Structure, expression and mutational analysis of the hBRAG gene on 10q in the frequently deleted region in human endometrial cancer

We previously reported that chromosome arm 10q is one of the target regions of allelic loss in human endometrial cancer. To identify the gene in this region responsible for endometrial cancer, we further characterized this region and localized the hBRAG gene. The function of hBRAG has not yet been fully studied, and there is the possibility that this gene works as a tumor suppressor. This gene consist of 7 exons and 6 introns encoding 503 amino acids; all the introns start with GT and end with AG in agreement with the GT-AG rule. Expression of this gene was studied by Northern hybridization and suppressed expression was observed in one (SK-UT-1B) of the six endometrial cancer cell lines. Mutation analysis in 38 primary EC tissues and six EC cell lines disclosed no genetic alterations. The genomic structure of hBRAG elucidated in this study should contribute to the future analysis of the hBRAG gene.     

Acute aortic dissection with new massive cerebral infarction - a successful repair with ligature of the right common carotid artery.

It remains unclear whether or not the infarcted brain caused by aortic dissection should be reperfused when an emergency operation is needed for aortic arch dissection. A 64-year-old woman presented with severe back pain and syncope with a sudden left hemiplegia. CT scan demonstrated an aortic dissection of the entire aorta, obstruction of the right common carotid artery by extended aortic dissection, cerebral infarction of the right middle cerebral artery territory, brain edema and pericardial effusion. Though she was unable to communicate with us, she underwent an emergent aortic arch replacement and ligature of the right common carotid artery nine hours after the onset of stroke, when massive cerebral infarction was established. She survived the operation and regained full consciousness. When brain infarction was established by extended aortic dissection in emergent aortic surgery, concomitant ligature of the responsible artery to the brain infarction may be allowed for avoiding cerebral damage leading to brain death.     

Anterior resection following posterior transsacral stapling and transection of the anal canal for low-lying rectal cancer in males

(Received for publication on Apr. 10, 1997; accepted on Nov. 6, 1997)     

An improved fixation technique for maintaining the fine structure of the nuclear zone of neonatal mouse lens

The fine structure of the nuclear zone of neonatal mouse lenses can vary considerably according to the fixation used. When normal neonatal mouse lenses are fixed in a commonly used chilled glutaraldehyde solution, the nuclear zone develops a grossly visible opacity, and irregular sized protein granules appear in the subsequent sections. Similar artifacts of aggregated irregular sized protein granules appear when cataractous mouse lens are conventionally processed. These artifacts can be avoided by soaking the lens in 0.15 M reduced glutathione solution for 10-15 min before fixation in a phosphate buffered 2% glutaraldehyde solution (pH 7.4) at 27-35 C. Normal lenses treated in this manner maintain translucency in the nuclear zone throughout the fixation-embedding procedure, and the resulting sections show finely uniform granularity with the cell membrane well preserved. Similarly processed nuclear portions of cataractous lenses of Nakano mice show uniformly aggregated protein granules, measuring about 350A in diameter. The cell membranes in the cataractous zone are also not interrupted.     

MRI accurately depicts underlying DCIS in a patient with Paget's disease of the breast without palpable mass and mammography findings

Breast-conserving therapy must be carefully indicated amongpatients with Paget's disease of the breast, because the diseaseis often associated with an underlying in situ or invasive carcinoma,even when there are no palpable mass or mammography findings.We report a 52-year-old woman who complained of skin color changeof her right nipple for 11 months. No mass was palpable in herbreasts, and mammography did not show any density or calcification.Nipple biopsy revealed Paget's disease of the breast with ductalcarcinoma in situ (DCIS) in the breast epithelium just beneaththe nipple. Magnetic resonance imaging (MRI) of the breast demonstrateddiffuse segmental enhancement in two different quadrants. Accordingto the pattern of enhancement, the lesions depicted by MRI werediagnosed as an extensively spreading type of DCIS. Based oninformed consent, the patient received a total mastectomy. Thehistopathological examination demonstrated non-invasive ductalcarcinoma with comedo-necrosis. The histological mapping withsubserial sectioning demonstrated an extent of the lesions thatcorresponded accurately to the lesions defined by MRI. We concludethat MRI may play an important role in selecting candidatesfor breast-conserving therapy out of those patients with mammaryPaget's disease with no clinical evidence of an underlying breastcarcinoma.     

Basic studies on cancer pain control

According to the World Health Organization (WHO) guidelines for patients with moderate or severe pain, morphine has been used as a "gold standard" treatment for cancer pain. Recent clinical experiences have demonstrated that when morphine is used to control pain in cancer patients, psychological dependence is not a major concern. However, undue anxiety about psychological dependence on morphine in cancer patients has caused physicians and patients to use inadequate doses of opioids. In basic research, we reported that the morphine-induced rewarding effects can be dramatically suppressed under a neuropathic pain-like state induced by sciatic nerve ligation and an inflammatory pain-like state produced by intraplantar injection of formalin or carrageenan in rodents. The use of morphine for the treatment of pain is sometimes accompanied with side effects such as emesis, constipation and drowsiness. We show that the lower doses of morphine produce emesis, whereas antinociceptive doses of morphine show no emetic responses in ferrets. These findings provide further evidence that an adequate dose of morphine is useful and safe in a clinical setting.