[Prognosis of premenopausal patients with operable breast cancer related to the timing of operation]

OBJECTIVE

Determining the fact if the timing of mastectomy during the menstrual cycle influences the prognosis of premenopausal women with breast cancer.

METHODS

67 cases of breast cancer women with regular menstruation were reviewed and analyzed retrospectively by medical statistics in terms of 5-year overall survival, 5-year relapse-free survival and 5-year local-regional relapse survival.

RESULTS

Even though the 5-year overall survival and 5-year local-regional relapse survival were not different statistically, timing of operation did have a tendency to influence outcome. Meanwhile, estrogen receptor played the most important role in influencing the above-mentioned aspects in comparison with other factors.

CONCLUSION

We believe that operation during the last menstrual period might have influence on long-term survival of premenopausal breast cancer patients, but prospective studies are needed.

Are immunizations an incentive for well-child visits?

OBJECTIVE

To assess the beliefs of parents and the visit patterns of their children to determine whether immunizations act as an incentive to use well-child care.

DESIGN AND METHODS

Medical record audits provided data on immunizations and well-child visits. Two questions from a parent interview were used to identify 4 groups of parents: (1) motivated and (2) unmotivated to keep a well-child care appointment regardless of whether immunizations are scheduled, (3) vaccine-motivated and (4) checkup-motivated (parents who were influenced negatively by the prospect of receiving vaccinations). The percentage of children with a visit at each age window for well-child visits and the percentage up-to-date for their immunizations at given ages were compared across the 4 groups. The 4 groups were also compared for other parental attitudes about immunizations and well-child visits, and on sociodemographic and access characteristics.

RESULTS

Most (73.3%) of the 502 parents surveyed were classified as motivated and 5% as unmotivated to keep a well-child care appointment regardless of whether an immunization was scheduled. Only 18.3% were categorized as vaccine-motivated and 3.4% as checkup-motivated. For all 4 groups, there was no discernible difference in attendance between immunization and nonimmunization visits. Attendance in the windows for well-child visits and percentage of children up-to-date on immunizations declined with increasing age.

CONCLUSIONS

In this inner-city population, attendance patterns at visits did not support the incentive hypothesis. This finding should reassure clinicians that providing immunizations outside of regular well-child care visits will not necessarily decrease attendance at visits for well-child care.

Effect of gastrin-releasing peptide receptor number on receptor affinity, coupling, degradation, and modulation

The relationship between receptor number and agonist-induced intracellular responses has been well studied in receptors coupled to adenylate cyclase; however, for receptors coupled to phospholipase C (PLC), very little is known about the effect of receptor number on receptor-mediated processes. To explore this issue, we investigated the effect of the number of receptors for gastrin-releasing peptide (GRP) on ligand affinity and on the ability to activate intracellular messengers [PLC, tyrosine phosphorylation of p125 focal adhesion kinase (p125FAK)] and cause receptor modulation (internalization, desensitization, down-regulation) and ligand degradation. Three BALB 3T3 cell lines were made that stably expressed the gastrin-releasing peptide receptor (GRP-R) with receptor numbers varying by 280-fold (GRP-R-Low, GRP-R-Med, and GRP-R-Hi). Each cell line had the same affinity for agonist. The efficacy for bombesin to increase [3H]inositol phosphates but not tyrosine phosphorylation of p125FAK correlated well with receptor number. In contrast, the EC50 value for [3H]inositol phosphate generation for bombesin was the same in each cell line. Receptor number did not alter internalization. In the absence of protease inhibitors, there was an inverse correlation between receptor number and receptor down-regulation and desensitization. However, with protease inhibitors present, GRP-R-Med and GRP-R-Hi down-regulated significantly less than the GRP-R-Low. Similarly, GRP-R-Low desensitized significantly more than GRP-R-Med or GRP-R-Hi. GRP-R-Hi caused significantly greater ligand degradation than GRP-R-Low, and protease inhibitors completely inhibited degradation by GRP-R-Low and inhibited degradation by 70% for GRP-R-Hi. In conclusion, we show that for the PLC-coupled GRP-R, receptor number had little or no effect on binding affinity, potency for activating PLC, tyrosine phosphorylation of p125FAK, or extent of receptor internalization. In contrast, receptor number had an effect on ligand degradation, down-regulation, desensitization, and efficacy of PLC activation without altering the efficacy of tyrosine phosphorylation of p125FAK. These results demonstrate that the effect of receptor number differs for the different functions mediated by the GRP receptor and differs from that reported for adenylate cyclase-coupled receptors such as receptors mediating the action of adrenergic agents, secretin, and opioids.

Endogenous arachidonic acid release and pancreatic amylase secretion

Recent studies have suggested the involvement of phospholipase A2 (PLA2) in pancreatic amylase secretion. The present study was designed to investigate the secretory role of arachidonic acid (AA) in carbachol (Cch)-stimulated rat pancreatic acini and its origin. From enzymatic assays, PLA2 and diacylglycerol (DAG) lipase were activated by Cch and respectively inhibited by the PLA2 inhibitors, mepacrine and aristolochic acid, and by the DAG lipase inhibitor, RHC 80267. Melittin-activated PLA2 activity was also inhibited by the PLA2 inhibitors. Cch-stimulated endogenous AA release from pancreatic acini was partially inhibited by 150 microM RHC 80267 and by 150 microM mepacrine or 200 microM aristolochic acid and totally inhibited by a combination of the two enzyme inhibitors. Exogenous AA caused amylase release in a concentration-dependent manner. Eicosatetraynoic acid (a cyclooxygenase and lipoxygenase inhibitor), significantly increased basal and Cch-induced AA release and amylase secretion. RHC 80267 and the PLA2 inhibitors separately and partially suppressed Cch-stimulated amylase secretion, with an additive effect observed when the DAG lipase and the PLA2 inhibitors were combined. A combination of RHC 80267, mepacrine, or aristolochic acid and the phospholipase C (PLC) inhibitor U73122 completely inhibited Cch-stimulated amylase secretion. Finally, the PLA2 activator melittin-stimulated amylase secretion was blocked by the two PLA2 inhibitors. We conclude that exogenous and endogenous AA can induce amylase secretion. Therefore, AA released from either PLC-DAG lipase or PLA2 pathways can be considered an additional and important intracellular mediator of amylase secretion.

Caerulein-stimulated arachidonic acid release in rat pancreatic acini: a diacylglycerol lipase affair

This study was performed to evaluate the effect of caerulein, a cholecystokinin analogue, on arachidonic acid (AA) release in rat pancreatic acini and to determine the cellular mechanism involved. Caerulein did not stimulate phospholipase A2 (PLA2); however, diacylglycerol (DAG) lipase activity was increased. Validity of PLA2 or DAG lipase inhibitors was confirmed by their ability to selectively inhibit PLA2 or DAG lipase activities. Caerulein increased AA release from acini prelabeled with [3H]AA both dose and time dependently. Inhibitors were used to evaluate the involvement of different signaling pathways. Mepacrine and aristolochic acid, two PLA2 inhibitors, did not inhibit caerulein-induced AA release, whereas the DAG lipase inhibitor RHC-80267 did. The phospholipase C (PLC) inhibitor U-73122 totally inhibited caerulein-induced AA release, whereas the phospholipase D (PLD) inhibitor wortmannin had no effect. Our data indicate that caerulein-induced AA release results from the combined action of PLC and DAG lipase without PLA2 or PLD activation.

Basic fibroblast growth factor-stimulated arachidonic acid release in rat pancreatic acini: sequential action of tyrosine kinase, phospholipase C, protein kinase C and diacylglycerol lipase

This study was performed to evaluate the effect of human recombinant basic fibroblast growth factor on arachidonic acid release from rat pancreatic acini and to determine the cellular mechanism involved. From enzymatic assays, basic fibroblast growth factor did not significantly stimulate phospholipase A2 activity, whereas it significantly increased diacylglycerol lipase activity. Validity of phospholipase A2 or diacylglycerol lipase inhibitors was confirmed by their ability to inhibit phospholipase A2 or diacylglycerol lipase activities. Basic fibroblast growth factor increased intracellular accumulation and extracellular release of arachidonic acid from metabolically labelled acinar cells in a concentration- and time-dependent manner. This effect was maximal with 50 pM basic fibroblast growth factor and became significant after a 5-min incubation period. The protein tyrosine kinase inhibitor, 0.5 mM genistein, inhibited arachidonic acid release in basic fibroblast growth factor-stimulated acini, whereas 100 microM vanadate, a protein tyrosine phosphatase inhibitor, enhanced arachidonic acid release. Two phospholipase A2 inhibitors, mepacrine and aristolochic acid, failed to attenuate basic fibroblast growth factor-stimulated arachidonic acid release. A diacylglycerol lipase inhibitor RHC 80267 at 150 microM and 50 microM completely inhibited 50 pM basic fibroblast growth factor-induced intracellular accumulation and extracellular release of arachidonic acid, respectively. Furthermore, basic fibroblast growth factor stimulated arachidonic acid release was also inhibited by 10 microM U73122 and by 100 nM staurosporine, phospholipase C and protein kinase C respective inhibitors. Wortmannin, an inhibitor of basic fibroblast growth factor-stimulated phospholipase D, did not affect arachidonic acid release. 100 nM 4 beta-phorbol 12-myristate 13-acetate also increased arachidonic acid release, an effect also inhibited by staurosporine. Taken together, these data demonstrate activation of diacylglycerol lipase and arachidonic acid release in pancreatic acini upon stimulation by basic fibroblast growth factor, and strongly indicate that arachidonic acid release in response to basic fibroblast growth factor depends upon the sequential action of tyrosine kinase, phospholipase C, protein kinase C and diacylglycerol lipase but not from phospholipase A2 not phospholipase D activation.

[Experience of surgical treatment of patients with N2 lung cancer]

From January 1987 to December 1993, 426 patients with lung cancer were operated in our hospital, among which 159 patients were diagnosed postoperatively to be N2 disease by pathology including 81 central type and 78 peripheral type lung cancer. Radical operations were performed on 135 cases, palliative operations on 24 cases. Follow up study: one-year survival rate was 71.7%, three-year survival rate 29.0% and five-year survival rate 21.7%. The main factors affecting operative results are tumor cell type, the number and location of metastatic lymph nodes and the thoroughness of dissection. Tumor staging, except T4 tumor is not a main factor influencing prognosis. The indications of operation performed on N2 lung cancer and the necessity of extensive nodal exenteration are also discussed in this article. We consider extensive hilar and mediastinal nodal exenteration necessary in order to achieve radical resection and good prognosis.

Dual pathways for carbamylcholine-stimulated arachidonic acid release in rat pancreatic acini

Recent studies suggested the involvement of arachidonic acid in the mediation of pancreatic amylase release. However, an effect of carbamylcholine on arachidonic acid release has not yet been reported in the exocrine pancreas. This study was performed to evaluate the effect of carbamylcholine on arachidonic acid release and determine the underlying intracellular mechanisms. From enzymatic assays, phospholipase A(2) and diacylglycerol lipase were activated by carbamylcholine and these activations were inhibited by the phospholipase A(2) inhibitors, mepacrine and aristolochic acid, and by the diacylglycerol lipase inhibitor RHC 80267. Carbamylcholine also increased arachidonic acid release in a concentration-dependent manner. Both phospholipase A(2) and diacylglycerol inhibitors partially inhibited carbamylcholine-stimulated arachidonic acid release. The phospholipase C inhibitor U73122 and the protein kinase C inhibitor staurosporine also caused partial inhibition. Arachidonic acid release by carbamylcholine was suppressed by the simultaneous addition of RHC 80267 with either phospholipase A(2) inhibitors. Our data demonstrate that phospholipase A(2) and diacylglycerol lipase are activated and arachidonic acid is released in pancreatic acini by carbamylcholine. Dual pathways are responsible for carbamylcholine-induced arachidonic acid release. One such pathway involves the sequential action of phospholipase C, protein kinase C and diacylglycerol lipase, whereas the other involves phospholipase A(2) activation.

[The relationship between prognosis of esophageal squamous carcinoma and Langerhans cell]

The operative tumor specimen of esophageal squamous carcinoma were studied with immunohistochemical (ABC) method S-100 protein staining. Under the light microscopy, we observed the morphology, number and distribution of Langerhan's cells (LC) in different portion of the tumor mass and its relationship with the pathological staging in 167 cases. We observed also the relationship between LC and the postoperative survival period in 127 cases followed for more than 3 years. These results suggested found that positive relation between the number of LC in the cancer nest and in the lymphfollicle with the increasing of TNM classification. The number of LC in the cancer nest significantly increased in state III and IV cases than II cases. On the contrary, the number of LC in the peritumor and interstitial tissue decreased while the TNM classification was increasing. These findings suggested that the survival period was shorter in patients whose LC had increased in the cancer nest, whereas the survival period would be longer in those patients whose LC had increased in the tissue around the tumor mass, in the mucosa near the tumor as well as in the interstitial tissue. These two points might be used as an immunological para-meter for the assessment of the prognosis.

[Thoracoscopic esophagectomy for esophageal carcinoma: report of 8 patients]

Eight patients with esophageal carcinoma were treated by VATS in our hospital since March 1995. Of the 8 patients, 2 had lower-middle segment esophageal carcinoma and 6 middle segment. The operations performed on seven patients were successful except one that had to be changed to thoractomy as a result of invasion of tumor. Techniques of VATS in treating esophageal carcinoma and indication were discussed.

[Experience in repair of eyelid ectropion with temporofrontal flap]

We used the temporofrontal flap to repair eyelid ectropion in 12 patients. The results were satisfactory. The indications, advantages and disadvantages, and the points for attention of this operation method were discussed. Experiences and lessons were summarized in this article.

[Evaluation of two glycolipids from M. tuberculosis in the serodiagnosis of tuberculosis]

Sera from 112 healthy controls and 120 pulmonary tuberculous patients (61 untreated patients and 59 active patients) were assayed, by ELISA, to test the activity of IgG and IgM antibodies against antigen of 2, 3-diacyl-trehalose-2'-sulphate (SL IV) a phenolglycolipid antigen (PGLTb1) and purified protein derivative (PPD) from M. tuberculosis. Respectively, for SL IV-IgG-ELISA, SL IV-IgM-ELISA, PGLTb1-IgG-ELISA, PGLTb1-IgM-ELISA, PPD-IgG-ELISA, the specificities were of 96.43, 96.43, 96.43, 96.43 and 95.53%; the sensitivities were of 51.67, 32.50, 14.17, 18.33 and 33.33%; the efficiencies were of 73.28, 63.36, 53.88, 56.03 and 62.93%; the predictive values for a positive result were of 96.87, 86.67, 80.95, 84.62 and 88.64%. Among the three antigens tested, SL IV was found to be better than PGLTb1 and PPD.

Genetic analysis of a phosphatidylinositol 3-kinase SH2 domain reveals determinants of specificity

Phosphatidylinositol 3-kinase is an important element in both normal and oncogenic signal transduction. Polyomavirus middle T antigen transforms cells in a manner depending on association of its tyrosine 315 phosphorylation site with Src homology 2 (SH2) domains on the p85 subunit of the phosphatidylinositol 3-kinase. Both nonselective and site-directed mutagenesis have been used to probe the interaction of middle T with the N-terminal SH2 domain of p85. Most of the 24 mutants obtained showed reduced middle T binding. However, mutations that showed increased binding were also found. Comparison of middle T binding to that of the platelet-derived growth factor receptor showed that some mutations altered the specificity of recognition by the SH2 domain. Mutations altering S-393, D-394, and P-395 were shown to affect the ability of the SH2 domain to select peptides from a degenerate phosphopeptide library. These results focus attention on the role of the EF loop in the SH2 domain in determining binding selectivity at the third position after the phosphotyrosine.

DNA sequencing with a hexamer string primer and dye-labeled terminators

A method for fluorescence-based DNA sequencing using a hexamer string primer and dye-labeled terminators is described. Sequencing protocols have been determined that provide an average read length of 393 bases with 99.6% base-calling accuracy for single-stranded M13mp18 DNA, and an average read length of 367 bases with 99.4% base-calling accuracy for double-stranded M13mp19 DNA. The signal intensity is stronger than that obtained with a standard 18-mer primer, while the resolution and length of readable sequence are comparable.

Identification of two SH3-binding motifs in the regulatory subunit of phosphatidylinositol 3-kinase

Src homology 3 (SH3) domains have been recently shown to bind to proline-rich sequences contained in 3BP1, 3BP2, and SOS. In a recent study we demonstrated that phosphatidylinositol 3-kinase (PI 3-kinase) associates with the Fyn SH3 domain. Here we show that p85, the regulatory subunit of PI 3-kinase, binds directly to the SH3 domains of Abl, Lck, Fyn, and p85 itself. An examination of p85 amino acid sequence revealed two proline-rich sequences in its N-terminal region similar to those present in 3BP1, 3BP2, and SOS. To test whether these sequences mediate the association of p85 with SH3 domains two peptides with amino acid composition corresponding to the p85 alpha proline-rich sequences were synthesized and used in competition assays. Both peptides worked equally well in inhibiting the binding of PI 3-kinase activity and p85 alpha to Fyn SH3 domain, whereas a control peptide had no effect. These results indicate that, as in 3BP1 and SOS, the proline-rich sequences in p85 mediate its interaction with SH3 domains. These results also suggest that the SH3 domain of p85 may "self-associate" with the proline-rich motifs of the same subunit as part of the PI 3-kinase regulatory mechanism.

Poly(A) site selection in the yeast Ty retroelement requires an upstream region and sequence-specific titratable factor(s) in vitro

In the Ty retrotransposon of Saccharomyces cerevisiae, as in most retroelements, the polyadenylation site of the 5' long terminal repeat (LTR) is ignored and the one in the 3' LTR is efficiently used. We examine here the contribution to this poly(A) site selection of the region termed 'U3', corresponding to the upstream non-transcribed portion of the 5' LTR. Using an established assay in vitro, we find that 3' processing is accurate and efficient with an RNA substrate corresponding to most of the LTR, whereas none is detectable with a shorter transcript lacking the U3 region, thus explaining why the 5' poly(A) site is ignored in genomic Ty mRNA. When HIS4 coding RNA, representing 'non-specific' sequence, replaces the U3 region, the Ty polyadenylation site is activated to 50% of the wild-type level. Within one specific region (TS1) in U3, 90-95 nt upstream of the poly(A) site, the change of UAGUAU to UCGCAU reduces processing efficiency by half, to the non-specific level provided by other sequences or by a deletion of the TS1 region. Another region (TS2) near the poly(A) site appears to be independently responsible for the remaining half of the processing activity. Alteration of both TS1 and TS2 eliminates processing entirely. In competition assays, excess unlabeled U3, but not its mutated counterparts, reduces the processing of radiolabeled Ty mRNA, suggesting the involvement of some sequence-specific titratable factor(s) in the whole cell extract for U3-specific activation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Detection of antibodies to sulpholipid IV from mycobacterium tuberculosis in pulmonary tuberculosis patients]

Serum IgG and IgM antibodies against a novel 2,3-diacyl-trehalose-2'-sulphate (SLIV) antigen using ELISA were determined in control (n = 112) and in pulmonary tuberculosis (n = 120) patients. The specificity and sensitivity of SLIV-IgG-ELISA were 96% and 52%, respectively. Those of SLIV-IgM-ELISA were 95% and 33%, respectively. Compared with PPD-IgG-ELISA, SLIV-IgG-ELISA showed that the specificity was about the same but the sensitivity was higher.

Solitary pedunculated polypoid gastric gland heterotopia

A solitary pedunculated gastric polyp in the gastric fundus was removed from an asymptomatic 36-year-old woman with normal gastric acid secretion and a normal serum gastrin level. This lesion exhibited distinctive histological features including prominent proliferation of pseudopyloric glands, fundic glands, foveolar epithelium and a fibromuscular stroma. Moreover, its surface was entirely covered by a layer of normal gastric epithelium. Biopsies of the background mucosa taken from the gastric fundus revealed only mild superficial gastritis. A gastric gland heterotopia was diagnosed because of its unique morphology.

Secretion of somatostatin and gastrin by human antral mucosa--an in vitro study in duodenal ulcer patients and control subjects under stimulation of bombesin

In order to ascertain possible abnormalities in somatostatin and gastrin secretion in patients with duodenal ulcer, the author compared bombesin-stimulated somatostatin and gastrin secretion by antral mucosal explants in patients with duodenal ulcer, those with atrophic gastritis and normal controls. An organ culture technique was employed. This excluded neurogenic, hormonal and circulatory influences. Bombesin in concentrations of 10(-7) M to 10(-5) M stimulated gastrin and somatostatin secretion at a dose-dependent manner. In all subjects, bombesin (10(-7) M) stimulated antral gastrin release and increased explant gastrin content significantly (p < 0.05). Bombesin significantly increased somatostatin release and explant somatostatin content in normal subjects (p < 0.05) but not in patients with duodenal ulcer (p > 0.05). In the presence of bombesin, the total net increase of gastrin in medium and explants was greater in duodenal ulcer patients (31.57 +/- 5.20 ng/mg wet w.) compared with normal subjects (19.63 +/- 4.50 ng/mg wet w.) (p < 0.01). The total net increase of somatostatin in the presence of bombesin was significantly less in duodenal ulcer patients (0.10 +/- 0.02 ng/mg wet w.) than in normal subjects (1.45 +/- 0.24 ng/mg wet w.) (p < 0.01). The results suggest that abnormalities in somatostatin and gastrin secretion of the antrum contribute to the pathogenesis of increased gastric acid secretion in duodenal ulcer.

Interactions of polyomavirus middle T with the SH2 domains of the pp85 subunit of phosphatidylinositol-3-kinase

The binding of phosphatidylinositol-3-kinase to the polyomavirus middle T antigen is facilitated by tyrosine phosphorylation of middle T on residue 315. The pp85 subunit of phosphatidylinositol-3-kinase contains two SH2 domains, one in the middle of the molecule and one at the C terminus. When assayed by blotting with phosphorylated middle T, the more N-terminal SH2 domain is responsible for binding to middle T. When assayed in solution with glutathione S transferase fusions, both SH2s are capable of binding phosphorylated middle T. While both SH2 fusions can compete with intact pp85 for binding to middle T, the C-terminal SH2 is the more efficient of the two. Interaction between pp85 or its SH2 domains and middle T can be blocked by a synthetic peptide comprising the tyrosine phosphorylation sequence around middle T residue 315. Despite the fact that middle T can interact with both SH2s, these domains are not equivalent. Only the C-terminal SH2-middle T interaction was blocked by anti-SH2 antibody; the two SH2 fusions also interact with different cellular proteins.

The bingo model of survivorship: 1. probabilistic aspects

A "bingo" model is one in which the pattern of survival of a system is determined by whichever of several components, each with its own particular distribution for survival, fails first. The model is motivated by the study of lifespan in animals. A number of properties of such systems are discussed in general. They include the use of a special criterion of skewness that probably corresponds more closely than traditional measures to what the eye observes in casually inspecting data. This criterion is the ratio, r(h), of the probability density at a point an arbitrary distance, h, above the mode to that an equal distance below the mode. If this ratio is positive for all positive arguments, the distribution is considered positively asymmetrical and conversely. Details of the bingo model are worked out for several types of base distributions: the rectangular, the triangular, the logistic, and by numerical methods, the normal, lognormal, and gamma.