Molecular changes in the testes of COVID-19 patients

After the sudden outbreak of the COVID-19 pandemic, scientists and clinicians around the world have significantly expanded understanding of the pathogenesis of the disease as well as the impact of SARS-CoV-2 on various organs and tissues. To date, it is accepted to consider the new coronavirus infection as a multisystem disease, but the data on the effect on fertility remains unclear. Previous works by other authors have presented controversial results, and there is no evidence of a direct effect of the new coronavirus on the male gonads. Thus, further studies are needed to verify the hypothesis that the testicles are the target organ for SARS-CoV-2. Groups were formed: Group I (n = 109; age from 25 to 75 years, Median (IQR) - 60 (23) years), cause of death - new coronavirus infection; Group II (n = 21, age from 25 to 75 years, Median (IQR) - 55 (29.5) years) - autopsy testicular material obtained outside the pandemic. We used RT-PCR to detect the presence of viral RNA in testicular tissue. In addition, we investigated the levels of proteins that provide viral invasion, such as ACE-2 and Furin. In the present study, we detected genetic material of a new coronavirus and increased proteins required for viral invasion in testicular tissue of patients with COVID-19 by RT-PCR. Thus, based on our findings, we assume that testicular tissue is potentially vulnerable to SARS-CoV-2.Communicated by Ramaswamy H. Sarma.

Morphological Evaluation and Immunohistochemical Analysis of the Reparative Potential of the Buccal Fat Pad

Background and Objectives: There are many surgical techniques for oroantral communication treatment, one of which is the buccal fat pad. Of particular interest is the high reparative potential of the buccal fat pad, which may be contributed to by the presence of mesenchymal stem cells. The purpose of this work is to evaluate the reparative potential of BFP cells using morphological and immunohistochemical examination. Materials and Methods: 30 BFP samples were provided by the Clinic of Maxillofacial and Plastic Surgery of the Russian University of Medicine (Moscow, Russia) from 28 patients. Morphological examination of 30 BFP samples was performed at the Institute of Clinical Morphology and Digital Pathology of Sechenov University. Hematoxylin-eosin, Masson trichrome staining and immunohistochemical examination were performed to detect MSCs using primary antibodies CD133, CD44 and CD10. Results: During staining with hematoxylin-eosin and Masson's trichrome, we detected adipocytes of white adipose tissue united into lobules separated by connective tissue layers, a large number of vessels of different calibers, as well as the general capsule of BFP. The thin connective tissue layers contained neurovascular bundles. Statistical processing of the results of the IHC examination of the samples using the Mann-Whitney criterion revealed that the total number of samples in which the expression of CD44, CD10 and CD133 antigens was confirmed was statistically significantly higher than the number of samples where the expression was not detected (p < 0.05). Conclusions: During the morphological study of the BFP samples, we revealed statistically significant signs of MSCs presence (p < 0.05), including in the brown fat tissue, which proves the high reparative potential of this type of tissue and can make the BFP a choice option among other autogenous donor materials when eliminating OAC and other surgical interventions in the maxillofacial region.

Methotrexate & rheumatoid arthritis associated atherosclerosis: A narrative review of multidisciplinary approach for risk modification by the international board of experts

Rheumatoid arthritis (RA) is an idiopathic, autoimmune connective tissue disorder that primarily affects the synovial joints, causing symmetric, erosive-deforming polyarthritis. It is also associated with extra-articular manifestations, particularly cardiovascular (CV) diseases (CVD). CV risk modification in RA remains unsolved despite recent advances in the management of RA. RA is an independent risk factor for atherosclerosis. RA and atherosclerosis share similar pathophysiological features (such as the pro-inflammatory cascade activation including interleukin-6) and risk factors (such as microflora dysbacteriosis and smoking). Patients with RA experience an exacerbation of atherogenesis, with atheromas destabilization, endothelial dysfunction, vasculitis, and hypercytokinemia. Consequently, the inflammatory response associated with RA is the basis for CVD development. The treat-to-target strategy not only improved RA control but also had a favorable effect on the morpho-functional state of the CV system in patients living with RA. Thus, disease-modifying antirheumatic drugs (DMARDs) - in particular methotrexate - may have a beneficial effect on the prevention of CV events in RA. It must be mentioned that RA is a serious multi-system disease, not only because of a window period during which the course of RA can be reversed, but also due to early damage to the heart and blood vessels. For this reason, a thorough cardiological assessment must be performed for all patients with RA, regardless of sex, age, disease stage, and disease activity score.

Digital twin concept: Healthcare, education, research

Introducing the concept of digital twins in healthcare, medical education, and research is a complex multistage challenge requiring participation of multidisciplinary teams. In pursuing this goal, we have created a validated database of scans of colorectal tumor slides associated with relevant clinical and histological information. This database is also linked to the blood bank, which opens a wide range of opportunities for further research. Herein, we present our experience within the scope of the digital twins initiative.

Cerium-Containing N-Acetyl-6-Aminohexanoic Acid Formulation Accelerates Wound Reparation in Diabetic Animals

Background: The main goal of our study was to explore the wound-healing property of a novel cerium-containing N-acethyl-6-aminohexanoate acid compound and determine key molecular targets of the compound mode of action in diabetic animals. Methods: Cerium N-acetyl-6-aminohexanoate (laboratory name LHT-8-17) as a 10 mg/mL aquatic spray was used as wound experimental topical therapy. LHT-8-17 toxicity was assessed in human skin epidermal cell culture using (4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. A linear wound was reproduced in 18 outbred white rats with streptozotocin-induced (60 mg/kg i.p.) diabetes; planar cutaneous defect was modelled in 60 C57Bl₆ mice with streptozotocin-induced (200 mg/kg i.p.) diabetes and 90 diabetic db/db mice. Firmness of the forming scar was assessed mechanically. Skin defect covering was histologically evaluated on days 5, 10, 15, and 20. Tissue TNF-α, IL-1β and IL-10 levels were determined by quantitative ELISA. Oxidative stress activity was detected by Fe-induced chemiluminescence. Ki-67 expression and CD34 cell positivity were assessed using immunohistochemistry. FGFR3 gene expression was detected by real-time PCR. LHT-8-17 anti-microbial potency was assessed in wound tissues contaminated by MRSA. Results: LHT-8-17 4 mg twice daily accelerated linear and planar wound healing in animals with type 1 and type 2 diabetes. The formulated topical application depressed tissue TNF-α, IL-1β, and oxidative reaction activity along with sustaining both the IL-10 concentration and antioxidant capacity. LHT-8-17 induced Ki-67 positivity of fibroblasts and pro-keratinocytes, upregulated FGFR3 gene expression, and increased tissue vascularization. The formulation possessed anti-microbial properties. Conclusions: The obtained results allow us to consider the formulation as a promising pharmacological agent for diabetic wound topical treatment.

Prognostic Role of FGFR3 Expression Status and Tumor-Related MicroRNAs Level in Association with PD-L1 Expression in Primary Luminal Non-Muscular Invasive Bladder Carcinoma

BACKGROUND

bladder cancer is one of the most common urinary tract malignancies. Establishment of robust predictors of disease progression and outcome is important for personalizing treatment of non-muscular invasive bladder carcinoma (NMIBC). In this study we evaluated association of PD-L1 expression with other prognostic biomarkers, such as expression of miRNA-145 and miRNA-200a, FGFR3 gene expression, and mutation status in tissue specimens of the luminal subtype of newly diagnosed high and low grade NMIBC.

METHODS

twenty patients with primary luminal NMIBC were enrolled in the study. Tumor grade and risk level were determined in accordance with European Organization for Research and Treatment of Cancer (EORTC) guidelines and World Health Organization (WHO) classification. Neoplasm molecular subtype and PD-L1 expression level were assessed by immunohistochemistry. We used real-time PCR to evaluate the expression of microRNAs and FGFR3. We detected FGFR3 hotspot mutations in codons 248 and 249 by Sanger sequencing.

RESULTS

high grade primary luminal NMIBC showed comparatively higher expression of PD-L1 and microRNA-145 than a low grade tumor, whereas the latter had a higher FGFR3 expression and hotspot mutation rate. The tumor grade (HR = 571.72 [11.03-2.96] p = 0.002), PD-L1 expression (HR = 2.33 [0.92-1.92] p = 0.012), and FGFR3 expression (HR = 0.08 [0.17-0.42] p = 0.003) were associated with relapse-free survival.

CONCLUSIONS

tumor grade in association with PD-L1 and FGFR3 expression can be considered as a complex predictor for primary luminal NMIBC progression.

Immunohistochemical and morphological characteristics of tissues response to polylactic acid membranes with silver nanoparticles

Background

The aim of this research was to study anti-microbial and anti-inflammatory characteristics of silver nanoparticles helping bone structures to recover during late stage of parodontitis, which afterwards will increase the effect of bone regeneration operations.

Material and Methods

We assessed colloid solution-derived silver nanoparticles coating of polylactic acid membrane regarding tissue foreign body response. Thirty eight polylactic acid membranes were implanted intracranially in rabbits – ten unmodified (control group) and twenty eight with silver nanoparticles coating (experimental group). In controls, penicillin was used for infection prophylaxis. Tissue response was assessed by light microscopy and immunohistochemistry (CD3, CD15, CD30) 2 weeks after implantation.

Results

inflammation markers in experimental group were significantly lower than in control group, there were no signs of forming a fibrosis capsule nor infectious signs.

Conclusions

colloid silver solution can be used as a source of nanoparticles for anti-microbial and anti-inflammatory biodegradable membranes’ coating.

Key words:Guided bone regeneration, polylactic acid membrane, silver nanoparticles.

Patient-Derived Non-Muscular Invasive Bladder Cancer Xenografts of Main Molecular Subtypes of the Tumor for Anti-Pd-l1 Treatment Assessment

Background: Establishment of heterotopic patient-derived xenografts of primary and relapsed non-muscular invasive bladder cancer (NMIBC) to explore the biological property of PD-L1 signaling that may impact bladder tumor growth in humanized animals. Methods: Tumor cells of luminal, basal, and p53 subtypes of primary and relapsed NMIBC were engrafted to irradiated (3.5 Gy) NOG/SCID female mice along with intraperitoneal transplantation of human lymphocytes (5 × 10⁷ cells/mouse); a role of PD-L1 signaling pathway inhibition for bladder cancer growth was assessed in humanized animals that carried PD-L1-expressing main molecular subtypes of bladder carcinoma patient-derived xenografts (PDX) and provided with selective anti-PD-L1 treatment. We used two-tailed Student’s t test to explore differences between main and control subgroups. Significance of intergroup comparison was measured with one-way ANOVA followed by the Tukey’s or Newman–Keul’s criterion. Survival curves were analyzed with the Gehan’s criterion with the Yate’s correction. The Spearman’s correlation was used to assess the link between CD8⁺ expression and sPD-L1 serum level. Differences were considered statistically significant at p < 0.05. Results: Heterotopic primary and relapsed luminal, basal, and p53 subtypes of NMIBC PDXs were established. More than 25% of counted tumor cells of all PDX specimens expressed PD-L1, so the tumors were ranged as PD-L1 positive. Anti-PD-L1 intervention increased survival of the animals that carried both primary and relapsed luminal noninvasive, muscular invasive, and relapsed luminal bladder cancer xenografts. There was significant retardation of tumor volume duplication time in aforementioned subgroups correlated with PD-L1 expression. Bad response of p53 mutant subtypes of NMIBC on specific anti-PD-L1 treatment may be associated with low CD8⁺ cells representation into the tumors tissue. Conclusions: Established PD-L1-positive NMIBC PDXs differently replied on anti-PD-L1 treatment due to both NMIBC molecular subtype and tumor T-suppressors population. The results may have major implications for further clinical investigations.

Primary phloem-specific expression of a Zinnia elegans homeobox gene

Some plant homeobox genes are expressed specifically in vascular cells and are assumed to function in the differentiation of specific types of vascular cells. However, homeobox genes exhibiting primary phloem-specific expression have not been reported. To elucidate the molecular mechanisms of vascular development, we undertook to isolate from Zinnia elegans primary phloem-specific homeobox genes that may function in phloem development. An HD-Zip type homeobox gene, ZeHB3, was isolated. This gene encodes a class I HD-Zip protein, and constitutes a gene subfamily with the Daucus carota gene CHB6, and Arabidopsis thaliana genes Athb-5, Athb-6, and Athb-16. In situ hybridization of 1-, 14- and 50-day-old plants demonstrated that ZeHB3 mRNA accumulation is restricted to a few cells destined to differentiate into phloem cells and to the immature phloem cells surrounding the sieve elements and companion cells. ZeHB3 protein was also localized to immature phloem cells. These findings clearly indicate that ZeHB3 is a novel homeobox gene that marks, and may function in, the early stages of phloem differentiation.

A possible role of glutathione and glutathione disulfide in tracheary element differentiation in the cultured mesophyll cells of Zinnia elegans

We investigated the relationship between the cellular redox state of GSH or GSSG and tracheary element (TE) differentiation using a Zinnia experimental system, in which isolated mesophyll cells transdifferentiate to TEs. TE differentiation was suppressed by the application of L-buthionine sulfoximine (BSO), a potent inhibitor of GSH biosynthesis, at the early stage of cell culture. Application of GSSG at the early culture stage promoted the differentiation, but that of GSH or GSSG at an advanced period of culture suppressed the differentiation. Application of GSH and GSSG nullified the TE differentiation-suppressing effect of BSO. The results suggest that changes in the redox states of GSH and GSSG have a role in TE differentiation.

Brassinosteroid levels increase drastically prior to morphogenesis of tracheary elements

As the first step toward understanding the involvement of endogenous brassinosteroids (BRs) in cytodifferentiation, we analyzed biosynthetic activities of BRs in zinnia (Zinnia elegans L. cv Canary Bird) cells differentiating into tracheary elements. The results of feeding experiments suggested that both the early and late C6-oxidation pathways occur during tracheary element differentiation. Gas chromatography-mass spectrometry analysis revealed that five BRs, castasterone, typhasterol, 6-deoxocastasterone, 6-deoxotyphasterol, and 6-deoxoteasterone, actually existed in cultured zinnia cells and culture medium. Quantification of endogenous BRs in each stage of tracheary element differentiation by gas chromatography-mass spectrometry exhibited that they increased dramatically prior to the morphogenesis, which was consistent with the idea that BRs are necessary for the initiation of the final stage of tracheary element differentiation. Moreover, the proportion of each BR in culture medium was quite different from that in cells, suggesting that specific BRs are selectively secreted into medium and may function outside the cells.

Inhibition of proteasome activity by the TED4 protein in extracellular space: a novel mechanism for protection of living cells from injury caused by dying cells

In maturation process of tracheary element (TE) differentiation, many hydrolases are activated to execute programmed cell death of TEs. Such hydrolases are released from maturing TEs into extracellular space. The release of hydrolases should be harmful to surrounding cells. The TED4 protein, a tentative plant non-specific lipid transfer protein that is expressed preferentially in TE-induced culture of zinnia (Zinnia elegans L.), is secreted into the apoplastic space prior to and associated with morphological changes of TEs. Our studies on the interrelationship between the TED4 protein and proteolytic activities using an in vitro TE differentiation system of zinnia revealed the following facts. (1) Active proteasome is released into medium at maturation stage of TE differentiation. (2) The TED4 protein forms a complex with proteasome in culture medium. (3) The TED4 protein inhibits proteasome activity in the medium and crude extracts of zinnia cells. (4) The depletion of the TED4 protein from culture medium results in an increase in mortality of other living cells. These results strongly suggest that the secreted TED4 protein acts as an inhibitor of proteasome to protect other cells from undesirable injury due to proteolytic activities exudated from dying TEs.

The relationship between technical parameters of external beam radiation therapy and complications for localized prostate cancer

BACKGROUND

This study was performed to review retrospectively the clinical course of chronic rectal bleeding as a complication of external beam radiation therapy for localized prostate cancer and to analyze the relationship between technical parameters of radiation therapy and the complications.

METHODS

Seventy-one patients with stages A2, B and C were treated with local-field radiotherapy (total dose 52.5-66 Gy, daily dose 2.0-3.28 Gy, field area 30-81 cm2, number of fields 3-15 ports, planning simulations X-ray or CT-based) between 1989 and 1998 at three institutions. The protocols were consistent during this same period at these institutions.

RESULTS

Multivariate analysis revealed pretreatment PSA and Gleason sum to be statistically significant predictors of 5 year prostatic specific antigen (PSA) relapse-free rates in a median follow-up period of 42 months (range 12-119 months). The significant risk factors for higher grading of acute morbidity were a biological equivalent dose, alpha/beta = 10(BED10) > or =65 Gy, dose per fraction > or =3.0 Gy, field area > or =42 cm2, fewer ports and X-ray planning simulation. However, no parameter was associated with higher grading of late morbidity. Eleven patients (15.4%) experienced a late GI complication: grade 1 (4.2%), grade 2 (9.8%), grade 3 (1.4%). The median time to occurrence of rectal bleeding was 12 months after radiotherapy and the mean duration of morbidity was 11 months.

CONCLUSIONS

Higher total dose and dose per fraction, larger field area, fewer ports and X-ray simulation increased the grades of acute morbidity. A majority of chronic rectal bleedings were transient and responded to conservative treatment.

Isolation of a vascular cell wall-specific monoclonal antibody recognizing a cell polarity by using a phage display subtraction method

Using a strategy consisting of (i) the isolation of cell walls from synchronously differentiating cells of Zinnia, (ii) the generation of mAbs with an antibody phage display method, and (iii) screening with a subtraction method, we isolated mAbs recognizing vascular development-specific cell wall components without prior antigen identification. One of the isolated mAbs, designated CN 8, recognized a cell wall component contained in the hemicellulosic fraction. Immunohistochemical analyses showed that the CN 8 epitope was localized to the cell wall of immature tracheary elements and xylem parenchyma cells. In immature tracheary elements, the CN 8 epitope had a polarized localization pattern regardless of whether the cells are formed as parts of vessels in situ or as single tracheary elements in vitro, suggesting that cell polarity autonomously formed on the cell wall may function in tracheary element differentiation.

Treatment of metastatic nonseminomatous germ cell tumors of the testis: significance of the international consensus prognostic classification as a prognostic factor-based staging system

BACKGROUND

We reviewed treatment results in patients with metastatic nonseminomatous germ cell tumors of the testis and examined the significance of the International Consensus Prognostic Classification to make appropriate risk-based decisions concerning induction chemotherapy.

METHODS

We divided 37 patients treated with platinum-based combination chemotherapy into good, intermediate, and poor prognostic groups utilizing the International Consensus Prognostic Classification. The data was analyzed for both overall survival and progression-free survival among the 3 prognostic groups.

RESULTS

Among the 37 patients, 10 died (8 of progressive disease, 1 of pneumonia during induction chemotherapy and 1 of cyclophosphamide-induced hemorrhagic cardiomyolitis during salvage chemotherapy). The survivors were followed for 6 to 1 84 months from the beginning of induction chemotherapy (median, 80 months). Five of the 37 patients (14%) were classified as having a good prognosis, 1 8 (48%) as intermediate, and 14 (38%) as having a poor prognosis. The patients in the poor prognostic group had a 5-year overall survival of only 40%, while those in the good and intermediate groups had 5-year overall survivals of 100% and 94%, respectively. When we applied the International Consensus Prognostic Classification to patients with advanced disease classified by the Indiana University Staging System, these patients could be clearly divided into good-risk and poor-risk groups.

CONCLUSIONS

The International Consensus Prognostic Classification is easily applicable and accurate for risk assessment in patients with metastatic nonseminomatous germ cell tumors of the testis. This classification will now be widely used in general oncology practices and for clinical trials in these patients.

[Application and limitation of neoadjuvant hormonal therapy for prostate cancer]

Of 156 patients, 111 (clinical stage T1a-b; 21, T1c; 17, T2a-b; 36, T2c; 27, T3; 10) immediately underwent radical prostatectomy (surgery group), and 45 (clinical stage T1a-b; 8, T1c; 4, T2a-b; 10, T2c; 9, T3; 14) received neoadjuvant hormonal therapy (NHT group). NHT offered probability of increasing organ-confined cancer(OCC; pathological stage pT2 or lower N0M0) in the following group, which contains (a) patients who had moderately differentiated adenocarcinoma in the biopsy specimen and T2b or lower diseases, and (b) those who had well differentiated adenocarcinoma, T2c diseases and PSA levels of 10 ng/ml or higher, referred to as "OCC suitable criteria". Of 156 patients, 51 (33%) met OCC suitable criteria. In those cases, the proportion of OCC in NHT group was significantly higher than that in surgery group (11/12 (92%) vs. 16/39 (41%), p = 0.002). NHT is useful for increasing OCC in patients who meet OCC suitable criteria.

5-fluorouracil and low-dose recombinant interferon-alpha-2a in patients with hormone-refractory adenocarcinoma of the prostate

BACKGROUND

The effectiveness of a chemotherapy regimen including 5-fluorouracil (5-FU) and recombinant interferon-alpha-2a (rIFN-alpha-2a) was evaluated in hormone-refractory prostate cancer patients.

METHODS

Patients received a continuous intravenous infusion of 5-FU at 600 mg/m2/day for 5 days (D1-D5), followed by a bolus injection of 5-FU on D15 and D22. Patients received intramuscular injection of rIFN-alpha-2a at 3 million IU on D1, D3, D5, D15, and D22. This schedule was repeated every 4 weeks.

RESULTS

Between 1993 and 1995, 23 patients with hormone refractory prostate cancer were enrolled in this study. Two of five patients with nodal disease exhibited partial responses according to the NPCP criteria. Fourteen of 17 patients with bone disease showed stable disease. Of 21 patients assessible for response, 9 patients had a decrease in the PSA level greater than 50% of baseline. Bone pain disappeared partially or completely in 8 of 14 patients with this symptom at entry. The median overall survival was 18 months. The associate toxicity was well tolerable.

CONCLUSIONS

Combination chemotherapy of 5-FU and low dose rIFN-alpha-2a in patients with hormone-refractory prostate cancer proved feasible, and with acceptable toxicity.

Expression of the Zinnia TED3 promoter in developing tracheary elements of transgenic Arabidopsis

To determine the regulatory mechanism of gene expression in the early stages of tracheary element (TE) differentiation, we isolated and characterized a genomic fragment of TED3 whose mRNA is expressed preferentially in differentiating TEs 12-24 h before morphological changes in the in vitro Zinnia system. Transgenic Arabidopsis plants with a chimeric gene of the 537 bp TED3 promoter and the beta-glucuronidase (GUS) reporter gene indicated the strong expression of the GUS gene by the TED3 promoter in TEs, in particular in immature TEs as well as stipules and trichomes. GUS expression driven by the promoter was also induced in callus, in which GUS activity was localized in immature TEs and slender cells around TEs that may be TE precursor cells. The TED3 promoter was not significantly activated by wounding. This pattern of expression differed clearly from that of other vascular tissue-related genes such as PAL, 4CL, and GRP1.8. The nature of TED3 promoter enables us to use it to monitor TE differentiation in tissue and to introduce foreign genes preferentially into immature TE.

Brassinosteroids induce entry into the final stage of tracheary element differentiation in cultured Zinnia cells

To elucidate the involvement of brassinosteroids in the progression of tracheary element differentiation in cultured Zinnia cells, we analyzed the effects of uniconazole, an inhibitor of brassinosteroid synthesis, and brassinolide, a biologically active brassinosteroid, on the accumulation of mRNAs for various genes that were expressed in different stages of differentiation. Uniconazole specifically suppressed the accumulation of transcripts for genes that were induced in the final stage of differentiation in association with secondary wall formation and cell death. This suppression was recovered with the addition of brassinolide. These results strongly suggest that endogenous brassinosteroids induce entry into the final stage of differentiation.

Differential expression of three genes for different beta-tubulin isotypes during the initial culture of Zinnia mesophyll cells that divide and differentiate into tracheary elements

Complementary DNA clones for three different beta-tubulin isotypes (ZeTubB1, ZeTubB2 and ZeTubB3) were isolated from a cDNA library generated from RNA of cultured mesophyll cells of Zinnia elegans that were differentiating into tracheary elements and/or dividing. Sequence analysis revealed that the proteins encoded by ZeTubB1 and ZeTubB3 and that encoded by ZeTubB2 were each homologous to two of three groups of beta-tubulin isotypes in Arabidopsis. RNA gel blot analysis of the expression of the ZeTubB transcripts indicated that transcripts that corresponded to each clone were differently expressed during culture of Zinnia mesophyll cells. In particular, the level of expression of ZeTubB1 and ZeTubB3 transcripts increased rapidly prior to cell division and secondary wall formation, and such expression was promoted by combinations of auxin and cytokinin that induced tracheary element differentiation as well as cell division. Results of an in situ hybridization experiment with an antisense RNA probe derived from ZeTubB1 cDNA suggested the preferential expression of ZeTubB transcripts in differentiating xylem cells, as well as in the ground meristem and the procambium, of Zinnia seedlings.

The proportion of free to total prostate specific antigen: a method of detecting prostate carcinoma

BACKGROUND

Prostate specific antigen (PSA) is the most useful marker for prostate carcinoma (CaP). However, the sensitivity and specificity for PSA are not sufficient for the diagnosis of organ-confined prostate carcinoma. Recent studies have revealed that anti-PSA antibody identifies both PSA complexed to alpha-1-antichymotrypsin and free PSA, whereas anti-gamma-seminoprotein antibody recognizes free PSA exclusively. To enhance the ability of PSA to detect CaP in patients with total PSA levels of 10 ng/mL or lower, we developed the ratio of gamma-seminoprotein and PSA (free/total PSA index).

METHODS

We measured free/total PSA indices for 285 patients who had serum PSA levels of 10 ng/mL or lower and who were diagnosed pathologically.

RESULTS

Of the 285 patients, 228 had no prostate carcinoma (NC) and 57 had CaP. The mean total PSA level for CaP (5.137 +/- 2.483 ng/mL; mean +/- standard deviation) was significantly greater (P < 0.0001) than that for NC (3.251 +/- 2.129). The mean free/total PSA index for CaP (0.774 +/- 0.468 was significantly lower (P < 0.0001) than that for NC (1.563 +/- 0.938). The sensitivity for the free/total PSA index was similar to that for total PSA (78.9% vs. 75.4%). However, the specificity, positive predictive value, and overall accuracy for the free/total PSA index (75.9%, 45%, and 76.5%, respectively) increased by 15-20% compared with those for total PSA (56.6%, 30.3%, and 60.4%, respectively).

CONCLUSIONS

The free/total PSA index improved the specificity of PSA without impairing the sensitivity in detecting CaP among patients with serum PSA levels of 10 ng/mL or lower.

[Prognostic factors in patients with advanced prostatic cancer (stage D2) initially treated with endocrine therapy]

BACKGROUND

In order to make clear the prognostic factors in patients with advanced prostatic cancer (stage D2) whose initial treatment was hormone therapy, we reviewed 34 men with newly diagnosed advanced prostatic cancer for 6 years from May 1987 at the Hospital of Hokkaido University.

METHODS

All patients had histologically proven prostatic adenocarcinoma. The mean age was 67.9 years (range 54 to 86 years). Median follow-up period was 26 months (range 5 to 66 months). The parameters studied were age, performance status, histological grade, extent of disease on bone scan, pretreatment values of PSA, gamma-Sm, PAP and PSA/gamma-Sm ratio, posttreatment values of PSA, gamma-Sm and PAP at 6th month, and the ratio of PSA at 3rd month to PSA at 6th month.

RESULTS

Univariate analysis revealed that performance status (PSO vs. PS2, p = 0.006, PS1 vs. PS2, p = 0.016) and extent of disease on bone scan (p = 0.004) in background factors, gamma-Sm (p = 0.005) among pretreatment values of markers, PAP at 6th month (p < 0.001) and the ratio of PSA at 3rd month to PSA at 6th month (p < 0.001) among posttreatment values of markers, significantly related with the cause-specific survival. Based on multivariable analysis, PAP at 6th month and the ratio of PSA at 3rd month to PSA at 6th month were significantly correlated with the cause-specific survival at 24th month and 36th month, respectively.

CONCLUSION

We conclude that posttreatment values of markers are more important prognostic factors in patients with advanced prostatic cancer (stage D2) following hormone therapy than pretreatment background factors and values of markers.

[Three cases of lung metastases of renal cell carcinoma treated with a combination of interferon-alpha, 5-fluorouracil and leucovorin]

Three patients with lung metastases of renal cell carcinoma (RCC) were treated with a combination of interferon-alpha, leucovorin and 5-fluorouracil. All patients were male between 60 and 66 years and had been treated by nephrectomy prior to the combination therapy. Interferon-alpha was administered at the dose of 9 x 10(6) IU intramuscularly 3 times/week, leucovorin at 30 mg/m2 per day intravenously (day 1 to 5) and 5-fluorouracil at 500 mg/m2 daily by continuous infusion intravenously (day 1 to 5) followed by weekly bolus therapy. One patient achieved complete response for 17 months and the other two achieved stable disease for 6 and 16 months. Side effects related to this therapy were diarrhea, stomatitis, alopecia, leucocytopenia and thrombocytopenia. Grade 3 stomatitis occurred after the continuous administration of 5-fluorouracil in one patient; he recovered by discontinuation of 5-fluorouracil. Combination therapy with interferon-alpha, leucovolin and 5-fluorouracil might be effective for the treatment of lung metastases of RCC.

[5-Fluorouracil and alpha-2a interferon in patients with hormone-refractory prostate cancer]

BACKGROUND

Hormone-refractory metastatic prostate cancer remains a disease for were limited therapeutic options are available. Therefore, the establishment of newly, more effective chemotherapy is expected. Experimental data suggest that PC-3, a human hormone refractory prostate cancer cell line, showed a 2-fold increase in 5-Fluorouracil (5FU) sensitivity in the presence of alpha-2a Interferon (IFN alpha 2a) at 100 IU/ml, compared to that without IFN alpha 2a. Based on this data, we treated 11 patients with 5FU and IFN alpha 2a in order to determine the clinical response and toxicity of this combination chemotherapy.

METHODS

One course of this combination chemotherapy consisted of a continuous intravenous infusion of 5FU at 600 mg/m2/day for 5 days (D1-D5) with IFN alpha 2a 3 million units (MU) intramuscularly 3 times weekly (D1, D3, D5) followed by a bolus injection of 5FU at 600 mg/m2 and IFN alpha 2a at 3 MU/day on D15 and D22.

RESULTS

Based on the Response Criteria for Prostate cancer Treatment, one of 9 patients with bony metastasis had partial response, 2 patients with nodal disease on the CT scan obtained partial response. Six of 11 patients had more than 50% decrease in post-therapy prostatic antigen levels, 3 of whom obtained complete response. Significant myelosuppression did not occur. There were no chemotherapy-related deaths.

CONCLUSION

These results suggest that the combination of 5FU and IFN alpha 2a, although preliminary, is an active regimen against hormone-refractory metastatic prostate cancer.

[Prostate specific antigen (PSA)/gamma-seminoprotein ratio in the cases with PSA levels less than or equal to 10.0 ng/ml]

Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) have been revealed to be the same protein and used as tumor markers for prostate cancer (CaP). However, it seems impossible to detect prostate cancer in the cases with PSA levels of 10.0 ng/ml or less. We now report on PSA/gamma-Sm ratio in the cases with PSA levels of 10.0 ng/ml or less, and on the relation between PSA and gamma-Sm in those cases. Serum samples were obtained from the patients with no cancer (NC) (n = 118) and CaP (n = 39). In the cases with PSA ranging from 4.1 to 10.0 ng/ml, gamma-Sm levels in the patient with CaP were significantly lower than in those with NC (3.744 +/- 2.481 (mean +/- SD, n = 27) VS. 7.573 +/- 4.182 (n = 41), p < 0.0001) though PSA levels in both groups were not significantly different, and consequently, PSA/gamma-Sm ratio in the patients with CaP were significantly higher than in those with NC (2.181 +/- 0.802 VS. 1.095 +/- 0.804, p < 0.0001). In the cases with PSA levels of 4.0 ng/ml or less, gamma-Sm levels in the patient with CaP were significantly lower than in those with NC (1.600 +/- 0.705 (n = 12) VS. 3.243 +/- 2.456 (n = 77), p = 0.0064), while PSA levels in the patients with CaP were not significantly different from those in the patients with NC, and consequently, PSA/gamma-Sm ratio in the patients with CaP were significantly higher than in those with NC (1.762 +/- 0.544 VS. 0.808 +/- 0.330, p < 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)

Expression of androgen receptor in X-linked spinal and bulbar muscular atrophy and amyotrophic lateral sclerosis

Images

[Mucinous adenocarcinoma of the prostate. A case report and analysis of the literature]

An 80-year-old man, who had been treated for colon cancer 25 years ago, presented with gross hematuria. Rectal examination revealed a soft nodule in the right lobe. The serum prostatic specific antigen (PSA) was elevated to 5.2 ng/ml, while prostatic acid phosphate (PAP) was normal. Transrectal ultrasound revealed a hypoechoic mass in peripheral zone of the prostate and dilated seminal vesicle. A needle biopsy of the prostate showed mucinous adenocarcinoma. Under the diagnosis of prostatic tumor with seminal vesicle involvement, radical prostatectomy was performed. Histological findings showed organ confined cancer, of which most was composed of extracellular mucin lakes. Immunohistochemical study revealed the tumor cells positive for PSA and PAP. Mucinous adenocarcinoma of the prostate has been known to be clinically different from non-mucinous adenocarcinoma, in that the former is insensitive to hormonal therapy, is rarely associated with elevated PAP and rarely metastasize to the bone. But our analysis of the literatures is Japan showed no significant difference clinically between mucinous and non mucinous prostatic adenocarcinoma. However mucinous adenocarcinoma with signet ring cell rarely responds to hormonal therapy, which should not be classified to true mucinous adenocarcinoma in the current criteria. True mucinous adenocarcinoma could be a variant of prostatic adenocarcinoma, which is peripheral origin and should be treated like non-mucinous adenocarcinoma.

Novel vascular cell-specific genes whose expression is regulated temporally and spatially during vascular system development

We have isolated three cDNA clones (TED2, TED3, and TED4) for genes expressed preferentially in cells that redifferentiate into tracheary elements from mesophyll cells isolated from leaves of Zinnia elegans. Sequence analyses of TED clones revealed that TED2 encodes a hydrophobic polypeptide with a significant similarity to the guinea pig lens-specific protein (zeta-crystallin) and that the deduced polypeptide of TED3 may be a novel cell wall protein. In situ hybridization of the TED probes with young Zinnia seedlings showed that expression of the three TED genes was restricted to vascular cells and regulated in a temporal and spatial manner during vascular development. TED3 transcripts were localized specifically to a few cells that are to differentiate or are differentiating into tracheary elements in all organs examined. TED4 transcripts were present mainly in the immature primary xylem both of cotyledons and of the boundary region between the root and hypocotyl and in the procambium of roots. In contrast, TED2 transcripts accumulated not only in immature primary xylem cells but also in immature phloem cells both in roots and in the boundary region between the root and hypocotyl. In addition, TED2 transcripts were expressed in the procambium cells of roots. In cotyledons, TED2 transcripts did not accumulate in xylem or phloem cells but only in two regions that might form a new vein just outside the phloem of the main leaf vein. Taken together, our findings indicate that TED2, TED3, and TED4 can be novel and efficient markers for development of the vascular system.

[Diagnosis of prostate cancer by means of the ratio of prostate specific antigen/gamma-seminoprotein (P/S ratio)]

Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) are revealed to be the same protein. However, the serum concentrations of PSA and gamma-Sm in the same samples are frequently different. We previously measured a ratio of serum PSA concentration and gamma-Sm concentration (P/S ratio), and evaluated its usefulness for diagnosis of prostate cancers. In this paper, we tried to determine the cutoff value which brings better efficiency and diagnose prostate cancer by means of P/S Ratio. Between April 1988 and September 1992, 221 men underwent prostatic biopsy and/or TUR-P, and were diagnosed pathologically. Of 221 patients, 130 were diagnosed as BPH, prostatis or normal prostate (no cancer; NC) and 91 were diagnosed as prostate cancer (CaP). 1) The mean +/- SD of P/S ratio in 130 patients with NC was 0.919 +/- 0.563. While, the mean +/- SDs of P/S ratio were 12.447 +/- 44.353 in 91 patients with CaP and 2.052 +/- 0.751 in 39 Cap patients with serum PSA level of < or = 10 ng/ml. The mean P/S Ratios in CaP patients with serum PSA of < or = 10 ng/ml as well as in all CaP patients were significantly higher than those in NC patients (p < 0.0001). 2) When the cutoff value of P/S Ratio was determined to be 1.45, the highest efficiency (= sensitivity x specificity divided by 100), 83.4, was obtained. The sensitivity and specificity were 91.2% and 91.5%, respectively as a cutoff value of 1.45.(ABSTRACT TRUNCATED AT 250 WORDS)

[Analysis of growth fractions of renal cell carcinoma by the monoclonal antibody Ki-67]

The monoclonal antibody Ki-67 recognizes a human nuclear antigen that is present in proliferating cells (G1, S, G2 and M cycling stages of cell division) exclusively, but is absent in G0 cycling stage. We performed immunohistochemical analysis of renal cell carcinomas using Ki-67 antibody, and investigated the relationship between the proportion of Ki-67 positive cells and pathological findings of renal cell carcinomas. The tissues were obtained from 36 patients with renal cell carcinoma who underwent radical nephrectomy. Cryostatfrozen sections were cut at 5 microns and stained with avidin-biotin-peroxidase complex method. The percentage of Ki-67 positive cancer cells to the total amount of cancer cells was expressed as growth fraction (GF). We obtained the following results with regard to the relationship between GF and pathological findings of renal cell carcinomas. 1) GFs in pathological grades were 6.58 +/- 4.57% (mean +/- SD) for grade 2 (n = 13) and 1.20 +/- 0.70% for grade 1 (n = 21). GF in grade 2 was significantly higher than that in grade 1 (p < 0.01). GF for Grade 3 (n = 2) were 9.2% and 27.8% respectively. 2) GFs in the pathological stages were 8.12 +/- 7.64% for pT3 (n = 13) and 1.84 +/- 1.30% for pT2 (n = 23). GF in pT3 was significantly higher than that in pT2 (p < 0.01). 3) GFs in the cancers with and without lymph node involvement were 13.84 +/- 8.48% (n = 5) and 2.80 +/- 2.74% (n = 27), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Molecular cloning and characterization of cDNAs associated with tracheary element differentiation in cultured Zinnia cells

Mesophyll cells isolated mechanically from leaves of Zinnia elegans L. cv Canary bird differentiate into tracheary elements (TE) semisynchronously and at high frequency. Using this system, three cDNA clones, TED2 to TED4, whose corresponding mRNAs were expressed in a close association with tracheary element differentiation, were isolated by differential screening of a lambda gt11 cDNA library. The library was prepared using poly(A)+ RNA from cells cultured in a TE-induced medium for 48 h prior to morphological changes, including secondary cell-wall thickenings and autolysis. Northern analysis indicated that mRNAs corresponding to the clones were expressed preferentially in cells differentiating into TEs prior to the morphological changes. The expression of the mRNAs was found not to be induced by alpha-naphthaleneacetic acid or benzyladenine solely and not to be associated directly with cell division. Analysis of the nucleotide sequence of TED4 showed that the cDNA contains an open reading frame of 285 bp, encoding a polypeptide comprising 95 amino acid residues with a predicted molecular mass of 10.0 kD. A homology search of the nucleotide and amino acid sequences of TED4 with several data bases revealed a significant similarity to those of the barley aleurone-specific clone B11E, which was isolated as an aleurone-specific cDNA from 20-d postanthesis grain.

Measurement of prostate specific antigen and gamma-seminoprotein ratio: a new means of distinguishing benign prostatic hyperplasia and prostate cancer

We measured a ratio of serum prostate specific antigen (PSA) and gamma-seminoprotein concentrations (referred to as the PSA/gamma-seminoprotein ratio) and evaluated its usefulness for the diagnosis of prostate cancer. Between April 1988 and October 1992, 214 men underwent prostatic biopsy and/or transurethral resection of the prostate, and the disease was diagnosed pathologically. Of 214 patients 127 were diagnosed as having benign prostatic hyperplasia, prostatitis or a normal prostate (no cancer), while 87 had prostate cancer. Of 61 patients with a serum PSA level greater than 10 ng./ml. 50 (82.0%) had prostate cancer, compared to 31 of 84 (36.9%) with a serum PSA level of 3.0 to 10 ng./ml. Of 113 patients with a serum gamma-seminoprotein level greater than 4.0 ng./ml. 52 (46.0%) had prostate cancer. The mean plus or minus standard deviation of the PSA/gamma-seminoprotein ratio for 127 patients without cancer was 0.942 +/- 0.564, while that for 87 prostate cancer patients was 12.840 +/- 45.327 (Wilcoxon p < 0.0001). The mean plus or minus standard deviation of the PSA/gamma-seminoprotein ratios for 37 prostate cancer patients with a PSA level of 10 ng./ml. or less and for 50 prostate cancer patients with a PSA level of more than 10 ng./ml. were 2.044 +/- 0.767 and 20.829 +/- 58.757, respectively. Even the mean PSA/gamma-seminoprotein ratio for prostate cancer patients with a PSA level of 10 ng./ml. or less was significantly greater than that for patients without cancer (Wilcoxon p < 0.0001). The sensitivities for PSA (cutoff value 3.0 ng./ml.), gamma-seminoprotein (cutoff value 4.0 ng./ml.) and PSA/gamma-seminoprotein ratio (cutoff value 1.45) were 93.1%, 59.8% and 92.0%, respectively, and the specificities were 49.6%, 52.0% and 91.3%, respectively. Of 91 patients with a PSA/gamma-seminoprotein ratio of 1.45 or more 80 (87.9%) had prostate cancer, while 116 of 123 (94.3%) with a PSA/gamma-seminoprotein ratio of less than 1.45, had no cancer. These results suggest that PSA/gamma-seminoprotein ratio yields the same sensitivity as PSA and more specificity than PSA levels, offering significant advantage over PSA in detecting prostate cancer. The mean plus or minus standard deviations of PSA/gamma-seminoprotein ratios for stages A, B, C and D prostate cancer were 1.847 +/- 0.786 (11 patients), 2.740 +/- 1.536 (30), 7.626 +/- 9.140 (12) and 27.149 +/- 70.500 (34), respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

[A case of epididymal sarcoidosis]

We reported a case of epididymal sarcoidosis. The patient was a 13-year-old boy with a chief complaint of right scrotal mass. On physical examination, a firm, nontender 7 mm mass was palpable in the right hemiscrotum and appeared to involve the head of the epididymis. Ultrasonography showed a highly echogenic mass in the epididymis. A routine chest X-ray revealed lymphadenopathy of the mediastinum and reticular shadows in bilateral lung fields. Because the lesion might be confined to the epididymis, a partial epididymectomy was performed. The histopathologic specimen showed noncaseating granulomas consistent with sarcoidosis. Lung biopsies also revealed noncaseating granulomas. Subsequent pulmonary function studies revealed a mild obstructing ventiratory defect, therefore therapy was instituted with systemic steroids. There were no further recurrent scrotal masses. Although sarcoidosis is known to affect many organs, involvement of the genital system is relatively rare. Most of the patients with intrascrotal sarcoid lesions have an abnormal chest X-ray. We need to differentiate these lesions from advanced testicular cancer. This is the 5th case of intrascrotal sarcoidosis in Japanese literature.

Identification of androgen receptor in the rat spinal motoneurons. Immunohistochemical and immunoblotting analyses with monoclonal antibody

Androgens play an important role in motoneuron growth, development and regeneration. We proved the existence of androgen receptor (AR) in the motoneurons of the rat spinal cord by the immunohistochemical stain and Western blotting. The possibility that AR protein in spinal cord is expressed in tissue-specific form is proposed, being different from other androgen-dependent tissues. AR abnormality in X-linked spinal and bulbar muscular atrophy (SBMA) among a variety of motor neuron diseases were reported recently. Our study may give some clue to the AR abnormality leading to the degeneration of motoneurons.

[Expression of progesterone-binding protein in normal and neoplastic human adrenals]

Specific progesterone-binding protein (P4-BP) is demonstrated in adrenocortical nuclei of the guinea pig, but, not in nuclei of other animals. We tried to demonstrate the progesterone-binding activity in nuclei of human normal adrenals and adrenal tumors. Normal adrenals were obtained from six patients with renal cell carcinomas undergoing radical nephrectomy. Seven adrenocortical adenomas were obtained: five tumors from patients with Cushing's syndrome, one tumor from non-functioning adenoma, and one from aldosteronoma. Nuclei were purified from the tissues, and progesterone binding assay was performed. We could not demonstrated progesterone-binding activity in nuclei of six normal human adrenals. However, we demonstrated progesterone-binding activity in nuclei purified from human adrenocortical adenomas associated with Cushing's syndrome. Saturation analysis revealed a Kd of 13.85 +/- 1.99 nM (mean +/- SD, n = 5) and a binding capacity of 1.95 +/- 0.37 pmol/mg DNA (mean +/- SD, n = 5). A Kd of progesterone-binding activity in human adrenocortical adenoma was similar to that of guinea pig P4-BP, and a binding capacity was about one-fifteenth of guinea pig P4-BP. However, nuclei purified from a non-functioning adrenocortical adenoma and an aldosteronoma failed to demonstrate progesterone-binding activity. The binding activity was specific for progesterone. 5 alpha-pregnane-3,20-dione was a modest competitor, while 17 beta-estradiol, testosterone, cortisol, and other related steroids were poor competitors. Thus the progesterone-binding activity in human adrenals was similar to guinea pig P4-BP in the affinity and specificity of binding.(ABSTRACT TRUNCATED AT 250 WORDS)

[Usefulness of prostate specific antigen/gamma-seminoprotein ratio for diagnosis of prostate cancer]

Prostate specific antigen (PSA) and gamma-seminoprotein (gamma-Sm) are used as tumor markers of the prostate cancer. However, the serum concentrations of PSA and gamma-Sm are frequently increased in patients with benign prostatic hypertrophy (BPH). We measured the ratio of serum PSA to gamma-Sm concentration (P/S ratio), and evaluated its usefulness for diagnosis of prostate cancers. Between April 1988 and July 1992, 162 men underwent prostatic biopsy and/or TUR-P, and were diagnosed pathologically. Of 162 patients, 112 were diagnosed as BPH and 50 were diagnosed as prostate cancer. Of 24 patients with serum PSA level of > 20 ng/ml, 23 (95.8%) were prostate cancer, while, of 79 patients with serum PSA level of 3.0-20 ng/ml, 23 (29.1%) were prostate cancer. The sensitivity and the specificity for PSA were 92.0% and 49.1%, respectively. Of 85 patients with serum gamma-Sm level of > 4.0 ng/ml, 30 (35.3%) were prostate cancer. The sensitivity and the specificity for gamma-Sm were 60.0% and 50.9%, respectively. A mean +/- SD of P/S ratio in 112 patients with BPH was 0.954 +/- 0.591. While, the mean +/- SD of P/S ratio was 16.295 +/- 58.584 in all prostate cancer patients, and 2.031 +/- 0.654 in 27 prostate cancer patients with serum PSA level of < or = 20 ng/ml. P/S Ratio in prostate cancer patients with serum PSA of < or = 20 ng/ml as well as in all prostate cancer patients were significantly higher than P/S Ratio of BPH patients (p < 0.0001). Of 55 patients with P/S Ratio of > or = 1.50, 45 (81.8%) were prostate cancer and 10 (18.2%) were BPH. While, of 107 patients with P/S Ratio of < 1.50, 102 (95.3%) were BPH and 5 (4.7%) were prostate cancer. The sensitivity and the specificity for P/S Ratio were 90.0% and 91.1%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Localization of androgen receptor in male sex organ, accessory sex organs and external genital skin]

Previously, we established an anti-androgen receptor (AR) monoclonal antibody. Using the antibody, we investigated immunohistological AR localization in human testes, epididymides, seminal vesicles and scrotal skins. The testes, epididymides and scrotal skins were obtained from a prostate cancer patient without pre-hormonal therapy undergoing bilateral orchiectomy. The seminal vesicles were obtained from a bladder cancer patient undergoing radical cystectomy. The tissues were immediately frozen in liquid nitrogen and kept at -80 degrees C until used. Cryostat-frozen sections were cut at 5 microns and stained by an indirect method. We obtained the following results. 1) In the testes, nuclei of Leydig cells were stained though Sertoli cells were not stained. AR localization in Leydig cells which produce testosterone suggests autocrine or intracrine mechanism in the testis. 2) In the epididymides, nuclei of epithelial cells of epididymal ducts were stained, while muscles and connective tissues were not stained. In the seminal vesicles, nuclei of glandular epithelial cells were stained. 3) In the scrotal skins, the cells of squamous cell layer have positive stainings. The cells in the upper portion of squamous cell layer were stained more intensely than the cells in the lower portion. The basal layer was not stained. The cells of the outer root sheath of hair follicles in the scrotal skins were also stained. 4) In androgen target organs, AR-positive cells and AR-negative cells were mixed in the epithelium of a glandular duct, which suggests heterogeneity of AR localization in the androgen target organs.

Androgen receptor abnormality in X-linked spinal and bulbar muscular atrophy

X-linked spinal and bulbar muscular atrophy (SBMA) is usually associated with feminization and hypogonadism. We were unable to find androgen receptor (AR) in the scrotal skin of three patients with SBMA, and propose that AR abnormality is the cause of the disease.