A review and development of sentinel node navigation surgery for lung cancer

Sentinel node navigation surgery (SNNS) for lung caner has not yet been established. Sentinel node (SN) identification using dye or radioisotope has been developed; however, the SN identification rate was less than 50% in the dye method and use of radioisotopes is strongly restricted in Japan. The novel method using a CT or MRI contrast medium are expected. A study of local immune reaction for lung cancer in SN is also a very interesting issue.     

A trial of the new procedure of sentinel node biopsy in the lower rectal cancer by a transsacral approach

We describe a new method of sentinel node (SN) biopsy in the lower rectal cancer by a transsacral approach. Before the operation, an endoscopic clipping was performed around the tumor. The patient was placed in a jack knife position. A transverse incision was made over the S4-S5 joint. Subsequently, the S4-S5 joint was dissected, and the lower rectum was exposed without destroying the perirectal fatty tissue. CH-40 dye was injected into the submucosal layer of the rectal cancer. The lymph nodes that were blackened within 15 minutes were recognized to be SNs. Few investigations were reported with regard to sentinel node navigation surgery (SNNS) for lower rectal cancer, because the anatomical properties of the lower rectum make it difficult to inject the dye and recognize rectal tumors or lymph nodes. In our method, the lower rectum was exposed without destroying the perirectal fatty tissue, the dye was easily injected, and the SNs were easily found and extirpated. Our method of transsacral approach is considered to be useful.     

Antisense therapy specific to mutated K-ras gene in hamster pancreatic cancer model. Can it inhibit the growth of 5-FU and MMC-resistant metastatic and remetastatic cell lines?

K-ras point mutation at codon 12 has a relationship greater than 90% with pancreatic cancer. Cancer therapy should also include the treatment of metastatic disease because it is known that the properties of metastatic cells may vary considerably from those of the primary tumor. AIM: To clarify if the same drugs, which can inhibit the tumor growth in the parental cell line, can inhibit the pancreatic metastatic and remetastatic cell lines at the same concentrations and to compare the inhibition with antisense oligonucleotides mismatched to K-ras gene, in Syrian golden hamsters. MATERIALS AND METHODS: HaP-T1, a BHP-induced hamster pancreatic cancer cell line, MS-PaS-1 (a metastatic cell line established from "return trip" metastases from the liver to the pancreas) and MS-PaS-2 named as a "remetastatic cell line", i.e., metastases from MS-PaS-1 were used. MTT and MTT-agarose assays were performed, using 5-Fluorouracil (5-FU), Mitomycin C (MMC) and antisense oligonucleotide specific to K-ras oncogene. RESULTS: The inhibitory concentration (IC50) of 5-FU, which inhibited HaP-T1, had to be increased by 50-fold to inhibit MS-PaS-1 and 100-fold to inhibit MS-PaS-2. MMC had to be increased by 10-fold to inhibit MS-PaS-1 and 50-fold to inhibit MS-PaS-2. However, IC50 was the same when antisense oligonucleotide was tried in these 3 cell lines. CONCLUSION: Antisense oligonucleotide-targeted K-ras gene may be a good choice for therapy because it could inhibit the growth in metastatic and remetastatic cells as well as in primary tumor cells.     

Water solubility and partitioning behavior of brominated phenols

The water solubility (Sw) in the temperature range from 283 to 308 K and 1-octanol/water partition coefficient (Kow) for the nonionic form of brominated phenols (BPhs) of varying bromine content (4-bromophenol, 2,4-dibromophenol, 2,4,6-tribromophenol, and pentabromophenol) were measured by the generator-column or shake-flask method and by the high-performance liquid chromatography method, respectively. The temperature dependence of Sw, namely enthalpy of solution (deltaHsolution), was calculated using the van't Hoff Equation. To determine the activity coefficients in water (gammaw) of BPhs from the Sw data, enthalpy of fusion (deltaHfusion) and melting point (Tm) were measured by a differential scanning calorimetry method. The gammaw was used for evaluating data consistency as well as for predicting other physico-chemical properties, such as the Henry's law constant (Hw). The present work systematically reports, to our knowledge for the first time, the experimental values of Sw, Kow, deltaHsolution, deltaHfusion, Tm, and gammaw for BPhs with one to five bromines, and it discusses the effects of bromine content on these physico-chemical properties. Finally, the overall physico-chemical characteristics of BPhs are compared with those of polychlorinated phenols, polycyclic aromatic hydrocarbons, and brominated benzenes with the same solubility level as BPhs.     

A case of 9p-deletion syndrome with congenital median nasal fistula

We report a case of 9p-syndrome with congenital median nasal fistula in a boy born to a 28-year-old mother as the second child by normal delivery. The fistula opened at the base of the bridge of the nose and ran between the nasal septum cartilage to the anterior cranial fossa. A frontal craniotomy and transcolumellar skin incision were conducted to extirpate the fistula. In the 10 months since, no fistula has recurred.     

Expression of BLM (the causative gene for Bloom syndrome) and screening of Bloom syndrome

Bloom syndrome (BS) is a rare autosomal recessive genetic disorder characterized by growth deficiency, unusual facies, sun-sensitive telangiectatic erythema, immunodeficiency and predisposition to cancer. The causative gene for BS is the BLM gene which encodes the BLM RecQ helicase protein. The BLM gene has 4437 bp and encodes 1417 amino acids. The detection of BLM gene mutations for laboratory diagnosis of BS is laborious and impractical, unless there are common mutations in a population. Here we describe the immunoblot and immunohistochemical analyses for the detection of the BLM protein using a polyclonal BLM antibody. The BLM gene and protein were consistently and clearly detected in Epstein-Barr virus (EBV)-transformed or phytohemagglutinin (PHA)-stimulated lymphoblasts from control and various human hematopoietic cell lines. In a 7-week old human fetal brain, the BLM gene expression was strongly detected in contrast to an adult human brain. The BLM protein was not detected in EBV-transformed lymphoblasts from three BS patients. By immunohistochemistry, nuclear dots of the BLM protein were detected in both EBV-transformed lymphoblasts and PHA-stimulated lymphoblasts from the control. However, in lymphoblasts from BS patients no nuclear dots of the BLM protein were detected. These results indicate that the combinational analysis of immunoblotting and immunohistochemistry is a useful approach to screening of BS, although a mutation analysis is necessary for a definitive diagnosis of BS.     

Marked decrease of intracranial atherosclerosis in contrast with unchanged coronary artery stenosis in Japan

We conducted comparative studies on intracranial atherosclerosis and coronary artery stenosis over the past 28 years. Two-year consecutive autopsy case studies from an urban geriatric hospital between 1974-1975 (Group I. 484 cases). 1986-1987 (Group II, 504 cases) and 2000-2001 (Group III, 273 cases) were employed. Atherosclerotic changes of the bilateral middle cerebral arteries and basilar artery were semiquantitatively evaluated as none (0), mild (1), moderate (2) and severe (3) and values of the 3 arteries were totalled to give a value of 0-9 which was taken as the intracranial atherosclerotic index (ICAI). The coronary stenotic index was calculated as previously reported (Sugiura et al 1969). ICAI and CSI were directly compared with each other, together with risk factors for each, including mean blood pressure (BP), serum level of total cholesterol (Tch) and the history of diabetes mellitus (DM+). Chronologically ICAI decreased dramatically but CSI did not change at all. There was continuous lowering of BP, elevation of Tch and increased incidence of DM+. There was a significant positive correlation in BP in relation to both ICAI and CSI (p < 0.01). DM+ vs. CSI (p < 0.01) and ICAI (p < 0.05), and Tch vs. CSI (p < 0.01) but not ICAI. Regression analysis highlighted age and BP as major risk factors for ICAI. Our study provides the first morphological confirmation of marked decrease of the intracranial atherosclerosis in the recent 28 years, in contrast with unchanged coronary stenosis in Japanese elderly subjects.     

Analysis of T-cell repertoire and mixed chimaerism in a patient with aplastic anaemia after allogeneic bone marrow transplantation

We analysed 26 T-cell receptor (TCR) beta chain subfamilies (VB) of a patient with aplastic anaemia (AA) who underwent allogeneic bone marrow transplantation (allo-BMT). The patient developed pancytopenia at d 80. The patient's T cells were skewed in 10 of 26 TCR-VB on d 83. These TCR-VB, especially VB15, which were almost entirely CD8-positive cells, were skewed throughout her clinical course. Chimaerism analysis of the CD8-positive cells indicated that they were of recipient origin. Therefore, some immune responses induced by the recipient CD8-positive T cells had an important role in pancytopenia in AA patients after allo-BMT.     

The occurrence of unusual smooth muscle bundles expressing alpha-smooth muscle actin in human intestinal atresia

Background/Purpose: Intestinal dysmotility is an important problem in the postoperative management of patients with intestinal atresia (IA). Changes in the intramural components have so far been histochemically and immunohistochemically examined in both the proximal and distal segments of IA, but no detailed analysis of the muscular elements has been performed. The aim of this study was to carefully examine any alterations in the muscular elements in the intestines from patients with IA. Methods: Resected intestines were obtained from 6 patients with ileal atresia, 4 patients with jejunal atresia, and 3 controls without gastrointestinal diseases obtained by autopsy (congenital diaphragmatic hernia). All specimens were immunochemically stained with a monoclonal antibody to [alpha ]-smooth muscle actin ([alpha ]-SMA) as a smooth muscle marker. Results: In the normal small intestine, almost all the enteric smooth musculature were positive for [alpha ]-SMA antiserum, except for the bulk of the circular musculature. In the proximal segments of all cases with IA, a reduced staining intensity for [alpha ]-SMA was observed mainly in the severely hypertrophic muscle layers. In addition, some bundles of smooth muscle also were located in the submucosal connective tissue near the border of the innermost layer of the circular musculature, in which large amounts of smooth muscle fibers extended occasionally from the innermost layer of the circular musculature to the muscularis mucosae in the proximal segments of 4 cases. In the distal segments of IA, the distribution of [alpha ]-SMA[ndash ]positive smooth muscle fibers was similar to that in the control intestines, excluding mild to moderate hypertrophy of the muscular layers. Conclusions: Both severe hypertrophy and a reduced immunoreactivity for [alpha ]-SMA were observed in the circular muscle layer of the proximal segments. In addition, the occurrence of [alpha ]-SMA[ndash ]positive abnormal smooth muscle fibers was recognized in the submucosal layers of the proximal segments, thus, suggesting a delay in the intestinal muscular formation or a regressive reaction secondary to dilatation. These muscular alterations in the proximal segments might be considered to contribute to the postoperative intestinal dysmotility in IA cases. J Pediatr Surg 38:161-166.     

Duodenal atresia with a deletion of midgut associated with left lung, kidney, and upper limb absences and right upper limb malformation

Duodenal atresia with midgut deletion without abdominal wall defects is extremely rare. The authors report a newborn boy with this disease associated with left pulmonary, kidney, and upper limb absences and a contralateral upper limb malformation. At autopsy, agenesis of the arteries to such organs was confirmed. A fetal vascular disruption is presumed to be the main cause of these anomalies.