Carbonic anhydrase II is a tumor vessel endothelium-associated antigen targeted by dendritic cell therapy.

Tumor-associated antigens are promising candidates as target molecules for immunotherapy and a wide variety of tumor-associated antigens have been discovered through the presence of serum antibodies in cancer patients. We previously conducted dendritic cell therapy on 10 malignant melanoma patients and shrinkage or disappearance of metastatic tumors with massive necrosis occurred in two patients. In this study, we found a 29-kDa protein against which antibody was elicited by dendritic cell therapy in one of the two patients. Matrix-assisted laser desorption ionization-time of flight/mass spectrometry analysis of the protein isolated by two-dimensional electrophoresis combined with Western blots revealed that the 29-kDa protein was carbonic anhydrase II (CA-II). Immunohistochemistry of the tumors and normal tissues showed that CA-II was expressed in the tumor vessel but not in normal vessel endothelium. CA-II expression in tumor endothelium was observed as well in other cancers including esophageal, renal, and lung cancers. In an in vitro angiogenesis model, CA-II expression of normal human vein endothelial cells was significantly up-regulated when cells were cultured in the acidic and hypoxic conditions indicative of a tumor environment. These findings suggest that CA-II is a tumor vessel endothelium-associated antigen in melanoma and other cancers, and elicitation of serum anti-CA-II antibody by dendritic cell therapy may be associated with good clinical outcome including tumor reduction.     

Intraoperative hemodilutional autotransfusion using a closed circuit for patients of Jehovah's Witness

We conducted hemodilutional autotransfusion using a closed circuit combined with a cell washing reinfusing system (Cell Saver) for two surgical patients of Jehovah's Witness. One was a 12 yr-old boy for extirpation of the teratoma in the anterior mediastinum and another was a 44 yr-old woman for left total hip replacement. The patients and their relatives had consented to the use of blood substitutes, hemodilutional autotransfusion using a closed circuit and Cell Saver. We devised a closed circuit system for hemodilutional autotransfusion combined with Cell Saver, in which two pumps for blood transfusion were used; one was for drawing blood from the femoral or the internal jugular vein and the other for returning blood to the peripheral vein. Blood volume in a bag interposed in the closed circuit was easily controlled by adjusting the speed of each pump. Blood collected from the surgical field by Cell Saver was also led to the bag. Acid citrate dextrose solution was infused into the closed circuit from the site close to the blood drawing. Both of our surgical patients were safely managed without homologus blood transfusion, although there remained some problems concerning the use of anticoagulants.     

Evaluation with blink reflex of bilateral facial palsy

We examined the accuracy of electroneuronography (ENoG) and blink reflex as prognostic indicators in four patients with bilateral facial palsy. Electrophysiological investigation consisted of the recording of ENoG amplitude and R1 amplitude of blink reflex elicited by the peripheral nerve stimulation. Examinations were performed at the first visit, after 10 days, 2, 4 and 6 weeks. ENoG amplitude was less reliable for the neurological evaluation of bilateral facial palsy, because in three cases amplitude ratio of affected side to the other side was more than 100%. R1 amplitude of blink reflex recovered satisfactorily in two cases of good outcome. In other two cases of poor outcome, R1 amplitude was absent during the examination period. These findings suggest that analysis of blink reflex provides valuable information for evaluation of the prognosis of patients with bilateral facial palsy.     

The cheek of a cheater: Effects of posing the left and right hemiface on the perception of trustworthiness

Our cognitive mechanisms are designed to detect cheaters in social exchanges. However, cheater detection can be thwarted by a posed smile, which cheaters display with greater emotional intensity than cooperators. The present study investigated the role of hemifacial asymmetries in the perception of trustworthiness using face photographs with left and right cheek poses. Participants (N?=?170) observed face photographs of cheaters and cooperators in an economic game. In the photographs, models expressed happiness or anger and turned slightly to the left or right to show their left or right cheeks to the camera. When the models expressed anger on their faces, cheaters showing the right cheek were rated as less trustworthy than cooperators (irrespective of cheeks shown) and cheaters showing the left cheek. When the models expressed happiness, trustworthiness ratings increased and did not differ between cheaters and cooperators, and no substantial asymmetries were observed. These patterns were replicated even when the face photographs were mirror-reversed. These results suggest that a cheater’s fake smile conceals an uncooperative attitude that is displayed in the right hemiface, ultimately disguising cheater detection.     

Two Japanese cases of dermatitis herpetiformis associated each with lung cancer and autoimmune pancreatitis but showing no intestinal symptom or circulating immunoglobulin A antibodies to any known antigens

Dermatitis herpetiformis (DH) is common in some Caucasian populations but extremely rare in Japanese, probably because of different immunogenetic backgrounds. We report two Japanese DH cases with typical clinical, histological and direct immunofluorescence features. However, no symptom of gluten‐sensitive enteropathy was shown. The diagnosis was confirmed by eliminating other autoimmune blistering diseases by indirect immunofluorescence, enzyme‐linked immunosorbent assays and immunoblotting. However, circulating immunoglobulin (Ig)A anti‐endomysium, reticulin and gliadin antibodies were not detected. IgA antibodies to tissue and epidermal transglutaminases were also negative. One case was associated with lung cancer and the other one with autoimmune pancreatitis. On review of 17 cases of DH reported in Japan over the previous 10 years, including our cases, one case was associated with gluten‐sensitive enteropathy, four with malignant neoplasms, two with autoimmune systemic disorders and one with psoriasis. Although our cases were typical of DH in clinical, histopathological and IgA deposit features, they showed different human leukocyte antigen haplotypes, no gluten‐sensitive enteropathy and no DH‐specific IgA antibodies, including those to epidermal and tissue transglutaminases. These results suggest that studies of unique characteristics in Japanese DH patients should facilitate further understanding of pathogenesis in DH.