Follow up of women with simple ovarian cysts detected by transvaginal sonography in the Tokyo metropolitan area

OBJECTIVE

To investigate the management of women with asymptomatic ovarian masses, to determine the appropriate duration of follow up, and to identify diagnostic indicators of growing cysts.

DESIGN

Review of women's hospital records.

SETTING

Tokyo Metropolitan Cancer Detection Center, Japan.

POPULATION

Two hundred and twenty-five pre- and postmenopausal women with a diagnosis of ovarian cyst < 6 cm in diameter and normal serum level of CA125, diagnosed between 1 October 1990 and 25 December 1991.

MAIN OUTCOME MEASURE

Change in size of cyst as shown by ultrasound.

RESULTS

Seventy-five months after initial diagnosis, 29 (13%) of the masses had progressed, 31 (14%) had persisted, and 165 (73%) had regressed. One hundred and nine masses (48%) had regressed within six months of the initial diagnosis. In univariate analysis transvaginal ultrasonographic assessment of morphology findings, cyst diameter, carcinoembyronic antigen (CEA) and CA19-9 were associated with the prognosis of the cyst. Multivariate regression analysis demonstrated that only the initial serum CA19-9 level and serum CEA level were significant predictors of ovarian masses that regressed (P for trend = 0.004 and 0.02, respectively).

CONCLUSION

Simple ovarian cysts in patients with a normal level of CA125 have a low risk for ovarian cancer. Vaginal ultrasound at six months will identify regression of most simple cysts. CA19-9 and CEA at the initial diagnosis are useful parameters to predict future regression of ovarian cysts.

Laparoscopy-assisted intrapelvic sonography with a high-frequency, real-time miniature transducer for assessment of the Fallopian tube: a preliminary report

Our purpose was to visualize normal and abnormal Fallopian tubes using laparoscopy-assisted intrapelvic sonography with a specially developed 20 MHz flexible catheter-based high-resolution, real-time miniature (2.4 mm outer diameter) ultrasound transducer in infertile women. A total of 21 women (20 infertile, one with unilateral hydrosalpinx, and one tubal pregnancy) were studied with pelvic saline effusion under laparoscopy. Fimbriae were clearly depicted with a cockscomb-like form in 95% of patients. All ampullae were visualized, and mucosal layers were clearly distinguished from muscle layers in 70% of patients. Scanty intratubal effusion was noted in 50% of patients, and tubal spastic findings were found in 10% of patients. In all, 60% of isthmuses were detected, and mucosal layers were distinguished from muscle layers in 30%. In the subject with hydrosalpinx, the tubal wall was thinner, and it was not possible to distinguish between muscle and mucosal layers. In the subject with a tubal pregnancy, the amniotic membrane and decidua were depicted more clearly than by transvaginal sonography. In conclusion, laparoscopy-assisted intrapelvic sonography with a high-frequency, real-time miniature transducer may be useful in the assessment of tubal texture and function in tubal disorders, possibly in infertility practice.

[In vivo scavenging effect of ethylcysteine on reactive oxygen species in human semen]

PURPOSE

The production of reactive oxygen species (ROS) is a normal physiological event in various organs including the testis. Overproduction of ROS, however, can be detrimental to sperm, being associated with male infertility. In vivo experiments using vitamin E (Vit. E), one of the major membrane protectants against ROS and lipid peroxidation, have shown its significant potential in treating ROS-associated male infertility. There has been no study that the scavenging drugs reduce the level of ROS in human semen. Previously we reported the in vitro scavenging effectiveness of ethylcysteine (EC) against ROS in human semen. The present study was performed in order to determine the effectiveness of the in vivo administration of EC as treatment for ROS-associated male infertility.

PATIENTS AND METHODS

Ten cases of male infertility, with the exceptions of azoospermia and pyospermia, were chosen. Patients were divided randomly into two groups. Each group received either 600 mg/day of EC (Group A) or Vit. E 600 mg/day (Group B) for 3 months. Then, after a 1-month wash-out period, the patients were switched to another treatment. Conventional semen analysis, computerized motility assessment, measurement of ROS generation and sperm function assessment by triple stain were performed before and after administration of EC and Vit. E. The levels of EC and Vit. E were also assessed in patients' blood serum and seminal plasma before and after administration of EC and Vit. E.

RESULTS

Sperm density and sperm motility did not improve but sperm function had a significant tendency toward improvement after administration of EC and Vit. E. ROS levels significantly decreased only after administration of EC After administration of EC and Vit. E, their levels significantly increased in patients' blood serum but were unchanged in patients' seminal plasma.

CONCLUSION

Since our study showed that oral administration of EC produced results similar to those of Vit. E, we conclude that EC is an effective treatment agent for ROS-associated male infertility.

Three-dimensional ultrasonographic evaluation of ovarian tumours: a preliminary study

Our objective was to determine the accuracy of three dimensional (3D) ultrasonography in the differentiation of ovarian tumours. Women (n = 20) with ovarian tumours (13 benign and seven malignant) were first examined using two-dimensional (2D) ultrasonography and were then evaluated with three-dimensional (3D) ultrasonography. All patients underwent surgery within 7 days of 2D and 3D ultrasonographic evaluations, and a histopathological diagnosis was made. A 2D ultrasonographic diagnosis of malignancy was done using an established scoring system. Diagnostic criteria for ovarian malignancy by 3D ultrasonography were: irregular thick septa, irregular papillary projection, mostly solid tumour, high echogenicity, and irregular inner wall. Compared with 2D ultrasound, 3D ultrasound had a significantly higher specificity (P < 0.005) and accuracy (P < 0.01), and a significantly lower false positive rate (P < 0.005). Our results suggest that 3D ultrasonography might be a better means of differentiating between malignant and benign ovarian tumours. However, in view of the small number of ovarian tumours, these observations must be considered preliminary.

Restoration of p16INK4A protein induces myogenic differentiation in RD rhabdomyosarcoma cells

p16INK4A (p16) tumour suppressor induces growth arrest by inhibiting function of cyclin-dependent kinase (CDK)4 and CDK6. Homozygous p16 gene deletion is frequent in primary rhabdomyosarcoma (RMS) cells as well as derived cell lines. To confirm the significance of p16 gene deletion in tumour biology of RMS, a temperature-sensitive p16 mutant (E119G) gene was retrovirally transfected into the human RMS cell line RD, which has homozygous gene deletion of p16 gene. Decrease from 40 degrees C (restrictive) to 34 degrees C (permissive) culture temperature reduced CDK6-associated kinase activity and induced G1 growth arrest. Moreover, RD-p16 cells cultured under permissive condition demonstrated differentiated morphology coupled with expressions of myogenin and myosin light chain. These suggest that deletion of p16 gene may not only facilitate growth but also inhibit the myogenic differentiation of RD RMS cells.

Prenatal diagnosis of harlequin ichthyosis by the examination of keratinized hair canals and amniotic fluid cells at 19 weeks' estimated gestational age

Harlequin ichthyosis (HI) is an extremely severe and usually fatal congenital keratinization disorder whose responsible genes have not yet been identified. For prenatal diagnosis, the fetal skin biopsy is the only available method and has been usually performed at 21 to 22 weeks' estimated gestational age (wEGA). Hair canal keratinization is thought to occur around 15 wEGA prior to the interfollicular keratinization, and characteristic abnormalities of HI are known to be expressed more strongly in the hair canal. Thus, we expected the fetal skin specimen at 19 wEGA to have sufficient information for prenatal diagnosis. Fetal skin biopsy was undertaken from a fetus at risk at 19 wEGA. Electron microscopy demonstrated abnormal vacuoles in keratinized cells and malformation of lamellar granules in the hair canal. Clumps of aberrantly keratinized cells containing lipid droplets were seen in the amniotic fluid. The fetus was diagnosed as affected. The abortus at 21 wEGA demonstrated HI phenotype clinically. The present results indicate that the prenatal diagnosis of HI is possible at 19 wEGA, an earlier stage of gestation than previously reported, by the ultrastructural observation of the hair canal and the amniotic fluid cells, but not the interfollicular epidermis, of fetuses at risk.

Inhibition of light- or glutamate-induced mPer1 expression represses the phase shifts into the mouse circadian locomotor and suprachiasmatic firing rhythms

mPer1, a mouse gene, is a homolog of the Drosophila clock gene period and has been shown to be closely associated with the light-induced resetting of a mammalian circadian clock. To investigate whether the rapid induction of mPer1 after light exposure is necessary for light-induced phase shifting, we injected an antisense phosphotioate oligonucleotide (ODN) to mPer1 mRNA into the cerebral ventricle. Light-induced phase delay of locomotor activity at CT16 was significantly inhibited when the mice were pretreated with mPer1 antisense ODN 1 hr before light exposure. mPer1 sense ODN or random ODN treatment had little effect on phase delay induced by light pulses. In addition, glutamate-induced phase delay of suprachiasmatic nucleus (SCN) firing rhythm was attenuated by pretreatment with mPer1 antisense ODN, but not by random ODN. The present results demonstrate that induction of mPer1 mRNA is required for light- or glutamate-induced phase shifting, suggesting that the acute induction of mPer1 mRNA in the SCN after light exposure is involved in light-induced phase shifting of the overt rhythm.

Cytostatic concentrations of anticancer agents do not affect telomerase activity of leukaemic cells in vitro

Telomerase, the enzyme that maintains the ends of linear eukaryotic chromosomes, is more active in the majority of malignant tumours than in normal somatic cells. Telomerase plays a key role in the maintenance of chromosomal stability in tumours, but it still remains unknown whether anticancer agents can inhibit telomerase activity. In this study, we evaluated the effect of various anticancer agents (etoposide, cisplatin, irinotecan, mitomycin C and daunorubicin) on the telomerase activity of three human haematopoietic cancer cell lines (Daudi, K562 and U937). A decrease of telomerase activity was not observed in cells treated with IC50 doses of the drugs, except for irinotecan-treated Daudi cells and daunorubicin- and irinotecan-treated U937 cells. Propidium iodide staining disclosed that the cells with decreased telomerase activity were severely damaged. U937 cells exposed to 5 microM (IC90) etoposide showed three different stages of cell viability during treatment. Apoptotic cells with an intact plasma membrane still maintained high telomerase activity, while cells with plasma membrane damage lost telomerase activity. The mRNA of the telomerase catalytic subunit (hTERT) showed a decrease in expression along with the decline of telomerase activity. These results indicate that the concentrations of drugs resulting in cytostatic effects on cells do not affect telomerase activity.

Abnormalities of basal cell keratin in epidermolysis bullosa simplex do not affect the expression patterns of suprabasal keratins and cornified cell envelope proteins

Basal keratins, suprabasal keratins, filaggrin, and cornified cell envelope (CCE) precursor proteins are expressed during the differentiation of epidermal keratinocytes. These molecules are coordinately expressed during epidermal differentiation. The present study investigated the expression patterns of keratins and CCE precursor proteins in 15 patients with epidermolysis bullosa simplex (EBS), which is caused by mutations in the genes that encode for the basal keratins, keratins 5 and 14. The patterns of expression of keratins 5, 14, 1 and 10, filaggrin, and of the three major CCE precursor proteins, involucrin, loricrin and small proline-rich proteins 1 and 2 (SPRs), were studied immunohistochemically and by electron microscopy. In 14 of the 15 patients with EBS, the distribution pattern of keratins was not altered. In one neonate with EBS, basal cell keratins were expressed in the suprabasal layers. Ultrastructurally, numerous clumped tonofilaments were observed in the basal and suprabasal cells. In all cases, findings were positive for filaggrin in the granular cells, with positivity for involucrin in the upper spinous and granular cells. The upper spinous cells and granular cells were positive for SPRs 1 and 2, and loricrin was expressed in granular cells. Ultrastructurally, no marked abnormality was observed in the suprabasal layers such as a decrease in, or agglutination of, keratin filaments, except in one neonate. A CCE about 15 nm thick was formed normally in the cell membrane of cornified cells. The patterns of distributions of basal cell keratins, suprabasal keratins, filaggrin, and CCE precursor proteins, as well as the ultrastructural findings, resembled those of normal skin. Thus, the abnormality in basal cell keratins in patients with EBS did not appear to alter the patterns of expression of the keratins and CCE precursor proteins.

Potentiating action of MKC-242, a selective 5-HT1A receptor agonist, on the photic entrainment of the circadian activity rhythm in hamsters

Serotonergic projections from the midbrain raphe nuclei to the suprachiasmatic nuclei (SCN) are known to regulate the photic entrainment of circadian clocks. However, it is not known which 5-hydroxytryptamine (5-HT) receptor subtypes are involved in the circadian regulation. In order to verify the role of 5-HT1A receptors, we examined the effects of 5-¿3-[((2S)-1,4-benzodioxan-2-ylmethyl)amino]-propoxy¿-1,3-b enzodioxole HCl (MKC-242), a selective 5-HT1A receptor agonist, on photic entrainment of wheel-running circadian rhythms of hamsters. MKC-242 (3 mg kg(-1), i.p.) significantly accelerated the re-entrainment of wheel-running rhythms to a new 8 h delayed or advanced light-dark cycle. MKC-242 (3 mg kg(-1), i.p.) also potentiated the phase advance of the wheel-running rhythm produced by low (5 lux) or high (60 lux) intensity light pulses. In contrast, 8-hydroxydipropylaminotetralin (8-OH-DPAT)(5 mg kg(-1), i.p.), a well known 5-HT1A/5-HT7 receptor agonist, only suppressed low intensity (5 lux) light-induced phase advances. The potentiating actions of MKC-242 on light pulse-induced phase advances were observed even when injected 20 or 60 min after the light exposure. The potentiating action of MKC-242 was antagonized by WAY100635, a selective 5-HT1A receptor blocker, but not by ritanserin, a 5-HT2/5-HT7 receptor blocker, indicating that MKC-242 is activating 5-HT1A receptors. Light pulse-induced c-fos expression in the SCN and the intergeniculate leaflet (IGL) were unaffected by MKC-242 (3 mg kg(-1), i.p.). HPLC analysis demonstrated that MKC-242 (3 mg kg(-1), i.p.) decreased the 5-HIAA content in the SCN. The present results suggest that presynaptic 5-HT1A receptor activation may be involved in the potentiation of photic entrainment by MKC-242 in hamsters.

Low-frequency ultrasound penetrates the cranium and enhances thrombolysis in vitro

OBJECTIVE

Refinements of treatment methods are sought to rapidly reduce the volume of intracranial clots and to decrease patient exposure to possible complications of thrombolytic therapy for intracranial hematomas. We assessed the possibility of adding ultrasonication using model systems including human blood clots and temporal bone in vitro.

METHODS

The transmittance of ultrasound through temporal bone obtained at autopsy was compared between the frequencies 211.5 KHz and 1.03 MHz, using a meter to determine the power delivered. The frequency 211.5 KHz was chosen to assess the ultrasound effect on the weight of 24-hour-old clots prepared from human blood after exposures at 37 degrees C to 2 mg/ml urokinase with no additional treatment, ultrasound, or agitation during an interval of up to 12 hours. At these times, fibrin degradation products also were measured.

RESULTS

The transmittance of low-frequency ultrasound (211.5 KHz) through temporal bone was approximately 40%, which is four times higher than that of high-frequency ultrasound (1.03 MHz). Ultrasound but not agitation significantly increased clot lysis (140% of lysis with urokinase alone), with correspondingly increased fibrin degradation products.

CONCLUSION

We conclude that low-frequency ultrasound transmits well through human temporal bone and enhances thrombolysis in vitro. Clinically, this method may be promising for reducing dosages of thrombolytic agents and shortening the period of clot removal.

Three-dimensional ultrasonographic assessment of fetal hands and feet

OBJECTIVE

The aim of this study was to describe fetal hands and feet using three-dimensional ultrasonography.

DESIGN

This was a randomized prospective study.

METHODS

Ninety-seven fetuses from 12 to 40 weeks' gestation were studied with a specially developed trans-abdominal three-dimensional transducer (3.5 MHz). The imaging system used in this study can provide conventional two-dimensional ultrasound images and can also generate, within seconds, high-quality three-dimensional images in the surface and transparent modes with no need for an external workstation. The rate of visualization of the hands/fingers and feet/toes at each gestational-age interval was calculated using two-dimensional and three-dimensional ultrasonography.

RESULTS

The ability to visualize fetal hands/fingers and feet/toes was better with three-dimensional than with two-dimensional ultrasonography in the late first trimester (detection rates were 65% and 41% by three-dimensional ultrasonography for hands and feet, respectively, and 41% and 12%, respectively, by two-dimensional ultrasonography). For the early second trimester, detection rates were 82% for hands and 72% for feet by three-dimensional ultrasonography, and 54% for hands and 45% for feet by two-dimensional ultrasonography. Optimal visualization of the fetal fingers using three-dimensional ultrasonography was achieved between 28 and 35 weeks of gestation, although at this stage there were no significant differences in detection rates for hands and feet between two- and three-dimensional imaging. During this period it was possible with three-dimensional ultrasonography adequately to depict at least one hand in 93% of the fetuses at 28-31 weeks and in 88% at 32-35 weeks. The percentage of visualization of at least one fetal foot between 16 and 35 weeks using three-dimensional ultrasonography ranged from 50 to 85%. Before 15 weeks or after 36 weeks, the respective percentages decreased.

CONCLUSIONS

Three-dimensional ultrasonography provides a novel means of visualizing fetal fingers and toes. Our observations suggest that three-dimensional ultrasonography may enhance the diagnostic potential of two-dimensional ultrasonography and might be useful in identifying fetal malformations and anatomical markers of chromosomal abnormalities prenatally in high-risk pregnancies.

[Physiological, pharmacological and molecular aspects of mammalian biological clocks]

Circadian rhythm is an endogenous rhythm that persists in constant conditions with a period of nearly but not identical to 24 hr. Under natural conditions, the circadian clock is precisely entrained to the daily (24 hr) cycle, because environmental stimulus (especially light) induces a phase shift of the clock. In mammals, the suprachiasmatic nucleus (SCN) of the hypothalamus has been shown to be the primary pacemaker that drives daily rhythms of behavioral and physiological activity. Photic information is conveyed from the retina to the SCN directly by the retinohypothalamic tract (RHT) and indirectly by the geniculo-hypothalamic tract (GHT). The transmitter of the RHT is glutamate, while the GHT is GABA and neuropeptide Y. Serotonergic innervation from the median raphe and melatonin from the pineal body are likely to provide non-photic information to the SCN. Single gene mutations that dramatically alter circadian phenotype were found in the hamster (tau) and mouse (clock). Moreover, the homologous genes of the Drosophila clock gene, per, were found in mammals and the homologue of the mammalian clock was found in Drosophila. These data suggest that the some constitutes of the biological clock may be conserved between Drosophila and mammals, and a transcription-translation feedback loop involving some clock gene products may be a oscillator itself.

Mutation of the gene for the second-largest subunit of RNA polymerase I prolongs the period length of the circadian conidiation rhythm in Neurospora crassa

The period length of the circadian conidiation rhythm was examined in a mutant strain of Neurospora crassa, un-18, that is temperature sensitive for mycelial growth. The un-18 mutant showed a temperature-sensitive phenotype with respect to both mycelial growth and the period length of the conidiation rhythm. Below 22 degrees C, the un-18 mutation did not affect the period length, but at temperatures between 22 degrees C and 32 degrees C, the period length of the un-18 mutant was approximately 2 h longer than that of the wild-type strain. The un-18+ gene was cloned and was found to encode the second-largest subunit of RNA polymerase I, which is involved in the synthesis of rRNA. These results indicate that a defect in ribosome synthesis, which must result in a lower rate of protein synthesis, lengthens the period of the circadian conidiation rhythm in Neurospora.

[Myelodysplastic syndrome (RAEB in T) developed in a renal allograft recipient]

A 46-year-old man who had been treated with azathioprine (150 mg/day) and prednisolone (7.5-10 mg/day) for 16 years after allogeneic renal transplantation was admitted to our hospital in July 1996 for evaluation of pancytopenia. Three years earlier he had been given a diagnosis of renal pelvic and ureteral cancer, and underwent left nephrectomy with total uretectomy. His bone marrow was normocellular with excess of blasts (27.6%), and displayed trilineage myelodysplasia. A chromosomal analysis of the bone marrow revealed 43-45, XY with del (1) (p13), -5, del (7) (q22), -17, -18, and -19. The patient was given a diagnosis of refractory anemia with excess of blasts in transformation (RAEB in T), and treated with idarubicin and cytosine arabinoside. Two months later, overt acute leukemia developed and reinduction chemotherpay was started, but the patient died of cerebral hemorrhage in October. This case suggests that immunosuppressive agents such as azathioprine might play an important role in the pathogenesis of MDS (RAEB in T) and renal pelvic and ureteral cancer after renal transplantation.

MDM2 protein overexpression inhibits apoptosis of TF-1 granulocyte-macrophage colony-stimulating factor-dependent acute myeloblastic leukemia cells

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a growth factor for acute myeloblastic leukemia (AML) cells. Murine double minute 2 (MDM2) oncoprotein, a potent inhibitor of wild-type p53 (wtp53), can function both to induce cell proliferation and enhance cell survival, and is frequently overexpressed in leukemias. Therefore, we focused on the importance of MDM2 protein in GM-CSF-dependent versus GM-CSF- independent growth of AML cells. The TF-1 AML cell line, which has both wtp53 and mutant p53 genes, showed GM-CSF-dependent growth; deprivation of GM-CSF resulted in G1 growth arrest and apoptosis. MDM2 mRNA and protein were highly expressed in proliferating TF-1 cells in the presence of GM-CSF and decreased significantly with deprivation of GM-CSF. In contrast, p53 protein increased with GM-CSF deprivation. Ectopic overexpression of MDM2 in TF-1 AML cells conferred resistance to GM-CSF deprivation, and is associated with decreased p53 protein expression. Moreover, a variant of TF-1 cells that grows in a GM-CSF-independent fashion also expressed high levels of MDM2 and low levels of p53. These results suggest that GM-CSF-independent growth of AML cells is associated with overexpression of MDM2 protein and related modulation of p53 expression.

MERIT-9: a patient information exchange guideline using MML, HL7 and DICOM

To realize clinical data exchange between healthcare providers, there must be many standards in many layers. Terms and codes should be standardized, syntax to wrap the data must be mutually parsable, then transfer protocol or exchange media should be agreed. Among many standards for the syntax, HL7 and DICOM are most successful. However, everything could not be handled by HL7 solely. DICOM is good for radiology images, but, other clinical images are already handled by other 'lighter' data formats like JPEG, TIFF. So, it is not realistic to use only one standard for every area of clinical information. For description of medical records, especially for narrative information, an standard generalized mark-up language, document type definition (SGML DTD) for medical information, called MML (medical markup language) had been created in Japan. It is already implemented in more than ten healthcare providers. However, it is again not realistic to use MML solely for clinical information in various level of detail. Therefore, we proposed a guideline for use of available medical standards to facilitate clinical information exchange between healthcare providers. It is called MERIT-9 (Medical Records, Images, Texts, -Information Exchange). A typical use is HL7 messages, DICOM files, referred from an MML file in a patient record, as external entities. Both MML and MERIT-9 have been research projects of Japanese Ministry of Health and Welfare and the purpose is to facilitate clinical data exchanges. They are becoming to be used in technical specifications for new hospital information systems in Japan.

Abnormal cornified cell envelope formation in mutilating palmoplantar keratoderma unrelated to epidermal differentiation complex

Mutilating palmoplantar keratoderma represents a heterogeneous group of disorders, unified by characteristic mutilation of the fingers or toes, associated with palmoplantar keratoderma. Although loricrin gene mutations were recently reported in Vohwinkel's syndrome and erythrokeratoderma, the genetic basis of mutilating palmoplantar keratoderma is largely unexplored. We studied a family of non-Vohwinkel's syndrome, nonerythrokeratoderma mutilating palmoplantar keratoderma. The proband and his sister were similarly affected. Recessive inheritance was expected from the consanguineous family history. The patients had hyperkeratosis restricted to the palms and the soles. No other body sites were affected. Digital constriction was seen on all the fingers and the mutilation was severe on the distal interphalangeal region of several fingers. Histopathologically, hyperkeratosis without parakeratosis was seen in the lesional skin. Ultrastructural, immunohistochemical, and immunoelectron microscopic analyses revealed malformed cornified cell envelopes, the abnormal intracytoplasmic loricrin retention, and reduced deposition of loricrin to cornified cell envelopes. Involucrin and small proline-rich proteins 1 and 2 were normally distributed. Sequencing of the entire exons and exon-intron borders of loricrin gene of the patients excluded a mutation in loricrin DNA sequence. Linkage analysis excluded the possibility of causative mutation in the epidermal differentiation complex region of 1q21, including loricrin, involucrin, small proline-rich proteins, filaggrin, and trichohyalin. These data confirm the presence of non-Vohwinkel's syndrome mutilating palmoplantar keratoderma phenotype with abnormal loricrin cross-linking at the final stage of cornified cell envelope formation, which is caused by mutations outside the epidermal differentiation complex region.

Precise ultrastructural localization of in vivo deposited IgG antibodies in fresh perilesional skin of patients with bullous pemphigoid

Bullous pemphigoid (BP) is a blistering skin disease in which the patient develops autoantibodies to the epidermal basement membrane zone. Using postembedding immunogold electron microscopy, we previously demonstrated that autoantibodies against the 230-kDa BP antigen (BPAG1) bind to the intracellular hemidesmosomal component of normal skin, whereas those against the 180-kDa BP antigen (BPAG2) bind only along the plasma membrane of hemidesmosomes. The purpose of the present study was to elucidate the precise localization of the in vivo deposited IgG antibodies in fresh perilesional skin of patients with BP. Samples of fresh perilesional skin were obtained from three patients with BP whose sera reacted only with BPAG1, only with BPAG2, and with both BPAG1 and BPAG2 upon immunoblotting using epidermal extracts. Cryofixed and cryosubstituted skin samples were used as a substrate for on-surface immunolabelling. In all three cases, most of the gold particles were observed close to the plasma membrane of the basal keratinocytes. A quantitative analysis revealed that most (> 80%) of the in vivo deposited IgG antibodies in the three cases were localized within 10 nm inside to 50 nm outside of the cell membrane, with a single peak observed 0-10 nm outside of the cells (> 50%). This distribution corresponded to the location of BPAG2, but not to that of BPAG1. These findings suggest that most, if not all, of the in vivo deposited IgG antibodies in the perilesional skin of BP are directed against BPAG2, rather than against BPAG1, thus further supporting the crucial role of anti-BPAG2 autoantibody in the initial stage of blister formation in BP.

A close correlation between electron spin resonance (ESR) dosimetry from tooth enamel and cytogenetic dosimetry from lymphocytes of Hiroshima atomic-bomb survivors

PURPOSE

To estimate gamma-ray doses received by Hiroshima atomic bomb survivors using electron spin resonance (ESR) of tooth enamel and to compare the results with cytogenetic data.

MATERIALS AND METHODS

Tooth enamel ESR was performed for 100 teeth donated from 69 Hiroshima survivors, and conventional cytogenetic examinations were conducted for 61 of the tooth donors. To evaluate possible contamination from dental X-ray exposure, which primarily affects the tooth's buccal surface, each tooth was divided into buccal and lingual parts for subsequent independent enamel isolation and ESR measurement.

RESULTS

Almost 20 teeth showed considerably larger buccal doses than lingual doses, but most of these discrepant teeth were incisors and canines. The results are probably attributable to solar light exposure. In contrast, the buccal and lingual doses found in molars were similar. Conventional translocation data of lymphocytes and ESR-estimated doses of 40 donors of molars showed the dose-response for translocations to be almost the same as that expected from in vitro gamma-ray irradiation experiments.

CONCLUSIONS

Both tooth enamel ESR and lymphocyte cytogenetics are useful measures for individual biodosimetry of acute radiation exposure, even half a century after the exposure occurred.

Identification of a major PAF acetylhydrolase in human serum/plasma as a 43 kDa glycoprotein containing about 9 kDa asparagine-conjugated sugar chain(s)

Platelet-activating factor (PAF) acetylhydrolase from human serum/plasma was identified on a polyvinylidene difluoride (PVDF) membrane by electroblotting proteins separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). The enzyme activity was detected in the 43 kDa region on the membrane as a decrease in the beta-radioluminescence of [3H]acetyl-PAF or by the convenient method for determining PAF acetylhydrolase activity (the TCA precipitation method). The enzyme activity on treatment with N-glycosidase F shifted to the 34 kDa region on the PVDF membrane. On the other hand, only one band was observed, corresponding to a molecular mass of 53 kDa, on analysis by SDS-PAGE with silver staining. Treatment of the 53 kDa protein with N-glycosidase F changed its molecular mass to 43 kDa (protein A). The NH2-terminal 32 amino acid sequence of protein A completely corresponds to that of the heterogenous enzyme with 54 amino acids deleted from the NH2 terminus reported by Tjoelker et al. (Nature 374, 549-553, 1995). Even after trypsin treatment of the N-glycosidase F-digested enzyme, its PAF-AH activity remained in the 34 kDa region, but the contaminating protein A disappeared, on the PVDF membrane. In addition, the majority of serum PAF-AH was retained on a Sambucus sieboldiana agglutinin (SSA)-agarose column and was eluted with the hapten sugar, lactose. These results indicate that PAF acetylhydrolase consisting of a 34 kDa protein and about 9 kDa asparagine-conjugated sugar chain(s) is a major enzyme in human serum/plasma.

[The direct effect of anticancer agents on the telomerase activity in human cancer cell lines]

Telomerase, a ribonucleoprotein that maintains the ends of linear eukaryotic chromosomes, is expressed in the majority of malignant cells, while most normal somatic cells have no telomerase activity except germline and stem cells. Therefore, telomerase activity is considered one of important characteristics of tumors. In reviewing the possibility that conventional anticancer agents can partly perform their functions through modulation of telomerase. Several data including ours suggest that the down-modulation of telomerase activity along with inhibition by agents is the secondary event associated with cell death. Moreover, cells growth arrested at specific phase of cell cycle by agents still show the high level of telomerase activity. Since telomerase activity well correlates to the cell viability of treated cells, to study telomerase provides us a new implement to examine the sensitivity of cancer cells to agents.