Myxoid leiomyosarcoma of the uterus

A 70-year-old, menopausal Japanese woman with large uterine tumor underwent total hysterectomy. Microscopic examination revealed a myxoid leiomyosarcoma with 5 to 6 mitoses/10 high power field (HPF). Immunohistochemically, the tumor cells reacted with desmin, suggesting that they are derived from uterine smooth muscle cells. The patient was treated with the combination chemotherapy consisting of cisplatin, adriamycin and cyclophosphamide, and she has been free from disease for 70 months after the operation.

[From medicolegal toxicology to forensic toxicology]

The importance of forensic toxicology has been increasing until now, because of the increasing numbers of toxic substances and poisoning incidents. In Japan, a special translational word "houi-chudoku-gaku" has been used for the forensic toxicology especially in the field of legal medicine. The Japanese word, however, does not seem appropriate for translation of forensic toxicology, because it covers medicine, pharmacy and police sciences interdisciplinary. In 1980, Emeritus Prof. Hidetoshi Yoshimura created an appropriate word "hochudoku-gaku" for translation of forensic toxicology. In 1982, Prof. Yoshimura and his friends established the Japanese Association of Forensic Toxicology, consisting of people from legal medicine, pharmacy and police institutes. This Association enabled lively discussions among different fields and greatly contributed to advances of forensic toxicology in Japan. We started studies of forensic toxicology using gas chromatography (GC)/mass spectrometry (MS) in 1979. Until now, we delt with solid-phase extraction (1987-1994), surface ionization GC (1989-1997), negative ion chemical ionization MS (1981-now), solid-phase microextraction (1994-now), cryogenic oven trapping GC (1997-now), surface ionization organic MS (1998-now) and high-performance liquid chromatography/tandem MS (1998-now). In this review, the author presents some details of solid-phase microextraction, negative ion chemical ionization MS, cryogenic oven trapping GC and surface ionization organic MS. Unprecedented poisoning terrorism by use of sarin took place in Matsumoto and Tokyo in 1994 and 1995, respectively. On July 25, 1998, a curry poisoning incident using arsenious acid occurred in Wakayama, resulting in the death of 4 people and injury of 63 people. Since then, more than 30 imitative poisoning cases have been reported by mass communication within 1 year. In spite of the above continuing poisoning cases, almost no effective measures have been taken by the administration of our country and local governments. Many serious problems concerning poisoning and drug abuse are accumulating in Japan. In this review, the problems are also made manifest, and some proposals are presented to solve the problems.

[Prognostic factors of hepatocellular carcinoma: analysis by the proportional hazard model]

Five hundred fifty patients hospitalized to our hospital during 1990 to 1999 were studied. Subjects consisted of 413 males and 102 females and mean age was 62.1 years. Association with HBV infection, HCV infection and both infection was 11.1%, 78.4% and 2.5% respectively. According to the criteria based in Liver Cancer Study of Japan, 5 year survival rate in clinical stage I, II, III was 42.3%, 38.8% and 17.5%. Tumor morphology was nodular type in 78.9%, massive type in 9.1% and diffuse type in 10.5% of cases. Portal tumor thrombus and distal metastasis were observed in 19.9% and 6.3% of all cases. The 1-, 3- and 5-year survival rate in patients received any therapy was 80.8%, 44.6% and 28.7%, respectively. Analysis by the proportional hazard model showed that HBV infection, advanced clinical stage, multiple tumors, a tumor diameter in excess of 5 cm and AFP positivity were shown as significant factors on poor prognosis.

A curious autopsy case of accidental carbon monoxide poisoning in a motor vehicle

A 26-year-old man was found dead in his car. All doors and windows were locked inside. The ignition key was in the "on" position; but the engine was not running and the fuel tank was empty. His post-mortem lividity was cherry-pink, and marked congestion was observed in the lungs and brain macroscopically. Massive intracardiac blood containing a small amount of cruor was found in the heart. In histological examination of the heart, partial disarrangement or necrosis was found in the myocardium. The liver cells showed derangement and degenerative changes, with focal lymphocyte infiltration in the portal regions, although they were not severe. The chemical tests showed that the blood concentration of carboxyhemoglobin was 46.6%. Stimulants were also detected from his blood and urine; the concentrations of methamphetamine and amphetamine were 3.25 and 0.84 microg/ml, respectively, for his cardiac blood. Therefore, it seemed reasonable to judge that the cause of his death was carbon monoxide poisoning; the cardiomyopathy and the presence of stimulants in blood might facilitate his death. Upon careful investigation of his car, it was disclosed that exhaust gas, leaked from small holes of the exhaust pipe due to rust-through, invaded the interior through four holes on the floor of the car during parking with the engine being on for the purpose of air-conditioning of the interior. It is very common to commit suicide by introducing exhaust gas into an interior of a closed motor car, but the present accidental case of carbon monoxide poisoning in a car seems rare and worthwhile reporting.

Separation methods for amino group-possessing pesticides in biological samples

The separation methods for pesticides include liquid-liquid extraction, solid-phase extraction and solid-phase microextraction, gas chromatography (GC), GC-mass spectrometry (MS), GC-MS-MS, high-performance liquid chromatography (LC), LC-MS and LC-MS-MS. This review deals with each technique commonly used for extraction, chromatographic separation and detection of amino group possessing pesticides, such as diazines, triazines, carbamates, dinitroanilines and chloroacetanilides in biological samples. The methods presented for analysis of the pesticides in complicated biological matrices seem to be easily applicable to surface or groundwater in environmental chemistry.

Situations of poisoning and analytical toxicology in Japan

Unprecedented poisoning terrorism by use of sarin took place in Japan in 1994 and 1995. On July 25, 1998, a curry poisoning incident in Wakayama occurred resulting in the death of four people and injury of 63 people. Since then, more than 30 imitative poisoning cases have been reported by mass communication within 1 year. In this brief review, we present some details of a series of poisoning cases and measures taken by the Japanese Government and non-government groups. In addition some research projects on analytical toxicology being conducted in our laboratories are also introduced; gas chromatography (GC) with cryogenic oven trapping for volatile organic compounds, and GC/surface ionization organic mass spectrometry for tertiary amino compounds are described especially as new techniques for biological samples.

Analyses of butyrophenones and their analogues in whole blood by high-performance liquid chromatography-electrospray tandem mass spectrometry

Five butyrophenones and two analogues contained in human whole blood have been analyzed by high-performance liquid chromatography (HPLC)-electrospray (ES)-tandem mass spectrometry (MS). All compounds gave the base peaks due to [M+1]+ by HPLC-ES-single MS. The product ions formed from each quasi-molecular ion by HPLC-ES-tandem MS showed the base peaks at m/z 165 for four compounds. The mass chromatography of HPLC-ES-tandem MS showed much higher sensitivity than that of HPLC-ES-single MS for all drugs spiked to whole blood. Therefore, regression equations, detection limits, recovery rates and precision were studied for haloperidol, bromperidol and fluoropipamide spiked to human whole blood by means of mass chromatography of HPLC-ES-tandem MS. The three compounds showed good linearity in the range of 0.2-0.8 ng/ml with a detection limit of about 0.1 ng/ml. Recoveries of the three compounds spiked to whole blood (0.2 and 0.8 ng added to 1 ml whole blood) were 23.6-81.2%; the coefficients of intra- and inter-day variations were 8.4-10.4 and 14.5-17.5%, respectively. The three compounds in whole blood could be actually determined 3 and 6 h after oral administration of 1 mg each of haloperidol and bromperidol, and 10 mg of floropipamide in a volunteer.

Determination of phenothiazines in human body fluids by solid-phase microextraction and liquid chromatography/tandem mass spectrometry

Eleven phenothiazine derivatives with heavy side-chains were found to be extractable from human whole blood and urine samples by solid-phase microextraction (SPME) with a polyacrylate-coated fiber. The fiber was then injected into the desorption chamber of an SPME-liquid chromatography (LC) interface for LC/tandem mass spectrometry (MS/MS) with positive ion electrospray (ES) ionization. All compounds formed base peaks due to [M + 1](+) ions by LC/ES-MS/MS. By use of LC/ES-MS/MS, the product ions produced from each [M + 1](+) ion showed base peaks due to side-chain liberation. Selected reaction monitoring (SRM) and selected ion monitoring (SIM) were compared for the detection of the 11 phenothiazine derivatives from human whole blood and urine. SRM showed much higher sensitivity than SIM for both types of sample. Therefore, a detailed procedure for the detection of drugs by SRM with SPME-LC/MS/MS was established and carefully validated. The extraction efficiencies of the 11 phenothiazine derivatives spiked into whole blood and urine were 0. 0002-0.12 and 2.6-39.8%, respectively. The regression equations for the 11 phenothiazine derivatives showed excellent linearity with detection limits of 0.2-200 ng ml(-1) for whole blood and 4-22 pg ml(-1) for urine. The intra- and inter-day precisions for whole blood and urine samples were not greater than 15.1%. The data obtained after oral administration of perazine or flupentixol to a male subject are presented.

Follicle selection in cyclic guinea pigs with active immunization against inhibin alpha-subunit

Experiments were conducted to elucidate the mechanisms of active immunization against inhibin on ovarian follicular development and selection in guinea pigs. Estrous cycle was synchronized in experimental guinea pigs by implanting progesterone containing tubes. Antibodies that bound 125I-labeled bovine inhibin were produced by all guinea pigs receiving the inhibin vaccine (recombinant ovine alpha-subunit in oil emulsion) without any effects on duration of the estrous cycle. Active immunization against inhibin increased the plasma concentrations of progesterone during the luteal phase and the plasma concentrations of estradiol but failed to increase the plasma concentration of follicle-stimulating hormone (FSH) during preovulatory period. The treatment also increased the number of corpora lutea (from 1.3+/-0.3 to 7.0+/-1.6 per each ovary), and preovulatory sized follicles (from 1.8+/-0.6 to 7.0+/-1.6 per each ovary), and follicles stained positively for inhibin alpha-subunit (from 2.3+/-0.5 to 6.3+/-1.3 per each ovary) significantly. The results indicate that active immunization against inhibin enhances ovulation rate by affecting the follicle selection and only dominant follicle can be stained for inhibin alpha-subunit in guinea pigs. This study is firstly to provide direct evidence that inhibins play important role in follicle selections in guinea pigs.

Increase in production of ascorbate radical in tissues of rat treated with paraquat

The production of ascorbate radical (A*-) was investigated in tissues of rats intoxicated with paraquat (PQ) to know the protective role of antioxidant ascorbate (AH-) in tissues. The electron spin resonance (ESR) method is applied to observe A*-. To eliminate increased biosynthesis of ascorbic acid (AH2) by PQ intoxication, ODS rats were chosen and fed with or without 250 ppm PQ in the diet. The radical A*- was detected only in the lung and spleen homogenates of both intoxicated and control rats at the beginning of ESR measurement. The radical levels of intoxicated rat lung and spleen were increased rapidly to twice the initial level after 3 h and decreased to 0.2-0.6 times the initial level after 24 h, whereas those of control rats were increased slowly to 1.1 times the initial level after 4 h and decreased slowly to 0.7 times the initial level after 24 h at 4 degrees C. In other organs such as liver, kidney, heart and testis, A*- was not detected initially but detected afterwards. Higher A*- level was observed in the intoxicated rat liver than the control but no appreciable differences of A*- levels were observed between the intoxicated kidney, heart and testis and the respective controls. In the intoxicated rat lung the concentration of AH2 is only half but that of A*- is twice as high as that of the control. Larger amounts of A*- produced in the intoxicated rats decayed more quickly than those in the control rats. The simple addition of PQ to the control organ enhanced neither A*- production nor A*- quenching. These facts suggest that the tissues damaged by PQ require larger amounts of AH- to detoxicate harmful oxidants, resulting in concomitant production of A*-.

Development of embryos in superovulated guinea pigs following active immunization against the inhibin alpha-subunit

Embryo recovery and subsequent embryonic development from guinea pigs treated with or without inhibin vaccines were compared to determine the effect of active immunization against the inhibin alpha-subunit. Twenty female guinea pigs of the Hartley strain were injected 3 times either with 1 ml inhibin vaccine (recombinant ovine inhibin a-subunit in oil emulsion: 50 microg/ml, inhibin-immunized group), or 1 ml placebo (saline in oil emulsion; control group) at 4 week intervals. After one estrous cycle following the last injection, females were naturally mated and embryos were collected at 11:00 hr of day 6 of pregnancy (Day 1: sperm in the vaginal smear) for culture in vitro. Active immunization increased the number of corpora lutea (12.6+/-3.0 vs. 4.6+/-0.2, P<0.05), recovered embryos (9.8+/-1.9 vs. 3.6+/-0.4, P<0.01) and normal embryos (7.8+/-1.4 vs. 3.6+/-0.4, P<0.05), although estrous cycle length was not affected (P>0.05). During subsequent 8 day culture in vitro, most of the recovered embryos formed trophoblast outgrowth; 100% (14/14) and 88.2% (15/17) in control and immunized groups, respectively. High levels of inhibin antibody titers were sustained in the inhibin-immunized guinea pigs at least for 5 months after the last injection while no antibody titer was detected in the control animals. These results indicate that active immunization against the inhibin a-subunit is a long-acting and efficient method to induce superovulation with normal embryonic development in the guinea pig.

Recent advances in the microinsemination of laboratory animals

Microinsemination techniques were applied to laboratory animals, including mice, Mongolian gerbils, mastomys, guinea pigs and cynomolgus monkeys. After micro-insemination with spermatozoa or round spermatids, their oocytes were successfully fertilized and subsequently developed into 4-cells to blastocysts, depending on species. The efficiencies of microinsemination techniques for producing fertilized oocytes were comparable with, or superior to those of IVF in these species.

A simple semisolid subtraction method using carbodiimide-coated microplates

In this article, we develop a novel subtraction method using carbodiimide-bound microplates. This method utilizes the high affinity of carbodiimides for both single- and double-stranded nucleic acids. Carbodiimide-mediated end-attachment of driver RNA to microplates allows semisolid phase hybridization between driver RNA and target cDNA, and ensures easy removal of RNA/cDNA hybrids composed of the genes commonly expressed in driver and target. As a result, the target-specific genes are left unhybridized and enriched in the hybridization supernatant. We define the optimal conditions for the method as a target/driver RNA ratio of 1:10 and a period of hybridization of 24 h. There are at least three major advantages with the present method: (1) The entire procedure, which consists of two steps, is very simple; (2) hybridization efficiency can be monitored before further processing of the samples; and (3) rare transcripts can be effectively enriched. This method may be a powerful tool to isolate the genes specifically expressed in particular cell or tissue types, and is easily applicable to many studies in molecular biology and genetics. Isolation of polyploid megakaryocyte-specific genes is shown as an example.

Production of male cloned mice from fresh, cultured, and cryopreserved immature Sertoli cells

Although it is generally accepted that relatively high efficiencies of somatic cell cloning in mammals can be achieved by using donor cells from the female reproductive system (e.g., cumulus/granulosa, oviduct, and mammary gland cells), there is little information on the possibility of using male-specific somatic cells as donor cells. In this study we injected the nucleus of immature mouse Sertoli cells isolated from the testes of newborn (Days 3-10) males into enucleated mature oocytes in order to examine the ability of their nuclei to support embryonic development. After activation of the oocytes that had received the freshly recovered immature Sertoli cells, some developed into the morula/blastocyst stage, depending on the age of the donor cells (22.0-37.4%). When transferred into pseudopregnant females, 7 (3.3%, 7 of 215) developed into normal pups at term. Nuclear transfer of immature Sertoli cells after 1 wk in culture also produced normal pups after embryo transfer (3.1%, 2 of 65). Even after cryopreservation in a conventional cryoprotectant solution, their ability as donor cells was maintained, as demonstrated by the birth of cloned young (6.7%, 7 of 105). Immature Sertoli cells transfected with green fluorescent protein gene also supported embryo development into morulae/blastocysts, which showed specific fluorescence. This study demonstrates that immature Sertoli cells, male-specific somatic cells, are potential donors for somatic cell cloning.

T-cell epitope analysis of Mag 3, an important allergen from the house dust mite, Dermatophagoides farinae

Here we describe the detection of T-cell epitope region on the house dust mite allergen Mag 3, which has been shown to trigger T-cell proliferation in mite-allergic asthmatic patients. We first examined murine T-cell epitope using T-cell fraction prepared from recombinant Mag 3 (r-Mag 3)-primed H-2k mice. Initial proliferation assay with truncated r-Mag 3 indicated that N-terminal 113 amino acid region was required for triggering T-cell activation. Subsequent epitope scanning with synthetic overlapping peptides revealed that T-cell reactive region was assigned within amino acid range 56-75. We also explored human T-cell determinant using specific T-cells from mite-allergic patients. Intriguingly, we found that amino acid range 56-85, a portion partially overlapping with that identified in r-Mag 3-primed mice, was exclusively recognized by T-cells from different patients. Further investigation of unique T-cell epitope region found in this study would provide insight into the development of animal therapeutic model and/or peptide vaccine for asthma.

Rupture of infected pseudoaneurysms in patients with implantable ports for intra-arterial infusion chemotherapy

Intra-arterial hepatic chemotherapy via implantable reservoirs is being used increasingly. In our department, five patients have undergone emergency surgery since 1991 because of rupture of an infected pseudo-aneurysm at the site of entry of the catheter. Surgical procedures included removal of the catheter and the reservoir, and closure of the affected artery with or without reconstruction. Of these patients, three (60%) died from uncontrollable sepsis. The poor prognosis emphasizes the need, in patients with carcinoma, for strict aseptic technique and hemostasis at the time of catheter placement, and for careful device maintenance.

Ultrasensitive determination of phencyclidine in body fluids by surface ionization organic mass spectrometry

Gas chromatography (GC)/surface ionization organic mass spectrometry (SIOMS) has been found to give much higher sensitivity for measurements of phencyclidine (PCP) than the conventional GC/electron impact (EI)-mass spectrometry (MS). Thus, we have established a detailed procedure for measurements of PCP in body fluids by both mass chromatography and selected-ion monitoring (SIM) of SIOMS using pethidine as an internal standard (IS). Good linearity was found in the range of 0.25-10 ng/mL of whole blood or urine, when measured by mass chromatography, and in the range of 0.025-1.0 ng/mL of whole blood by SIM. The recoveries of PCP and IS spiked to whole blood were 106 +/- 17% at 1 ng/mL and 113 +/- 11% at 5 ng/mL; that of IS was 97.8 +/- 10.4% at 5 ng/mL. The detection limits (signal-to-noise ratio = 3) were estimated to be 0.05 ng/mL of whole blood or urine by mass chromatography and 0.01 ng/mL of whole blood by SIM. The coefficients of intraday and interday variations were not greater than 10.3%. We could detect PCP from rat whole blood 2 h after subcutaneous injection of PCP (1 mg/kg) by mass chromatography. The mean PCP concentration in rat blood was 47.7 +/- 6.2 ng/mL (mean +/- SD, n = 4).

Purification and characterization of sea squirt α-N-acetylgalactosaminidase

Sea squirt alpha-N-acetylgalactosaminidase was purified to homogeneity. Its molecular weight was estimated to be approximately 160,000 by gel filtration and 40,000 by SDS-polyacrylamide gel electrophoresis (SDS-PAGE) under reducing condition. The chromatographic and electrophoretic behaviors indicated that the enzyme was composed of four subunits. The optimum pH of the enzyme reaction was about 4.0 at 37 degrees C, while the enzyme was stable in the range of pH 5.0 to 6.0 during 4 h preincubation at 37 degrees C. Although the enzyme (0.1 unit) was stable at 0 degrees C for 30 min in the presence of 7.5 mM metal ions (Al3+, Ba2+, Ca2+, K+, Mn2+, Pb2+, Sr2+, and Zn2+), almost 40% of the enzyme activity was lost in the presence of Cu2+, Hg2+, monoiodoacetic acid, and EDTA. The enzyme hydrolyzed aryl N-acetyl-alpha-D-galactosaminide as well as GalNAcalpha1(-->4GalNAcalpha1-->)n 4GalNAc-p-aminobenzoic acid ethyl ester (ABEE) (n = 1-4), but GalNAcalpha1-->4GalNAc-ABEE only scarcely. Furthermore, an allergenic pentasaccharitol ABEE derivative, GalNAcalpha1-->2Fucalpha1-->3(GalNAcbeta1-->4) GlcNAcbeta1-->2(3-acetoamido-3-deoxy)L-threose-ABEE, the minimum structural unit for the sea squirt allergenicity was hydrolyzed to 95 mol% for 72 h incubation with the enzyme. The enzyme could be utilized as a powerful tool for the structural analyses of the carbohydrate epitopes of the sea squirt allergen molecules.

Determination of pentazocine in human whole blood and urine by gas chromatography/surface ionization organic mass spectrometry

Pentazocine has been found to be measurable with much higher sensitivity by gas chromatography (GC)/surface ionization (SI) organic mass spectrometry (OMS) than by the conventional GC/electron ionization (EI) mass spectrometry. The compound was extracted from human whole blood and urine with Sep-Pak C(18) cartridges before analysis by GC/SIOMS; recoveries were > 96.6% for both samples. The calibration curves were linear in the range 6.25-100 ng ml(-1) and the detection limits were 500 pg ml(-1) of a sample by selected ion monitoring (SIM) with GC/SIOMS. The intra- and inter-day relative standard deviations for the determination of pentazocine in whole blood and urine were not greater than 9.6%. The sensitivity for pentazocine obtained by SI-SIM was about 60 times higher than that obtained by EI-SIM. To validate the present GC/SIOMS method for pentazocine, whole blood and urine samples collected from two volunteers 1-6 h after intramuscular injection of 15 mg of pentazocine were analyzed. The concentrations were 13.5-59.3 ng ml(-1) for whole blood and 0.39-4.00 microg ml(-1) for urine.

Endovascular treatment of unruptured vertebro-basilar aneurysms

We reviewed 201 unruptured vertebro-basilar aneurysms encountered at our institute and 35 affiliated hospitals over the past 8 years. Of these, 106 aneurysms in 103 patients were treated with surgical or endovascular approaches: 43 aneurysms, surgically with clipping or wrapping; and 63 endovascularly with embolization. Outcome was excellent or good in 87 patients (84.5%). Among 24 patients with 36 complications, 16 had unfavorable outcomes including five deaths. Twelve patients (27.9%) with surgical treatment and two (3.3%) with endovascular treatment had unfavorable results because of treatment-related complications. Two patients with surgical treatment had complications related to perioperative management. Vascular occlusive complications were likeliest to occur in surgically treated basilar artery aneurysms (41%). Among surgically treated aneurysms the vertebral artery site was relatively associated with cranial nerve injuries. Complications numbered 36, occurring in 24 patients and 54% of complications affected outcome. Overall morbidity and mortality of surgical treatment were 18.6% and 7.0%, respectively, while those of endovascular treatment were 5.0% and 3.3%. In conclusion, complications of surgery tend to be serious and affect outcome, and endovascular treatment is safer than surgical for vertebro-basilar aneurysms. Embolizations are particularly advantageous for patients who are poor surgical risks.

Implantation of octacalcium phosphate (OCP) in rat skull defects enhances bone repair

Synthetic octacalcium phosphate (OCP) enhances bone formation if implanted into the subperiosteal region of murine bone. Such implanted OCP may be resorbed and replaced by bone with time. We hypothesized that OCP could be used as an effective bone substitute. To test this hypothesis, we designed the present study to investigate if bone repair in a rat skull defect is enhanced by the implantation of OCP. Rats were divided into two groups: OCP-treated animals and untreated controls. Six rats from each group were fixed at 4, 12, and 24 weeks after implantation. A full-thickness standardized trephine defect was made in the parietal bone, and synthetic OCP was implanted into the defect. After being examined radiographically, the specimens were decalcified and processed for histology. OCP implantation significantly promoted bone repair compared with the controls. A statistical analysis showed an increase in the area of radiopacity within the skull defect between week 4 and week 12. Histologically, bone was formed on the implanted OCP and along the defect margin at week 4. At week 12, the implanted OCP was surrounded by newly formed bone. At week 24, the defect was almost completely filled with bone. In the control, bone formation was observed only along the defect margin. The present results demonstrate that OCP could be used as an effective bone substitute.