Six Cases of So-Called Carcinosarcoma of the Esophagus -- Histological and Ultrastructural Study on its Histogenesis --

Histopathological aspects of six cases of so-called carcinosarcomaof the esophagus are reported. Four of the patients had polypoidtumors and the other two had ulcerated lesions. Histologically,every tumor in the six cases was composed of both carcinomatousand "sarcoma-like" elements. The carcinomatous element was squamouscell carcinoma in five cases and anaplastic carcinoma in thesixth. The "sarcoma-like" element was "sarcomatous" proliferationof spindle cells. Histologically transitional features betweencarcinomatous and "sarcoma-like" components were observed inevery tumor. Electron microscopic study of semi-serial sectionsadjacent to toluidine blue-stained histological sections revealedthat the spindle-shaped cells in the "sarcoma-like" tissue wereof squamous epithelial cell origin. Therefore, these findingsled to a conclusion that so-called carcinosarcoma of the esophagusof the six cases was carcinoma associated with "sarcomatous"proliferation of carcinoma cells.     

Heterogeneity in F-actin polymerization of cord blood polymorphonuclear leukocytes stimulated by N-formyl- methionyl-leucyl-phenylalanine

BACKGROUND: To elucidate the mechanism responsible for defects of polymorphonuclear leukocyte (PMNL) chemotaxis of neonates, we determined actin polymerization of NBD (7-nitrobenz-2-oxa-diazol)-phallacidin-stained PMNL following stimulation with either N-formyl-methionyl-leucyl-phenylalanine (fMLP) or phorbol myristate acetate (PMA) in cord blood and adult controls. METHODS: We measured F-actin content in PMNL stained with NBD-phallacidin using flow cytometry. RESULTS: Relative F-actin polymerization, that is, a ratio of stimulated F-actin to basal F-actin, was significantly decreased in cord blood PMNL when compared with that of adult PMNL. Distribution of fMLP-stimulated F-actin showed a bimodal pattern, while adult PMNL disclosed a single pattern. Following stimulation with PMA, however, F-actin levels were equal in both cord and adult PMNL. A fluorescein isothiocyanate-conjugated fMLP receptor assay showed no significant difference in binding capacity of fMLP receptors between adult and cord PMNL. CONCLUSION: These results indicate that a deficiency of PMNL chemotaxis in neonates may be due, in part, to decreased relative F-actin polymerization, which may be caused by functional heterogeneity in cord blood PMNL.     

INVOLVEMENT OF GENETIC POLYMORPHISM OF ALCOHOL AND ALDEHYDE DEHYDROGENASES IN INDIVIDUAL VARIATION OF ALCOHOL METABOLISM

The involvement of genetic polymorphism at the alcohol dehydrogenase2 (ADH2) and aldehyde dehydrogenase 2 (ALDH2) loci in determiningblood acetaldehyde levels and the rate of ethanol eliminationafter ethanol intake was investigated. Sixty-eight healthy subjectsingested 0.4 g of ethanol per kg of body weight over 10 min.Blood acetaldehyde levels scarcely increased in the subjectshomozygous for ALDH2^*I, regardless of their ADH2 genotypes (ADH2^*1/^*1,ADH2^*1/^*2 and ADH2^*2/^*2). The acetaldehyde levels in the subjectswith the ALDH2^*1/^*2 heterozygote increased to 23.4 µMon average, and no significant differences were observed betweenthe three ADH2 genotype groups. Subjects homozygous for ALDH2^*2showed very high levels of blood acetaldehyde, and the averagevalue was 79.3 µM. The values of Widmark's ß₆₀(mg/ml/hr)and ethanol elimination rate (mg/kg/br) showed significant differencesamong the three ALDH2 genotypes, and in decreasing order thevalues were ALDH2^*1/^*1, ALDH2^*1/^*2, ALDH2^*2 However, no significantdifferences were seen among the ADH2 genotypes.     

Clinical Significance of Biological Markers at Primary Operation for Metastatic Breast Cancer

Purpose： To identify the prognostic value of biological markers at initial operation for metastatic breast cancer, we measured the presence of estrogen receptor-alpha （ERα）, progesterone receptor （PgR） and human epidermal growth factor receptor type 2 （HER2）, and histological grade （PIG） of tumors. Methods： One-hundred and seventy-six patients, aged 29 to 90 （median： 51 years）, with recurrent breast cancer underwent primary operation at our department during the period from 1983 to 2000. Clinicopathological factors examined at primary operation included menopausal symptoms, presence of axillary lymph node metastasis, tumor size, HG, HER2, ERα and PgR. Factors examined at recurrence included site of primary recurrence, disease-free interval（DFI） and tumor markers, such as CEA and CA15-3. The relationship between these factors and prognosis following recurrence was assessed. Results： Menopausal status, axillary lymph node metastasis and tumor size at primary operation had no significant effect on prognosis. Patients with low HG, positive expession of ERα and PgR, and low HER2 expression had a good prognosis, similar to those with long DFI and distant metastases. After distant metastases, HER2 was found to be the most important prognostic factor following recurrence and in predicting response to drug therapy. Conclusion： Biological factors indicating tumor malignancy at the time of the first operation are also important prognostic factors following tumor recurrence.     

Stool decay-accelerating factor as a marker for monitoring the disease activity during leukocyte apheresis therapy in patients with refractory ulcerative colitis

Background and Aims:  We have shown previously that concentrations of stool decay-accelerating factor (DAF; CD55), a complement regulatory protein, in patients with ulcerative colitis (UC) are increased in relation to the severity of the colonic mucosal inflammation. In the present study, we evaluated the usefulness of stool DAF as a marker for monitoring disease activity in patients with steroid-resistant active UC being treated with leukocyte apheresis performed with a centrifugal cell separator.
Methods:  Twenty-one patients with active and steroid-resistant UC were treated with leukocyte apheresis once a week for 4 weeks, and stool DAF concentrations were determined weekly by immunoassay.
Results:  After treatment, 11 (52%) of the 21 UC patients went into remission. Stool DAF concentrations decreased promptly and steadily in the responsive group. The difference reached statistical significance as soon as after the second apheresis session ( P <  0.003), compared with values before the therapy and corresponding values in the non-responsive group ( P =  0.024). The reduction in stool DAF concentrations after the second apheresis session was significantly greater in the responsive group (median 90%, range 22–90%) than in the non-responsive group (median −13%, range −307–94%) ( P =  0.008). Hematological tests, that is, white blood cell (WBC) count and C-reactive protein, declined significantly during the apheresis therapy, but not in relation to therapeutic response.
Conclusion:  Stool DAF concentration is a useful marker in the clinical response of UC patients to treatment with leukocyte apheresis.     

口腔鳞癌细胞分泌的胞外体对其生物学行为的影响

目的:研究口腔鳞状细胞癌细胞细胞株(OSC-4)分泌的胞外体对细胞生物学行为的影响。方法:培养 OSC-4,从其上清培养液中分离提纯胞外体(exosome, EXO),CD9标记,将提取的胞外体作用于OSC-4,MTT检测胞外体对 OSC-4增殖能力的影响,细胞划痕实验检测胞外体对OSC-4迁移能力的影响,transwill小室侵袭实验检测胞外体对OSC-4侵袭能力的影响。结果:细胞上清液提取物免疫金标结果可见金标记的CD9,即分离提纯物为胞外体;MTT检测结果显示胞外体作用后的OSC-4的增殖能力增强(P＜0.05),细胞划痕实验结果显示其迁移能力增强和transwill小室侵袭实验结果显示其侵袭能力也增强(P＜0.05)。结论:OSC-4分泌的胞外体可以促进口腔鳞状细胞癌细胞的增殖、迁移、浸润能力。     

Sarcoidosis during infliximab therapy for Crohn’s disease

Tumor necrosis factor‐α (TNF‐α) antagonists are effective for inflammatory diseases, such as Crohn’s disease, rheumatoid arthritis (RA) and psoriasis. Although TNF‐α antagonists are also useful for sarcoidosis, paradoxical occurrence of sarcoidosis or sarcoidal reaction may be observed. We report a Crohn’s disease patient, who developed sarcoidosis during infliximab therapy. A 35‐year‐old man had been receiving infliximab for 7 months for Crohn’s disease. He developed cough and fever, accompanied by an infiltrated erythematous plaque on his right knee. The chest radiography, skin biopsy and laboratory findings were all consistent with sarcoidosis.     

Relationship between the distribution of pseudoxanthoma elasticum skin and mucous membrane lesions and cardiovascular involvement

Pseudoxanthoma elasticum (PXE) primarily affects organs that are abundant in elastic fibers, such as the skin, eye and blood vessels, and may eventually cause loss of vision or cardiovascular disease (CVD). Because CVD is a potentially life-threatening complication, its early detection is important for improving the quality of life of PXE patients. To determine the relationship between the distribution of skin and mucous membrane lesions and the prevalence of CVD in patients with PXE, we examined 14 PXE cases who presented between 2004 and 2007. All patients had angioid streaks (AS) and positive pathological findings. The skin lesions in PXE patients are distributed discontinuously and thus the degrees of skin involvement were assessed by determining the presence or absence of PXE skin and mucous membrane lesions in six sites (oral mucosa, neck, periumbilical region, cubital fossa, axillae and inguinal regions). Each site was given a binary score (i.e. present = 1, absent = 0) irrespective of severity and the scores were summed to yield a total distribution score (potential range of 0–6). Four cases had PXE-associated CVD. Their mean distribution score was 5.7, which was significantly higher than the score of the cases without CVD (1.8) ( P  =   0.0049). There was also significant correlation between the high distribution score ( P  =   0.0053) as well as CVD ( P  =   0.029) with the maximum width of AS. A higher distribution score and the presence of oral mucosal lesions were associated with CVD. This scoring method may be useful for predicting the presence of CVD in PXE patients.