T929I and K1774N mutation pair and M918L single mutation identified in the voltage-gated sodium channel gene of pyrethroid-resistant Thrips tabaci (Thysanoptera: Thripidae) in Japan

Pyrethroid-resistance in onion thrips, Thrips tabaci, has been reported in many countries including Japan. Identifying factors of the resistance is important to correctly monitoring the resistance in field populations. To identify pyrethroid-resistance related genes in T. tabaci in Japan, we performed RNA-Seq analysis of seven T. tabaci strains including two pyrethroid-resistant and five pyrethroid-susceptible strains. We identified a pair of single point mutations, T929I and K1774N, introducing two amino acid mutations, in the voltage-gated sodium channel gene, a pyrethroid target gene, in the two resistant strains. The K1774N is a newly identified mutation located in the fourth repeat domain of the sodium channel. Genotyping analysis of field-collected populations showed that most of the T. tabaci individuals in resistant populations carried the mutation pair, indicating that the mutation pair is closely associated with pyrethroid-resistance in Japan. Another resistance-related mutation, M918L, was also identified in part of the resistant populations. Most of the individuals with the mutation pair were arrhenotokous while all individuals with the M918L single mutation were thelytokous. The result of differentially expressed gene analysis revealed a small number of up-regulated detoxification genes in each resistant strain which might be involved in resistance to pyrethroid. However, no up-regulated detoxification genes common to the two resistant strains were detected. Our results indicate that the mutation pair in the sodium channel gene is the most important target for monitoring pyrethroid-resistance in T. tabaci, and that pyrethroid-resistant arrhenotokous individuals with the mutation pair are likely to be widely distributed in Japan.

SurePath® LBC improves the diagnostic accuracy of intrahepatic and hilar cholangiocarcinoma

INTRODUCTION

The current study aimed to compare cytology using SurePath^® (SP)-LBC and biliary tissue histology (BTH) for the diagnosis of biliary disease.

METHODS

Between January 2014 and December 2016, 57 patients underwent endoscopic retrograde cholangiopancreatography for the diagnosis of biliary disease. Biliary cytological samples were processed using SP-LBC and subsequently BTH was performed. A final diagnosis was confirmed by surgery (23 malignant cases) and clinical follow-up (34 benign and malignant cases): 18 extrahepatic cholangiocarcinoma; 17 intrahepatic/hilar cholangiocarcinoma (intra/H-CC); eight other malignant disease; and 14 benign biliary disease. The diagnoses made using SP-LBC and BTH were classified into four categories: (1) benign; (2) indeterminate; (3) suspicious for malignancy/malignant; and (4) inadequate. In addition, diagnostic accuracy was compared between SP-LBC and BTH.

RESULTS

Although 23% (13/57) of BTH samples were classified as inadequate, all SP-LBC cases were classified as adequate. Among 43 malignant cases, 11 normal, four indeterminate and 28 suspicious for malignancy/malignant were found using SP-LBC (26%, 9% and 65%, respectively), in contrast to 10 inadequate, nine normal, 10 indeterminate and 14 suspicious for malignancy/malignant observed using BTH (23%, 21%, 23%, and 33%, respectively). The identification of malignant cells was strikingly different between SP-LBC and BTH. Furthermore, limited to intra/H-CC, accuracy was significantly higher using SP-LBC than using BTH (P < .001).

CONCLUSIONS

SP-LBC of the biliary tract is a useful and reliable method for diagnosing biliary malignant disease and has an advantage over BTH for detecting malignant cells and accurately diagnosing intra/H-CC.

Morning attenuation of endothelium-dependent, flow-mediated dilation in healthy young men: possible connection to morning peak of cardiac events?

BACKGROUND AND HYPOTHESIS

Brachial artery flow-mediated dilation (FMD), a noninvasive, widely used clinical index of endothelial function and magnitude of FMD, has been reported to be closely related to many coronary risk factors and coronary atherosclerosis. However, there has been no study that examines the diurnal change of FMD. We designed this study to reveal the diurnal variation of FMD in healthy volunteers.

METHODS

We examined FMD in response to reactive hyperemia by high resolution ultrasound in 13 healthy young men (age 25-32) at four different times over the course of a day.

RESULTS

Mean measures of brachial artery FMD was 4.0% at 8:00, 5.3% at 12:00, 9.7% at 17:00, and 6.9% at 21:00 hours. Flow-mediated dilation at 8:00 and at 12:00 hours was significantly lower than that at 17:00 (p < 0.05).

CONCLUSIONS

These results show that endothelial function has diurnal variation and is significantly attenuated in the morning. Morning attenuation of endothelial function should be recognized in clinical research and may play an important role in the circadian variation of the occurrence of acute cardiovascular events.

Effects of a high-cholesterol diet on cell behavior in rat periodontitis

Studies have shown an association between periodontitis and serum cholesterol levels. We hypothesized that high dietary cholesterol could influence periodontitis as a result of proliferation of the junctional epithelium. Rats were divided into 4 groups. Two groups were fed a regular diet, and 2 groups were fed a high-cholesterol diet. One of each dietary group was treated with periodontitis-inducing agents (lipopolysaccharide and proteases), while the other was treated with pyrogen-free water. Feeding rats with a high-cholesterol diet induced an increase in blood total cholesterol and a decrease in high-density lipoprotein cholesterol. Proliferation of the junctional epithelium with increasing bone resorption was promoted by the consumption of a high-cholesterol diet. High dietary cholesterol further increased the cell-proliferative activity of the junctional epithelium induced by lipopolysaccharide and proteases. These results suggest that high dietary cholesterol can initiate and augment periodontitis in the rat periodontitis model.

Anterior mediastinal bronchogenic cyst: demonstration of complicating malignancy by CT and MRI

A case is presented of anterior mediastinal bronchogenic cyst associated with adenocarcinoma arising from the cyst wall. The presence of a solid component in the lower portion of the mass was suspected from CT and confirmed by MRI.

Coagulation process proceeds on cultured human mesangial cells via expression of factor V

BACKGROUND

In a previous clinicopathological study, we observed mesangial factor V expression accompanied by the intact form of cross-linked fibrin deposition in the active type of IgA nephropathy. The conversion of prothrombin to thrombin by factor Xa is potently accelerated more than 104-fold by the presence of factor V, which is a membrane-bound cofactor. Another membrane-bound cofactor, tissue factor, is known to play an initiating role in the coagulation cascade and to be synthesized in mesangial cells (MCs) by the stimulation of tumor necrosis factor-alpha (TNF-alpha). However, the synthesis of factor V, which plays on the terminating stage of prothrombin activation, has not been reported previously in MCs by in vitro study. Our current study tested the coagulation process via expression of factor V by the stimulation of proinflammatory cytokine, TNF-alpha, in cultured human MCs.

METHODS

To evaluate factor V protein expression, immunoperoxidase staining with densitometric evaluation and Western blot analysis were conducted after stimulation of TNF-alpha. To test factor V activity, stimulated MCs were incubated in combination with factor Xa, prothrombin, fibrinogen and factor XIII, and fibrin production on MCs was assessed after immunoperoxidase staining on the cell surface. In a blocking test using an antibody against factor V, suppression of fibrin production was evaluated to clarify the role of factor V activity. For the evaluation of factor V mRNA expression in cultured human MCs, in situ hybridization and Northern blot analysis were performed.

RESULTS

Factor V protein expression in MCs after TNF-alpha stimulation increased both time- and dose-dependently. As a marker of factor V activity with exogenous factor Xa, fibrin production on TNF-alpha-stimulated MCs was increased in a time-dependent manner and was inhibited by the addition of anti-factor V antibody. Factor V mRNA was identified in MCs by in situ hybridization and showed an increase after stimulation with TNF-alpha on Northern blot analysis.

CONCLUSIONS

Our data suggest that the coagulation process proceeds on MCs as the result of increased expression of endogenous factor V activity on its cell surface in cooperation with exogenous factor Xa.

Human gelsolin prevents apoptosis by inhibiting apoptotic mitochondrial changes via closing VDAC

Gelsolin is a Ca2+-dependent actin-regulatory protein that modulates actin assembly and disassembly, and is believed to regulate cell motility through modulation of the actin network. Gelsolin was also recently suggested to be involved in the regulation of apoptosis: human gelsolin (hGsn) has anti-apoptotic activity, whereas mouse gelsolin (mGsn) exerts either proapoptotic or anti-apoptotic activity depending on different cell types. Here, we studied the basis of anti-apoptotic activity of hGsn. We showed that both endogenous and overexpressed hGsn has anti-apoptotic activity, that depends on its C-terminal half. We also found that hGsn and its C-terminal half but not mGsn could prevent apoptotic mitochondrial changes such as Apsi loss and cytochrome c release in isolated mitochondria to a similar extent as Bcl-xL, indicating that hGsn targets the mitochondria to prevent apoptosis via its C-terminal half. In the same way as anti-apoptotic Bcl-xL, which we recently found to prevent apoptotic mitochondrial changes by binding and closing the voltage-dependent anion channel (VDAC), hGsn and its C-terminal half inhibited the activity of VDAC on liposomes through direct binding in a Ca2+-dependent manner. These results suggest that hGsn inhibits apoptosis by blocking mitochondrial VDAC activity.

Interleukin 12 induces crescentic glomerular lesions in a high IgA strain of ddY mice, independently of changes in IgA deposition

BACKGROUND

Our recently established high immunoglobulin (Ig)A inbred strain (HIGA) of ddY mice showed constantly high serum IgA levels, progressive mesangial sclerosis accompanied by IgA deposits, and elevated renal expression of transforming growth factor (TGF)-beta, mimicking IgA nephropathy. In the present study, we assessed the role of the immune system, especially of T cells, in this strain.

METHODS

The in vitro production of interferon (IFN)-gamma, interleukin (IL)-4 and TGF-beta1 by splenic CD4+ T cells was assessed in HIGA mice at 14 and 28 weeks of age by comparison with age-matched C57BL/6 and BALB/c mice, T-helper (Th) 1, and Th2 prone controls respectively. Moreover, recombinant murine IL-12 was administered intraperitoneally to HIGA mice and serum IgA and renal lesions were analysed.

RESULTS

The production of IFN-gamma by splenic CD4+ T cells was markedly upregulated in HIGA mice at both ages as compared with age-matched C57BL/6 and BALB/c mice. Although splenic CD4+ T cells from HIGA mice produced less IL-4 than those from BALB/c mice at both ages, the former produced significantly more IL-4 with age, which contrasted with the age-associated decrease in the latter. Moreover, TGF-beta1 production of these cells in HIGA mice was equal to or greater than that in the two groups of control mice at both ages. Daily intraperitoneal administration of IL-12 for 1 week significantly enhanced crescent formation with glomerular macrophage accumulation and interstitial cell infiltration, whereas it reduced the serum IgA level.

CONCLUSIONS

In HIGA mice, Th1 is markedly upregulated from a young age and there is an age-associated Th2 increase with TGF-beta1 upregulation in helper T cells. The former may be related to the exacerbation of inflammatory renal lesions on IL-12 administration, while the latter may contribute to increased IgA production, leading to glomerular IgA deposition and progressive glomerulosclerosis in HIGA mice. The pathogenic role of T cell function and fluctuation of these subsets, especially the Th1/Th2 balance, is crucial to the immunopathological phenotype of the renal lesions in HIGA mice.

Developmental conversion of inotropism by endothelin I and angiotensin II from positive to negative in mice

Inotropic effects on isolated neonatal and adult mouse myocardium of endothelin I and angiotensin II were examined. Endothelin I produced a sustained positive inotropic response in the neonate but a sustained negative response in the adult. Both were concentration-dependent and were inhibited by the endothelin ETA receptor antagonist, BQ-123 (Cyclo(D-a-aspartyl-L-prolyl-D-valyl-L-leucyl-D-tryptophyl)). Angiotensin II produced a sustained positive inotropic response in the neonate while a sustained negative response in the adult. Both were concentration-dependent and were inhibited by the angiotensin AT1 receptor antagonist, YM358 (2,7-diethyl-5-((2'-(1 H-tetrazol-5-yl)biphenyl-4-yl)methyl-5H-pyrazolo(1,5-b)(1,2,4)tria zole potassium salt monohydrate). These results indicate that inotropic responses of the mouse heart to cardioactive peptides are unique among experimental animal species and may be reversed during development.

A cloning method for caspase substrates that uses the yeast two-hybrid system: cloning of the antiapoptotic gene gelsolin

Caspase-mediated proteolysis is a critical and central element of the apoptotic process; therefore, it is important to identify the downstream molecular targets of caspases. We established a method for cloning the genes of caspase substrates by two major modifications of the yeast two-hybrid system: (i) both large and small subunits of active caspases were expressed in yeast under ADH1 promoters and the small subunit was fused to the LexA DNA-binding domain; and (ii) a point mutation was introduced that substituted serine for the active site cysteine and thereby prevented proteolytic cleavage of the substrates, possibly stabilizing the enzyme-substrate complexes in yeast. After screening a mouse embryo cDNA expression library by using the bait plasmid for caspase-3, we obtained 13 clones that encoded proteins binding to caspase-3, and showed that 10 clones including gelsolin, an actin-regulatory protein implicated in apoptosis, were cleaved by recombinant caspase-3 in vitro. Using the same bait, we also isolated human gelsolin cDNA from a human thymus cDNA expression library. We showed that human gelsolin was cleaved during Fas-mediated apoptosis in vivo and that the caspase-3 cleavage site of human gelsolin was at D352 of DQTD352G, findings consistent with previous observations on murine gelsolin. In addition, we ascribed the antiapoptotic activity of gelsolin (which we previously reported) to prevention of a step leading to cytochrome c release from the mitochondria into the cytosol. Our results indicate that this cloning method is useful for identification of the substrates of caspases and possibly also of other enzymes.

Gastric cancer: evaluation of triphasic spiral CT and radiologic-pathologic correlation

PURPOSE

The purpose of this study was to evaluate the utility of triphasic spiral CT with water-filling method in the preoperative T staging of gastric cancer.

METHOD

We performed triphasic spiral CT in 108 patients with gastric cancer (53 with early and 55 with advanced gastric cancer). The CT findings were prospectively analyzed and correlated with the histopathologic findings. Spiral CT scans were assessed for the layered pattern of the normal gastric wall, the detectability of tumor, the enhancing pattern of the tumor, and the depth of tumor invasion.

RESULTS

The layered pattern of the normal gastric wall was clearly demonstrated in the arterial-dominant or parenchymal phase. All 12 early cancers detected with spiral CT were most clearly depicted in the arterial-dominant or parenchymal phase. On the other hand, 15 (28%) of 54 advanced cancers were most clearly depicted in the equilibrium phase due to the gradual enhancement from the inner mucosal side of the tumor. Most of these tumors were scirrhous type tumor containing abundant fibrous tissue stroma. The accuracy of spiral CT for tumor detection and T staging was 98 and 82%, respectively, in advanced gastric cancer and 23 and 15%, respectively, in early gastric cancer.

CONCLUSION

Spiral CT with triphasic scan technique improved the accuracy of estimating the depth of tumor invasion in advanced gastric cancer.

Different expressions of sialyl Tn antigen between polypoid and flat-type early colorectal cancers

PURPOSE

Sialyl Tn (STn) antigen is a cancer-associated carbohydrate antigen expressed in cancers of the digestive tract. We compared the proportion of specimens of flat-type colorectal cancers expressing STn with that of polypoid cancers, by examining the immunohistochemical reactivity of STn in various morphologic types of early and advanced colorectal cancers.

METHODS

A total of 111 biopsies from the colorectal area were examined for STn expression, including 11 adenomas, 58 early cancers, and 42 advanced cancers. Each section was stained immunohistochemically for STn antigen. In each section, we examined STn expression in the cancer area, adjacent mucosa, and normal epithelium.

RESULTS

STn expression was detected in 90.9 percent of adenomas, 36.2 percent of early cancers (T1), 64.3 percent of advanced cancers (>T1), and 52 percent of mucosa adjacent to cancer. The morphology of cancer tissue did not influence the number of specimens exhibiting STn antigen expression in mucosa adjacent to cancer cells. STn antigen was rarely expressed in flat or depressed-type early cancers (T1; 7.1 percent), and the expression was higher in moderately than in well-differentiated adenocarcinomas. In advanced cancers (>T1), a similar proportion of protruding and small ulcerative cancers expressed STn.

CONCLUSION

Our results suggest that the low expression of STn antigen in flat-type cancers may be the result of different mechanisms of cellular transformation during carcinogenesis from the usual adenoma-carcinoma sequence in colorectal neoplasms.

Involvement of caspase-4(-like) protease in Fas-mediated apoptotic pathway

Proteases of the caspase family, especially caspase-1 (ICE)(-like), caspase-3 (CPP32/Yama/apopain)(-like) and caspase-8 (MACH/FLICE/Mch5) proteases, are implicated in Fas (APO-1/CD95)-mediated apoptosis. Here, we show that the caspase-4 (TX/ICH-2/ICE(rel)II)(-like) protease, another member of the caspase family, is also involved in Fas-mediated apoptosis, based upon the observations: (i) caspase-4 is processed in response to an agonistic anti-Fas antibody treatment, (ii) overexpression of a mutant caspase-4 with active site mutations in both p20 and p10 subunits delays Fas-mediated apoptosis, (iii) microinjected anti-caspase-4 antibodies inhibit Fas-mediated apoptosis. Together with our observations that the mutant caspase-4 inhibits the Fas-mediated activation of caspase-3(-like) proteases and purified caspase-4 cleaves pro-caspase-3 to generate a subunit of active form, these results suggest that Fas-mediated apoptosis is driven by a caspase cascade in which the caspase-4(-like) protease transmits a death signal from caspase-8 to caspase-3(-like) proteases probably through directly cleaving pro-caspase-3(-like) proteases.

[Numerical aberration of chromosome 17 is correlated with multiple primary cancer in colorectal carcinoma]

Numerical aberration of chromosome 17 of 14 cases of colorectal carcinoma with multiple primary cancer (: multiple cancer) was compared with that of 35 cases of colorectal carcinoma without any other cancer (: single cancer). Fluorescence in situ hybridization with p17H8 was performed on touch smear from fresh materials. The proportion of aneusomy 17 (NCAI: numerical chromosome aberration index) in multiple cancers was significantly higher than that of single cancers (37.7 +/- 10.5% VS 46.1 +/- 8.0%; p < 0.01). Although NCAI of single cancers conformed to cancer progression (26.1 +/- 4.7% in Dukes A, 33.1 +/- 7.1% in Dukes B, 39.9 +/- 6.9% in Dukes C, and 45.7 +/- 12.0% in Dukes D), that of multiple cancers was high in all stages (44.7 +/- 7.3%, 44.4 +/- 6.8%, 50.4 +/- 11.2%, and 49.6 +/- 5.6%, respectively). Furthermore, the multiple numerical aberration of chromosome 17 in multiple cancers was more often than that of single cancers (64.3% VS 22.9%; p < 0.01).

Gain of chromosome 20 is a frequent aberration in liver metastasis of colorectal cancers

To investigate the characteristics of the numerical chromosome aberrations in liver metastasis of colorectal cancers, fluorescence in situ hybridization (FISH) for chromosomes 8, 18, 14/22, and 20 was performed in 18 specimens of primary regions and 18 of metastatic regions in liver metastasis of colorectal cancers compared with 15 of non-liver metastatic cancers. Among these numerical aberrations, the gain of chromosome 20, especially copy numbers exceeding three, was frequently observed in primary and metastatic cancers. Among these numerical aberrations, the gain of chromosome 20, especially copy numbers exceeding three, was frequently observed in primary and metastatic regions of liver metastasis groups compared with that of the non-liver metastasis group (P < 0.05). The incidences of gain of chromosome 20 in both regions of the liver metastasis group were higher than that of the non-liver metastasis group (P < 0.05). The gain of chromosome 20 is a frequent aberration in primary and metastatic regions in patients with liver metastatic colorectal cancers and may be available as a genetic marker for the diagnosis or prediction of liver metastasis.

Opposite effects of isoniazid and fasting on the expression of CYP2E1 protein and mRNA in house musk shrew (Suncus murinus)

The effects of isoniazid and fasting on hepatic CYP2E1 in the suncus were investigated. Aniline hydroxylation and N-nitrosodimethylamine demethylation, which are known to be catalyzed by CYP2E1, in liver microsomes were induced and suppressed by the treatment with isoniazid and the fasting, respectively. Immunoblot analysis indicated that CYP2E1 protein in liver microsomes from isoniazid-treated suncus was increased in contrast to the result with the fasting of the suncus. Northern blot analysis showed that the treatment of suncus with isoniazid increased the expression of CYP2E1 mRNA in livers although the fasting of the suncus significantly decreased CYP2E1 mRNA. These results suggest that the regulation of hepatic CYP2E1 in the suncus by treatment with isoniazid and fasting was different from that in rats.

Quantitative analysis of numerical chromosome aberrations in various morphological types of colorectal carcinomas

Quantitative analysis by fluorescence in situ hybridization (FISH) on thin paraffin-embedded tissue sections, using specific probes for chromosomes 11, 17, and 18 was employed in various morphological types of early and advanced colorectal cancer to clarify tumor cytogenetics. The chromosome index (CI) was calculated as a quantitative measure of the chromosome copy number. Compared with the CI of normal epithelium, the CI of chromosome 11 in villous components of adenomas or polypoid early cancers was decreased, while the CI in flat type or advanced colorectal cancers, conversely, was increased (P < 0.05). The CI of chromosome 17 in villous components of adenomas and all cancers was higher than that of normal epithelium (P < 0.05), but the differences were not significant. In protruding advanced cancers, the CI of chromosome 18 was significantly decreased (P < 0.01) compared to the CI of normal epithelium. There was no significant chromosomal heterogeneity between the superficial and the deepest layer in each cancer. In mucosa adjacent to sessile and flat type cancers, the CI of chromosome 17 was significantly higher than the CI in normal epithelium or adenomas (P < 0.05). These results suggest that numerical chromosome aberrations are associated with the histological type of adenoma and the morphological diversity of cancer in the colorectum, and that chromosome 17 abnormality occurs in mucosa adjacent to sessile and flat cancers.

[A case of solitary splenic metastasis from colon cancer]

A 58-year-old male who had a left hemicolectomy for descending colon cancer on July 1, 1993 was admitted to our hospital. A CT scan revealed a homogeneous low-density mass in the inferior portion of the spleen. Under the diagnosis of solitary splenic metastasis, a splenectomy was performed on August 10, 1995. Histologically, splenic tumor revealed moderately differentiated adenocarcinoma consistent with the primary tumor. Flow cytometric analysis revealed DNA diploidy in the primary tumor, and DNA aneuploidy (DNA index = 1.76) in the metastatic tumor. Using fluorescence in situ hybridization with p17 H8, numerical aerrations of chromosome 17 were observed in the primary tumor.

Chromosomal assignment of the Bcl2-related genes, Bcl2l and Bax, in the mouse and rat

The Bcl2-related genes, Bax and Bcl2l (formerly called Bclx), are involved in the regulation of apoptotic cell death, and the chromosome location of these two genes was determined in the mouse and rat by fluorescence in situ hybridization. Bcl2l was localized to mouse chromosome 2H1 and rat chromosome 3q41.2, and Bax was localized to mouse chromosome 7B5 and rat chromosome 1q31.2. Both genes mapped in a region of conserved linkage homology between the two the species. Molecular linkage analysis using interspecific backcross mice revealed the murine Bcl2l locus at 0.7 cM terminal to D2Mit22, and the murine Bax locus at 0.8 cM terminal to D7Nds5.

Evidence for the lack of hepatic N-acetyltransferase in suncus (Suncus murinus)

The abilities of liver cytosol fractions from the suncus and Sprague-Dawley (SD) rats to N-acetylate aniline, p-aminobenzoic acid, p-aminosalicylic acid and 2-aminofluorene (AF) were compared. The cytosol from rats N-acetylated these substrates at efficient rates, whereas the cytosol from the suncus did not N-acetylate these substrates at detectable rates. When AF was given to the suncus, 2-acetylaminofluorene (AAF), a metabolite of AF formed by N-acetyltransferase (NAT), was not detectable in serum, whereas the metabolite was seen clearly in rats. Northern blot and Southern blot analyses, using cDNAs coding for human NATs as probes, indicated that not only the transcripts but also the genes of the enzymes were undetectable in suncus. These results suggest that the suncus is among the few species known to lack NATs.

Anal metastasis from carcinoma of the lung: report of a case

We report herein the case of a 75-year-old man who developed anal canal metastasis from squamous cell carcinoma of the lung. Initially, he underwent a right middle and lower lobectomy combined with left atrial wall resection under cardiopulmonary bypass. He presented 3 months later with an anal polyp which had prolapsed and bled, for which he underwent a transanal polypectomy. Histologically, the polyp was classified as squamous cell carcinoma and considered to be a metastasis from the primary lung cancer. He is presently well with no signs of recurrence 9 months after his initial operation. To our knowledge, there has been no other case of anal metastasis from lung cancer ever reported.

An immunohistochemical study of the distribution of blood group substances and related antigens in primary colorectal carcinomas and metastatic lymph node and liver lesions, using monoclonal antibodies against A, B, H type 2, Le(a), and Le(x) antigens

Using indirect immunoperoxidase staining, we examined the distribution of blood group substances and related antigens, including Le(a), A, B, H type 2, and Le(x), in 87 carcinomas and 42 normal mucosal specimens of colon and rectum, as well as in metastatic lesions of 32 lymph nodes and 9 liver specimens. The compatible expression rate of A/B/H type 2 antigens was 33.3% (3/9) in proximal normal colon, but only 6.1% (2/33) in distal normal colon. Compatible expression was observed in 14 of 25 carcinomas in the proximal colon (56.0%), but these antigens in distal colon cancers reappeared with a high positive rate, 62.9% (39/62). The rate of H type 2 accumulation with the deletion of A and/or B antigens was 6.9% (6/87). Incompatible expression was not observed in colorectal cancer. Le(a) and Le(x) antigens were expressed in normal mucosa and primary carcinoma throughout the colon. Le(a) and Le(x) in primary carcinoma that showed A/B deletion with/without H type 2 accumulation was expressed more than in carcinoma with A/B/H type 2 compatible expression (88.2% vs 71.7% for Le(a); 94.1% vs 88.7% for Le(x), respectively). In 16 of 32 patients (50.0%), A/B/H type 2 antigen expression in metastatic lesions had disappeared or was decreased compared with that in primary carcinoma, followed by metastasis to regional lymph nodes. These results suggested that: (a) A/B/H type 2 blood group substances in the distal colon behave as tumor-associated antigens in colorectal carcinoma. (b) Most frequently, A/B/H type 2 antigens expressed in primary carcinoma were weakened or had disappeared in metastatic lymph nodes. Further investigation of the biological function of carbohydrate chains, such as those of blood group substances and related antigens on cancer cell surfaces may lead to a solution of the problem of the metastatic behavior of tumor cells.

An immunohistochemical employer monoclonal antibodies against Le(a), sialyl Le(a), Le(x), and sialyl Le(x) antigens in primary colorectal, carcinomas and lymph node and hepatic lesions

The immunohistochemical expression of sialylated and non-sialylated forms of both Le(x) and Le(a) were studied in 87 carcinomas and 42 normal mucosal specimens of colon and rectum, as well as in 32 metastatic lymph nodes and 9 hepatic lesions, using an indirect immunoperoxidase staining. Their antigens were expressed in normal mucosa with the following frequencies: Le(a), 95.2% (40/42); sialyl Le(a), 88.1% (37/42); Le(x), 95.2% (40/42); and sialyl Le(x), 17.0% (7/42), whereas in carcinomas, the respective rate of frequency were: 78.2% (68/87); 78.2% (68/87); 90.8% (79/87); and 93.1% (81/87). Sialyl Le(x) antigen showed the highest tumor specificity compared to other antigens. In three normal mucosal specimens and four carcinomas with Le(a-b-) phenotype, the expression of type 1 antigens (Le(a) and sialyl Le(a)) was not consistent, whereas type 2 antigens (Le(x) and sialyl Le(x)) were consistently observed in carcinomas. The staining of type 1 antigens and Le(x) was decreased in metastatic lesions compared with primary carcinomas, whereas sialyl Le(x) antigen had the same positive-staining rate in both. Metastatic carcinoma expressed the sialylated form more predominantly than the non-sialylated form in type 2 antigens whereas the opposite result was observed in type 1 antigens. These results suggested that: (a) sialyl Le(x), defined by monoclonal antibody CSLEX1, may be useful as a tumor-associated antigen in colorectal carcinoma, and (b) the alteration of Lewis-related carbohydrate antigens in cancer cell membranes, including sialylation and/or aberrant glycosylation, may be related to metastatic behavior.

Activities of drug-metabolizing enzymes in the liver of Suncus murinus: possible lack of N-acetyltransferase activity in liver cytosol

The amounts of several drug-metabolizing enzymes in livers of Suncus murinus (suncus) were studied in comparison with rats. The content of cytochrome P450 in suncus was less than one third that seen in rats. Activities of glutathione S-transferase, UDP-glucuronyltransferase and arylhydroxycarbon hydroxylase in suncus were less than half those in rats. Activity of flavin-containing monooxygenase in suncus was 71% that of rats. Interestingly, N-acetyltransferase (NAT) activity in suncus liver cytosols was not detectable: no detectable activities were seen with aniline, p-aminobenzoic acid and p-amino-salicylic acid as substrates. We propose that suncus is a unique animal possibly lacking NAT in liver cytosol.

Clinical study of audiograms in the initial stage and fixed stage of sudden deafness

Audiograms in the initial stage and the fixed stage of sudden deafness were analyzed in 79 cases using the following 5 criteria; i) the onset is sudden and time of onset definite, ii) hearing loss at 1 kH is more than 35 dB, iii) the course of hearing recovery is clear, iv) unaffected ear has normal hearing, and v) the first examination and treatment is within 15 days after onset. Consequently, at least in cases receiving treatment within 6-15 days after onset, it was considered that the prognosis of hearing recovery could be established rather than the pattern of hearing loss than by the period of treatment after onset.

Immunohistochemical expression of sialyl Lex antigen in relation to survival of patients with colorectal carcinoma

BACKGROUND

The alterations of carbohydrate chains in cancer cell membrane can be related, not only to the formation of tumor-associated antigens, but also to cell biologic significance. There is, furthermore, a possibility of their relationship to tumor metastatic behavior and subsequent survival of patients with cancer. Recent clinical studies elucidated that a carbohydrate antigen, sialyl Lex, is a useful tumor marker in colorectal cancer. However, the sialyl Lex antigen immunoreactivity in colorectal carcinoma in relation to patient survival is unknown. The aim of the study was to elucidate whether sialyl Lex expression in tumors was correlated with patient survival.

METHODS

Immunohistochemical expression of sialyl Lex antigen, as detected by monoclonal antibody CSLEX1, was studied in 175 specimens of primary colorectal carcinoma from 120 patients who received radical surgery.

RESULTS

The positive expression of sialyl Lex was observed in 87 of 120 patients (72.5%). There was no statistically significant association between the negative or positive of sialyl Lex and clinicopathologic factors, excluding Dukes stage and histologic type. The difference between overall 5-year survival of patients with sialyl Lex-negative tumors and that of patients with sialyl Lex-positive tumors (81.2% versus 60.6%) was statistically significant (P = 0.0263). In proportion to staining intensity that was expressed as a score based on the percentage of the total field stained positive with CSLEX1, 5-year survival of patients indicated a worse outcome (P = 0.0113). The prognostic value was then studied in a Cox regression model. Dukes stage had the strongest association with patient survival, whereas sialyl Lex expression was found to be the second-ranking parameter.

CONCLUSIONS

When examining the expression of sialyl Lex antigen, as detected by monoclonal antibody CSLEX1, clinically useful information for patient survival after radical resection of colorectal cancer is given.

[Continuous hyperthermic peritoneal perfusion (CHPP) for prevention or treatment of peritoneal dissemination]

We performed CHPP with concomitant use of CDDP and etoposide for prevention or treatment of peritoneal dissemination in gastric (10 cases) and colon (1 case) cancers with serosal invasion or peritoneal dissemination. The patients received intra-abdominal perfusion by saline heated to 41.5-42 degrees C dissolving CDDP and etoposide for 40-50 minutes. The blood concentrations of total CDDP and etoposide rapidly increased and reached maximum at the end of perfusion. Post-operative complications were more frequent in the group without STS than with STS. The prognosis of patients with peritoneal dissemination (P3) was poor, but ascites was observed to disappear in four of five cases. All patients with S (+) or P1 have been alive and free from disease for 1 to 12 months after CHPP. These results suggested that CHPP was effective for prevention and treatment of peritoneal dissemination.

Surgical experience with 5 n3(+) early gastric carcinoma cases

Of 370 patients who underwent a resection for early gastric carcinoma, 317 (85.6%) were N(-), 28 n1(+), 20 n2(+) and five (1.4%) n3 respectively. In this study, n3(+) early gastric cancers were clinicopathologically evaluated and sites of the metastatic nodes were also defined. In addition, a comparative study in DNA ploidy patterns between primary and metastatic node cell was performed according to Hedley's method using a FACS-IV scan of paraffin-embedded tissues. All n3(+) early gastric cancers showed an aneuploidy pattern. R2 or R3 operations are recommended for early gastric carcinomas with aneuploidy pattern and most of the metastatic nodes arise from the identical stem cell line of cancer cells.

Esophagectomy for metastatic carcinoma of the esophagus from lung cancer

A patient with metastatic carcinoma of the esophagus from lung cancer is reported. The patient was a 54-year-old woman who underwent a left lower lobectomy for lung cancer 5 years previously. The authors performed a thoracic esophagectomy, dissection of mediastinal lymph nodes, and reconstruction of the esophagus; the surgery was followed by chemotherapy. Because the histologic pattern of the esophageal tumor was similar to that of lung cancer and mucosal involvement was not seen, the esophageal tumor was interpreted to be a metastasis from lung cancer. The patient is well without recurrence of disease 23 months after operation. This is the first report of a successful esophagectomy for metastatic carcinoma of the esophagus from lung cancer.

[Study of combined hepatocellular and cholangiocarcinoma]

Four patients with combined hepatocellular and cholangiocarcinoma were studied. One case received hepatic arterial infusion therapy (HAIT), 2 hepatectomy and the case with extrahepatic cholangiocarcinoma underwent enucleation. According to Allen's classification, two were combined type and the others mixed type. Tumor ploidy patterns on flow cytometric DNA analysis were aneuploid in 2 cases with curative resection, of which one is still alive 6 years and 3 months after surgery. It suggested that the patient's survival was affected by the pathological factors more than the ploidy patterns of the tumor. A case treated by HAIT improved considerably in terms of symptoms and evidenced reduction in the size of the deposits. Selection of anticancer agents sensitive to both hepatocellular and cholangiocarcinoma is required.

[Studies on tissue concentration of tegafur, 5-fluorouracil, uracil after UFT administration together with the study of microangiography of colorectal cancer]

In order to elucidate the effect of tumor vascularity on a various regimens concentration in tumor tissue, correlation among tegafur, 5-fluorouracil (5-FU), uracil concentrations in tissue and the microangiography were examined in 27 patients with colorectal cancer after preoperative administration of UFT (400 mg/day for 7 days). The concentrations of tegafur, 5-FU and uracil in tumor were higher than those in normal tissue (p < 0.01). There was no definite correlation between tissue concentration in each regimen and the extra or intramural vascular changes. A significant high concentration of 5-FU was found in the protuberant cancer and the ulcerative cancer with horizontal growth than that in the ulcerative cancer with vertical growth (p < 0.05). The present study indicates that the vascular changes within a tumor and the vascular pattern of tumor may be a contributing factor affecting the tissue concentration in the regimens.

Decrease in the content of cytochrome P450IIE by fasting in liver microsomes of house musk shrew (Suncus murinus)

The effects of fasting on hepatic cytochrome P450 in the mature male house musk shrew, Suncus murinus (suncus), were studied by Western blot analyses and enzyme assays. The content of P450IIE protein was decreased, by fasting, to 24% of the control level in contrast to the results with rats, in which P450IIE protein was increased to 172% by fasting. These changes reflected on catalytic activities, such as aniline hydroxylase and N-nitrosodimethylamine demethylase activities, which were decreased to about 45% and 28%, respectively, of the control levels by fasting, while in fasting rats, the catalytic activities of these enzymes were 2-3-fold higher than in controls.

[Pharmacokinetic study of tegafur in the hepatic tissue obtained from the patients with liver cancer]

SF-SP capsules, containing sustained release granules of tegafur, were given to 17 patients with liver cancer (5 primary and 12 metastatic), and tissue levels of tegafur and its metabolites, inhibition of thymidylate synthetase were examined. 5-FU and FdUMP, the active metabolites of tegafur, showed a good accumulation in hepatic lesion and their levels were found to be higher in patients with primary lesion than in metastatic one. In contrast, inhibitory rate of thymidylate synthetase in metastatic lesion was larger than in primary one, suggesting that the agent has stronger antitumor effect against metastatic lesion. This result is consistent with our clinical experiences. No clear relationship between tissue level of tegafur or its metabolites and inhibitory rate of thymidylate synthetase was found. Inhibition of DNA synthesis and/or RNA function are thought to be the action mechanisms of 5-FU and its derivatives. The present study suggests that measurement of the inhibition of thymidylate synthetase in malignant tissue together with the concentration of the drug and its metabolites may contribute for the elucidation of the antitumor effect of the drug.

Effects of Catuaba extracts on microbial and HIV infection

Pretreatment of mice with hot water and alkaline extracts of Catuaba casca (Erythroxylum catuaba Arr. Cam.) effectively protected them from lethal infection of Escherichia coli and Staphylococcus aureus. The extracts significantly inhibited both the human immunodeficiency virus (HIV)-induced cytopathic effect and the expression of HIV antigen in HIV-1HTLV-IIIB or HIV-2ROD infected human lymphotropic virus type I (HTLV-1) positive MT-4 cells. The 50% effective concentrations of the active fractions (21-263 micrograms/ml) were 1/4 - 1/43 of their 50% cytotoxic concentrations. Their anti-HIV activity was shown to be induced, at least in part, via the inhibition of HIV adsorption to the cells. The data suggest a medicinal potential of Catuaba extracts against opportunistic infection in HIV patients.

[A study on hepatic arterial infusion for metastatic liver tumor]

This study was designed to evaluate whether hepatic arterial infusion is effective in terms of response rate and survival time of patients with unresectable liver metastasis from colorectal and gastric cancer. In 19 patients with liver metastasis from colorectal cancer, one patient had a CR, 3 had a PR or MR and the remainder showed NC or PD, with an overall response rate of 16.7%. The response rate was higher in men than in women as well as in patients with metachronous liver metastasis. The dose schedules showed no effectiveness in patients with histologically well-differentiated adenocarcinoma. However, there was a statistical difference in survival time according to the response. The overall response rate in 7 patients with liver metastasis from gastric cancer was 42.9% with one patient achieving CR, 2 patients PR and the others PD. As a result, hepatic arterial infusion of antitumor regimen was an effective method for inoperable metastatic liver cancer.

Serological and immunohistochemical studies on sialylated carbohydrate antigens in colorectal carcinoma

Sialylated carbohydrate antigens, such as CA19-9 (sialyl Lea), CA-50 (sialyl Le4), CSLEX1 (sialyl Lex) and SLX (sialyl Lex-i), were assayed in the same preoperative serum samples of 63 patients with colorectal cancer, and compared with CEA. In addition immunohistochemical expressions of sialyl Lea, sialyl lex and sialyl Lex-i antigens were studied in 62 colorectal carcinomas and 42 normal mucosal sites remote from the malignant lesion using monoclonal antibodies CSLEA1, CSLEX1 and FH-6, respectively, in order to elucidate their tumor-specificity and clinical usefulness as a tumor-associated antigen. Serologically, the percent positive rates of CA19-9, CA-50, CSLEX1, SLX and CEA were 30.2%, 17.7%, 23.8%, 16.1% and 44.4%, respectively. In dukes' A and B, these sialylated carbohydrate antigens, especially CSLEX1 and SLX, showed low positive rates, but the percent positive rates of CSLEX1 and SLX correlated with operative radicality. The positive spectrum of CSLEX1 differed from that of CA19-9 in sera, and CEA had no correlation with these two antigens. The immunohistochemical expression rates of sialyl Lea, sialyl Lex and sialyl Lex-i were 88.1%, 17.0% and 9.5% in normal mucosa, but were 77.8%, 90.5% and 71.4% in carcinoma, respectively. These data suggested that the type 2 chain antigens CSLEX1 and SLX, which have high tumor-specificity compared with CA19-9, may be useful in preoperative diagnosis for extension of carcinoma and operative radicality, although early diagnosis using these sialylated carbohydrate antigens may be difficult, while the combined use of CA19-9, CSLEX1 and CEA should make it possible to detect a wide range of colorectal cancer patients.

Immunohistochemical expression of blood group substances and related carbohydrate antigens in breast carcinoma

In forty-one carcinomas and sixteen benign lesions (fibroadenoma and mastopathy) of the human breast, immunohistochemical expression of sialylated and non-sialylated forms of both Lea and Lex, and the A, B, and H type 2 blood group substances were studied by using an indirect immunoperoxidase staining. In normal ductal epithelium and benign lesion of breast, Lewis-related antigens were mostly expressed. Breast carcinomas showed these antigens with the following frequencies: Lea, 31.7% (13/41); sialyl Lea, 56.1% (23/41); Lex, 46.3% (19/41); sialyl Lex, 68.3% (28/41); A/B/H type 2, 38.1% (16/41). Sialylated forms of Lea and Lex were observed more frequently than their respective non-sialylated forms in breast carcinomas. In both one normal epithelium and four carcinomas of breast with Le(a-b-) phenotype, the expressions of type 2 antigens were observed, while type 1 antigens were not consistently expressed. Although compatible expression was observed in all specimens of both normal epithelium and benign lesion of breast, twenty-four cases with the deletion of A and/or B antigens, six cases with H type 2 accumulation and one case with incompatible expression were demonstrated in breast carcinoma. Thirty-one breast carcinomas which showed the deletion of A/B/H type 2 expressed the Lewis-related antigens more frequently than nine cases which showed compatible expression. These results suggested that the activation of terminal fucosyltransferase and sialyltransferase as well as inactivation of some glycosyltransferases had occurred in cancer cell membrane, and sialyl Lex, defined by a new monoclonal antibody CSLEX1, may be useful as a tumor-associated antigen independent of Lewis blood group type in breast cancer.

[Multihospital randomized study on pre- and post-operative adjuvant chemotherapy for colorectal cancer (Part 2)]

Prior to surgery, 400 mg/day of UFT was administered for seven days to 86 patients with colorectal cancer. After surgery, the survival rate and side effects of the MMC only group (group A) and the MMC + UFT group (group B) were investigated. The two year survival rate for all cases was 79.8% for group B as opposed to 67.1% for group A. The two year survival rate for cases of histological curative resection were 80.0% for group A and 91.4% for group B, but the difference was not significant. There were few side effects in either group, and a significant difference in the incidence was not observed. Based on the above, MMC combined with UFT, as adjunctive chemotherapy for colorectal cancer, is considered to be a safe and effective treatment.

Signet ring cell early gastric cancer presenting as an elevated lesion

Early gastric cancer composed of signet ring cell carcinoma is usually present as a depressed lesion and rarely manifests as a protruding lesion. To our knowledge, only eight cases have been reported in the literature. We herein report such a rare lesion which developed in an asymptomatic 55-year-old man.

[Study of small hepatocellular carcinomas]

In order to evaluate the factors affecting patient survival, 32 patients with a solitary hepatocellular carcinoma (HCC) smaller than 5 cm have been studied. Most patients were diagnosed as having a HCC during the periodic follow-up examinations for their underlying liver disease. For HCCs smaller than 2 cm, ultrasonography demonstrated the highest detection rate compared with CT and angiography. In patients with tumors larger than 2 cm, a portal vein thrombus and/or satellite tumors were frequently recognized, resulting in a lower patient survival rate when compared to those with a smaller HCC. Results have indicated that early detection of such tumors without a portal vein thrombus and/or a satellite tumor, and an adequate hepatic resection, such as segmentectomy or subsegmentectomy, are most important factors HCC patient survival.

[Sialyl Lewis(x)-I (SLX) as a tumor-associated carbohydrate antigen in sera in patients with gastric and colorectal cancer--evaluation according to clinico-pathological factors]

Sialyl Lewis(x)-i (SLX) as a new tumor-associated antigen was assayed in sera of 133 gastric cancer and 62 colorectal cancer patients with preoperative state in order to elucidate the clinico-pathological features. The percent positives in sera of patients with gastric and colorectal cancer were 12.7% (17/133) and 16.1% (10/62), respectively, and there were few positive cases in the early stages. Therefore, it is suggested that the early diagnosis for gastric and colorectal cancer using SLX alone may be difficult. However, it is revealed that SLX has a high tumor-specificity in consideration of the clinico-pathological properties such as H, P, n, ly, v factors, depth of cancer invasion and operative radicality. These data suggested that SLX could be applicable as a useful tumor-marker which shows the metastasis or extension of carcinoma.

Glucose enzyme electrode with percutaneous interface which operates independently of dissolved oxygen

An enzyme glucose electrode that operates even when no oxygen is dissolved in the glucose solution has been developed and its in vitro performance evaluated. The electrode has been designed to be used with a percutaneous interface for future in vivo use. Oxygen is supplied to the electrode from the atmosphere. The electrode is based on the conventional H2O2 detecting enzyme electrode, in which an Ag cylinder 4.5 mm in diameter and 16 mm in length is used as a cathode. A Pt wire 0.5 mm in diameter is fixed in the centre for an anode, and 0.5 micrograms of albumin-linked glucose oxidase is immobilised at the tip of the anode. A recess of 3.6 mm diameter and 5 mm depth is made at the top of the electrode, and a breathing orifice 0.8 mm in diameter is drilled along the axis of the electrode to link the recess to the atmosphere. A thin oxygen permeable silicone layer fills the recess, allowing oxygen in the atmosphere to be supplied to the enzyme through the silicone layer. The electrode has a linear response to glucose concentration at an electrode output current ranging from 0 to 20 nA even when the oxygen concentration of the glucose solution is zero. The use of polyurethane as a diffusion barrier to glucose limits the electrode output current at a glucose concentration of 500 mg dl-1 (27.8 mmol 1-1] to 20 nA. Therefore, the electrode can measure glucose concentrations up to 500 mg dl-1 (27.8 mmol 1(-1] with no oxygen dissolved in the glucose solution. The electrode with the percutaneous interface seems suitable for implantation in sites of low oxygen concentration such as subcutaneous tissues.