Prostate-specific antigen in mass screening for carcinoma of the prostate

BACKGROUND

Prostate-specific antigen (PSA) has various advantages over prostatic acid phosphatase (PAP) as a marker for prostate cancer, but its role in prostate cancer mass screening remains controversial. We measured serum PSA in addition to serum PAP determination and digital rectal examination (DRE) in our mass screening program to assess the usefulness of PSA for prostate cancer mass screening.

METHODS

Serum PSA and PAP measurements and DRE were performed in 1249 patients in mass screening for carcinoma of the prostate in 1989 and 1990. Thirteen cancers were diagnosed. We calculated the mean plus standard deviations (2SD) of the PSA and PAP values of men without cancer, and assessed the usefulness of PSA for prostate cancer screening by using these figures as the upper limit of normal.

RESULTS

The number positive for PSA, PAP and DRE were 39, 36 and 48, respectively. If our screening had been performed without DRE, three cancers would have remained undetected, and the number would have been the same if performed without PSA. If the screening had been performed without PAP, on the other hand, no cancers would have remained undetected. The sensitivities of PSA and PAP were 54% and 23%, respectively. The screening detection rate with DRE and PSA was 0.88%, and with DRE and PAP was 0.64%.

CONCLUSIONS

Measurement of serum PSA values with adjustment of the cut-off value was considered more useful than PAP in mass screening for prostate cancer.

Interaction between undulated and Patch leads to an extreme form of spina bifida in double-mutant mice

The aetiology of spina bifida involves genetic and environmental factors, which may be why major genes contributing to pathogenesis have not been identified. Here we report that undulated-Patch double-mutant mice have a phenotype reminiscent of an extreme form of spina bifida occulta in humans. This unexpected phenotype in double-mutant but not single-mutant mice shows that novel congenital anomalies such as spina bifida can result from interaction between products of independently segregating loci. This example of digenic inheritance may explain the often sporadic nature of spina bifida in humans.

High-performance liquid chromatography of fullerence (C60) in plasma using ultraviolet and mass spectrometric detection

Fullerence (C60) was determined by high-performance liquid chromatography using both ultraviolet and mass spectrometric detection. The detection limit for each method was 0.05 and 2.0 ng (signal-to-noise ratio (S/N = 2)) per injection, respectively. Rat plasma spiked with C60 (10 micrograms/ml) was extracted using solid phase extraction with a recovery of 62.1% and the coefficient of variation (c.v., n = 5) between intra-day assays was 4.0%. The calibration curve for peak area and plasma C60 concentration with ultraviolet detection showed good linearity (r = 0.996) over the range 0.5-60 micrograms/ml. This newly developed method was applied to rat plasma samples after intravenous administration of C60 solubilized with polyvinylpyrrolidone.

Elevation of serum soluble vascular cell adhesion molecule-1 (sVCAM-1) levels in bronchial asthma

We have previously shown the elevation of serum soluble intercellular adhesion molecule-1 (sICAM-1) and soluble E-selectin (sE-selectin) in patients with bronchial asthma during asthma attacks. In the present study, we extended our earlier study by measuring serum sVCAM-1 levels by ELISA in 45 patients with bronchial asthma (23 atopic and 22 non-atopic) during asthma attacks and in stable conditions in order to assess further the state of adhesion molecules in allergic inflammation of bronchial asthma. The levels of sVCAM-1 in sera obtained during bronchial asthma attacks were higher than those in sera obtained in stable conditions. These findings were observed regardless of atopic status. To examine the regulatory mechanism in the elevation of serum sVCAM-1 levels, serum tumor necrosis factor-alpha (TNF-alpha) levels were measured by ELISA. TNF-alpha levels in sera obtained during bronchial asthma attacks were higher than those in sera obtained in stable conditions. The nature of change in serum TNF-alpha levels correlated with the nature of change in serum sVCAM-1 levels, but serum TNF-alpha levels did not correlate with serum sVCAM-1 levels. These results suggest that higher levels of sVCAM-1 during asthma attacks may reflect the up-regulation of VCAM-1 expression in allergic inflammation, and that a soluble form of VCAM-1 molecules may be useful markers for the presence of allergic inflammation. TNF-alpha is shown to enhance the expression and release of VCAM-1 in vitro, however; the regulatory mechanism in the elevation of serum sVCAM-1 levels remains to be clarified.

Cysteine produced from lymph node stromal cells suppresses apoptosis of mouse malignant T-lymphoma cells

Mouse malignant T-lymphoma CS-21 cells can grow when cocultured with CA-12 lymph node stromal cells, but they undergo apoptotic cell death with DNA fragmentation when separated from CA-12 stromal cells. In the course of examining the effects of the soluble factor(s) secreted by CA-12 stromal cells on CS-21 cell growth, we found that cysteine produced from CA-12 stromal cells promoted CS-21 cell growth and suppressed apoptosis in the isolated culture of CS-21 cells. The expression of anti-apoptotic protein Bcl-2, however, was not induced by cysteine. These results indicate that cysteine produced from CA-12 stromal cells participates not only in the cell growth but also in the inhibition of CS-21 apoptosis without inducing the expression of Bcl-2 protein.

Degradation of vitronectin by matrix metalloproteinases-1, -2, -3, -7 and -9

The susceptibility of vitronectin (Vn) purified from human plasma to digestion by matrix metalloproteinases (MMPs) was examined. MMP-2, -3, -7 and -9 except for MMP-1 degraded Vn into multiple fragments. MMP-7 showed the highest activity to the substrate among these MMPs, digesting 8-, 30- and 44-fold more preferentially than MMP-2, -3, and -9, respectively. These data suggest that MMP-2, -3, -7 and -9 may be responsible for the pathological degradation and/or normal turnover of Vn.

Determination of D-amino acids in serum from patients with renal dysfunction

D-Ala and D-Ser were detected in the sera of both normal subjects and patients with renal dysfunction, and their concentrations were higher in the patients than in the normal subjects. A positive correlation between the concentration of D-Ala or D-Ser and that of creatinine (r = 0.733, p < 0.001 or r = 0.634, p < 0.001) or blood urea nitrogen (BUN) (r = 0.449, p < 0.05 or r = 0.629, p < 0.001) was observed in sera from 20 patients with renal dysfunction. The fraction (%D) of D-Ala in the total Ala in serum ([D/(D+L)] x 100) correlated well with the concentration of creatinine (r = 0.811, p < 0.001), suggesting that it is a candidate as a marker for renal proximal tubular dysfunction. The correlations of %D of Ser with creatinine and BUN levels were 0.796 (p < 0.001) and 0.919 (p < 0.001), respectively, indicating that %D of Ser may reflect protein turnover or catabolism in certain tissues as well as renal proximal tubular dysfunction.

Estimation of the total saliva volume produced per day in five-year-old children

Fifteen boys and 15 girls were asked to record for 2 days the time spent awake, eating meals or snacks, and sleeping. The salivary flow rates elicited by chewing foods were also determined. The mean flow rate (+/- SD) of unstimulated saliva was 0.26 +/- 0.16 ml/min and that of saliva while chewing six different foods was 3.6 +/- 0.8 ml/min. The mean times spent eating, and awake but not eating, were 80.8 +/- 27.3 and 820 +/- 59 min, respectively, and the volumes of saliva produced during those periods would average about 288 and 208 ml, respectively. If the flow rate is virtually zero during sleep, the estimated total salivary volume produced per day is calculated to be about 500 ml.

A highly sensitive, broad-spectrum infectivity assay for infectious bursal disease virus

In order to develop an infectivity assay for infectious bursal disease virus (IBDV), an enzyme-linked immunosorbent assay (ELISA) for detecting IBDV antigens was developed using a rabbit antiserum to IBDV. The ELISA detected both serotypes 1 and 2 of IBDV, purified virus proteins at a concentration of about 0.1 ng/well and about 10(4) to 10(5) infectious units/well, and was about 10(3) times more sensitive than an agar gel precipitin test. By using the ELISA for detecting IBDV antigens in the cultured fluids, infectivity titration could be determined within 5 days of cultivation in seven of the 10 virus-cell combinations when chicken embryo fibroblasts (CEFs), BGM-70 cells, and LSCC-BK3 cells were used. IBDV antigens were not detected in three combinations remaining after 7 days of cultivation. When 18 IBDV strains, including highly virulent, classically virulent, and attenuated strains, were tested for growth in four types of cells using the ELISA, eight strains in CEFs, seven strains in chicken kidney cells, five strains in BGM-70 cells, and 17 strains in LSCC-BK3 cells were detected. These results indicated that LSCC-BK3 cells had the broadest spectrum for IBDV. When 26 field bursal homogenates were tested for infectious IBDV using LSCC-BK3 cells, all 19 field IBDV isolates that were detected by immunostaining of the cells were also detected by the ELISA. These results indicate that this infectivity assay for IBDV using LSCC-BK3 cells and the ELISA has a high sensitivity and a broad spectrum for IBDV and is especially useful for large-scale applications.

Availability of phenylisothiocyanate for the amino acid sequence/configuration determination of peptides containing D/L-amino acids

A potential use for phenylisothiocyanate (PITC), the most popular Edman reagent, is presented for analysis of the amino acid sequence and configuration in peptides containing D/L-amino acids. After derivatization with PITC of the N-terminal amino acid (L-Tyr) of an enkephalin analogue, [D-Ala2, D-Leu5]-enkephalin, followed by cleavage/cyclization with trifluoroacetic acid at 50 degrees C for 5 min, the liberated 2-anilino-5-thiazolinone-L-Tyr (ATZ-L-Tyr) was further treated with 20% aqueous trifluoroacetic acid at 50 degrees C for 10 min. The resultant phenylthiohydantoin (PTH)-L-Tyr was then separated on a chiral stationary phase (a penylcarbamoylated cyclodextrin column), retaining its configuration. The residual sequence and configurations of the peptide (D-Ala-Gly-L-Phe-D-Leu) were also determined by separating the corresponding PTH-D- or L-amino acids on chiral columns. This method may be applicable to an automatic Edman sequence analyzer for the configuration determination of peptides containing D/L-amino acids.

Epidemiological characteristics of prostate cancer in Gunma Prefecture, Japan. Gunma University Urological Oncology Study Group

BACKGROUND

Prostate cancer is rare in Asia, but the number of patients is increasing in Japan. We conducted an epidemiological study of prostate cancer in Gunma Prefecture, Japan, to investigate the trends and characteristics of the disease.

METHODS

The subjects were 1,411 prostate cancer patients newly diagnosed between 1985 and 1992, and 656 patients who died from prostate cancer between 1981 and 1992. The incidence and mortality rates were calculated by year, demographic region and age.

RESULTS

The yearly incidence rate showed an increase but the mortality rate showed no marked fluctuations. There was no significant difference between urban and rural districts in either incidence or mortality rate. The incidence rate tended to be high in the northern part of the prefecture, but no marked variation in mortality rate was seen. The incidence and mortality rates in districts with a history of manganese mining were high compared to those in districts without mining. In contrast, the incidence and mortality rates in districts with a history of zinc mining were comparatively lower. Both incidence and mortality rates showed a marked increase with age. The age-specific incidence showed a double logarithmic relationship to age.

CONCLUSIONS

The increase of the yearly incidence rate might be due to changes in lifestyle and environmental factors, improved diagnostic techniques, and increased awareness among the general public regarding prostate disease. Further investigation is needed to clarify the pattern and the causes of regional differences in the incidence and mortality rates. The possibilities that managanese and zinc might be related to prostatic carcinogenesis are suggested.

Determination of D-amino acids, derivatized with 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F), in wine samples by high-performance liquid chromatography

The concentrations of D-amino acids and their enantiomeric ratios in wind samples were determined by high-performance liquid chromatography with fluorometric detection. We used Pirkle type chiral stationary phases and fluorogenic reagent, 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F) for simplicity and high sensitivity. The amino acids determined were D-enantiomers of alanine (Ala), aspartic acid, glutamic acid, isoleucine (Ile) and leucine (Leu), D-Asparagine, -glutamine and -lysine were not detected. D-Leu was detected in red and rosé wine samples, and D-Ile was determined only in rosé wine. In contrast, neither D-Leu nor Ile were detected in white wine samples. The concentration of D-Ala was the most prominent among these amino acids with the highest content of approximately 180 microns (D/D + L ratio; 25%) in rosé wine.

Novel ligand binding properties of the myoglobin substituted with monoazahemin

The iron complex of alpha-azamesoporphyrin XIII was combined with apomyoglobin to investigate influence of the meso nitrogen on ligand binding properties in the reconstituted protein. Stoichiometric complex formation between the two components was confirmed, and conservation of the native coordination structures in the resultant myoglobin was established with spectroscopic criteria and apparently normal ligand binding. The visible absorption spectra of various ferric and ferrous derivatives are characteristic with less intense Soret peaks and enhanced visible bands. The electron paramagnetic resonance spectrum with g = 5.2 suggests an anomalous intermediate spin (S = 3/2) character for the aquomet protein. The oxygen affinity of reduced azaheme myoglobin, 0.010 mm Hg, is 50 times larger than that of the native myoglobin. In addition, azaheme myoglobin forms stable complexes with imidazole, pyridine, or cyanide in ferrous state. All of these new properties were consistently explained in terms of stronger equatorial ligand field of the heme iron in a narrower coordination cavity. Similarities of azaheme to verdoheme were also pointed out.

[A case of surgical treatment of acute aortic dissection without an intimal tear]

We experienced a case of acute aortic dissection without an intimal tear. A 55-year-old woman with SLE presented with acute chest pain. TEE study showed dissection of the ascending aorta, and accompanied by pericardial effusion. An emergency operation was performed four hours after onset. Intraoperatively, thrombus was encountered in the false lumen of the ascending aorta and the proximal arch. However, intimal tear was not found. She underwent graft replacement of the ascending aorta and the total aortic arch, and had an uneventful postoperative course. Histological examination of a segment of ascending aorta showed no evidence of mucinous degeneration and pathological rupture of the elastic fiber.

Polymyositis associated with thymoma and the subsequent development of pure red cell aplasia

A 53-year-old woman with polymyositis associated with thymoma subsequently developed pure red cell aplasia (PRCA). She was hospitalized because of fever and muscle weakness, and diagnosed as having polymyositis by muscle biopsy. Remarkable clinical improvement followed administration of prednisolone. Progressive anemia became evident, however, while prednisolone was being tapered. Erythroid aplasia and the presence of thymoma confirmed the diagnosis of PRCA. Further examinations revealed that cytotoxic T cells may play an important role in the pathogenesis of this case.

Cardiac sympathetic denervation in transthyretin-related familial amyloidotic polyneuropathy: detection with iodine-123-MIBG

In familial amyloidotic polyneuropathy (FAP), the peripheral nervous system is predominantly impaired. Cardiac sympathetic function has not been directly assessed. A 65-yr-old man with severe peripheral neuropathy due to primary systemic amyloidosis was studied. Echocardiograms and scintigraphic examinations with 20Tl and 99mTc-pyrophosphate demonstrated highly thickened but normally perfused left ventricular walls with intense diffuse amyloid deposits. No definite myocardial activity of [123I]metaiodobenzylguanidine (MIBG) was detected in any cardiac region, indicating lack of sympathetic nerve endings. Despite maintained cardiac contractility, left ventricular diastolic performance and heart rate variability assessed by power spectral analysis were markedly depressed. Thus, the myocardial defect of MIBG activity may provide direct evidence of impaired cardiac sympathetic nerve endings due to amyloid deposits in FAP.

Resistance of hepatic lysosomes, mitochondria and microsomes of protoporphyrin-administered rats to peroxidative damage

Antioxidative inhibition by protoporphyrin (PP) of peroxidative damage in lysosomes, mitochondria and microsomes of rat liver was investigated at 24 h after an intravenous administration of PP. Using a lysosome-containing (3500 x g) fraction, the release of lysosomal marker enzymes, acid phosphatase and aryl sulfatase, from lysosome which had been stimulated by L-ascorbic acid (AsA), was decreased dose-dependently, as was the inhibition of lipid peroxidation by PP in the fraction. Swelling of mitochondria induced by Fe2+ and AsA was also inhibited in the PP-injected rat. In microsomes, lipid peroxidation stimulated by AsA caused a decrease in activity of a microsomal marker enzyme, glucose 6-phosphatase, and in P450 content. The extent of the decrease by AsA, both in activity and content, was diminished in PP-administered rat liver microsomes. These results indicate that PP protects those subcellular fractions from deterioration by lipid peroxidation.

[A case of ANCA negative Wegener's granulomatosis with pulmonary giant bulla showing high level of soluble ICAM-1]

This paper reports a rare case of the limited form of Wegener's granulomatosis (WG) with pulmonary giant bulla, which was pathologically identified only in the lung and showed a high level of soluble intercellular adhesion molecule-1 (ICAM-1) but not anti-neutrophil cytoplasmic antibody (ANCA). A 46 year-old male was admitted for the further examination of right anterior chest pain and dyspnea. Chest X-ray and CT examination showed giant bulla accompanied with the invasive lesions in upper lobe of right lung. Partial lobectomy was done. Granulomatous and necrotizing vasculitis characteristics of WG were confirmed by the histopathology of resected tissues. Immunological analysis on admission showed a high level of soluble ICAM-1 and ANCA negative, but that of soluble ICAM-1 was reduced after surgical operation and remained within normal range during an administration of prednisolone and cyclophosphamide. These results suggest that soluble ICAM-1 may be one of the useful parameters for a diagnosis of WG and for an estimation of its treatments, especially in the cases of ANCA negative WG.

Differential effects of the immunosuppressants cyclosporin A, FK506 and KM2210 on cytokine gene expression

Cyclosporin A (CsA) inhibited interleukin 2 (IL-2), IL-3, interferon gamma (IFN gamma), GM-CSF and tumor necrosis factor alpha (TNF alpha) mRNA expression in spleen cells stimulated with concavalin A (Con A) when determined by the semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) method. FK506 which has a similar immunosuppressive mechanism to that of CsA also showed the same inhibitory effects except for decreased IL-5 and IL-6 mRNA expression. In contrast, both CsA and FK506 enhanced transforming growth factor beta (TGF beta) and IL-1 beta mRNA expression. Another immunosuppressant KM2210 did not show any inhibitory effects on cytokine gene expression but rather enhanced IL-10, IL-6, TGF beta and IL-1 mRNA expression, thus suggesting that KM2210 has a completely different immunosuppressive mechanism from that of CsA and FK506. Anti-TFG beta 1 antibody abrogated the suppression by KM2210 of BALB/c anti-3H/He mixed lymphocyte reaction (MLR) whereas this antibody did not abrogate the suppression by CsA and FK506 of BALB/c anti-C3H/He MLR. These results indicate that TGF beta is one of the major cytokines in KM2210 immunosuppression, in addition to IL-10, but not in immunosuppression by CsA and FK506.

Immunolocalization of desmoglein and intermediate filaments in human oral squamous cell carcinomas

BACKGROUND

Information is limited as to how to predict the malignant behavior of the oral squamous cell carcinomas. The invasive and metastatic phenotype of the carcinoma cells may be related to changes in the expression of desmosomal and cytoskeletal proteins.

METHODS

To investigate the expression of desmoglein, cytokeratins, and vimentin, 22 biopsy specimens of oral squamous cell carcinomas were examined by immunohistochemistry. The data were analyzed by morphometry with reference to the cell differentiation, mode of invasion, and cervical lymph node metastasis.

RESULTS

The expression of desmoglein, a major desmosomal glycoprotein, was remarkably reduced in the poorly differentiated, highly invasive, and metastatic carcinomas. Although the immunohistochemical expression of cytokeratins in the carcinoma cells was a good marker for the differentiation status of the carcinomas, the level of expression demonstrated no correlation with tumor invasiveness or lymph node metastasis. On the other hand, the vimentin expression was inversely correlated to the differentiation and mode of invasion, and carcinomas in the metastatic group had significantly higher levels of vimentin expression than the nonmetastatic group.

CONCLUSION

The results suggest that immunohistochemical examination of desmoglein and vimentin in oral squamous cell carcinomas is valuable in evaluating the malignant behavior of tumors.