Expression of pepsinogen II with androgen and estrogen receptors in human prostate carcinoma

The expression of pepsinogen II (PG II), an aspartyl proteinase usually involved in the digestion of proteins in the stomach, was immunohistochemically investigated in conjunction with androgen (AR) and estrogen receptor (ER) status in prostate adenocarcinomas. Of a total of 38 samples obtained from radical prostatectomies, 23 tumors (60.5%) were positive for PG II and there was a significant positive correlation to the expression of AR but not to ER. Cells positive for PG II were localized mainly to the peripheral zones of tumorous glands which, in normal prostate, are negative, and in areas also expressing AR. In addition, a significant correlation between AR and ER was detected in the prostate carcinomas examined, which suggests a hormone-dependent status. On the basis of these results, PG II expression might be closely related to hormonal alterations associated with the development of prostate tumors.

Use of expanded polytetrafluoroethylene sutures as artificial tendinous cords in children with congenital mitral regurgitation

OBJECTIVE

To determine the efficacy in the intermediate term of artificial cords inserted in children with congenital mitral regurgitation.

METHODS

We reconstructed the tendinous cords using expanded polytetrafluoroethylene (ePTFE) sutures in 11 children with severe mitral regurgitation. In these patients, the aortic (anterior) leaflet of the mitral valve had been markedly prolapsed, the tendinous cords being partially lacking in seven, and elongated in the remaining four. In addition, one of the papillary muscles was hypoplastic in five and absent in three. The number of artificial cords constructed varied from two to six. Conventional annuloplasty was performed in all to plicate the dilated annular attachment of the valve. Ventricular septal defect was present in four patients, and other associated malformations in another two. Age at operation ranged from 9 months to 9 years old, with a mean of 4.5 years.

RESULTS

All patients survived the operation. No reoperation has been needed thus far. No complications were encountered related to the use of the prosthetic materials or anticoagulation. As judged by echocardiography, regurgitation became trivial or slight immediately after the repair. In two patients, however, regurgitation recurred within 1 year of the operation. Coaptation between the leaflets was maintained by a compensatory growth at the site of attachment of the artificial cords. Catheterization demonstrated significant improvements in the end-diastolic volume of the left ventricle.

CONCLUSION

Expanded polytetrafluoroethylene sutures can be used as artificial cords when attempting to repair the malformed mitral valve in children, providing excellent results in the short- and the intermediate-term after the surgical procedure.

As originally published in 1992: new surgical technique for total-defect aortopulmonary window. Updated in 1999

A new technique is described to repair aortopulmonary window with total defect in an 8-day-old baby. Because we expected the future growth of aorta, we used the anterior wall of the pulmonary artery as a large flap to reconstruct the posterolateral aortic wall. An equine pericardial patch was used to repair the defect in the pulmonary artery. This is a logically effective method for aortic reconstruction in a neonate with a large aortopulmonary septal defect.

N-acetyltransferase 1 genetic polymorphism influences the risk of prostate cancer development

The potential involvement of N-acetyltransferase 1 (NAT1) genetic polymorphisms in prostate cancer (PCa) patients was analyzed in 101 patients with PCa and 97 controls with no incidental malignancy. Identification of NAT1*10, the variant allele associated with the rapid acetylator phenotype was by allele-specific polymerase chain reaction (PCR). When the NAT1*10 heterozygote and other genotypes without NAT1*10 allele were considered as low risk genotypes, NAT1*10/NAT1*10 had a significantly higher risk of PCa (OR = 2.4, 95% CI; 1.0-5.6). If our preliminary results can be confirmed in a larger population, it may be a useful marker for PCa risk.

A human gene, hSGT1, can substitute for GCR2, which encodes a general regulatory factor of glycolytic gene expression in Saccharomyces cerevisiae

To determine whether similar regulatory mechanisms control the expression of glycolytic genes in yeast and human cells, we screened a human brain cDNA library for clones which complement the growth defect of the gcr2 mutant of Saccharomyces cerevisiae, and isolated hSGT1 (human suppressor of GCR two). Further work confirmed that the rescue of growth was associated with recovery of glycolytic enzyme activities, and that hSGT1 did not complement the growth defect of a gcr1 mutant. A hybrid protein comprising hSgt1p and the DNA-binding domain of Gal4p (GBD) activated a GAL1-lacZ reporter gene fusion, suggesting that the cloned gene may be a transcriptional activator. Two-hybrid experiments in yeast also indicate that hSgt1p interacts with Gcr1p. Northern analysis showed that hSGT1 is highly expressed in muscle and heart. Although the predicted amino acid sequence of hSgt1p does not display significant similarity to Gcr2p, we speculate that their functions may be analogous.

[Long-term results of aortic root replacements with pulmonary autografts (Ross procedure) in five cases]

Aortic root replacement with a pulmonary autograft (the Ross Procedure) has been successfully performed in our hospital since November, 1992. The long-term results of five of the earliest cases are reported in this paper (2-3 year follow-up). The patients' ages were two months to eighteen years old. Four of the patients suffered from aortic valve stenosis, and one suffered from aortic regurgitation. Severe left ventricular failure was recognized in three cases. However, the patients recovered from surgery smoothly and without significant aortic regurgitation and left ventricular outflow tract gradients. A serious concern exist as to whether the implanted autograft in 2 months old infant would grow. In this patient, postoperative cardiac catheterization was performed after sixty days, one year, and two years. The diameter of the anulus of the pulmonary autograft enlarged from 12 mm to 18 mm over the period of two years. Compared with the calculated aortic valvular diameter from a standardized body surface area, these diameters were equivalent to 150%-162% of the standardized size at each age. The implanted pulmonary autograft has subsequently enlarged gradually and proportionally. Its function as an aortic valve was maintained even after significant enlargement of the aortic anulus to 18 mm. We therefore conclude that the Ross procedure can be recommended because of the apparent ability the pulmonary autograft to grow over time.

Genomic aberrations in renal cell carcinomas detected by restriction landmark genomic scanning

In order to reveal and characterise genetic events occurring in renal tumorigenesis, samples of sporadic renal cell carcinomas (RCCs) were examined using restriction landmark genomic scanning (RLGS), an electrophoretic separation technique which detects gene amplification and deletion. We were able to find two fragments frequently amplified and 10 others commonly showing reduced signal intensity within the 16 tumour samples analysed. These altered spots were located on chromosomes 2, 3, 9-12, 16, 17 and 18 according to chromosomal assigned RLGS. A subset of reduced fragments appeared to be correlated to tumour type and were located within a new chromosomal region, suggesting genetic specificity within the process of renal carcinogenesis.

[A successful biventricular repair in an adult case with "common ventricle" and isomeric atrial appendages previously undergoing the conventional Glenn procedure]

We describe herein a successful biventricular repair in a 21-year-old male who had severe hypoplasia of isomeric right appendages. He had previously undergone the conventional Glenn procedure at the age of one and a half years. Although he had grown uneventfully until adolescence, cyanosis as well as fatigue than gradually became worse. When referred to us for further treatment, we deemed a Fontan type procedure to be contraindicated, because of the hypoplastic nature of the right pulmonary artery, and the presence of abundant collateral arteries supplying the right lung. In terms of ventricular morphology, however, because both apical components were present, separated by the hypoplastic septum, biventricular repair seemed feasible. Initially, the Glenn anastomosis was taken down, and systemic-to-pulmonary shunts were constructed via a median sternotomy to both the right and left pulmonary arteries. This was followed by surgical division of the developed collaterals to the right lung via the right thoracotomy. Definitive biventricular repair was then carried out by reconstructing the pulmonary arteries and right ventricular outflow tact, separating and rerouting within the ventricles using a EPTFE patch, and achieving redirection of blood within the atriums using bovine pericardium. Such staged surgical approaches, although extensive, can provide useful options when seeking definitive repair in grown-up patients with complicated malformations.

[Analysis of the prognostic factor in the patients with locally invasive bladder cancer who underwent total cystectomy]

OBJECTIVES

Prognosis and related factors were analysed as for the patients with locally invasive bladder cancer who underwent total cystectomy and pelvic lymph node dissection.

METHODS

Between January 1977 and December 1996, a hundred and one patients with locally invasive bladder cancer underwent total cystectomy and pelvic lymph node dissection at University Hospital. Survival rates of these patients were calculated by Kaplan-Meier method and statistical significances were analysed by univariate and multivariate analyses.

RESULTS

Most significant factor was PS at cystectomy and pN was next. Survival rate of the patients who underwent total cystectomy after 1988 showed significantly better than others. Thirteen patients achieved complete response by preoperative therapy. But, two of them who had positive nodes were died by cancer.

CONCLUSION

Considering from these results, performance status at cystectomy and lymph node metastasis are predictable prognostic factor for locally invasive bladder cancer patients.

The structure of the common atrioventricular valve in hearts having isomeric atrial appendages and double inlet ventricle

BACKGROUND AND AIMS OF THE STUDY

It is now well recognized that regurgitation through a common atrioventricular valve can compromise the clinical course both before and after surgical interventions in patients with visceral heterotaxy. This may reflect the anatomic structure of the valve. This study aimed to determine whether the structure of the common atrioventricular valve found in the setting of hearts with isomeric atrial appendages and double inlet ventricle differs from that of the valve guarding a common junction in hearts with biventricular atrioventricular connections.

METHODS

Sixty-three autopsied hearts with double inlet ventricle and isomeric atrial appendages were studied, in addition to 79 with isomerism and biventricular atrioventricular connections, all having a common valve guarding the atrioventricular junctions.

RESULTS

A valve with three or four leaflets was seen more frequently in hearts with double inlet ventricle than in those with biventricular atrioventricular connections (p = 0.016, chi-squared test). Complicated multiple orifices within the valvular curtain, including abnormal accessory orifices within a leaflet, were found in seven cases with double inlet to a dominant morphologically left or right ventricle. The presence of four papillary muscles was the most common pattern in hearts with double inlet ventricle. Straddling of the papillary muscles to a rudimentary and incomplete ventricle was seen in 23% of cases. Direct attachment of tendinous cords to the ventricular septum or parietal wall was seen 81% of hearts with double inlet.

CONCLUSIONS

These features of the common valve found with double inlet atrioventricular connection seem less suited to function as the inlet valve supporting the systemic circulation. The recognized abnormal features should be identified preoperatively so as to plan more effective valvular plasty, or alternatively to establish different surgical strategies.

Detection of DNA amplification in human renal cell carcinoma cell lines using restriction landmark genomic scanning

Gene amplification, which has often been observed in various human cancers, appears to be associated with the development and progression of malignant phenotypes. However, in renal cell carcinoma (RCC), conventional analytic methods requiring specific primers and probes have revealed infrequent amplification of known oncogenes. We attempted to determine if gene amplification was truly uncommon in RCC. The genomic DNAs extracted from 5 human RCC cell lines were examined by restriction landmark genomic scanning (RLGS), a two-dimensional gel analysis which allows evaluation of approximately 2,000 radiolabelled DNA fragments. By this method, we detected 24 distinct spots commonly amplified in at least 2 RCC cell lines compared to normal kidneys. Comparing the present results with chromosomal assigned-RLGS, approximately one half of these DNA fragments proved to be located on chromosome 2, 5 or 7. Our data suggest that amplification of unknown genes is likely to occur in RCC cell lines.

Bradykinin B2-receptor-mediated modulation of membrane currents in guinea-pig cardiomyocytes

1. In order to define the electrophysiological mechanism(s) responsible for bradykinin (BK)-induced positive inotropic and chronotropic responses in isolated guinea-pig atria, effects of BK on the membrane currents were examined in isolated atrial cells using patch clamp techniques. 2. BK (0.1-1000 nM) increased the L-type Ca2+ current (I(Ca)), which was recorded from enzymatically-dissociated atrial myocytes by the nystatin-perforated patch method, in a concentration-dependent fashion, and the calculated EC50 value for increasing I(Ca) was 5.2 nM. In conventional ruptured patch experiments, BK inhibited the muscarinic acetylcholine receptor-operated K+ current (I(K.ACh)) that was activated by the muscarinic agonist carbachol (1 microM) with an EC50 value of 0.57 nM. Both the increase in I(Ca) and the decrease in I(K.ACh) were blocked by HOE140, a selective bradykinin B2 receptor antagonist. 3. The BK-induced inhibition of I(K.ACh) was significantly attenuated by staurosporine and calphostin C, protein kinase C inhibitors. In addition, the I(K.ACh) inhibition by BK was also attenuated by the tyrosine kinase inhibitor genistein or tyrphostin but not by daidzein, an inactive analogue of genistein. However, neither protein kinase C inhibitor nor tyrosine kinase inhibitor affected the BK-induced increase in I(Ca). 4. In the presence and absence of muscarinic stimulation, BK prolonged the action potential recorded from the atrial cells in the current clamp mode. 5. We conclude that BK increases I(Ca) and decreases I(K.ACh) in atrial cells, resulting in positive inotropic and chronotropic responses in atrial preparations. Protein kinase C activation, and possibly tyrosine kinase activation, may be involved in the B2-receptor-mediated I(K.ACh) inhibition.

Induction of an intronic enhancer of the human ciliary neurotrophic factor receptor (CNTFRalpha) gene by the TR3 orphan receptor

A hormone response element, CNTFRalpha-NBRE (5'-AAAGGTCA-3') has been identified in the fifth intron of the alpha component of ciliary neurotrophic factor receptor gene (CNTFR-15) for the human TR3 orphan receptor (TR3). A specific binding between in vitro expressed TR3 and CNTFRalpha-NBRE was demonstrated by using electrophoretic mobility shift assay. A reporter gene assay using chloramphenicol acetyl-transferase (CAT) showed that CNTFR-15 has an enhancer activity that could be induced by TR3 in a dose-dependent manner. This induction was significantly reduced in the absence of CNTFRalpha-NBRE. Together, these results indicate CNTFRalpha-NBRE is sufficient to mediate TR3 action in inducing the enhancer activity of CNTFR-15. Our finding may, therefore, suggest CNTFRalpha is a target gene regulated by TR3 and expand the role of TR3 in the nervous system.

Detection of telomerase activity in prostate needle-biopsy samples

BACKGROUND

Telomerase in an enzyme ribonucleoprotein responsible for cell immortality and oncogenesis. Telomerase activity has been detected in most cancers, including prostate cancer. To verify whether the detection of telomerase in prostate needle biopsy samples could have diagnostic value, we blindly assayed telomerase activity in samples from patients who were clinically suspected of having prostate cancer.

METHODS

A total of 183 prostate biopsy samples was obtained from 63 patients who were suspected of having prostate cancer. Telomerase activity was determined by polymerase chain reaction (PCR)-based telomeric repeat amplification protocol (TRAP) assay. An internal telomerase assay standard (ITAS) was used in this study to distinguish false negatives.

RESULTS

Telomerase activity was detected in 17 of 19 (89.5%) patients with prostate cancer (chi(2) test, P < 0.005). In 39 of 42 (92.9%) biopsy samples from these 19 prostate cancer patients, confirmed histologically as prostate cancer, telomerase activity (chi(2) test, P < 0.005) was detected. Meanwhile, we also found one false-positive sample. In contrast, all of 44 normal or benign prostate disease patients (124 biopsy specimens) were telomerase-negative. We also revealed that poorly differentiated prostate cancer often expresses a high level of telomerase activity. The area of cancer tissue in biopsy specimens was not associated with relative telomerase activity.

CONCLUSIONS

This study suggests that determination of telomerase activity in prostate needle-biopsy samples might be a useful tool for detecting prostate cancer.

Distribution of endothelin-B receptor-like immunoreactivity in rat brain, kidney, and pancreas

We investigated the distribution of endothelin B (ETB) receptor-like immunoreactivity in rat brain, kidney, and pancreas, using an antiserum against amino acid residues 425-439 of the rat ETB receptor modified by the multiple-antigen peptide complex system. In the brain, immunoreactive fibers were observed mainly in the hypothalamus and diagonal band of Broca. Densely arranged immunoreactive fibers were observed in the organum vasculosum of the lamina terminalis and the median eminence. In these areas, the immunoreactive fibers corresponded to luteinizing hormone-releasing hormone-immunoreactive fibers. In the kidney, intense ETB receptor-like immunoreactivity was seen in structures that were presumably proximal tubules. In other segments of renal tubules and collecting ducts, immunoreactive puncta were scattered. In the glomerulus, a few immunoreactive puncta were seen on the capillaries. In the pancreas, ETB receptor-like immunoreactivity was seen in the acinar cells and islets of Langerhans. By analysis of double staining in the same section, B and D cells showed intense immunoreactivity, whereas A cells showed only weak immunoreactivity. These results suggest that the ETB receptor or its subtype is localized in specific cell types in the organs investigated. In these cells, ET(s) may modulate the function of each cell type via this type of receptor.

Establishment of total cavopulmonary connection without use of cardiopulmonary bypass

OBJECTIVE

To minimize deleterious postoperative influences of cardiopulmonary bypass on the pulmonary circulation immediately after the Fontan type procedure, total cavopulmonary connection was achieved without use of cardiopulmonary bypass.

METHODS

Since April 1996, 15 patients including five patients with visceral heterotaxy, in whom no intracardiac procedure was needed, have undergone this operative maneuver. Age at operation ranged from 1.2 to 44.6 years. Construction of a systemic to pulmonary shunt had been previously employed in seven patients, banding of the pulmonary trunk in two patients, and the Norwood procedure in one patient. The superior caval vein was initially anastomosed to the pulmonary arteries in bidirectional fashion under temporary bypass from the superior caval vein to the atrium. The channel for draining the inferior caval vein was subsequently constructed with the aid of temporary bypass from the inferior caval vein to the atrium, using a Goretex tube in ten patients, using a pedicled autologous pericardial roll in four patients, and directly anastomosing the pulmonary trunk to the orifice of the inferior caval vein in one patient. In patients with visceral heterotaxy and an independent hepatic venous drainage, redirection of the blood flow via the caval vein as well as the hepatic vein could be successfully achieved by placing dual temporary bypasses into these veins.

RESULTS

Postoperative courses were excellent in all patients. Superior caval venous pressure was 11 +/- 2 mmHg at 12 h after the operation. No blood transfusion was needed in nine patients(60%).

CONCLUSION

This alternative operative procedure is undoubtedly attractive when establishing the Fontan circulation in patients undergoing no intracardiac maneuvers.

Artificial chordae for mitral valve reconstruction in children

BACKGROUND

Congenital mitral regurgitation continues to present a challenge for cardiac surgeons because of the diversity of the anatomy of the congenitally malformed mitral valve. We undertook aggressive repair of the mitral valve with artificial chordae for reconstruction of the prolapsed anterior leaflet in some children. The short-term results are reported herein.

METHODS

Three patients with isolated congenital mitral regurgitation underwent mitral valve repair with use of expanded polytetrafluoroethylene sutures as artificial chordae.

RESULTS

There have been no late deaths and no valve-related complications. Serial follow-up echocardiographic examinations have not revealed any increase in the severity of mitral regurgitation with continuing patient growth up to 39 months after the operation.

CONCLUSIONS

When combined with other conservative methods of mitral valve repair, chordal replacement with expanded polytetrafluoroethylene sutures in children undergoing mitral valve reconstruction produces good short-term results. We believe that it delays and possibly prevents the need for a mechanical prosthesis with its associated complications in this young patient population.

[Telomerase activity in association with the pathological differentiation of prostate cancer]

We analyzed the telomerase activity in association with the pathological differentiation of prostate cancer. Furthermore, to verify whether the detection of telomerase in prostate needle biopsy samples could be valuable for diagnosis, we assayed the telomerase activity in needle biopsy samples. Telomerase activity was examined by PCR-based telomeric repeat amplification protocol (TRAP) assay. Among 31 primary prostate cancer tissues, 28 samples (90%) displayed telomerase activity, in which of relative levels were associated with pathological differentiation. High activity of telomerase in primary and biopsy samples was more frequently detected in poorly differentiated adenocarcinoma. These studies suggest that determination of telomerase activity in prostate cancer might be an useful examination for detecting prostate cancer and evaluating the biological malignant potentials.

Antisense TR3 orphan receptor can increase prostate cancer cell viability with etoposide treatment

In androgen-responsive LNCaP human prostatic cancer cells, human TR3 orphan receptor, a member of the steroid receptor superfamily, can be rapidly induced by androgen. In contrast, ablation of androgen by castration can induce the expression of the TR3 orphan receptor gene in rat ventral prostate that has undergone apoptosis. This phenomenon prompted us to further analyze the potential role of human TR3 orphan receptor in prostate cancer cells in which apoptosis had been induced. Northern blot analysis shows that human TR3 orphan receptor expression can be induced rapidly after treatment of LNCaP and PC-3 prostate cancer cells with calcium ionophore or etoposide. Our data further demonstrate that a much higher concentration of etoposide was needed to kill the same number of cells in LNCaP and PC-3 cells transfected stably with antisense TR3 orphan receptor compared with that in control vector transfectants. Together, our data suggest that the human TR3 orphan receptor may play an important role in modulating drug-induced prostate apoptosis.

[Prognostic significance of clinical stage including extent of disease (EOD) in prostate cancer]

We analyzed the prognostic significance of clinical stage using extent of disease (EOD) grading system in 288 patients with prostate cancer between 1970 and 1994. The cause-specific survival rate for EOD4 was significantly lower (p < 0.01) than that for the other EOD categories. On the other hand, the cause-specific survival rate for EOD1 was significantly higher (p < 0.01) than that of the other EOD categories, and moreover, it was similar to the cause-specific survival rates for stage C and D1. The cause-specific survival rate of EOD1 and poorly differentiated cases was higher than that of EOD2 or 3 and well or moderately differentiated cases until 2 years after treatment, but after 3 years, the cause-specific survival rate for EOD1 and poorly differentiated cases was lower than that for EOD2 or 3 and well or moderately differentiated cases. These findings suggest that the volume of cancer is associated with the prognosis of prostate cancer that failed in radical treatment and that in stage D2, histological grade is more closely associated with the prognosis after treatment for 3 years.

Molecular and biological characterization of rabbit mannan-binding protein

Mannan-binding protein (MBP) is a member of the collectin family of protein. There are two types of MBP, MBP-A and MBP-C, which were found in rodent (rats and mice), rhesus monkey, and cynomolgus monkey, while chimpanzee and human have only one MBP. It was considered that the loss of one MBP gene occurred during hominoid evolution. In this article two rabbit MBP, a liver and serum MBP, were characterized biologically and genetically. Analyses by SDS-PAGE under reduced condition and their amino acid sequences of both MBPs showed that they have a same molecular weight of 32 kDa and their amino acid sequences were identical. A serum MBP has a higher ability to activate complement than does a liver MBP; however, a liver MBP inhibits hemagglutination by influenza virus as strongly as a serum MBP does. cDNA clones encoding the rabbit MBP were isolated from a rabbit cDNA liver library using whole cDNA of mouse MBP-C as a probe. The cDNA carried an insert of 744 bp coding for a protein of 247 acid residues with a signal peptide of 22 residues. The deduced amino acid sequence of the cDNA was identical to that of amino acid sequences of the 32 kDa proteins determined here. Northern blot analysis showed that mRNA transcripts of about 0. 9 and 3.0 kb were expressed only in the liver. The analysis of the phylogenetic tree of rabbit and bovine MBPs and other collectins indicates that the loss of MBP gene occurred not only during hominoid evolution but also at some points after the separation of birds and mammals.