Reduction of androgen receptor mRNA concentration by testosterone in mouse submandibular gland

In this study, we examine the effect of testosterone on the steady-state concentration of androgen receptor (AR) mRNA of mouse submandibular gland. Northern blot analysis showed the expression of an AR-specific 10-kb transcript in the submandibular glands of both sexes. Quantitative analysis was done by means of reverse transcription-polymerase chain reaction (RT-PCR) with a non-radioactive label of digoxigenin. The RT-PCR demonstrated that the steady-state of AR mRNA concentration was less in males than in females. Moreover, AR mRNA increased in the castrated male mice, while the administration of testosterone reduced the AR mRNA in female mice. In conclusion, the amount of AR mRNA in mouse submandibular gland is reduced by androgen.

Solitary pulmonary nodule: preliminary study of evaluation with incremental dynamic CT

PURPOSE

To use incremental dynamic computed tomography (CT) to evaluate solitary pulmonary nodules (SPNs).

MATERIALS AND METHODS

Thirty-two adult patients with SPNs less than 3 cm in diameter had 18 primary lung cancers, 10 tuberculomas, and four hamartomas. The CT numbers of the inner area of the nodule were calculated before and 30 seconds, 2 minutes, and 5 minutes after administration of contrast material.

RESULTS

All lung cancers and one of four hamartomas showed significantly greater enhancement (P < .0001) than benign SPNs, which did not show enhancement (except for one hamartoma). All lung cancers and one of four hamartomas showed complete enhancement, one hamartoma showed peripheral enhancement, two hamartomas and eight of 10 tuberculomas showed capsular enhancement, and two tuberculomas showed no enhancement.

CONCLUSION

Maximum attenuation of 20-60 HU appears to be a good predictor of malignancy.

[Clinical significance of inverted T-waves during the acute phase of myocardial infarction in patients with myocardial reperfusion]

The relationship between the time course of inverted T-waves during the acute phase and infarct size and left ventricular (LV) function was studied in 46 patients (mean age: 57.3 +/- 9.7 years) with reperfused first anterior wall acute myocardial infarction (MI). All patients had coronary reflow within 6 hrs after the onset of MI and were without subsequent reocclusion for at least 14 days. The T-wave inverted progressively and rapidly with maximum depth between 26 and 60 hrs (mean time: 37.1 +/- 12.4 hrs). A significant correlation was found between the maximum T-wave depth (T-peak) in all patients and peak CPK, left ventricular ejection fraction (LVEF), regional wall motion, % abnormally contracting segment (%ACS), end-diastolic and end-systolic volume indices (EDVI,ESVI) at day 14 after the onset of MI (p < 0.05). T-wave inversion within 24 hrs after onset of MI was observed in 43 patients (93%). There were significant correlations between the depth of T-wave inversion occurring in patients 24 hrs after onset of MI (T24) and peak CPK, LVEF, regional wall motion, % ACS, EDVI, and ESVI at day 14 (p < 0.05). The sensitivity and specificity for patients with EDVI > 87.0 ml/m2 at day 14 increased by more than 20% over normal values, predicted by a T24 of 3.0 mm or less, were 94% and 93%, respectively. The sensitivity and specificity for patients with EF < 40% at day 14 predicted by a T24 of 3.0 mm or less, were 90% and 75%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Lifetime alcohol consumption and risk of breast cancer

The relation of lifetime alcohol intake to risk of breast cancer in pre- and postmenopausal women was examined in a case-control study in western New York. Cases with incident primary histologically confirmed breast cancer diagnosed during the period 1986-1991 (n = 740) and controls, frequency age-matched women drawn from New York state driver's license records (age < 65 yrs) and from records of the Health Care Finance Administration (age > or = 65 yrs, n = 810), were interviewed regarding intake of wine, beer, and hard liquor 2, 10, and 20 years ago and at 16 years of age. Although women in this study had generally low intakes of alcohol, there was little evidence of increased risk of breast cancer with intake of alcohol at any of the time periods or with an index of total lifetime intake. There was a weak indication of an increase in risk with beer for intakes of at least one drink per day. This risk was evident for 2, 10, and 20 years ago but not at 16 years of age. In this group with relatively low intakes of alcohol, evidence was weak for an association of increased risk of breast cancer with intake of alcohol, with the possible exception of a weak association with beer intake.

Biophysical properties of protein-free, totally synthetic pulmonary surfactants, ALEC and Exosurf, in comparison with surfactant TA

An artificial pulmonary surfactant prepared from chloroform-methanol extract of bovine pulmonary surfactant (surfactant TA) has been shown to be effective in both the prevention and the treatment of respiratory distress syndrome in premature babies. Recently, two types of protein-free totally synthetic surfactants, artificial lung expanding compound (ALEC) and Exosurf, have been evaluated in clinical trials of surfactant therapy. Artificial lung expanding compound was used initially as a dry powder, but is now prepared as a crystalline suspension in saline at 4 degrees C. In this study we compared the biophysical properties of three different forms of ALEC (dry powder, crystalline suspension at 4 degrees C and 37 degrees C), Exosurf and surfactant TA (Surfacten) using a modified Wilhelmy surface balance and a pulsating bubble surfactometer. Surface activity of a crystalline suspension of ALEC in cold saline was no better than the dry powder of ALEC. Surfactant activity of ALEC was improved by addition of hydrophobic surfactant protein B and C (SP-B, SP-C) which are important constituents of surfactant TA. Surface properties of ALEC in any form and Exosurf were not superior to those of surfactant TA. These results suggest that a surfactant which contains SP-B and SP-C does not necessarily have to be dry or crystalline for an effective exogenous surfactant.

Cysteine protease activity of streptococcal pyrogenic exotoxin B

Streptococcal pyrogenic exotoxin B (SPE B) was purified and its protease and mitogenic activities were investigated. The apparent molecular mass of SPE B purified in the presence of iodoacetic acid was 42 kDa, whereas 29-kDa SPE B was predominant without the reagent. A polyclonal antibody raised against the 29-kDa species reacted with both species, indicating that the 42-kDa species was a precursor of the 29-kDa entity. Both the 42- and 29-kDa species enhanced [3H]thymidine incorporation into human peripheral blood mononuclear cells, whereas neither had any effect on T cell depleted mononuclear cells. The 29-kDa SPE B possessed caseinolytic activity, with an optimal pH of 8, and the activity was specifically suppressed by the antibody. A group of cysteine protease inhibitors, but no serine-, metallo-, or acidic-protease inhibitors, limited the protease activity, whereas dithiothreitol increased the activity. The DNA sequence around a putative active cysteine residue was identical among the speB genes from Streptococcus pyogenes R70, NY-5, and T19. Taken together, these results indicate that SPE B is identical to a cysteine protease, streptopain (EC 3.4.22.10).

Cardiomyopathy and angiopathy in patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes

In four patients with mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes (MELAS) in which mutated mitochondrial deoxyribonucleic acid was seen, hypertrophic cardiomyopathy and angiopathy was demonstrated by echocardiography, dipyridamole stress scintigraphy, and cardiac catheterization. On stress scintigraphy with dipyridamole, three patients showed hypoperfusion in the early image and a "filling-in" pattern in the late image. However, coronary angiography did not demonstrate narrowing of the large vessels in these patients. Light and electron microscopy of endomyocardial biopsy specimens indicated abnormal mitochondria, with marked increase in the number and size of mitochondria in endothelium. Modified Gomori's trichrome staining in biopsied endomyocardial specimens revealed a red-purple deposit similar in appearance of the ragged-red fibers in skeletal muscle, a characteristic finding of mitochondrial disease. Deterioration of complex I in the mitochondrial electron transfer system, which is widely observed in various mitochondrial diseases, appeared in biopsied skeletal muscle of our patients, indicating deficiency of some subunits of complex I. These results indicate that mitochondrial diseases such as MELAS show not only cardiomyopathy but also angiopathy. We speculate that proliferation of mitochondria leads to narrowing of the lumen of arterioles, which might be responsible for the ischemic findings observed scintigraphically.

Human arylhydrocarbon receptor: functional expression and chromosomal assignment to 7p21

We isolated the human arylhydrocarbon receptor (AhR) cDNA from a human lung cDNA library, by using mouse AhR cDNA as a labeled probe. The nucleotide sequence of cloned human AhR cDNA is identical to the previously reported human AhR sequence [Dolwick et al. (1993), Mol. Pharmacol. 44, 911-917] from cell line HepG2. The overall amino acid identity with mouse AhR from cell line Hepa-1 is 72.5%. The human AhR expressed either in COS-7 cells or in a reticulocyte lysate in vitro translation system showed specific dioxin-binding activity and Arnt-dependent DNA-binding activity. Chromosomal localization of the AhR gene was determined to be chromosome 7p21 by fluorescent in situ hybridization and DNA blot hybridization using 23 human x mouse or Chinese hamster hybrid cell DNAs.

Dimerization characteristics of the DNA- and steroid-binding domains of the androgen receptor

The DNA-binding domain (DBD) of the androgen, mineralocorticoid, and glucocorticoid receptors and the steroid-binding domain (SBD) of the androgen receptor (AR) were expressed separately as fusion proteins with glutathione-S-transferase (GST) in Escherichia coli. Native polyacrylamide gel electrophoresis and gel exclusion HPLC demonstrated that the GST-ARDBD fusion protein was present as a dimer. On the other hand, the GST-ARSBD fusion protein formed a high-molecular weight oligomer, which seemed to be formed by two separate interactions, i.e. GST-GST and ARSBD-ARSBD between the fusion molecules. These findings strongly suggest that ARSBD has a potent ability to form a homodimer and that ARDBD does not. GST-ARDBD specifically interacted with the glucocorticoid response elements of the mouse mammary tumor virus long terminal repeat (GREMMTV). Cleavage of the fusion protein by thrombin abolished the binding, while the nonspecific DNA-cellulose binding ability was retained. Therefore, the dimeric configuration of GST-ARDBD, even if accomplished through the interaction with the GST moiety, is needed for high-affinity binding to the response element. The binding of GST-ARDBD to GREMMTV was strongly competed by the glucocorticoid response element of rat tyrosine aminotransferase gene, followed by the androgen response element of the rat probasin gene. A palindromic thyroid response element showed no competition. Unexpectedly, no apparent different in the binding affinity to these response elements was observed among the DBDs of androgen, mineralocorticoid and glucocorticoid receptors.

Changes of cell cycle-regulating genes in interferon-treated Daudi cells

Interferon (IFN) modulates the expression of several genes and some of them are considered to be responsible for the inhibition of cellular growth. However, the alterations of cell cycle-regulating genes produced by IFN still remain unclear. Accordingly, we studied the expression of cell cycle-regulating genes during IFN-induced growth arrest. Cell cycle synchronized and unsynchronized Daudi Burkitt lymphoma cells were treated with IFN. Both the cell cycle distribution and the expression of cell cycle-regulating genes (cdk2, cdc2, cyclins A, B, C, D3, cdc25, and wee 1) were studied by flow cytometry and by Northern blot hybridization or the reverse-transcription polymerase chain reaction, respectively. Treated cells passed through the first G1 phase and gradually accumulated in the following G1 phase. Expression of cyclins A, B, and D3 oscillated along with the cell cycle progression in control cells, and the alterations of cyclin B expression were especially prominent. Both cdc2 and cdk2 also showed changes, but these were not so distinct as observed with cyclin B. Expression of cdc25 and wee1 was little affected by cell cycle progression. In IFN-treated cells, expression of cyclins A and B were down-regulated, while that of cyclin C was not. Cyclin D3 expression was also down-regulated at 48 h, followed by an increase at 72 h. Expression of both cdc2 and cdk2 was down-regulated, especially that of the later. Wee1 expression was down-regulated by IFN but, the expression of cdc25 remained stable. These findings suggest that the modulation of cell cycle-regulating genes, particular by cyclin A and cdk2, plays an important role in IFN-induced cellular growth arrest.

Myxoid leiomyoma of the vulva mimicking aggressive angiomyxoma

A case of vulvar leiomyoma with extensive myxoid change in a 40 year old female is described. The tumor had a unique connection with a non-degenerative leiomyoma that compressed the rectum and the bladder. Scattered smooth muscle cells in a loose myxoid stroma were immunoreactive for desmin. Fibroblast-like spindle cells were immunoreactive for vimentin but not for desmin. The initial, although incorrect, pathological diagnosis of the tumor was aggressive angiomyxoma based on the similarity in both clinical and pathological aspects with this more invasive tumor. Myxoid vulvar leiomyoma should also be differentiated from angiomyofibroblastoma. The key to the differential diagnosis is the presence of interlacing smooth muscle cells and an awareness of tendency toward myxoid change in vulvar leiomyomas.

[A case of idiopathic hyperaldosteronism with normal plasma aldosterone concentrations for 5 years after onset: a 12-year follow-up study]

We report a 54-year old man diagnosed as idiopathic hyperaldosteronism (IHA) at least 12 years after the onset. At the age of 42, he showed hypertension (162/100mmHg), hypokalemia, metabolic alkalosis, low plasma renin activity (PRA) and normal plasma aldosterone concentration (PAC) in a supine posture. Both PRA and PAC were elevated after a 2-hour ambulation following furosemide (60mg) injection. Since the accumulation of radioactivity following 131I-aldosterol injection with combined administration of dexamethasone was equally detected in both adrenal areas, he was diagnosed as low-renin essential hypertension (LREH). Blood pressure (BP) decreased to the normal range after treatment with nifedipine (40mg/day). At the age of 47, however, BP was hypertensive (164/106mmHg) serum potassium (K) level was normal. Although PAC was normal in a supine posture, it increased after a 2-hour ambulation following furosemide (60mg) injection. PRA after the stimulation was still suppressed despite the increase in PAC. At the age of 54, BP was 172/94mmHg. Serum K level was 3.4mEq/L. PRA was suppressed below 0.1 ng/ml/hr, while PAC was above the normal range (170pg/ml) in a supine posture. Serum cortisol and urinary excretion of 17-OHCS and 17-KS were within normal limits. PRA was still suppressed below 0.1 ng/ml/hr after a 2-hour ambulation following furosemide (60mg) injection, but PAC was markedly increased (330pg/ml). There was a diurnal rhythm of aldosterone, which was parallel to that of ACTH.(ABSTRACT TRUNCATED AT 250 WORDS)

Exposure to breastmilk in infancy and the risk of breast cancer

Early childhood nutrition may affect the subsequent risk of breast cancer in adulthood. We examined the association of having been breastfed with risk of breast cancer in a case-control study of women age 40-85 years in western New York. Cases (N = 528) had newly diagnosed primary, pathologically confirmed breast cancer; controls (N = 602) were randomly selected from the same community and were frequency matched on age. Having been breastfed was associated with decreased risk. The multivariate adjusted odds ratio was 0.74, and the 95% confidence interval was 0.56-0.99. We found little difference in the association for pre- and postmenopausal women despite a much higher frequency of breastfeeding among the older women. These findings indicate that early nutriture in general and bottle feeding in particular may relate to breast cancer development in adulthood.

Changes of G1 cyclins, cdk2, and cyclin A during the differentiation of HL60 cells induced by TPA

Differentiation induction by 12-o-tetradecanoyl 13-acetate (TPA) results in the growth arrest of HL60 cells in the G1 phase. However, little is known about the changes of cell cycle-regulating genes during this differentiation process. We investigated the changes of mRNA for various cyclins (A, C, D1, D2, D3 and E) and cdk2. Synchronized HL60 cells began to proliferate immediately after release from cell cycle block and cell cycle synchrony was obvious until the second S phase. TPA-treated cells accumulated in G1 phase within 24 h and most of the cells were arrested in this phase at 36 h. The expression of cyclins and cdk2 was studied by Northern blot hybridization of the reverse-transcription polymerase chain reaction (RT-PCR). TPA treatment altered the expression of all genes studied. The expression of cdk2 and cyclin A mRNA was markedly down-regulated. Cyclin E mRNA expression was also prominently down-regulated from 12 h to 36 h, at which time a second increase of its expression was observed in control cells. In contrast, the expression of cyclin D1 mRNA was induced by TPA, while its expression in control cells was undetectable by Northern blot hybridization throughout the cell cycle. Cyclin C expression was faint and fluctuated irrelevant of cell cycle, but its expression in both control and TPA-treated cells was higher than at baseline. Cyclin D2 expression remained stable in control cells and TPA treatment resulted in slight down-regulation at 12 h, but no difference was observed after 24 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Specific expression of the neurofibromatosis type 1 gene (NF1) in the hamster Schwann cell

The gene responsible for neurofibromatosis type 1 (NF1) has sequence homology to the GTPase-activating protein (GAP) and demonstrates GAP activity against ras p21. To study tissue-specific and/or tumor-specific expression of the NF1 gene product, now called neurofibromin, immunostaining and immunoblotting were applied to the N-nitroso-N-ethylurea (ENU)-induced Syrian hamster neurofibromatosis model using polyclonal antibodies against the NF1 fusion protein and a synthetic peptide. Strong expression was observed specific to the Schwann cells of the normal peripheral nerves by immunostaining. Neoplastic Schwann cells showed specific binding of anti-NF1; however, the frequency of positive cells was diminished. Immunoblotting also revealed positive expression of the 250-kd NF1 gene product in the brain, the normal peripheral nerves, and 7 of 14 ENU-induced neurofibromas. Although ENU-induced melanoma and Wilms' tumor were negative for neurofibromin, foci of Schwannian differentiation in both primary and transplanted melanomas were positive. These results suggest that neurofibromin plays some role in differentiation and growth regulation of the Schwann cell.

neu proto-oncogene mutation is specific for the neurofibromas in a N-nitroso-N-ethylurea-induced hamster neurofibromatosis model but not for hamster melanomas and human Schwann cell tumors

Point mutations of the transmembrane domain coding region of the neu proto-oncogene in N-nitroso-N-ethylurea-induced hamster neurofibromas were found at high frequency (93%; 14 of 15). They involved codons 659 as well as 658, the latter not having been reported previously in rat tumors. The mutational change was seen even in the early stage neurofibroma. On the other hand, no mutations were detected in melanomas or Wilms' tumors induced in the same N-nitroso-N-ethylurea-treated animals, even when the melanomas demonstrated extensive schwannian differentiation. Moreover, any human Schwann cell tumors including neurofibroma, schwannoma, and malignant schwannoma did not show the mutation of c-erbB-2 gene (0 of 34), which is homologous to the hamster neu. Since high expression of neu mRNA is evident in the hamster Schwann cell at the late gestational and neonatal stages, transplacental administration of N-nitroso-N-ethylurea is considered to interact directly to carcinogenesis of the hamster Schwann cell through neu gene mutation.

Superior vena cava syndrome caused by a right apical tense bulla

Superior vena cava (SVC) syndrome is caused by several diseases, although to our knowledge, a bullous lesion has not been reported previously. In the present case, severe pleural adhesion prevented the expanding bulla from stretching the visceral pleura and from compressing the residual lung, subsequently causing compression of the SVC and thus SVC syndrome.

Effects of a six-week exposure to excess iodide on thyroid glands of growing and nongrowing male Fischer-344 rats

A 6-wk exposure to excess iodide intake (EII) via drinking water (260 mg potassium iodide/L) demonstrated different effects on growing (4-wk old) and nongrowing (45-wk old) male Fischer-344 rats. In growing rats, EII induced a significant increase in thyroid weight, pituitary weight, serum thyroid-stimulating hormone (TSH), and thyroxine (T4). The labeling index (LI) of thyroid follicular cells was slightly increased, although not statistically significant. Histologically, an increase in follicular cell height, an increase in colloid accumulation, and evidence of colloid absorption were noted. The effect of bovine TSH (bTSH) and protirelin tartrate (TRH-t) on LI was significantly augmented by EII. In nongrowing rats, EII induced a significant increase in thyroid weight and serum T4 but no increase in pituitary weight, serum TSH, and the LI of follicular cells. Histologically, an increase in colloid accumulation was found in small follicles. EII did not augment the effect of bTSH and TRH-t on the LI of follicular cells. This study suggests that growing rats are still susceptible to acute hypothyroidism even after 6 wk of continuous exposure to excess iodide, whereas nongrowing rats are refractory within an equivalent treatment period.

Patterns of cocaine use and HIV infection among injection drug users in a methadone clinic

To investigate patterns of cocaine use, a total of 440 injection drug users (IDUs) in two consecutive cohorts were recruited from a methadone maintenance program in New York City. IDUs who had injected cocaine more frequently during the prior year were more likely to be found HIV positive than IDUs who had injected cocaine less frequently, even after controlling for age, gender, and ethnicity. The study investigated noninjecting cocaine use among IDUs, such as snorting and smoking cocaine, which is often overlooked in epidemiological research investigating the relationship between HIV infection rate and drug use behaviours among IDUs. This study revealed that older IDUs were more likely to use IV cocaine and speedball, whereas younger IDUs were more likely to use crack or snort cocaine. In the 1987 cohort, after statistically controlling for age, analyses revealed that Hispanic IDUs snorted cocaine more frequently than other groups, and that black female IDUs used crack more frequently than other groups. Future research should investigate whether these crack and cocaine users, particularly black and Hispanic female IDUs, have changed their drug behaviors because of an awareness of the high risk of IV drug use for HIV infection, or whether they have started using these drugs as stepping stones for future IV cocaine and speedball use.

Closed continuous irrigation as a treatment for infection in the hand

A method of closed irrigation has been devised to treat infections in the hand. After adequate débridement, two tubes are placed in the infected area, an inlet tube and an outlet tube. For a small infection, one tube serves both purposes. The wound is closed completely. Irrigation with saline and antibiotic solution is continued for 1 week, extended up to 3 weeks in cases of severe infection. This method has been applied in 31 cases including pyogenic tenosynovitis, tuberculous tenosynovitis, pyogenic arthritis, osteomyelitis, bite injury, crush injury and amputation stump infection. Infection healed primarily in 29 cases. Further surgery was needed in two cases which healed finally.

Different binding properties of three monoclonal antibodies to sialyl Le(x) glycolipids in a gastric cancer cell line and normal stomach tissue

We established a mouse monoclonal antibody (Mab) KM93 which recognized sialyl Le(x)-carbohydrate epitope determined by solid phase radioimmunoassay using a panel of authentic glycolipids. The specificity of KM93 was similar to another anti-sialyl Le(x) Mab CSLEX-1 established previously, and different from that of Mab FH6 which recognized sialyl Le(x)-i (sialyl dimeric Le(x)). In a further study, however, we found that KM93 reacted with some glycolipids much more strongly than CSLEX-1 did on thin-layer chromatography (TLC) plates. We purified two gangliosides named K-1 and K-2 from gastric cancer cell line KATOIII, and three gangliosides named H-1, H-2, and H-3 from human stomach. KM93 reacted with all of these glycolipids. CSLEX-1 reacted with K-1 and K-2 with less intensity than KM93 did, and faintly reacted with H-1, but not at all with H-2 or H-3. FH6 did not react with K-1, K-2 or H-1, while it stained H-2 and H-3. In spite of this different reactivity with Mabs, analysis by proton nuclear magnetic resonance (1H NMR) proved that carbohydrate structure of K-1 and H-2 were the same: NeuAc alpha 2-->3Ga1 beta 1-->4 [Fuc alpha 1-->3] G1cNAc beta 1-->3 Ga1 beta 1-->4G1c beta 1-->1Cer. The H1 NMR spectrum of H-3 also indicated that H-3 consisted of the same sugars as K-1. These results indicated that KM93 had wider reactivity than CSLEX-1, and that the distinct reactivity of KM93 from CSLEX-1 was not caused by sugar moiety. It was also shown that the interaction of sialyl Le(x) sugar determinant with MAb depended on the tissue origin of molecules carrying carbohydrate.

In vivo antimelanoma effects of 4-S-cysteaminylphenol, a newly synthesized therapeutic agent specific to melanoma

Antimelanoma effects of 4-S-cysteaminylphenol (4-S-CAP), which is a newly synthesized melanin precursor, as a chemotherapeutic agent specific to malignant melanoma were determined in an in vivo system using mouse B16 melanoma. The intraperitoneal injection of 4-S-CAP induced a slight delay in the growth period of subcutaneous melanoma of C57BL/6 mice. Survival times of mice after treatment with 4-S-CAP were a little longer than those of control mice (P < 0.05), although all mice died from the local growth of tumours. The viable cell ratio of in vivo subcutaneous tumour cells reduced to 52.8% within 24 h after treatment with 4-S-CAP, but the ratio had recovered to the control level 72 h after treatment (> 90%). Similarly, the proliferating-cell-nuclear-antigen-positive cell ratio of melanotic melanoma had reduced 24 h after treatment and recovered within 72 h after treatment, while 4-S-CAP had no effect on amelanotic tumours. The formation of lung colonies by intravenous inoculation of malignant melanoma cells was compared between mice with intraperitoneal injection of 4-S-CAP and phosphate-buffered saline only. The 4-S-CAP-treated mice had significantly fewer lung colonies compared with the control mice (P < 0.01). The results indicate that the agent, 4-S-CAP, would have a therapeutic effect on malignant melanoma for a short time in vivo and therefore the agent can be effective against a small number of tumour cells, such as lung colonies, although it had little effect on the local tumours.

Dual roles of 90-kDa heat shock protein in the function of the mineralocorticoid receptor

Association of the 90-kDa heat shock protein (HSP90) is required for the high-affinity ligand-binding of the glucocorticoid receptor (GR), but not for that of the androgen receptor [Ohara-Nemoto, Y., Nemoto, T., & Ota, M. (1991) J. Biochem. 109, 113-119]. In the present study, we investigated the ligand- and HSP90-binding characteristics of the mineralocorticoid receptor (MR), which shares to some degree the ligand-binding specificity of the GR. A truncated human MR (designated MR351) starting from Gly-351 was translated in vitro with rabbit reticulocyte lysate. Scatchard analysis revealed the presence of a single class of high-affinity binding sites for [3H]aldosterone (Kd = 0.35 +/- 0.2 nM), comparable to those of the native receptor in target tissues. Glycerol gradient centrifugation and immunoadsorption analyses showed that MR351 associated with rabbit HSP90. Exposure to 0.4 M NaCl induced the dissociation of HSP90 from MR351 and simultaneously enhanced binding of MR351 to DNA-cellulose. Moreover, when measured at 10 nM, HSP90-free MR351 showed only 9% of the [3H]aldosterone-binding found in the presence of HSP90. On the other hand, when MR351 was expressed in Escherichia coli as a protein tagged with a histidine hexamer at the N-terminus (designated H6MR351), specific binding of [3H]aldosterone was detected. The binding affinity (Kd = 338 +/- 45 nM) was, however, 1,000-fold lower than that of MR351 translated in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

N-nitroso-N-ethylurea-induced hamster melanoma: a new method for efficient induction and schwannian differentiation of melanoma

Melanocytic tumors as well as multiple neurofibromas were induced in 35 of 88 Syrian golden hamsters by a single s.c. administration of 100 mg/kg of N-nitroso-N-ethylurea applied 48 h after birth. The lesions were all observed proliferating in the dermis and demonstrated melanosomes and premelanosomes. High cellularity, nuclear atypia and transplantability of the tumors in outbred hamsters suggested a malignant nature. Some of the melanomas were morphologically heterogenous and contained Schwann-like cells as minor components. In addition, transplantation of the melanomas resulted in increased schwannian differentiation even for primary tumors which did not contain any Schwann-like cell foci. One of the transplanted melanomas mimicked malignant peripheral nervous tumor. Schwannian differentiation was also proved by the fact that glial fibrillary acidic protein was positive in 22.2% of the cases. The present results suggest that the induced hamster melanomas originate from neural crest-derived cells which are able to differentiate into both melanocytes and Schwann cells.

Results of salvage mastectomy for local recurrence after breast-conserving surgery without radiation therapy

BACKGROUND

Between 1975 and 1987, 128 patients with infiltrating breast cancer, categorized as clinical Stage I and II disease, were treated by breast conservation surgery without radiation therapy.

MATERIALS

After a median disease-free interval of 20 months (range, 8-64 months), 25 of 128 patients had local recurrence, for which salvage mastectomy was performed. The results of modified radial mastectomy as a salvage procedure were analyzed in these 25 patients.

RESULTS

After a median disease-free interval of 52 months (range, 8-75 years) after the salvage procedure, 12 patients had chest wall and distant recurrences, whereas 13 patients remained free of disease. The 5-year actuarial disease-free and overall survival rates after the salvage mastectomy were 51% and 65%, respectively.

CONCLUSIONS

Univariate analyses of factors affecting disease-free survival and overall survival showed that the size of the local recurrence (< or = 2 cm) (P = 0.009) and the number of pathologically positive axillary nodes at the time of the salvage procedure (fewer than four nodes) (P = 0.002) were associated with a better prognosis.

Coronary artery lesions in Takayasu arteritis: pathological considerations

This communication reviews the clinical and pathological features of coronary artery lesions in Takayasu arteritis. The incidence of coronary artery involvement has been reported to be 9% to 10%, and is observed mainly in autopsy cases because coronary artery disease is usually not evident until the occurrence of angina pectoris or myocardial infarction, or after the onset of congestive heart failure. On the basis of pathological features, the following three types of coronary artery lesions can be distinguished: type 1, stenosis or occlusion of the coronary ostia and the proximal segments of the coronary arteries; type 2, diffuse or focal coronary arteritis, which may extend diffusely to all epicardial branches or may involve focal segments, so-called skip lesions; and type 3, coronary aneurysm. Most of the coronary artery lesions in Takayasu arteritis are of type 1. Narrowing of the coronary arteries is mainly due to the extension of the inflammatory processes of proliferation of the intima and contraction of the fibrotic media and adventitia from the ascending aorta. In some cases, coronary stenosis may be caused by coronary arteritis as skip lesions in Takayasu arteritis, but even in these cases the lesions have been reported to affect mainly the proximal segments of the coronary arteries. Diffuse lesions of the coronary artery and coronary artery aneurysm seem to be very rare in Takayasu arteritis. Other causes of coronary ostial stenosis, coronary arteritis and coronary artery aneurysm are also discussed.

Pure progressive autonomic failure: a clinicopathological study

Two cases of pure progressive autonomic failure (PAF) are presented. A postmortem study of one case (case 2) showed a pathology resembling that of Parkinson's disease. Marked cell loss was noted in the substantia nigra, nucleus ceruleus, and intermediolateral column of the spinal cord, while cell loss in the sympathetic ganglion was not remarkable. This case may be an exceptionally rare case of late-onset PAF in which autonomic failure was mainly ascribed to preganglionic (and central) pathology, although autonomic function tests suggested postganglionic sympathetic disorder in both cases.

Behavioral characteristics of seroconverted intravenous drug users

A total of 440 participants (218 in 1987 and 222 in 1988) were recruited from methadone maintenance clinics in New York City. After obtaining informed consent, a standardized questionnaire was administered. Also, sera were collected and tested for HIV antibody. The overall HIV infection rate was 60% in 1987 and 52% in 1988. In 1987 and 1988, respectively, 19 of 23 and 23 of 40 participants who admitted to a previous HIV seronegative result were found to test HIV seropositive. The behavioral factors which differentiated suspected seroconverters from participants who remained seronegative were frequencies of sharing needles (p < .01), sharing cookers (p < .02), and use of shooting galleries (p < .05) during the last 5 years. Needle-sharing behaviors continue to be associated with HIV seroconversion among IVDUs. More effective education to stop needle sharing among IVDUs is needed.

[A case of pulmonary leiomyosarcoma followed up for five years]

A 70-year-old woman with leiomyosarcoma, followed up for 5 years as tuberculoma, is described. The tumor, in the left lower lobe, had enlarged from 1.5 x 1.5 cm to 3.4 x 3.4 cm in 5 years, and doubling time was calculated to be 540 days. Another tumor (1.8 x 1.8 cm) was also recognized in the right lower lobe at the later time. Since not only a benign tumor but metastatic disease was suspected, thoracotomy was performed, and the intraoperative pathologic diagnosis was leiomyosarcoma. However, only partial lung resection was performed because of the low growth rate of the tumor, the patient's advanced age, limited lymphatic metastasis and favorable prognosis with only partial resection. DNA analysis of the tumor based on flow cytometry showed a diploid pattern, and this was thought to account for the long doubling time of the tumor. The postoperative course was satisfactory without any signs of recurrence at the operation site.

Effects of breast cancer treatments on plasma nutrient levels: implications for epidemiological studies

The interpretation of case-control studies in which blood nutrient levels are examined as etiological factors in cancer is complicated by the possibility that either the disease or its treatment may alter these levels. Circulating levels of selected nutrients were examined prior to diagnostic biopsy and compared with levels 3 to 4 months after diagnosis among 71 women with breast cancer and 95 women with benign breast disease. Among women with benign breast disease or women with breast cancer who were not given postsurgical adjuvant drug therapy, levels of alpha-carotene, lycopene, alpha-tocopherol, cholesterol, and triglycerides did not change over time. In contrast, women who received chemotherapy had increased levels of cholesterol, retinol, and alpha- and gamma-tocopherol, and women on antiestrogen therapy showed increased levels of triglycerides and alpha-tocopherol. Overall, the concentrations of carotenoids (lycopene, alpha-carotene, and beta-carotene) did not change in breast cancer cases, although subgroup analyses showed increased levels of beta-carotene among cases not receiving drug treatment and decreased levels among those receiving antiestrogens. In summary, blood levels of some nutrients did not appear to be affected by breast cancer or its treatments, but changes were noted for levels of plasma lipids, tocopherols, retinol, and beta-carotene. Those investigating the etiological relationship between breast cancer and circulating nutrients need to consider these effects in designing and interpreting epidemiological studies.

Association of the 90-kDa heat shock protein does not affect the ligand-binding ability of androgen receptor

An N-terminal truncated androgen receptor with putative DNA- and ligand-binding domains (AR438) and that with a ligand-binding domain (AR612) were expressed under control of the T7 promoter in E. coli or translated in vitro with rabbit reticulocyte lysate, and their ligand-binding properties and the interaction with HSP90 were investigated. Bacterially expressed AR438 and AR612 bound a synthetic androgen, [3H]R1881, with apparent dissociation constants of 2.6 +/- 0.2 and 3.1 +/- 0.7 nM, respectively, values which are comparable to those of androgen receptor in target tissues. The recombinant androgen receptors sedimented at the 4-5 S region irrespective of the presence of 10 mM tungstate, indicating that the receptor exists free from HtpG, which is the bacterial homolog of eukaryotic HSP90. The apparent dissociation constant of truncated androgen receptors translated in vitro was 0.1 nM for AR438 and 0.2 nM for AR612. Sedimentation coefficients of in vitro translated molecules were converted from 7-8 S in the presence of tungstate to 3 S in the absence of tungstate. Both AR438 and AR612 translated in vitro were retained by anti-rat HSP90 antibody-protein A Sepharose. Exposure to 0.3 M NaCl in the presence of ligand caused dissociation of AR438 and AR612 from HSP90, and concomitantly, the DNA-cellulose binding ability of AR438 was enhanced. Thus, we conclude that the androgen receptor associates with HSP90 through the ligand-binding domain and that this association prevents the interaction of the androgen receptor with DNA. However, HSP90 seems to have little effect on the ligand-binding characteristics of the androgen receptor.

[An adult case of dyspnea and overinflation of the residual lung with disappearance of the postpneumonectomy space after left pneumonectomy]

Mediastinal shift and overinflation of the residual lung after pneumonectomy are well known, and sometimes cause pulmonary insufficiency. However, most of such cases occur after surgery in childhood or adolescence. We present a 49-year-old woman who had dyspnea and severe overinflation of the residual lung after left pneumonectomy. She had undergone pneumonectomy at the age of 33 years. Dyspnea on exertion occurred 4 years later, and became much more severe 9 years later (H-J IV degrees). Computed tomography showed that the postpneumonectomy space and completely disappeared and the right lung was overinflated to the left posterior axillary line. Low vital capacity with high residual volume and low maximal ventilatory volume were detected by pulmonary function test. Pulmonary function after pneumonectomy is difficult to predict because mediastinal shift and overinflation of the residual lung may occur. To avoid this, prosthesis plombage for the postpneumonectomy space is necessary.

The effects of cromolyn sodium in dogs undergoing high-frequency oscillation superimposed on conventional mechanical ventilation

The effects on gas exchange of superimposition of high-frequency oscillation (HFO) (40 Hz) on conventional mechanical ventilation were investigated in mongrel dogs with eucapnic gas exchange on conventional mechanical ventilation (CMV). The dogs were anesthetized, paralyzed, and ventilated with CMV until stable. Oscillation was then superimposed for 15 min, followed by CMV alone for a further 30 min. During HFO superimposed on CMV (CMV-HFO), the arterial carbon dioxide tension (PaCO2) increased from 43.6 +/- 1.2 mm Hg to 47.2 +/- 1.4 mm Hg (p less than 0.02), whereas the arterial oxygen tension (PaO2) did not change at all. The change was inhibited completely by administration of intravenous cromolyn sodium (CS) (6 mg/kg/min). The mean pulmonary arterial pressure (mPAP), cardiac output (CO), pulmonary capillary wedge pressure (PCWP), and pulmonary vascular resistance (PVR) did not change during the experiment. These results demonstrate that CMV-HFO appears to cause CO2 accumulation and eliminates the impaired O2 transfer, and that these effects are inhibited completely by CS administration.

[A case report of AML M0:CD7, 33 (+) AML M0 case initially presented with cervical lymphadenopathy]

A 59-year-old man was admitted because of generalized lymphadenopathy with fever and vomiting. His peripheral blood showed leukocytosis with a WBC of 93,500/microliters, and the bone marrow picture revealed a predominance of blast cells. The blasts were negative for peroxidase, alpha-naphthyl butyrate esterase and PAS, and had the phenotype of CD 7, 13 and 33 positive. A diagnosis of AML M0 was made, based on the criteria of the NCI-sponsored workshop in 1988. His initial status had been compromised by acute renal failure which necessitated hemodialysis. He responded partially to chemotherapy consisting of daunorubicin, cytarabine and prednisolone. However leukemia recurred and the patient suffered from various episodes of infection and died six months after admission. The Southern blotting showed the germ line configuration for TCR-beta chain and immunoglobulin heavy chain genes. No messenger RNA was detected for myeloperoxidase, c-myc and c-jun, while c-fms, c-fos and c-myb were expressed on Northern blotting. It is intriguing to detect c-fms and c-fos expression in these poorly differentiated leukemic cells.

[A case of primary pulmonary paraganglioma]

A case of primary paraganglioma of the lung in a 48-year-old woman is presented. She was found to have a coin lesion in lower lobe on routine radiography. Results of bronchoscopic examination were negative, and exploratory right thoracotomy was performed. At operation, non-invasive encapsulated tumor found in posterior basal segment of the right lower lobe was enucleated. Histological analysis of the resected tumor proved to be compatible with pulmonary paraganglioma. Pulmonary paraganglioma is said extreme rare, and so only 21 cases were previously reported in the literature including this case.

Four clinical types of panic disorders

The authors attempted to classify panic disorders into four types according to a clinical course and accompanying neurotic or depressive symptoms. The characteristics of each type are as follows; type I: a single panic attack is the only symptom, type II: only panic attacks occur frequently without any accompanying neurotic or depressive symptoms, type III: a recurrence of panic attacks and the gradual development of neurotic symptoms, such as anticipatory anxiety, generalized anxiety, agoraphobia, or hypochondriasis, type IV: depressive symptoms develop in the course of recurring panic attacks. Type IV is further divided into three subtypes. Type IV-1: depressive symptoms develop secondary to panic attacks and major depression later coexists with panic disorder. Type IV-2: panic disorder continuously changed into major depression. Type IV-3: panic attacks and depressive symptoms are seen independently. The most common types are type III and type IV-1, and seem to be a core group of the panic disorder. Typical cases of each type are presented and underlying psychopathology is discussed.

[A case of miliary tuberculosis and chest wall cold tuberculous abscess with contents draining into the epidural space]

A 37-year-old man was admitted because of miliary tuberculosis. However, his fever and general condition did not improve with chemotherapy. Six months later, paraplegia occurred following sudden radicular back pain without any alteration of segmental sensation. There were no abnormal findings on X-ray films of the thoracic and lumbar vertebrae. Examination by magnetic resonance imaging revealed that the contents of a cold tuberculous abscess in the right chest wall had drained into the epidural space through the intervertebral foramen. Drainage of the chest wall abscess and laminectomy were performed. Further investigation showed that this case did not belong to the usual type of atypical spinal tuberculosis reported previously.

[An experimental study on compression neuropathy--changes of the neurofilament and axonal tubulin content detected by enzymatic antibody technique]

Changes of axonal transport were investigated by enzymatic antibody technique in an experimental model of compression neuropathy. Neurofilament and tubulin were selected as marker protein and avidin-biotin-peroxidase complex method was used to stain specimens. Compression was applied on the sciatic nerves of the mongrel dogs by the KEIO compression clamps with compression force of 15, 30, and 50 grams. Staining was performed at 1, 2, 3, 4, 6, 8 weeks after the onset of the compression. Electrophysiologic and histologic examination were also studied. As a result, neurofilament and axonal tubulin content decreased in the site distal to the compression clamps. The degree of the changes was correlated with the duration and force of the compression. The decrease of axonal tubulin content closely corresponded with the decrease of neurofilament content. In conclusion, axonal transport was impaired in the peripheral nerve even under a low compression force.

Palliation of left main bronchus compression due to malignant tumor by intubation via a tracheostomy tube

Intubation of the left main bronchus via a tracheostomy tube was performed in a patient with local recurrence of lung cancer associated with invasion and obstruction of the left main bronchus after right sleeve pneumonectomy. The result was satisfactory not only for preventing asphyxia, but also for maintaining the patency of the airway after extubation of the endotracheal tube.

Nutritional epidemiology of postmenopausal breast cancer in western New York

The authors studied 439 postmenopausal breast cancer cases, identified in hospitals throughout western New York, with an interview schedule that considered frequency and amount ingested of 172 foods and provided data for an estimate of total calories ingested. These were compared with age-matched controls comprising a random sample of the same communities as the cases. The extensive interviews, requiring 2.0 hours on average to administer, also covered alcohol ingestion, Quetelet index, and a wide variety of reproductive factors. The authors found, as have most investigators over the past 25 years, that risk increased with increases in age at first pregnancy, decreased with increases in numbers of children and pregnancies, and increased in those with history of benign breast disease and in those with female relatives previously affected with breast cancer. Risk adjusted for potential confounders was highest among women with the lowest ingestion of carotene or a substance correlated with its ingestion. Risk was not associated with retinol ingestion. It increased with increases in Quetelet index. Fat intake, whether studied in terms of quantity or the proportion of total calories derived from fat, was not associated with risk of breast cancer. Our analyses of these factors were adjusted for age, education, and the reproductive history traits described above.