A case of advanced esophageal cancer with suspected tracheoesophageal fistula that responded to chemoradiotherapy

Chemoradiotherapy combined cisplatin, 5-FU and radiation was carried out in an advanced esophageal cancer with suspected tracheoesophageal fistula after insertion of an expandable metallic stent. Regression of the primary tumor was observed, and oral intake could be started. Chemoradiotherapy after insertion of the expandable metallic stent was useful in this case of advanced esophageal cancer with suspected tracheoesophageal fistula.     

Synthetic peptide (P-21) derived from Asp-hemolysin inhibits the induction of apoptosis on HUVECs by lysophosphatidylcholine

Lysophosphatidylcholine (LPC), formed during low-density lipoprotein (LDL) oxidation and located within atherosclerotic plaques, regulates a variety of cellular functions, some of which could be construed to promote atherosclerotic lesion development, including vascular muscle cell proliferation, monocyte attraction, and endothelial cell apoptosis. We have previously reported that the synthetic peptide derived from Asp-hemolysin, named P-21, inhibits oxidized LDL (OxLDL)-induced macrophage proliferation through binding of P-21 to OxLDL. In this study, to clarify the interaction between P-21 and LPC as a typical lipid moiety of OxLDL, we examined the influence of P-21 on LPC-induced apoptosis in human umbilical vein endothelial cells (HUVECs). Based on flow cytometric analysis, using annexin V-fluorescein isothiocyanate and propidium iodide as probes to assess apoptosis, LPC induced the apoptosis of HUVECs, and P-21 significantly inhibited this activity by 82.4%. Furthermore, dissociation-enhanced lanthanide fluorometric immunoassay indicated that LPC inhibited the binding of P-21 to OxLDL in a dose-dependent manner. A 50% inhibition dose was estimated to be 4.65 microM of LPC. These results suggest that P-21 inhibits LPC-induced HUVEC apoptosis through binding of P-21 to LPC.     

Oxidized low-density lipoprotein-binding specificity of the Asp-hemolysin-related synthetic peptides from Aspergillus fumigatus

Oxidatively modified low-density lipoprotein (OxLDL) is present in atherosclerotic lesions and has been proposed to play an important role in atherogenesis. In the present study, in order to clarify the structure-binding activity relationship of Asp-hemolysin-related peptides to OxLDL, we investigated the interaction between Asp-hemolysin-related peptides consisting of 4 to 29 amino acid residues and OxLDL. The incubation of OxLDL with each Asp-hemolysin-related peptide resulted in the formation of an Asp-hemolysin/OxLDL complex. In particular, the tetrapeptide, YKDG (P-4), bound to OxLDL and inhibited the OxLDL-induced macrophage proliferation in a dose-dependent manner. Furthermore, we demonstrated that lysophosphatidylcholine (LysoPC) extracted from OxLDL inhibited the binding of P-21 to OxLDL in a dose-dependent manner and synthetic [14C]LysoPC bound to P-21. We propose here that the YKDG region is one of the important sites for the binding of these peptides to OxLDL, and LysoPC as a typical lipid moiety of OxLDL is attributed to the binding of OxLDL to these peptides.     

Adrenal tumors associated with renal cell carcinoma

We experienced two cases with renal cell carcinoma who showed enlargement of the contralateral adrenal gland. In case 1, the enlarged adrenal gland was a non-functioning adrenal adenoma, and in case 2, it was a metastatic adrenal tumor. Non-functioning adrenal adenomas are benign tumors of the adrenal cortex often found incidentally at autopsy or on computed tomography (CT) studies of the upper abdomen. Adrenal adenomas have been reported to occur in 9.5-14% of patients with renal cell carcinoma, while the incidence being 1.5-8.7% in the general population. Since metastases of renal cell carcinoma to the adrenal glands are not uncommon, it is important to distinguish between non-functioning adrenal adenomas and metastatic tumors. Therefore, we studied the incidence of adrenal tumors (including metastatic tumors and benign tumors) in patients with renal cell carcinoma who underwent the abdominal CT study in our hospital. From 1982 to 1989, CT had been performed in 67 patients with renal cell carcinoma. Six adrenal masses were identified with CT in these patients. Three out of the 6 patients probably had metastatic tumors and one of the 3 adrenal masses was pathologically diagnosed as metastatic tumor. The other three masses were benign on pathology and only one of them was pathologically diagnosed as non-functioning adrenal adenoma. The incidence of adrenal adenomas on the CT study was lower than that of previous studies based on autopsy. The reasons of this difference in results between their studies and ours are not clear.(ABSTRACT TRUNCATED AT 250 WORDS)     

Inhibition of surface immunoglobulin centeral capping of Daudi cells and cell spreading of HeLa-S3 cells by neocarzinostatin.

The effects of an antitumor antibiotic, neocarzinostatin (NCS), on the surface immunoglobulin central capping induced by anti-immunoglobulin M antibody on Daudi cells and on the cell spreading of trypsinized HeLa-S3 cells were examined. Pretreatment of Daudi cells and HeLa-S3 cells with NCS, 5 to 30 micrograms/ml, for 4 hr inhibited cap formation and cell spreading, respectively. It was shown that there is a direct relationship between the dose and the degree of inhibition. Inhibitors of DNA synthesis such as bleomycin, mitomycin C, and 1-beta-D-arabinofuranosylcytosine showed no inhibitory effect on cap formation or cell spreading. However, known microtubule-acting agents such as colchicine and vinblastine sulfate completely inhibited both capping and cell spreading at a dose of 10 micrograms/ml. In view of the fact that 10 micorograms NCS per ml also inhibit the formation of microtubular paracrystals induced by vinblastine sulfate in HeLa-S3 cells and that other agents known to influence microtubule function such as local anesthetics and calcium ionophores also inhibit both paracrystal formation and cap formation, these new observations add further support to our hypothesis that NCS affects microtubular proteins transmembranously in vivo.     

Surgical treatment of the internal carotid-posterior communicating artery aneurysm--from the experience of 213 cases (author's transl)]

213 cases of so-called posterior communicating artery aneurysm submitted to surgical operation without using microscope were reviewed from the technical point of view. Aneurysm project boradly to two directions, i.e. postero-inferior and lateral directions. We have treated these anuerysms with two very distinct operative approaches in order to reach the aneurysmal neck from the right angle. Frontal approach is used for the aneurysms projecting laterally. In contrast, the aneurysms projecting postero-inferior are reached laterally by mobilizing the tip of the temporal lobe. Of 213 patients, 15 died (mortality rate 7.0%) and 19 were poor (8.9%). The operative result of the cases in which the aneurysm ruptured during the exposure of the aneurysmal neck was poor. Therefore, intensive care is emphasized to avoid the aneurysm rupture during surgery. Other important technical points which affect the operative results were discussed.     

Acute-onset sarcoidosis with erythema nodosum and polyarthralgia (Löfgren's syndrome) in Japan: a case report and a review of the literature

L?fgren's syndrome is an acute form of sarcoidosis that is characterized by erythema nodosum (EN), bilateral hilar lymphadenopathy (BHL), and polyarthralgia or polyarthritis. This syndrome is common among white people, but is considered rare among Japanese people. We present the case of a 26-year-old Japanese woman with L?fgren's syndrome. The patient complained of polyarthritis and EN of the lower extremities that lasted for 3 months. A chest radiograph revealed BHL and nodular shadows. The angiotensin-converting enzyme (ACE) level was within the normal range. Transbronchial lung biopsy revealed a noncaseating granuloma with giant cells. Six Japanese cases of L?fgren's syndrome have been reported previously. Five of the seven Japanese patients with L?fgren's syndrome had normal ACE levels; all of them exhibited BHL. L?fgren's syndrome should be considered as a possibility when examining a patient with EN and articular symptoms, even if the patient is Japanese.     

Global gene profiling and comprehensive bioinformatics analysis of a 46,XY female with pericentric inversion of the Y chromosome

XY females are rare individuals who carry a Y chromosome but are phenotypically female. In approximately 80–90% of these cases, there are no mutations in the SRY gene, a testis-determining gene on the short arm of the Y chromosome, and the pathophysiology of XY females without SRY mutation remains unclear. In the present study, we used a molecular data mining technique to analyze the pathophysiology of an XY female with functional SRY and pericentric inversion of the Y chromosome, and compared the results with those of a normal male. Interestingly, upregulations of numerous genes included in the development category of the Biological Process ontology, including genes associated with sex determination and organ morphogenesis, were seen in the patient. Additionally, the transforming growth factor-β (TGF-β) signaling pathway and Wnt signaling pathway, in which most cell–cell interactions during embryonic development are involved, were altered. Alterations in the expression of numerous genes at the developmental stage, including alterations at both the gene and pathway levels, may persist as a vestige of anomalies of sex differentiation that presumably began in the fetal period. The present study indicates that a data mining technique using bioinformatics contributes to identification of not only genes responsible for birth defects, but also disorders of sex development (DSD)-specific pathways, and that this kind of analysis is an important tool for clarifying the pathophysiology of human idiopathic XY gonadal dysgenesis. Our findings could serve as one of the basic datasets which will be used for future follow-up investigations.