[A case of adenocarcinoma of the reconstructed bladder following ileocystoplasty]

We experienced a case of adenocarcinoma occurring in the reconstructed bladder 38 years after ileocystoplasty. The patient was a 48-year-old woman, who had undergone ileocystoplasty and left nephrectomy at the age of 10 for the treatment of tuberculous contracted bladder and left renal tuberculosis. She had often suffered from right pyelonephritis following the operation. She visited our hospital for work-up of a high value of carcinoembryonic antigen (CEA). The findings of cystoscopy, cystogram and urine cytology showed a malignant tumor of the reconstructed bladder. Then, we performed total cystectomy and right ureterostomy. The histopathological examination showed that the tumor was an adenocarcinoma which developed mainly from the ileal segment of the reconstructed bladder.

Effects of mild hypothermia on cerebral blood flow-independent changes in cortical extracellular levels of amino acids following contusion trauma in the rat

The mechanism of hypothermic cerebroprotection after traumatic brain injury (TBI) is unknown. The present study was conducted to investigate the effects of mild hypothermia on the changes in cortical extracellular amino acids and cerebral blood flow (CBF) caused by cerebral contusion created in the rat parietal cortex by a weight-drop method. CBF in both normothermia (37 degrees C) and hypothermia (32 degrees C) groups, which was monitored using the hydrogen clearance technique, decreased significantly after contusion, but never fell below the threshold for ischemia. Cortical levels of glutamate, aspartate, glycine and taurine, which were measured by intracerebral microdialysis, were significantly increased after contusion in each group. However, these increases were greater in the hypothermic than in the normothermic rats. Normal plasma amino acid levels were high, and autoradiography following intravenous injection of 14C-labeled glutamate revealed marked extravasation of [14C]glutamate at the site of cortical impact. These results suggest that the post-traumatic increase in extracellular amino acids occurs independently of CBF reduction, and that extravasation of amino acids from the vascular compartment partly contributes to this increase. Hypothermic cerebroprotection in TBI is thus likely to occur through a mechanism other than reduction in interstitial excitatory amino acids. In TBI, it is postulated that the postsynaptic effects of hypothermia may be more important than the presynaptic effects, when CBF is kept above the ischemic threshold.

Role of gammadelta T lymphocytes in the development of Behçet's disease

Phenotypic and functional properties of gammadelta T cells, which play an important role in mucocutaneous immunity, were examined to elucidate whether immunological abnormality in Behcet's disease may be related to a specific T cell population. We found that CD45RA+ Vgamma9+ Vdelta2+ gammadelta T cells, which constitute a minor population of gammadelta T cells in healthy individuals, were increased in number in Behçet's disease irrespective of disease activity. This CD45RA+ subset of gammadelta T cells in the active, but not inactive, phase of this disease expressed IL-2Rbeta and HLA-DR, suggesting that they are activated in vivo in active Behçet's disease. In addition, the CD45RA+ gammadelta T cells produced extreme amounts of tumour necrosis factor and contained perforin granules. These data indicate that a phenotypically distinct subset of gammadelta T cells, CD45RA+ CD45RO- Vgamma9+ Vdelta2+, may contribute to immunological abnormalities which may lead to complexity of pathophysiology in Behçet's disease.

Expression of the G2-M checkpoint regulators cyclin B1 and cdc2 in nonmalignant and malignant human breast lesions: immunocytochemical and quantitative image analyses

We investigated the in vivo expression of cyclin B1 and Cdc2 (key molecules for G2-M transition during the cell cycle) in nonmalignant and cancerous human breast lesions using immunohistochemistry and quantitative proliferative index (PI) analysis. Breast epithelial cells co-expressed cyclin B1 and Cdc2 in their cytoplasm in the G2 phase and in their nuclei in the M phase. Cyclin B1, but not Cdc2, immunostaining rapidly disappeared from the nuclei during the mitotic metaphase to anaphase transition. Static image analysis revealed the mean proliferative index for cyclin B1/cdc2 for each type of lesion to be as follows: normal glands (n = 20), 2.0/2.5%; benign lesions, including typical ductal hyperplasia (n = 76), 2.5/5.8%; atypical ductal hyperplasia (n = 21), 3.0/6.6%; carcinomas in situ (n = 70), 7.4/14.0%; and invasive carcinomas (n = 58), 10.0/22.9%. Proliferative index data for atypical hyperplasia were virtually identical to those for benign lesions and were significantly lower than those for breast cancer, suggesting that expression levels of cyclin B1 and Cdc2 may be used to distinguish premalignant human breast lesions from advanced disease. Furthermore, the proliferative index for cyclin B1 for comedo-type ductal carcinomas in situ agreed with that for invasive ductal carcinomas (mean, 10.1% versus 9.5%), apparently explaining the clinicopathological aggressiveness of this tumor at the molecular level.

Transient brain activity used in magnetic resonance imaging to detect functional areas

Functional areas were detected with short stimuli eliciting transient brain activity using the method of 'transient' regions of interest (ROIs) and functional magnetic resonance imaging (fMRI). This method was validated by comparing the results with sustainedly activated areas identified conventionally. Eighty-eight and 89% of the total areas of transient ROIs derived from 0.2 and 2 s stimulation, respectively, were identified at 5-7 s and 5-9 s, respectively, after stimulus onset. Eighty-eight and 76%, respectively, of these areas overlapped 'conventional' ROIs derived from 20 s stimulation. These results suggest that the delineation of transient ROIs, by targeting a period approximately 7 s after transient neural activity, can be useful for fMRI studies of cognitive functions.

Coordination between palatal and laryngeal muscle activities in response to rebreathing and lung inflation

The soft palate and larynx play an important role in respiration and phonation, regulating the airflow in the upper airway. The levator veli palatini muscle (LVP) is the principal muscle responsible for generating palatal movements. The lateral cricoarytenoid muscle (LCA) is a laryngeal adductor muscle, and the posterior cricoarytenoid muscle (PCA) is a laryngeal abductor muscle. This study was designed to define, by electromyographic techniques, the coordination between palatal and laryngeal muscle activities in response to rebreathing and lung inflation. We performed tracheotomies on 12 mongrel dogs anesthetized with sodium pentobarbital and compared the effects of rebreathing and lung inflation on LVP activities with those on LCA and PCA activities. During rebreathing, expiratory LVP and inspiratory PCA activities were progressively augmented, but expiratory LCA activity was inhibited. On the other hand, lung inflation caused augmentation of LVP and LCA activities. In contrast, lung inflation inhibited PCA activity. We thus concluded that LVP activity coordinates with PCA activity in response to alternation of Paco2 and Pao2 levels, while it coordinates with LCA activity in response to lung inflation.

Regulation of transmembrane signalling system during senescence of human epidermal keratinocytes

Cultured normal human epidermal keratinocytes show an increase in doubling time with increasing passage number and finally the cells show growth arrest. This is known as senescence of cultured cells. However, the mechanisms governing senescence of cells remain to be clarified. Stimulation from outside the cell and the response to the stimulation are important essential initial events for cell function. Alteration of intracellular Ca2+ is one of the essential responses of cells to stimulation from outside. Thus we studied whether cultured normal human epidermal keratinocytes show a modulation of the alteration of intracellular Ca2+ during senescence. Epinephrine and histamine induced transient increases in intracellular Ca2+ in the third to eighth passages in normal human epidermal keratinocytes. With increase in the passage number the responsiveness (the number of responding cells per examined cells) decreased particularly beyond the sixth passage. The attenuation of the responses was more obvious with epinephrine than with histamine. All-trans-retinoic acid and 1,25-dihydroxyvitamin D3 did not augment the responsiveness to epinephrine of normal human epidermal keratinocytes. We expected that such an essential and immediate reaction would be confined to living cells, and that during senescence cells would show reduced responsiveness. Some of the changes during senescence of cultured keratinocytes may be due to the attenuation of the responsiveness to stimulation through the cell membrane.

Localization of annexin I (lipocortin I, p35) mRNA in normal and diseased human skin by in situ hybridization

Annexin I is a calcium- and phospholipid-binding protein that is involved in the regulation of cellular differentiation. The aim of the present study was to determine the localization of annexin I mRNA expression in normal and diseased human skin. In situ hybridization with a specific digoxigenin-labelled RNA probe was used throughout. We detected no annexin I mRNA signals in basal and suprabasal cells of normal epidermis, but positive signals were evident in the sudoriferous ducts. Annexin I mRNA expression was detected in the keratinizing squamous cells in keratotic type seborrhoeic keratosis and in keratinocytes at the periphery of the horn pearl in well-differentiated squamous cell carcinoma. Positive signals were also seen at the border between involved and noninvolved skin in psoriasis vulgaris and in dyskeratotic epidermal keratinocytes in keratosis follicularis Darier. By contrast, no annexin I mRNA signals were detected in tumour cells in basal cell carcinoma. The present results suggest that annexin I expression is related to, and may play a role in, keratinization disorders.

Expression of beta-catenin in normal breast tissue and breast carcinoma: a comparative study with epithelial cadherin and alpha-catenin

Expression of beta-catenin was investigated in normal breast tissue and 66 breast carcinomas in conjunction with expression of epithelial cadherin (E-CD) and alpha-catenin. In normal mammary ducts and acini, intense beta-catenin immunoreactivity was present at the basolateral surfaces of luminal epithelium and weak immunoreactivity was observed at the lateral borders of myoepithelial cells. No beta-catenin was revealed at the myoepithelial basal surface. The intercellular expression of beta-catenin, as well as of E-CD and alpha-catenin, was also observed in carcinoma tissues with varying staining intensity. Almost all of 10 intraductal carcinomas and approximately 70% of 41 invasive ductal carcinomas expressed the three molecules at the same level as in normal glands, whereas approximately 80% of 13 invasive lobular carcinomas showed severe deficiency of them. Two lobular carcinomas in situ showed complete absence of all of the proteins. Some of these findings were confirmed biochemically by immunoblotting analysis. In invasive ductal carcinomas, alpha-catenin was reduced more frequently in diffuse than in solid type tumours, whereas the level of expression of beta-catenin and E-CD was unchanged between them. No correlation was present between reduced expression of the adhesion molecules and lymph node metastasis.

Comparison of methods to evaluate acute rejection in heterotopic heart transplantation in rats

We compared palpation and electrocardiograms (ECG) as methods of evaluation of acute rejections, and also studied the mode of expression of rejection from histological findings by means of a cervical heart transplantation model in LEW strain rats with (LEW x BN) F1 rats as donors. Evaluation by palpation mainly involved changes in the intensity of the beat of the transplanted heart. With this method, it was also possible to observe changes in the size of the graft, and to investigate these changes over time. Unlike with abdominal heart transplants, the time of cardiac arrest can be clearly determined without any influence from the heart rate of the recipient. But with the ECG evaluation method, it was possible to distinguish clearly between the waveforms of the graft and the recipient waveforms unlike with the conventional lead method. In histological findings, the time of transfer of infiltrating cells into the graft and the time of appearance of CD8 positive cells matched the times when changes occur in the intensity of the beat and in the heart rate seen with palpation. Unlike the palpation and ECG methods, however, these findings are not suitable for evaluation of the time of cardiac arrest of the graft. The graft survival time was 6.1 +/- 0.6 days (n = 73) by palpation and 8.5 +/- 1.8 days (n = 73) by ECG. Since the graft survival time was significantly longer in the ECG evaluation than in the evaluation by palpation (P < 0.001), it appeared better to use these methods independently rather than concurrently in consideration of their features. Histological examination appeared to be useful in experimental systems for clarification of the mode of expression of the acute rejection after its has occurred.

Cell-free conversion of a ubiquitous nuclear protein into a killer-cell-specific form that binds to the NF-P enhancer element of the mouse perforin gene

Two nuclear factors, designated NF-PI and NF-P2, have been shown to bind to an enhancer 9-base motif (5'-ACAGGAAGT-3', NF-P motif) present within the 5'-flanking region of the mouse perforin gene. Our previous studies have shown that, although NF-P1 and NF-P2 differ in cell-type distribution and molecular mass, with NF-P2 being killer-cell-specific and smaller, the two factors appear to share common DNA-binding subunit(s). We have postulated that the biochemical event involved in the induction of NF-P2 could be the dissociation of a non-DNA-binding subunit from NF-P1, rendering the newly formed NF-P2 transcriptionally active. By using a cell-free system in the present study, we have demonstrated that a variety of chemical agents capable of denaturing or dissociating protein complexes, including guanidinium/HCl, detergents (SDS plus Nonidet P-40) and high-salt solutions, could convert NF-P1 into NF-P2. Unlike in intact cells, where induction of NF-P2 is restricted to killer lymphocytes, this conversion occurred in nuclear extracts derived from both cytotoxic lymphocytes and non-cytotoxic cells. Although the mechanism that restricts the induction of NF-P2 to killer- lymphocytes in vivo remains unresolved, these results support the hypothetical 'dissociation' model for the generation of NF-P2. The results also imply that the absence of perforin expression in non-cytotoxic cells may be due to the suppression of the induction of the killer-cell-specific trans-acting factor NF-P2.

Expression of epithelial cadherin and alpha- and beta-catenins in nontumoral livers and hepatocellular carcinomas

Expression of the cell adhesion molecule, epithelial cadherin (E-CD) and its binding proteins, alpha- and beta-catenins, in normal liver, chronic liver diseases, and hepatocellular carcinomas (HCCs) was investigated immunohistologically. In normal liver, weak immunostaining of E-CD and catenins was observed at the lateral membranes of the hepatocytes, whereas at the interlobular bile duct epithelia, they stained strongly. No immunoreactions were seen in sinusoidal Kupffer cells. Similar results were observed in the majority of livers from chronic hepatitis and cirrhosis sufferers; however, hepatocytes undergoing regeneration and rosette formation, as well as Hering canals and proliferating ductules, showed markedly increased molecular expression. Analysis of 66 HCC lesions revealed that the majority (64.3-96.6%) of thin trabecular- and pseudoglandular-type tumors preserved or overexpressed E-CD and catenins, whereas thick trabecular-type HCCs frequently showed low E-CD and alpha-catenin expression (56.5-65.2% reduction), suggesting that the thick trabecular histology represented diffuse tumor cell growth. Likewise, the E-CD and catenin expression levels correlated with the HCC cell differentiation grades. These collective results indicate that intercellular adhesion mediated by the E-CD-catenin system plays a role in morphological changes in nonmalignant and malignant hepatic diseases.

Cellular localization of the Trk neurotrophin receptor family in human non-neuronal tissues

We investigated the distribution of the high-affinity neurotrophin receptors TrkA, TrkB, and TrkC in a wide range of normal non-neuronal tissues of adult human by immunohistochemical methods. Trk immunoreactivity (IR) was detected at various levels in all tissues examined, except for the heart and liver. The gastric parietal cells showed strong TrkA and TrkC IR and all of the Trks had IR for the putative intestinal neuroendocrine cells. In the pancreas, TrkA and TrkC IR was detected in the sub-intralobular ducts, whereas TrkB IR was found specifically in the alpha-islet cells. The lymph node and spleen exhibited TrkB IR in monocytes/macrophages. The adrenal cortex showed selective TrkA IR with TrkC IR in the medulla. In the reproductive system, TrkA IR was detected in the prostatic epithelial cells, TrkC in the ovarian theca and granulosa cells, TrkA and TrkC in the secretory-phase endometrium, and TrkA in the mammary ducts. The kidney showed strong TrkA and TrkC IR in it tubules, but no Trk receptors were present in the glomeruli. In the skin, TrkA and TrkB/TrkC were present in the basal and granular layers of the epidermis, respectively.

[Preoperative management of the aged patients with cancer of the esophagus]

The peak incidence of esophageal cancer is in the sixth decade, but the number of resections in patients older than 70 is increasing. 184 patients who underwent esophageal resections (C > or = 1) were divided into five groups according to age; Group A: under 50, B: 50s, C: 60s, D: 70s E: over 80. Five-year survival for Group D (20.5%) was much lower than other groups. Group E had better 1- and 2-year survival than Group D. Preoperative condition, stage and postoperative course were investigated in 145 patients who underwent subtotal esophagectomy with two-field lymphadenectomy and reconstruction with the stomach. In Group D, more respiratory dysfunction and abnormality of electrocardiogram were seen than Group C (p < 0.05) preoperatively. There was no difference in stage. Group D had higher incidence of postoperative pneumonia, abnormal ECG (p < 0.01) and delirium (p < 0.05). Group D had less cancer deaths and more deaths from other diseases. These results indicate that patients older than 70 should be called aged and it is safe to reduce the lymph node dissection in the upper mediastinum for these patients.

Detecting cortical activities from fMRI time-course data using the MUSIC algorithm with forward and backward covariance averaging

A method is proposed for processing time-course fMRI data taken with successive single-shot echo-planar imaging. The proposed method uses a two-dimensional version of the multiple signal classification (MUSIC) algorithm and the technique called covariance averaging, both of which were developed in the field of sensor-array processing. The proposed method consists of four steps: calculate the averaged data covariance matrix, determine the number of activities using this covariance matrix, estimate the locations of the activities, and estimate their time evolution curves. Computer simulation results showed that a nearly fourfold improvement in the spatial resolution can be attained due to the method's super-resolution capability.

Sequential changes in cerebral blood flow, early neuropathological consequences and blood-brain barrier disruption following radiofrequency-induced localized hyperthermia in the rat

We investigated the temperature distribution, early histological changes, blood brain barrier (BBB) disruption and sequential changes in cerebral blood flow (CBF) following hyperthermia ranging from 37 to 45 degrees C in a new rat model of radiofrequency-induced localized cerebral hyperthermia. Significant histological changes and BBB disruption were observed in brain regions heated to 43 degrees C and above. In the cortex heated to 41 degrees C, the CBF doubled 20 min after hyperthermia induction, and then returned gradually to the pre-hyperthermic level. In the cortex heated to 43 degrees C, the CBF increased to 134% of the baseline level 10 min after hyperthermia induction, and then fell gradually to reach its minimum level (31% of the baseline level). In the cortex heated to 45 degrees C, the CBF decreased immediately after hyperthermia induction to reach 10% of the baseline level. The results indicate that hyperthermia-induced cellular injury in the central nervous system is associated with cerebral ischaemia and the threshold temperature for such injury is 43 degrees C. This model is useful for investigating the effects of hyperthermia on various cerebral functions and the CBF changes demonstrated in the present study may provide key information for the analysis of other cerebral functions.

Nonerythroid membrane skeletal proteins in normal and diseased human skin

A number of reports have described the presence and localization of membrane skeletal proteins in nonerythroid tissues and cultured cells. Interactions of these proteins, which have been extensively characterized in erythrocytes, may be physiologically important in other cell types. This review focuses on recent developments concerning proteins analogous to erythrocyte spectrin, protein 4.1, adducin and ankyrin in epidermal keratinocytes, and discusses their significance from physiological and pathological stand points. Keratinocyte proteins are involved in a wide variety of functions such as the cell-to-cell and cell-to-substratum adhesion, stratification, and maintenance of the cell shape. In epidermal keratinocytes, these nonerythroid membrane skeletal proteins may play a role in maintaining the polarity of membrane proteins by connecting them to the cytoskeleton, regulating cell-cell interdigitations and stabilizing newly synthesized cell membranes before elaboration of cell-cell interdigitations. Furthermore, altered expression and distribution of these proteins may be important in the pathogenesis of skin disease such as psoriasis.

Differentiation-associated localization of small proline-rich protein in normal and diseased human skin

The expression of SPRR (small proline-rich protein) was investigated in normal human skin and in diseased skin from patients with psoriasis, squamous cell carcinoma, basal cell epithelioma, naevus pigmentosus, ichthyosis vulgaris and several inflammatory skin diseases, by immunohistochemical staining. A polyclonal antibody was raised against a synthetic peptide for a C-terminal common region for SPRR1 and SPRR3. In immunoblot analysis, a positive band of 18 kDa was detected, which showed the presence of SPRR1 in human epidermal keratinocytes. In normal epidermis, positive staining for SPRR was observed in keratinocytes in the granular layer and the uppermost or two spinous cell layers, with no staining of the other spinous or basal layers. The staining was obvious at the cell periphery, weak at the cytoplasm, and absent in the nucleus. Staining was observed in several outer layers of the follicular infundibulum to the isthmus. No staining was detected in the inner root sheath of the hair follicles, hair matrix, sebaceous gland, eccrine gland, eccrine duct, melanocytes, Langerhans cells or fibroblasts. The arrectores pilorum, striated muscles, muscle layers of vessels, and myoepithelia of eccrine gland, were weakly stained. In psoriatic skin, stained keratinocytes were distributed in the spinous cell layers except for the basal layer. In ichthyosis vulgaris, SPRR was barely expressed in the uppermost living cell layers of the epidermis. In epidermolytic hyperkeratosis, degenerated squamous cells widely expressed SPRR. In Darier's disease, dyskeratotic cells were clearly stained. In squamous cell carcinoma, staining was observed in keratotic cells around horny pearls. In basal cell epithelioma, naevus pigmentosus, and malignant melanoma, the tumour cells or naevus cells were not stained. The distribution of SPRR was similar to that of involucrin in normal and several diseased skin, except for ichthyosis vulgaris. We conclude that SPRR is expressed in close association with epidermal differentiation in normal skin and skin diseases. The alteration of the expression of the proteins correlated to terminal differentiation, and differs from disease to disease.