Clinicopathologic study of esophageal squamous cell carcinoma confined to the mucosa

The authors studied patients with esophageal squamous cell carcinoma confined to the mucosa (ESCM) with respect to various clinicopathologic factors to investigate the course of invasion of very early-stage esophageal cancers. A total of 74 patients with ESCM were studied. Fifty of these patients had tumor invasion of the basement membrane confined to the lamina propria mucosae (m2 cancer), and 24 patients had tumor invasion of the muscularis mucosa (m3 cancer). All lesions were investigated with regard to clinicopathologic factors such as tumor differentiation, pattern of invasion, endoscopic morphology, and inflammatory response. The patients were divided into groups of 8 patients with positive lymphatic invasion, lymph node involvement, or both (Inv[+] group), and a group of 66 patients with no lymphatic invasion or lymph node involvement (Inv[-] group). The inflammatory response was evaluated on the basis of lymphocyte infiltration at the tumor invasion front and lymphocytic follicles beneath the tumor invasion front. Mean lesion size was significantly greater in the Inv(+) group than in the Inv(-) group (p < 0.05). However, there was no significant difference in the mean area of invasion of the lamina propria mucosae or deeper between the Inv(+) group and Inv(-) group. Patients with m2 cancer had a significantly higher rate of high-degree lymphocytic follicles than those with m3 cancer (p < 0.01). In patients with m2 cancer, the mean area of invasion of the lamina propria mucosae in patients with high-degree lymphocytic follicles was significantly greater than that in patients with low-degree lymphocytic follicles (p < 0.05), whereas there was no significant difference in mean lesion size between patients with high-degree and low-degree lymphocytic follicles. In patients with ESCM, lesion size was an important risk factor for lymphatic invasion and nodal involvement, lymphocytic follicles were prominent beneath the front of relatively broad cancer invasion, and lymphocytic follicles were less common with deeper cancer invasion.

Spatial differences of chemical features of atmospheric deposition between rainy season and winter in the areas facing to the Japan Sea, Japan

Atmospheric deposition was collected using filtrating bulk samplers at 32 sites in the areas facing to the Japan Sea (AFJS) from April 1991 to March 1994. The data were analyzed for winter (January and February) and the rainy season (June and July) when the climate is just the opposite. The AFJS was geographically divided into five areas, that is western Tohoku (WT), Hokuriku (HR), eastern San-in (ES), western San-in (WS) and northern Kyushu (NK). WT, HR and ES receive more precipitation than other regions in winter. H+ depositions increase in winter except NK. This is mainly due to high winter H+ concentrations. In spite of large amounts of precipitation in WT, HR and ES in winter, nss-SO4(2-) concentration was nearly equal to the average throughout Japan. Namely, nss-SO4(2-) depositions in these areas were nearly twice the national mean. In WT, HR and ES, nss-Ca2+ concentrations in winter are lower than the average of the whole country (less than the half). This may be the cause of the lower potentials of neutralization and the higher remaining acid concentrations in WT, HR and ES than NK and WS.

Matrix metalloproteinase matrilysin (MMP-7) participates in the progression of human gastric and esophageal cancers

Matrilysin is one of matrix metalloproteinases, which is supposed to have a specific role in tumor progression. Expression of matrilysin was investigated in gastric and esophageal cancers by an immunohistochemical examination. Matrilysin was expressed in all esophageal squamous cell carcinomas (13/13) and in the majority of gastric adenocarcinomas (31/35, 89%). The positive staining was observed in tumor cells of cancerous tissues. In gastric cancers, there were significant statistical correlations between matrilysin expression at the invasive front and nodal metastasis or advanced stage. These results suggest that overexpression of matrilysin has an important role in the progression of upper gastrointestinal cancers.

Direct action of a protein-bound polysaccharide, PSK, on transforming growth factor-beta

We investigated the action of a protein-bound polysaccharide, PSK, on transforming growth factor-beta (TGF-beta). (1) In in vitro-mixed culture of peripheral blood mononuclear cells (PBMC) from healthy human and mitomycin C-treated human colon cancer cells, PSK or polyclonal antibody to TGF-beta significantly enhanced incorporation of 3H-thymidine into PBMC, and apparently decreased TGF-beta1 levels of acid-treated culture supernatant. (2) PSK or the antibody interfered with the quantitation by enzyme immunoassay of TGF-beta1 in acid-treated supernatant of the mixed culture. (3) PSK was suggested to form a complex with 125I-human recombinant TGF-beta1 standard, when changes in molecular weight of radioactivities were assessed by gel filtration. Recombinant human TGF-beta1 inhibited growth of mink lung epithelial cell line Mv1Lu and promoted collagen synthesis in rat kidney fibroblast cell line NRK49F, but the complex did not have such activities. (4) In addition to TGF-beta1, PSK bound with TGF-beta2 and platelet-derived growth factor; however, PSK did not bind with 22 other species of cytokines and growth factors. (5) Protein moiety of PSK is suggested to play an important role in the expression of the activity. These results suggest that PSK modulates the biological activity of TGF-beta1 by binding to its active form.

Inactivation of hepatitis C virus cDNA transgene by hypermethylation in transgenic mice

Transgenic mice were produced by microinjection of a partial hepatitis C virus (HCV) genome sequence including the structural protein region, under the control of the albumin promoter and enhancer into fertilized eggs of C57BL/6 and BDF1 mice. Three founders carrying at least five copies of the transgene but not expressing HCV-specific RNA were generated. Methylation analysis indicated that the transgene was extensively methylated. Mapping of methylated cytosine residues of the transgenic mouse DNA showed that all C residues of a particular part of the HCV genome but not all the CpG island like sequences were methylated. Transiently expressed HCV cDNA in COS7 cells and the active endogenous albumin gene were not methylated. Furthermore, 5-azacytidine, a potent demethylating agent, induced HCV gene expression in a line of these transgenic mice. These results suggest that methylation of HCV cDNA is a cause of its inactive expression in transgenic mice, and that this phenomenon may occur in other stable systems for expression of the HCV genome.

[Clinical evaluation of endoscopic ultrasonography (EUS) in the diagnosis of superficial esophageal carcinoma]

Pre-operative diagnosis of the depth of invasion is important to decide the treatment of superficial esophageal carcinoma. The ability of EUS to diagnose the depth of invasion was examined in 40 lesions with superficial esophageal carcinoma between January 1993 and April 1994. The depth of invasion was classified as m1 or m2, m3 or sm1, and sm2 or more. Mucosal carcinoma could be detected clearly by using the 20MHz miniature probe. The diagnostic accuracy was 82.5% in all 40 lesions, and 77.8% in mucosal carcinoma (included with sm1). The reasons for incorrect diagnosis were broadness of the lesion, microinvasion, and artifact of endoscopic biopsy. EUS is considered to be useful even for superficial esophageal carcinoma as one of the preoperative diagnostic imagings.

[Successful neoadjuvant chemotherapy in a patient with advanced gastric cancer with multiple liver metastases]

We described a case of advanced gastric cancer with multiple liver metastases, who was placed on neoadjuvant chemotherapy using CDDP and 5-FU (FP therapy) with a marked reduction in tumor load. The case was a 67-year-old male, who was admitted with a Borrmann III type advanced gastric cancer with multiple liver metastases. FP chemotherapy was carried out two times as neoadjuvant chemotherapy. As a result, both primary cancer and the metastatic tumors showed a remarkable reduction. Then, total gastrectomy with combined resections of spleen and transverse colon was done, and a reservoir was inserted into the hepatic artery. Postoperatively, intrahepatic arterial infusion of CDDP with oral administration of 5-FU was done in the outpatient clinic for about eleven months. But thirteen months later, he died from the rapid recurrence of the tumor.

Alpha-melanocyte stimulating hormone (MSH) antagonizes the anorexia by corticotropin releasing factor (CRF)

We examined a hypothesis that alpha-Melanocyte Stimulating Hormone (MSH) can antagonizes the anorexia induced by intracerebroventricular injection of corticotropin releasing factor (CRF). Food intake of the rats deprived of food for 18 h was significantly inhibited by 4 h after intracerebroventricular injection of CRF. alpha-MSH also suppressed food consumption by 4 h after the treatment. However, simultaneous administration of alpha-MSH attenuated the anorexic effect of CRF at 0-2 h period and food consumption for 4 h was equal to controls. In addition, simultaneous administration of alpha-MSH deleted the stimulatory effects of CRF on serum corticosterone levels. The present experiment demonstrated that alpha-MSH can antagonizes the anorexia and activation of hypothalamo-pituitary-adrenal axis by CRF, suggesting that the processing step of proopiomelanocortin may be important for the induction of anorexia elicited by CRF.

Lymphoscintigraphic assessment of leg oedema following arterial reconstruction using a load produced by standing

Lymphoscintigraphy using a test involving standing from a supine position and performed following an intradermal injection of 99Tcm-human serum albumin (HSA) was developed to evaluate the function of the lymphatic system in the lower extremities of patients who developed lymphoedema following arterial reconstructive surgery. In normal subjects, the load produced by standing tended to increase lymphatic function as indicated by the frequent appearance of a large spiking wave and a rapid stepwise increase in tracer activity and, less often, a phase of decreasing tracer activity. However, there was either no or less activation of lymph flow following standing in the group which developed leg oedema postoperatively. These findings indicate that lymphatic disruption is responsible for the leg oedema seen in these patients. Performance of this test following an intradermal injection of 99Tcm-HSA is technically simple, requires no special apparatus, and can be completed in 30 min. Lymphoscintigraphy using our new method can provide useful information on abnormalities in lymphatic function.

[Effect of dopaminergic agents on the endocrine profile in labor and early puerperium]

The purpose of this study was to investigate the prolactin (PRL) releasing mechanism of the hypothalamo-pituitary axis during labor and early puerperium. Ten full-term gravidas during labor and 42 women in early puerperium were examined in this study. The plasma PRL levels rose significantly (p less than 0.001 approximately 0.05) after an intravenous bolus of 10mg metoclopramide (MCP). The peak values for PRL increase were 609.3 +/- 194.1ng/ml during labor and 447.0 +/- 62.3ng/ml in early puerperium. However, there were no significant differences in PRL response to MCP between these two groups. The plasma PRL levels dropped significantly (p less than 0.001 approximately 0.01) after an oral administration of 2.5mg bromocriptine (BRC), and the PRL release from the pituitary by MCP was suppressed significantly (p less than 0.001) by pretreatment with BRC in the puerperium. In addition, no significant changes in plasma 17 beta-estradiol (E2), progesterone (P) and cortisol levels could be observed after MCP. We concluded that the control mechanism of PRL secretion remained unchanged during labor and early puerperium.