Hydroxylforms of p-boronophenylalanine as potential boron carriers on boron neutron capture therapy for malignant brain tumors

Hydroxylforms of boronophenylalanine (BPA) were synthesized by conjugation with a cascade of polyols to decrease the BPA uptake of normal parenchyma without affecting uptake into the tumor. We determined their tumor cell killing effect on boron neutron capture therapy (BNCT) against BPA using the human glioma cell line T98G. The thermal neutron doses yielding the D37 (dose used to inhibit 63% colony formation) values of dl-p-BPA(OH)n were 1.45 x 10(12)nvt (n = 1), 1.33 x 10(12)nvt (n = 2), 3.37 x 10(12)nvt (n = 4), and 1.72 x 10(12)nvt (n = 0). The relative tumor cell killing effect on BNCT of dl-p-BPA(OH)n against dl-p-BPA, which was defined as the ratio of D37-BPA to D37-BPA(OH)n, was 1.18 (n = 1) 1.29 (n = 2), and 0.51 (n = 4). The tumor:normal brain ratio of dl-p-BPA(OH)n in 9L rat brain tumor models was improved 1.2- (n = 1) and 1.4-fold (n = 2) against that of dl-p-BPA without a decrease of its uptake into the tumor. The water solubility of BPA(OH)n increased against BPA, and the toxicity represented as the IC50 value of dl-p-BPA(OH)2 was nearly one half that of dl-p-BPA, being established in our previous works. Hydroxylforms of BPA, especially dl-p-BPA(OH)2, might be more suitable boron carriers of BNCT to malignant brain tumors since the radiation injury to the normal parenchyma surrounding the tumor is reduced.

Hemostasis activation during sclerotherapy of lower extremity varices

The influence of compression sclerotherapy upon hemostasis activation was investigated in 41 consecutive patients with lower extremity varices by serial measurement of thrombin-antithrombin III complexes (TAT), D-dimer, fibrinogen and C-reactive protein (CRP). Blood sampling was carried out before operation and on the 7th and 28th post-operative day in patients randomly assigned to either the control group (n = 18), in which high ligation of sapheno-femoral junction and local excision of varices were performed, or the sclerotherapy group (n = 23) in which the comparable surgical intervention and compression sclerotherapy using hypertonic saline were performed simultaneously. In both groups, the TAT, D-dimer and fibrinogen concentrations at day 7 were significantly elevated compared to the value before operation while CRP showed no significant change during the observation period. In the sclerotherapy group, higher incidence of superficial thrombosis was observed and the TAT concentration at day 7 was significantly higher than that in the control group (p < 0.01), and the TAT at day 28 was still significantly elevated compared to the pre-operative level (p < 0.05). However, no relationship between TAT and D-dimer concentrations and the extent of superficial thrombosis was observed. We conclude that compression sclerotherapy for lower extremity varices causes latent activation of coagulation system and can be a risk factor for venous thromboembolism.

Surgical treatment for the recurrence of colorectal cancer

We report the results of a retrospective study conducted on patients who developed recurrence following surgery for colorectal cancer, and present a practical plan to improve the survival rates. Of 974 patients who underwent surgery for colorectal cancer in our hospital during the 20 years between 1974 and 1993, 152 developed recurrence, as local recurrence in 70 (7.2%), as liver metastasis in 47 (4.8%), and as pulmonary metastasis in 35 (3.6%). The number of patients who underwent reoperation or curative resection was 54 (77.1%) and 13 (24.1%), respectively, of those with local recurrence, 16 (34.0%) and 6 (37.5%) of those with liver metastasis, and 6 (17.1%) and 6 (100.0%) of those with pulmonary metastasis. The 3- and 5-year survival rates were 13.4% and 8.9%, respectively, after reoperation for local recurrence, 14.4% and 0%, after reoperation for liver metastasis, and 53.3% and 53.3% after reoperation for pulmonary metastasis. Although evaluation was difficult owing to the small number of patients with lung metastasis, resection of a pulmonary lesion resulted in a good outcome. Furthermore, a significant difference in 3- and 5-year survival rates was observed between patients who underwent reoperation and those who underwent conservative treatment, for whom the survival rates were 0% and 0% following local recurrence, 4.6% and 0% following liver metastasis, and 0% and 0% following lung metastasis, at 3 and 5 years, respectively. These findings indicate that aggressive surgery for recurrence may result in a better outcome.

Platelet microparticles: a carrier of platelet-activating factor?

Platelet-activating factor (PAF) has been considered to be released in a soluble form from activated platelets. Also a considerable number of microparticles were released from stimulated platelets. To evaluate the possibility that microparticles contain PAF, the amount of PAF in whole activated platelets, microparticles and the suspending medium was determined by means of bioassay. The total amount of PAF released from 3 x 10(8) platelets activated with thrombin (0.5 U/ml) plus collagen (10 micrograms/ml) for 10 minutes was 4.6 +/- 1.5 x 10(-12) mol (n = 8, mean +/- S.D.). Eighty-seven percent of the PAF released from platelets was associated with microparticles. PAF released in microparticles is susceptible to plasma acetylhydrolase and may be localized on the outer surface of microparticles. This is the first report implicating the role of microparticles as a novel carrier of mediators formed in the cells.

Tumor necrosis factor alpha and lymphotoxin stimulate human myeloblastic leukemia cell (ML-1) invasion through a reconstituted basement membrane (Matrigel) with concomitant induction of 92 kDa gelatinase secretion

We have examined the effects of tumor necrosis factor alpha (TNF) and lymphotoxin (LT) on gelatinase (72 kDa and 92 kDa) and tissue inhibitor of metalloprotease 1 (TIMP1) secretion by human myeloblastic leukemia cells (ML-1) in vitro. TNF (0.1-30 ng/ml) significantly stimulated 92 kDa gelatinase secretion in a dose-dependent manner, but did not significantly stimulate 72 kDa gelatinase secretion. LT also significantly stimulated 92 kDa gelatinase secretion, but the stimulation was less effective compared to TNF. TNF, but not LT, concentrations at 30 ng/ml slightly stimulated TIMP1 secretion. Because 92 kDa gelatinase is thought to play a pivotal role in tumor invasion, we examined the effect of TNF or LT on ML-1 cell invasion through a reconstituted basement membrane (Matrigel). Exposure of ML-1 cells to TNF (3, 10, and 30 ng/ml) or LT (3, 10, and 30 ng/ml) stimulated ML-1 cell invasion through Matrigel in a dose-dependent manner in vitro. The data suggest that TNF- and LT-stimulated 92 kDa gelatinase secretion could play an important role in TNF- or LT-stimulated ML-1 cell invasion.

The coagulofibrinolytic state of patients with primary varicose veins of the lower legs

The relationship between a local hypercoagulable state and primary varicose veins of the lower legs was investigated by measuring the plasma levels of D-dimer (DD) and the thrombin-antithrombin-III complex (TAT) in 122 consecutive patients before treatment, and in 46 patients after surgical intervention and compression sclerotherapy. Elevated levels of DD and TAT were found in 25% and 20%, respectively, of the 122 patients, being significantly elevated in the patients with thrombophlebitis compared to the patients with no dermal symptoms, pigmentation, or stasis dermatitis. There was no significant difference in either parameter among eight groups of patients classified according to their valvular incompetence. The levels of DD and TAT were elevated before treatment in 25% and 20%, respectively, of 45 treated patients, but became significantly reduced after treatment. These results indicate that even though the local hypercoagulable state in varicose veins without thrombophlebitis is too subtle to be detected by systemic parameters such as DD and TAT, a local hypercoagulable state can be detected in a certain proportion of patients with venous stasis by these parameters.

Identification of a novel exon and spliced form of Duffy mRNA that is the predominant transcript in both erythroid and postcapillary venule endothelium

The Duffy gene has been shown not to be split by introns, even in its 5' untranslated region, and to be expressed not only in erythroid but in postcapillary venule endothelium of almost every organ in the body. To further investigate the transcriptional start position in erythroid and postcapillary venule endothelium, we performed 5'-rapid amplification of cDNA ends (5'-RACE). While every positive clone of 5'-RACE encoded the identical sequence of previously identified cDNA downstream from nucleotide 203, the upstream sequences were different. The upstream sequences corresponded to the sequence from nucleotide -279 to -308/-357 in erythroblasts and from -279 to -355/-383 in lung and were regarded as comprising a novel exon. This novel exon encoded seven residues initiated with a methionine, linked to nucleotide 203 in-frame and in agreement with the GT-AG splicing rule. The major erythroid transcriptional start position was identified in human erythroleukemia cells by primer extension and in bone marrow by ribonuclease protection analysis at 34 bases upstream from the first ATG codon. Distinctively, in lung and kidney, the transcription was started at 82 bases upstream from the ATG. Both Northern blotting and reverse transcription-polymerase chain reaction followed by Southern analysis indicated a predominance of the novel spliced form of mRNA of about 50- to 200-fold comparing with the unspliced form, in every studied organ and erythroid lineage cells. The spliced form of cDNA has been transfected into a human erythroleukemic cell line, K562, and the expressed protein reacted with Duffy-specific murine monoclonal antibody Fy6. These studies indicate that the product from the spliced form of mRNA is the major product of the Duffy gene in the erythroid lineage and postcapillary venule endothelium.

[Autosomal dominant polycystic kidney]

A 48-year-old male had autosomic dominant polycystic kidneys with dimensions, to the best of our knowledge, never previously reported; the right kidney weighed 15,100 g and measured 53 x 33 x 9cm and the left one 10.200 g and 46 x 21 x 7cm, with cysts measuring up to 14cm in diameter. Nephrectomy was done to control persistent hematuria and to relief disconfort caused by the large kidneys. The renal function is stable four years after transplantation.

Association of human papillomavirus with malignant and premalignant lesions of the uterine endometrium

The possible association of human papillomavirus (HPV) with endometrial hyperplasia and endometrial adenocarcinoma was investigated. DNA from frozen tissues of 30 endometrioid carcinomas of Japanese patients was tested for HPV DNA by Southern blot hybridization analysis. Screening with HPV type 58 probe under low stringency conditions showed the presence of HPV DNA in two of 30 endometrioid carcinomas. High stringency hybridization identified HPV type 16 in the two positive specimens. The presence of HPV was further analyzed by polymerase chain reaction (PCR)-Southern blot analysis of DNA from archival tissue blocks of the initial 30 endometrioid carcinomas as well as an additional 17 endometrioid carcinomas and 13 atypical hyperplasias of the endometrium from Japan and 38 endometrioid carcinomas from the United States. Polymerase chain reaction amplification using type 16-specific HPV primers for a portion of the E6 open reading frame was positive in six of 47 (13%) endometrioid carcinomas from Japan, including two in which HPV 16 was not detected by Southern blot analysis and two of 38 (5%) endometrioid carcinomas from the United States. Polymerase chain reaction amplification using L1 consensus sequence primers was positive for HPV in two of 13 (15%) endometrial hyperplasias, 13 of 47 (28%) endometrioid carcinomas from Japan, and six of 38 (16%) endometrioid carcinomas from the United States. Slot blot hybridization identified HPV type 16 in seven of the L1 PCR products, including all but one specimen testing positive for HPV type, 16 using E6 type specific primers. In situ hybridization was positive for HPVs 16/18 in glandular epithelial tumor cells in six of the PCR-positive specimens. An additional specimen showed staining for HPVs 16/18 in acellular luminal debris in association with squamous metaplasia of the tumor, but staining was negative in the glandular cells of the tumor. Human papillomavirus was not detected by in situ hybridization in the remaining specimen, which was PCR positive for HPV 16. In situ hybridization was weakly positive for HPVs 31/33/35 in one specimen and was weakly positive for HPVs 6/11 in benign endometrial epithelial cells but not in tumor cells of another specimen that tested positive for HPV by L1 PCR. Two dimensional gel electrophoresis performed on two specimens showed that HPV DNAs were integrated into cellular DNA with no episomal coexistence. These findings suggest that HPV, especially HPV 16, may play an etiologic role in a fraction of endometrioid adenocarcinomas.

[Detection of chromosomal aberration using fluorescence in situ hybridization on breast cancer]

The relationship between interphase cytogenetics and prognostic factors, especially the grade of nuclear atypism, nuclear DNA content, histological lymph node metastasis and clinical data was examined in 48 primary breast cancer specimens (touch preparation). Using fluorescence in situ hybridization (FISH) with a chromosome-specific DNA probe, the copy number of pericentrometric sequences on chromosome 17 was examined within the interphase nuclei in touch preparations from the tumor. The copy number of chromosome 17 was correlated with the increase in the grade of nuclear atypism, tumor size, histological lymph node metastasis and nuclear DNA content. In the diploid type of nuclear DNA content, the copy number of chromosome 17 was correlated with the increase in the grade of nuclear atypism and histological lymph node metastasis. In conclusion, the numerical chromosomal aberrations detected by FISH were found in the DNA diploid cases by FCM. The detection of numerical chromosomal aberrations by FISH provide important information about the prognostic factors.

Synthesis and biological properties of water-soluble p-boronophenylalanine derivatives. Relationship between water solubility, cytotoxicity, and cellular uptake

Water-soluble p-boronophenylalanine (BPA) derivatives having cascade polyols, the monohydroxy derivative BPA(OH) (4), the dihydroxy analogue BPA(OH)2 (5), and the tetrahydroxy analogue BPA(OH)4 (6), were synthesized in order to elucidate a relationship between the molecular structures and the cellular uptake. Biological properties of these compounds in addition to BPA (1) itself were investigated. Water solubility increased in the order of BPA < BPA(OH) < or = BPA(OH)2 > BPA(OH)4. Cytotoxicity to B-16 melanoma and TIG hybrobrast cells decreased in the order of BPA >> BPA(OH) > or = BPA(OH)2 > BPA(OH)4. The cellular uptake by both B-16 and TIG cells decreased in the order of BPA > BPA(OH) > or = BPA(OH)2 > BPA(OH)4, whereas the uptake ratio of B-16/TIG increased in the order of BPA < BPA(OH) < or = BPA(OH)2 < BPA(OH)4. The latter ratio indicates the selectivity on the uptake by a cancer to normal cell.

Cloning and expression of the gene of hemocytin, an insect humoral lectin which is homologous with the mammalian von Willebrand factor

Invertebrate lectins play an important role in a non-specific self-defense mechanism, as invertebrates do not synthesize specific antibodies. We report the cloning of several overlapping cDNAs encoding the entire silkworm (Bombyx mori) lectin, which we propose to call hemocytin. The sequence (10477 bp) encoded 3133 amino acids. The characteristics features of the carbohydrate-recognition domain of C-type animal lectin were revealed at C-terminal sequence of hemocytin. When cDNA encoding this region was introduced into baculovirus vector, hemagglutinating activities were detected in the culture fluid of a recombinant virus-infected cells. These activities were inhibited by D-mannose, N-acetyl-D-galactosamine, and D-maltose which are haptenic saccharides of authentic hemocytin. Analysis of dot and Northern blot hybridization revealed that hemocytin gene was transcribed in hemocytes of the silkworm at larval-pupal metamorphosis and/or after the injection of Escherichia coli and lipopolysaccharide. After silkworm larvae were injected with C-terminal portion of hemocytin, aggregation of hemocytes was observed in the hemolymph. Hemocytin has significant homology with mammalian von Willebrand factor which involves in platelet adhesion to subendothelium. Also, hemocytin has a homologous region with coagulation factor V and VIII. These results suggest that hemocytin molecule is an adhesive protein and relates to hemostasis or encapsulation of foreign substances for self-defense.

Genomic organization of the glycoprotein D gene: Duffy blood group Fya/Fyb alloantigen system is associated with a polymorphism at the 44-amino acid residue

The Duffy blood group antigen has been characterized by its roles on red blood cells: as a receptor for the malarial parasites and as a promiscuous receptor for chemokine superfamily. Recently, the Duffy blood group associated glycoprotein D (gpFy) cDNA has been cloned (Chaudhuri et al: Proc Natl Acad Sci USA 90:10793, 1993). In this report we describe the organization of genomic DNA coding for the gpFy and elucidate the molecular nature of Fya/b polymorphisms. By a Southern blotting analysis probed with gpFy cDNA, gpFy gene was shown to be composed of three DNA fragments; 1.1-kb Sac I, 1.9-kb EcoRI, and their intervening 47-bp fragments. We cloned the 1.1-kb Sac I and 1.9-kb EcoRI fragments by inverted polymerase chain reaction (IPCR) procedure. The promoter region of the gpFy gene was cloned by IPCR of 1.1-kb Sac I fragment and the 3' flanking sequence was cloned by IPCR of 1.9 kb EcoRI fragment. The both IPCR products contained on both side the known gpFy cDNA sequence without introns, as expected. Although no TATA or CCAAT boxes are present in the promoter sequence, several transcription factor binding site motifs are contained, including AP-1, HNF-5, TCF-1, ApoE B2, W-element, H-APF-1, and Sp-1. The 3' flanking region has two additional polyadenylation signals, other than that used in the cDNA, and also has an indirect and a direct repeat sequence clustered with the 5' flanking region. These facts indicate a possibility that the gpFy gene has been evolved by multiple retrotransposition events. By comparing the coding area of the gpFy gene in 28 Duffy-positive individuals, we elucidated that one base change that results in an amino acid substitution [GA-T(Asp44)-->GGT(Gly)] is in accordance with the Fya/Fyb polymorphism. This fact proves that the gpFy cDNA and its gene described in this report encode the Duffy blood group system.

[A case of occult cancer of pancreas which was appropriately resected by intra operative cytodiagnosis using a balloon catheter]

A new method of intraoperative cytodiagnosis was performed for one patient with occult neoplasms of the pancreas in order to locate the original site of cancer cells, using a balloon catheter. Cancer cells were detected in the pancreatic juice obtained from the pancreatic body only. The pancreatic body was removed, and the tail of the pancreas was anastomosed to the stomach. The post operative course was good without diabetes, and it was confirmed histologically that minimally invasive adenocarcinoma existed in the pancreatic body. Thus this procedure is beneficial because it can preserve as much pancreatic function as possible without losing the chance of cure by surgery.

The prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma

OBJECTIVE

To evaluate the prognostic significance of surgical margin in liver resection of patients with hepatocellular carcinoma.

DESIGN

Retrospective study.

SETTING

The Center for Adult Diseases, Osaka, Japan, between 1980 and 1989.

PATIENTS

One hundred eighty-five patients with hepatocellular carcinoma who underwent liver resection with complete extirpation.

MAIN OUTCOME MEASURE

Cumulative survival rate.

RESULTS

The patients were divided into a wide surgical margin group, in which the lesion was excised with a margin of 1.0 cm or more, and a narrow surgical margin group, in which the margin was less than 1.0 cm. No significant differences could be detected in survival rates for 3 years or longer. Mean +/- SE tumor sizes were 3.4 +/- 0.4 cm and 4.4 +/- 0.3 cm, respectively, in the wide and narrow surgical margin groups. The patients were divided into three groups according to tumor size: group 1, 2.0 cm or less in diameter; group 2, greater than 2.0 cm but 5.0 cm or less in diameter; and group 3, greater than 5.0 cm in diameter. In groups 2 and 3, no significant differences in survival rates were found between the wide and narrow surgical margin groups. In group 1, the survival rate was significantly higher in the wide surgical margin group than in the narrow surgical margin group (P < .05).

CONCLUSIONS

Small hepatocellular carcinomas of 2.0 cm or less in diameter should be resected with an adequate surgical margin. However, surgical margin was not a significant factor in the resection of hepatocellular carcinomas larger than 2.0 cm.

Differential splicing of the glycophorin A mRNA

Two truncated mRNAs, in contrast to the full length of mRNA associated with the glycophorin A gene (GpA-TI, GpA-TII), were isolated from erythroid cells cultured by the selective two-phase liquid culture system for erythroid progenitors in peripheral blood from a normal individual. The GpA-TI mRNAs displayed a direct transition from exon I to exon III, so that the deletion of exon II resulted in the deletion of 33 amino acids encoded by this exon. Furthermore, the GpA-TII showed two direct transitions from exon I to exon III and from exon III to the exon V of the GpA gene. This mRNA lacked both exons II and VI, resulting in the deletion of 46 amino acids. Is is concluded that these truncated mRNAs are transcribed from the same gene as the GpA gene and correspond to splicing isoforms lacking different exons.

Flow cytometric analysis of phenotypes of canine red blood cells with FITC-labeled Clerodendron trichotomum lectin

Canine red blood cells were divided into a positive type (C type) and a negative type (c type) by a agglutination test with Clerodendron trichotomum lectin (CTL). Blood cells changed from c to C type after suffering from mammary tumor were named cm. The c type blood cells treated with neuraminidase were named cn. These red blood cells were studied with flow cytometry using a directly fluoresceinated CTL. Positive percents of C type, cm type, and cn type were 49.3%, 43.8% and 81.0% respectively. While C showed one peak in histogram, cm showed two peaks. The positive peak in the cm blood cells suggested an appearance of a new blood cell population with a novel sugar chain structure after suffering from the tumor.

Lymphotoxin and TNF differ greatly in capacity to induce differentiation of human myeloblastic leukemia ML-1 cells

We found that recombinant and natural lymphotoxin differ from TNF in that they only marginally induce differentiation of human myeloblastic leukemia ML-1 cells. Even at 1,000-fold concentrations, lymphotoxin was significantly less potent than TNF. Lymphotoxin competitively, but not completely, inhibited TNF-induced differentiation. Based on studies of the two types of TNF receptors (55 kDa and 75 kDa) using monoclonal antibodies, the binding activity of lymphotoxin to the receptors was less than 1/3 that of TNF, but lymphotoxin could bind to both TNF receptors. Both receptors were involved in induction of differentiation by TNF. However, lymphotoxin, differed from TNF; it seemed to be weak in sending signals for differentiation through the 75 kDa receptor.

Apoptosis of acinar cells in the pancreas of rats fed on a copper-depleted diet

Male Fischer 344 rats weighing 80-90 g were fed on a copper-depleted diet supplemented with 0.6% triethylenetetramine tetrahydrochloride (a copper chelator), and the death of pancreatic acinar cells of these rats was investigated morphologically and biochemically. The weight of the pancreas of these rats decreased from 3 weeks after feeding, and concomitantly the percentage of dead acinar cells increased to the maximum in about the 5th week and decreased subsequently. These dead acinar cells showed light microscopic and electron microscopic characteristics of apoptosis. Furthermore, the electrophoretic pattern of DNAs extracted from the pancreas having many dead acinar cells showed a ladder-like distribution, characteristic of apoptosis. The present results indicate that feeding of rats on a copper-depleted diet supplemented with a copper chelator results in apoptosis of acinar cells of the pancreas.

Lymphotoxin lacks effects on 75-kDa receptors in cytotoxicity on U-937 cells

We examined differences in cytotoxic activity between human lymphotoxin (LT) and tumor necrosis factor (TNF) as functions of their interaction with two types of TNF receptors, 55-kDa (p55R) and 75-kDa (p75R). Cytotoxic activity of LT was much lower than that of TNF on a human monocytic cell line, U-937, on which p75R was predominant. Monoclonal antibodies specific for p55R (htr-5 and htr-9) and p75R (utr-1) significantly diminished TNF cytotoxicity, whereas, utr-1 was only slightly inhibitory to LT cytotoxicity, and htr-5 reduced it significantly. TNF individual binding to p75R increased cytotoxic activity when p55R was occupied by htr-9 and a mutein of TNF which significantly lost affinity to p75R. However, LT binding to p75R did not increase. Scatchard analysis with [125I]LT and [125I]TNF showed that LT still had approximately half of the affinity to p75R and slightly less affinity to p55R than TNF. These results indicate slight cytotoxicity of LT compared to TNF, due to inability of LT to signal through p75R on U-937 cells without significant loss of affinity to p75R.

An exon 28 mutation resulting in alternative splicing of the glycoprotein IIb transcript and Glanzmann's thrombasthenia

The alternatively spliced from mRNA of platelet glycoprotein IIb (GPIIb) with a deletion of exon 28 (GPIIb-28) has been isolated from the HEL cell cDNA library. The defective expression on the surface of DNA cotransfected COS-1 cells with GPIIb-28 and GPIIIa cDNAs was described in an earlier report. We studied siblings with Glanzmann's thrombasthenia who expressed only the GPIIb-28 mRNA in their platelets. Flow cytometry showed that the patients' platelets failed to bind GPIIb/IIIa complex-specific and GPIIb-specific monoclonal antibody. Western blotting showed that the patients' platelets had defective GPIIb and have trace amounts of GPIIIa. Sequence analysis was performed after polymerase chain amplification of the patients' GPIIb and GPIIIa mRNAs. The patients' GPIIb cDNA had a deletion of the exon 28 nucleotides. The polymerase chain reaction (PCR) from exon 27 to 29 showed that the GPIIb-28 mRNA was 3% +/- 1.6% of the normally, spliced form in control platelets, and 61% in the megakaryoblastic cell line UT-7. The patients' platelets showed only the GPIIb-28. Family study and quantitative PCR studies showed that these patients were compound heterozygotes of two GPIIb gene defects. The father's allele is described in this report and involves skipping exon 28 secondary to a base substitution at codon Gln948, CAG-->TAG. The mother's allele appears to involve decreasing GPIIb mRNA levels in platelets. Our results indicate that the GPIIb-28 is not expressed on platelet membranes as a stable GPIIb/IIIa heterodimer or left as a monomer in platelets. Our studies confirm the previous data observed in COS-1 cells expressing recombinant GPIIb-28.

Failure of FK-506, a new immunosuppressant, to prevent cerebral vasospasm in a canine two-hemorrhage model

In order to clarify the possible role of immunological reaction in the pathogenesis of cerebral vasospasm, the authors examined the prophylactic effect of the immunosuppressant agents FK-506 and cyclosporin A on chronic vasospasm in a canine two-hemorrhage model. While a mean constriction of the basilar artery to 81.0% +/- 4.0% (+/- standard error of the mean) occurred on Day 2 and to 63.8% +/- 3.5% on Day 7 in the untreated group, constriction to 77.9% +/- 3.4% on Day 2 and 62.8% +/- 3.0% on Day 7 was demonstrated in the FK-506-treated group (difference not significant). This tendency was also noted in the cyclosporin A-treated group, with basilar artery constriction to 81.8% +/- 3.7% and 56.3% +/- 2.7%, respectively (difference not significant). The histological changes of the basilar artery, including corrugation of the elastic lamina, detachment of endothelial cells, and vacuolar formation in the smooth-muscle layer were not different in the two treated groups and the one control group. Since these immunosuppressant agents are known to inhibit the release of interleukin-2 (IL-2), the level of IL-2 was examined in the cerebrospinal fluid of patients with cerebral vasospasm. While interleukin-1 gradually increased in level as time passed, the level of IL-2 was consistently low during the course of the study, indicating less participation of IL-2 in the pathogenesis of cerebral vasospasm. This clinical observation matched the experimental results. The authors conclude that cell-mediated immunoreaction, initiated mainly by IL-2, plays little role in the pathogenesis of cerebral vasospasm.

["Partial wrapping therapy" for recurrent hepatocellular carcinoma by transthoracic route]

Two patients with recurrent hepatocellular carcinoma close to the diaphragma, underwent TAE following decollateralization using silicone rubber sheeting with thoracotomy. The patients suffered from severe liver cirrhosis. Laparotomy was not carried out for the preservation of hepatic function. After wrapping therapy, serum AFP level was reduced to almost the normal range in one case, but in another case to half because of bilateral lung metastasis. The maximum serum level of postoperative serum total bilirubin in these 2 cases was 2.0 mg/dl and 1.6 mg/dl, respectively. We think wrapping therapy with thoracotomy is readily applicable for patients with severe cirrhosis.

Estimating the age at death in a group of historically unknown adults

Ten diaphysis specimens of femurs and humeri from a total of 4 bodies, three excavated from 14th-15th century graves. (Muromachi period) and one from a tomb of the 7th century (period of ancient burial mounds), were examined using histomorphological methods to estimate their ages. The estimation formula was established using humeri (72 specimen) and femurs (71 specimen) from Japanese aged between 26 and 75 years. The formula was prepared based on a multiple regression analysis of the following 3 items: number of osteons/mm2, mean diameter of osteons, and mean diameter of the Haversian canals. Four estimation formulas were established based on the humeri from all subjects, the femurs from all subjects, the humeri from subjects between 26 and 55, and the femurs from subjects between 26 and 53, respectively. Since the age of the excavated human bones was unknown, we used morphological age estimates (e.g. attrition of teeth, cranial suture closure and similar items) for comparison. Histological and visual estimates correspond in 2 of the 10 cases, but the histological age estimates were higher than the visual estimates in the other cases. In 4 of the 10 cases, age estimates produced by the formulas for younger ages were lower than those by the formulas for all age groups. Thus the formulas for younger ages were not so successful.

[Significance of preoperative TAE as an adjuvant therapy for hepatocellular carcinoma]

In 304 patients with hepatocellular carcinoma who underwent hepatic resection, 162 patients received chemoembolization before surgery (group A) and the remaining 142 patients received no therapy before surgery (group B). The 5-year disease-free survival (DFS) of group A and B were 36% and 21%, respectively, and there were no significant differences between them. In the groups of patients with good liver function (Child A), or patients with solitary tumor, or patients with tumors more than 5 cm in size, DFSs of group A were significantly better than those of group B. The difference of DFS between group A and B was largest in the group of the patients with tumors more than 5 cm in size.

Roles of two tumor necrosis factor receptors in induction of differentiation of ML-1 cells

The individual roles of two types of TNF receptors (55 kDa and 75 kDa) in induction of differentiation of human myeloblastic leukemia ML-1 cells were investigated using three monoclonal antibodies. The antibody htr-9, which recognizes the 55 kDa receptor, induced differentiation of ML-1 cells. Utr-1, which recognizes the 75 kDa receptor, blocked 125I-TNF binding by about 80% and inhibited by about 80% the TNF-induced NBT reducing activity. Htr-5 recognizes the 55 kDa receptor, blocked 125I-TNF binding by about 20% and inhibited by about 60% the TNF-induced NBT reducing activity. The data suggest that either of the two TNF receptors alone can mediate signals for the differentiation of ML-1 cells, and that simultaneous stimulation of both receptors will induce differentiation more effectively.

Point mutation in the band 4.2 gene associated with autosomal recessively inherited erythrocyte band 4.2 deficiency

A patient who represented acute hemolytic crisis was studied. Analysis of the erythrocyte membrane proteins by SDS-PAGE revealed a deficiency of band 4.2. In the family, the sister of the patient who had been clinically normal was also shown to be deficient in band 4.2. Binding studies showed that the propositus' membranes were able to bind normal band 4.2 protein as much as control. It was suggested that the binding sites for the protein were prepared on the membrane. We analyzed the band 4.2 cDNA of the propositus and detected a mutation that changes a codon for alanine to one for threonine at residue 142. Band 4.2 exon III of genomic DNA which included the mutation site was amplified and sequenced directly in the family members, and it was revealed that only the homozygotes of the mutation allele manifested band 4.2 deficiency and the parents, who were heterozygotes, showed normal amounts of band 4.2. Recently, the same mutation was reported as Protein 4.2NIPPON in another 4 cases (Bouhassira et al. Blood 1992: 79: 1846-1854). This study supports the hypothesis that this mutation is the pathogenetic cause of band 4.2 deficiency and not a polymorphism.

[Analysis of the state of patients with rheumatoid arthritis using a personal computer]

The present study was designed to analyze the state of 203 patients with rheumatoid arthritis (RA) in our clinic using a personal computer. The duration of the disease was significantly correlated with the progression of radiographical stages of RA, indicating that no drugs were able to prevent the progression of joint destruction. Nevertheless, bucillamine, a newly developed anti-rheumatic drug, was found to be effective in some patients who did not respond to D-penicillamine, but not vice versa. Although seropositive RA patients had more severe disease than seronegative RA patients, serum rheumatoid factor levels were not significantly correlated with Lansbury indices in seropositive RA patients. Overall, either the liver function or the renal function was not significantly affected in any category of the patients. Taken together, it is suggested that analysis of the data of the RA patients with personal computer systems provide useful information on the management of the RA patients.

Isolation of a new cDNA clone encoding an Rh polypeptide associated with the Rh blood group system

The polymerase chain reaction (PCR) was used to amplify Rh-related cDNAs from erythroid cells cultured by the selective two-phase liquid culture system for human erythroid progenitors in peripheral blood. Direct sequencing based on PCR presents heterozygous bands. Two Rh polypeptide cDNAs have been isolated from the PCR products and tentatively designated RhPI cDNA and RhPII cDNA. Both cDNA clones have an open reading frame composed of 1251 nucleotides. The RhPI cDNA clone shows a single nucleotide substitution with no amino acid substitution compared with the published sequence. The RhPII cDNA clone, on the other hand, differs from the above by 41 nucleotide substitutions with the open reading frame, resulting in 31 amino acid substitutions.

Effects of surgical orthodontic treatment for malalignment due to the prolonged retention of deciduous canines in young dogs

This study was conducted to clarify the effects of surgical orthodontic treatment for malalignment caused by the prolonged retention of deciduous canines in young dogs. Fifty-five dogs with malocclusion or pre-malocclusion were divided into two groups. Group 1 received surgical orthodontic treatment (32 dogs) using modification of Ross and Yamane's method of treating for malalignment due to prolonged retention of deciduous canine teeth; Group 2 received no treatment (23 dogs). Occurrence of malocclusion 1-3 weeks after treatment of the group receiving surgery was only 3.8%. However, malocclusion was seen in 73.4% of the non-treatment group approximately 2 years after the first examination. Surgical orthodontic treatment was very useful in treating malalignment due to prolonged retention of deciduous canines in young dogs.

[Effects of typhoon-caused power failure on medical care facilities]

In the evening of September 27, Typhoon 19 passed Yamaguchi prefecture. The wind velocity exceeded anything that the local meteorological observatory has ever recorded so far in this area. When the typhoon was off shore near Yamaguchi prefecture, the gale brought down many electric-light poles around Hofu city with power failure in Hofu city continuing for more than a week. At the same time the total number of emergency patients in Hofu area was the most in the prefecture. Because the power failure continued for many days, there was more indirect damage attributable to this power failure than the damage related directly to the typhoon. The capacity of the emergency electric power generator equipment installed in the Central prefectural hospital in Hofu city is the largest in Yamaguchi prefecture. Even while electric power failed completely in the Hofu city area, treatment of most of the emergency patients at this hospital was possible. There is no hospital that has as large an electric generator as the Central hospital has. Had this typhoon hit in another area, the ensuring confusion which might have occurred at hospitals in that area would have put many patients in danger with the power failure in many hospitals. Power consumption needs in hospitals have increased over that expected on the time the hospital was built. Therefore, the electric power generators installed in hospitals are of the times very small and unable to cope with massive electrical outage.

Detection of capsid antigen of human papillomavirus (HPV) in benign lesions of female genital tract using anti-HPV monoclonal antibody

We established a murine monoclonal antibody (K1H8) to human papillomavirus (HPV) using alkaline-disrupted virions of HPV type 1 (HPV-1) as the immunogen. K1H8 recognized a 57 kD capsid protein of HPV-1 and detected the antigen in paraffin sections of formalin-fixed tissue. With K1H8, we examined immunohistochemically 68 biopsy specimens obtained from the female genital tract. The specimens were histologically condyloma acuminatum or koilocytotic lesions with or without dysplasia and each specimen was found to harbour a single type of genital HPV, such as types 6, 11, 16, 18, 31, 33, 42, 51, 52, 56, and 58, by Southern blot hybridization analysis. The antigen was localized in the nuclei and occasionally in the cytoplasm of squamous cells showing koilocytotic changes. Eighty-four per cent of the specimens (57 cases) showed positivity for the antigen, indicating that K1H8 is a broadly-reactive antibody to various genital HPVs. The results suggest that benign mucosal lesions of the female genital tract are more frequently associated with viral production and are a potential source of transmission.

Alterations of the p53 gene in human primary cervical carcinoma with and without human papillomavirus infection

A previous report using cervical carcinoma cell lines suggests that the inactivation of two tumor suppressor gene products, p53 and pRB, either by complex formation with the E6 and E7 proteins of oncogenic human papillomaviruses (HPVs) or by mutation, may be an important step in cervical carcinogenesis (M. Scheffner et al., Proc. Natl. Acad. Sci. USA, 88: 5523-5527, 1991). The present study was designed to clarify the association between p53 inactivation and infection with oncogenic HPVs in primary carcinomas of human uterine cervix. We examined 36 primary cervical carcinomas for the presence of HPV DNAs by Southern blot analysis with probes specific for HPV-16, -18, -31, -33, -52, -56, and -58. HPV DNA sequences were detected in 19 of 36 tumors: 10 cases with HPV-16; 3 cases with -18; 3 cases with -58; 2 cases with -56; and one case with -52. The presence of HPV-16 and -18 in cervical carcinomas was further reexamined using polymerase chain reaction. HPV DNA sequences were detected in an additional 10 cases: 9 cases with -16 and one case with -18. The inactivation of the p53 gene by allelic loss or by point mutation was also examined. No allelic loss at the polymorphic site in codon 72 of the p53 gene was detected in any of 10 informative cases. Missense point mutations in the highly conserved regions of the p53 gene were demonstrable as single-stranded conformational polymorphisms of polymerase chain reaction-amplified DNA fragments and subsequently identified by direct DNA sequencing. Point mutations were detected in only two cases: one with an ATG----CTG transversion in codon 133 of exon 5, resulting in a Met----Leu substitution, and another with a CGG----TGG transition in codon 248 of exon 7, resulting in an Arg----Trp substitution. Both tumors with point mutations in p53 genes were among 10 tumors which contained a small copy number of HPV-16 DNA sequences (1 copy of HPV/10(1) to 10(5) cells) detectable by polymerase chain reaction amplification but not by Southern blot analysis of genomic DNAs derived from the tumors. None of 19 tumors with a large copy number of HPV DNA sequences detectable by Southern blot analysis (more than 1 copy of HPV/2 to 10 cells) nor any of 7 tumors with undetectable HPV DNA sequences contained p53 gene mutations in the regions examined.(ABSTRACT TRUNCATED AT 400 WORDS)

[Evaluation of hepatic resection for stage IV hepatocellular carcinoma-comparison with arterial embolization therapy]

To evaluate the application of hepatic resection (HR) for patients with Stage IV hepatocellular carcinoma (HCC), we compared the back-ground factors and survivals after therapies between Stage IV HCC patients who underwent HR (n = 38) and those who received arterial embolization (n = 186, group C). Of the patients who had HR, 17 (45.1) had relative noncurative (RN) resection (group A) and the remaining 21 (55%) had absolute noncurative (AN) resection (group B). Back-ground factors in relation to liver function were significantly better in both A and B than in C. On the other hand, tumor-relating factors were better in A than in both B and C, and were worse in B than in C. Five-year survival rates of group A and group C were 37.1 and 13.1 respectively (A to C; p < 0.05) and there were no longer survivors than two years in group B. These results suggested that the group which had better back-ground factors gained the better prognosis. To compare the survivals in the patients having well back-ground factors who were dominant in group A, the patients whose clinical stage was I or the number of tumors was two or less were selected from each group. Among these selected patients, the survivals of group A were significantly better than those of the other groups.

[Regional therapy to prevent recurrence after surgery in hepatocellular carcinoma]

The significance of regional therapy to prevent recurrence after surgery for hepatocellular carcinoma (HCC) was evaluated. In 275 patients who underwent hepatic resection for HCC, 143 (52%) had recurrences. Post-recurrence survival of the patients with regional therapy for recurrent foci was significantly better than that of patients without such therapy. Five-year post-recurrence survival of the patients treated with second surgery (77%) was significantly better than that of patients treated with chemoembolization (17%). The difference in 5-year survival between the former and the latter seemed to be caused by the difference in the degree of tumor progression at the recurrence. A second hepatic resection was the treatment of choice for a solitary intrahepatic recurrent tumor. However, chemoembolization was recommended for two or more recurrent foci.

["Wrapping therapy" for advanced hepatic cancer with arterial and intraportal infusion chemotherapy]

A new treatment method to intercept collaterals using silicone rubber sheeting was used for 5 patients with advanced hepatic cancer. The therapy was carried out to prevent new collaterals. This procedure was followed by arterial chemoembolization, arterial infusion chemotherapy and intraportal infusion chemotherapy. The results were complete response in 2 patients, partial response in 2 patients, and no change in 1 patient. The overall survival time was 7-54 months after wrapping. Although a randomized control study is necessary to assess the true value of this method, the new therapy is considered worth using as an adjuvant treatment for advanced hepatic malignancies uncontrolled by arterial chemotherapy or chemoembolization.

Characterization of a 28-kD polymorphic polypeptide detected by two-dimensional electrophoresis of human platelets

A genetic polymorphism of a human platelet polypeptide with a molecular weight of 28 kD detected by two-dimensional electrophoresis was investigated in family and population studies, and cell distribution. The 28-kD polypeptide showed autosomal codominant inheritance of two alleles. The gene frequencies of the two alleles were 0.925 and 0.075, respectively. The 28-kD polypeptide was observed in lymphocytes, neutrophils, eosinophils and monocytes, in addition to platelets. This polypeptide showed good reproducibility in electrophoresis, and appears to be useful as a genetic marker of the human genome in gene mapping and pedigree analysis.

Isolation of cDNA clones coding for humoral lectin of silkworm, Bombyx mori, larvae

In the hemolymph of the silkworm, Bombyx mori, lectin with hemagglutinating activity against sheep red blood cells increases at larval-larval ecdysis and at spinning stage (Suzuki and Natori, 1983) and is induced by infection with cytoplasmic polyhedrosis virus. A Bombyx lectin polypeptide with molecular weight approx 280K is responsible for hemagglutinating activity, since antiserum raised against this polypeptide inhibited hemagglutinating activity. The site of synthesis of Bombyx lectin was determined by primary tissue cultures of fat body and hemocytes. A hemagglutinating activity assay demonstrated that hemocyte is responsible for the release of hemagglutinin into the culture medium. Isolation of cDNA clones coding for Bombyx lectin was carried out on the cDNA library prepared in an expression vector lambda gt11 starting with poly(A)+ RNA from spinning larval hemocytes. As a result of immunoscreening, several positive clones were obtained, and the cDNA clones were characterized.

[Rupture of hepatocellular carcinoma with multiple pulmonary metastasis successfully treated by transcatheter arterial embolization (TAE) of tumor: a case report]

A 66-year-old woman was hospitalized in a state of shock with rupture of hepatocellular carcinoma and multiple pulmonary metastasis. Her bleeding was successfully controlled by emergency transcatheter arterial embolization with Lipiodol (Lp-TAE). Treatments with UFT, OK-432 and two additional Lp-TAE caused the disappearance of pulmonary metastasis with AFP levels decreased and natural killer cell activity increased. The patient died one and a half years after the emergency Lp-TAE. The disappearance of pulmonary metastatic lesions seemed to be caused by improvement of the patient's immunity, which related to the regression of primary tumor after Lp-TAE. It was suggested that Lp-TAE is worth undertaking even in rupture of hepatocellular carcinoma with remote metastatic lesions.

Human papillomavirus type 58 DNA sequence

The complete nucleotide sequence of human papillomavirus type 58 (HPV 58) DNA cloned from an invasive cervical carcinoma was determined. The HPV 58 genome consists of 7824 nucleotides, containing 37.9% of GC residues, and has a similar genome organization of other HPVs. On the nucleotide sequence level, it conserves the signal sequences for regulation of gene expression as with other genital HPVs and exhibits an extensive homology with HPV 33 (77%). Comparative analysis of amino acid sequences reveals that HPV 58 is closely related with HPVs 16, 31, and 33, and is more distantly related with HPVs 6, 11, 18, and 39. HPVs 58, 16, 31, and 33 can be regarded as a group in HPV.

[Percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE) for recurrent hepatocellular carcinoma--report of 2 cases]

Two patients with recurrent hepatocellular carcinoma underwent reoperation following percutaneous ethanol injection therapy (PEIT) and transarterial embolization (TAE). In the first case, although the nodules where the accumulation of Lipiodol (LpD) was seen showed complete necrosis, viable cancer cells were seen in the areas with slight accumulation of LpD. One nodule with no accumulation of LpD where PEIT seemed to have been performed, developed necrosis. In the second case, the nodules with LpI) accumulation also showed almost complete necrosis. The area where PEIT was performed was mixed with necrosis and bleeding, where a small viable cancer nodule existed. The reason for incomplete anticancer effects by PEIT seemed to be the too small ethanol injection.

A new genetic polymorphism in human platelet polypeptides detected by two-dimensional electrophoresis

We described a new genetic polymorphism of human platelet polypeptide, detected by two-dimensional polyacrylamide gel electrophoresis followed by silver-staining. The polymorphism was tentatively designated thrombocyte B (ThB) with a molecular weight of 34 kDa and isoelectric point of 4.7-4.8. In this polypeptide, three different electrophoretic types (1-1, 1-2, 2-2) were identified. Family and population studies indicate that the three phenotypes of the polypeptide are determined by two common alleles at a single autosomal locus. In a Japanese population, the gene frequency of ThB 1/ThB 2 was 0.74/0.26. The ThB polypeptide was not found in other blood cells and decreased or disappeared during the preparation or storage of platelets.