Secretion of intelectin-1 from malignant pleural mesothelioma into pleural effusion.

BACKGROUND: Malignant pleural mesothelioma (MPM) is a rare but fatal tumour. Although most MPM patients show pleural effusion at even the early stage, it is hard to diagnose as MPM at the early stage because a sensitive and reliable diagnostic marker for MPM has not been found in plasma or pleural effusion. METHODS: In this study, we investigated whether intelectin-1 was specifically contained in MPM cells and the pleural effusion of MPM patient by immunohistochemistry, western blotting, and enzyme-linked immunosorbent assay. RESULTS: Malignant pleural mesothelioma cell lines, but not lung adenocarcinoma cell lines, secreted intelectin-1. In immunohistochemistry, epithelioid-type MPMs, but neither pleura-invading lung adenocarcinomas nor reactive mesothelial cells near the lung adenocarcinomas, were stained with anti-intelectin antibodies. Pleural effusion of MPM patients contained a higher concentration of intelectin-1 than that of lung cancer patients. CONCLUSION: These results suggest that detection of intelectin-1 may be useful for a differential diagnosis of epithelioid-type MPM in immunohistochemistry and that a high concentration of intelectin-1 in pleural effusion can be used as a new marker for clinical diagnosis of MPM.

[Clinical diagnosis of malignant pleural mesothelioma].

Accurate and rapid diagnosis of malignant pleural mesothelioma is important because of its rapid progress. But diagnosis of this disease is often difficult. We reviewed 64 cases with a pathological diagnosis of malignant pleural mesothelioma in the past 14 years in our hospital. We made diagnosis of this disease by cytologic study of pleural fluid (11 cases), percutaneous needle biopsy (16), thoracoscopic biopsy (34), or surgery (2). When cytologic findings are inconclusive, thoracoscopic biopsy is the most effective method for diagnosis and should be done without delay.

[Extrapleural pneumonectomy for malignant pleural mesothelioma].

We analyzed 14 patients with malignant pleural mesothelioma (MPM) who underwent extrapleural pneumonectomy (EPP). 14 men had a mean age of 58.5 years. Preoperarive histological diagnosis was as follows: epithelial 12, biphasic 1, sarcomatous 1. Postoperative diagnosis was: 8, 5, 1, respectively. According to staging of International Mesothelioma Interest Group (IMIG), 3 patients had stage 11 disease, 8 did stage Ill and 3 did stage IV, postoperatively. The operative mortality rate was 7% (1 death), and morbidity rate was 50% (7 cases). The median survival time and 2- and 5-year survival rate were 20.2 months, 33. 8.3%, respectively. EPP for strictly selected patients has been successful in improving survival of patients with negative-node, epithelial type and negative residual tumors.

Cloning and sequences of two macrolide-resistance-encoding genes from mycinamicin-producing Micromonospora griseorubida.

Two macrolide-resistance determinants were cloned from a mycinamicin (Mm)-producing Micromonospora griseorubida strain in Streptomyces lividans and Streptomyces parvulus. One of the cloned genes, designated myrA, was cloned as a gene which conferred strong resistance to Mm and tylosin (Ty), but not to erythromycin (Er) or josamycin (Jm) on S. lividans. Another gene, named myrB, was cloned as an ErR-encoding gene which conferred MLS resistance (to macrolide, lincosamide and streptogramine B antibiotics) on S. parvulus. Both myrA and myrB were sequenced and the corresponding ORFs were determined. The deduced amino acid (aa) sequence of myrA showed no similarity to proteins in the available databases, suggesting that an unknown mechanism of macrolide resistance is exerted by the MyrA protein. The deduced aa sequence of myrB exhibited high similarity to 23S rRNA methyltransferases (MTases), such as ErmE and CarB, from a variety of microorganisms.

ABCA3 is a lamellar body membrane protein in human lung alveolar type II cells.

The ABCA3 gene, of the ABCA subclass of ATP-binding cassette (ABC) transporters, is expressed exclusively in lung. We report here the cloning, molecular characterization, and distribution of human ABCA3 in the lung. Immunoblot analysis using the specific antibody reveals a 150-kDa protein in the crude membrane fraction of human lung. Immunohistochemical analyses of alveoli show that ABCA3 is expressed only in the type II cells expressing surfactant protein A. At the ultrastructural level, ABCA3 immunoreactivity was detected mostly at the limiting membrane of the lamellar bodies. Since members of the ABCA transporter family are known to be involved in transmembrane transport of endogenous lipids, our findings suggest that ABCA3 plays an important role in the formation of pulmonary surfactant in type II cells.

Alpha fetoprotein-producing acinar cell carcinoma of the pancreas showing multiple lines of differentiation.

An alpha fetoprotein (AFP)-producing tumour occurring in the head of the pancreas of a 30-year-old woman is reported. Histological examination revealed a markedly solid proliferation of tumour cells with prominent nucleoli and occasional luminal structures, some of which contained mucinous material stained with mucicarmine and alcian blue. No squamoid corpuscles were recognized. Immunohistochemistry showed intense positivity for lipase trypsin, and AFP basically, and single cells were also positive for carcino-embryonic antigen, CA19-9, synaptophysin and neuron-specific enolase. Pancreatic hormone-positive cells were absent. Electron microscopical examination revealed numerous granules of variable sizes in the tumour cells, which were considered to be zymogen. The tumour is an acinar cell carcinoma with multi-directional differentiation including the ability to produce AFP. Among AFP-positive pancreatic tumours, acinar cell carcinoma and pancreatoblastoma seem to be the most frequent.

Enhancement of mycinamicin production by dotriacolide in Micromonospora griseorubida.

Production of macrolide antibiotic mycinamicin was greatly increased by addition of sulfate ion into the culture medium of Micromonospora griseorubida. An O-sulfate ester compound, also produced by the strain, was shown to be dotriacolide. In an M. griseorubida dotriacolide non-producing strain, the production level of mycinamicin remained low, but increased to the level of dotriacolide producing strain by the addition of dotriacolide. Dotriacolide enhanced mycinamicin production in M. griseorubida by the formation of micelles with mycinamicin. As a result, dotriacolide played a critical role in mycinamicin production in M. griseorubida.

Morphologic alterations and cytokinetic studies of tracheal autograft epithelium in rabbits.

BACKGROUND: Although tracheobronchoplasty has been used widely in the field of thoracic surgery, few details of the morphologic changes in and cytokinetics of the graft epithelium have been reported. The aim of this study was to focus on these aspects in autografted rabbit tracheas. METHODS: Resected cervical tracheas were anastomosed immediately after removal, retrieved on postoperative days 1 through 28, and examined morphologically. Mitotic and bromodeoxyuridine-labeling indices of the graft epithelium were analyzed. RESULTS: On postoperative days 1 to 4, the graft epithelium showed focal desquamation at the anastomoses. Ciliated cells disappeared during postoperative days 4 to 7 and then increased gradually. Nonciliated cells retained a somewhat columnar shape on postoperative days 4 to 7, except at denuded foci. Thereafter, the grafts were covered completely with pseudostratified mucociliary epithelium. On postoperative day 4, both indices were maximal and appeared higher at the anastomotic than midgraft sites. CONCLUSIONS: Most of the graft epithelium was preserved during acute ischemia and then started to regenerate. The increased regenerative activity near the anastomoses may be attributable to mechanical damage or different nutritional conditions.

beta-Lactamase and beta-lactam antibiotics resistance in acinetobacter anitratum (syn: A. calcoaceticus).

The cephalosporin beta-lactamase (cephalosporinase) produced by Acinetobacter was studied. The enzyme was partially purified by means of column chromatography and its properties were investigated. The enzyme was induced by benzylpenicillin, 6-aminopenicillanic acid and cephaloridine. Its molecular weight is 30,000 its optimal temperature 40C, and its optimal pH 7.25 similar to 7.50. Substrate specificity studies using various cephalosporins and penicillins, showed that the enzyme functioned as a cephalosporinase rather than penicillinase.

Effect of a combination of benzylpenicillin or ampicillin and dicloxacillin on peptidoglycan synthesis in a cell-free enzyme system from a beta-lactamase producing strain of Citrobacter freundii.

The membrane fraction prepared from beta-lactamase producing Citrobacter freundii GN346 catalyzed in vitro peptidoglycan synthesis from uridine-5'-diphosphate-N-acetylmuramyl-L-alanyl-D-glutamyl-meso-diaminopimelyl- D-alanyl-D-alanine and uridine-5'-diphosphate-N-acetylglucosamine, which was accompanied by the release of alanine from the carboxyl terminal end of the former substrate. Though this reaction was inhibited by benzylpenicillin (PCG) and ampicillin (ABPC), the reaction was relatively insensitive compared with that catalyzed by the membrane fraction from a derived beta-lactamaseless mutant strain GN346/16. In contrast, the enzyme activity of the parent strain was strongly inhibited by a combination of PCG or ABPC and dicloxacillin (MDIPC). The beta-lactamase present in the membrane fraction from the parent strain showed stronger activity than that from the mutant strain, and the activity was inhibited by MDIPC as in the case of the soluble enzyme localized in the periplasmic space.

Mycinamicins, new macrolide antibiotics. XIII. Isolation and structures of novel fermentation products from Micromonospora griseorubida (FERM BP-705).

Novel 16-membered macrolide antibiotics, mycinamicins IX, XII, XIII, XIV, XV, XVI, XVII and XVIII have been isolated from the culture filtrate of Micromonospora griseorubida (FERM BP-705). Fermentation, isolation, structure determination and biosynthetic consideration of these mycinamicin analogs are described.

The acetylation of 6'-amino group of amikacin by a new enzyme prepared from serratia sp.

It was found that Serratia marcescens 43, Serratia proteamaculans 48 and Serratia sp. 45, all of which were clinically isolated, produced a new type of aminoglycoside acetyltransferase which acetylated amikacin at the 6'-amino group. 1-N-[(S)-3-Amino-2-hydroxypropionyl]-gentamicin B (HAPA-B, SCH 21420) and gentamicin C2 were hardly inactivated by the enzymes and had effective antimicrobial activities against these strains both in vitro and in vivo. This kind of aminoglycoside acetyltransferase should be classified into a new group other than previously reported AAC(6') enzymes.

Evaluation of phosphate removal from water by immobilized phosphate-binding protein PstS.

The phosphate (P(i))-binding protein PstS is a member of a family of periplasmic proteins that act as high-affinity receptors for active transport systems in bacteria. PstS protein purified from Pseudomonas aeruginosa was immobilized to N-hydroxysuccinimide-activated Sepharose, packed into a plastic column (5 x 70 mm), and examined for its potential ability to remove P(i) from water. The PstS-Sepharose column completely removed P(i) from 32P-labeled pond water containing about 0.5 microM P(i) (0.015 mg P per liter). More than 90% of 32P-P(i) that was retained in the column could be eluted by washing with low-pH water.

[New inactivating enzyme of aminoglycoside antibiotics produced by genes on R-plasmid of Serratia spp. and nosocomial infection].

Though incident due to Serratia spp. has decreased with the use of third generation cephems, S. marcescens with multiple drug resistance are still clinically occasionally isolated S. marcescens strains 218, 219 and 220 we isolated clinically, were found to possess aminoglycoside inactivating enzyme activities which had not been expected to exist in Serratia spp. These isolates inactivated aminoglycoside antibiotics except strains 218 and 219 were sensitive to isepamicin whereas strain 220 was sensitive to isepamicin and gentamicin. It was found that strains 218 and 219 possessed aminoglycoside inactivating enzyme AAC(2'), and strain 220 AAC (6'). The genes coding for these inactivating enzymes were found to be on R-plasmid and transferred between bacterial cells. Frequencies of transfer of the R-plasmid from Serratia to Escherichia coli chi-1037 were be low, but the transfer definitely occurred as frequencies of 4.3 x 10(-7) from strain 218, 5.2 x 10(-7) from strain 219, and 8.3 x 10(-7) from 220 were determined. To prevent nosocomial infections, the eradication of multi-resistant Serratia strains is strongly recommended when they are isolated even apparent symptoms of infections are not observed.

[Synergistic effect of ampicillin and dicloxacillin on penicillin and cephalosporin-susceptible Escherichia coli (author's transl)].

An effect of a combination of ampicillin (ABPC) and dicloxacillin (MDIPC) on penicillins and cephalosporin-susceptible E. coli was determined. Minimum inhibitory concentrations of the combined drug were as same as that of ABPC, but bacterial growth was inhibited by the combined drug stronger than ABPC, low activity of beta-lactamase was detected in sonicated E. coli 0.225 cells, and this activity was inhibited by relatively low concentration of MDIPC. We considered that a weak synergism of the combined drug might attribute to the inhibition of the beta-lactamase activity by MDIPC.

[Clinicopathological features and diagnostic points of uncommon pancreatic tumors].

Clinicopathological features of uncommon pancreatic tumors including solid cystic tumor (SCT), acinar cell carcinoma and pancreatoblastoma are described, based upon a literature survey and own experiences. They are often discovered by US and CT as asymptomatic pseudocystic tumor. SCTs almost always occur in young female and Pancreatoblastoma, in children less than five years old. The prognosis is very favorable in SCT, and relatively good in acinar cell carcinoma and pancreatoblastoma. Pancreatoblastoma is often associated with the elevation of serum AFP levels. Characteristic histological features and immunocytochemical features are also described, all of which are very different from those of usual pancreatic ductal carcinoma. Molecular biological features including the results of k-ras and p53 point mutation are also discussed. In addition to the clinicopathological features, these uncommon tumors are very different from usual ductal carcinoma in the molecular biological features.

[Use of omental pedicle flap for the prevention of bronchopleural fistula after surgery: an unsuccessful case in a management of bronchopleural fistula].

We report a case of bronchopleural fistula after preoperative neo-adjuvant chemotherapy for advanced lung cancer. A 55-year-old man admitted to our institution and was diagnosed to have advanced lung cancer. Right pneumonectomy was carried out after chemotherapy. Parietal pleura and the right main bronchus were thick because of severe fibrosis due to chemotherapy. On the 16th postoperative day, bronchopleural fistula was found. After drainage, further resection of bronchial stump and wrapping with omentum was carried out. However, he died of pneumonia due to repeated bronchopleural fistula. Since this experience, we use omental wrapping procedure in patients undergoing surgery for the hilar type lung cancer after chemotherapy, and conclude that omental wrapping is useful for prevention of bronchopleural fistula.

[Completion pneumonectomy after lobectomy or bilobectomy for lung cancer].

Six cases who were performed completion pneumonectomy after lobectomy or bilobectomy for lung cancer were reported. The reason for completion pneumonectomy was the recurrence of lung cancer, 4 cases; second primary lung cancer, 1 case; and the destroyed lung after bilobectomy, 1 case. The intervals between the first resection and completion pneumonectomy for the patients who were recognized the recurrence were 14, 40, 83, 112 months. This results suggest that it is important that the patients who were performed curative resection are carefully followed. The patients who were performed completion pneumonectomy had the pulmonary function as follows; more than 800 ml as FEV1. The postoperative complication were not observed for the six patients.

[Results of resection of T3 primary lung cancer].

Primary resection for lung cancer was performed in 711 patients. Extensive surgery was performed in 99 T3 lung cancer (13.7%). Overall 5-year survival rate was 31.7%. Overall hospital mortality was 7.5%. Mean 5-year survival was 34.9% for patients with complete resection, 0% for patients with incomplete resection (p < 0.05). In patients with complete resection, mean 5-year survival was greater in patients with N0 (39.1%) than in patients with N1 (23.5%) or N2 (27.7%), but there was no statistically significant difference. There was also no statistically significant difference between adenocarcinoma and squamous cell carcinoma. Mean 5-year survival rate for patients with invasion of chest wall was 34.1%, with invasion of mediastinal pleura was 37.5%, with invasion of main bronchus was 58.3%, with interlobular invasion was 18.7%. Complete resection of T3 lung cancer may yield long time survival.

[Empyema caused by perforation of metastatic colon cancer: a case report].

The patient was a 51-year-old female, underwent total gastrectomy for gastric cancer 6 years ago. She was admitted to a local hospital with the complaint of fever, the chest X-ray showed niveau in the left pleural cavity. Fecal material flowed out by drainage. Barium enema showed fistula of diaphragma from transverse colon. She was transferred to our hospital. Partial transverse colon resection and removal of the diaphragma fistula were performed. The colon tumor was histologically determined to be metastasis from gastric cancer with thoracic empyema.