Heavy ion irradiation induces autophagy in irradiated C2C12 myoblasts and their bystander cells

Autophagy is one of the major processes involved in the degradation of intracellular materials. Here, we examined the potential impact of heavy ion irradiation on the induction of autophagy in irradiated C2C12 mouse myoblasts and their non-targeted bystander cells. In irradiated cells, ultrastructural analysis revealed the accumulation of autophagic structures at various stages of autophagy (i.e. phagophores, autophagosomes and autolysosomes) within 20 min after irradiation. Multivesicular bodies (MVBs) and autolysosomes containing MVBs (amphisomes) were also observed. Heavy ion irradiation increased the staining of microtubule-associated protein 1 light chain 3 and LysoTracker Red (LTR). Such enhanced staining was suppressed by an autophagy inhibitor 3-methyladenine. In addition to irradiated cells, bystander cells were also positive with LTR staining. Altogether, these results suggest that heavy ion irradiation induces autophagy not only in irradiated myoblasts but also in their bystander cells.

Insufficient membrane fusion in dysferlin-deficient muscle fibers after heavy-ion irradiation

Recently, SJL/J mice have been used as an animal model in studies of dysferlinopathy, a spectrum of muscle diseases caused by defects in dysferlin protein. In this study we irradiated muscle fibers isolated from skeletal muscle of SJL/J mice with heavy-ion microbeam, and the ultrastructural changes were observed by electron microscopy. The plasma membrane of heavy-ion beam irradiated areas showed irregular protrusions and invaginations. Disruption of sarcomeric structures and the enhancement of autophagy were also observed. In addition, many vesicles of varying size and shape were seen to be accumulated just beneath the plasma membrane. This finding further supports the recent hypothesis that dysferlin functions as a membrane fusion protein in the wound healing system of plasma membrane, and that the defect in dysferlin causes insufficient membrane fusion resulting in accumulation of vesicles.

Heavy ion microbeam irradiation induces ultrastructural changes in isolated single fibers of skeletal muscle

The effects of heavy ion microbeams on muscle fibers isolated from mouse skeletal muscles were examined by electron microscopy. The plasma membranes of heavy ion beam-irradiated areas of muscle fibers showed irregular protrusions and invaginations. In the cytoplasm, an irregular distribution of microfilaments was found near the plasma membrane. Sarcoplasmic reticula in the irradiated regions showed a distended appearance with flocculent material within the lumen. These changes were seen as early as 2 min after irradiation, and persisted until as late as 22 min after irradiation. Many autophagic vacuoles could be seen at 7 min after irradiation. At 22 min, the vacuoles became more prominent and showed more variety. These observations suggest that heavy ion beam irradiation causes disruption of the cellular architecture and the autophagy is involved in removal of this disruption.

Paclitaxel-platinum combination chemotherapy for advanced or recurrent ovarian clear cell adenocarcinoma: a multicenter trial

The therapeutic effect of a combination of paclitaxel (PTX) and platinum (PLT) in ovarian clear cell adenocarcinoma (CC) patients with measurable disease has yet to be elucidated. In this study, we used retrospective review to evaluate the results of treatment with a combination of PTX and PLT in CC patients with measurable disease. A total of 28 patients with measurable residual CC (15 cases with primary disease, 13 cases with recurrent disease) treated with combination PTX-PLT chemotherapy was identified through medical records from ten institutions. Clinical response to chemotherapy was evaluated using Response Evaluation Criteria in Solid Tumors criteria. Of the 28 cases, 8 of 15 patients with primary disease (53.3%) and 3 of 13 patients with recurrent disease (23.1%) responded to PTX-PLT chemotherapy. The response rate for cases with late recurrent disease (>12 months) was 20% (1/5), whereas the rate was 25% (2/8) for cases with early recurrent (<12 months) or refractory disease. Our results indicate that the combination of PTX and PLT may have greater efficacy against CC than conventional PLT-based chemotherapy that does not include PTX.

Histological Effect and Protein Expression in Subthreshold TranspupillaryThermotherapy in Rabbit Eyes

OBJECTIVE

To investigate the histological effect of subthreshold transpupillary thermotherapy (TTT) on the retina.

METHODS

We performed TTT in normal pigmented rabbit eyes using an 810-nm diode laser with spot size of 1.2 mm, power of 50 mW, and varying durations of 15, 30, or 60 seconds. Four weeks later, fluorescein angiography was performed, and the enucleated eyes were examined by means of electron microscopy and immunohistochemical staining.

RESULTS

Funduscopy immediately and at 4 weeks showed no discernable changes at TTT sites, and fluorescein angiography at 4 weeks showed no abnormalities. However, electron microscopy showed photoreceptor and retinal pigment epithelium cell disruption, changes more prominent with longer durations of treatment. Immunohistochemical staining was positive for heat shock protein 60, heat shock protein 70, tumor necrosis factor alpha, and vascular cell adhesion molecule 1 in the photoreceptors and retinal pigment epithelium at TTT sites. Untreated control eyes showed no staining.

CONCLUSIONS

Despite the absence of changes evident by funduscopy and fluorescein angiography, TTT resulted in dose-dependent histological changes in photoreceptors and retinal pigment epithelium. The induction of heat shock proteins, cytokines, and cell adhesion molecules may play a role in the tissue response to subthreshold TTT. Clinical Relevance Unrecognized damage to the retina and retinal pigment epithelium may contribute to visual loss in eyes that undergo subthreshold TTT.

Changing patterns of intraocular inflammatory disease in Japan

PURPOSE

We investigated the frequencies and clinical characteristics of Japanese patients with uveitis.

METHODS

Records of 189 patients referred from April 1999 to March 2001 were retrospectively reviewed.

RESULTS

Fifty-six patients (29.6%) had anterior uveitis, 13 (6.9%) intermediate uveitis, 59 (31.2%) posterior uveitis, 58 (30.7%) panuveitis, and three (1.6%) papillitis. The most common diagnoses were Vogt-Koyanagi-Harada (VKH) disease (10.1%), biopsy-proven or presumed sarcoidosis (9.5%), acute anterior uveitis (7.9%), tuberculosis (6.9%), and Behçet's disease (5.8%). Seventy-three patients (38.6%) were treated with local therapy alone, and 95 patients (50.3%) required systemic therapy. Ocular complications developed in 19.6% of patients, and systemic complications in 2.1%.

CONCLUSIONS

These results confirm a continued high frequency of VKH disease and sarcoidosis, but suggest a decreased frequency of Behçet's disease and an increased frequency of tuberculosis. Roughly one-half of the patients required systemic treatment in addition to local therapy, and ocular and/or systemic complications developed in one-fifth of the patients.

Trans-Tenon's retrobulbar triamcinolone infusion for the treatment of uveitis

AIM

To assess efficacy and complications of trans-Tenon's retrobulbar infusion of triamcinolone acetonide for posterior uveitic inflammation.

METHODS

Non-randomised, uncontrolled, retrospective study of 51 eyes of 37 patients who underwent triamcinolone infusion for vitritis, cystoid macular oedema (CMO), or posterior retinal vasculitis using a long blunt cannula via an incision made through conjunctiva and Tenon's capsule.

RESULTS

Overall clinical efficacy was 86%; 96% for vitritis, 82% for CMO, and 33% for posterior retinal vasculitis. Mean visual acuity improved within 1 month after triamcinolone infusion (p <0.05). Cataract progression and intraocular pressure elevation were observed in 31% and 27% of eyes, respectively.

CONCLUSION

Trans-Tenon's retrobulbar triamcinolone infusion may be a safe and effective treatment for posterior uveitic inflammation.

Bilateral anterior optic neuritis in adult measles infection without encephalomyelitis

PURPOSE

To describe anterior optic neuritis in adult measles infection.

DESIGN

Interventional case report.

METHODS

A 31-year-old woman presented with bilateral visual loss 6 days after the onset of maculopapular rash. Complete ophthalmic and neurologic examinations, radiologic studies, and lumbar puncture were performed.

RESULTS

Visual acuities were counting fingers in both eyes, with bilateral optic disk hyperemia and swelling noted. Neurologic examination was unremarkable, and computed tomography and magnetic resonance imaging of the brain were normal. The cerebrospinal fluid (CSF) was devoid of white cells, although measles immunoglobulin M (IgM) antibodies were detected in both CSF and serum. Intravenous corticosteroids were administered, and clinical findings resolved within 1 month. A fall in serum IgM and a rise in serum IgG titers were observed.

CONCLUSIONS

Although rare, optic neuritis in the absence of encephalomyelitis may occur in measles. Whether treatment is effective is unknown.

Tuberculin skin testing in uveitis patients and treatment of presumed intraocular tuberculosis in Japan

PURPOSE

To evaluate the results of tuberculin skin testing in Japanese patients with intraocular inflammation and to assess the outcome of treatment for presumed intraocular tuberculosis in selected patients.

DESIGN

Prospective, noncomparative, interventional case series.

PARTICIPANTS

One hundred twenty-six patients, newly referred to the Ocular Inflammation Service at the Kyorin Eye Center from April 1998 to August 2000, underwent systemic evaluation for the diagnosis and/or treatment of uveitis.

METHODS

Tuberculin skin testing with purified protein derivative was performed as part of the systemic evaluation. The diagnosis of presumed intraocular tuberculosis was made when findings were consistent with possible intraocular tuberculosis, the tuberculin skin test was positive (induration more than 10 mm), and no other cause of uveitis was suggested by symptoms, signs, or ancillary testing. Using these criteria, 10 patients were given a diagnosis of presumed intraocular tuberculosis and treated with antituberculosis therapy consisting of isoniazid, with or without rifampicin. Some of these patients also received a tapered course of oral corticosteroids after the initiation of antituberculosis treatment. None of the patients had any signs or symptoms of acquired immunodeficiency syndrome.

MAIN OUTCOME MEASURES

Visual acuity and ophthalmologic examination to assess degree of intraocular inflammation.

RESULTS

Twenty-six of the 126 patients (20.6%) had a positive tuberculin skin test result. Ten of these 26 patients (38.5%) were treated for a diagnosis of presumed intraocular tuberculosis. Nine patients had no evidence of pulmonary tuberculosis, and one patient had presumed tuberculous hilar lymphadenitis. The predominant clinical finding was choroidal or optic disc nodule in three patients, retinal vasculitis in three patients, and choroiditis in four patients. Nine patients exhibited decreased intraocular inflammation with treatment.

CONCLUSIONS

Roughly one fifth of the uveitis patients who underwent systemic evaluation had a positive tuberculin skin test result, and 9 of 10 selected skin test-positive patients with clinical findings consistent with intraocular tuberculosis had a favorable response to antituberculosis therapy. These results suggest that intraocular tuberculosis continues to be a major diagnostic consideration for uveitis patients in Japan.

Use of sublingual isosorbide dinitrate tablet for manual extraction of a retained placenta

We present the first report of the use of an isosorbide dinitrate tablet for the purpose of uterine relaxation for manual extraction of a retained placenta. The tablet administered sublingually proved to be a rapid and effective uterine muscle relaxant for manual removal of the placenta without overt adverse effects.

Are the care levels of people with dementia correctly assessed for eligibility of the Japanese long-term care insurance?

BACKGROUND

A new long-term care insurance system was launched in Japan in April 2000.

OBJECTIVES

We performed the first national survey on special units of psychiatric hospitals for dementia patients to examine whether their disabilities were well reflected in the eligibility assessment.

METHODS

Of all 248 dementia special units of psychiatric hospitals in Japan, 180 units (72.6%) participated in the survey. Five patients were randomly selected in each unit, and we used data of 802 (89.1%) of 900 patients whose care levels were obtained by the primary computer assessment. These patients were assessed using the Mini-Mental State Examination (MMSE), dementia rating scale by Gottfries et al. (1982) (GBS), and Activities of Daily Living (ADL). The mean score (SD) of the MMSE was 9.3 (6.9).

RESULTS

Multiple regression analysis revealed that the scores of motor function in GBS, ADL, MMSE, and the degree of bedridden explained 73% of the variation of care level. The higher care levels were inversely related to lower MMSE scores. In the group of people who were not bedridden, the MMSE score sharply decreased even though their physical functions were maintained. There were no significant differences in the MMSE scores among the care level 1 and 5 groups except between care level 1 and 3 after controlling for the motor function scores in GBS.

CONCLUSIONS

Our results suggest that care level and cognitive impairment are generally correlated in the primary assessment, but some adjustment measure for cognitive impairment is needed in mildly or moderately physically disabled patients.

Angiosarcoma of vagina successfully treated with interleukin-2 therapy and chemotherapy: a case report

We report a case of angiosarcoma of the vagina in a 61-year-old woman who had undergone radical hysterectomy and pelvic irradiation for uterine cervical adenocarcinoma 14 years previously. Combination chemotherapy (cyclophosphamide, vincristine, doxorubicin and dacarbazine) and interleukin-2 induced complete remission of the tumor. The patient remained free from disease for 15 months.

The value of pre-operative diagnostic procedures for cervical involvement in uterine corpus carcinoma

OBJECTIVE

To assess the value of procedures for pre-operative diagnosis of cervical involvement of uterine corpus carcinoma.

MATERIALS AND METHODS

Four diagnostic procedures, including cervical cytology, endocervical curettage (ECC), magnetic resonance imaging (MRI), and hysteroscopy, were performed for diagnosis of cervical involvement in 60 patients with uterine corpus carcinoma. The preoperative diagnosis based on results obtained using by each procedure was retrospectively compared with the diagnosis based on histological examination of surgical specimens. Data were analyzed according to the standard definition of sensitivity, specificity, positive predictive value and negative predictive value.

RESULTS

Cervical involvement was confirmed in 18 patients (30%). ECC showed high sensitivity (90.9%) and specificity (88.9%). Cervical cytology showed high specificity (88.6%). MRI showed very high specificity (99.2%) and high sensitivity (88.5%) in cases with cervical stromal invasion.

CONCLUSION

Cervical cytology and MRI are useful for excluding cervical involvement. ECC is useful for positive diagnosis. MRI may be useful for cases with stromal invasion. The use of a combination of several procedures is essential for obtaining an accurate diagnosis of cervical involvement in cases of uterine corpus carcinoma.

Myxoid leiomyosarcoma of the uterus

A 70-year-old, menopausal Japanese woman with large uterine tumor underwent total hysterectomy. Microscopic examination revealed a myxoid leiomyosarcoma with 5 to 6 mitoses/10 high power field (HPF). Immunohistochemically, the tumor cells reacted with desmin, suggesting that they are derived from uterine smooth muscle cells. The patient was treated with the combination chemotherapy consisting of cisplatin, adriamycin and cyclophosphamide, and she has been free from disease for 70 months after the operation.

Re-assessment of stage I uterine cervical carcinoma according to revised JSGO (1997) staging

BACKGROUND

The Japanese Society of Gynecologist and Obstetrician (JSGO) revised criteria for early uterine cervical cancer.

OBJECTIVE

In this study, we investigated the value of the revised JSGO criteria.

METHOD

Retrospective review was performed for 70 patients with tumors limited to the uterine cervix who were classified stage I under old JSGO criteria.

RESULT

Forty patients were re-classified into stage IA1 and 4 patients into stage IA2. Incidence of lymph-vascular infiltration (LVI) in stage IA1 and IA2 were 5% and 25%. There was one patient with stage IA1 disease who had nodal metastasis and no patients with stage IA2 disease. There were 14 patients with stage IB1 disease and 12 patients with stage IB2 disease. Mortality of patients with stage IB2 disease was 25% and significantly higher than that of patients with stage IA and IB1 disease (P<0.001 and <0.05)

CONCLUSION

Although the revised JSGO criteria for early cervical cancer are acceptable for assessment of patients, the therapy of patients is still controversial. We recommend that patients with stage IA1 and negative LVI should have less radical hysterectomy and patients with stage IA1 with LVI or stage IA2, IB should have radical hysterectomy.

Familial dementia with Lewy bodies (DLB)

We report a rare familial case of dementia with Lewy bodies (DLB). The patient was a man who died at the age of 51. His parents were first cousins. Among three siblings, two were diagnosed as probable cases of DLB, and one was a possible case, according to the clinical diagnostic criteria of the consortium on DLB. Following the patient's autopsy, he was found to have had DLB without neurofibrillary tangles or senile plaques (pure form of diffuse Lewy body disease). His other siblings have been followed for more than ten years. Although these patients with familial DLB displayed clinical variability, all three siblings showed progressive dementia of early onset and progressive language disorder with paraphasia and difficulty in finding words. Psychotic features were also seen in the three siblings. The patient's sister showed compulsive behavior, and the other two siblings showed symptoms of parkinsonism. Neuropathologically, in addition to the usual neuropathology of DLB, the autopsy findings showed numerous small spheroids in the stratum pyramidale from the subiculum to CA1 of the hippocampus. Significant neuronal loss in CA2-3 of the hippocampus was detected. Axonal flow disturbance may be involved in the hippocampal formations of this incidence of familial DLB.

A twenty-year period in mass screening for uterine cervical cancer in Fukushima Prefecture

To explore the change in age distribution of patients with uterine cervical cancer and its precursors, we analyzed 2,168,923 women in a series of mass screening for uterine cervical cancer in Fukushima Prefecture. The first examination rate was not increased over a 20-year period. During the screening period, severe dysplasia was found in 693 women, carcinoma in situ in 672 women, microinvasive carcinoma in 517 women, and frank invasive carcinoma in 421 women. The numbers of patients with frank invasive carcinoma was decreased gradually in every age group, which might reflect the effectiveness of our mass screening project. Although the detection rates of severe dysplasia, carcinoma in situ and microinvasive carcinoma have not changed in patients groups over 40 years old, the detection rates were increased in patients under the age of 39. These results may reflect a recent tendency for cervical cancer to increase in young women. It is important, therefore, to increase the screening rate for young women to prevent the progression with advanced cervical cancer.

Dysgerminoma with syncytiotrophoblastic giant cells arising from 46,XX pure gonadal dysgenesis

BACKGROUND

Dysgerminoma with syncytiotrophblastic giant cells is a rare ovarian tumor. Only ten cases of this tumor have been reported, and all tumors developed in normal ovaries. This report presents a case of dysgerminoma with syncytiotrophoblastic giant cells arising in a patient with 46,XX pure gonadal dysgenesis.

CASE

An 18-year-old phenotypic female of normal height without somatic anomalies with nonfunctional ovaries underwent a bilateral gonadectomy for a right ovarian tumor and left streak gonad. The tumor revealed a dysgerminoma containing scattered syncytiotrophoblastic giant cells. Her serum hCG was elevated, and hCG was demonstrated within syncytiotrophoblastic giant cells immunohistochemically. The clinical diagnosis was stage Ia dysgerminoma with syncytiotrophoblastic giant cells. Her karyotype was 46,XX and the sex-determining region Y gene was not detected in tumor DNA by polymerase chain reaction analysis.

CONCLUSION

This rare gonadal tumor may arise from dysgenetic gonads in addition to gonadoblastoma and pure dysgerminoma. It is an example of tumorgenesis in pure gonadal dysgenesis with no identifiable Y chromosome component.

Evaluation of immunostaining for MIB1 and nm23 products in uterine cervical adenocarcinoma

In this study, we evaluated whether proliferative activity and metastatic potential are prognostic factors in adenocarcinoma of the cervix. Formalin-fixed, paraffin-embedded sections from 34 patients with cervical adenocarcinoma or adenosquamous carcinoma were immunostained with monoclonal antibody MIB1, expressed in proliferating cells, and anti-nm23 antibody, reacts with metastasis suppression gene products. MIB1 positivity ranged from 0.2 approximately 54.7% with a mean of 21.4%. The level did not differ significantly between various clinicopathological categories. Although patient survival of high or low MIB1 expressing tumor was not significantly different, the disease-free interval of high (> or =25%) expressing tumor was significantly lower than that of low (<25%) expressing tumor. Strong and medium expression for nm23 were detected in 7 (21%) and 3 (9%) of patients. Tumor with strong nm23 expression tended to have a higher relapse rate. Although the survival of strong and weakly nm23 expressing tumor was not significantly different, the disease-free survival of strong nm23 expressing tumor was lower than that of weakly nm23 expressing tumor. MIB1 and nm23 immunostaining might be some of prognostic indicators of recurrence in cervical adenocarcinoma. In cervical adenocarcinoma, the nm23 gene products may not function as metastatic suppression but reflect proliferative activity.

Estimation and comparison of the contents of blood group B antigens in selected human tissues by microphotometric quantification of Griffonia simplicifolia agglutinin I-B4 staining with or without prior alpha-galactosidase digestion

Griffonia simplicifolia agglutinin I-B4 (GSAI-B4) has broader specificity for B antigen variants and can recognize the antigens in a wide variety of human tissues. Thus, the concentration range of GSAI-B4 required for staining and the susceptibility of staining to alpha-galactosidase digestion is presumed to correlate well with the density of B antigens in tissue sections. By microphotometric quantification of staining intensity at different concentrations of GSAI-B4 with or without alpha-galactosidase digestion, concentration of B antigens in selected tissues was evaluated and compared. Based on the present results and the previous ones of direct measurement of galactose of B antigens in sublingual glands and red blood cells (Ito et al., 1993), the order of concentration of B antigens in tissues examined was estimated as follows; mucous cells of sublingual glands from German nonsecretors < red blood cells and vascular endothelial cells (= 2.7 x 10(-3) nmole/cm2), thyroid papillary carcinomas and Hassall's corpuscles from nonsecretors < mucous cells of sublingual gland from Japanese nonsecretors < pancreatic acinar cells from both secretor and nonsecretors, Hassall's corpuscles and kidney collecting tubules form secretors < mucous cells of sublingual gland from secretors (> 8.5-11.7 nmole/cm2) and mucous cells of Brunner's gland from nonsecretors < mucous cells of Brunner's gland from secretors. From the above estimation, it is apparent that the expression of B antigen in Brunner's gland is partly dependent on the secretor status of individuals and that Japanese nonsecretors secrete substantial amounts of B antigens from sublingual gland while German nonsecretors do not. The present results also revealed an unexpected staining behavior of GSAI-B4 in some tissues, i.e. in mucous cells of sublingual glands and collecting tubules of kidney from secretors, staining intensity was markedly depressed at higher concentration of the lectin and this depression was recovered by prior alpha-galactosidase digestion. In addition, the present method was successfully applied for the estimation of the content of B antigens neo-expressed in thyroid papillary carcinomas, showing that the content of B antigen had a similar level to that of red blood cells and vascular endothelial cells.

Ovarian epithelial borderline tumor and carcinoma in young women

To clarify the influence of age on clinical and histologic features, young women with ovarian epithelial borderline tumors and carcinomas were analyzed. A retrospective review of 93 patients with ovarian common epithelial borderline tumors and carcinomas was performed. Twenty-one of 93 patients (22.6%) were under age 40. Predominant symptoms in young patients were abdominal pain or abdominal distention, but 4 (19%) patients had no symptom. Eleven (11/21; 52.4%) patients were nulliparous and six patients received conservative surgery to preserve fertility. The rate of histologic type and stage did not significantly differ between the young and older groups. Although overall survival between young and older patients did not significantly differ, the survival of young patients with advanced disease (stage III and IV) was significantly worse than in older patients with advanced disease. (p < 0.05).

Evaluation with MIB1 antibody of proliferative activity in ovarian clear cell adenocarcinoma

The purpose of this study was to determine whether proliferative activity is a prognostic factor in ovarian clear cell adenocarcinoma. The paraffin-embedded sections from eight cases of ovarian clear cell adenocarcinoma were immunostained with monoclonal antibody MIB1 using microwave oven heating for antigen retrieval. The difference in survival (Kaplan-Meier) between patients with high and low MIB1 expression was estimated with the generalized Wilcoxon test. MIB1 positivity ranged from 1.80 to 27.12% with a mean of 11.43%. A cutoff point of 10% dichotomized patients into two groups. The survival of high (> or = 10%) expressing tumors was worse than that of low (< 10%) expressing tumors (p < 0.05). MIB1 immunostaining may have useful prognostic value in ovarian clear cell adenocarcinoma.

Uterine cervical clear-cell adenocarcinoma with a choriocarcinomatous component: a case report

A 55-year-old woman presented with vaginal bleeding. A tumor was found in the cervix; it was composed of 2 distinctive elements: a clear-cell adenocarcinoma and a choriocarcinoma. Histologic findings suggested that the choriocarcinomatous element was derived from a preexisting clear-cell adenocarcinoma through a metaplastic process.

Localization of binding sites of Ulex europaeus I, Helix pomatia and Griffonia simplicifolia I-B4 lectins and analysis of their backbone structures by several glycosidases and poly-N-acetyllactosamine-specific lectins in human breast carcinomas

Several studies have shown the deletion of blood group A or B antigens and the accumulation of H antigens in human breast carcinomas. Other studies have independently demonstrated that the binding sites of lectins such as Helix pomatia agglutinin (HPA) and Griffonia simplicifolia agglutinin I-B4 (GSAI-B4) are highly expressed in these cells. In order to clarify the molecular mechanisms of malignant transformation and metastasis of carcinoma cells, it is important to understand the relationship between such phenotypically distinct events. For this purpose, we examined whether the binding sites of these lectins and Ulex europaeus agglutinin I (UEA-I) are expressed concomitantly in the same carcinoma cells and analyzed their backbone structures. The expression of the binding sites of these lectins was observed independently of the blood group (ABO) of the patients and was not affected by the histological type of the carcinomas. Observation of serial sections stained with these lectins revealed that the distribution of HPA binding sites was almost identical to that of GSAI-B4 in most cases. Furthermore, in some cases, UEA-I binding patterns were similar to those of HPA and GSAI-B4 but in other cases, mosaic staining patterns with these lectins were also observed, i.e., some cell clusters were stained with both HPA and GSAI-B4 but not with UEA-I and adjacent cell clusters were stained only with UEA-I. Digestion with endo-beta-galactosidase or N-glycosidase F markedly reduced the staining intensity of these lectins. Together with the reduction of staining by these lectins, reactivity with Griffonia simplicifolia agglutinin II appeared in carcinoma cells following endo-beta-galactosidase digestion. Among the lectins specific to poly-N-acetyllactosamine, Lycopersicon esculentum agglutinin (LEA) most vividly and consistently stained the cancer cells. Next to LEA, pokeweed mitogen agglutinin was also effective in staining these cells. Carcinoma cells reactive with these lectins corresponded well to those stained with both HPA and GSAI-B4, and in some cases, with UEA-I. These results demonstrate that the binding sites of UEA-I, HPA, and GSAI-B4 are expressed concomitantly in the same carcinoma cells and all carry linear and branched poly-N-acetyllactosamine on N-glycans, suggesting that the synthesis of this complex carbohydrate is one of the most important and basic processes leading to the malignant transformation of cells, invasion, and metastasis of carcinoma cells.

Simultaneous expression of keratan sulphate epitope (a sulphated poly-N-acetyllactosamine) and blood group ABH antigens in papillary carcinomas of the human thyroid gland

The monoclonal antibody 5-D-4 recognizes heavily sulphated forms of keratan sulphate epitope. It reacted strongly with the cell surfaces of most thyroid papillary carcinomas from all the individuals examined, independently of the blood group of the patients. Cells of follicular variants of papillary carcinomas were also labelled by 5-D-4. In contrast, no labelling with this antibody was observed in other types of thyroid neoplasms, or in normal tissues. The reactivity of 5-D-4 with papillary carcinomas was markedly reduced or abolished by prior digestion with endo-beta-galactosidase, keratanase II, or N-glycosidase F. Although keratanase digestion had no effect on 5-D-4 labelling, it revealed the binding sites of Griffonia simplicifolia agglutinin II (GSA-II), which recognizes terminal N-acetylglucosamine in a limited number of carcinoma cells from some individuals. Blood group ABH antigens, which are simultaneously expressed together with keratan sulphate epitope in cancer cells, were eliminated by digestion with endo-beta-galactosidase and N-glycosidase F, but were resistant to keratanase and keratanase II treatment. These results indicate that keratan sulphate oligosaccharides are cancer-associated and are probably oncofoetal antigens, as are the blood group antigens in human thyroid glands. The results suggests that poly-N-acetyllactosamine, which is ubiquitously and consistently produced in papillary carcinomas, is modified in two different ways: sulphation on the 6-position of at least some units of either galactose or N-acetylglucosamine or both, and decoration of non-reducing termini with the blood group antigens. Along with the endo-beta-galactosidase-GSA-II labelling procedure, labelling with 5-D-4 may be a useful diagnostic means for distinguishing papillary carcinoma from other types of thyroid neoplasms.

[A method to calculate the probability of paternity between relatives--a paternity case where the putative father was a deceased granduncle]

To test paternity in a case where the putative father was a deceased uncle of mother (plaintiff's granduncle), we designed a new method to calculate the probability of paternity likelihood. The putative father's genotypes of red cell antigens, HLA and short tandem repeat (STR) polymorphism were estimated from those of mother and sister of the plaintiff. When the probability was calculated from the frequencies in the unrelated individuals (the standard method), a significant bias might be introduced since the putative father and the plaintiff were likely to have the same alleles come from their common ancestry. Therefore, we designed a new method to calculate the likelihood ratio from the frequencies in the group of mother's uncles estimated from mother's genotypes. The probability (0.9299) calculated with our method was found to be lower than that (0.9992) done with the standard method indicating that the new method could remove the bias introduced from the incest.

[Paternity probability in the cases of incest]

To calculate the paternity probability in the cases of incest where the alleged father was either the father or the brother of the plaintiff's mother, some algebraic expressions applicable to a simple codominant diallelic genetic marker system were derived by modifying the formulas of Essen-Möller and Komatsu (the both formulas gave the same result). The paternity probability in the incest case is generally lower than that in usual case, because in the former case an allele present in the mother is sometimes found in both the alleged father and the child (plaintiff), even if the alleged father is not true father. The paternity probability in the incest case, however, becomes higher than that in usual case when an allele is common to both the alleged father and the child but not to the mother. The mean value of paternity probability becomes lower, as the relationship becomes closer between the alleged father and the mother.

Inhibitory effects of negatively charged liposomes on nitric oxide production from macrophages stimulated by LPS

The effects of liposomes on nitric oxide (NO) productions induced by lipopolysaccharide were investigated using thioglycollate-induced mouse peritoneal macrophages. Negatively charged liposomes composed of phosphatidic acid (PA-liposomes) and phosphatidylserine (PS-liposomes) showed inhibitory effect on NO production in a dose dependent manner, but not in liposomes composed of phosphatidylcholine (PC-liposomes). Pretreatment of macrophages with liposomes was required in order to observe the inhibitory effect on NO production. NO production induced by IFN-gamma was also inhibited by negatively charged liposomes. To clarify the mechanism of inhibitory effect of liposomes, immune blotting was performed using anti mouse inducible nitric oxide synthase (iNOS) antibody. An immunoreactive band at 130 kDa was observed in the extract of control and PC-liposome- treated macrophages, whereas a faint or no band was observed in PS- and PA-liposome-treated ones. These finding revealed that the inhibition of NO production by negatively charged liposomes could be a result in the inhibition of iNOS induction, but not enzyme activity.

Expression of classical protein kinase C subspecies in non-neoplastic lymphocytes and non-Hodgkin's lymphomas: an immunohistochemical study

It is generally accepted that phosphorylation plays a pivotal role in the cellular response of cell differentiation and proliferation. Immunohistochemical expression of classical protein kinase C (cPKC) subspecies (alpha, beta and gamma) in eight reactive lymphoid tissues, three normal spleens and 149 non-Hodgkin's lymphomas was examined. cPKC beta was observed primarily in the mantle zone B cells, but appeared as very faint staining in Ki-67 positive proliferated B cells in the germinal centers of secondary lymph follicles. In contrast to the reactive state, high levels of cPKC subspecies were recognized in the majority of 149 cases of non-Hodgkin's lymphoma, including those thought to have arisen from germinal center cells such as follicular lymphoma. The expression of cPKC alpha was found in higher frequency in T cell lymphomas than B cell lymphomas (P < 0.01) by the Chi-squared test. High levels of cPKC alpha were present only in high grade or highly aggressive lymphomas, showing the highest incidence in the small non-cleaved cell type, according to the International Working Formulation and National Cancer Institute (P < 0.01). cPKC gamma was not detected in normal lymphoid cells and was expressed in only four cases of non-Hodgkin's lymphomas. It is presumed that cPKC alpha and beta have a relationship to cell activation and proliferation of lymphoid cells of reactive and neoplastic states. It might be considered that the expression of cPKC alpha may have a relationship with aggressiveness in non-Hodgkin's lymphomas.

Histochemical demonstration and analysis of poly-N-acetyllactosamine structures in normal and malignant human tissues

Poly-N-acetyllactosaminyl structures carry a variety of physiologically and pathologically important carbohydrate antigens and are presumed to have essential roles in the process of cellular recognition, differentiation, malignant transformation and cancer metastasis. Monoclonal antibodies, lectins and endo-beta-galactosidase are useful histochemical tools for detecting and analyzing poly-N-acetyllactosamines in tissue sections. I (branched structure) and i (linear structure) antigens recognized by monoclonal antibodies have been shown to be differentiation antigens in mouse embryo and mouse and human teratocarcinoma cells as well as in human erythrocytes. They are also oncofoetal antigens and are expressed in carcinoma cells in several tissues and organs. Immobilized lectins specific to poly-N-acetyllactosamine structures have been successfully applied for fractioning glycoproteins with poly-N-acetyllactosamine, but histochemical use of these lectins has been restricted to some animal tissues. Among them, pokeweed mitogen agglutinin was used to detect branched poly-N-acetyllactosamine in normal and malignant human colon, demonstrating that it has a highly selective affinity for colorectal carcinomas. Griffonia simplicifolia agglutinin-II staining following endo-beta-galactosidase digestion procedure revealed the presence of poly-N-acetyllactosamine structures with or without blood group-specificities in several normal human tissues. By using this procedure, it was demonstrated that the blood group-related antigens oncofoetally expressed in thyroid carcinoma cells are carried by poly-N-acetyllactosamines containing a domain susceptible to the enzyme digestion. Staining with lectins specific to poly-N-acetyllactosamine in combination with endo-beta-galactosidase digestion demonstrated that poly-N-acetyllactosaminyl structures ubiquitously and consistently produced in thyroid papillary carcinomas are highly heterogeneous in their chain length and branching status and quite different from those produced in other thyroid neoplasms. Staining with monoclonal antibodies or lectins combined with endo-beta-galactosidase digestion procedures have been proven to be powerful tools for localizing and analyzing different types of poly-N-acetyllactosamine structures in normal and malignant tissues.

Histochemical demonstration of different types of poly-N-acetyllactosamine structures in human thyroid neoplasms using lectins and endo-beta-galactosidase digestion

Blood-group-related antigens expressed in papillary carcinomas and other types of neoplasm of the human thyroid glands have been shown to be carried by poly-N-acetyllactosamines containing a linear domain susceptible to endo-beta-galactosidase digestion. To make clear more precisely the backbone poly-N-acetyllactosamine structures, labelled lectins specific to different types of these structures and specific to core structures with beta 1-6GlcNAc branching of N- and O-linked glycoproteins were employed in conjunction with prior endo-beta-galactosidase digestion on formalin-fixed, paraffin-embedded neoplasms of the human thyroid glands. In papillary carcinomas, Datura stramonium agglutinin (DSA) and succinyl wheat germ agglutinin (Suc-WGA) reacted most consistently and frequently with papillary carcinomas from all the individuals examined. Pokeweed mitogen (PWM) likewise stained the cells of papillary carcinomas from all the individuals examined, but in some individuals the number of lectin-reactive cells were very small. Lycoperscion esculentum aggultinin (LEA), Solanum tuberosum agglutinin (STA), Phaseolus vulgaris agglutinin L (PHA-L) and Artocarpus integrifolia agglutinin (jacalin) similarly bound to the cancer cells from most of the individuals, and in these cases the number of reactive cells was usually much more restricted than was the case with DSA or PWM. In adenoma and other types of carcinoma, such as follicular carcinomas, these lectins specific to poly-N-acetyllactosamine exhibited slight or no reactivity with the cells, whereas PHA-L and jacalin similarly bound to the cells of adenomas and carcinomas from most of the individuals examined. Prior digestion with endo-beta-galactosidase completely eliminated or markedly reduced the reactivity with PWM and LEA in papillary carcinomas. Reactivity with DSA, Suc-WGA, STA, PHA-L and jacalin was slightly reduced or not at all affected by enzyme digestion. These results confirmed that poly-N-acetyllactosamine species found in papillary carcinomas are quite different from those in other types of thyroid neoplasm, suggesting that at least three different types of poly-N-acetyllactosamine, that is, linear unbranched short and long sequences and highly branched ones are produced in these cells.

Coexistence of Pick bodies and atypical Lewy bodies in the locus ceruleus neurons of Pick's disease

We observed abundant Pick argentophilic inclusion bodies (PBs) as well as some atypical Lewy bodies (LBs) in the locus ceruleus (LC) from a patient with Pick's disease. In addition, there were a few neurons which contained both PBs and LBs. PBs in the LC frequently appeared multiple and had lobulated or irregular shapes, though their ultrastructural elements were the same as those of the PBs appearing in the cerebral cortex, and consisted of randomly arranged smooth-surfaced straight tubules of 15 nm in diameter, mixed with a small number of long-period constricted fibrils. The ultrastructure of the LB coexisting with PB was identical with that previously reported; a dense core was surrounded by concentric layers of radially oriented 10-nm filaments and was clearly distinguishable from the PB. Immunohistochemical examination with various antibodies related to neurofibrillar pathology demonstrated that anti-tau antibodies reacted positively with both PB and the rim portion of LB in the present case; an unusual finding for LB. The anti-neurofilament 200-kDa protein stained only LBs, even when PBs and LBs coexisted in the same neuron. These findings show that two kinds of neuronal fibrillar inclusions, whose underlying cytoskeletal abnormalities are thought to be different, can coexist in the same neuron. In addition, the formation of multiple, lobulated PBs may suggest some particularity of cytoskeletal composition of the LC neurons.

A case of uterine cervical adenoid cystic carcinoma: immunohistochemical study for basement membrane material

BACKGROUND

Adenoid cystic carcinoma is a rare neoplasm of the cervix. Only two reports of immunohistochemical studies for basement membrane material in adenoid cystic carcinoma of the cervix have been reported.

CASE

An 80-year-old Japanese woman complained of atypical vaginal bleeding and underwent removal of a cervical polyp; the biopsy specimen revealed a solid variant of adenoid cystic carcinoma. The tumor was composed of nests and nodules of small carcinoma cells, and there were few characteristic cribriform patterns. Immunohistochemical findings for type IV collagen and laminin revealed intercellular cylinders composed of basement membrane material in the solid area without a cribriform pattern.

CONCLUSION

The immunohistochemical finding of intercellular cylinders that reacted for type IV collagen was useful for the diagnosis of a solid variant of adenoid cystic carcinoma.

Gaucher's disease, type I (adult type), with massive involvement of the kidneys and lungs

A 33-year-old Japanese male, first diagnosed as having Gaucher's disease at the age of 3 years, died of renal and pulmonary failure. Autopsy findings disclosed the proliferation of Gaucher's cells in the liver, bone marrow, lymph nodes, kidneys and lungs. Electron-microscopical findings suggested that the Gaucher's cells observed in the renal glomeruli might be derived from circulating macrophages.

A case of ovarian Brenner tumor with stromal estrogenic activity

An 88-year-old menopausal Japanese female suffering from atypical genital bleeding received a left oophorectomy for a tumor of the left ovary. A vaginal smear before removal of the tumor revealed high estrogenic activity. The patient's ovarian tumor was a benign Brenner tumor and contained theca-like cells in its stroma. The pathological findings relating to these theca-like cells suggested their estrogenic activity, and a vaginal smear after removal of the tumor revealed that estrogenic activity had disappeared.

A case of quadruplet pregnancy containing complete mole and three fetuses

A case of a quadruplet pregnancy containing a complete mole and three fetuses is reported. A 29-year-old Japanese woman who had received clomiphene therapy was delivered of a complete mole, one dead and two living fetuses, and three placentas. Deoxyribonucleic acid fingerprint analysis proved the androgenesis of molar tissue and the trizygosity of the three fetuses.

Localization of blood-group-related linear poly-N-acetyllactosamine structure in different human tissues by Griffonia simplicifolia agglutinin-II staining following endo-beta-galactosidase digestion

Endo-beta-galactosidase from Escherichia freundii cleaves polylactosaminyl structures as follows: R-GlcNAc beta I-3Gal beta I-4GlcNac beta I-R' + H2O-->R-GlcNAc beta I-3Gal + GlcNAc beta I-R'. By staining with Griffonia simplicifolia agglutinin-II following the enzyme digestion, the distribution of R-GlcNAc beta I-3Gal beta I-4GlcNAc can be demonstrated in tissue sections. This carbohydrate chain is one of the backbone structures carrying the blood-group-related antigens and, thus, localization of this structure may provide detailed information about the distribution of variants with different backbone structures. Various formalin-fixed, paraffin-embedded tissue sections were stained by Griffonia simplicifolia agglutinin-II with or without prior enzyme digestion and the reactivity of the agglutinin imparted by enzyme digestion was studied in the following tissues and cells: pancreatic acinar cells, gastric surface mucosae, duct cells and mucous cells of salivary glands and tracheal glands, surface epithelium of trachea, goblet cells of large intestine, columnar epithelium of uterine cervical glands, distal and collecting tubules of kidney, certain cells of anterior lobe and colloid of middle lobe of pituitary glands, epithelial reticular cells and Hassall's corpuscles of thymus and Kupffer cells of liver. In gastric surface mucosae, the reactivity of the agglutinin appeared in non-secretor individuals but not in the secretor individuals, and in mucous cells of salivary and tracheal glands the reactivity appeared in Le(a- b-) non-secretor individuals but not in Le(a + b-) non-secretor or secretor individuals.(ABSTRACT TRUNCATED AT 250 WORDS)

Protein kinase C isozyme expression in human leukemia-lymphoma cell lines--an immunocytochemical study

There have been an increasing number of reports describing a pivotal role for phosphorylation in cellular responses for cell differentiation and proliferation. We examined an immunocytochemical expression of protein kinase C(PKC) isozymes (type I, II, and III) in 22 leukemia-lymphoma cell lines. Of these cell lines, 21 expressed type II PKC and 17 showed the co-expression of both types II and III PKC in varying degree. The cell line without PKC activity showed far less [3H]-TdR uptake and no heterotransplantation in nude mice. Types II and III PKC appear to relate to cell proliferation in certain leukemia-lymphoma cell lines.

An autopsy case of late infantile and juvenile neuroaxonal dystrophy with diffuse Lewy bodies and neurofibrillary tangles

The clinical and pathological features of a sporadic case of juvenile neuroaxonal dystrophy beginning at the age of 10 and leading to death at the age of 26 are described. Clinical manifestation began with cerebellar symptoms. The subject subsequently developed dementia, pes cavus (Friedreich's feet), epilepsy, myoclonus, and Parkinsonian syndrome, but demonstrated neither tremor nor choreoathetoid movement. Pathological examination showed typical generalized axonal dystrophy throughout the central nervous system (Seitelberger's disease). Iron-positive pigmentation was seen in the pallidonigral system, diffuse Lewy bodies (brainstem type and cerebral type) were demonstrated in the brainstem nuclei and cerebral cortex, and neurofibrillary tangles were observed.

A novel monoclonal antibody specific for human pre-B cell leukemia/lymphoma

A novel monoclonal antibody, designated WH14-antibody (WH14-Ab), was produced by using a non-T ALL cell line (HBL-3) as an immunogen. 35S-labelled immunoprecipitate revealed that the antigen reacting with WH14-Ab was estimated to be 30 Kd. Immunoglobulin isotype of WH14-Ab was IgG1. In the normal hematopoietic tissue, WH14-Ab reacted with a small number of monocytes (less than 30%) in the peripheral blood, but neither with the lymphocytes nor granulocytes. WH14-Ab reacted with HBL-3 and REH, but not with other B-cell leukemia/lymphoma and EBV-transformed cell lines. In addition, WH14-Ab reacted with most non-T ALL and pre-B lymphoblastic lymphoma. WH14-Ab did not react with all T-cell lymphomas. These findings indicate that the WH14-Ab may recognize the cell surface determinant shared by immature B cells, especially pre-B cells, in the B-cell lineage. WH14-Ab may be useful not only for the detection of pre-B cell leukemia/lymphomas but also for the investigation of maturation and differentiation of B-cell lineage.

Crystalline light-chain deposition and amyloidosis in the thyroid gland and kidneys of a patient with myeloma

A 48-year-old Japanese woman died of multiple myeloma (lambda light-chain type) with chronic renal failure. Histological examination revealed deposition of a homogeneous substance and crystals in the kidneys and thyroid gland. The homogeneous substance was stained with Congo red after permanganate treatment but did not stain with antibody to amyloid A protein, and it was recognized as AL-type amyloid. Crystals were not stained with Congo red, but crystals were stained with antibody to the lambda light chain. Since AL-type amyloid is considered to be derived from a myeloma light chain, the present case showed two different types of deposition, both of which were derived from the same myeloma protein.

Multivariate analysis for histologic prognostic factors in soft tissue sarcomas

To investigate histologic prognostic factors in soft tissue sarcomas (STS), multivariate analysis was performed on 236 patients with complete clinical information. These included 141 males and 95 females with an age range from 1 to 85 years (median, 47.6 years). Histologically, malignant fibrous histiocytoma (33.5%) was the most common type followed by synovial sarcoma (11%), liposarcoma (10%), rhabdomyosarcoma (7%), and leiomyosarcoma (7%). Monofactorial analysis revealed that sex, depth, location, histologic grade, cellularity, frequency of mitosis, and necrosis were significant prognostic factors. By multivariate analysis, only frequency of mitosis and depth of tumors were proved to be of prognostic significance. The prognostic importance of the frequency of mitosis as shown in previous and the present studies indicates that further investigation of the cell proliferation in patients with STS is required.

Benign chondroblastoma of the occipital bone

We report the case of a 14-year-old boy with benign chondroblastoma in the occipital bone associated with a cerebellar hemorrhage. The clinical features, radiologic and histologic appearances, and histogenesis in this case are described. Other reports of benign chondroblastomas of the cranial bones are also discussed.

Electron-microscopic observation of the nucleus basilis of Meynert in human autopsy cases

The large neurons of the nucleus basalis of Meynert (nbM) were examined with the electron microscope in 13 autopsied human adults. The neurons were characterized by a prominent Nissl substance and accumulation of lipofuscin granules. Lamellar bodies were often observed among the Nissl substance. Many of the lipofuscin granules were large and had a characteristic pronounced mosaic pattern of pale areas within gray zones. Menbranous structures within the nucleus and periodic transverse processes in the cristae of the mitochondria were regarded as postmortem alterations. Alzheimer's neurofibrillary tangles (NFT) were observed in two cases. Intranuclear fibrillary bundles were identified in four cases. Crystalloid formation in rough endoplasmic reticulum was identified in two cases. Hirano body was observed in a case of parkinsonism with dementia. Axonal swelling was seen in three cases and interpreted as axonal dystrophy, an age-related phenomenon. A basal body, which is unusual in neurons of the central nervous system (CNS), was observed in one case. Lewy bodies were observed in a case of parkinsonism.