Lack of association between DNA base excision repair gene XRCC1 Gln399Arg polymorphism and risk of malignant lymphoma in Japan

Growing evidence suggests that the polymorphism of DNA base excision repair gene XRCC1 Arg399Gln is associated with altered DNA repair proficiency and subsequent cancer susceptibility; however, no evidence is available for malignant lymphoma. We therefore conducted a case-control study (372 cases, 500 controls) to evaluate links with malignant lymphoma risk in Japan. The risk was evaluated in terms of odds ratio (OR) and 95% confidence interval (CI) adjusted for age and sex in an unconditional logistic regression model. There was no statistical risk change with the Arg/Gln (adjusted OR 0.89; 0.65-1.23, P = 0.492) or the Gln/Gln (0.57; 0.27-1.17, P = 0.127) compared with the Arg/Arg of the XRCC1 Arg399Gln polymorphism. The results were unchanged in analyses according to histological subtype (diffuse large lymphoma, follicular lymphoma, low-grade lymphoma of mucosa-associated lymphoid tissue, and others). These data suggest that XRCC1 Gln399Arg polymorphism plays a limited role in lymphomagenesis. Further study on the interaction between the polymorphism and environmental exposure is required.     

Dosimetric properties of radiophotoluminescent glass rod detector in high-energy photon beams from a linear accelerator and cyber-knife

A fully automatic radiophotoluminescent glass rod dosimeter (GRD) system has recently become commercially available. This article discusses the dosimetric properties of the GRD including uniformity and reproducibility of signal, dose linearity, and energy and directional dependence in high-energy photon beams. In addition, energy response is measured in electron beams. The uniformity and reproducibility of the signal from 50 GRDs using a 60Co beam are both +/- 1.1% (one standard deviation). Good dose linearity of the GRD is maintained for doses ranging from 0.5 to 30 Gy, the lower and upper limits of this study, respectively. The GRD response is found to show little energy dependence in photon energies of a 60Co beam, 4 MV (TPR20(10)=0.617) and 10 MV (TPR(20)10=0.744) x-ray beams. However, the GRD responses for 9 MeV (mean energy, Ez = 3.6 MeV) and 16 MeV (Ez = 10.4 MeV) electron beams are 4%-5% lower than that for a 60Co beam in the beam quality dependence. The measured angular dependence of GRD, ranging from 0 degrees (along the long axis of GRD) to 120 degrees is within 1.5% for a 4 MV x-ray beam. As applications, a linear accelerator-based radiosurgery system and Cyber-Knife output factors are measured by a GRD and compared with those from various detectors including a p-type silicon diode detector, a diamond detector, and an ion chamber. It is found that the GRD is a very useful detector for small field dosimetry, in particular, below 10 mm circular fields.     

Effects of growth hormone treatment on thyroid function in pediatric patients with Prader–Willi syndrome

It is unclear whether hypothyroidism is present in patients with Prader–Willi syndrome (PWS). This study aimed to clarify the state of the hypothalamic–pituitary–thyroid axis and the effects of growth hormone (GH) treatment on thyroid function in pediatric patients with PWS. We retrospectively evaluated thyroid function in 51 patients with PWS before GH treatment using a thyroid‐releasing hormone (TRH) stimulation test (29 males and 22 females; median age, 22 months). We also evaluated the effect of GH therapy on thyroid function by comparing serum free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) levels at baseline, 1 year, and 2 years after GH therapy. TSH, fT4, and fT3 levels were 2.28 μU/ml (interquartile range [IQR]; 1.19–3.61), 1.18 ng/dl (IQR; 1.02–1.24), and 4.02 pg/dl (IQR; 3.54–4.40) at baseline, respectively. In 49 of 51 patients, the TSH response to TRH administration showed a physiologically normal pattern; in two patients (4.0%), the pattern suggested hypothalamic hypothyroidism (delayed and prolonged TSH peak after TRH administration). TSH, fT4, and fT3 levels did not change significantly during 1 or 2 years after GH treatment. The TSH response to TRH showed a normal pattern in most patients, and thyroid function did not change significantly during the 2 years after initiating GH treatment.     

A unique localization of mechanoreceptors in the periodontal tissue of guinea pig teeth

This study describes the unique distribution of Ruffini endings (RE) in the periodontal tissues of the guinea pig teeth with special references to their presence in the enamel-related aspects of the continuously growing incisors and molars. In guinea pig incisors, immunohistochemistry for PGP 9.5 and glia specific S-100 protein revealed a condensed distribution of well-developed RE in the bone-related part of the lingual periodontal ligament as has been reported in many other rodents. In most cases, some RE-like nerve elements characterized by dendritic ramification and rounded terminal Schwann cells were found to be located in the labial, enamel-related regions, where no periodontal ligament-like fiber arrangement was established. In the molar periodontal ligament, well-developed RE-like nerve elements were also distributed in the enamel-related part, but in intimate relation to thick periodontal fiber bundles inserted in the cementum pearls grown on the enamel surface. In some cases, few RE were located in the apical region of the alveolar socket, where no periodontal fiber bundles could be identified. Our data provide the first morphological evidence of the presence of RE-like nerve elements in the enamel-related, fibrous connective tissue of continuously erupting rodent incisors. These data indicate that RE in guinea pig periodontal tissues have variable spatial correlation to the surrounding fibers, implicating their diverse mechanoreceptive properties depending on the anatomical location.     

A possible role of two hydrophobic amino acids in antigen recognition by synovial T cells in rheumatoid arthritis

Synovial T cells play a crucial role in the pathogenesis of rheumatoid arthritis (RA) synovitis. We have quantitatively analyzed the T cell receptor (TcR) variable (V) region gene repertoire of freshly isolated synovial fluid (SF) T cells, comparing it with that of peripheral blood (PB) T cells in RA. The TcR V gene repertoire of PB and SF T cells in RA and osteoarthritis was heterogeneous. In contrast, Vail in SF was expressed to a greater degree in three of five RA patients, and increased levels of Vp6, 1-3 were found in the SF of four of six RA, compared with paired PB. Of note, Vβ6, 1–3 was universally used in four RA patients with a disease duration of less than 10 years, irrespective of their HLA-DR types. This was in contrast to two other RA patients, suffering for more than 20 years, who showed different Vα and Vβ usages. β-chain sequence analysis in RA patients with a preference for Vβ6, 1–3 has shown that a few clones dominated in SF, whereas polyclonality was observed in PB. These findings suggest oligoclonal expansion of T cells in response to specific antigen(s) in the SF of these patients with RA of relatively short duration. Concomitant use of two hydrophobic amino acids, leucine and valine, in the Dβ region was noticeable among the predominant SF clones. These two amino acids might directly contact a peptide specific for the induction of synovitis in RA patients. TcR-directed therapy may, therefore, be useful for the treatment of early RA synovitis.     

MARKED EPITHELIAL HYPERPLASIA OF THE RAT GLANDULAR STOMACH INDUCED BY LONG-TERM ADMINISTRATION OF IODOACETAMIDE

Iodoacetamide (IAA), an ulcerogenic compound, was continuously given to male Wistar rats for up to 74 weeks. No carcinomas developed but marked glandular hyperplasias were frequently observed accompanied by chronic ulcer or erosion in the fundic region. They showed pseudo-invasive growth into the submucosa, the granulomatous tissue and even into the muscle layer, but no cellular and nuclear atypia was observed in their glands. Characteristically the mucosal damage caused by chronic IAA treatment was restricted to the fundic mucosa along the limiting ridge. Abnormally regenerated mucosa in the damaged area showed pyloric gland type metaplasia, demonstrated histo-chemically by paradoxical concanavalin A-staining and high-iron diamine-Alcian blue staining for mucin. No intestinal metaplasia was observed in these mucosa.     

Importance of luxury flow for critically ill patients receiving a left ventricular assist system

The presence of a significant organ dysfunction does not immediately exclude patients from consideration for treatment with a left ventricular assist system (LVAS). However, in treating morbid circulatory shock patients with multiple organ failure, it is important to know the preoperative and postoperative factor or factors related to the recovery of the damaged organ function. In this study, we retrospectively analyzed patients receiving a LVAS at our institution and tried to determine the important factors related to the survival of patients with multisystem failure. Twenty-seven patients who underwent LVAS placement at Saitama Medical School Hospital between 1993 and 2003 were included in this study. The preoperative risk factors analyzed were renal dysfunction, respiratory dysfunction, hepatic dysfunction, the existence of active infection, and the combination of all four factors. As a postoperative factor, the pump flow index (mean LVAS pump flow during the first 2 weeks after LVAS surgery divided by the body surface area) was analyzed. None of the analyzed preoperative factors could predict survival after LVAS surgery, but a pump flow index of less than 2.5 l/min/m² had a significant relationship with death after LVAS surgery. Further analysis revealed that all the patients with a pump flow index of 3.0 l/min/m² or more could overcome preoperative organ dysfunction. Congestive heart failure patients with multisystem failure need luxury pump flow for successful LVAS surgery; this factor could be especially important in device selection and postoperative management.     

Role of Ca channel in the renal autoregulatory vascular response analysed by the use of BAY K 8644

Summary The role of Ca channel and extracellular Ca²⁺ on autoregulation of renal blood flow was investigated in the perfused kidney of the anesthetized dog. The perfusion pressure was changed in the range between 60 and 200 mm Hg. Intra-arterial infusion of nifedipine (5 g/min) increased renal blood flow at a perfusion pressure above 100 mm Hg and inhibited autoregulation. Simultaneous infusion of 5 g/min of BAY K 8644 antagonized the effect of nifedipine. Renal blood flow was increased and autoregulatory relationship between flow and perfusion pressure was inhibited by EDTA (30 mg/min) infusion. The inhibitory effect of EDTA on renal autoregulation was counteracted by simultaneous infusion of CaCl₂ at 30 mg/min, but not counteracted by that of BAY K 8644 (5 g/min). BAY K 8644 also could not antagonize the inhibitory effect of a vasodilator, papaverine (5 mg/min) on renal blood flow autoregulation. These results provide the evidence that the renal autoregulation involves the process of Ca²⁺ influx into the vascular smooth muscle cell through the Ca channels. Send offprint requests to N. Ogawa at the above address     

Different effects of noradrenaline,angiotensin II and BAY K 8644 on the abolition of autoregulation of renal blood flow by verapamil

Summary To examine the role of Ca channels in autoregulation of renal blood flow in response to changes of perfusion pressure, experiments were performed with perfused kidney in anesthetized dogs using a Ca channel activator, BAY K 8644, and vasoconstrictors such as noradrenaline and angiotensin II. Control observations usually showed excellent autoregulation of renal blood flow at pressures between 120 and 200 mm Hg, the autoregulatory index being less than 0.2. Verapamil (50 g/min, i.a. infusion) obviously inhibited the renal autoregulation. Simultaneous infusion of 5 g/min of BAY K 8644 with verapamil prevented both the increase of renal blood flow and the impairment of the autoregulation caused by verapamil. Whereas simultaneous infusion of noradrenaline (1 and 3 g/min) or angiotensin 11 (0.1 and 0.3 g/min) with verapamil dose-dependently reduced renal blood flow, these drugs could not antagonize the inhibitory effect of verapamil on autoregulation. The present experiments show that Ca channels play an important role in establishing renal autoregulation, and that a mere vasoconstriction by noradrenaline and angiotensin II is distinguished from autoregulatory performance.     

Can random bladder biopsies be eliminated after bacillus Calmette–Guérin therapy against carcinoma in situ?

Purpose

Intravesical bacillus Calmette–Guérin (BCG) is the standard of care for bladder carcinoma in situ (CIS). The response to BCG therapy against CIS is generally assessed by random bladder biopsy (RBB). In this study, we examined the necessity of routine RBB after BCG therapy.

Methods

We retrospectively identified 102 patients who were initially diagnosed with CIS with or without papillary tumor and received subsequent 6–8-week BCG therapy. Thereafter, all patients underwent voiding cytology analysis, cystoscopy, and RBB to evaluate the effects of BCG therapy. We evaluated the association between clinical parameters (voiding cytology and cystoscopy findings) and the final pathological results by RBB specimens.

Results

According to the pathological results of RBB, 30 (29%) patients had BCG-unresponsive disease (remaining urothelial carcinoma was confirmed pathologically) and 20 were diagnosed with CIS. Positive/suspicious voiding cytology and positive cystoscopy findings were well observed in patients who had BCG-unresponsive disease compared with their counterparts (p?=?0.116, and p?<?0.001, respectively). The sensitivity (Sen.), specificity (Spe.), positive predictive value (PPV), and negative predictive value (NPV) of voiding cytology were 50%, 68%, 39%, and 77%, respectively. The values for cystoscopy findings were as follows: Sen.: 87%, Spe.: 57%, PPV: 46%, and NPV: 91%. The values for their combination (having either of them) were as follows: Sen.: 100%, Spe.: 44%, PPV: 43%, and NPV: 100%.

Conclusion

RBB after BCG therapy for patients with negative voiding cytology and negative cystoscopy may be omitted because their risk of BCG-unresponsive disease is significantly low (NPV: 100%).