Solitary malignant schwannoma of the lower extremity-a case report

A case of solitary malignant schwannoma, appearing as a painless mass near the right ankle of a 46-year-old female, is presented. Solitary malignant schwannoma without neurofibromatosis is considered to be quite rare. However, this disorder has a better prognosis than neurofibromatosis. Previous reports indicate that the treatment usually chosen is wide local excision without lymph node dissection, unless clinically involved nodes are present.

Increased expression of integrins by heparin-binding EGF like growth factor in human esophageal cancer cells

The adhesion of cancer cells to vascular endothelium is an important step in the hematogenous metastasis of cancer. The authors investigated the alteration of integrin expression in human esophageal cancer cells, following the selectin-mediated initial adhesion to endothelial cells. The expression of alpha2 beta1 and alpha3 beta1 integrins in esophageal cancer cells (TE-1 and T.Tn), strongly expressing EGF-receptors, were markedly increased by the addition of the heparin-binding EGF like growth factor (HB-EGF). The increase of integrin expression in esophageal cancer cells was inhibited by the addition of the tyrosine kinase inhibitor, genistein. HB-EGF treatment of esophageal cancer cells resulted in the augmentation of cancer cell adhesion to immobilized collagen. When esophageal cancer cells were co-cultured with endothelial cells, similar levels of augmentation of cancer cell adhesion to collagen were observed. The augmentation of cancer cell adhesion to collagen was inhibited by the addition of anti-HB-EGF neutralizing antibody. Our interpretation of the results described above is that the cancer cells receive stimulation from cytokines, such as HB-EGF, produced by endothelial cells, following initial adhesion of cancer cells via selectins. This results in a secondary increase in the expression of cell adhesion molecules, such as the beta1 integrin family, and leads to augmentation in the adhesive activities of cancer cells at vessel walls. We postulate that this sequence of events involves the enhanced transmigration of cancer cells to extravascular tissues, following the selectin-mediated adhesion to the endothelium.

Direct fermentative production of acyltylosins by genetically-engineered strains of Streptomyces fradiae

A tylosin-producer, Streptomyces fradiae, was transformed with plasmids carrying genes from Streptomyces thermotolerans that are involved in acyl modification of macrolide antibiotics. A transformant with pMAB3, in which macrolide 4"-O-acyltransferase gene (acyB1) and its regulatory gene (acyB2) are subcloned, produced several types of 4"-O-acyltylosins. A transformant with pAB11 delta EH containing macrolide 3-O-acyltransferase gene (acyA) in addition to the above two genes produced 3-O-acetyltylosin and 3-O-acetyl-4"-O-acyltylosins. Among the products of the latter transformant, 3-O-acetyl-4"-O-isovaleryltylosin (AIV) was detected as a minor component. When L-leucine, a precursor of isovaleryl-CoA, was added to the medium at the late stage of the fermentation, AIV content among the total macrolides increased ten-fold and AIV became a main product. This fact suggests that a high level of endogenous isovaleryl-CoA may be essential for the selective production of AIV by S. fradiae carrying pAB11 delta EH.

Adhesion of Human Breast Cancer Cells to Vascular Endothelium Mediated by Sialyl Lewis &supx; /E-selectin

The adhesion molecules involved in the attachment of breast cancer cells to endothelial cells were investigated in vitro. All six human breast cancer cell lines expressed sialyl Lewis &supx; antigen(s-Le &supx;). Only two cell lines expressed sialyl Lewis&supa; antigen. A correlation was found between the degree of s-Le&supx; expression and the attachment of cancer cells to human umbilical vein endothelial cells (HUVECs) activated by IL-1beta. Monoclonal antibodies against s-Le &supx; or E-selectin inhibited this adhesion. These findings suggest that s-Le &supx; on the surface of cancer cells and E-selectin on the surface of endothelial cells play roles in adheision of breast cancer cells to vascular endothelium.

[Biological functions of cell adhesion molecules in breast cancer]

We investigated the mechanisms of adhesion of breast cancer cells to vascular endothelial cells which is an important step in hematogenous metastasis. The results from the present studies are as follows. The breast cancer cells induce the expression of E-selectin on the endothelial cells chiefly through the release of cytokines, such as IL-beta, from lymphocytes. Following the initial adhesion mediated by E-selectin via sialyl Lewis, breast cancer cells receive stimulation from cytokines, such as HB-EGF, produced by endothelial cells and transmigrate to extravascular tissues through the augmentation of integrins.

Suppressive effect of iodine on DMBA-induced breast tumor growth in the rat

Concerning the suppressive effect of inorganic iodine on the growth of 7,12-dimethyl-benz(a)anthracene (DMBA)-induced breast tumor in female Sprague-Dawley (SD) rats, we previously reported that although iodine itself had a suppressive effect on the tumor growth, its effect was not as strong as that of MPA (medroxy-progesterone acetate). However, the combined medication of iodine at a low concentration + MPA showed a stronger effect than MPA alone. The purpose of the present study is to elucidate this mechanism of action by determining the uptake of the administered iodine into breast tumor tissue. Breast tumors were induced with DMBA in female SD rats, and these animals were treated with MPA + inorganic iodine at various concentrations for 4 weeks to determine tumor growth and tumor iodine content. In the comparison of tissue iodine content in growth-suppressive tumors with that in nonsuppressive tumors, the former showed a much higher iodine content. This suggests that direct uptake of inorganic iodine by breast tumors led to the suppression of tumor growth.

Collagenous colitis in a Japanese patient

A case of collagenous colitis is reported. A 48 year old female who had been complaining of mild diarrhea had been under medication for a gastric ulcer. Colonoscopy revealed almost normal appearance of the colonic mucosa except for one hyperplastic polyp of the cecum. Specimens of the ascending, transverse and descending colon showed a distinctively thickened collagen band beneath the surface epithelium, 10-20 microns thick, which was irregularly distributed, even within the same specimen. In some areas, the thickened collagen band was found around the upper part of the pits. Periodic acid-Schiff (PAS), Azan staining and silver impregnation were positive for this thickened collagen band. Immunohistochemically, the thickened collagen band was weakly positive for collagen type III, but negative for collagen types I and IV. Plasma cells, lymphocytes and eosinophils were observed in the lamina propria in addition to intraepithelial lymphocytic infiltration. Capillaries were increased in the thickened collagen band. The arrangement of surface epithelial cells was irregular. Crypts were not distorted. Edema, diffuse or extensive fibrosis and congestion were not found. Through these findings the patient was diagnosed as having collagenous colitis. Many cases of this had been reported in western countries, but very few in Japan. The Japanese literature was reviewed for cases of collagenous colitis and it was found that only two cases had been presented.

[Biological malignant potential and carbohydrate antigens in breast cancer]

We investigated the association of expression of carbohydrate antigens with the degree of malignancy in breast cancer. When this expression was compared in the cancerous portion and adjacent non-cancerous portion in each of the patients, increased expression of type2 carbohydrate antigens were found in cancerous portions. The prognosis of patients in whom type2 carbohydrate antigens were increased in the cancerous portion was significantly poorer than in patients in whom they were not increased. The experimental studies, using cell lines derived from human breast cancer, resulted that the adhesion of cancer cells to vascular endothelial cells was mediated by sialyl Lewis(x) via E-selectin. Moreover, it was suggested that there were the induction of E-selectin expression on the endothelial cells by cancer cells and secondary adhesional system following the initial adhesion mediated by E-selectin and carbohydrate ligands. Consequently, it appears that the role that carbohydrates play in metastasis as cell adhesion molecules, is the underlying the relationship between the expression of carbohydrates and the prognosis of patients with breast cancer.

Crohn's disease in a 92-year-old male

A case of Crohn's disease in an extremely elderly man (92-years-old) is reported. He was admitted for abdominal pain and was operated on under a diagnosis of ischemic colitis. At the mucosal surface, many linear and irregularly shaped shallow ulcers were found on the mesenteric side. Microscopically, transmural inflammatory cell infiltration, bead-like lymphoid aggregates around the propriate muscle, small epithelioid cell granulomas, fissure, and volcano-like streamers of inflammatory cells were found. Nerve fibers in Meissner's and Auerbach's plexi seemed to be increased in number, and some were hyperplastic. There was no feature of ischemic colitis or Yersinia enteritis. Serially sectioned tissue specimens did not show dysplastic mucosal change. Many cases of Crohn's disease in the elderly have been reported but an extremely elderly patient such as the present one is very rare, especially in Japan. Characteristics of elderly patients with Crohn's disease are discussed.

Lymphangiomatous hamartoma of the spleen

A 72 year old female was admitted for an operation of gastric cancer. At the operation, a 3 x 3 cm-sized, whitish and multilocular nodule was incidently found at the left side of the spleen. This nodule was adjoining the splenic capsule and was characterized with sparsely found multilocular lymphatic cysts with varying sizes. The walls of these cysts were composed of partly thin fibrous tissue, or partly thin to thick splenic trabeculae. Abnormally elongated, nodular or fragmentary trabeculae were also present in the nodule. White and red splenic pulp was found widely dispersed among the cysts. The surrounding splenic tissue was not compressed. We considered the essence of this tumor to be an abnormal mixture of normal splenic elements such as lymphatics, splenic trabeculae, and red and white pulp, and regarded this tumor as a focal malformation (lymphangiomatous hamartoma) rather than a true neoplasm such as a lymphangioma.

Corticosteroids and medroxyprogesterone acetate inhibit the induction of E-selectin on the vascular endothelium by MDA-MB-231 breast cancer cells

The vascular endothelium plays a critical role in cancer metastasis by directing circulating cancer cells into extravascular tissues and by expressing cell adhesion molecules. The authors investigated the interaction between breast cancer cells and vascular endothelial cells in the expression of E-selectin, and the effect of corticosteroids or medroxyprogesterone acetate (MPA) on such interaction. An MDA-MB-231 cell line, derived from human breast cancer induced E-selectin on the cell surface of human umbilical vascular endothelial cells. This induction was enhanced with a supplement of mononuclear cells of peripheral blood added to the culture medium. Corticosteroids and MPA blocked the induction of E-selectin proportional to concentration. Anti-IL-1 beta, but not anti-IL1 alpha or- TNF a, antibodies blocked induction. These findings suggest that MDA-MB-231 cells induce expression of E-selectin on vascular endothelium by releasing IL-1 beta directly or indirectly, but this induction is blocked by corticosteroids and MPA. Corticosteroids and MPA may inhibit cancer metastasis by blocking E-selectin expression on the vascular endothelium.

Mobilization of gastric histamine during repeated administration of a proton potassium adenosine triphosphatase inhibitor in intact and antrectomized rats

Intact and antrectomized female rats were treated with the potent proton pump inhibitor, E3810 (daily 40 mg/kg weight, s.c.) for 4 weeks. Plasma gastrin concentration and urinary excretion of N-terminal big gastrin increased until day 14 and persisted at a high level in intact rats treated with E3810, but did not increase in antrectomized rats. Urinary excretion of histamine increased progressively and reached 7 times the control value following 4 weeks of treatment with E3810 in intact rats, but not in antrectomized rats. At the termination of the treatment, the endocrine cell density in the oxyntic mucosa of intact rats had increased by 85% with increased histamine content and elevated histidine decarboxylase activity, while antrectomized rats showed a low histamine level and low histidine decarboxylase activity. Administration of gastrin-17 I (10 micrograms/kg weight, sc) itself caused a significant increase in urinary excretion of histamine, which was inhibited by the specific gastrin receptor antagonist, L-365,260. These results suggests that the massive urinary excretion of histamine caused by the treatment with E3810 reflects gastrin-induced mobilization of gastric histamine and that neither E3810 itself nor E3810-induced luminal pH elevation has direct effects on mobilization of oxyntic mucosal histamine.

[Structure and function of cell adhesion molecules in selectin family and their roles in cancer metastasis]

Cell adhesion molecules of selectin family are involved in the metastasis of cancer at the step of attachment of cancer cells to endothelial cells. P-selectin mediated adhesion of cancer cells with platelets, and L-selectin mediated adhesion of leukocytes to cancer cells would also be involved in the process of hematogenous metastasis through the microthrombus formation. Upon adhesion to cancer cells, platelets and leukocytes secrete cytokines that induce E-selectin expression of endothelial cells, and this further facilitates hematogenous metastasis.

[Intracranial plasma cell granuloma: a case report]

Plasma cell granuloma occurs most frequently in the lung and upper respiratory tract; fewer than ten cases have been reported to occur in the central nervous system. A case of intracranial plasma cell granuloma in a 69-year-old male was reported. He visited our clinic, complaining of progressive visual disturbance. The CT in this patient showed a suprasellar mass, diagnosed as a tuberculum sellae meningioma. Over a 10-year observation period the tumor grew remarkably and, when finally removed, it proved to be a plasma cell granuloma. This report presents CT scans and MR images and a review of the literature relevant to this rare intracranial lesion. The most common preoperative diagnosis in these cases, as reported here, was meningioma. Although plasma cell granuloma rarely occurs intracranially, the existence of this entity should be borne in mind in the differential diagnosis of meningioma.

Pleomorphic adenoma of the breast: case report and review of the literature

A tumor of the right breast was noticed in a 70 year old female. The tumor was round, 1 x 1 cm, and was encapsulated with thin fibrous tissue. The boundary was clear. The cut surface showed a mosaic pattern of brown and white dots and the texture was gritty. Histologically, glandular structures, trabecular or solid epithelial cell nests, myxoid, cartilaginous and osteoid areas, and one ossifying focus were found. Round, polyhedral or fusiform myoepithelial cells proliferated around the glandular structures and were dispersing into the myxoid and cartilaginous tissue. Myoepithelial proliferation was especially marked around the small glandular structure. Immunohistochemically, S-100 protein was strongly positive for the myoepithelial cells around the glandular structures and in the cartilaginous tissue. Until now, 54 cases of pleomorphic adenoma of the breast have been reported. In those cases, the subareolar region was a common site for the tumor, and pleomorphic adenoma was thought to arise from large ducts in this region. No Oriental patients have been reported in the literature.

Peutz-Jeghers syndrome with osseous metaplasia of the intestinal polyps

A case of Peutz-Jeghers syndrome (PJS) with osseous metaplasia in three of 15 hamartomatous polyps of the small intestine is reported. At 35 years of age, the patient was diagnosed as having PJS by cutaneous pigmentation around the mouth and polyposis of the stomach, duodenum and intestine. Fifty-two polys of the large intestine were resected, which were characteristic of those of PJS. Three of them showed adenomatous and carcinomatous changes, but there was no osseous metaplasia in any of the resected polyps. At age 40, he had surgery under the diagnosis of intestinal obstruction. There were 15 polyps in the resected jejunum. These polyps were also characteristic of those of PJS. Additionally, three of these polyps were accompanied by osseous metaplasia. Histologically, mature bone formation and calcification were found close to the hyperplastic glands in the submucosa or in the propriate muscle. Malignant transformation was not observed. Osseous metaplasia is extremely rare in benign polyps, and it has not been reported in hamartomatous polyps of PJS to date. The knowledge of this association may be helpful in the clinical diagnosis of this benign lesion in PJS.

Circumferential Peyronie's disease involving both the corpora cavernosa

An extraordinary form of Peyronies disease is reported. The patient was a 52 year old male, who died of a malignant thymoma with multiple bone metastasis, extensive pleural carcinomatosis of the left lung and some metastatic nodules in the liver and the mesenterium. At autopsy, the proximal and middle portions of the penis were very hard. Macroscopically, the entire tunica albuginea of both the corpora cavernosa was markedly thickened, 2-4 mm; and calcified. Microscopically, the tunica albuginea showed extensive hyaline degeneration, calcification and ossifying foci with osteoblasts and osteoclasts. Inflammatory cells were frequently found beneath the thickened tunica albuginea. In the corpus cavernosum, cavernous arteries showed marked intimal thickening and medial muscular degeneration with a few inflammatory cells. Smooth muscles of the stroma were extensively atrophic and degenerative, and some of them were infiltrated with a few inflammatory cells. In the corpus spongiosum, the tunica albuginea was not thickened, but the smooth muscle in the stroma was atrophic and degenerative and a few inflammatory cells were also found. Surprisingly, there was no Littrés gland around the urethra. In Peyronies disease, the dorsal part of the penis is usually involved, and less frequently lateral or ventral sites are involved. The circumferential involvement of both the corpora cavernosa has not been reported until now, as far as the authors know.

Binding and functional characterization of alpha-2 adrenoceptors in isolated swine myometrium

1. Alpha-adrenoceptors in the uterus of cyclic mature pigs were investigated for their binding characteristics as shown by a radioligand study employing [3H]-prazosin and [3H]-rauwolscine, and the alpha-adrenoceptors were studied for their functional roles on motility as shown mechanically in vitro. 2. Noradrenaline (10 nM-1 microM) caused a tetrodotoxin-resistant contraction in the cornual longitudinal muscle. The response was decreased by yohimbine (10 nM-1 microM) but not by prazosin (1 microM). 3. Clonidine, xylazine, phenylephrine and methoxamine also elicited a concentration-dependent contraction of the cornual longitudinal muscle. The ranking according to the potency was clonidine > xylazine >> phenylephrine > or = methoxamine. On the other hand, these alpha-adrenoceptor agonists did not elicit contraction of the cornual circular muscle even at 100 microM. 4. Noradrenergic contraction induced by transmural stimulation was significantly decreased by yohimbine (10-100 nM) but not by prazosin (1 microM). 5. The swine myometrium contained both alpha-1 (13%) and alpha-2 (87%) adrenoceptors. The distribution of alpha-adrenoceptors was muscle layer-specific, i.e. the number of both types of adrenoceptors in the longitudinal muscle was four times higher than that in the circular muscle. 6. These results show that although swine myometrium contains both alpha-1 and alpha-2 adrenoceptors, the alpha-2 type is predominant and largely responsible for mediating the excitatory response to both exogenous and endogenous noradrenaline in the cornual longitudinal muscle.

Concentric fibrosis and cellular infiltration around bile ducts induced by graft-versus-host reaction in mice: a role of CD8+ cells

We report in this paper on obvious fibrotic lesions in the liver of mice undergoing specified graft-versus-host reaction (GVHR). B6 CD8+ splenocytes were transferred into (bm 12 x bm 1)F1 mice to induce GVHR. Recipient mice had been thymectomized and administrated with anti-CD8 monoclonal antibody (mAb) to deplete CD8+ cells from the hosts. Two weeks after the mAb administration, recipient mice were injected with B6 CD8+ cells and sacrificed further two or four weeks later for analyzing hepatic lesions histopathologically. Light microscopic analyses revealed the presence of concentric fibrosis around both small and large duct levels and the infiltration of mononuclear cells into portal areas. Focal necrosis of hepatocytes was also detected electron-microscopically. These findings suggest that CD8+ T lymphocytes might play an important role in the induction of fibrotic lesions in the liver.

Fibrovascular polyp of the sigmoid colon

A case of a fibrovascular polyp of the sigmoid colon is reported. The patient tested positively for fecal occult blood on a mass survey for colorectal cancer, and underwent colonoscopic examination which revealed a pedunculated submucosal tumor in the sigmoid colon. The tumor, about 10 mm in diameter, had a short thin stalk and was removed endoscopically; the histological diagnosis was fibrovascular polyp. This extremely rare polyp is discussed, and particular attention is focused on the unusual endoscopic features and on the appropriate management.

Discrepancy between PNMT presence and relative lack of adrenaline production in extra-adrenal pheochromocytoma

Among catecholamine synthesizing enzymes, phenylethanolamine-N-methyltransferase (PNMT) exists only in adrenal and extra-adrenal pheochromocytoma has been believed not to produce adrenaline. However, adrenaline production is clinically active in some extra-adrenal cases. To investigate this controversy, the localization of catecholamine synthesizing enzymes was studied by immunohistochemical staining in extra-adrenal and adrenal cases. The results showed that PNMT was expressed not only in many cases of adrenal pheochromocytoma, but also in extra-adrenal pheochromocytoma. It is suspected that little adrenaline production in extra-adrenal cases is attributable to a lack of a good environment for the activation of PNMT by a high concentration of glucocorticoids.