Gastric carcinosarcoma with neuroendocrine differentiation as the carcinoma component and leiomyosarcomatous and myofibroblastic differentiation as the sarcomatous component.

Gastric carcinosarcoma with neuroendocrine differentiation is a very rare neoplasm. In this article we present such a case. The gastroendoscopic examination of a 59-year-old Japanese man disclosed gastric cancer during follow-up after operation for rectal cancer. Subsequently, total gastrectomy was carried out because of gastric cancer. A large tumor measuring 9.2 x 8.4 cm was observed in the posterior wall of the upper portion of the stomach. The tumor was composed of carcinoma and sarcomatous cells, and the histological transition of both components was observed. Immunohistochemically, carcinoma and sarcomatous cells were positive for cytokeratin CAM5.2. The carcinoma contained adenocarcinoma and malignant cells with neuroendocrine differentiation. The sarcomatous component showed leiomyosarcomatous and myofibroblastic differentiation. The present tumor is the fifth case of gastric carcinosarcoma with neuroendocrine differentiation and the first case of gastric carcinosarcoma with myofibroblastic differentiation. Pathologists should bear in mind that gastric carcinosarcoma may show various types of differentiation.

Validation of an analytical method for a potent antitumor agent, TZT-1027, in plasma using liquid chromatography-mass spectrometry.

A sensitive and specific analytical method for a potent antitumor agent, TZT-1027, in plasma has been developed using liquid chromatography-mass spectrometry (LC-MS) with [2H4]TZT-1027 as an internal standard (I.S.). A plasma sample was purified by solid-phase extraction on a C18 cartridge, followed by solvent extraction with diethyl ether. The extract was then injected into the LC-MS system. Chromatography was carried out on a C18 reversed-phase column using acetonitrile-0.05% trifluoroacetic acid (TFA) (55:45) as a mobile phase. Mass spectrometric analysis was performed in atmospheric pressure chemical ionization (APCI) mode with positive ion detection, and the protonated molecular ions ([M+H]+) of TZT-1027 and I.S. were monitored to allow quantitation. The method was applied to the determination of TZT-1027 in human, monkey, dog, rat and mouse plasma. As far as the sample preparation was concerned, good recoveries (73.5-99.1%) were obtained. The calibration curves were linear over the range of 0.25-100 ng per 1 ml of human, dog and rat plasma, per 0.5 ml of monkey plasma, and per 0.1 ml of mouse plasma. From the intra- and inter-day accuracy and precision, the present method satisfies the accepted criteria for bioanalytical method validation. TZT-1027 was stable when stored below -15 degrees C for 6 months in human plasma and for 3 weeks in plasma from other species. TZT-1027 was also stable in plasma through at least three freeze-thaw cycles.

Cytochrome P450 enzymes involved in the metabolic pathway of the histamine 2 (H2)-receptor antagonist roxatidine acetate by human liver microsomes.

Roxatidine acetate hydrochloride (ROX, 2-acetoxy-N-[3-[m-(1-piperidinylmethyl)phenoxy]propyl]acetamide hydrochloride, CAS 78273-80-0), a histamine 2 (H2)-receptor antagonist, has been clinically applied for the treatment of gastritis, gastric and duodenal ulcers. There is no report on the identification of the metabolic enzyme of M-1 (2-hydroxy-N-[3-[m-(1-piperidinylmethyl)phenoxy]propyl]acetamide), the pharmacologically active metabolite, in humans. In this study, the Cytochrome P450 (CYP or P450) enzymes which participate in the metabolism of ROX were identified using human liver microsomes and S9 fractions. M-1 was converted to M-4 (3-[m-(1-piperidinyl-methyl)phenoxy]propylamine) by the enzyme reaction with the S9 but not with microsomes. M-4 was further metabolized to M-5 (3-[m-(1-piperidinylmethyl)phenoxy]propanol) by microsomes. The metabolism was inhibited by coumarin and anti-CYP2A1 serum. (3-[m-(1-piperidinylmethyl)-phenoxy]propionic acid) and M-3 (m-(1-piperidinylmethyl) phenol) formation from M-5 were inhibited by quinidine and anti-CYP2D6 serum. Moreover, M-5 was converted to M-2 and M-3 by cDNA-expressed CYP2D6. In conclusion, this study shows that microsomal enzymes do not participate in the clearance of the active metabolite M-1, CYP2A6 primarily catalyzes M-5 formation from M-4, and CYP2D6 primarily catalyzes M-2 and M-3 formation from M-5 in humans.

Endotoxin induces delayed ovulation following endocrine aberration during the proestrous phase in Holstein heifers.

The effect of endotoxin on follicular growth and on secretion of LH, estradiol-17beta, progesterone and cortisol during the proestrous phase in cattle was investigated. Holstein heifers were treated with PGF2alpha at 11-13 d after ovulation to induce luteolysis. At 42 hr after PGF2alpha treatment, heifers were administered either lipopolysaccharide (LPS; Escherichia coli, O111:B4, 5 microg/kg, n = 6) or saline (control; n = 6) by i.v. bolus injection. Ovarian structures were monitored daily by transrectal ultrasonography, and blood samples were collected at various times for hormonal analysis. The duration from PGF2alpha treatment to ovulation was significantly longer in the LPS group (8.0 +/- 1.3 d) than in the control group (4.2 +/- 0.2 d). LPS significantly reduced the pulse frequency of LH for 6 hr after the administration, and increased the mean concentration and pulse amplitude of LH from 3 to 6 hr after the administration. The plasma concentrations of progesterone and cortisol were transiently increased after LPS administration. The plasma concentration of estradiol-17beta was significantly decreased at 24 hr after LPS administration compared to that in the controls. Five of six LPS-treated heifers exhibited no preovulatory LH surge until 120 hr after PGF2alpha treatment and the remaining heifer exhibited the surge at 108 hr after PGF2alpha treatment, while the LH surge was observed at 54-78 hr after PGF2alpha treatment in control heifers. These results suggest that endotoxin disrupts progression of the proestrous phase of cattle, interrupting the preovulatory estradiol rise and thus delaying the LH surge and the subsequent ovulation.

Gonadotropin-releasing hormone in third ventricular cerebrospinal fluid of the heifer during the estrous cycle.

The release profile of GnRH in cerebrospinal fluid (CSF) and its correlation with LH in peripheral blood of ovary-intact heifers during the estrous cycle were investigated. A silicon catheter was placed into the third ventricle of six heifers using ultrasonography. During the mid-luteal phase, the heifers were injected with prostaglandin F(2alpha) to induce luteolysis. Surges of CSF GnRH (66.7 h after prostaglandin F(2alpha) administration) and peripheral LH (66.3 h) occurred simultaneously and were coincident with the onset of estrus (67.0 h). Duration of elevated GnRH concentration considerably overlapped with the estrous phase in each of the heifers. Mean pulse frequencies of both GnRH and LH were significantly higher during the proestrous and early luteal phases than during the mid-luteal phase, while mean concentration and pulse amplitude of both GnRH and LH were not different between these three phases. Of all the GnRH pulses identified, more than 80% were accompanied by an LH pulse during the proestrous and early luteal phases. However, the proportion of GnRH pulses that were coincident with an LH pulse during the mid-luteal phase decreased to 60%. The results clearly demonstrate that a dynamic (pulse) and longer-term (surge) changes of GnRH release into CSF are physiologically expressed during the estrous cycle in heifers, and the pattern of pulsatile GnRH secretion in heifers depends upon their estrous cycle.

Effects of activin A and follistatin on developmental kinetics of bovine embryos: cinematographic analysis in a chemically defined medium.

The effects of recombinant human activin A and follistatin on the developmental kinetics of bovine presumptive zygotes matured and fertilized in vitro using time-lapse cinematography were investigated. The presumptive zygotes were cultured for 9 days in a chemically defined medium (modified synthetic oviduct fluid, control) and modified synthetic oviduct fluid supplemented with activin A or follistatin. Development under cine-recording conditions was similar to that in an incubator. Addition of activin A to modified synthetic oviduct fluid increased, while addition of follistatin decreased, the percentage of zygotes that developed to morulae and blastocysts. Follistatin significantly prolonged the timing of development to the 9-16-cell stage compared with the control and activin A media. Activin A significantly shortened the duration of the third cell cycle compared with the control, but follistatin significantly prolonged the fourth cell cycle compared with the control and activin A. Developmental arrest ('lag-phase') during the 4-8-cell stage was observed in 95% of embryos developed to more than the 9-16-cell stage in all treatments. The greater the number of cells at the onset of the lag-phase, the earlier the onset of the phase and the shorter the duration of the phase, the further embryos were able to develop by day 9 in all treatments. The number of cells at the onset of the lag-phase in the medium containing activin A was significantly higher than it was in control or follistatin-containing media. Moreover, activin A significantly shortened the duration of the lag-phase compared with follistatin. The present results indicate that activin A may enhance in vitro development of bovine embryos by improving developmental kinetics, especially by increasing the number of cells at the onset of the lag-phase and shortening the duration of this phase.

Characterizations of mouse hepatic microsomal monooxygenase catalyzing 11beta-hydroxylation of osaterone acetate.

Osaterone acetate (17alpha-acetoxy-6-chloro-2-oxa-4,6-pregnadiene-3,20-dione, OA) is a new steroidal antiandrogen. There is a marked species difference in the metabolism of OA in that 11beta-hydroxylated metabolites are found in the plasma, feces, and urine of mice after oral administration of OA, but there is very little metabolism in rats and humans. OA reduces the adrenal gland weight in mice, but not in rats, and this effect in mice might be explained by the species difference in 11beta-hydroxylation activity. The objectives of this study were to elucidate the enzyme(s) involved in this particular oxidation and to explain the species difference observed. Mouse hepatic microsomes oxidize OA to 11beta-OH OA, and this oxidation requires NADPH as a cofactor. The use of various competitive and allosteric inhibitors of cytochrome P450 and flavin-containing monooxygenase (i.e. CO, N-octylamine, and methimazole) showed that the oxidation of OA was catalyzed by cytochrome P450. In microsomes from mice pretreated with phenobarbital (a CYP2B-selective inducer), 3-methylcholanthrene (a CYP1A-selective inducer), pregnenolone-16alpha-carbonitrile (a CYP3A-selective inducer), and EtOH (a CYP2E-selective inducer), an increase in the rates of oxidation was seen only in microsomes from EtOH-treated animals. However, metyrapone, a selective inhibitor for enzymes of the cytochrome P45011B and P4502B family, inhibited mouse hepatic microsomal 11beta-hydroxylation by < 30%. The results obtained showed that the production of 11beta-OH OA may be catalyzed by a novel cytochrome P450 in mouse liver.

Precocious estrus and reproductive ability induced by PG 600 in prepuberal gilts.

A total of 29 SPF Large White prepuberal gilts (mean age 152 days at treatment) were examined for estrous and ovulatory responses after PG 600 treatment. After treatment, 85.2% of the gilts showed standing estrus within 6 days. Whereas the treatment-to-estrus interval and duration were 3.7 and 1.9 days respectively. As ovulation occurred on Day 5 to 6, appropriate timing of artificial insemination would be about 4 days after treatment. Fertility of gilts revealed to be excellent, giving rise to a high percentage of normal embryos, 85.3%. Meanwhile, development and growth of fetuses were mostly normal. Other reproductive performances recorded were: mean litter size 6.8; mean birth weight 1.26 kg; weaning-to-return estrus interval 5 to 8 days. In conclusion, PG 600 was found to be useful in inducing fertile estrus in prepuberal gilts, a result which will be of interest for commercial pig farms.

Histologic study of the recurrent laryngeal nerve in spasmodic dysphonia.

It has been reported that there were no significant changes in the recurrent laryngeal nerves of patients with adductor spasmodic dysphonia, which could explain the cause of this disease. However, the researchers who made these reports appeared to have investigated only the extralaryngeal part of the nerve involved in the neck. Because the recurrent laryngeal nerve contains many components that distribute to various organs, we must study in greater detail a more peripheral part of the motor nerve, which has a much closer relationship to vocal cord movements. At the time of surgery we obtained specimens of the thyroarytenoid branches of the recurrent laryngeal nerves in two female patients with adductor spasmodic dysphonia. Although histologic analysis revealed no apparent signs of either destruction or degeneration, the percentage of thin nerve fibers, the diameter of which may range from 5 to 10 microm, was higher than in normal controls. This suggests the possibility of a neurologic abnormality in the larynges of ASD patients.

Activin A and follistatin regulate developmental competence of In vitro-produced bovine embryos.

The effects of activin A and/or follistatin on the development of bovine embryos were investigated. Presumptive zygotes matured and fertilized in vitro were cultured in a chemically defined medium (modified synthetic oviduct fluid medium; mSOF). Addition of 1-100 ng/ml of activin A to mSOF significantly increased the percentage of zygotes that developed to morulae and blastocysts (48-54% and 31-41%, respectively) compared with no addition (41% and 25%, respectively). In contrast, addition of 1-100 ng/ml follistatin significantly reduced the percentage of zygotes developing to morulae and blastocysts (29-31% and 17-20%, respectively) compared with no addition (41% and 28%, respectively). In a culture with 10 ng/ml of activin A, supplementation with the same concentration of follistatin neutralized the positive effect of activin A, while supplementation with 100 ng/ml of follistatin reduced the percentage of zygotes that developed. The total cell numbers in morulae and blastocysts were not affected by the addition of activin A and/or follistatin. The development-enhancing effects of activin A and the development-impeding effects of follistatin were observed when embryos were exposed to activin A or follistatin at a concentration of 10 ng/ml prior to the 9- to 16-cell stage. These results suggest that activin A and follistatin may affect bovine embryos until the third cell cycle and may play important roles in regulation of the developmental competence of bovine embryos.

Changes of ovarian structures, plasma LH, FSH, progesterone and estradiol-17 beta in a cow with ovarian cysts showing spontaneous recovery and relapse.

In a cow diagnosed as having ovarian cysts, we observed changes in the ovarian structures by ultrasonography for 71 days and examined plasma concentrations of sex hormones. The cow had 2 regressing cysts at the start of this study and 3 new follicles subsequently developed into cysts. With regression of these cysts, 2 new follicles developed and ovulated spontaneously, followed by the formation of 2 corpora lutea. On the day prior to ovulation, a preovulatory luteinizing hormone (LH) surge was detected. With regression of the corpora lutea, a new follicle developed and underwent atresia. Meantime, another follicle developed and became a cyst without ovulation. No preovulatory LH surge was observed during the period from regression of the corpora lutea to cyst formation. The results indicate that absence of the preovulatory LH surge is associated with occurrence of ovarian cysts and this endocrine aberration is reversible.

Differential responses to ligands of overexpressed thyroid hormone and retinoid X receptors in a Xenopus cell line and in vivo.

In an attempt to explain the contrasting patterns of expression of Xenopus thyroid hormone (xTR) and retinoid X (xRXR) receptor genes and to extend our understanding of the role of heterodimerization of these receptors during amphibian metamorphosis, we have investigated the response to their respective ligands of cells in which xTR and xRXR were overexpressed. Results obtained with two separate approaches are now described. In the first, 3,3'5-triiodothyronine (t3) was found to strongly upregulate xTR beta mRNA in XTC-2 cells, but not of xTR alpha or xRXR alpha mRNAs, while xRXR gamma transcripts could not be detected. 9-cis-retinoic acid (9-cis-RA) did not substantially influence the expression of any of these four receptor genes. When transcription from three different thyroid response elements (TREs) (a palindromic TREpal, an inverted repeat +6 [F2] and a direct repeat +4[DR+4] as present in the promoter of xTR beta gene) was measured in XTC-2 cells in which xTR beta and xRXR alpha were overexpressed, only T3 upregulated transcription while 9-cis-RA, alone or together with T3, was ineffective. 9-cis-RA however enhanced transcription from an RXR responsive element (RXR-RE). THe second approach involved overexpression of xTR beta and xRXR alpha in premetamorphic Xenopus tadpole tail muscle followed by measuring the response of the tails to T3 in organ culture. After validating the microinjection/culture procedure histochemically, we found that T3 enhanced transcription from the xTR beta DR +4 TRE in tails in which xTR beta was overexpressed but the overexpression of xRXR alpha failed to modify this response. It is concluded that in both XTC cells and tadpole tails, overexpressed xRXR fails to modify the enhanced transcriptional response of endogenous and overexpressed xTR beta to T3 and that exogenous 9-cis-RA is ineffective.

Ultrasonic observations on the turnover of ovarian follicular cysts and associated changes of plasma LH, FSH, progesterone and oestradiol-17 beta in cows.

Changes in the diameters of individual follicular structures on ovaries were measured by transrectal ultrasonography for 29 to 40 days and the plasma concentrations of luteinising hormone (LH) follicle-stimulating hormone (FSH), progesterone and oestradiol-17 beta were determined in four cows with ovarian cysts. When these structures decreased in size, new follicular structures appeared and developed into cysts. Progesterone concentrations in plasma were below 1.0 ng ml-1 during the experimental periods. Plasma concentrations of oestradiol-17 beta fluctuated. The mean concentration of oestradiol-17 beta in plasma differed (P < 0.01) depending on the stage of the cyst. No preovulatory surges of LH were detected during the developmental stage of the cysts.

Hepatic sinusoidal endothelial cells can store and metabolize serum immunoglobulin.

Sinusoidal inclusion-containing endothelial cells in the liver were investigated with particular interest in their capacity of metabolizing immunoglobulin. Formalin-fixed deparaffinized liver specimens were used for immunohistochemistry, and pronase digestion was proved to be effective for antigen retrieval of immunoglobulin. The inclusions in sinusoidal endothelial cells were strongly immunostained with anti-immunoglobulin (Ig)G, IgA, and IgM antibodies in predigested sections. The complements were not identified immunohistochemically in the inclusions even after pronase treatment. Two women with autoimmune liver disease, who initially represented high levels of serum gamma globulin and abundant inclusion-containing endothelial cells, were studied. The subsequent biopsy after effective corticosteroid therapy demonstrated significant histological improvement as well as the disappearance of inclusion-containing endothelial cells (ICECs). During and after treatment, their serum gamma globulin levels were drastically reduced. In conclusion, the hepatic sinusoidal endothelial cells can take up serum immunoglobulin, probably through a receptor-mediated pathway, and its excessive storage results in the formation of cytoplasmic inclusions that are easily recognized by a light microscope. The stored immunoglobulin may be degraded in the cytoplasm, and the inclusions would disappear in association with the reduction of sinusoidal gamma globulin content. In other words, the intralobular density of inclusion-containing endothelial cells is a morphological predictor for the serum gamma globulin level.

Application of anti-bovine CD2 monoclonal antibody to the rosette inhibition test for detection of early pregnancy factor in cattle.

To reliably detect early pregnancy factor (EPF) in cattle, monoclonal antibody specific for bovine CD2 molecule, which is the sheep red blood cell (SRBC) receptor on bovine T cell surface, was applied to the rosette inhibition test. The rosette inhibition titers (RITs) were significantly higher in pooled sera from early pregnant cattle than in those of non-pregnant cattle using two anti-bovine CD2 monoclonal antibodies, B26A4 (P < 0.001) and BAQ95A (P < 0.01). The dissociation value of RITs between pregnancy and non-pregnancy with B26A4 was greater than that with BAQ95A. The B26A4 monoclonal antibody was therefore applied to the rosette inhibition test in subsequent experiments. The RITs in serum of individual pregnant and non-pregnant cows 8 days after estrus were significantly different (P < 0.001) by three or more dilutions. When the rosette inhibition test was carried out in sera from individual pregnant and non-pregnant cows at estrus and at 24, 72 and 168 hr after ovulation, the RITs of pregnancy sera increased significantly at 24 hr after ovulation as compared with non-pregnancy sera (P < 0.001). These results indicate anti-bovine CD2 monoclonal antibody can be utilized with the rosette inhibition test to detect EPF in cattle, and that this assay detects bovine EPF for pregnancy serum at least 24 hr after ovulation.

Exacerbation of primary biliary cirrhosis during interferon-alpha 2b therapy for chronic active hepatitis C.

A 60-year-old woman with chronic active hepatitis C was treated with 6 million units of rIFN-alpha 2b daily for two weeks and subsequently three times weekly for several months. Histological examination proved a severe form of chronic active hepatitis C unexpectedly complicated with primary biliary cirrhosis (PBC). Before treatment, levels of serum alkaline phosphatase (ALP) or gammaglutamyltranspeptidase (GGT) had remained within normal limits over six months, although anti-mitochondrial antibody (AMA) was shown to be positive. After eight weeks of therapy, the daily dose of rIFN was reduced to 3 million units because of a marked increase of ALP and GGT, although the serum alanine aminotransferase (ALT) was normalized. Four months later, IFN treatment was suspended because of continuous elevation of the ALP and GGT levels, and administration of ursodeoxycholic acid was substituted. Two months later, the ALP and GGT levels returned to the normal range, although ALT was not normalized and HCV-RNA remained positive. This is the first report case that demonstrates IFN treatment potentially exacerbates PBC associated with chronic active hepatitis C. It is important for treating physicians to keep this association in mind.

Sequential changes in human Ito cells and their relation to postnecrotic liver fibrosis in massive and submassive hepatic necrosis.

To examine the relationship of Ito cells to postnecrotic liver fibrosis, liver specimens, obtained at autopsy from 17 patients with acute massive necrosis (AMN) and acute submassive hepatic necrosis (ASMN), were examined immunohistochemically. In normal adult livers, Ito cells positive for alpha-smooth muscle actin isoform (ASMA) were rarely seen, scattered along hepatic sinusoids. In contrast, in AMN the Ito cells in necrotic areas became strongly positive for ASMA. They were swollen with elongated cytoplasmic processes along collapsed sinusoidal walls. Around these ASMA-positive Ito cells, there were numerous infiltrated macrophages and lymphocytes present. There was no significant alteration of fibroblasts in the portal tracts. In the middle and late stages of ASMN, the spindle-shaped ASMA-positive Ito cells formed a continuous cellular network. New fibre formation was predominantly around them. In this immediate postnecrotic fibrosis, ASMA-positive stromal cells of Ito cell origin were distributed irregularly and were closely associated with reticulin and newly-formed collagen fibres. Regenerative nodules were surrounded by dense layers of ASMA-positive stromal cells. Throughout the stages of ASMN, portal fibroblasts remained negative for ASMA. We believe that Ito cells in necrotic areas show myofibroblastic transformation and play a central role in the postnecrotic liver fibrosis. Portal fibroblasts play no significant part in this type of fibrosis.

DNA typing of HLA class II genes; DRB1*0803 increases the susceptibility of Japanese to primary biliary cirrhosis.

The association between human leukocyte antigens and primary biliary cirrhosis is controversial, but major histocompatibility complex class II antigen DR8 was recently reported to be associated with increased susceptibility for primary biliary cirrhosis in some Caucasians and Japanese. Accordingly, we performed DNA typing of HLA class II genes in Japanese patients with primary biliary cirrhosis. The genotypes of HLA DRB1, DRB3-5, DQA and DQB were determined by polymerase chain reaction and subsequent hybridization with sequence specific oligonucleotides in 31 primary biliary cirrhosis patients and 215 racially matched local controls. DR8 was found in 24 of the 31 primary biliary cirrhosis patients and was highly concentrated in DRB1*0803. The gene frequency of DRB1*0803 was significantly increased in the patients (35.5% vs 7.4%, relative risk = 6.84, p < 0.0001). DQA1*0103 and DQB1*0601 were also increased in the primary biliary cirrhosis patients, in relation to linkage disequilibrium with DRB1*0803 on the same haplotype. In contrast, DQA1*0102 showed a significantly lower frequency in the primary biliary cirrhosis patients (p < 0.05). These data suggest that DRB1*0803 is one of the HLA class II genes related to an increased risk of primary biliary cirrhosis in Japanese individuals.