Ascitic autotaxin as a potential prognostic, diagnostic, and therapeutic target for epithelial ovarian cancer

BACKGROUND

Malignant ascites contributes to the metastatic process by facilitating the multifocal dissemination of ovarian tumour cells onto the peritoneal surface. However, the prognostic and diagnostic relevance of ascitic fluid remains largely unknown. Herein, we investigated the potential clinical value and therapeutic utility of ascitic autotaxin (ATX) in epithelial ovarian cancer (EOC).

METHODS

ATX expression was assessed in clinical samples. Spheroid-forming assay, real-time PCR, western blot analysis, invadopodia assay, and adhesion assays were performed.

RESULTS

Ascitic ATX expression was highly elevated in patients with ovarian cancer compared to those with benign ascites and was associated with advanced stage, high grade, and a short disease-free period in patients with EOC. Combining the diagnostic ability of ascitic ATX and serum CA-125 levels significantly improved the area under the curve (AUC) value for EOC compared to serum CA125 level alone. This marker combination showed a large odds ratio for short disease-free period in high-risk EOC groups. Functional studies revealed that ascitic ATX was required for maintaining cancer stem cell-like characteristics and invadopodia formation.

CONCLUSION

Ascitic ATX levels may serve as a useful prognostic indicator for predicting aggressive behaviour in EOC. ATX-linked invadopodia are a potential target to prevent peritoneal dissemination in ovarian cancer.

Nectin-4 as a Predictive Marker for Poor Prognosis of Endometrial Cancer with Mismatch Repair Impairment

The adhesion molecule Nectin-4 is a new potential therapeutic target for different types of cancer; however, little is known about its diagnosis significance in endometrial cancer (EC). We found that Nectin-4 expression was significantly higher in EC tissues than in nonadjacent normal tissue. The area under the receiver operating characteristic curve value of 0.922 indicated good diagnostic accuracy for Nectin-4 expression in EC. Furthermore, Nectin-4 expression was associated with DNA mismatch repair (MMR) protein deficiency. Notably, the high Nectin-4 expression group of patients with MSH2/6-deficient EC had shorter progression-free survival than that of the low Nectin-4 expression group. The number of lymphovascular space invasion-positive patients in groups with MMR deficiency and high Nectin-4 expression was also increased compared with that in the low Nectin-4 expression group. Bioinformatics analysis revealed that alteration in Nectin-4 and MMR genes is associated with Nectin-4 expression in EC. To the best of our knowledge, this is the first study to show that Nectin-4 expression may be a potential biomarker for EC diagnosis and that high Nectin-4 expression in MMR-deficient patients with EC can predict short progression-free survival, thus providing clues to identify patients for adjuvant therapy.

High-Dose Selenium Induces Ferroptotic Cell Death in Ovarian Cancer

Selenium is a promising multi-target chemotherapeutic agent with controversial clinical results. Hence, reassessing the anticancer effects of Se is necessary to clearly understand the potential of high-dose selenium in cancer treatment. Here, we observed that high-dose sodium selenite (SS) significantly decreased the proliferation and increased the death of ovarian cancer cells, mediated by an increased generation of reactive oxygen species. Notably, high-dose SS decreased the levels of glutathione peroxidase (GPx), a selenoprotein with antioxidant properties, without altering other selenoproteins. Furthermore, high-dose SS triggered lipid peroxidation and ferroptosis, a type of iron-dependent cell death, due to dysregulated GPx4 pathways. We demonstrated that intravenous high-dose SS significantly reduced the tumor growth and weight in SKOV3-bearing mice. Consistent with our in vitro results, mice with SKOV3 cells treated with high-dose SS showed decreased GPx4 expression in tumors. Therefore, we highlight the significance of high-dose SS as a potential chemotherapeutic agent for ovarian cancer. High-dose SS-mediated ferroptotic therapy integrating glutathione depletion and ROS generation is a promising strategy for cancer therapy.

Anti-cancer effects of high-dose selenium via lipid peroxidation in ovarian cancer

e17547

Background: Selenium is an essential trace element and act as a regulator in the oxidation-reduction system. Selenium deficiency is observed in various cancers. Therefore, we investigated the relevance of high-dose selenium with the anticancer effect of ovarian cancer. Methods: We evaluated cytotoxicity and cell death by MTT assay and Annexin V-FITC/PI-labeled flow cytometry and biological function by invasion assay, ROS assay, immunoblotting, and FACS analysis. Using SKOV3-bearing xenograft mouse models, we evaluated the anti-cancer effect of high-dose selenium. Selenium toxicity was evaluated by the amount of ALT, AST, BUN and creatinine in the serum of C57BL/6 mice. Results: We observed that high-dose selenium, which was exposed to ovarian cancer cells, significantly increases the generation of reactive-species oxygen (ROS), leading to more significant cell death and cytotoxicity compared to low doses. We found that high-dose selenium triggers lipid peroxidation-mediated cell deaths and causes a reduction of glutathione peroxidase (GPX) systems. As a result of examining the lethal dose of selenium to the C57BL/6 nude mouse, it occurred in the concentration range of 3000 μg/Kg or more. SKOV3-bearing mouse models revealed the high-dose selenium administration (2000 μg/Kg) significantly reduced the ovarian tumor growth (p < 0.05). Moreover, we confirmed that high-dose selenium inhibited the expression of increased GPX in SKOV3-bearing mice. Conclusions: Our results suggest that high-dose selenium induces an anticancer effect through lipid peroxidation regulation according to the GPX redox system. Furthermore, we can suggest that chemotherapy based on high-dose selenium may have the effect of maximizing therapeutic efficacy and reducing anticancer drug resistance in ovarian cancer.

Engineered Corynebacterium glutamicum as the Platform for the Production of Aromatic Aldehydes

Aromatic aldehydes, including 4-hydroxybenzaldehyde (4-HB aldehyde), protocatechuic (PC) aldehyde, and vanillin, are used as important flavors, fragrances, and pharmaceutical precursors and have several biological and therapeutic effects. Production of aromatic aldehydes in microbial hosts poses a challenge due to its rapid and endogenous reduction to alcohols. To address this hurdle, prospecting of the genome of Corynebacterium glutamicum yielded 27 candidate proteins that were used in comprehensive screening with a 4-hydroxybenzyl (4-HB) alcohol–producing strain. We identified that NCgl0324 has aromatic aldehyde reductase activity and contributed to 4-HB aldehyde reduction in vivo since the NCgl0324 deletion strain HB-Δ0324 produced 1.36 g/L of 4-HB aldehyde, that is, about 188% more than its parental strain. To demonstrate that NCgl0324 knockout can also improve production of PC aldehyde and vanillin, first, a basal MA303 strain that produces protocatechuate was engineered from 4-hydroxybenzoate-synthesizing C. glutamicum APS963, followed by deletion of NCgl0324 to generate PV-Δ0324. The PC aldehyde/alcohol or vanillin/vanillyl alcohol biosynthetic pathways, respectively, were able to be expanded from protocatechuate upon introduction of carboxylic acid reductase (CAR) and catechol O-methyltransferase encoded by a mutated comt^m gene. In shake flask culture, the resulting NCgl0324 deletion strains PV-IΔ0324 and PV-IYΔ0324 were shown to produce 1.18 g/L PC aldehyde and 0.31 g/L vanillin, respectively. Thus, modulation of the identified NCgl0324 gene was shown to have the potential to boost production of valuable aromatic aldehydes and alcohols.

An initial experience with a novel technique of single-port robotic resection for rectal cancer

BACKGROUND

The da Vinci single-port (SP) system is designed to facilitate single-incision robotic surgery in a narrow space. We developed a new procedure of rectal resection using this system. The aim of the present study was to evaluate the technical feasibility and safety of SP robotic rectal resection for rectal cancer patients based on our initial experience.

METHODS

A study was conducted on consecutive patients with mid or low rectal cancer who had SP robotic resection at our institution between July and September 2020. The demographic characteristics, perioperative data, and pathology results of the patients were retrospectively analyzed.

RESULTS

There were 5 patients (3 males, 2 females, median age 57 years (range 36-73 years). The median tumor height from the anal verge was 4 cm (range 3-5 cm). Two patients received preoperative chemoradiotherapy for advanced rectal cancer. A single docking was conducted, and the median docking time was 4 min 20 s (range 3 min 30 s to 5 min). The median total operation time was 195 min (range 155-240 min), and the median time of pelvic dissection was 45 min (range 36-62 min). All patients had circumferential and distal tumor-free resection margins. One patient experienced an anastomosis-related complication. The median duration of hospital stay was 7 days (range 7-8 days).

CONCLUSIONS

Our initial experience suggests that SP robotic rectal resection is safe and feasible. Further clinical trials comparing SP and multiport robotic rectal resection should be conducted to verify the superior aspects of this new system.

The association between season of birth, age at onset, and clozapine use in schizophrenia

OBJECTIVE

This study aimed to determine whether the rate of clozapine use, an indicator of refractoriness in schizophrenia, is associated with the season of birth and age at onset in patients with schizophrenia based on nationwide data.

METHODS

Patients with schizophrenia (n = 114 749) who received prescriptions for antipsychotic medication between 2008 and 2014 were retrospectively identified from the Korean National Health Insurance Service database. The study population was divided into three groups based on their age at the onset of schizophrenia (early, middle, and late onset). We assessed differences in the month of birth between patients and the general population. In addition, the cumulative clozapine use was calculated.

RESULTS

Compared to the late-onset schizophrenia group, the early- and middle-onset groups showed a higher probability of birth during the winter season. In addition, the early-onset group showed the highest cumulative clozapine use rate. In the middle-onset group, the initiation of clozapine use was significantly earlier for patients born in winter compared to those born in summer.

CONCLUSION

Our results indicate that the age at onset is an important factor in predicting the prognosis of schizophrenia patients. The season of birth also affects the prognosis, but with less robustness. Specifically, it appears that early disease onset and winter birth might be associated with poor outcomes in Korean patients with schizophrenia.

Ras promotes transforming growth factor-β (TGF-β)-induced epithelial-mesenchymal transition via a leukotriene B4 receptor-2-linked cascade in mammary epithelial cells

Inflammation and inflammatory mediators are inextricably linked with epithelial-mesenchymal transition (EMT) through complex pathways in the tumor microenvironment. However, the mechanism by which inflammatory mediators, such as the lipid inflammatory mediators, eicosanoids, contribute to EMT is largely unknown. In the present study we observed that BLT2, leukotriene B4 receptor-2, is markedly up-regulated by oncogenic Ras and promotes EMT in response to transforming growth factor-β (TGF-β) in mammary epithelial cells. Blockade of BLT2 by the BLT2 inhibitor LY255283 or by siRNA reduced EMT induced by Ras in the presence of TGF-β. In addition, stimulation of BLT2 by the addition of a BLT2 ligand, such as leukotriene B4, restored EMT in the presence of TGF-β in human immortalized mammary epithelial MCF-10A cells. We further searched BLT2 downstream components and identified reactive oxygen species and nuclear factor κB as critical components that contribute to EMT. Taken together, these results demonstrate for the first time that a BLT2-linked inflammatory pathway contributes to EMT. This provides valuable insight into the mechanism of EMT in mammary epithelial cells. In addition, considering the implications of EMT with the stemness of cancer cells, our finding may contribute to a better understanding of tumor progression.

TIS21/BTG2 inhibits invadopodia formation by downregulating reactive oxygen species level in MDA-MB-231 cells

PURPOSE

Invasion of cancer cells depends on the proteolytic degradation of extracellular matrix regulated by actin-driven membrane protrusions, called invadopodia. However, the mechanisms underlying invadopodia formation in cancer cells remain largely unknown.

METHODS

By employing adenoviral transduction of breast cancer cells with either β-galactosidase (Ad-LacZ) or TIS21(/BTG2/Pc3) (Ad-TIS21) gene, the regulation of invadopodia formation was investigated. Invasion activity was examined by invadopodia assay and Matrigel assay. Intracellular reactive oxygen species (ROS) was monitored by FACS-based analysis.

RESULTS

Here, we observed that TIS21 suppressed invadopodia formation as well as invasion activity along with F-actin remodeling. The inhibition of TIS21-mediated invadopodia formation was accompanied with attenuation of ROS generation in the TIS21 expressers, indicating that TIS21-mediated inhibition of ROS plays a critical role for invadopodia formation by regulating actin-associated protein remodeling. This was further confirmed in the TIS21(-/-)MEF cells.

CONCLUSIONS

This is the first report to provide insight into invasion signals regulated by tumor suppressor, TIS21(/BTG2/Pc3) gene, in the intractable breast cancer cells.

BLT2 up-regulates interleukin-8 production and promotes the invasiveness of breast cancer cells

BACKGROUND

The elevated production of interleukin (IL)-8 is critically associated with invasiveness and metastatic potential in breast cancer cells. However, the intracellular signaling pathway responsible for up-regulation of IL-8 production in breast cancer cells has remained unclear.

METHODOLOGY/PRINCIPAL FINDINGS

In this study, we report that the expression of BLT2 is markedly up-regulated in the highly aggressive human breast cancer cell lines MDA-MB-231 and MDA-MB-435 compared with MCF-10A immortalized human mammary epithelial cells, as determined by RT-PCR, real-time PCR and FACS analysis. Blockade of BLT2 with BLT2 siRNA knockdown or BLT2 inhibitor treatment downregulated IL-8 production and thereby diminished the invasiveness of aggressive breast cancer cells, analyzed by Matrigel invasion chamber assays. We further characterized the downstream signaling mechanism by which BLT2 stimulates IL-8 production and identified critical mediatory roles for the generation of reactive oxygen species (ROS) and the consequent activation of the transcription factor NF-κB. Moreover, blockade of BLT2 suppressed the formation of metastatic lung nodules by MDA-MB-231 cells in both experimental and orthotopic metastasis models.

CONCLUSIONS/SIGNIFICANCE

Taken together, our study demonstrates that a BLT2-ROS-NF-κB pathway up-regulates IL-8 production in MDA-MB-231 and MDA-MB-435 cells, thereby contributing to the invasiveness of these aggressive breast cancer cells. Our findings provide insight into the molecular mechanism of invasiveness in breast cancer.

BaTiO3 doped Na0.5K0.5NbO3 thin films deposited by using eclipse shutter enhanced pulsed laser deposition method

We have investigated structural, electrical, and electro-mechanical properties of lead-free piezoelectric BaTiO3 doped Na0.5K0.5NbO3 (BTO-NKN) thin films deposited by pulsed laser deposition (PLD) methods. BTO-NKN thin films have been deposited on La0.5Sr0.5CoO3 (LSCO) bottom electrodes with LaAlO3 (LAO) substrates. X-ray diffraction data have shown that all the BTO-NKN and bottom electrodes are highly oriented with their c-axes normal to the substrates. In order to improve the morphology of BTO-NKN thin films, we have located an eclipse shutter between a target and a substrate. Root-mean-square roughness was changed from 91 nm to 21 nm with eclipse shutter enhanced PLD (E-PLD) method. Furthermore, the enhanced surface morphology leads to the improvement in electrical or electro-mechanical properties mainly due to increased density. Typical capacitance and d33 values of a BTO-NKN film deposited by E-PLD method are 1000 pF and 30 pmN, respectively.

Reactive oxygen species are generated through a BLT2-linked cascade in Ras-transformed cells

Although production of reactive oxygen species (ROS) by oncogenic Ras is thought to be crucial for Ras transformation, very little is known about the signaling mechanism involved. In the present study, we investigated whether BLT2, a low-affinity leukotriene B(4) receptor, is involved in the generation of ROS in H-Ras(V12)-transformed fibroblasts. We show that downregulation of BLT2 using RNA interference or antisense oligonucleotides inhibits ROS generation, and that Nox1 acts downstream of BLT2. Moreover, BLT2 overexpression caused increased ROS production and partial transformation. Taken together, our results suggest that a BLT2-Nox1-linked cascade is responsible for the elevated ROS generation in Ras-transformed cells. Our finding may contribute to clarifying the signaling events underlying the enhanced levels of ROS frequently observed in various transformed cells and possibly serve as a basis for developing new therapeutic strategies for human cancers.

Cellular metabolic responses of PET radiotracers to (188)Re radiation in an MCF7 cell line containing dominant-negative mutant p53

We investigated the relations between the cell uptakes of metabolic radiotracers and beta-radiation pretreatment using a dominant mutant p53 (p53mt) cell line to evaluate the effects of p53 genes on (18)F labeled positron emission tomography (PET) radiotracer uptakes.

METHODS

pCMV-Neo-Bam (control), which contains a neo-resistance marker, and p53 dominant-negative mutant expression constructs were stably transfected into MCF7 cell line. Cells were plated in 24-well plates at 1.0x10(5) cells for 18 h. Rhenium-188 ((188)Re) (a beta emitter) was added to the medium (3.7, 18.5, 37 MBq) and incubated for 24 h. We performed gamma-counting to determine the cellular uptakes of 2-[(18)F]fluoro-2-deoxy-d-glucose (FDG), o-(2-[(18)F]fluoroethyl)-l-tyrosine (FET) and 2'-[(18)F]fluoro-2'-deoxythymidine (FLT) (370 kBq, 60 min). Cell viabilities were determined by trypan blue staining and flow cytometry.

RESULTS

p53mt cells showed 1.5-2-fold higher FDG uptake than wild-type p53 cells in basal condition, and the difference of FDG uptake was greater after (188)Re treatment (P<.01). FET uptake increased with (188)Re dose without a significant difference between p53 statuses. p53mt cells showed lower FLT uptake than wild-type p53 cells in basal condition, and the difference of FLT uptake was greater after (188)Re treatment. By cell viability testing and FACS analysis, p53mt cells showed lower viability and a larger apoptotic fraction (sub-G1) than wild-type p53 cells after (188)Re treatment.

CONCLUSION

We speculate that p53 dysfunction increases glucose and decreases thymidine metabolism in cancer cells and that this may be exaggerated by (188)Re beta-radiation. Our findings suggest that FDG could reflect tumor viability and malignant potential after (188)Re beta-radiation treatment, whereas FLT could be a more useful PET radiotracer for assessing therapeutic response to beta-radiation, especially in cancer cells with an altered function of p53.

Inhibition of receptor internalization attenuates the TNFalpha-induced ROS generation in non-phagocytic cells

Reactive oxygen species (ROS) are important regulatory molecules implicated in the signaling cascade triggered by tumor necrosis factor (TNF)alpha, although the events through which TNFalpha induces ROS generation are not well characterized. Here, we report that TNFalpha-induced ROS production was blocked by pretreatment with internalization inhibitor monodansyl cadaverine (MDC). Similarly, a transient expression of a GTP-binding and hydrolysis-defective dynamin mutant (dynamin(K44A)) that had been shown to be defective in internalization significantly attenuated the TNFalpha-induced intracellular ROS production. Importantly, the inhibition of receptor internalization suppressed TNFalpha signaling to mitogen-activated protein kinases (MAPKs) stimulation. Together, our results suggest that receptor internalization is somehow necessary for the TNFalpha-induced ROS generation and subsequent intracellular downstream signaling in non-phagocytes.

Phytosphingosine in combination with ionizing radiation enhances apoptotic cell death in radiation-resistant cancer cells through ROS-dependent and -independent AIF release

The use of chemical modifiers as radiosensitizers in combination with low-dose irradiation may increase the therapeutic effect on cancer by overcoming a high apoptotic threshold. Here, we showed that phytosphingosine treatment in combination with γ-radiation enhanced apoptotic cell death of radiation-resistant human T-cell lymphoma in a caspase-independent manner. Combination treatment induced an increase in intracellular reactive oxygen species (ROS) level, mitochondrial relocalization of B-cell lymphoma-2(Bcl-2)-associated X protein (Bax), poly-adenosine diphosphate (ADP)-ribose polymerase 1 (PARP-1) activation, and nuclear translocation of apoptosis-inducing factor (AIF). siRNA targeting of AIF effectively protected cells from the combination treatment-induced cell death. An antioxidant, N-acetyl-L-cysteine (NAC), inhibited Bax relocalization and AIF translocation but not PARP-1 activation. Moreover, transfection of Bax-siRNA significantly inhibited AIF translocation. Pretreatment of PARP-1 inhibitor, DPQ (3,4-dihydro-5-[4-(1-piperidinyl)-butoxy]-1(2H)-isoquinolinone), or PARP-1-siRNA also partially attenuated AIF translocation, whereas the same treatment did not affect intracellular ROS level and Bax redistribution. Taken together, these results demonstrate that enhancement of cell death of radiation-resistant cancer cells by phytosphingosine treatment in combination with γ-radiation is mediated by nuclear translocation of AIF, which is in turn mediated both by ROS-dependent Bax relocalization and ROS-independent PARP-1 activation. The molecular signaling pathways that we elucidated in this study may provide potential drug targets for radiation sensitization of cancers refractive to radiation therapy. (Blood. 2005;105:1724-1733)

Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty

PURPOSE

To evaluate the risk factors related to the development of new fractures in adjacent vertebrae after vertebroplasty.

MATERIAL AND METHODS

The study was conducted on 106 patients in whom 212 vertebroplasties were performed during a period of 3 years. Evaluations of the five vertebrae superior and inferior to the treated vertebra were performed. Consequently, 913 vertebrae were evaluated and the fracture-free interval of the vertebral body adjacent to the treated vertebra was calculated. Survival analysis was performed using the Kaplan-Meier method and Cox proportional hazards regression analysis.

RESULTS

Seventy-two (7.9%) new fractures were revealed. The Kaplan-Meier estimate of the 1-year fracture-free rate was 93.1%. The mean fracture-free interval was 32 months (95% CI, 32 to approximately 33 months). The greater degree of height restoration of the treated vertebra, the location of the adjacent vertebra in the TL junction, and the shorter distance between the treated and the adjacent vertebra increased the risk of new vertebral fractures.

CONCLUSION

Thoracolumbar junction, shorter distance from the treated vertebrae, and greater degree of height restoration of the cemented vertebrae may increase the fracture risk of vertebrae adjacent to cement vertebrae after vertebroplasty.

Opposite effects of Ha-Ras and Ki-Ras on radiation-induced apoptosis via differential activation of PI3K/Akt and Rac/p38 mitogen-activated protein kinase signaling pathways

It has been well known that Ras signaling is involved in various cellular processes, including proliferation, differentiation, and apoptosis. However, distinct cellular functions of Ras isozymes are not fully understood. Here we show the opposing roles of Ha-Ras and Ki-Ras genes in the modulation of cell sensitivity to ionizing radiation. Overexpression of active isoform of Ha-Ras (12V-Ha-Ras) in Rat2 cells increases resistance to the ionizing radiation. Constitutive activation of phosphoinositide-3-kinase (PI3K) and Akt is detected specifically in 12V-Ha-Ras-overexpressing cells. The specific PI3K inhibitor LY294002 inhibits PI3K/Akt signaling and potentiates the radiation-induced apoptosis, suggesting that activation of the PI3K/Akt signaling pathway is involved in the increased radio-resistance in cells overexpressing 12V-Ha-Ras. Overexpression of activated Ki-Ras (12V-Ki-Ras), on the other hand, markedly increases radiation sensitivity. The p38 mitogen-activated protein kinase (MAPK) activity is selectively enhanced by ionizing radiation in cells overexpressing 12V-Ki-Ras. The specific p38 MAPK inhibitor, PD169316, or dominant-negative p38 MAPK decreases radiation-induced cell death. We further show that the mechanism that underlies potentiation of cell death in cells overexpressing 12V-Ki-Ras involves Bax translocation to the mitochondrial membrane. Elevated Bax translocation following ionizing irradiation in 12V-Ki-Ras-overexpressing cells is completely inhibited by PD169316 or dominant-negative p38 MAPK. In addition, introduction of cells with RacN17, a dominant-negative mutant of Rac, resulted in a marked inhibition of radiation-induced Bax translocation and apoptotic cell death as well as p38 MAPK activation. Taken together, these findings explain the opposite effects of Ha-Ras and Ki-Ras on modulation of radiosensitivity, and suggest that differential activation of PI3K/Akt and Rac/p38 MAPK signaling by Ha-Ras and Ki-Ras may account for the opposing response to the ionizing radiation. These data provide an explanation for the diverse biological functions of Ras isozymes, and partly accounts for the differential response of transformed cells to anticancer treatments.

Suppression of Extracellular Signal-related Kinase and Activation of p38 MAPK Are Two Critical Events Leading to Caspase-8- and Mitochondria-mediated Cell Death in Phytosphingosine-treated Human Cancer Cells

We previously demonstrated that the phytosphingosine-induced apoptosis was accompanied by the concomitant induction of both the caspase-8-mediated and mitochondrial activation-mediated apoptosis pathways. In the present study, we investigated the role of mitogen-activated protein kinases (MAPKs) in the activation of these two distinct cell death pathways induced by phytosphingosine in human cancer cells. Phytosphingosine caused strong induction of caspase-8 activity and caspase-independent Bax translocation to the mitochondria. A rapid decrease of phosphorylated ERK1/2 and a marked increase of p38 MAPK phosphorylation were observed within 10 min after phytosphingosine treatment. Activation of ERK1/2 by pretreatment with phorbol 12-myristate 13-acetate or forced expression of ERK1/2 attenuated phytosphingosine-induced caspase-8 activation. However, Bax translocation and caspase-9 activation was unaffected, indicating that down-regulation of the ERK activity is specifically required for the phytosphingosine-induced caspase-8-dependent cell death pathway. On the other hand, treatment with SB203580, a p38 MAPK-specific inhibitor, or expression of a dominant negative form of p38 MAPK suppressed phytosphingosine-induced translocation of the proapoptotic protein, Bax, from the cytosol to mitochondria, cytochrome c release, and subsequent caspase-9 activation but did not affect caspase-8 activation, indicating that activation of p38 MAPK is involved in the mitochondrial activation-mediated cell death pathway. Our results suggest that phytosphingosine can utilize two different MAPK signaling pathways for amplifying the apoptosis cascade, enhancing the understanding of the molecular mechanisms utilized by naturally occurring metabolites to regulate cell death. Molecular dissection of the signaling pathways that activate the apoptotic cell death machinery is critical for both our understanding of cell death events and development of cancer therapeutic agents.

Phytosphingosine induces apoptotic cell death via caspase 8 activation and Bax translocation in human cancer cells

PURPOSE

Sphingolipid metabolites, such as sphingosine and ceramide, are highly bioactive compounds and are involved in diverse cell processes, including cell-cell interaction, cell proliferation, differentiation, and apoptosis. However, the physiological roles of phytosphingosine are poorly understood. In this study, we report that phytosphingosine can potently induce apoptotic cell death in human cancer cells via caspase activation and caspase-independent cytochrome c release.

EXPERIMENTAL DESIGN

Phytosphingosine-induced apoptosis was determined by Hoechst 33258 staining, flow cytometric analysis, and DNA fragmentation assay. Involvement of caspases was determined by immunoblot analysis and cell death detection assays after treatment with synthetic inhibitor z-Val-Ala-Asp-fluoromethyl ketone, z-DEVD-fmk, or z-IETD-fmk. Death receptor (DR) dependency was analyzed by examining expression of DRs (Fas, DR4, DR5, TNFR1, and R2), and interaction of Fas-associated death domain and caspase 8. Involvement of the mitochondria pathway was examined by monitoring of the mitochondria membrane potential, cytochrome c release, and Bax translocation.

RESULTS

Phytosphingosine-treated cells displayed several features of apoptosis, including increase of sub-G(1) population, DNA fragmentation, and poly(ADP-ribose) polymerase cleavage. We observed that phytosphingosine cause activation of caspase 8 in a DR-independent fashion. Phytosphingosine also induced activation of caspase 9 and 3, loss of mitochondrial membrane potential, and the cytochrome c release from mitochondria. However, we failed to detect Bid cleavage. Moreover, caspase 8 inhibitor z-IETD-fmk did not affect phytosphingosine-induced cytochrome c release and caspase 9 activation, suggesting that phytosphingosine-induced cytochrome c release is caused by caspase 8-independent manner. Phytosphingosine induced mitochondrial translocation of Bax from the cytosol without changes in the protein levels of Bcl-2, Bcl-xL, and Bax. In addition, Bcl-2/Bax interaction was diminished after addition of phytosphingosine.

CONCLUSION

These findings indicate that phytosphingosine induces apoptotic cell death in human cancer cells by direct activation of caspase 8, and by mitochondrial translocation of Bax and subsequent release of cytochrome c into cytoplasm, providing a potential mechanism for the anticancer activity of phytosphingosine.

Intra-articular ganglion cysts of the knee: clinical and MR imaging features

The purpose of this study was to present clinical and MR imaging features of intra-articular ganglion cysts of the knee. Retrospective review of 1685 consecutive medical records and MR examinations of the knee performed at three imaging centers allowed identification of 20 patients (13 men and 7 women; mean age 35 years), in whom evidence of intra-articular ganglion cyst was seen. Of the 20 ganglion cysts, 5 were found in the infrapatellar fat pad, 10 arose from the posterior cruciate ligament, and 5 from the anterior cruciate ligament. Three of five patients with ganglion cyst in the infrapatellar fat pad had a palpable mass. In 7 of 15 patients with ganglion cyst in the intercondylar notch, exacerbation of pain occurred in a squatting position. On four MR arthrographies, ganglion cysts were an intra-articular round, lobulated, low signal intensity lesion. Five cases of fat-suppressed contrast-enhanced T1-weighted SE images demonstrated peripheral thin rim enhancement. The clinical presentation of intra-articular ganglion cyst is varied according to its intra-articular location. The MR appearance of intra-articular ganglion cyst is characteristic and usually associated with the cruciate ligament or the infrapatellar fat pad. Magnetic resonance arthrography has no definite advantage over conventional MR in the evaluation of the lesion. For intra-articular ganglion cyst in the infrapatellar fat pad, fat-suppressed contrast-enhanced MR imaging could be useful, because a thin, rim-enhancing feature of intra-articular ganglion cyst allows it to be distinguished from synovial hemangioma and synovial sarcoma.

Involvement of p38 mitogen-activated protein kinase in the cell growth inhibition by sodium arsenite

It is well-known that p38 mitogen-activated protein kinase (p38MAPK) participates in cellular responses to mitogenic stimuli, environmental and genotoxic stresses, and apoptotic agents. Although there are several reports on p38MAPK in relation to cell growth and apoptosis, the exact mechanism of p38MAPK-mediated cell growth regulation remains obscure. Here, we examined possible roles of p38MAPK in the sodium arsenite-induced cell growth inhibition in NIH3T3 cells. Sodium arsenite induced transient cell growth delay with marked activation of p38MAPK. In addition, arsenite induced CDK inhibitor p21(CIP1/WAF1) and enhanced its binding to the CDK2, which resulted in inhibition of CDK2 activity. The levels of cyclin D1 expression and the CDK4 kinase activity were also significantly reduced. pRB was hypophosphorylated by sodium arsenite. SB203580, a specific inhibitor of p38MAPK, blocked arsenite-induced growth inhibition as well as the arsenite-induced p21(CIP1/WAF1) expression. Expression of dominant negative p38MAPK also blocked arsenite-induced p21(CIP1/WAF1) expression. Inhibited-CDK2 activity was also completely reversed by SB203580 or expression of dominant negative p38MAPK, while the decreased-cyclin D1 protein by the compound was not restored. These data demonstrate a possible link between the activation of p38MAPK and induction of p21(CIP1/WAF1), suggesting that the activation of p38MAPK is, at least in part, related to the cell growth inhibition by sodium arsenite.

Induction of cell cycle arrest and apoptosis in human breast cancer cells by quercetin

Quercetin, a widely distributed bioflavonoid, has been shown to induce growth inhibition in certain cancer cell types. In the present study we have pursued the mechanism of growth inhibition in MCF-7 human breast cancer cells. Quercetin treatment resulted in the accumulation of cells specifically at G2/M phase of the cell cycle. Mitotic index measured by MPM2 staining clearly showed that cells were transiently accumulated in M phase, 24 h after treatment. The transient M phase accumulation was accompanied by a transient increase in the levels of cyclin B1 and Cdc2 kinase activity. However, 24 h or longer treatment caused a marked accumulation of cells in G2 instead of M phase. Levels of cyclin B1 and cyclin B1-associated Cdc2 kinase activity were also decreased. We also found that quercetin markedly increased Cdk-inhibitor p21CIP1/WAF1 protein level after treatment for 48 h or longer, and the induction of p21CIP1/WAF1 increased its association with Cdc2-cyclin B1 complex, however, up-regulation of p53 by quercetin was not observed. Quercetin also induced significant apoptosis in MCF-7 cells in addition to cell cycle arrest, and the induction of apoptosis was markedly blocked by antisense p21CIP1/WAF1 expression. The present data, therefore, demonstrate that a flavonoid quercetin induces growth inhibition in the human breast carcinoma cell line MCF-7 through at least two different mechanisms; by inhibiting cell cycle progression through transient M phase accumulation and subsequent G2 arrest, and by inducing apoptosis.

Preoperative evaluation of gastric cancer: value of spiral CT during gastric arteriography (CTGA)

BACKGROUND

To evaluate the utility of dual-phase spiral computed tomography during gastric arteriography (CTGA) in the preoperative staging of gastric cancers.

METHODS

We performed CTGA in 21 patients with pathologically proven gastric cancers. CTGA findings were prospectively analyzed and correlated with surgical and pathologic findings. Dual-phase scans were performed at 10 s (early) and 60-100 s (delayed) after injection of 120 mL of contrast medium at an injection rate of 6 mL/s through a preset 5-Fr catheter positioned in the celiac trunk. Spiral CT scans were assessed for enhancing pattern of the normal gastric wall, tumor detectability, and accuracy of tumor staging.

RESULTS

Normal gastric mucosa was clearly visible as two or three layers in all patients on early-phase scans and in eight patients on delayed-phase scans. The primary tumors were correctly detected with CTGA in seven (88%) of the eight early gastric cancers and in all 13 (100%) advanced gastric cancers. The accuracy of CTGA for T staging was 50% and 77% in early and advanced gastric cancers, respectively. The overall accuracy for tumor detection and T staging was 95% and 67%, respectively. The accuracy of CTGA for the degree of serosal invasion and regional lymph node metastasis was 77% and 76%, respectively.

CONCLUSION

The CTGA technique improved tumor detection rate and accuracy of tumor staging, especially in early gastric cancer, and may be very useful in the preoperative staging of gastric cancer.

CT bronchus sign in malignant solitary pulmonary lesions: value in the prediction of cell type

The aim of this study was to evaluate differences in the prevalence of patterns of CT bronchus sign in malignant solitary pulmonary lesions (SPLs), according to their histologic cell types and with respect to size, location, and degree of cell differentiation. Computed tomography scans of 78 patients, in whom pathologically confirmed malignant SPLs with CT bronchus sign were present, were randomly selected and reviewed by two radiologists under consensus. All 78 were CT scans done using spiral technique with 10-mm collimation and 10-mm reconstruction intervals with enhancement, and 75 included additional high-resolution CT scans. Lesions were classified into four cell types as squamous cell carcinoma (n = 24), small cell carcinoma (n = 12), adenocarcinoma (n = 23), bronchioloalveolar carcinoma (BAC; n = 9), and others (n = 12), into three degrees of differentiation, into three size groups, and according to location (central or peripheral). Patterns of CT bronchus sign were classified into abruptly obstructing (I), patent (II), displacing (III), or tapered narrowing (IV) types. The relationships between the patterns of CT bronchus sign and cell type and degree of cell differentiation were evaluated. Eighty patterns of CT bronchus sign were observed in 78 patients. According to cell type, squamous cell carcinoma showed most often type-I pattern (45.8%) but no type-II pattern, which was the most common pattern observed in BAC (77.8%) and adenocarcinoma (34.8%; p<0.01). Small cell carcinoma showed a varied distribution among the four patterns of CT bronchus sign. According to location, in central squamous cell carcinomas, type-I pattern was more common(55%; p<0.01). Bronchioloalveolar carcinoma showed more peripheral lesions and in both central and peripheral lesions, type-II pattern was significantly more common (100 and 66.7%; p<0.01). In SPLs with CT bronchus sign of obstructing pattern, especially if central location, squamous cell carcinoma should be suspected, whereas in SPLs with patent CT bronchus sign, regardless of the location, the strong possibility of BAC should be considered.

Large cell neuroendocrine carcinoma of the lung: radiologic and pathologic findings

PURPOSE

The purpose of this work was to determine the radiologic and pathologic findings of large cell neuroendocrine carcinoma (LCNEC).

METHOD

We retrospectively evaluated chest radiographs, CT scans, and pathologic findings of five patients with pathologically confirmed LCNEC. They were confirmed by percutaneous needle biopsy (n = 2) and by surgery (n = 3). The average age of patients was 60 (51-70) years, and all five were smokers (mean 30 pack-years) and men. Radiologic findings were reviewed for the pattern of lesion, location, and associated findings by two radiologists under consensus. Pathologic findings were reviewed by two pathologists.

RESULTS

In all five patients, tumors were represented as a peripherally located nodule or mass without associated secondary pneumonitis or distal atelectasis radiographically. On CT scan, masses were oval or round and well demarcated with lobulated margin in all cases, their sizes ranged from 2 to 5 cm, and they did not show internal calcification and necrosis. On contrast-enhanced CT, three cases showed moderate enhancement more than the chest wall muscle. Lymphadenopathy was observed in ipsilateral hilar and mediastinal areas in three cases. Distant metastasis to liver was noted in one case. One case of LCNEC was Stage IV, two were Stage IIIa, and two were Stage Ia at the time of diagnosis.

CONCLUSION

Although the epidemiology of LCNEC is more similar to that of small cell carcinoma than atypical carcinoids, in its strong association with smoking, rapid progression, and poor prognosis, our five cases of LCNEC show peripherally located pulmonary nodule or mass with or without regional lymphadenopathy, which are findings similar to those of atypical carcinoids rather than small cell carcinoma.

Hepatic arterioportal shunts not directly related to hepatocellular carcinoma: findings on CT during hepatic arteriography, CT arterial portography and dual phase spiral CT

AIM

To evaluate findings of arterioportal shunts not directly related to hepatocellular carcinoma (HCC) which were seen within third-order portal branches on computed tomography (CT) during hepatic arteriography (CTHA), arterial portography (CTAP), and dual phase spiral CT.

MATERIALS AND METHODS

At CTHA in 112 patients, we examined third-order portal vein branches to find arterioportal shunts not directly related to HCC. Six cases were found. We evaluated the findings of these shunts on CTHA and investigated whether CTAP (n = 6) and dual phase spiral CT (n = 5) showed perfusion defects in the corresponding areas on arterioportal shunts.

RESULTS

Five of six cases showed abrupt visualization of portal branches without visualization of the proximal portion of CTHA. Five of six cases showed no perfusion defect on CTAP and no hyperattenuating area on CTHA. Four of five cases showed no hyperattenuating area on hepatic arterial phase spiral CT.

CONCLUSION

Arterioportal shunts not directly related to HCC and occuring within third-order portal branches mainly showed abrupt visualization of portal branches on CTHA. These occurred frequently without perfusion defects on CTAP and without a hyperattenuating area on CTHA and hepatic arterial phase spiral CT.Park, C. M. (2000). Clinical Radiology55, 465-470.

Fas (APO-1/CD95) ligand and Fas expression in renal cell carcinomas: correlation with the prognostic factors

BACKGROUND AND OBJECTIVE

Fas ligand (FasL, CD95L) is a type II transmembrane protein of the tumor necrosis factor family that induces cells to send an apoptotic signal to cells expressing Fas (CD95, APO-1). It has been shown that cancers have a dysregulated expression of Fas and FasL system, conferring a survival advantage. It is important to understand FasL and Fas expression in tumors, because the growth of cancer might be controlled by Fas-mediated apoptosis.

METHODS

The expressions of FasL and Fas were studied by immunohistochemical analyses in 51 cases of renal cell carcinomas and the adjacent normal renal tissues, respectively. In addition, their expressions were compared with prognostic factors, such as tumor size, nuclear grade, TNM stage, and histologic types.

RESULTS

In nonneoplastic renal tissues, FasL was expressed in all nephron segments, whereas Fas also expressed in all tubules, except for glomeruli. In renal cell carcinomas, FasL protein was detected in 50 (98.0%) of 51 cases, whereas Fas expressed in 38 (74.5%) of 51 cases. In fact, the immunostaining of Fas was less intense than that in the adjacent normal segments of all cases. The staining pattern showing both high expression of FasL and low expression of Fas was found in 36 (70.6%) (P = .04) of 51 cases, most of which were Fuhrman grade 2 or 3 tumors. However, the expression pattern did not correlate statistically with the tumor size, histologic type, or clinical stage. On the other hand, most grade 4 tumors displayed high expression of both FasL and Fas (P<.001).

CONCLUSION

These data indicate that high expression of FasL and low expression of Fas protein in renal cell carcinomas may play a role in evading surveillance of the immune system. In addition, the FasL and Fas expressions appear to have a therapeutic implication for high-grade tumors rather than a prognostic one.

Evaluation of consumer drug information databases

OBJECTIVES

To evaluate prescription drug information contained in six consumer drug information databases available on CD-ROM, and to make health care professionals aware of the information provided, so that they may appropriately recommend these databases for use by their patients.

DESIGN

Observational study of six consumer drug information databases: The Corner Drug Store, Home Medical Advisor, Mayo Clinic Family Pharmacist, Medical Drug Reference, Mosby's Medical Encyclopedia, and PharmAssist.

SETTING

Not applicable.

PATIENTS OR OTHER PARTICIPANTS

Not applicable.

INTERVENTIONS

Information on 20 frequently prescribed drugs was evaluated in each database. The databases were ranked using a point-scale system based on primary and secondary assessment criteria.

MAIN OUTCOME MEASURES

For the primary assessment, 20 categories of information based on those included in the 1998 edition of the USP DI Volume II, Advice for the Patient: Drug Information in Lay Language were evaluated for each of the 20 drugs, and each database could earn up to 400 points (for example, 1 point was awarded if the database mentioned a drug's mechanism of action). For the secondary assessment, the inclusion of 8 additional features that could enhance the utility of the databases was evaluated (for example, 1 point was awarded if the database contained a picture of the drug), and each database could earn up to 8 points.

RESULTS

The results of the primary and secondary assessments, listed in order of highest to lowest number of points earned, are as follows: Primary assessment--Mayo Clinic Family Pharmacist (379), Medical Drug Reference (251), PharmAssist (176), Home Medical Advisor (113.5), The Corner Drug Store (98), and Mosby's Medical Encyclopedia (18.5); secondary assessment--The Mayo Clinic Family Pharmacist (8), The Corner Drug Store (5), Mosby's Medical Encyclopedia (5), Home Medical Advisor (4), Medical Drug Reference (4), and PharmAssist (3).

CONCLUSION

The Mayo Clinic Family Pharmacist was the most accurate and complete source of prescription drug information based on the USP DI Volume II and would be an appropriate database for health care professionals to recommend to patients.

Lung metastases manifesting as pulmonary infarction by mucin and tumor embolization: radiographic, high-resolution CT, and pathologic findings

We present a case of lung metastasis manifesting as lung infarction by mucin and tumor embolization. The radiograph and high-resolution CT showed multiple focal consolidations with ground glass attenuation in subpleural areas of both lungs. Diagnosis was made by open lung biopsy, which revealed pulmonary infarction caused by intravascular adenocarcinoma with numerous mucus emboli in pulmonary arteries. Subpleurally located consolidations on high-resolution CT correlated well with the histologic findings of lung infarction by mucin and tumor emboli.

Synthesis and antifungal evaluation of 6-(N-arylamino)-7-methylthio-5,8-quinolinediones

A series of 6-(N-arylamino)-7-methylthio-5,8-quinolinedione derivatives 4a-4l was newly synthesized for the evaluation of antifungal activity. 6-(N-Arylamino)-7-methylthio-5,8-quinolinediones were prepared by regioselective nucleophilic substitution of 6,7-dichloro-5,8-quinolinediones with arylamines in the presence of Ce3+, and Na2S/dimethylsulfate. The MIC values of 4a-4l were determined for antifungal susceptibility in vitro against Candida species by agar streak method. The derivatives 4a-4l had generally potent antifungal activities against all human pathogenic fungi. Especially they had the most potent activity against C. krusei at 12.5-0.8 micrograms/ml. Compounds 4d, 4g, 4h, 4j and 4k had more potent antifungal activities than fluconazole. Compounds 4g and 4h completely inhibited the fungal growth at 0.8-6.3 micrograms/ml against all Candida species, while fluconazole inhibited the growth at 25 micrograms/ml. The compounds such as 4g and 4h containing an N-(4-bromo-2-methylphenyl)- or N-(4-bromo-3-methylphenyl)amino substituent exhibited the most potent antifungal activities.