Metabolic syndrome is not associated with markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes

AIMS

Metabolic syndrome is characterized by its association with certain cardiovascular disease risk factors. The aim of this study was to investigate the relationships between metabolic syndrome and markers of subclinical atherosclerosis, serum adiponectin and endogenous androgen concentrations in Japanese men with Type 2 diabetes.

METHODS

Using the 2005 International Diabetes Federation (IDF) definition, we assessed the prevalence of the metabolic syndrome in 424 consecutive men with Type 2 diabetes aged 40-75 years in a cross-sectional study. We compared characteristics including ultrasonographic carotid atherosclerosis markers, pulse-wave velocity (PWV), and serum adiponectin, free testosterone, and dehydroepiandrosterone sulphate (DHEA-S) concentrations in diabetic patients with and without the metabolic syndrome.

RESULTS

The prevalence of the metabolic syndrome in Japanese men with Type 2 diabetes was 46.9%. Men with the metabolic syndrome had higher urinary albumin excretion rate than those without. Carotid intima-media thickness (0.97 +/- 0.26 vs. 0.91 +/- 0.18 mm), plaque score [3.3 (1.5-8.1) vs. 3.8 (1.3-6.2)], PWV (1818 +/- 331 vs. 1749 +/- 331 cm/s) and ankle-brachial index (1.10 +/- 0.14 vs. 1.08 +/- 0.16) did not differ significantly between patients with and without the metabolic syndrome. Similarly, serum adiponectin [3.70 (2.06-6.09) vs. 4.65 (3.09-7.02) microg/ml], free testosterone (36.4 +/- 10.7 vs. 34.7 +/- 11.1 pmol/l), and DHEA-S concentrations (3.29 +/- 1.83 vs. 3.17 +/- 1.63 micromol/l) did not differ significantly between groups,

CONCLUSIONS

The metabolic syndrome, as defined by the IDF, is not significantly associated with subclinical atherosclerosis markers, serum adiponectin, or endogenous androgen concentrations in Japanese men with Type 2 diabetes.

p53 gene mutations in esophageal squamous cell carcinoma and their relevance to etiology and pathogenesis: results in Japan and comparisons with other countries

Esophageal squamous cell carcinoma is a form of cancer that has varying incidence rates among different countries, distinct geographic areas and different ethnic groups. According to previous reports, p53 gene mutations have been identified in 20-80% of these tumors, and these mutations have occurred at an early stage. These findings suggest that such mutations play an important role in esophageal carcinogenesis, and highlight the importance of mutagens, which cause sequence alterations in the p53 gene. In order to clarify the environmental factors and the molecular mechanisms that may be responsible for the occurrence and prevention of a specific mutation in the process of esophageal carcinogenesis, we analyzed p53 gene mutations in 95 samples of esophageal squamous cell carcinoma. We further reviewed published reports investigating the frequency of p53 gene mutations in esophageal cancer from high-risk areas to normal-risk areas and compared these findings to our results in Japan. The frequency of p53 gene mutations in Japanese esophageal cancer is 47.4% and there are three prominent features: (1) a predominance of transversions, in particular the G:C to T:A transversion; (2) a relatively low frequency of transitions; and (3) a relatively high percentage of frameshift mutations. These results indicate the possible importance of the benzo[a]pyrene metabolite and oxidative DNA damage in esophageal carcinogenesis and scarcely correlate with DNA replication errors or alkylation in comparison to other gastrointestinal cancers. In addition, we observed a peculiar sequence of frameshift mutations. Taken together, these data suggest that this tumor suppressor gene plays a critical role in the multistep carcinogenesis process for esophageal squamous cell cancer.

Recent advances in the surgical treatment for esophageal cancer in Japan: An experience of 1000 cases who underwent an esophagectomy at a single institute

15011

Background: Most cases of esophageal cancer are squamous cell carcinoma in Japan and the prognosis of such patients tends to be poor. However, the clinical results after an esophagectomy have recently been reported to improve. Methods: The mortality and morbidity as well as the patients’ prognosis were evaluated in 1000 cases of esophageal cancer who all underwent an esophagectomy in the Department of Surgery and Science (Department of Surgery II), Kyushu University, Japan from 1964 to 2006. The incidence of squamous cell carcinoma was 94 %. The patients were divided into three groups according to the operation period: Group I (n=197), Group II (n=432), and Group III (n=371) underwent an esophagectomy during the periods of ‘64-’80, ’81-’93, and ’93-’06, respectively. The incidences of TNM Stage 0 or I gradually increased (4, 19 and 24 %, respectively), while those of Stage IV decreased (28, 19 and 14 %). Results: The 5-yr overall survival rates (OSR) and cause-specific survival rate (CSR) after an esophagectomy for all 1000 cases were 30 and 37 %, respectively. The 5-yr OSRs of Groups I, II and III were 14, 27 and 46 %, while the 5-yr CSRs were 18, 36, and 52 %, respectively (P<0.01 between each group). When the prognoses were compared for each TNM stage, an improvement in the prognosis was observed at every tumor stage. A multivariate analysis (Cox proportional hazard model) revealed not only the age, depth of invasion, node metastasis, curability (each P<0.001) and extent of a lymphadenectomy (P<0.05) but also the operation period (P<0.001) to be independent prognostic factors. The morbidity rates of Groups I, II and III were 62, 38, and 33 %, and the incidences of pulmonary complications were 42, 13 and 14 %, respectively (P<0.01, Group I vs. II and I vs. III). The 30-day mortality rates were 8.1, 2.1 and 0 %, respectively (P<0.01 between each group). Conclusions: An analysis of a total of 1000 cases with esophageal cancer revealed that an esophagectomy has generally been safely performed without any critical pulmonary complications, while an increasingly favorable prognosis has been achieved due to recent advances in surgical techniques and treatment modalities.

No significant financial relationships to disclose.

Why did the gender difference influence survival in patients with completely resected stage I adenocarcinoma of the lung?

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Background: This study evaluates the influence of gender on survival and tumor recurrence in patients with completely resected stage IA and IB adenocarcinoma of the lung based on the analysis of the Japan Lung Cancer Research Group trial, which was a randomized prospective study of adjuvant chemotherapy with uracil-tegaful for stage I pulmonary adenocarcinoma. Methods: Patients were randomized to receive either oral uracil-tegaful (250 mg of tegaful/m2/day) for 2 years postoperatively or no adjuvant treatment. Survival was calculated from randomization until death. Survival estimated using the Kaplan-Meier method, and difference in survival between two groups was compares with the log-rank test. Results: The 5-year survival rate was 88.9% for the 502 women and 84.3% for the 477 men (median follow-up 72 months, p=0.0066). The relative risk of death for men vs women was 0.658 (95% C.I., 0.476–0.910, p=0.011), although the mean age of men was significantly less than that of women (p=0.041). There was no interaction between the gender differences and the efficacy of uracil-tegaful (p=0.657). However men presented with significantly more preoperative complications, more T2 diseases (p=0.0006), less non-papillary growth for histology (p=0.0078), less well differentiated subtype (p<0.001), higher serum carcinoembryonic antigen (CEA) level (p=0.004), and more smoking history than women (p<0.0001). Disease recurrence patterns were similar between the genders. The postoperative mortality showed a tendency to go up in men. Conclusions: Although longer life expectancy for women in Japan may in part explain, gender influences survival after complete resection for stage IA-B lung adenocarcinoma. The reasons for prolonged survival of women with this disease may be related to the several differences in the distribution of preoperative complications, smoking history and tumor biological behaviors such as T descriptor, histologic subtype, and serum CEA level. However cause- specific mortality was difficult to be explained. Further molecular epidemiologic and molecular profiling studies regarding gender as a prognostic and predictive factor for survival should be done.

No significant financial relationships to disclose.

Phase I/II study of S-1 combined with triweekly irinotecan for advanced or recurrent colorectal cancer

14541

Background: A dose-escalation study of irinotecan (CPT-11) combined with S-1, an oral dihydropyrimidine dehydrogenase inhibitory fluoropyrimidine, was performed to determine the maximum-tolerated dose (MTD), recommended dose (RD), dose-limiting toxicities (DLTs), and objective response rate (RR) in advanced or recurrent colorectal cancer. Methods: The subjects were untreated patients with inoperable advanced or recurrent colorectal cancer aged 20–75 years. S-1 was administered orally at 80 mg m-2 day-1 from day 1 to 14 of a 21-day cycle and CPT-11 was given intravenously on day 1 at an initial dose of 80 mg m-2 day-1, stepping up to 150 mg m-2. The treatment was repeated every 3 weeks, unless disease progression was observed. Results: In the phase I portion, only one of six patients at level 1 (80 mg m-2 of CPT-11) developed DLT, grade 3 diarrhea. No other serious adverse reactions occurred (either hematological or non- hematological), and all patients at levels 2 (100 mg m-2) to 5 (150 mg m-2) could receive therapy safely on an outpatient basis. The final RD was determined to be 150 mg m-2. In the phase II portion, fourteen patients including three patients in the final RD phase I portion were evaluated. The median treatment course was six (range: 2–17). The incidences of severe (grade 3–4) haematological and nonhaematological toxicities were 41.7 and 8.3%, respectively, but all were manageable. The RR was 50% (7 of 14, 95%CI: 23.0–77.0%), and Disease Control Rate (PR + SD) was seen in 71.4%. MST is not reached. Conclusions: Our phase I/II trial showed that S-1 combined with CPT-11 achieved a high response rate and could be given safely on an outpatient basis. These findings suggest that the therapy has potential as first- line treatment for inoperable advanced recurrent colorectal cancer. The updated analysis will be presented at the meeting.

No significant financial relationships to disclose.

Antitumor effects of the MIG and IP-10 genes transferred with poly [D,L-2,4-diaminobutyric acid] on murine neuroblastoma

The number of tumor-infiltrating lymphocytes is known to be related to outcomes in patients with a variety of malignancies. Interferon (IFN) gamma-inducible protein-10 (IP-10) and monokine induced by IFNgamma (MIG) have chemotactic effects on activated T lymphocytes and natural killer (NK) cells. The aim of this study was to evaluate the antitumor effects of exogenous expression of the MIG and IP-10 genes delivered to solid tumors by poly [D,L-2,4-diaminobutyric acid] (PDBA). The murine MIG and IP-10 genes were transfected into mouse neuroblastoma cells with PDBA. MIG and IP-10 levels in supernatants of transfected cells were measured by enzyme-linked immunosorbent assay. The chemotactic activities of MIG and IP-10 in the supernatants of cell cultures were measured by chemotaxis assay. Tumors were injected in vivo with PDBA/pmMIGColon, two colonsIP-10 complexes to evaluate the effects of these genes on tumor volume and survival time of mice. Transfected PDBA/pmMIGColon, two colonsIP-10 complexes produced MIG and IP-10 protein in vitro. MIG and IP-10 proteins secreted into the culture medium showed chemotactic activity. MIG and IP-10 gene therapy with the PDBA system in vivo significantly inhibited tumor growth and prolonged survival time of mice. In conclusion, PDBA-mediated MIG and IP-10 gene therapy may be useful for treatment of solid tumors.

Prognosis and postoperative lymphocyte count in patients with hepatocellular carcinoma who received intraoperative allogenic blood transfusion: a retrospective study

AIMS

The effect of perioperative blood transfusion on the survival of hepatocellular carcinoma (HCC) has not been fully investigated. To clarify the prognostic value of intraoperative allogenic blood transfusion, we conducted a comparative retrospective analysis of 224 patients with HCC who underwent hepatic resection.

METHODS

We compared clinicopathologic background and survival after hepatic resection between patients who received intraoperative blood transfusion (n=101) and those who did not (n=123).

RESULTS

Patients with blood transfusion had a larger tumor and more frequent vascular invasion than those without blood transfusion. The 5-year cancer-related survival rate after hepatic resection, but not the disease-free survival rate, was significantly lower in patients who underwent blood transfusion than in those who did not (38.3% vs. 66.7%, P<0.01). Multivariate analysis showed intraoperative blood transfusion (P=0.02), microscopic portal invasion (P<0.01), and preoperative serum alpha-fetoprotein elevation (P=0.03) to be independent risk factors for poor outcome after hepatic resection. The negative effect of blood transfusion on postoperative survival was observed only in patients with a tumor larger than 50mm in diameter. The absolute peripheral blood lymphocyte count on postoperative day 1 was significantly lower in patients who underwent blood transfusion (880/mm(3)) than in those who did not (1081/mm(3)) (P<0.01).

CONCLUSIONS

Our data suggest that intraoperative blood transfusion results in immunosuppression in the early postoperative period, allowing for progression of residual HCC after resection. Therefore, intraoperative allogenic blood transfusion should be avoided in patients with resectable HCC, particularly in those with a large tumor.

Measurement of elastic properties of blood vessels

This paper is related to the measurements of the modulus of elasticity of an artery by studying the deformations due to the inflation of an angioplasty balloon catheter used for Interventional Radiology (IR) procedures. Various types of balloons are studied in order to characterize and compare their behaviors at the time of inflation. A test bench, consisting of an angioplasty balloon, a Polyvinyl alcohol model and an actuator used to inflate a balloon, is developed for the realization of the experiments. The pressure-volume curve during the inflation of a balloon is observed. Elasticity modulus are derived with an analytical model of the measurement system. The results are then analyzed and compared to existing data from literature.

Measurement of internal constraints during an interventional radiology procedure

This paper presents a novel method for measurements of internal constraints during an Interventional Radiology procedure. Fiber-optic strain gauge, operating as a Fabry-Perot interferometer, is inserted and navigated inside a polyvinyl alcohol (PVA) model. The information obtained from deformation of the Fabry-Perot cavity is analyzed and the results are then rescaled through a calibration procedure for catheters. The measures help to locate the maximum interaction forces between catheter and blood vessel wall at approximately 1.3 N and to observe the shape of dynamic interaction during manipulation.

The evaluation of facial palsy by amount of feature point movements at facial expressions

At present, in the medical field 40-point method and facial nerve grading system are generally used for evaluation of facial palsy. However, these methods have limitation in the precise evaluation, because of subjectivity in diagnosis. Purpose of This work is to propose quantitative evaluation of facial palsy based on the amount of movements of the feature point on the face. Facial nerve symptoms generally appear in either side of the face. In facial expression movement, the motion in the palsy side becomes smaller than that of the healthy side. We defined some indices of palsy grade obtained by the observation of the facial motion. Those indices showed the asymmetry of the facial motion quantitatively. We confirmed that our proposed method is valid for estimation of facial palsy from comparison with 40 points method.

Efficient induction of specific cytotoxic T lymphocytes to tumor rejection peptide using functional matured 2 day-cultured dendritic cells derived from human monocytes

Dendritic cells (DCs) are powerful antigen-presenting cells (APCs), that have so far been applied for cancer specific immunotherapy. Recent results suggest that matured DCs derived from human monocytes have a significant impact on the outcome of vaccination. The conventional generation of mature DCs from human monocytes in vitro has been reported to require 5 days for differentiation with granulocyte macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-4 and 2 days for stimulation. We herein report a new strategy for the functional maturation of monocyte-derived DCs within only 2 days of in vitro culture and the induction of specific cytotoxic T lymphocytes (CTLs) to tumor rejection peptide. The monocytes were incubated for 1 day with GM-CSF and IL-4, followed by activation with a bacterial product, OK-432 and prostaglandin E2 (PGE2) for another 1 day (rapid DC). Rapid DC expressed mature DC surface markers as well as chemokine receptor 7 and secreted Th1-type cytokines. The DCs generated in this study mobilized Ca2+ in response to CCL21/6Ckine and SDF-1, but only marginally did so to Mip-1alpha. Moreover, when rapid DC were compared with mature conventional 7-day DCs, they were equally potent in inducing specific CTLs in vitro. These results indicate that the rapid DC is as effective as the monocyte-derived conventional DCs. The rapid DC would be a potentially useful new cancer-specific immunotherapy.

Absence of tyrosine kinase mutations in Japanese colorectal cancer patients

Tyrosine kinases, which are important regulators of intracellular signal-transduction pathways, have mutated forms that are often associated with oncogenesis and are attractive targets for therapeutic intervention. Recently, systematic mutational analyses of tyrosine kinases revealed that a minimum of 30% of colorectal cancer contain at least one mutation in the tyrosine kinases. To further explore these mutations, we examined all reported mutations of NTRK3, FES, KDR, EPHA3, NTRK2, JAK1, PDGFRA, EPHA7, EPHA8, ERBB4, FGFR1, MLK4 and GUCY2F genes in the 24 colorectal cancer cell lines. Unexpectedly, among 24 colorectal cancer cell lines, only two cell lines (LoVo and CaR1) harbored mutation C1408T (R470C) in MLK4 gene. The mutation rate was extremely low compared to that previously reported. Therefore, we analyzed mutations in 46 colorectal cancer samples resected from the same number of Japanese patients. Surprisingly, none of the 46 samples contained any of the mutations reported. Based on our study, we advise that a more comprehensive tyrosine kinase gene mutation assay is necessary in the future.

Inclusion of the transcervical approach in video-assisted thoracoscopic extended thymectomy (VATET) for myasthenia gravis: a prospective trial

BACKGROUND

Because evidence-based data regarding the quality of video-assisted thoracoscopic thymectomy for the treatment of myasthenia gravis are lacking, a prospective trial comparing three different operative approaches was conducted to evaluate their efficacy.

METHODS

This prospective study enrolled 20 consecutive patients with nonthymomatous myasthenia gravis. A series of three approaches for bilateral video-assisted thoracoscopic extended thymectomy (VATET) using the anterior chest wall-lifting method (original), the original method with a flexed-neck position (modified), and the original method with a transcervical approach (final) were prospectively performed in each patient for quantitative and pathologic evaluation of the residual thymus after each approach.

RESULTS

Complete VATET required 242 +/- 48 min, with the transcervical procedure requiring 23 +/- 12 min. After the modified method, the residual thymus in the cervical region was 1.5 cm in size and weighed 0.8 g (0.8% of the entire thymus), as compared with a size of 2.2 cm and a weight of 1.3 g (3.2%) after the original method. Each value is the result of comparison with the final method. Histopathologic studies showed residual tissue in the germinal center as well as Hassall's corpuscles in more than 70% of cases.

CONCLUSION

The findings show that VATET without the transcervical approach could be an immunologically incomplete treatment for myasthenia gravis. Therefore, the transcervical approach should be included in VATET procedures to ensure radicality.

Preoperative transcatheter arterial chemoembolization reduces long-term survival rate after hepatic resection for resectable hepatocellular carcinoma

AIMS

To study the effect of preoperative transcatheter arterial chemoembolization (TACE) on long-term survival after hepatic resection for hepatocellular carcinoma (HCC), we conducted a comparative analysis in 235 HCC patients who underwent hepatic resection with a curative intent.

METHODS

We compared clinicopathologic background, mortality, and survival rates after hepatic resection between those who underwent preoperative TACE (n=109) and those who did not (n=126).

RESULTS

One hundred and two patients in the TACE group (93.6%) received TACE only once. The mean interval between TACE and hepatic resection was 33.1days. Patients in the TACE group were younger than those in the non-TACE group, and liver cirrhosis and non-anatomical hepatic resection were more prevalent in this group. The 5-year overall survival rate after hepatic resection was significantly lower in the TACE group (28.6%) than in the non-TACE group (50.6%), especially in patients without cirrhosis or with stage I or II tumor. There was no difference between the two groups in mortality or disease-free survival after hepatic resection. Multivariate analysis showed preoperative TACE, preoperative aspartate aminotransferase elevation, and microscopic portal invasion to be independent risk factors for a poor outcome after hepatic resection.

CONCLUSIONS

Preoperative TACE should be avoided for patients with resectable HCC, especially for those without cirrhosis or with an early stage tumor.

The influence of tumor size, histological differentiation and smoking history in patients with completely resected stage I adenocarcinoma of the lung

7197

Background: To test the hypothesis that patients with completely resected p-stage I adenocarcinoma [Ad.] of the lung contain a favorable subgroup of patients with well differentiated histology and tumor 2.0 cm or less in greatest dimension, we analyzed the results of the JLCRG trial (a randomized prospective trial of adjuvant chemotherapy with Uracil-Tegaful for stage I adenocarcinoma of the lung) by tumor size, smoking history, degree of histological differentiation and more. Methods: Patients were randomized to receive either oral uracil-tegaful (250 mg of tegaful /m2/day) for 2 years postoperatively or no adjuvant treatment. Multivariate analyses and interactions with the Cox proportional-hazards model were used to estimate the simultaneous effects of prognostic factors on survival. Results: The 5-year survival rate of the 412 patients with tumor 2cm or less in size was 89.8% (95% confidence interval [CI]: 86.8 to 92.8) versus 84.4% (95% CI: 81.3–87.4) for the 569 patients with tumor more than 2cm in size (median follow-up 72 months, p = 0.002). Although univariate analysis demonstrated improved survival for the patients with no smoking history and female gender, the selected covariates by multivariate analysis were as follows: age (hazard ratio [HR] for patients aged 70 years or more, 2.25; 95% CI: 1.58 to 3.14, p < 0.0001), tumor size (HR for more than 2cm in size, 1.55; 95% CI: 1.10 to 2.21, p = 0.012), histological differentiation (HR for moderate and poor differentiation, 1.75, 95% CI: 1.25 to 2.47, p = 0.001), and treatment group (HR for the uracil-tegaful group, 0.68; 95% CI: 0.49 to 0.94, p = 0.02). For these prognostic factors, there was only one significant interaction between tumor size and the adjuvant treatment. Conclusions: 1) Patients with completely resected stage I Ad. of the lung contain a favorable subgroup of patients with aged less than 70 years, well differentiated histology, and a maximum tumor dimension of 2.0 cm or less. 2) Adjuvant chemotherapy with oral uracil-tegaful should also be considered for stage I Ad. patients more than 2 cm in tumor size. 3) 2cm in tumor size might be a good benchmark candidate of the description of T factor to facilitate treatment strategies and revisions of the TNM staging system.

No significant financial relationships to disclose.

Method to quantify flow reduction in aneurysmal cavities of lateral wall aneurysms produced by stent implants used for flow diversion

SUMMARY

Stent implants placed across the neck of cerebral aneurysms are capable of reducing aneurysmal flow when coils are not used for filling the aneurysms. It is important to evaluate the effects of flow reduction caused by stent implants used for the treatment of cerebral aneurysms. Subtracted vortex centers path line method (SVC method) is one of the image post processing methods employed for quantitative flow measurement. We developed a modified SVC method by employing Cinematic Angiography (25 frames/s) and digital video recording (30 frames/s) with a commercial digital camera.We successfully compared the flow effectiveness using a tubular silicon model with a sidewall aneurysm. The result suggests that our modified SVC method is useful for a comparative examination of the effect of aneurysmal flow reduction caused by stent implants.

Laparoscopy-assisted right hepatic lobectomy using a wall-lifting procedure

This article describes a new technique for performing a laparoscopy-assisted right hepatic lobectomy using a hanger wall-lifting procedure. The patient is placed in the left semi-lateral position. A cholecystectomy and hemi-hepatic vascular inflow control are then performed through a midline incision, through which the resected liver can be removed. Next, the right lower chest and right upper abdominal wall are lifted by two wires vertical to the abdominal wall. Two ports, a 5-mm port in right lateral abdomen for forceps and a 12-mm port just right of the umbilicus for the laparoscope, are inserted. The obtained view of the operative field in the right upper abdominal cavity is thus excellent. The laparoscopy-assisted mobilization of the right hepatic lobe is done with the assistance of a hand inserted through the midline incision, including a dissection of the hepato-renal ligament, the right triangular ligament, and the right coronary ligament. A parenchymal dissection is then performed using the Cavitron Ultrasonic Surgical Aspirator (CUSA) and the resected specimen is passed through the midline incision without any morcellation of the liver. This procedure can minimize the length of the wound, while avoiding the lethal complications associated with pneumoperitoneum.

Expression of the TRAG-3 gene in human esophageal cancer: the frequent synchronous expression of MAGE-3 gene

We previously reported some cancer testis antigens, especially for MAGE genes, to be expressed in a relatively high population of gastro-intestinal and breast cancers. TRAG-3 (Taxol resistant associated gene-3) may be another cancer testis antigen; however, its expression has still not been fully studied. The TRAG-3 expression was evaluated in a total of 57 cancer cell lines and 322 cancer samples of gastrointestinal and breast cancers by RT-PCR. TRAG-3 was expressed in 23/57 (40%) of the cell lines: the highest expression was found in gastric cancer (6/9: 67%), followed by esophageal (13/28: 46%), colon (3/11: 27%) and liver (1/4: 25%) cancers. In clinical samples, the expression was the highest in esophageal cancer (32/58: 55%), followed by liver (13/50: 26%), bile duct (5/27: 19%), gastric (5/50: 10%), breast (5/50: 10%) and colon (2/87: 2.3%) cancers. The TRAG-3 expression significantly correlated with the expression of MAGE-3 in esophageal cancer (p<0.05). As the TRAG-3 gene is located on Xq28, which is the same locus as the MAGE gene family, we found a frequent synchronous expression pattern with TRAG-3 and MAGE-3 in esophageal cancer.

Iron overload and antioxidative role of perivascular astrocytes in aceruloplasminemia

Aceruloplasminemia (ACP) is an inherited disorder of iron metabolism caused by the lack of ceruloplasmin activity; the neuropathological hallmarks are excessive iron deposition, neuronal loss, bizarrely deformed astrocytes, and numerous 'grumose or foamy spheroid bodies (GFSBs)'. We histopathologically examined two autopsied ACP brains, and observed for the first time that GFSBs form in clusters at the ends of perivascular astrocytic foot processes. Both the deformed astrocytes and the GFSBs contained ferric iron and were intensely immunolabelled with antibodies against the antioxidant proteins ferritin and manganese superoxide dismutase (Mn SOD). Ceruloplasmin is largely produced by perivascular astrocytes in the central nervous system and exhibits a ferroxidase activity that inhibits iron-associated lipid peroxidation and hydroxyl radical formation; therefore, the lack of ceruloplasmin causes direct oxidative stress on astrocytes. The intense immunolabelling of ferritin and Mn SOD most likely reflects a defensive response to iron-mediated oxidative stress. This study suggests that astrocytes play key roles in iron trafficking and the detoxification of iron-mediated free radicals at the blood-brain barrier and in the parenchyma in ACP brain. The antioxidative ability of astrocytes is one of their essential neuroprotective effects, and the decompensation of this ability may lead to secondary neuronal cell death in ACP.

The hepatitis B virus X protein enhances AP-1 activation through interaction with Jab1

Hepatitis B virus X protein (HBx) has many cellular functions and is a major factor in hepatitis and hepatocellular carcinoma caused by HBV infection. A proteomic approach was used to search for HBx-interacting proteins in order to elucidate the molecular mechanism of hepatocarcinogenesis. HBx was attached to myc and flag tags (MEF tags) and expressed in 293T cells; the protein complex formed within the cells was purified and characterized by mass spectrometry. COP9 signalosome (CSN) subunits 3 and 4 were subsequently identified as HBx-interacting proteins. In addition, CSN subunit 5, Jun activation domain-binding protein 1 (Jab1), was shown to be a novel cellular target of HBx. In vivo and in vitro interactions between HBx and Jab1 were confirmed by standard immunoprecipitation and GST pull-down assays. An analysis of HBx deletion constructs showed that amino acids 30-125 of HBx were responsible for binding to Jab1. Confocal laser microscopy demonstrated that HBx was mainly localized in the cytoplasm, while Jab1 was found mainly in the nucleus and partially in the cytoplasm, and that the two proteins colocalized in the cytoplasm. The cotransfection of HBx and Jab1 resulted in substantial activator protein 1 (AP-1) activation and knockdown of endogenous Jab1 attenuated AP-1 activation caused by HBx. In addition, the coexpression of HBx and Jab1 potentiated phosphorylation of JNK, leading to the subsequent phosphorylation of c-Jun, whereas the level of c-Jun and JNK phosphorylation induced by HBx was decreased in Jab1 knockdown cells. These results suggest that the interaction between HBx and Jab1 enhances HBx-mediated AP-1 activation.