Effect of preoperative 5-fluorouracil on apoptosis of advanced gastric cancer

BACKGROUND

Several studies have reported on apoptosis and the effect of anticancer chemotherapy.

METHODS

We studied apoptosis induced by 5-fluorouracil (5-FU) given preoperatively to 28 patients with advanced gastric cancer and compared the findings with 101 untreated patients. The expression of bcl-2 oncoprotein, cell phase fractions, and histological chemotherapeutic effects were also compared with the apoptotic changes.

RESULTS

The apoptotic and S-phase fractions in 5-FU-treated patients (apoptotic fraction: 10.46 +/- 6.93%, S-phase fraction: 17.49 +/- 11.65%) were significantly greater than those in untreated controls (apoptotic fraction: 6.56 +/- 5.06%, S-phase fraction: 12.17 +/- 6.78%). A positive correlation was observed between 5-FU-induced apoptosis and accumulation of tumor cells in the S-phase fraction. There was an inverse relationship between bcl-2 oncoprotein expression and apoptosis in 5-FU-treated patients, but no significant correlation between histological effect and apoptosis. However, two patients with significant histological effects showed no bcl-2 oncoprotein expression, whereas the histological effects were mild in all the bcl-2-positive patients.

CONCLUSIONS

Apoptosis may be induced by 5-FU administered preoperatively and bcl-2 oncogene expression may suppress 5-FU-induced apoptosis.

Localization of a gene for an autosomal recessive form of juvenile Parkinsonism to chromosome 6q25.2-27

An autosomal recessive form of juvenile Parkinsonism (AR-JP) (MIM 600116) is a levodopa-responsive Parkinsonism whose pathological finding is a highly selective degeneration of dopaminergic neurons in the zona compacta of the substantia nigra. By linkage analysis of diallelic polymorphism of the Mn-superoxide dismutase gene (SOD2), we found a family with AR-JP showing perfect segregation of the disease with the SOD2 locus. By extending the linkage analysis to 13 families with AR-JP, we discovered strong evidence for the localization of the AR-JP gene at chromosome 6q25.2-27, including the SOD2 locus, with the maximal cumulative pairwise LOD scores of 7.26 and 7.71 at D6S305 (theta = .03) and D6S253 (theta = .02), respectively. Observation of obligate recombination events, as well as multipoint linkage analysis, placed the AR-JP gene in a 17-cM interval between D6S437 and D6S264. Delineation of the AR-JP gene will be an important step toward our understanding of the molecular mechanism underlying selective degeneration of the nigral neurons.

Cataract extraction as a means of treating postfiltration hypotony maculopathy

Hypotony maculopathy may arise after glaucoma filtering surgery. This can be treated by inducing inflammation and scarring within the filter, with the aim of increasing intraocular pressure (IOP) and promoting resolution of maculopathy. Cataract extraction can promote such inflammation. Phacoemulsification with posterior chamber intraocular lens (PC IOL) implantation was performed in two consecutive patients with postfiltration hypotony maculopathy and preexisting cataracts. After cataract extraction, improvement of IOP, visual acuity, maculopathy, and metamorphopsia occurred in both patients. Cataract extraction can be beneficial in the management of postfiltration hypotony maculopathy.

Machado-Joseph disease in four Chinese pedigrees: molecular analysis of 15 patients including two juvenile cases and clinical correlations

Machado-Joseph disease (MJD) is an autosomal dominant neurodegenerative disorder associated with the expansion of a (CAG)n array in the MJD1 gene. We analyzed the sizes of the (CAG)n array using DNA samples from 61 members of four Chinese MJD families and 18 Chinese normal control subjects and confirmed that the (CAG)n array in 15 MJD chromosomes was expanded to 72-86 repeat units. There were no subjects with (CAG)n array sizes intermediate between those of normal and MJD affected groups. Meanwhile, we found a significant negative correlation between the age of onset of symptoms and (CAG)n array size. The largest (CAG)n array of 86 repeat units was in the youngest patient, whose age of onset was 5 years. The intergenerational increase in number of CAG repeat units was associated with the clinical phenomenon of anticipation.

Effect of the Form of the Quaternary Ammonium Ion on the Ion-Pair Phase Separation Phenomenon with Perfluorooctanoic Acid

The effect of the form of 10 types of quaternary ammonium ions (Q+) for the phase separation phenomenon, which accompanies a charge neutralization with perfluorooctanoate ion (PFOA-) and Q+, was studied. The separated phase using the spherical form of Q+ (i.e., [4·4·4·4], [3·3·5·5], [3·3·3·7], and [2·2·6·6], where the numbers in square brackets represent the carbon numbers of four kinds of straight alkyl chains which were directly bonded to the nitrogen atom) was in the liquid state. On the other hand, the separated phase using the rod form ([2·2·2·10] and [1·1·1·13]) was in the solid state. The volume, specific gravity, and water content of the liquid-separated phase using [3·3·5·5] were 116 &mgr;l, 1.27, and 6.98%, respectively, under the following experimental conditions: [Q+]T = 2.30 x 10(-2) mol dm-3, [PFOA-]T = 5.75 x 10(-3) mol dm-3, and 25°C. This liquid phase was stable to physical changes such as Q+ total concentration and temperature, compared with three other types of Q+ ([4·4·4·4], [3·3·3·7], and [2·2·6·6]), which formed similar liquid-separated phases.

Cystoid macular edema as an initial symptom of inflammatory orbital pseudotumor

We report a patient with pseudotumor with cystoid macular edema (CME). The initial finding in our case was only CME with a bilateral visual acuity decrease to 20/25. Approximately 3 months later, the visual acuity dropped to light perception in the right eye and 20/200 in the left eye. Computed tomography scan revealed a mass in the right orbital apex and band-shaped enhancement in the cavernous sinus and along the upper margin of the petrous bone. However, no mass was found intraoperatively, and a biopsy specimen of the bulging levator muscle showed polymorphonuclear leukocyte infiltration. The CME resolved postoperatively. The tumor also seemed to resolve; however, after 1 year, the tumor recurred and invaded the brain tissue. A temporal lobectomy revealed widespread inflammatory cell infiltration. To ensure early diagnosis, pseudotumor should be considered in patients with CME of which the cause is uncertain.

In vivo fluoride profiles at different sites of buccal and lingual enamel surfaces obtained by enamel biopsy of human maxillary first permanent molars in young adults

Twenty male volunteers, average age 24 years, participated in this study. Specimens were obtained by enamel biopsy using 5 microliters of 0.5 M HClO4 for 30 s. Using a regression curve, comparisons of fluoride concentrations were made at different depths. The fluoride concentrations (mean +/- SE) at a depth of 5 microns were highest in the distobuccal (1698 +/- 136), high in the mesiobuccal (1343 +/- 122), low in the distolingual (1119 +/- 107), and lowest in the mesiolingual sites (819 +/- 78). Of the interior enamels (> or = 10 microns in depth), the distobuccal site (1330 +/- 88 parts/10(6) F at 10 microns) had a higher-concentration than all other sites. The fluoride profiles were steepest to shallowest in the order: distobuccal, mesiobuccal, distolingual and mesiolingual. There were no correlations between the enamel fluoride concentrations and the fluoride concentration in parotid saliva. It was concluded that in vivo fluoride profiles of maxillary first molars reflect the wear of the tooth surface with age and the condition of dental plaque deposition, and, to some extent, the site-specific distribution of saliva between buccal and lingual surfaces.

Imipramine-induced inactivation of a cytochrome P450 2D enzyme in rat liver microsomes: in relation to covalent binding of its reactive intermediate

Preincubation of microsomes from male Wistar rats with imipramine (IMI) in the presence of NADPH caused a time-dependent loss of bunitrolol 4-hydroxylase activity, indicating that the CYP2D enzyme is inactivated during IMI metabolism, which has also been observed after in vivo administration of IMI. A similar effect was obtained when desipramine, an N-demethylated metabolite of IMI, was used as an inhibitor, whereas 2-hydroxy-IMI had no effect on the activity. Thus, it seems likely that the inactivation of the CYP2D enzyme is related to 2-hydroxylation process of IMI. Incubation of microsomes with [3H]IMI in the presence of NADPH resulted in covalent binding of a 3H-labeled material to microsomal protein. Formation rates of the reactive metabolites covalently bound to protein followed Michaelis-Menten kinetics, and the K(m) value (1.1 microM) was close to that for microsomal IMI 2-hydroxylation. The metabolism-dependent covalent binding of [3H]IMI was lower in Dark Agouti rats, which is an animal model of CYP2D deficiency, than in Wistar rats. The binding was inhibited by propranolol and quinidine, a substrate and an inhibitor of CYP2D, respectively, and by an antibody against CYP2D. Similar strain difference (Dark Agouti < Wistar) and inhibitory effects by the compounds and the antibody were observed in IMI 2-hydroxylase but not in N-demethylase activity. SDS-PAGE (sodium dodecyl sulfate-polyacrylamide gel electrophoresis) of microsomal protein incubated with [3H]IMI and NADPH showed that the binding was prominent at the molecular mass of approximately 50 kDa, which would be consistent with the P450 protein being a target for the binding. Furthermore, proteins to which [3H]IMI metabolites covalently bound were immunoprecipitated with the anti-CYP2D antibody. These results suggest that IMI is biotransformed into a chemically reactive metabolite (probably arene-oxide) through its 2-hydroxylation step by the CYP2D enzyme in rat liver microsomes, and the metabolite binds covalently to the enzyme itself, resulting in the inactivation.

[Report on the accuracy and the reliability of dip sticks]

Urinary examination with dip sticks is essential for clinical screening test and primary health care. Recently Japanese Society of Clinical Pathology has stressed the clinical use of dip sticks. Many dip sticks are available in Japan. However, few attempts have been done for external quality control of dip sticks. It is well known that there are considerable differences in the accuracy, sensitivity and stability of dip sticks. Makers are at variance in indicating concentration levels in accordance with the given color charts. Some urine chemistry analyzers for dip sticks have been developed. There was a few cases of simultaneous study on dip sticks from various makers. We, four technologists have attempted external quality control of eleven dip sticks for protein, glucose and occult blood with the same lot number (one was only for glucose) using the four different pooled urine samples and two artificial urine samples. Based on the results of this study, the following proposal to improve the accuracy and reliability of dip sticks was derived. 1) Users should have a plenty of knowledge on the difference of the quality of dip sticks of each makers. 2) Makers of dip sticks should clarify to users the method of examination, standard materials and errors. 3) Users should perform internal quality control using different pooled urine samples or different artificial urine samples on a daily basis before going with the routine work.

Identification of the spinocerebellar ataxia type 2 gene using a direct identification of repeat expansion and cloning technique, DIRECT

Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant, neurodegenerative disorder that affects the cerebellum and other areas of the central nervous system. We have devised a novel strategy, the direct identification of repeat expansion and cloning technique (DIRECT), which allows selective detection of expanded CAG repeats and cloning of the genes involved. By applying DIRECT, we identified an expanded CAG repeat of the gene for SCA2. CAG repeats of normal alleles range in size from 15 to 24 repeat units, while those of SCA2 chromosomes are expanded to 35 to 59 repeat units. The SCA2 cDNA is predicted to code for 1,313 amino acids-with the CAG repeats coding for a polyglutamine tract. DIRECT is a robust strategy for identification of pathologically expanded trinucleotide repeats and will dramatically accelerate the search for causative genes of neuropsychiatric diseases caused by trinucleotide repeat expansions.

[A case report of late-onset Huntington disease without family history and caudate atrophy who has diagnosed clinicopathologically and genetically]

We report a 66-year-old male with typical symptoms of Huntington's disease (HD), but without family history or atrophy of caudate nucleus on brain CT. The diagnosis of HD was confirmed in this apparently sporadic case by neuropathological findings as loss of small-sized neuron with gliosis in the striatum, and molecular testing of CAG repeat of the gene for HD using post mortem tissue. The DNA analysis showed that he had a mildly expanded allele with 45 repeat units, in the size range seen in HD chromosomes. The result suggests that there are some correlations between the repeat length and the clinicopathological findings such as late onset, lack of family history and insusceptible caudate atrophy.

Strong linkage disequilibrium and haplotype analysis in Japanese pedigrees with Machado-Joseph disease

To identify the markers tightly linked to Machado-Joseph disease (MJD) and to investigate whether a limited number of ancestral chromosomes are shared by Japanese MJD pedigrees, a detailed linkage analysis employing D14S55, D14S48, D14S67, D14S291, D14S280, AFM343vf1, D14S81, D14S265, D14S62, and D14S65 was performed. The results of multipoint linkage analysis as well as detection of critical recombination events indicate that the gene for MJD is localized in a 4-cM region between D14S280-D14S81. We found strong linkage disequilibria at AFM343vf1 and D14S81, and association of a few common haplotypes with MJD. These results indicate that there is an obvious founder effect in Japanese MJD and suggest the possibility of the existence of predisposing haplotypes which are prone to expansions of CAG repeats.

Occult intrasacral meningocele associated with spina bifida: a case report

We present a rare case of occult intrasacral meningocele associated with spina bifida and tethered cord syndrome in a 13-year-old female. The etiology is thought to be due to a dysraphic disorder. The pertinent literature is reviewed.

Association study between schizophrenia and dopamine D3 receptor gene polymorphism

Crocq et al. [1992: J Med Genet 29:858-860] reported the existence of an association between schizophrenia and homozygosity of a BalI polymorphism in the first exon of the dopamine D3 receptor (DRD3) gene. In response to this report, further studies were conducted; however, these studies yielded conflicting results. In the present study, we examined 100 unrelated Japanese schizophrenics and 100 normal controls to determine any association between this polymorphism and schizophrenia. Results suggest that neither allele nor genotype frequencies of the DRD3 gene in the schizophrenics as a whole are significantly different from those of the controls. Further, we found no association between any allele or genotype and any clinical subtype based on family history of schizophrenia and age-at-onset. A significantly high frequency of homozygosity of a dopamine D3 receptor gene allele was not observed in the schizophrenics as a whole, or in clinical subtypes. Our results suggest that an association between the dopamine D3 receptor gene and schizophrenia is unlikely to exist.

Intergenerational instability of the CAG repeat of the gene for Machado-Joseph disease (MJD1) is affected by the genotype of the normal chromosome: implications for the molecular mechanisms of the instability of the CAG repeat

Machado-Joseph disease (MJD) is an autosomal dominant neurodegenerative disorder caused by unstable expansion of a CAG repeat in the MJD1 gene at 14q32.1. To identify elements affecting the intergenerational instability of the CAG repeat, we investigated whether the CGG/GGG polymorphism at the 3' end of the CAG repeat affects intergenerational instability of the CAG repeat. The [expanded (CAG)n-CGG]/[normal (CAG)n-GGG] haplotypes were found to result in significantly greater instability of the CAG repeat compared to the [expanded (CAG)n-CGG]/[normal (CAG)n-CGG] or [expanded (CAG)nGGG]/[normal (CAG)n-GGG] haplotypes. Multiple stepwise logistic regression analysis revealed that the relative risk for a large intergenerational change in the number of CAG repeat units (< -2 or > 2) is 7.7-fold (95% CI: 2.5-23.9) higher in the case of paternal transmission than in that of maternal transmission and 7.4-fold (95% CI: 2.4-23.3) higher in the case of transmission from a parent with the [expanded (CAG)n-CGG]/[normal (CAG)n-GGG] haplotypes than in that of transmission from a parent with the [expanded (CAG)n-CGG]/[normal (CAG)n-CGG] or [expanded (CAG)n-GGG]/[normal (CAG)n-GGG] haplotypes. The combination of paternal transmission and the [expanded (CAG)n-CGG]/[normal (CAG)n-GGG] haplotypes resulted in a 75.2-fold (95% CI: 9.0-625.0) increase in the relative risk compared with that of maternal transmission and the [expanded (CAG)n-CGG]/[normal (CAG)n-CGG] or [expanded (CAG)n-GGG]/[normal (CAG)n-GGG] haplotypes. The results suggest that an inter-allelic interaction is involved in the intergenerational instability of the expanded CAG repeat.

Somatic mosaicism of expanded CAG repeats in brains of patients with dentatorubral-pallidoluysian atrophy: cellular population-dependent dynamics of mitotic instability

Dentatorubral-pallidoluysian atrophy (DRPLA) is an autosomal dominant neurodegenerative disease caused by unstable expansion of a CAG repeat in the DRPLA gene. We performed detailed quantitative analysis of the size and the size distribution (range) of the expanded CAG repeats in various regions of the CNS of eight autopsied patients with DRPLA. Expanded alleles (AE) showed considerable variations in size, as well as in range, depending on the region of the CNS, whereas normal alleles did not show such variations, which indicates the occurrence of somatic mosaicism of AE in the CNS. The AE in the cerebellar cortex were consistently smaller by two to five repeat units than those in the cerebellar white matter. Moreover, the AE in the cerebral cortex were smaller by one to four repeat units than those in the cerebral white matter. These results suggest that the smaller AE in the cerebellar and cerebral cortices represent those of neuronal cells. The ranges of the AE in the cerebral cortex, cerebral white matter, and cerebellar white matter showed considerable variation ranging from 9 to 23 repeat units, whereas those in the cerebellar cortex showed little variance and were approximately 7 repeat units. The ranges of the AE in the cerebral cortex, cerebral white matter, and cerebellar white matter were much broader in patients with higher ages at death than they were in patients with lower ages at death, raising the possibility that the range of AE increases with time, as the result of mitotic instability of AE.

Isolation and structure of staph-cAM373 produced by Staphylococcus aureus that induces conjugal transfer of Enterococcus faecalis plasmid pAM373

Enterococus faecalis plasmid pAM373 encodes a mating response to the sex pheromone, cAM373, which is secreted from pAM373-free E. faecalis. cAM373-like activity was detected in a culture filtrate of Staphylococcus aureus. The major active substance, termed staph-cAM373, was isolated, and its structure was identified as a H-Ala-IIe-Phe-IIe-Leu-Ala-Ala-OH heptapeptide.

Expression of gamma delta T cells and adhesion molecules in endometriotic tissue in patients with endometriosis and adenomyosis

PROBLEM

Are T cell subsets including gamma delta T cells. HLA antigens or adhesion molecules, expressed in eutopic and ectopic endometria in patients with endometriosis and adenomyosis?

METHODS

Subjects consisted of 23 patients with adenomyosis and 21 patients with endometriosis. Controls consisted of 15 patients with adenomyoma and 42 infertile women without habitual abortion and autoimmune diseases. Staining of the glandular cells in eutopic and ectopic endometria or T lymphocyte subsets or macrophages in the stroma were analyzed immunohistochemically to localize the expression of the antigens.

RESULTS

Immunohistochemical analysis revealed significantly increased expression of the antigens, particularly of the number of gamma delta T cells in the stroma and adhesion molecules and HLA antigens on the glandular cells in eutopic and ectopic endometria, compared with materials from patients with adenomyoma and infertile patients.

CONCLUSION

It is likely that three distinct pathways of cell-cell interactions are activated in patients with endometriosis or adenomyosis.