these survivors 108 patients were selected to be surveyed because they were being followed up by our attending physicians. The originally elaborated questionnaire was sent to parents in June 1989. Seventy-eight parents responded. The questionnaire consisted of four major questions. The first was how the QOL of the child compared to that of an ordinary child. The parents circled the appropriate level of QOL determined by our scale (1 lower, 4 the same as ordinary child, 7 excellent). The average score was 5.61 showing that parents felt their child's QOL is superior to an ordinary child. The second question concerned how the present status of the child was influenced by the experience of cancer. Answers were divided into five categories as follows: 1) Good or positive (10%); 2) nothing in particular (49%); minimum (29%); negative (9%); and other (7%). The third question concerned any anxieties. Most parents had numerous anxieties about the relapse, late effects, education, job prospects, marriage and offspring and getting the latest information. The fourth question dealt with what to tell the child as to their true diagnosis. Answers were divided as follows: absolutely no (56%); yes, but in the future (23%); yes, already done (10%); and yes, through our physician; (13%). After studying the questionnaires we interviewed the parents. We noticed that the parent/child relationship was very close. A meeting was conducted with parents and all the staff (doctors, psychologists and nurses). In conclusion, the QOL in surviving childhood cancer patients is considered to be better than that of ordinary children by their parents. This result is likely due to the excellent parent/child relationship.

[Prognostic factors of common epithelial ovarian cancer treated by surgery and cisplatin based combination chemotherapy]

Retrospective analysis of prognostic factors in 171 patients who had common epithelial ovarian cancer (WHO) and treated by surgeries and cisplatin based combination chemotherapies were performed by survival assay and multivariate analysis. In FIGO stage 3, the estimated parameter values were in following order: residual tumour age grade performance status histological type. On analysing Stage patients, histological grading and histological typing had an effect on prognosis. Patients with grade 2 or tumours had a worse prognosis than did those with grade 1 tumours, and patients with clear-cell carcinoma or undifferentiated adenocarcinoma showed a poor prognosis.