[Radiotherapy combined with daily administration of low dose cisplatin for head and neck cancer]

Radiotherapy combined with daily administration of low-dose cisplatin (CDDP) was applied to 12 cases with head and neck cancer. They consisted of 12 carcinomas, occurring in the epipharynx (3 cases), mesopharynx (3), oral cavity (1), larynx (3) and parasinuses (2). The total response rate (CR + PR) was 83.3%. There was a remarkable effect in reducing tumor size, particularly on patients with laryngeal or epipharyngeal carcinoma. Severe mucositis with ulcers as a side effect was seen in eight cases after the irradiation of 20 to 30 Gy. Six of them tolerated a full dose of irradiation, but CDDP administration was stopped except in one case. To continue the CDDP administration in cases having irradiation of over 40 Gy, it is necessary to reduce the frequency of CDDP administration and/or to give post-irradiative hydration with 500 ml saline. When this combination therapy is used as a preoperative treatment, daily administration should be continued. Incidence of nausea or vomiting was not so frequent and they could be easily controlled by a serotonin-antagonist. Leukopenia was not severe.

Hypersensitivity pneumonitis induced by spores of Pholiota nameko

A 42-year-old man experienced recurrent episodes of nonproductive cough, fever, and dyspnea on exertion. He had worked as a mushroom farmer for 10 years. The diagnosis of hypersensitivity pneumonitis was confirmed immunologically by detecting a precipitin to spores of Pholiota nameko but not to other antigens. After separation from the antigen along with an addition of corticosteroid therapy, the symptoms, inflammatory findings and a reduced level of PaO2 quickly subsided.

Catecholamine release caused by carbon dioxide insufflation during laparoscopic surgery

PURPOSE

We evaluated plasma catecholamine levels during pneumoperitoneum in laparoscopic surgery.

MATERIALS AND METHODS

Plasma epinephrine and norepinephrine were evaluated in 29 patients who underwent laparoscopic retroperitoneal surgery in a half lateral decubitus position (group 1) or laparoscopic varicocelectomy in a Trendelenburg position (group 2).

RESULTS

The levels of epinephrine and norepinephrine increased significantly 5 minutes after carbon dioxide insufflation compared to levels after Veress needle insertion and just before insufflation. The elevation of catecholamine levels during laparoscopic procedures was greater in group 1.

CONCLUSIONS

Our results indicate that carbon dioxide insufflation may cause catecholamine release during laparoscopic surgery. Careful monitoring of hemodynamics is mandatory at the beginning of the procedure.

Fibronectin harbors anticell adhesive activity

Effect of fibronectin (FN) fragment derived from the carboxyl-terminal heparin-binding (Hep 2) domain on cell adhesion was studied. A 30-kDa Hep 2 fragment showed no significant effect on adhesion of Mardin Darbyn caine kidney (MDCK) cells to FN substrate, whereas after exposure to urea, the Hep 2 fragment suppressed the MDCK cell adhesion to FN in an incompetitive fashion. This anti-cell adhesive Hep 2 fragment preferentially inhibited the RGD (Arg-Gly-Asp)-dependent cell adhesion to FN. No significant binding of the Hep 2 fragment with FN was detected. Additionally, data of flow cytometry showed the presence of specific binding site for the Hep 2 fragment on MDCK cell surface. These results indicate that the Hep 2 domain of FN has a cryptic molecular region having the anti-cell adhesive activity that is probably transduced by a putative cell surface receptor.

Effects of cholesterol on the lamellar and the inverted hexagonal phases of dielaidoylphosphatidylethanolamine

Effects of cholesterol on the lamellar and the inverted hexagonal (HII ) phases of dielaidoylphosphatidylethanolamine (DEPE) were studied by means of not only differential scanning calorimetry (DSC) but also simultaneous X-ray diffraction and DSC (XDDSC). XDDSC shows that structural changes are related to thermotropic events of the mixtures. Addition of cholesterol to DEPE induces to broaden the transition from the lamellar gel (L beta) to lamellar liquid-crystalline (L alpha) phase. In fact, in the broad transition region, a coexistence of two lamellar X-ray diffraction peaks of the L beta and L alpha phases take place. In samples containing above 30 mol% cholesterol, no peak at the L beta-L alpha phase transition was observed in the DSC thermogram. On the other hand, cholesterol causes biphasic effects on the L alpha-HII phase transition: At low cholesterol concentrations below 20 mol%, the incorporation of cholesterol reduces the transition temperature and at high cholesterol concentrations about 30 mol%, the transition temperature increases by addition of cholesterol. Based upon the results of X-ray diffraction, the thermal expansion coefficients of lattice spacings, i.e., the temperature dependence of lattice spacings, were calculated in each phase. Addition of cholesterol reduces the thermal expansion coefficients of the lamellar phases and, in contrast, increases that of the HII phase. From the above results it is suggested that cholesterol in cell membranes works in keeping the bilayer membrane nature notwithstanding the change of external conditions.

Molecular cloning and expression of the rat homologue of presenilin-1

The rat homologue of the presenilin-1 (PS-1) gene, which is responsible for early-onset familial Alzheimer's disease linked to chromosome 14, was cloned and sequenced. The predicted amino acid sequence showed quite high homology among rat, mouse, and human PS-1. Especially, the amino acid sequences of the putative transmembrane domains were highly conserved among the three species. The expression ĺevel of the PS-1 gene increased during brain development and the number of transcripts of the PS-1 gene changed during brain development. We found one transcript of the PS-1 gene in embryonic day 12 (E12)-E15 rat brain and two transcripts in E18-adult rat brain. Therefore, PS-1 may play a role in neurogenesis.

A newly discovered age-related synaptic change in the human locus ceruleus: morphometric and ultrastructural studies

We have recently found that in the human locus ceruleus (LC) some pigmented neurons contain granules in their cytoplasm that are immunoreactive (IR) for 38-kDa synaptic vesicle-specific protein (SVP). These represent synaptic terminals enveloped in the somatic cytoplasm. In the present study we analyzed LC pigmented neurons morphometrically in 48 autopsied individuals, whose ages at death ranged from 5 to 94 years, and also examined LC pigmented neurons ultrastructurally in 4 of these individuals. The number and incidence of LC pigmented neurons containing SVP-IR intracytoplasmic granules became significantly higher with age. The mean somatic area of the neurons was significantly higher than that of neurons without SVP-IR intracytoplasmic granules. Ultrastructurally, the synaptic terminals, which contained many round or flattened clear vesicles and sometimes dense-cored vesicles, were found to be enveloped by the somatic cytoplasm of some pigmented neurons and occasionally formed synaptic contacts with the cytoplasm. These enveloped synaptic terminals showed no apparent degenerative features. Our results strongly suggest that the enveloping of synaptic terminals by the somatic cytoplasm of human LC pigmented neurons is a phenomenon associated with the aging brain, and that this phenomenon may be related to intrinsic adaptive mechanisms of the LC pigmented neurons to certain environmental changes associated with aging.

Diagnostic and prognostic value of nucleolar organizer regions in squamous-cell carcinomas of the maxillary sinus

The clinicopathological implications of nucleolar organizer regions (NORs) were assessed in 25 squamous-cell carcinomas arising in the maxillary sinuses. NORs in the carcinoma tissue were stained with silver colloid and counted. As the histological differentiation of the tumors decreased, the mean AgNOR number rose significantly. The mean AgNOR number in T4 cancers was higher than that in T2 and T3 cancers, and the difference between T3 and T4 categories was significant. On the other hand, there were no significant differences in the AgNOR number between tumors of patients with and without recurrence after therapy, between those with different clinical stages or between those with good or poor response to treatment. Moreover, there was no significant difference in survival rates between patients with low and high AgNOR counts. These studies indicate that, in the collective examined, the AgNOR staining method was of no prognostic value for patients with squamous-cell carcinomas of the maxillary sinus.

Cubic phases in hydrated 1:1 and 1:2 dipalmitoylphosphatidylcholine-dipalmitoylglycerol mixtures

The structures of fully hydrated 1:1 and 1:2 (mol/mol) dipalmitoylphosphatidylcholine (DPPC)-dipalmitoylglycerol (DPG) mixtures were studied by means of small-angle x-ray diffraction. The x-ray diffraction pattern of the 1:1 (mol/mol) DPPC-DPG mixture at 65 degrees C contains three reflections with spacings in the ratio of 1:1/ square root of 2:1/ square root of 3 in addition to reflections of an inverted hexagonal (H11) phase. A possible interpretation of this result is that a cubic phase of the body-centered space group lm3m, with a lattice constant of 23.1 +/- 0.6 nm, is formed. This cubic phase appears at intermediate temperatures between the lamellar and the H11 phases. The 1:2 (mol/mol) DPPC-DPG mixture gives an x-ray diffraction pattern at temperatures higher than the lamellar-to-H11 transition containing a number of reflections that index a cubic phase structure. The space group of the cubic phase was assigned a face-centered group Fd3m with a lattice constant of 16.3 +/- 0.1 nm at 82 degrees C. The possible role of cubic phases in membrane phenomena such as transmembrane signal transduction and fusion is discussed.

Nerve coaptation studies with and without a gap in rabbits

Appropriate matching of proximal and distal fibers is a major objective when suturing a lacerated nerve. Recent studies suggest that neurotropic factors may influence motor/sensory specificity and affect the functional outcome. This was studied in animal models by direct coaptation of cut nerve ends inside a 5-mm collagen tube with and without appropriate sensory/motor alignment, as well as in models where the cut nerve ends were placed in a 10-mm collagen tube with a 5-mm gap, with and without appropriate sensory/motor alignment. The radial nerve of 49 New Zealand white rabbits was chosen because it has distinct motor and sensory divisions. The animals were killed at 24 weeks and electrophysiologic, histologic, and muscle contraction studies were performed. Axon counts and diameters were measured from the distal motor and sensory stumps. Nerve conduction velocity, dry muscle weight, and motor axon counts were not statistically different between the groups. The malaligned group without a gap had better regeneration in sensory nerves than other groups. The muscle contraction force of the malaligned group without a gap was significantly less than the other groups. The malaligned group with a 5-mm gap had the same muscle contraction force as the aligned group without a gap. In this study, a short nerve gap lessened the misdirection of motor fibers after nerve-end coaptation.

Inactivation of human immunodeficiency virus (HIV)-1 envelope-specific CD8+ cytotoxic T lymphocytes by free antigenic peptide: a self-veto mechanism?

Free peptide has been found to inhibit cytotoxic T lymphocyte (CTL) activity, and veto cells bearing peptide-major histocompatibility complex (MHC) complexes have been found to inactivate CTL, but the two phenomena have not been connected. Here we show that a common mechanism may apply to both. CD8+ CTL lines or clones specific for a determinant of the human immunodeficiency virus (HIV) 1 IIIB envelope protein gp160, P18IIIB, are inhibited by as little as 10 min exposure to the minimal 10-mer peptide, I-10, within P18IIIB, free in solution, in contrast to peptide already bound to antigen-presenting cells (APC), which does not inhibit. Several lines of evidence suggest that the peptide must be processed and presented by H-2Dd on the CTL itself to the specific T cell receptor (TCR) to be inhibitory. The inhibition was not killing, in that CTL did not kill 51Cr-labeled sister CTL in the presence of free peptide, and in mixing experiments with CTL lines of different specificities restricted by the same MHC molecule, Dd, the presence of free peptide recognized by one CTL line did not inhibit the activity of the other CTL line that could present the peptide. Also, partial recovery of activity could be elicited by restimulation with cell-bound peptide, supporting the conclusion that neither fratricide nor suicide (apoptosis) was involved. The classic veto phenomenon was ruled out by failure of peptide-bearing CTL to inactivate others. Using pairs of CTL lines of differing specificity but similar MHC restriction, each pulsed with the peptide for which the other is specific, we showed that the minimal requirement is simultaneous engagement of the TCR and class I MHC molecules of the same cell. This could occur in single cells or pairs of cells presenting peptide to each other. Thus, mechanistically, the inhibition is analogous to veto, and might be called self-veto. As a clue to a possible mechanism, we found that free I-10 peptide induced apparent downregulation of expression of specific TCR as well as interleukin 2 receptor, CD69, lymphocyte function-associated antigen 1, and CD8. This self-veto effect also has implications for in vivo immunization and mechanisms of viral escape from CTL immunity.

Bone composition and metabolism after hyperbaric oxygenation in rats with 1-hydroxyethylidene-1,1-bisphosphonate-induced rickets

We examined bone composition and metabolism after hyperbaric oxygenation (HBO) in Wistar rats with 1-hydroxyethylidene-1, 1-bisphosphonate (HEBP)-induced rickets. Twenty rats at 4 wk of age were divided into four groups of five rats each. The HEBP + HBO group received high dose (50 mg.kg-1.day-1) HEBP injections subcutaneously for 7 days and were then exposed to HBO for 7 days. The HEBP group received only high dose HEBP injection for the first 7 days. Control group A received neither HEBP nor HBO. Control group B received no HEBP injection and was exposed to HBO only for the second 7 days. Both bone mineral and hydroxyproline contents significantly increased in rats in the HEBP + HBO group as compared with the HEBP group. Alkaline phosphatase activity of bone, which is a marker of osteoblastic activity and bone formation, was high in the HEBP + HBO and HEBP groups compared with control groups A and B, although there was no difference between the former two groups. On the other hand, tartrate-resistant acid phosphatase activity, which is a marker of bone resorption, was lower in the HEBP + HBO group than in the HEBP group. These findings suggest that HBO suppresses bone resorption in high osteoblastic activity after the cessation of HEBP administration, and this phenomenon increases total bone mass.

[Thrombotic complication in the course of aplastic anemia-paroxysmal nocturnal hemoglobinuria syndrome; possible involvement of dysplasminogenemia (plasminogen Tochigi) in the pathogenesis of thrombosis]

A 44-year-old Japanese man having aplastic anemia (AA)-paroxyamal nocturnal hemoglobinuria (PNH) syndrome was referred to our hospital because of purpuras due to thrombocytopenia in July 1994. He suffered from pneumonia after admission, complicated with cerebral, splenic, and left renal infarction. Pulmonary infaction was also confirmed by perfusion lung scan. He had a plasma plasminogen (PLG) functional activity of 54.4% with a normal level of PLG antigen. The gel isoelectrofocusing pattern of the plasminogen derived from the patient showed 10 normal bands and 10 additional doublet bands with slightly higher isoelectric points than the normal components. Abnormal PLG is converted by urokinase to an inactive two-chain plasmin molecule. These findings were similar to those of a case with dysplasminogenemia (PLG Tochigi) reported by Aoki et al. He was given warfarin for the prevention of thrombosis in December 1994. As of October 1995, these was no recurrence of thrombosis. The cause of thrombosis in the present case have been the association with PNH, predisposition to PLG Tochigi, or the complication of pneumonia. This is the first report of AA/PNH syndrome associated with dysplasminogenemia.

Quantitative electromicroscope study of the oculomotor parasympathetic neurons projecting to the ciliary ganglion in cats: comparison of the synaptic (axon-somatic and axo-proximal dendritic) organization of anterior-dorsal and ventral cell groups

The synaptic organization of the oculomotor parasympathetic preganglionic neurons (OPNs), labeled retrogradely after a horseradish peroxidase (HRP) injection into the ciliary ganglion, was studied in cats by electron microscopy. We divided the OPNs into two groups, anterior-dorsal (ADG) and ventral (VG) cell groups, based upon physiological studies in cats suggesting that accomodation-related OPNs are predominantly located anterior and dorsal to the somatic nuclei of the oculomotor nuclear complex (i.e., the anteromedian and Edinger-Westphal nuclei, and the ventral central gray area), while pupillo-constriction-related OPNs are predominantly located ventral to the somatic nuclei (i.e., the ventral tegmental area). The synaptic organization of these two groups was quantitatively compared, using a nested analysis of variance to determine statistical significance (P < 0.05). Partial reconstructions of the labeled somata and proximal dendrites were made from tracings of electron micrographs of every 2nd section in serial ultrathin sections that included the nucleolus or were adjacent to sections that included the nucleolus. The mean number of boutons of apposition on a reconstructed labeled soma of VG was significantly greater than that of ADG (mean +/- SD; ADG, 5.3 +/- 3.3; VG, 8.6 +/- 3.2). The mean synaptic density on a VG soma was significantly greater than on an ADG soma (mean +/- SD; ADG, 3.74 +/- 2.11 counts/100 microns2; VG, 6.30 +/- 1.99 counts/100 microns2). The mean synaptic covering ratio on a VG soma was significantly greater than on an ADG soma (mean +/- SD; ADG, 5.21 +/- 2.91%; VG, 10.14 +/- 3.76%). The mean estimated number of boutons of apposition on a VG soma was significantly greater than on an ADG soma (mean +/- SD: ADG, 53 +/- 36; VG, 100 +/- 48). Boutons were classified on the basis of the shape of their synaptic vesicles as S-type (containing spherical clear synaptic vesicles) or P-type (containing both flattened and spherical clear synaptic vesicles). The significantly greater than on an ADG soma (mean +/- SD; ADG, 0.31 +/- 0.20; VG, 0.67 +/- 0.18). The differences demonstrated in this study reinforce, morphologically, the assumption of functional localization of OPNs, and further allow us to estimate the relative characteristics of the synaptic organization of accommodation-related OPNs and pupillo-constriction-related OPNs.

Cortical and subcortical SEPs following posterior tibial nerve stimulation

Intra-operative cortical and subcortical SEPs from the cerebral convexity and from the inter-hemispheric fissure were recorded following posterior tibial nerve (PTN) stimulation. Cortical and subcortical SEPs from the cerebral convexity after contra-lateral PTN stimulation consisted of N38 and P46, and their polarity reversed when the ipsi-lateral site was stimulated. On the other hand, cortical SEPs from the inter-hemispheric fissure always showed P38 and N46, whether the right or the left PTN was stimulated. Cortical and subcortical SEPs from the inter-hemispheric fissure showed clear cut polarity reversals. These findings provide good evidence for the existence of a tangential dipole oriented perpendicular to the inter-hemispheric fissure in the foot sensory area of the primary sensory cortex. SEPs recorded from the superficial part of the inter-hemispheric fissure showed smaller amplitudes and longer latencies than those of SEPs from the deeper regions. These findings suggest the existence of another dipole responsible for the generation of SEPs after PTN stimulation.

Inhibition of glutamine synthetase reduces ammonia-induced astrocyte swelling in rat

Astrocyte hypertrophy and swelling occur in a variety of pathophysiological conditions, including diseases associated with hyperammonemia. Ammonia is rapidly incorporated into glutamine by glutamine synthetase localized in astrocytes. We tested the hypotheses that (1) 6 h of hyperammonemia (500-600 microM) is adequate for producing astrocyte enlargement, and (2) astrocyte enlargement is attenuated by inhibition of glutamine synthetase with methionine sulfoximine. Pentobarbital-anesthetized rats received an intravenous infusion of either sodium or ammonium acetate after intraperitoneal pretreatment with vehicle, methionine sulfoximine (0.8 mmol/kg) or buthionine sulfoximine (4 mmol/kg), an analogue that does not inhibit glutamine synthetase. Hyperammonemia produced enlarged cortical astrocytes characterized by (1) decreased electron density of cytoplasmic matrix in perikaryon, processes and perivascular endfeet, (2) increased circumference of nuclear membrane, (3) increased numbers of mitochondria and rough and smooth endoplasmic reticulum in perikarya and large processes, and (4) less compact bundles of intermediate filaments. Pretreatment with methionine sulfoximine, but not buthionine sulfoximine, attenuated the decrease in cytoplasmic density and the increase in nuclear circumference; most perivascular endfeet remained as dense as occurred with sodium acetate infusion. However, increased numbers of organelles in expanded perikarya and large processes occurred after methionine sulfoximine treatment with and without ammonium acetate infusion. In separate groups of rats, hyperammonemia produced an increase in cortical tissue water content which was inhibited by methionine sulfoximine, but not buthionine sulfoximine. We conclude that clinically-relevant levels of hyperammonemia can cause astrocyte enlargement within 6 h in vivo characterized by both watery cytoplasm and increased organelles indicative of a cellular metabolic stress and altered astrocyte function. The watery cytoplasm component of astrocyte enlargement depends on glutamine synthesis rather than on ammonium ions per se, and is possibly caused by the osmotic effect accumulated glutamine.

The requirement for and mobilization of calcium during induction by sodium ascorbate and by hydrogen peroxide of cell death

The requirement for and mobilization of Ca2+ ions during induction of cell death by sodium ascorbate were compared with those during induction of cell death by hydrogen peroxide. When HL-60 cells were incubated with sodium ascorbate, a rapid increase in the intracellular concentration of Ca2+ ions and subsequent apoptotic cell death, characterized by cell shrinkage, nuclear fragmentation and cleavage of internucleosomal DNA to yield fragments that were multiples of 180-200 base pairs, were induced. However, these effects of sodium ascorbate were significantly reduced in Ca2+-depleted medium. By contrast, hydrogen peroxide induced similar apoptosis associated phenomena in the presence and in the absence of extracellular Ca2+ ions. The intracellular concentration of the reduced form of glutathione was not significantly affected and glutathione disulfide was undetectable during the early stages of apoptosis. These data suggest that sodium ascorbate and hydrogen peroxide initiate cell death by different mechanisms.

Sudden hearing loss as the initial manifestation of neurosarcoidosis

We report two cases of sudden hearing loss as the initial manifestation of neurosarcoidosis. The patients had no symptoms suggesting central nervous system or meningeal involvement. Eighth nerve involvement is an uncommon feature in patients with sarcoidosis. We discuss the pathophysiologic basis of sarcoid-induced hearing loss.

Sporothrix schenckii isolated from a cat in Japan

A yeast-like fungus isolated from a granulomatous and ulcerative skin lesion in a mongrel cat was mycologically examined. The isolate was identified as Sporothrix schenckii from the morphological findings and its pathogenicity in a mouse, confirming the first case of feline sporotrichosis in Japan. Fortunately, no transmission to humans occurred in this case, however the risk of humans contracting Sporothrix schenckii infection increases with the increase in the number of animals with sporotrichosis. Consequently when handling such animals protective clothing such as gloves should be worn to reduce the risk of transmission of the fungus through open wounds.

Neonatal meningitis caused by Bifidobacterium breve

We are reporting a male neonate with meningitis caused by Bifidobacterium breve. This is only the second case reported so far to our knowledge. The patient's clinical course was excellent and inflammatory indications, such as serum C-reactive protein, were weak. Although the antibiotics used for the patient were effective against this bacterium both in vitro and in vivo, two relapses occurred which might have been caused by an incomplete remission due to the low permeability of antibiotics through the blood-brain barrier under the very mild inflammation of the meninges, and also by the discrepancy between minimum bactericidal concentrations (MBC) and minimum inhibitory concentrations (MIC). Anaerobic meningitis is very rare, but it may exist in more than the reported cases. Anaerobic culture should be performed for patients with culture-negative purulent meningitis.

Promotion of callus formation by non-injurious mechanical stimulation in bean stems

We have examined the effect of non-injurious mechanical stimulation on callus formation of stem tissues. Mechanical stimulation by rubbing substantially promoted the wound-induced callus formation on the stems of beans (Phaseolus vulgaris L.). The promotion of callus formation also was observed in in vitro culture of the tissues excised from mechanically stimulated stems of beans. The results imply that mechanical stimulation induces some physiological changes preference for cell division in developing callus.

Effect of hyperbaric oxygenation on bone in HEBP-induced rachitic rats

The effect of hyperbaric oxygenation (HBO) treatment on rachitic change was studied using 4-wk-old, 1-hydroxyethylidene-1, 1-bisphosphonic acid disodium (HEBP-EHDP)-induced rachitic rats. After treatment, the dry weight, ash weight, Ca and P content, and bone mineral density of the hind leg bones were measured in each rat. These parameters were significantly increased in the rats that were treated with HBO after HEBP administration compared with those parameters in the rats that received HEBP alone. However, there was no significant differences between the rats treated simultaneously with HEBP and HBO and those that were treated with HEBP alone. These results were consistent with radiologic and histologic findings. Marked calcification in the center of the growth plate was revealed in the rats treated with HBO after HEBP administration. We suggest that intermittent high-pressure pure oxygen has a beneficial effect on osteogenesis in rachitic bone but does not prevent rachitic change.

p53 protein expression and gene analysis in clear cell adenocarcinoma of the vagina and cervix

OBJECTIVE

p53 is the most commonly mutated gene in human cancers. The objective of this study was to determine if clear cell adenocarcinomas (CCAs) of the vagina and cervix are associated with p53 gene mutations or alterations in p53 tumor-suppressor protein expression.

METHODS

Paraffin-embedded tissue specimens from 21 women (median age 22 years) with clear cell adenocarcinoma of the vagina or cervix were studied. Fifteen women had a prior history of in utero exposure to diethylstilbestrol. p53 protein expression was detected by immunohistochemical (IHC) analysis with monoclonal antibody DO-7 (Dako Corp.) which recognizes both wild-type and mutant p53 proteins. For p53 gene analysis, genomic DNA from malignant tissue was isolated and exons 4-10 were amplified by PCR and subjected to mutation screening by single-stranded conformation polymorphism (SSCP) analysis.

RESULTS

p53 protein was detected by IHC in tumors from 14 of 21 cases (67%). The observed p53 staining patterns were heterogeneous in both the proportion and intensity of tumor cells stained but were clearly overexpressed relative to the surrounding benign stroma. Metastatic tumors from 3 women with metastatic disease were also positive for p53 staining. SSCP analysis did not identify p53 mutations in any of the cases and strongly suggests that the tumors contained only wild-type p53 alleles.

CONCLUSIONS

Recent studies have demonstrated that wild-type p53 may accumulate in response to DNA damage which normally leads to growth arrest or programmed cell death. Our observations are consistent with the hypothesis that p53 overexpression in CCAs of the vagina and cervix is a response to generalized DNA damage, rather than a result of p53 protein half-life prolongation resulting from mutational inactivation of p53. Overexpression of wild-type p53 protein in vaginal and cervical CCA may relate to the more favorable prognosis of this subset of tumors in comparison to other gynecologic tumors containing mutated p53 genes.