Comparative studies on the actions of antigen and polyclonal B-cell activator in differentiation and proliferation of B-cells and B memory cells.

Using the capsular polysaccharide of Klebsiella pneumoniae (CPS-K) as a polyclonal B-cell activator (PBA) and sheep red blood cells (SRBC) as a T cell-dependent antigen, we compared the ability of PBA and antigen to differentiate (generate antibody-forming cells, AFC) and proliferate (generate immunological memory) virgin B cells and B memory cells. In vitro CPS-K induced the differentiation of IgM virgin B cells, IgM B memory cells and IgG B memory cells to AFC, as well as or better than SRBC. The differentiation of B memory cells to AFC by CPS-K did not require the participation of macrophages or T cells, whereas the action of SRBC depended strictly upon the helper actions of these cells. The responsiveness to CPS-K and SRBC of normal and antigen-primed spleen cells as judged by anti-SRBC PFC responses in vitro was markedly decreased after stimulation of virgin B cells and B memory cells in vivo by CPS-K injection into normal or primed mice but greatly increased after the injection of SRBC. The decrease in the responsiveness to CPS-K of spleen cells from mice treated with CPS-K appeared principally due to exhaustion of the functions of B cells and B memory cells. From the present data it has been concluded that the signals required for the differentiation and proliferation of B cells of B memory cells are different from each other, the signal for differentiation being provided by either antigen (SRBC) or PBA (CPS-K), while the signal for proliferation only by antigen.     

Ovarian cystadenofibroma with solid nodular components masqueraded as ovarian cancer

Introduction  The histological features and image findings on computed tomography (CT) and magnetic resonance imaging (MRI) for ovarian cystadenofibroma mimicking malignant ovarian tumor are reported. Case  A 62-year-old woman was diagnosed as an ovarian cancer on abdominal CT. However, it was diagnosed as a cystadenofibroma on magnetic resonance T2-weighted images that showed the solid components of the tumor with very low intensity. Although ovarian cystadenofibroma is a relatively rare benign tumor, its ultrasonographic feature of cystic lesions with solid components resembles that of malignant ovarian tumor. Conclusion  MRI was considered to be useful modality for ovarian cystadenofibroma to be effectively diagnosed preoperatively.     

Effects of counseling on climacteric symptoms in Japanese postmenopausal women

OBJECTIVES: We objectively assessed the effects of counseling on climacteric symptoms in Japanese postmenopausal women. METHODS: Symptoms in 44 women (age, 51.4 +/- 3.4 years; period after menopause, 3.6 +/- 3.4 years) treated with counseling were evaluated according to the Keio modified menopause index. The response to counseling was compared with that to hormone replacement therapy (HRT). RESULTS: Forty cases (90.9%) showed an improvement in index score. There were no significant relationships between improvement and age, the period after menopause, or the severity or type of symptoms before counseling. The most improved symptom was headache, followed by palpitation and insomnia. Physical symptoms accounted for most of the common symptoms. The pattern of improvement with counseling was markedly different from that with HRT. CONCLUSIONS: We suggest that counseling is effective for treating climacteric symptoms, since it improves not only psychological symptoms, but also physical ones. Counseling may deserve evaluation as a complementary treatment to HRT.     

Molecular biological study on the overexpression of c-myc gene in uterine cervical carcinomas]

The expression of mRNA for c-myc gene was investigated in 30 cases of human uterine cervical carcinoma by Northern blot hybridization, and c-myc gene amplification was also examined by Slot blot hybridization. Overexpression of c-myc gene was detected in one (7.7%) of 13 cases of carcinoma in situ (stage 0), one (10.0%) of 10 stage I and 4 (57.1%) of 7 stage II uterine carcinoma, and c-myc gene amplification was detected in 2 cases (6.7%) in which c-myc gene overexpression was also found. The patient whose c-myc mRNA level was more than 10 times as high as in normal uterine cervical tissue relapsed and died within 2 years after the first treatment. Our results suggest that the overexpression of c-myc gene occurred more frequently in advanced than in early uterine cervical carcinoma and that it might be useful in prognosing cervical cancer.     

Preservation of ovarian function and reproductive ability in patients with malignant ovarian tumors

In a study designed to determine the merit of preserving ovarian function and childbearing capability in women with unilateral malignant ovarian tumors, the results of radical surgery (n = 86) and conservative surgery (n = 106) were compared. The mean length of survival was slightly but not significantly shorter following conservative surgery. There were 15 recurrences (14%) and 11 deaths among the conservative surgery group. The incidence of metastasis to the preserved ovary was high. In the most cases restoration of normal menses was fairly rapid after initial treatment, but this appeared to depend on whether or not chemotherapy was given postoperatively, the specific agents used, and the duration of their administration. Hypergonadotropic hypogonadism was the most common finding among the anovulatory patients. Sixteen women experienced a total of 27 pregnancies and 18 normal infants were born. Abortion was induced when conception occurred during a course of chemotherapy. These findings are encouraging in terms of the feasibility of preserving childbearing capability in ovarian cancer patients. However, they also underscore the necessity for close, long-term follow-up, which will be improved as new technologies become available.     

Bilateral cervicomediastinal neurofibroma originating from the vagal nerve in a patient with von Recklinghausen's disease: report of a case

A 19-year-old woman with von Recklinghausen's disease was admitted with symptoms of hoarseness. A computed tomography scan showed a bilateral cervicomediastinal tumor. An extirpation of the left cervicomediastinal tumor was performed for the purpose of diagnosis and treatment. On thoracotomy, the tumor, which measured 9 × 8 × 4 cm in size, arose from the intrathoracic vagal nerve and the left tumor was resected with a segment of the vagal nerve and recurrent nerve. The pathological diagnosis of the tumor was a neurofibroma. The tumor on the right side was left untreated due to concerns about possibly causing palsy of the bilateral recurrent nerve and also because of the asymptomatic state of the right tumor. Mediastinal neuofibroma in a patient with von Recklinghausen's disease often arises from the intrathoracic vagal nerve. To our knowledge, this is the first report of bilateral cervicomediastinal neurofibroma originating from the vagal nerves. Received: November 15, 2001 / Accepted: May 7, 2002 Reprint requests to: M. Ohta     

Globosal basal cells are identified as proliferating cells in mouse olfactory epithelium

Although anti-bromodeoxyuridine (BrdU) antibodies are used for detecting proliferating cells, they may stain proliferating cells in phases following the S-phase, except for G1. Anti-Ki67 antibodies are widely used for detecting proliferating cells in all phases of the cell cycle (G1-, S-, G2-, and M-phase), but not in resting cells (G0-phase). Anti-cyclin D1 antibodies are used to detect proliferating cells in the G1-phase. The present study investigated the olfactory epithelium of mice by double immunostaining using antibodies to BrdU, Ki67. cyclin D1, and cytokeratin 14 (CK14). The cells positive to the anti-BrdU antibody, the anti-Ki67 antibody, and the anti-cyclin D1 antibody differed from the cells positive to the anti-CK14 antibody. Thus, we confirmed that the proliferating cells in all the phases of the cell cycle, including the G1-phase, were globosal basal cells, which were the precursors of the olfactory cells.     

Lifestyle management approaches in postmenopausal osteoporosis

Of the lifestyle management approaches to postmenopausal osteoporosis recommended, encouraging walking appears to be more relevant than ensuring appropriate nutritional intake in preventing bone loss. The focus of the current lecture is therefore on encouraging exercise, as it is not hard to imagine the physical impact of exercise on bone mineral density. As has long been pointed out, in fact, the initial management of postmenopausal osteoporosis consists in subjecting the bone to a continual physical stress, including exercise. In this regard, aerobic exercise including walking has been widely recommended;however, there is no clear evidence showing aerobic exercise to be superior to other kinds of exercise, while several studies reported on the benefit of combining aerobic exercise with pharmacological treatments in postmenopausal women, including our own series. Physical exercise programs or guidelines aimed at the prophylaxis of postmenopausal osteoporosis that draw on research evidence supporting the benefit of encouraging physical exercise need yet to be put in place as a matter of urgency.     

Prolonged renal parenchymal retention of 99mTc mercaptoacetyltriglycine after nephron-sparing surgery

OBJECTIVE: Nephron-sparing surgery is a treatment in which a part of a diseased kidney is resected and some parenchyma of the kidney is spared. Impairment of spared renal parenchyma after the surgery may cause prolonged prarenchymal retention in renal scintigraphy with Tc mercaptoacetyltriglycine (Tc-MAG3). The aim of this study was to determine whether or not parenchymal retention of Tc-MAG3 is prolonged after nephron-sparing surgery. METHODS: Twenty-two patients underwent a total of 29 Tc-MAG3 studies within 1 year after nephron-sparing surgery. In 17 patients (23 examinations) who had bilateral kidneys, the presence of diffuse prolongation of parenchymal retention was determined for the operated kidney. In all patients, the presence of regional prolongation around the surgical margin was assessed. RESULTS: Diffuse prolongation was observed in four of 10 examinations performed within 1 month after surgery and in none of 13 examinations performed later than 1 month after surgery. Regional prolongation was shown in 10 of 14 examinations performed within 1 month after surgery and in three of 15 examinations performed later than 1 month after surgery. In five patients who were studied both prior to and later than 1 month after surgery, regional prolongation was noted on the first study. On the second study, regional prolongation was improved and initial renal uptake around the surgical margin was intensified. CONCLUSIONS: Renal parenchymal retention of Tc-MAG3 is frequently prolonged in the early period after nephron-sparing surgery. Renal scintigraphy with Tc-MAG3 may aid in characterizing acute renal damage after nephron-sparing surgery.     

Pleural perfusion thermo-chemotherapy under VATS: a new less invasive modality for advanced lung cancer with pleural spread

BACKGROUND: We conducted a trial of a new less invasive, locoregional modality for lung cancer with pleural spread. This study was planned to investigate the feasibility, safety, and pharmacokinetics of pleural perfusion thermochemotherapy (PPTC) under video-assisted thoracoscopic surgery (VATS) and its modified method with a short perfusion time for preventing heat damage to the lung during the procedure. METHODS: Seventeen patients, 59 to 79 years old, underwent surgical resection of the primary lesions and PPTC under VATS without thoracotomy. All had pleural spread with malignant effusion due to lung cancer proven before the treatment. PPTC consists of irrigating the pleural space with 42 degrees C saline solution containing cisplatin (200 mg/m(2)) using a devised circuit. The time for perfusion was two hours in 10 patients (group L), and one hour in 7 patients (group S). RESULTS: All patients successfully completed this treatment with acceptable toxicities. The pharmacokinetic analysis showed that high platinum levels for the regional pleural exposure, which was 20- to 40-fold greater than those for the plasma in both groups. These values were equivalent between the groups, although the levels for the plasma were higher in group L than in group S. Postoperative lung damage was seen in 4 patients with no serious conditions in group L, and none in group S. The median survival for the L and S groups was 17 and 19 months, respectively. CONCLUSIONS: This less invasive modality seems to offer a safe, feasible, and pharmacokinetically advantageous procedure to have excellent local control for lung cancer with pleural spread.