A case of traumatic intrapleural foreign body with progressive supranuclear palsy removed by thoracoscopic surgery

Traumatic intrathoracic foreign bodies are said to occur in many cases when the patient himself/herself is aware of the trauma. However, at the time of injury, the patient may sometimes be accompanied by loss of consciousness. We report a case of traumatic intrathoracic foreign body that was difficult to diagnose due to loss of consciousness at the time of injury. A 51-year-old female was brought to our emergency department with a fall trauma due to loss of consciousness while bathing. The head computed tomography and electrocardiogram showed no abnormalities, and the laceration of approximately 3 cm in length was found on the left side thorax, and it was sutured and the patient was sent home. Four days later, she returned to our hospital with a complaint of left anterior chest pain, and chest X-ray showed a left degree pneumothorax and mediastinal emphysema. She underwent semi-emergency thoracoscopic removal of the foreign body, and was discharged from the hospital on the fourth postoperative day. She had progressive supranuclear palsy, and her memory at the time of injury was not clear due to loss of consciousness caused by central autonomic neuropathy, and she also had dementia, making it difficult to interview her. She had no thoracic symptoms, and the glass fragment that had strayed into the thoracic cavity was not exposed outside the body, making the diagnosis difficult at the time of initial examination. When a patient with loss of consciousness is difficult to interview at the time of injury, it is advisable to perform an imaging examination appropriate for the site of injury, taking into consideration the presence of foreign bodies.

Transcatheter arterial embolization followed by surgical laparotomy for hemorrhagic shock due to intestinal bleeding: a case report

Background

Acquired jejunal diverticula are relatively rare conditions. While mostly asymptomatic, they can occasionally cause life-threatening complications requiring surgical treatment. We herein report a case of hemorrhagic shock due to jejunal diverticulum with intestinal amyloidosis that was successfully managed via transcatheter arterial embolization (TAE) and surgery.

Case presentation

An 80-year-old female presenting with hematochezia and hemorrhagic shock was transferred to our institution. Contrast-enhanced computed tomography revealed extravasation in the small bowel around the upper jejunum. Massive transfusion was performed with subsequently planning for TAE to control bleeding followed by surgical laparotomy to evaluate the ischemic intestine. First, the second jejunal artery was selectively embolized with a 1:3 mixture of N-butyl cyanoacrylate (NBCA) and iodize oil, after which laparotomy was performed. Multiple jejunal diverticula were detected near Treitz’ ligament, and an induration of NBCA was palpable in the nearby mesentery. The intraoperative diagnosis was massive bleeding from acquired jejunal diverticula for which jejunectomy including the nearby diverticulum was performed to prevent future bleeding. Her postoperative course was stable. Histological examination of the specimen revealed several false diverticula with intestinal amyloidosis.

Conclusion

Hemorrhagic shock due to jejunal diverticulum with intestinal amyloidosis is extremely rare. Combined treatment of TAE and surgical laparotomy appears to be effective, because the bleeding point can be identified by palpation of the embolic material.

Acute Compartment Syndrome of the Upper Extremity in Acquired Hemophilia A: A Case Report and Literature Review

CASE

Acute compartment syndrome (ACS) with acquired hemophilia A (AHA) is rare and has no established treatment strategy. A 64-year-old woman presented with a giant hematoma in the rectus abdominis. Laboratory findings included decreased hemoglobin and increased activated partial thromboplastin time. Arterial embolization was performed for hemostasis. After catheter removal, she developed severe arm pain and numbness with blistering. Fasciotomy was performed to decrease intracompartmental pressure. Laboratory investigations revealed decreased factor VIII (FVIII) activity and increased FVIII inhibitor. AHA was diagnosed and treated with immunosuppressive and FVIII inhibitor-bypassing agents.

CONCLUSIONS

Fasciotomy should be performed promptly if ACS with AHA is suspected.

[Subcutaneous Metastasis from Rectal Carcinoma after Low Anterior Resection-A Case Report]

A 63-year-old woman was admitted to our hospital owing to advanced rectal carcinoma. The patient underwent laparoscopic lowanterior resectionwith D3 lymph node dissection and partial resection of the uterus. The histopathological diagnosis was fT4bN2M0, fStage Ⅲb. Thus, capecitabine plus oxaliplatin(CapeOX)therapy as adjuvant chemotherapy was scheduled for 6 months. However, after the 4th course of chemotherapy, contrast-enhanced CT revealed multiple metastases of the rectal carcinoma including metastases in the liver, peritoneum, retroperitoneum, and subcutaneous tissue of the left lower back. The patient received palliative treatment and died 8 months after surgery. Only a fewcases of subcutaneous metastasis of rectal carcinoma have been reported. Therefore, we herein report this case with a review of the literature.

Preoperative Neutrophil-lymphocyte Ratio Is a Predictor of High-output Ileostomy After Colorectal Surgery

BACKGROUND/AIM

High-output ileostomy (HOI) can affect quality of life, however, its primary cause remains unknown. This study aimed to identify a predictor of HOI after colorectal surgery.

PATIENTS AND METHODS

The medical records of forty-five patients who had undergone colorectal surgery with temporary ileostomy without postoperative complications, such as intra-abdominal abscess, paralytic ileus, outlet obstruction, or suture rupture, at our hospital between January 2016 and December 2017 were retrospectively investigated.

RESULTS

Significant differences in age, gender, operative situation, duration of operation, intraoperative blood loss, operation procedure, operation approach, preoperative body mass index, and preoperative hematological/biochemical parameters, such as leucocyte counts, hemoglobin, serum total protein, albumin, C-reactive protein, and preoperative complications, were not identified between the two groups. Preoperative neutrophil-to-lymphocyte ratio (NLR) of the HOI group was significantly higher than that of the non-HOI group (p=0.004).

CONCLUSION

Preoperative NLR seems to be a useful predictor of HOI after colorectal surgery.

[A Case of Ampullary Region Carcinoma in a Young Woman - A Case Report]

A 19-year-old woman with general fatigue who initially consulted a local hospital was referred to us for further examination of jaundice. Contrast-enhanced CT revealed apparent dilatation of the bile duct. Gastrointestinal endoscopy exhibited a tumor of the papilla of Vater(adenocarcinoma, tub2). Thus, pylorus-preserving pancreatoduodenectomy with D2 lymph node dissection was performed. Pathologically, she was diagnosed with a T3bN1M0, pStage ⅡB tumor. After surgery, the patient underwent adjuvant chemotherapy containing S-1 for 6 months. We herein report a juvenile case of ampullary region carcinoma that was successfully treated.

Intestinal obstruction caused by primary adenosquamous cell carcinoma of the small intestine: A case report and review of the literature

Primary adenosquamous cell carcinoma (ASCC) arising from the ileum is an exceptionally rare malignant neoplasm exhibiting mixed glandular and squamous differentiation. The clinicopathological characteristics of ASCC have not been clearly determined due to its rarity. We herein report a case of a 74-year-old man with a successfully treated ASCC of the ileum. The patient visited a medical clinic due to abdominal pain. Abdominal computed tomography imaging revealed an intestinal tumor in the ileum. Prior to undergoing capsule endoscopy, the patient complained of severe abdominal pain due to intestinal obstruction from the patency capsule and the tumor. Thus, the patient was referred to our hospital for emergency surgery. Upon relieving the obstruction by partial resection of the ileum, an impacted patency capsule with a tumor with ulceration was identified. On histological examination, the tumor consisted of malignant glandular and squamous cell elements. The postoperative course was uneventful, without complications. The patient subsequently received adjuvant chemotherapy with oxaliplatin and capecitabine for 6 months. The patient has no evidence of recurrence 20 months after surgery. To the best of our knowledge, only 8 cases of ASCC have been reported in the English literature to date. This case serves as an important reminder to consider small intestinal carcinoma, including ASCC, in the differential diagnosis of intestinal obstruction.

[Curatively Resected Stage ⅣGastric Cancer with Positive Peritoneal Cytology Due to SOX Therapy-A Case Report]

A 70-year-old man with epigastralgia who initially visited a local hospital was referred to us for further examination. Gastrointestinal endoscopy exhibited a type 3 tumor of the stomach from the body to the antrum(adenocarcinoma, por1). Contrast-enhanced CT revealed thickness in the wall of the gastric body with bulky lymph nodes and ascites. Staging laparoscopy showed that the patient was diagnosed with sStage Ⅳ gastric cancer with positive peritoneal cytology. Therefore, SOX therapy was administered. Subsequently, total gastrectomy with D2 lymph node dissection was performed, since the primary tumor and lymph nodes were significantly reduced. Histopathologically, the residual lesion was only observed in the mucosal layer without lymph node metastases. We herein report a case of Stage Ⅳ gastric cancer, which was successfully treated by conversion surgery after SOX therapy.

Daunorubicin can eliminate iPS-derived cancer stem cells via ICAD/CAD-independent DNA fragmentation

Aim: To identify a drug that can effectively eliminate these cancer stem cells (CSCs) and determine its mode of action.

Methods: CSCs were obtained from mouse induced pluripotent stem cells (miPSCs) using cancer cell-conditioned media. Drug screening was performed on these cells or after transplantation into mice. Apoptosis was analyzed by flow cytometry and western blotting.

Results: Drug screening studies showed that daunorubicin, a topoisomerase II inhibitor, is specifically cytotoxic to miPS-CSCs. Daunorubicin-induced apoptosis was found to be associated with p53 accumulation, activation of the caspase cascade, and oligonucleosomal DNA fragmentation. Treatment with the caspase inhibitor abolished daunorubicin-induced DNA fragmentation and was therefore considered to act downstream of caspase activation. This was also suppressed by treatment with a Ca²⁺-specific chelator, which suggested that CAD endonuclease does not contribute. Moreover, no obvious ICAD reduction/degradation was detected.

Conclusion: Daunorubicin effectively eliminated CSCs, which are dependent on the p53/caspase signaling cascade. The current findings provided the basis for further studies on CSC-targeted drugs for the development of cancer treatment strategies.

Anthropometric Assessment After Proctocolectomy Due to Ulcerative Colitis

BACKGROUND

Postoperative changes in patient anthropometric and nutritional statuses after proctocolectomy due to ulcerative colitis (UC) are unclear.

PATIENTS AND METHODS

Between January 2015 and December 2017, nine patients who underwent proctocolectomy with temporary ileostomy (PTI) for UC at our hospital were enrolled in this study. For the comparison group, eight patients who underwent low anterior resection (LAR) with temporary ileostomy for rectal cancer in the same period were recruited. Data, including body weight; body mass index (BMI); levels of total protein, albumin, cholinesterase, and hemoglobin; and lymphocyte counts, were analyzed. The changes in these parameters before surgery until 6 months after surgery were compared.

RESULTS

Before surgery, the levels of total protein, albumin, cholinesterase, hemoglobin and lymphocyte counts in the PTI group were significantly worse than those in the LAR group. However, significant differences were not identified in these factors at 1 month after surgery. The BMI was significantly lower in the PTI group than in the LAR group until 3 months after surgery. An increase in body weight to greater than that prior to surgery was found from 4 months after surgery in the PTI group. The LAR group did not have any effect of surgery in terms of any factor.

CONCLUSION

BMI appears to be the most useful predictor of clinical and nutritional changes postoperatively.

Prophylactic intra-arterial administration of fasudil hydrochloride for vasospasm following subarachnoid haemorrhage

PURPOSE

We evaluated patients treated with prophylactic intra-arterial administration of fasudil hydrochloride (IAF) after subarachnoid haemorrhage (SAH).

MATERIALS AND METHODS

Between August 1998 and December 2012, 92 patients with aneurysmal SAH were treated with IAF for angiographic vasospasm without ischemic symptoms after their follow-up angiography. Patients comprised 50 women and 42 men, aged 24-83 (mean 56.6) years. IAF consisted of 15 mg of fasudil hydrochloride dissolved in 20 ml physiological saline and injected through a catheter during approximately 15 min, after diagnostic angiography. The clinical outcome was evaluated using the Glasgow Outcome Scale (GOS) at discharge and ischemic lesions resulting from vasospasm were assessed on computed tomography (CT) scan at discharge.

RESULTS

Forty-eight patients underwent surgical clipping and 44 patients underwent endovascular coiling. Angiographic improvement was observed in all patients (100 %). At discharge, 76 (83.0 %) of 92 patients showed good recovery on GOS. Nine patients developed progression of delayed ischemic neurological deficits (DIND) and three of these patients had ischemic lesions on CT scans. No patient had any significant changes in vital signs or any other adverse effects resulting from IAF.

CONCLUSION

IAF therapy was safe and effective for patients with vasospasm following SAH. Prophylactic IAF therapy may prevent symptomatic vasospasm.

Characterization of cancer stem-like cells derived from mouse induced pluripotent stem cells transformed by tumor-derived extracellular vesicles

Several studies have shown that cancer niche can perform an active role in the regulation of tumor cell maintenance and progression through extracellular vesicles-based intercellular communication. However, it has not been reported whether this vesicle-mediated communication affects the malignant transformation of normal stem cells/progenitors. We have previously reported that the conditioned medium derived from the mouse Lewis Lung Carcinoma (LLC) cell line can convert mouse induced pluripotent stem cells (miPSCs) into cancer stem cells (CSCs), indicating that normal stem cells when placed in an aberrant microenvironment can give rise to functionally active CSCs. Here, we focused on the contribution of tumor-derived extracellular vesicles (tEVs) that are secreted from LLC cells to induce the transformation of miPSCs into CSCs. We isolated tEVs from the conditioned medium of LLC cells, and then the differentiating miPSCs were exposed to tEVs for 4 weeks. The resultant tEV treated cells (miPS-LLCev) expressed Nanog and Oct3/4 proteins comparable to miPSCs. The frequency of sphere formation of the miPS-LLCev cells in suspension culture indicated that the self-renewal capacity of the miPS-LLCev cells was significant. When the miPS-LLCev cells were subcutaneously transplanted into Balb/c nude mice, malignant liposarcomas with extensive angiogenesis developed. miPS-LLCevPT and miPS-LLCevDT, the cells established from primary site and disseminated liposarcomas, respectively, showed their capacities to self-renew and differentiate into adipocytes and endothelial cells. Moreover, we confirmed the secondary liposarcoma development when these cells were transplanted. Taken together, these results indicate that miPS-LLCev cells possess CSC properties. Thus, our current study provides the first evidence that tEVs have the potential to induce CSC properties in normal tissue stem cells/progenitors.

Cancer stem cells maintain a hierarchy of differentiation by creating their niche

The self-renewal and differentiation properties of cancer stem cells (CSCs) are regulated and maintained by the CSC niche. However, the mechanism of this maintenance, especially the maintenance contributed by differentiated cancer cells, remains to be fully elucidated. Recently, we have established a model of CSCs, miPS-LLCcm, from mouse induced pluripotent stem cells (miPSCs). In vitro cultured miPS-LLCcm cells were autonomously balanced with stem-like cells and differentiated cells including vascular endothelial cells. Under these conditions, the CSC properties appeared to be stable in the presence of the factor(s) secreted by the differentiated cells. The factor(s) activated Notch signaling and promoted self-renewal of CSCs. In addition, the secreted factor(s) appeared to regulate the differentiation lineage of CSCs. Our results indicate that the differentiated progenies of CSCs containing vascular endothelium play important roles for regulating the CSC's properties. Therefore, miPS-LLCcm cells create their own in vitro niche to maintain themselves in the hierarchy of differentiating CSCs.

Pneumatosis intestinalis in the small bowel of an adult: report of a case

We present the case of a 70-year-old man found to have pneumatosis of the small intestine. An abdominal computed tomography (CT) scan detected massive intramural air in the entire circumference of the small intestine without any venous gas. During emergency surgery, 80 cm of the small bowel was removed. The pathological findings of thrombi in the resected specimen thus indicated that surgical intervention should be immediately performed in patients with pneumatosis throughout the small intestine. CT was useful for confirming the presence of intramural gas in pneumatosis of the small intestine. The presence of a massive amount of intramural gas in the entire small intestine circumference on the CT findings is thus considered to be an early indication of bowel infarction.

Synthesis of 6-acetamido-5-amino- and -5-guanidino-3, 4-dehydro-N-(2-ethylbutyryl)- 3-piperidinecarboxylic acids related to zanamivir and oseltamivir, inhibitors of influenza virus neuraminidases

[reaction: see text] 6-Acetamido-5-amino- and -5-guanidino-3, 4-dehydro-N-(2-ethylbutyryl)-3-piperidinecarboxylic acids (8 and 9) have been synthesized starting from natural siastatin B, a bacterial neuraminidase inhibitor isolated from Streptomyces culture in a stereospecific fashion. These compounds are related to zanamivir and oseltamivir, inhibitors of influenza virus neuraminidases.

[Morpho-metrical features of the pelvis in standing posture]

The morpho-metrical features of the human pelvis differ according to gender, particularly with regard to size and shape, and bipedal standing posture appears to have been a major determinant of pelvic structure. In standing posture, the three points of the right and left superior anterior iliac spines and pubic tubercle are in contact with the vertical frontal plane. In this situation, the superior anterior iliac spine is lower than the superior posterior iliac spine. From a lateral view, the vertical line from the body's center of gravity passes through the center of the hip joint or acetabulum. The anatomical or biomechanical problem has been whether the line of gravity passes through the promontory or the center of auricular surface. To clarify this point, the three points of the acetabular center, promontory and auricular center were examined as to how they are positioned in relation to each other and the distance of each on the vertical frontal plane. Those measurements are as followed: A) distance between vertical frontal plane and promontory, B) distance between vertical frontal plane and anterior margin of auricular surface, C) distance between vertical frontal plane and mid-point of auricular surface computed from (B + D)/2, D) distance between vertical frontal plane and posterior margin of auricular surface, E) distance between vertical frontal plane and mid-point of acetabulum, F) inclination angle of the pelvis. From the results, the acetabular center and promontory are in alignment with the vertical line. The auricular center is positioned further back than the acetabular center or promontory. In this situation, the mean angle of inclination of the pelvis was found to be 63 degrees in 16 Japanese male specimens. The means of the other Japanese populations are into range of 63 degrees to 66 degrees in the males. If the auricular center coincides with the acetabular center, it is possible the angle of inclination of the pelvis would exceed 63 degrees. The frontal plane in contact with the right and left superior anterior iliac spines and pubic tubercle is not vertical. The morphological features clarified in the present study are that the promontory and acetabular center are in vertical alignment when viewed laterally and that the angle of inclination of the pelvis is 63 degrees.

Anti-viral and anti-tumor effects induced by an attenuated Marek's disease virus in CD4- or CD8-deficient chickens

By vaccination with an attenuated Marek's disease virus (MDV), strain CVI988, chickens are protected from the development of T cell lymphoma caused by an oncogenic MDV. To clarify the role of T lymphocyte subsets in the protection mechanisms of this vaccine, vaccinated chickens were depleted of T cell subsets by neonatal thymectomy and injections of monoclonal antibodies specific to chicken CD4 and CD8 molecules, and then challenged with an oncogenic MDV, strain Md5. The MDV titers rescued from CD8(+) T cells, which are the main targets for latent infection and subsequent transformation by MDV, was much higher in the CD8-deficient vaccinated chickens than in untreated vaccinated chickens at the early stage of the latent phase. However, the neonatal vaccination prevented lymphoma formation by strain Md5 even in either CD4(+) or CD8(+) T cell-depleted chickens. These results suggest that specific CD8(+) T cell responses induced by the MD vaccine play a crucial role in the prevention of MDV infection during the latent phase, but may not be essential for the prevention of lymphoma formation by an oncogenic MDV.

[Evaluation of peritoneal lavage smears and intraperitoneal administration of anti-neoplastic agents in stage III and IV gastric cancer]

Examinations of peritoneal lavage smears (cy) in gastric cancer surgical stages III and IV are very important for determining the disease stage. We have been carrying out these examinations for 8 years. One hundred sixty patients with gastric cancer were examined. The incidence of cy positivity was higher in T4 than in T3, and higher in P1,2,3 than in P0. We performed intraperitoneal administration of CDDP in 10 patients with gastric cancer using a reservoir (Infuse-A-Port) implanted in the abdominal wall once a week. No difference in survival was observed between patients who received chemotherapy via i.p. and those who received it i.v.

Secular change in the torsional angle of Japanese femora

The torsion angle of the Japanese femora of the early modern Edo (early and late series) and modern periods were measured. In the modern period, this angle is in males and females significantly larger than in the early series of the early modern Edo period and shows a gradual increase from the early modern Edo to the modern period. It is was always larger in females than in males. This change may be in part due to sedentary habits or living posture of the latter half in the early modern Edo period.

[Successful treatment of hepatic metastasis of gastric cancer with 5'-DFUR and Lentinan]

Satisfactory therapeutic effects are rarely obtained with oral chemotherapy for gastric cancer. We have experienced successful treatment for synchronous hepatic metastasis of gastric cancer with 5'-DFUR and Lentinan. The patient was a 78-year-old female, diagnosed as having gastric cancer with multiple hepatic metastases, who underwent gastrectomy. Immunohistochemistry of the resected specimens with anti-thymidine phosphorylase (dThdPase) antibody yielded positive results for dThdPase in the primary tumor as well as the hepatic metastases. Two months after surgery, administration of 400 mg of 5'-DFUR per day and 2 mg i.v. of Lentinan every other week was started. Four months after discharge, carcinoembryonic antigen (CEA) in plasma showed an abrupt logarithmic decline. Furthermore, a 99% reduction in hepatic metastases was demonstrated by abdominal CT. At present, 22 months after surgery, the patient is managed on an outpatient basis with no complaints of any side effects. Immunochemotherapy using 5'-DFUR and Lentinan may be effective against gastric malignancies expressing dThdPase activity.

Centrifuge microscope as a tool in the study of cell motility

The centrifuge microscope (CM) is composed of a centrifuge and a microscope optical system designed to observe minute objects, especially living cells, during the application of centrifugal acceleration. Structures and characteristics of various types of CM designed and constructed up to the present and studies done with the CM on cell biology, especially cell motility, are reviewed. These studies include observations of the behavior of cells and cell components in a centrifugal field, determination of the mechanical properties of the cell surface and cytoplasm, microsurgical operations on cells with centrifugal force, and determination of the magnitude and the site of generation of motive force for cell motility.

Flexural rigidity of echinoderm sperm flagella

The stiffness (flexural rigidity) of live sperm flagella, Triton-demembranated flagella (axonemes), trypsin-digested axonemes, and doublet microtubules of the axonemes in echinoderms was determined from the relationship between their deformation when a stream of medium was applied and the viscous resistance of the medium acting on the flagellum. The stiffness of the flagellum beating in seawater was 5.8 x 10(-21) Nm2 for bending in the direction perpendicular to the beating plane and 4.2 x 10(-22) Nm2 for bending within the beating plane. A similar difference in stiffness from the difference in bending directions was found in reactivated flagella with 1 mM ATP. The stiffness of live flagella immobilized in CO2-saturated seawater and axonemes in ATP-free medium was similar to that of beating flagella for bending in the direction perpendicular to the beating plane. The stiffness of motionless flagella significantly decreased with erythro-9-(2-hydroxy-3-nonyl) adenine (EHNA) and vanadate. The trypsin-digestion of motionless axonemes did not change their stiffness. The stiffness of doublet microtubules was 1.4 x 10(-23) Nm2 in 0.1 mM ATP medium and 6.1 x 10(-23) Nm2 in ATP-free medium. These results suggest that doublet pairs lying parallel to the beating plane of the flagellum retain fewer cross-bridges than doublet pairs lying perpendicular to the beating plane.

Sperm and its soluble extract cause transient increases in intracellular calcium concentration and in membrane potential of sea urchin zygotes

Fertilization is known to initiate a transient increase of intracellular calcium concentration and an accompanying change of membrane potential in sea urchin eggs. If the fertilization membrane and hyaline layer are removed, sperm can again enter fertilized eggs (refertilization). We have found that Ca2+ and voltage transients were repeatedly induced in fertilized eggs during refertilization. Similar changes were also obtained by external application of a soluble extract of sperm to fertilized eggs. This sperm extract caused no changes in unfertilized eggs. The active factor in the sperm extract survives heating (100 degrees C, 10 min) and incubation with pronase. Its molecular weight is less than 1300.

[The expression of neural cell adhesion molecule (NCAM), neural invasion and recurrence patterns in rectal cancer--a study using anti-NACM (neural cell adhesion molecule) antibody]

Neural invasion may be one of the main causes of local recurrence, but its mechanism has not been sufficiently clarified. We previously reported that the expression of NCAM on cancer cells was correlated with neural invasion in pancreatic cancer. In this study, we examined the neural affinity of rectal cancer cells and the relationship between neural invasion and recurrence patterns of rectal cancers. A total of 64 rectal adenocarcinoma were examined. Specimens from 17 patients (27%) revealed perineural invasion. The incidence of neural invasion increased with the frequency of venous invasion and the degree of lymph node metastasis, but not significantly. The incidence of the expression of NCAM in rectal cancer cell was 45.3 percent. Neural invasion of rectal carcinoma was significantly related to the expression of NCAM (p < 0.05). NCAM immunocytolocalization was classified into the focal type, and the diffuse type. Concerning the recurrence type, 8 of 9 cases that developed local recurrence showed either presence of neural invasion or expression of NCAM. Liver metastasis was associated with absence of neural invasion or NCAM expression. The expression of NCAM may contribute to local recurrence, whereas the absence of NCAM may predict liver metastasis.

Oscillation of intracellular free calcium in cleaving and cleavage-arrested embryos of Xenopus laevis

Changes in the intracellular free calcium levels in the cortical region of cleaving Xenopus eggs were examined using semi-synthetic aequorin. We detected periodic oscillations in the free calcium levels accompanying the cleavage cycle as early as the first cleavage onward. The calcium levels began to increase at early interphase and were maximal during metaphase of mitosis. Eggs injected with colchicine to inhibit cleavage showed periodic oscillations in the calcium levels similar to those of normal eggs. This fact indicates that the furrowing process is not necessary for the periodic changes in the intracellular free calcium levels, but the changes are associated with the autonomous periodic cytoplasmic activity which controls cell cycle events.

Right-left differences in the lengths of human arm and leg bones

Right-left differences in the maximum length of the humerus and radius, and the femur and tibia of the leg in an archaic population were investigated. The materials consisted of skeletons dated to the Neolithic Jomon period excavated in eastern Japan. The results obtained in this study were compared with those of four other populations. Dominant side in the arm and leg bones were found to be dissimilar based on the mean right-left differences. The arm bones of right side were significantly longer than those of left. The leg bones of the left side were longer than those of the right. Mean right-left differences of female arm bones were usually greater than those of males. Obvious sex-differences could not be seen for leg bones. The mean right-left differences of the humerus seemed to be more variable than those of the other three bones.

Site-specific mechanisms of initiation by chelated iron and inhibition by alpha-tocopherol of lipid peroxide-dependent lipid peroxidation in charged micelles

To obtain information on the role of iron-catalyzed lipid peroxidation in the presence of the small amount of lipid peroxide in deterioration of biological membranes, we examined factors affecting peroxidation of fatty acids in charged micelles. Peroxidation of linoleic acid (LA) was catalyzed by Fe2+ via reductive cleavage of linoleic acid hydroperoxide (LOOH) in negatively charged sodium dodecyl sulfate micelles, but not in positively charged tetradecyltrimethylammonium bromide (TTAB) micelles. However, this Fe2(+)-induced, LOOH-dependent lipid peroxidation could be induced in TTAB micelles in the presence of a negatively charged iron chelator, nitrilotriacetic acid (NTA). The linoleic acid alkoxy radical (LO.) generated by the LOOH-dependent Fenton reaction was also trapped by N-t-butyl-alpha-phenylnitrone at the surface of TTAB micelles in the presence of NTA, but not in its absence. The degradation rates of two spin probes, N-oxyl-4,4'-dimethyloxazolidine derivatives of stearic acid (5-NS and 16-NS), were investigated to determine the site of production of radicals formed during LOOH-dependent lipid peroxidation. The rate of consumption of 16-NS during the LOOH-dependent Fenton-like reaction was higher in TTAB micelles containing LA than in those containing lauric acid (LauA), although the rates of formation of LO. in the two types of fatty acid micelles were similar. The rates of 5-NS consumption in LA and LauA micelles were almost the same and were as low as that of 16-NS consumption in LauA micelles. 16-NS was more inhibitory than 5-NS of LOOH-dependent lipid peroxidation, and this inhibition was associated with its higher consumption of 16-NS than of 5-NS. alpha-Tocopherol inhibited NTA-Fe2(+)-induced LOOH-dependent lipid peroxidation in TTAB micelles, and was oxidized during this inhibition process. The rate and amount of alpha-tocopherol oxidized by the LOOH-dependent Fenton reaction were higher in LA micelles than in LauA micelles. alpha-Tocopherol inhibited the consumption of 16-NS during NTA-Fe2(+)-induced LOOH-dependent lipid peroxidation more effectively than that of 5-NS. The distribution of the chromanol moiety of alpha-tocopherol was studied by the fluorescence quenching method. There was no difference between Stern-Volmer plots of the quenchings of alpha-tocopherol fluorescence by 5-NS and 16-NS. From these results, we discuss the mechanism of induction of LOOH-dependent peroxidation of LA and the mechanism of the antioxidant effects of alpha-tocopherol on it from the viewpoint of site-specific reaction.

Mechanical properties of the cortex before and during cleavage

The changes in stiffness of the cell before and during cleavage reported previously for various kinds of echinoderm eggs are classified into three types. There is no general rule that cleavage starts when the stiffness attains a maximum or a minimum. Because the stiffness of the cell surface is much greater than that of the mitotic apparatus, the change in stiffness of the cell represents mainly the change in stiffness of the cell surface. The tension at the cell surface changes in parallel over the entire surface before the onset of cleavage. After the onset of cleavage, the tension at the furrow surface becomes greater in the direction parallel to the furrow than perpendicular to it. A remarkable change in mechanical properties occurs at the furrow surface simultaneously with the onset of cleavage. Judging from the temporal and spatial coincidence between this change and the formation of the contractile ring reported previously in sea urchin eggs at the onset of cleavage, it is concluded that this change is due to the formation of the contractile ring that generates the motive force for cleavage.

Effect of glucocorticoid replacement on tumor growth after adrenalectomy in mice

We studied the effects of glucocorticoid replacement on tumor growth after adrenalectomy of Meth A sarcoma in mice. Tumor growth was inhibited in the adrenalectomized mice when a minimum dose of corticosterone, 0.3 mg/day, was given for replacement, and higher doses led to an even greater inhibition. Corticosterone had no effect on tumor growth in the irradiated mice. Sinecomitant immunity in the case of growth of the retransplanted excised tumor was compromised in the adrenalectomized mice. In vivo neutralization and immunosuppressive activities were absent in the spleen cells of the adrenalectomized mice. It would thus appear that adrenalectomy suppresses tumor growth by mechanisms other than glucocorticoid ablation. For optimum tumor control, glucocorticoid replacement after adrenalectomy should be in excess of the minimum daily requirements.

Sarcoma-180 cells are more sensitive to heat than are mouse normal tissues: esophagus, stomach, small intestine, large intestine, liver, spleen, and kidney

Sensitivity of various mouse tissues to heat was determined using mouse sarcoma-180 (S-180) cells and normal tissues: esophagus, stomach, small intestine, large intestine, liver, spleen, and kidney. The in vitro succinate dehydrogenase inhibition (SDI) test was used. The succinate dehydrogenase (SD) activity of tissue fragments was assayed, following exposure to a temperature of 43 degrees C (heat treatment) or 37 degrees C (control) for 1, 2, 5, or 10 hr. The sensitivity to heat treatment was estimated by the percentage of SD activity of the heat-treated cells, compared to that of the control cells. The decrease in SD activity following exposure to heat varied with the tissue. The SD activity decreased to a greater extent in the S-180 cells than in the normal tissues. In the normal tissues, the order of sensitivity to heat was stomach, spleen, large intestine, small intestine, esophagus, kidney and liver. These results show that hyperthermia is tissue selective, hence heat treatment of a malignant lesion should be carefully designed.

The amino acid sequence, immunofluorescence and microinjection studies on the 15 kDa calcium-binding protein from sea urchin egg

The 15 kDa protein is the most abundant low molecular weight Ca2+-binding protein, different from calmodulin, in eggs of sea urchin, Hemicentrotus pulcherrimus. The data from the amino acid sequence demonstrated that the 15 kDa protein belonged to the troponin C superfamily. Based on immunofluorescent and immunomicroscopic observations, we showed that the 15 kDa protein localized in the nuclei of fertilized eggs and mitotic apparatus of dividing eggs. Microinjection of the antibody against 15 kDa protein into sea urchin blastomeres resulted in the arresting of cell division. These results suggest that the 15 kDa protein plays an important role in mitosis of sea urchin egg.

Mechanism of Ca2+ release in medaka eggs microinjected with inositol 1,4,5-trisphosphate and Ca2+

The reaction time of Ca2+ release from cytoplasmic stores induced by microinjection of inositol 1,4,5-trisphosphate (IP3), calcium ionophore A23187, Ca2+, Sr2+, Ba2+, and cyclic guanosine 5'-monophosphate (cGMP) in Oryzias latipes eggs in Ca2+-free medium was measured by the luminescence of aequorin injected into the egg. Microinjection of IP3 or calcium ionophore induced rapid Ca2+ release without a time lag, while microinjection of either Ca2+ or cGMP required a time lag of 5-30 sec for Ca2+ release. Following microinjection of both IP3 and Ca2+, Ca2+ release commenced in a cytoplasmic region close to the egg surface. These results suggest that in the medaka egg, cytoplasmic Ca2+ induces Ca2+ release from cytoplasmic stores indirectly, probably via a membrane factor such as IP3.

Lymphadenectomy for cure in patients with early gastric cancer and lymph node metastasis

The anatomic distribution, size, and histologic mode of involvement of 98 metastatic lymph nodes in 49 of 370 patients were examined to determine to what extent lymphadenectomy should be performed in addition to gastrectomy in patients with early gastric cancer. Nodal involvement in the marginal sinus (30 nodes) and partial medullary sinus (37 nodes) were commonly seen, and the lymph nodes of those types were enlarged compared with 1,086 patients with no metastatic lymph nodes (control group). Lymph nodes of the wide medullary sinus (11 nodes), small nodule (3 nodes), and massive involvement types (17 nodes) did not enlarge compared with those of the other types and those of the control group. Most of the metastatic sites (76.6 percent) were in the perigastric lymph nodes along the lesser and greater curvatures, about a fifth were in the extraperigastric nodes along the left gastric, common hepatic, celiac, and splenic arteries, and the least were in the extraperigastric nodes (3.1 percent) along the hepatoduodenal ligament. Since the rate of macroscopic diagnosis during operation was so poor, regardless of the histologic modes of nodal involvement, and also in cases of metastatic lymph nodes less than 15 mm in widest diameter, for curative operation of patients with early gastric cancer, perigastric and extraperigastric lymph nodes along the main arteries near the stomach should be completely dissected, in addition to resection of the stomach.

Cytoplasmic Ca2+ release induced by microinjection of Ca2+ and effects of microinjected divalent cations on Ca2+ sequestration and exocytosis of cortical alveoli in the medaka egg

Intracellular release of Ca2+ by microinjection of Ca2+ was analyzed by measuring the luminescence of aequorin loaded in eggs of the medaka (Oryzias latipes). Microinjection of Ca2+ into the cortical cytoplasm induced propagative waves of cytoplasmic Ca2+ release and exocytosis of cortical alveoli initiated at the injection point. The Ca2+ wave was initiated with a time lag after some was sequestered at the region of the microinjection. Microinjection of Mg2+ or Mn2+ failed to trigger Ca2+ release and exocytosis. When the aequorin-loaded eggs were inseminated after microinjection of Mg2+, Mn2+, or Co2+ into a restricted region of the vegetal hemisphere, the wave of Ca release was propagated through the injected region toward the vegetal pole, but neither Ca sequestration (fall in Ca-aequorin luminescence) nor exocytosis occurred at the area of cortex where the eggs were injected with these divalent cations. These results suggest that a significant period is required to induce Ca2+ release from cytoplasmic stores by the increased Ca2+ concentration and that both the phenomena of Ca2+ release and Ca sequestration are involved in the process of exocytosis.

Micromanipulation studies of the mitotic apparatus in sand dollar eggs

Mechanical properties of the mitotic spindle and the effects of various operations of the mitotic apparatus on the chromosome movement and spindle elongation were investigated in fertilized eggs and blastomeres of the sand dollar, Clypeaster japonicus. On the basis of results with mechanical stretching and compression of the spindle with a pair of microneedles and the behavior of an oil drop microinjected into the spindle, it was concluded that the equatorial region of the spindle is mechanically weaker than the half-spindle region. Anaphase chromosome movement occurred in the spindle from which an aster had been removed or separated with its polar end and in the spindle in which the interzonal region had been removed. This fact indicates that chromosomes move poleward in anaphase by forces generated near the kinetochores in the half-spindle. Because of the effects of separation or removal of an aster from the spindle on the spindle elongation in anaphase and the behavior of the aster, it was concluded that the spindle elongation in anaphase is caused by pulling forces generated by asters attached to the ends of the spindle.

[A case of carcinoma in the lower abdomen treated successfully with oral administration of bestrabucil]

A 72-year-old female was admitted because of a palpable hard tumor, 15 X 7 cm in size, in the left lower quadrant of the abdomen. According to a diagnosis of retroperitoneal tumor, laparotomy was performed, revealing a large tumor extending between the descending colon and the pelvic cavity, which could not be separated from the retroperitoneum, uterus, left ovary, urinary bladder or rectum. A number of metastatic nodules were disseminated to the peritoneum and mesenterium. The pathological diagnosis of the nodules was poorly differentiated carcinoma of transitional cell type, origin unknown. After discharge, oral administration of bestrabucil (100-200 mg/day), the benzoate of an estradiol-chlorambucil conjugate, was given to the patient at an outpatient clinic. The tumor ceased to be palpable when the total amount administered reached at 14 g. Ultrasonography and computed tomography demonstrated significant reduction in tumor size. A decrease in the peripheral leukocyte count was observed after every consecutive administration and it took about 2 months to recover to the normal level. No other side effects were observed in this case. Although administration was stopped at a total amount of 16.1 g, reenlargement of the tumor has not been observed for 9 months.

1-Hexylcarbamoyl-5-fluorouracil is more cytostatic than 5-fluorouracil against human tumors in vitro

The sensitivity of HeLa cells and 15 human tumors, including eight gastric cancers, five colorectal cancers and two lung cancers to 1-hexylcarbamoyl-5-fluorouracil (HCFU) was compared with that to 5-fluorouracil (5-FU) in vitro. HeLa cells were doubly sensitive to HCFU, as compared to 5-FU. After the HeLa cells had been treated with 5-FU or HCFU at 77 microM for 1-5 h, the intracellular levels of 5-FU and HCFU were determined, using gas chromatographic-mass spectrometric methods. The level of HCFU plus 5-FU in the HCFU-treated cells was twice as high as the level of 5-FU in the 5-FU-treated cells. The sensitivity to HCFU in 15 tumor tissues varied with the tissue; however, all tissues tested were more sensitive to HCFU than to 5-FU, assessed using the succinate dehydrogenase inhibition test. These results suggest that the hexylcarbamoyl structure facilitates the rapid uptake of HCFU through the cell membrane. HCFU may prove to be more effective for treating each individual patient with a malignant lesion.

Specific expression of the chicken delta-crystallin gene in the lens and the pyramidal neurons of the piriform cortex in transgenic mice

Two transgenic mice, 5-8 and 7-5, carrying the chicken delta-crystallin gene were produced by microinjecting cloned genes into male pronuclei. The mice were analyzed at 8 weeks of age with respect to gene integration and expression by means of blotting techniques and immunohistochemistry. Southern blot analysis indicated that both mice carried, on average, 50 copies of intact delta-crystallin gene per cell. Histological analysis of the mice using DNA-DNA in situ hybridization indicated that mouse 5-8 carried the delta-crystallin gene in every cell while mouse 7-5 was mosaic, with 20-40% of the cells of various tissues carrying the gene. Western blot analysis indicated that in both mice delta-crystallin is expressed in the lens and the cerebrum, but not in any other tissue examined. Immunohistological analysis revealed that, in the cerebrum of the mice, delta-crystallin was expressed specifically in pyramidal neurons located in layer IIb of the anterior piriform cortex. Thus, our results with transgenic mice not only demonstrate the primary specificity of delta-crystallin gene expression in authentic lens tissue, but reveal the unexpected specificity of this chicken gene in the central nervous system of the mouse.

Redistribution of fluorescently labeled tubulin in the mitotic apparatus of sand dollar eggs and the effects of taxol

Fluorescently labeled tubulin was quickly incorporated into the mitotic apparatus when injected into a live sand dollar egg. After a rectangular area (1.6 X 16 microns) of the mitotic spindle was photobleached at metaphase or anaphase by the irradiation of a laser microbeam, redistribution of fluorescence was almost complete within 30 sec. The photobleached area did not change in shape during the redistribution. During the period of redistribution, the bleached area moved slightly toward the near pole at metaphase and anaphase (means: 1.6 and 1.8 micron/min, respectively). These results indicate that redistribution was not due to the exchange of tubulin subunits only at the ends of microtubules but to their rapid exchange at sites along the microtubules in the bleached region. Furthermore, treadmilling of tubulin molecules along with the spindle microtubules possibly occurred at the rate of 1.6 micron/min at metaphase. Birefringence of the mitotic apparatus increased with a large increase in both the number and length of astral rays shortly after taxol was injected. However, the microtubules did not all seem to elongate at the same rate but appeared to become equalized in length. Chromosome movement stopped within 60 sec after the injection. Centrospheres became large and the labeled tubulin already incorporated into the centrospheres was excluded from the enlarged centrospheres. Shortly after the labeled tubulin was injected following the injection of taxol, it accumulated in the peripheral region of the centrospheres, suggesting that microtubules first assembled at this region. Fluorescently labeled tubulin in the mitotic apparatus in the egg after injection of taxol was redistributed much more slowly after photobleaching than in uninjected eggs.

Free calcium wave upon activation in Xenopus eggs

Eggs of Xenopus laevis were preloaded with aequorin and the spatial and temporal pattern of free calcium release in the egg cortex on artificial activation was determined by the aequorin luminescence emitted from the thin cortical layer of naturally opaque eggs. The aequorin luminescence was detected with a photonic microscope system consisting of a light microscope and a two-dimensional photon-counting system with an image processor. A free calcium increase was initiated around the point of prick activation. The state of increased Ca2+ propagated in the cortical cytoplasm of the egg as a wave with a velocity of about 8 micron/sec at 22 degrees C. This wave reached the antipode by 5 to 6 min of prick activation. The spatial pattern of the Ca2+ wave was similar to that of changes in brightness of the egg surface on activation, termed the "activation wave" by K. Hara and P. Tydeman (1979, Wilhelm Roux's Arch. Dev. Biol. 186, 91-94). To examine the temporal correlation between the Ca2+ wave and the activation wave, images of aequorin luminescence and those of the egg cortex taken by incident light illumination were recorded alternately in the same egg. The zone of free calcium increase corresponded to the light (relaxation) zone of the activation wave, where exocytosis of cortical granules and elongation of microvilli were taking place.

Effect of glucocorticoid deficiency after adrenalectomy on antitumor immunity

We studied the effect of corticosterone after adrenalectomy on antitumor immunity in immunogenic tumors in mice. Antitumor immunity in the glucocorticoid deficient adrenalectomized mice (ADX mice) examined via comitant immunity and cytotoxic activity of spleen cells was compromised. Antitumor immunity was detected in ADX mice receiving sufficient supplementary doses of corticosterone. Loaded stress compromised the cytotoxic activity of the spleen cells in the ADX mice receiving adequate corticosterone, and the failure also contributed to the glucocorticoid deficiency because the activity was not affected by stress in the sham ADX mice. A matured effector cell activity was transferred to the glucocorticoid deficient ADX mice. We conclude that glucocorticoid deficiency compromises the antitumor immune response and that glucocorticoid might play an important role in the maturation of immunocompetent cells.

Temporal and spatial dynamics of the periodic increase in intracellular free calcium at fertilization of golden hamster eggs

A series of periodic increases in intracellular free calcium concentration ([Ca2+]i) occurred upon fertilization in golden hamster eggs. The spatial distribution of the Ca2+ transients was investigated in single zona-free, aequorin-injected eggs, inseminated by single sperm. A supersensitive TV camera system for recording Ca2+-aequorin luminescence enabled us to observe the spatial distribution of the Ca2+ rise. In the first response, which usually occurred 10-30 sec after the sperm attachment, the increase in [Ca2+]i began near the sperm attachment site, and the Ca2+ rise spread over the entire egg within 4-7 sec. The Ca2+ rise attained its peak in 5-8 sec, declined with almost even distribution, and ceased in 12-17 sec. The spreading Ca2+ rise was repeated in the second and sometimes the third response, starting from the same focus, but spreading more rapidly (approximately 2 sec). In succeeding responses [Ca2+]i increased synchronously in the whole cytoplasm within 1 sec. When additional sperm attached to the egg after the occurrence of the first response by the first sperm, the spread of the Ca2+ rise could take place from near the site of additional sperm attachment but only in the second or third response.

A novel 15 kDa Ca2+-binding protein present in the eggs of the sea urchin, Hemicentrotus pulcherrimus

A novel Ca2+-binding protein, different from calmodulin, has been purified to homogeneity from the soluble cytoplasmic protein fraction of the egg of the sea urchin, Hemicentrotus pulcherrimus. This protein, designated as 15 kDa protein, shows a Ca2+-dependent mobility shift upon SDS-gel electrophoresis and has Ca2+-binding ability. This protein did not resemble the sea urchin egg calmodulin in either molecular mass or amino acid composition. The 15 kDa protein could not activate cyclic adenosine 3',5'-monophosphate-dependent phosphodiesterase from bovine brain and did not bind to fluphenazine-Sepharose 6B. Antibodies against the 15 kDa protein did not react with sea urchin egg calmodulin. These results suggest that the 15 kDa protein is a novel Ca2+-binding protein in the sea urchin egg.