A transforming growth factor beta type II receptor gene mutation common in sporadic cecum cancer with microsatellite instability

Mismatch repair genes are the responsible genes for hereditary non-polyposis colon cancer, and mutation of these genes causes replication error (RER). In several RER-positive colon cancer cell lines, mutations of repetitive sequences of transforming growth factor beta (TGF-beta) type II receptor (RII) gene have been reported. Since TGF-beta inhibits cell proliferation, loss of response to TGF-beta is an important tumor progression step. In this study, the relationship between RER status and mutation of the RII gene was analyzed in 112 cases of various types of sporadic gastrointestinal and hepatobiliary cancer (41 with gastric, 49 with colorectal, 5 with gallbladder, and 17 with hepatic cancers). RER was found in 17 cases (4 with gastric, 12 with colorectal, and 1 with gallbladder cancer), and 10 of those (3 with gastric and 7 with colorectal cancer) showed mutations of the RII gene. Of interest was that in all seven cases with colorectal cancer, tumors were located at the cecum. These data indicate that mutation of the RII gene, presumably caused by abnormality of repair gene, play an important role in carcinogenesis of sporadic gastrointestinal cancer, especially at the cecum.

[Variations of the constrictor pharyngeal muscles in humans]

Fifteen halves of ten nonrandomized human cadavers were dissected under a stereoscopic microscope in order to examine the existence of variations in the constrictor pharyngeal muscles. Obvious variations of the constrictor muscles were found in three cases. The results are summarized as follows: 1. In the first case of variations, the superior constrictors arose from the pterygomandibular raphe and merged into the outer surfaces of the middle and inferior constrictors. This muscle was supplied by the upper part of the pharyngeal branches of the vagus. 2. In the second case, the muscle bundle of inferior constrictors originated from the thyroid cartilage and passed upward, joining the muscular fibers of the outer surface of the superior constrictors arising from the pterygomandibular raphe. Some of these muscular fibers extended to the surface of the posterior part of the pharyngobasilar fascia. This muscle was innervated by the lower part of the pharyngeal branches of the vagus. 3. In the third case, the lower part of the superior constrictors passed laterally between the stylopharyngeus and the glossopharyngeal nerve, running between the external and internal carotids in the retrostyloid space and reaching the cervical fascia around the submandibular triangle. This anomalous muscular bundle of superior constrictors was innervated by the carotid branch of the glossopharyngeal nerve and the middle part of the pharyngeal branches of the vagus.

Efficacy of Doppler ultrasonography for assessment of transjugular intrahepatic portosystemic shunt patency

PURPOSE

To assess the efficacy of Doppler ultrasonography (US) as a noninvasive method for monitoring patency of the transjugular intrahepatic portosystemic shunt (TIPS).

METHODS

Twenty-nine patients who had received TIPS for bleeding esophagogastric varices and/or refractory ascites with portal hypertension underwent Doppler US studies within 2 weeks after TIPS. Further studies were performed in 15 of them at 6 months, in 9 at 1 year, and in 4 at 2 years for a total of 57 US studies. The US findings were compared with the angiographic findings obtained at the same time.

RESULTS

In 45 of the 57 studies, shunt patency was found by Doppler US, correlating to 44 patencies and one occlusion on angiography. Doppler signal in the shunt could not be detected in 12 studies resulting in the diagnosis of shunt occlusion. This correlated with angiographic occlusion in 8 studies and patency in the remaining 4. All angiographically patent shunts that were occluded by Doppler US had various degrees of stenosis. A number of technical factors were found to be responsible for Doppler US false-positive or false-negative diagnoses, some related to the type of stent used. The Doppler US sensitivity was therefore 92%, the specificity 89%.

CONCLUSION

Doppler US is a reliable noninvasive method to evaluate patency of TIPS.

Differentiation induction therapy with all-trans retinoic acid (ATRA) in a patient with secondary 11q23 leukemia

PURPOSE

Frequently recurrent leukemia is encountered in childhood and is usually resistant to multidrug therapy. We evaluated the efficacy of differentiation induction therapy in a child with leukemia.

PATIENT AND METHODS

We administered all-trans retinoic acid (ATRA) alone, and then a combination of low-dose 1-beta-D-arabinofuranosylcytosine (Ara-C), to a 7-year-old boy who had leukemia secondary to etoposide with chromosomal abnormality 11q23.

RESULTS

The patient exhibited a good response to ATRA and had a complete remission after combination therapy of ATRA and low-dose Ara-C.

CONCLUSION

Differentiation induction therapy with ATRA was effective in treating a patient with recurrence of leukemia without t(15;17) translocation, and which is resistant to conventional cytotoxic treatment.

Reactivity of anti-AraC-resistant cell monoclonal antibody, YU-311, in formalin-fixed paraffin-embedded specimens of various hematopoietic disorders

YU-311 is a monoclonal antibody reacting with cytosine arabinoside (AraC)-resistant human leukemic cell line and identifies a 92 kDa membrane protein. We have examined YU-311 reactivity with various hematopoietic disorders by an immunohistochemical method and evaluated a correlation between YU-311 expression and refractoriness to chemotherapy, retrospectively. YU-311 reacted with AraC-resistant human leukemia cell lines, in which a 92 kDa membrane protein was identified by Western blotting, whereas drug-resistant cell lines to other than AraC failed to express YU-311 antigen. The frequency of YU-311 positivity was significantly increased in relapsed cases. Only five cases were positive for YU-311 at diagnosis and 24 cases at relapse. Unexpectedly, only eight cases of relapsed leukemia/lymphoma expressed YU-311 and P-glycoprotein simultaneously. Most of the YU-311-positive relapsed cases showed clinical refractoriness for chemotherapy and then failed to induct complete remission or relapsed at short periods with short disease-free duration. These findings indicate that YU-311 expression is closely associated with some aspects of drug resistance, especially with AraC resistance.

[A quantitative study of regional cerebral blood flow in childhood using 123I-IMP-SPECT: with emphasis on age-related changes]

Single photon emission computed tomography (SPECT), using N-isopropyl-p-[123I] iodoamphetamine (123I-IMP) was used for quantitative analysis of regional cerebral blood flow (rCBF) on 26 individuals between 0 and 19 years of age. The rCBF showed age-related changes; it was low in early infancy, increased in late infancy through early childhood, and decreased and remained constant after puberty. The rCBF through cerebral cortex varied more greatly than through thalamus and cerebellum, and seemed to depend more closely on age. In the case of 4 months of age rCBF was very low at the frontal region and was very high at the occipital region. In more older cases, rCBF in the cerebral cortex was higher than in the thalamus. In childhood, rCBF was very inconsistent and showed a great inter-individual variance.

Involvement of beta-adrenergic receptor kinase-1 in homologous desensitization of histamine H2 receptors in human gastric carcinoma cell line MKN-45

The poorly differentiated human gastric carcinoma cell line MKN-45 possesses histamine H2 receptors which are homologously desensitized by histamine. In order to clone the cDNA of a receptor kinase specific for H2 receptors, we performed RT-PCR at a low annealing temperature using oligo-DNA primers bearing the conserved sequences of the kinase domain of the G protein-coupled receptor kinase (GRK) family. However, we were able to isolate only cDNAs for beta-adrenergic receptor kinase 1 (beta ARK1) and GRK6. Interestingly, treatment of MKN-45 cells with beta ARK1 antisense phosphorothioate oligo-DNA (PON) resulted in significant loss of desensitization of H2 receptors by histamine, whereas GRK6 antisense PON had no effect. Thus, beta ARK1 appears to be involved in the homologous desensitization of H2 receptors in MKN-45 cells.

Gq-coupled receptors transmit the signal for GLUT4 translocation via an insulin-independent pathway

Guanosine 5'-O-(3-thiotriphosphate) (GTPgammaS) induces the translocation of glucose transporter type 4 (GLUT4) from an intracellular pool to the cell surface and increases glucose uptake in adipocytes. The GTP-binding protein(s) responsible for the translocation has remained to be identified. Using a sensitive and quantitative method to assess the translocation of c-MYC epitope-tagged GLUT4, we obtained evidence that the activation of receptor-coupled Gq (neither Gi nor Gs) triggered GLUT4 translocation in cells, independently of insulin signaling pathway(s). Platelet-activating factor (PAF) induced GLUT4 translocation in the cells expressing the Gi- and Gq-coupled PAF receptor, but the translocation was induced even after pretreatment with wortmannin, an islet-activating protein and phorbol 12, 13-dibutyrate. Norepinephrine triggered GLUT4 translocation in cells expressing the Gq-coupled alpha1-adrenergic receptor, but prostaglandin E2 did not cause GLUT4 translocation in cells expressing the Gs-coupled EP4 receptor or the Gi-coupled EP3alpha receptor. The norepinephrine-stimulated GLUT4 translocation and glucose uptake via Gq may possibly contribute to the fuel supply required for thermogenesis in brown adipocytes and for the enhanced contractility in cardiomyocytes, both of which have an abundant endogenous GLUT4.

[Kinetics of peripheral blood CD34-positive cells and optimal timing of blood stem cell harvest after urological anticancer chemotherapy]

PURPOSE

We evaluated the changes in stem cells in peripheral blood and the optimal timing for harvesting peripheral blood stem cells (PBSCs) following the administration of conventional cancer chemotherapy in patients with urological malignancies.

PATIENTS AND METHODS

We evaluated the changes in PBSCs after the administration of cancer chemotherapy in 12 patients with urological malignancies (6 testis cancer, 3 bladder cancer, 3 prostate cancer) using flowcytometry analysis of CD34, a marker of blood stem cell. We evaluated the optimal timing for PBSCs harvesting following the administration of conventional cancer chemotherapy in 6 patients with urological malignancies (2 patients with testis cancer, 3 patients with prostate cancer, 1 patient with bladder cancer) using flowcytometry analysis of CD34 and granulocyte-macrophage colony-forming units (CFU-GM) counts. PBSC samples from 2 patients with prostate cancer were analyzed by the reverse transcriptase-polymerase chain reaction (RT-PCR) method to detect prostate cancer cells.

RESULTS

The percentages of CD34-positive cells tended to increase in the peripheral blood during the period of convalescence that followed the induction of marked myelosuppression produced by the cancer chemotherapy. The peak in CD34-positive cells occurred between days 15 and 31 after beginning of cancer chemotherapy. The percentage of CD34-positive cells was increased in the mononuclear cells in harvested PBSCs. The percentages of CD34-positive cells in peripheral blood and in mononuclear cells harvested from PBSCs was correlated with the CFU-GM counts in harvested PBSCs. The CFU-GM counts peaked between days 16 to 31 following cancer chemotherapy. RT-PCR detected prostate-specific antigen (PSA) mRNA expression in PBSCs obtained from 1 of the 2 patients with prostate cancer. An amount of contamination with PSA mRNA reduced as chemotherapy was repeated.

CONCLUSION

A sufficient number of PBSCs can be harvested after conventional cancer chemotherapy without the need for special cytotoxic mobilization that may be delayed the patient's treatment. RT-PCR results suggested that the harvested PBSCs should be examined for tumor cell contamination in patients with metastasis in bone marrow. If a sufficient amount of PBSCs will be harvested, the PBSC samples from the patient with bone marrow metastasis after repeated chemotherapy should be used by priority for PBSC transplantation as of today.

Identification of the nucleotide substitution that generates the fourth polymorphic site in human deoxyribonuclease I (DNase I)

In addition to the three polymorphic sites responsible for protein polymorphism, a new polymorphic site has been identified in intron 7 of the human deoxyribonuclease I (DNase I) gene. Three phenotypes were observed on single-strand conformational polymorphism analysis of a 266-bp polymerase chain reaction-amplified fragment containing exon 7 and part of intron 7 of the human DNase I gene. DNA sequencing analysis demonstrated that a C-G substitution occurred at position 1978 in intron 7. This substitution was confirmed by restriction fragment length polymorphism analysis, since a new Msp1 site is created by the substitution. Population and family studies showed that the inheritance of the genotypes for DNase I C1978G polymorphism is controlled by two codominant alleles, tentatively designated DNASE1*1978C and *1978G. The gene frequencies in a Japanese population were significantly different from those in a Caucasian (German) population. The C1978G polymorphism is in linkage disequilibrium with the common DNase I protein phenotypes 1, 1-2, and 2.

[Discovery of genetic polymorphism of human nucleases]

Research into the use of new genetic markers is difficult and costly, but it is necessary for more accurate criminal individualization and paternity testing as well as for analysis of genetic diseases. Recently, we discovered that human ribonuclease (RNase), deoxyribonuclease I (DNase I) and deoxyribonuclease II (DNase II) are characteristic markers showing genetic polymorphism and useful for forensic investigation. DNase I is particularly well suited to practical use, since it shows a well-balanced gene frequency, a high concentration in several body fluids (blood, sweat, urine, breast milk and semen) and tissues (pancreas, liver and kidney), stability against severe conditions (exposure of test samples to high temperature, high humidity and long-term storage), and easy and accurate detectability.

Relation of TGF-beta 2 to inhibition of limb bud chondrogenesis by retinoid in rats

A newly synthesized retinoid, Am-80 (4-[5,6,7,8-tetrahydro-5,5,8,8-tetramethyl-2-naphthalenyl] carbamoxyl) benzoic acid, induced limb reduction defects in rats in vivo. The present study was designed to investigate the mechanisms of its teratogenic action and also to examine whether transforming growth factor-beta (TGF-beta) is involved in limb reduction defects by using a rat limb bud cell culture system. Am-80 inhibited DNA synthesis and chondrogenesis of limb bud cells from day 12 embryos at concentrations of 1-4 ng/ml in a concentration-dependent manner. Quantities of TGF-beta 1 and 2 in culture medium from limb bud cells treated with Am-80 were evaluated using sandwich ELISAs. Although TGF-beta 1 was not detected in conditioned medium with or without Am-80, TGF-beta 2 increased in a concentration-dependent manner at drug concentrations that inhibited DNA synthesis and chondrogenesis. In addition, when TGF-beta 2 was exogenously added to limb bud cell culture medium, the synthesis of glycosaminoglycan (GAGs) was reduced even without Am-80 treatment. Neutralization of TGF-beta 2 with antibody prevented the inhibition of GAGs synthesis induced by Am-80. These results suggest that TGF-betas, especially beta 2, are involved in the inhibition of chondrogenesis caused by Am-80 in limb bud cells.

[Gore-tex covering of ultraflex stent and its usefulness for malignant esophageal stenosis: preliminary clinical results]

Malignant esophageal stenoses develop esophagorespiratory fistulae or perforations so frequently that esophageal stents must be required. We devised a covered stent with a thin Gore-Tex sheet and a nitinol stent system, Ultraflex, without increasing the size of the introducer assembly. Nine patients with malignant esophageal stenoses, including seven patients with perforation or fistulation, were carefully treated with the covered stent. All stent deployments were successfully carried out under fluoroscopic guidance. The average time required for full self-expansion was two weeks. The average grade of dysphagia improved from 3.7 to 1.2. Clinical symptoms due to esophagorespiratory fistulae were improved in three of four patients. No clinical or technical complications, such as migration, were observed, but a fistula developed at the bare site of the stent. This covering method for the flexible stent was simple and safe, and was considered to be useful in the treatment of malignant esophageal stenosis.

A new individualization marker of sweat: deoxyribonuclease I (DNase I) polymorphism

We confirmed for the first time, both biochemically and immunologically, the existence of deoxyribonuclease I (DNase I) in human liquid sweat. Isoelectric focusing of sweat samples on polyacrylamide gels (pH 3.5 to 5), followed by dried agarose film overlay detection, was used to determine the phenotypes of sweat DNase I. Because this detection method not only had high sensitivity, but also high band resolution, it was possible to determine DNase I types from sweat samples of 50 to 100 microL. Pretreatment of sweat samples with sialidase was essential for typing to enhance markedly the sensitivity accompanied by simplification of the isozyme pattern. The DNase I types in all sweat samples were consistently related to the types found in corresponding blood, urine, and semen samples. DNase I typing could, therefore, provide a novel discriminant characteristic in the forensic examination of sweat.

Tamoxifen mediated human endometrial carcinogenesis may not involve estrogenic pathways: a preliminary note

Seven cases of endometrial adenocarcinoma patients who had experienced long-term tamoxifen treatments as adjuvant therapy of breast carcinoma, were investigated with respect to estrogen receptor (ER) status. Four cases of endometrial adenocarcinoma without tamoxifen treatment but with a previous history of breast carcinoma were investigated for comparison. One of the 7 and two of the 4 cases were positive for ER immunohistochemically. Thus, the frequency of ER positivity in secondary endometrial adenocarcinoma seemed to be at random among tamoxifen-treated and non-treated breast cancer patients. These results suggest that tamoxifen-mediated human endometrial carcinogenesis may not involve estrogenic pathway(s) but may involve other carcinogenic mechanisms such as DNA adduct formation as shown in rat liver tumorigenesis.

Evaluation of apoptosis in human endometrial adenocarcinoma: comparison of nick end labeling and Le(y) antigen immunostaining method

In situ estimation of DNA fragmentation by the nick end labeling method and immunohistochemical detection of cell surface carbohydrate Le(y) were performed to establish correlation between the results of these two apoptosis-detecting techniques in human solid tumor tissues. Formalin-fixed and paraffin-embedded tissue samples from 10 cases of human endometrial adenocarcinoma were examined and compared by using the two techniques. A substantial fraction of carcinoma cells was found to be definitely stained by both methods, although Le(y) expression did not seem to be positively correlated with DNA fragmentation in the carcinoma tissue. These results suggest that Le(y) expression does not necessarily reflect apoptotic DNA fragmentation, at least in human endometrial adenocarcinomas, and simultaneous application of DNA nick end labeling and Le(y) immunostaining is necessary to show the relevant signs of apoptosis in histologic slides, especially gynecological cancers.

Expression of bcl-2 and apoptotic DNA fragmentation in human endometrial adenocarcinoma cells

Immunohistochemical detection of bcl-2 products and in situ estimation of DNA fragmentation during apoptosis by the nick and labelling method were performed to establish any correlation between these two apparently opposing processes in human solid tumors. Serial sections, one micrometer in thickness, from formalin-fixed and paraffin-embedded tissues of 10 cases of human endometrial adenocarcinoma were examined using the two techniques. A significant fraction of carcinoma cells were found to be stained by both methods, although there existed a general tendency for bcl-2 expression to be negatively correlated with DNA fragmentation in carcinoma tissue. The results thus suggest that bcl-2 expression does not always block apoptosis, and that simultaneous application of bcl-2 immunostaining and DNA nick end labeling is useful for showing the complex nature of apoptosis in histologic slides, especially in gynecological cancers.

[The importance of serum lipid level for restenosis following initial successful percutaneous transluminal coronary angioplasty in patients with unstable angina]

Serum lipids were investigated as a risk factor for restenosis following initial percutaneous transluminal coronary angioplasty (PTCA) for unstable angina (Braunwald III-B2). Follow-up angiography was used to classify 41 patients who received successful emergency PTCA into two groups: 21 patients with and 20 without restenosis. The clinical factors (age, sex), lesion characteristics and extent of coronary narrowing before and after PTCA were similar in the two groups. In the group without restenosis, the serum cholesterol level was significantly reduced from 225 +/- 48 (before PTCA) to 188 +/- 34 mg/dl (at the follow-up PTCA; p < 0.01), but in the group with restenosis serum cholesterol level showed no difference between before PTCA (211 +/- 42) and at the follow-up (201 +/- 32 mg/dl). The levels of triglycerides and high-density lipoprotein (HDL) cholesterol were not significantly different between before PTCA and at the follow-up in both groups. The restenosis rate in patients with serum cholesterol level reduced by 30 mg/dl or more at the follow-up after PTCA was significantly lower (three of 15 patients, 20%) compared with the restenosis rate in patients with serum cholesterol level lowered by less than 30 mg/dl (18 of 26 patients, 69%; p < 0.01). Moreover, the restenosis rate in patients with serum cholesterol level below 180 mg/dl at the follow-up angiography was significantly lower (six of 19 patients, 32%) compared with patients with serum cholesterol levels above 180 mg/dl (15 of 22 patients, 68%; p < 0.05). A high level of serum cholesterol may be a predictor of restenosis following PTCA in patients with unstable angina.

Geranylgeranylacetone induces heat shock proteins in cultured guinea pig gastric mucosal cells and rat gastric mucosa

BACKGROUND & AIMS

An antiulcer drug, geranylgeranylacetone (GGA), rapidly induces resistance of gastric mucosal cells to irritants in vivo and in vitro. The aim of this study was to elucidate the mechanism of this action.

METHODS

Heat shock proteins (HSPs) were detected by immunoblotting with antibody against HSP90, HSP70, heat shock cognate protein 70, or HSP60. HSP70 messenger RNA level was measured by Northern hybridization with an HSP70 complementary DNA probe. Activation of the heat shock factor was detected by gel mobility shift assay with the heat shock element oligonucleotide.

RESULTS

GGA induced resistance of cultured guinea pig gastric mucosal cells against ethanol-induced exfoliation and damage within 30 minutes, proportionally to the induction of the HSPs. This protection was blocked by cycloheximide but not by indomethacin. GGA caused rapid activation of heat shock factor 1 and expression of HSP70 messenger RNA in the cells. Intragastric administration of GGA to rats induced HSPs in gastric mucosa. The administration of GGA additionally enhanced the heat shock response and reduced ulcer formation in rats subjected to restraint and water-immersion stress.

CONCLUSIONS

GGA may induce transcriptional activation of HSP genes, and this novel action may increase gastric mucosal defense at conditions of stress.

Maltitol increases transepithelial diffusional transfer of calcium in rat ileum

We explored the mechanism whereby maltitol causes an increase of calcium absorption in the lower small intestine using everted ileal segments of rats. Under the calcium concentrations tested (1-20mM), which enabled us to assess the diffusional calcium transfer, maltitol in the mucosal-side medium (100mM) caused a 155% greater transepithelial calcium transfer as compared with the segments incubated without sugars. The maltitol-induced increment of calcium transfer was significantly higher than those elicited by glucose, sorbitol and maltose, and this increase was completely inhibited by W7, a calmodulin antagonist. Thus, our results suggest that maltitol might modulate the permeability of calcium through paracellular path, which possibly involves the activation of calmodulin.

Characterization of manganese(II) binding site mutants of manganese peroxidase

A series of site-directed mutants, E35Q, E39Q, and E35Q-D179N, in the gene encoding manganese peroxidase isozyme 1 (mnp1) from Phanerochaete chrysosporium, was created by overlap extension, using the polymerase chain reaction. The mutant genes were expressed in P. chrysosporium during primary metabolic growth under the control of the glyceraldehyde-3-phosphate dehydrogenase promoter. The mutant manganese peroxidases (MnPs) were purified and characterized. The molecular masses of the mutant proteins, as well as UV-vis spectral features of their oxidized states, were very similar to those of the wild-type enzyme. Resonance Raman spectral results indicated that the heme environment of the mutant MnP proteins also was similar to that of the wild-type protein. Steady-state kinetic analyses of the E35Q and E39Q mutant MnPs yielded K(m) values for the substrate MnII that were approximately 50-fold greater than the corresponding K(m) value for the wild-type enzyme. Likewise, the kcat values for MnII oxidation were approximately 300-fold lower than that for wild-type MnP. With the E35Q-D179N double mutant, the K(m) value for MnII was approximately 120-fold greater, and the kcat value was approximately 1000-fold less than that for the wild-type MnP1. Transient-state kinetic analysis of the reduction of MnP compound II by MnII allowed the determination of the equilibrium dissociation constants (KD) and first- order rate constants for the mutant proteins. The KD values were approximately 100-fold higher for the single mutants and approximately 200-fold higher for the double mutant, as compared with the wild-type enzyme. The first-order rate constants for the single and double mutants were approximately 200-fold and approximately 4000-fold less, respectively, than that of the wild-type enzyme. In contrast, the K(m) values for H2O2 and the rates of compound I formation were similar for the mutant and wild-type MnPs. The second-order rate constants for p-cresol and ferrocyanide reduction of the mutant compounds II also were similar to those of the wild-type enzyme.

High-dose chemotherapy with peripheral blood stem-cell transplantation for hormone-refractory advanced carcinoma of the prostate: experience of two cases

Two patients with hormone-refractory advanced prostate cancer were treated with high-dose chemotherapy and peripheral blood stem-cell transplantation. A satisfactory number of stem cells were collected by appropriately timed leukapheresis in these patients. The stem-cell samples collected from the first patient were positive for prostate-specific antigen messenger ribonucleic acid expression; such expression was not detected in the samples from the second patient. The first patient has remained in complete remission as of December 1995. The second patient died of the disease.

[Spiral volumetric CT venography of the lower extremities: preliminary report]

Twelve cases, including varicose veins (7), deep venous thrombosis (3), A-V malformation (1) and skin ulcer (1), were examined by three-dimensional CT venography (3D CTV), and comparison was made with conventional ascending venography. In the "double phase method," the first phase scan (40 seconds) of the femoral region was performed in order to rule out deep venous thrombosis, and the second phase scan (30 seconds) of the lower leg was performed to visualize varicose veins. Veins of the thigh and popliteal space were relatively well visualized. It is thought that 3D-CTV is particularly useful for spatially evaluating deep venous thrombosis and varicose veins.

Profile of cell cycle in hematopoietic malignancy by DNA/RNA quantitation using 7AAD/PY

Using 7-amino-actinomycin-D/pyronin Y (7AAD/PY), we analyzed the surface phenotypes and cell cycle of 22 hematopoietic cell lines based on their cellular DNA/RNA content. Populations of G1a, G1b, S, and G2M, the DNA index (DI), and the RNA index of S phase (SRI) were calculated by means of DNA/RNA dot plots. Two new parameters were extracted from the cell-cycle profiles: the nucleic acid index of S phase (NI) and the coefficient of variations in the RNA at S phase (SVC). DNA/RNA dot plots of cell lines revealed four characteristic profiles of the cell cycle, defined with the calculated NI and SCV. These were type 0 (small NI, large SCV), type I (small NI, small SCV), type II (large NI, small SCV), and type III (large NI, large SCV). Type O included four stem cell lines: one t(1;19) leukemia, two Ph1+ acute lymphocytic leukemia (ALL), and one biphenotypic crisis of chronic granulocytic leukemia (CGL). Type I included five ALL cell lines: three T-ALL and two common B-ALL. Type II contained 10 myeloid cell lines: five AML and five myeloid crisis of CGL. Type III contained three relatively immature lymphoma cell lines: two Burkitt's lymphoma and one follicular center lymphoma. Calculated NI/SCV (%) were as follows: type 0, 2.27 +/- 0.19/16.7 +/- 3.7; type I, 2.20 +/- 0.30/11.1 +/- 0.7; type II, 3.64 +/- 0.52/11.8 +/- 1.0; and type III, 3.60 +/- 0.53/17.5 +/- 1.9. Cell-cycle analysis of blasts using 7AAD/PY combined with surface phenotyping may yield important information for classifying hematopoietic malignancy within 2 hours of patient admission.

Symptomatic relief for patients with osseous metastasis treated with radiation and methylprednisolone: a prospective randomized study

A multi-institutional prospective study to evaluate the relief of symptoms for patients with osseous metastasis treated with irradiation and methylpredonisolone was performed. A total of 38 patients with osseous metastasis, treated between January 1991 and December 1992, were included in this study. Patients were randomly allocated to one of two treatments: radiation alone (RT alone) (n = 18) or radiation combined with methylpredonisolone (RT + MP) (n = 20). Symptoms were scored by patients themselves using original Quality of Life (QOL) scores. Stratification by urinary hydroxyproline/creatinine ratios (Hypro/Cr) showed no significant differences in QOL scores between RT and RT + MP in the group with good prognosis, which showed a lower Hypro/Cr (< 3.6 mg/g) during treatment. Following treatment, the score for both groups improved. On the other hand, in the group with poor prognosis, with a higher Hypro/Cr (> or = 3.6 mg/g), a significantly greater improvement in QOL scores was observed for the RT + MP group than for the RT alone group (p < 0.05). There was also a marked difference in the RTOG pain scores, evaluated by physicians before treatment and at the end of treatment, between the two treatment groups and the prognostic groups divided according to Hypro/Cr. No correlation was seen at initial presentation between urinary Hypro/Cr and serum tartrate-resistant acid phosphatase (TrACP). In conclusion, the treatment regimen of RT + MP is recommended for patients with osseous metastasis with poor prognosis who show relatively high Hypro/Cr values. Radiotherapy was equally effective in terms of RTOG pain score for both the poor and good prognostic groups. Serum TrACP was not useful for determining the prognosis of our patient groups.