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.

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.

Location and length of arteriovenous fistulas around axial-pattern skin-flap pedicles.

The importance of the location of a surgically-created arteriovenous fistula around the pedicle (both distal and proximal) on the viability of rat skin flaps was investigated. The animals were randomly divided into four groups. Group 1 included bilateral standard island groin flaps. The right side flap was used as a control. On the left side, after elevation of the flap, an X-type arteriovenous fistula greater than 1 mm (up to 2 mm) in length was created distal to the pedicle, and just before the bifurcation of the common femoral vessels. In Group 2, the flap was an axial-pattern medially-based peninsular flap, including the same vessels. In this group also, two flaps were elevated bilaterally, and the right side was used as a control; on the left side, an X-type arteriovenous fistula the same length as in Group 1 was also created distal to the pedicle. In both groups, all other branches of the common femoral vessels were kept intact. In a second part of the study, two other animal groups were used to clarify the importance of the length of the arteriovenous fistula on the viability of skin flaps. In Group 3, the model was the same as in Group 1, but the fistula was 1 mm in length. In Group 4, the length of the fistula was 1 mm, and its location was on the common femoral vessels proximal to the pedicle, using the same flap model. Flow values were measured repeatedly using a laser Doppler flowmeter. Histopathologic studies were also done. There are three important points arising from these studies. 1). The location of an X-type arteriovenous fistula around an island skin flap pedicle seems to be more important than diameter. An arteriovenous fistula proximal to the pedicle is more hazardous than an arteriovenous fistula distal to the pedicle, regarding island skin-flap viability. 2). However, the length of the fistula is also important, and an arteriovenous fistula distal to the pedicle, with a sufficiently long length, is not devoid of harmful effects. It is also clear that the larger the fistula, the greater the systemic effects. 3). An island skin flap with an arteriovenous fistula distal to its pedicle might be a useful model to study the relationship between skin-flap viability and edema formation.

Comparative study of fibrous dysplasia and osteofibrous dysplasia: histopathological, immunohistochemical, argyrophilic nucleolar organizer region and DNA ploidy analysis.

Fibrous dysplasia and osteofibrous dysplasia are both benign fibro-osseous lesions of the bone. We retrospectively studied the clinicopathological findings in 90 cases of fibrous dysplasia and 17 cases of osteofibrous dysplasia. In these cases, the expression of proliferating cell nuclear antigen (PCNA) and the presence of argyrophilic nucleolar organizer regions (AgNOR), as well as DNA ploidy, were examined. The bones affected by fibrous dysplasia were the maxilla, femur and frontal bone. Osteofibrous dysplasia occurred exclusively in the tibia or fibula. The average age of patients with fibrous dysplasia (24.0 years) was higher than that of patients with osteofibrous dysplasia (12.9 years). Fibrous dysplasias were divided into four major histological subtypes: Pagetoid, Chinese alphabet, small bone and parallel bone. Bone lining cells, which are known as resting osteoblasts, were seen in some cases of fibrous dysplasia. Cartilage differentiation was not seen in osteofibrous dysplasia. PCNA expression was strongly positive in the nuclei of osteoblasts around the bone trabeculae in osteofibrous dysplasia, but negative in the nuclei of bone lining cells around the bone trabeculae in fibrous dysplasia. The number of AgNOR in osteofibrous dysplasia was slightly higher than that in fibrous dysplasia. Both fibrous dysplasia and osteofibrous dysplasia were diploid. These features suggest that fibrous dysplasia can be differentiated from osteofibrous dysplasia by anatomical site, patient age, histological appearance, cartilage differentiation and PCNA positivity. DNA content by image cytometry is not a useful tool for differentiating these two diseases.

Immunohistochemical analysis of cyclooxygenase (COX)-2 expression in pancreatic endocrine tumors: association with tumor progression and proliferation.

An immunohistochemical study of cyclooxygenase (COX)-2 expression in pancreatic endocrine tumors (PET) was carried out, and the expression of COX-2 was compared with pathological features, the expression of several markers (hormones, vascular endothelial growth factor, single-stranded DNA, and the Ki-67 labeling index [LI]). Twenty PET, including 10 metastasizing cases (tumor size: 3-8 cm) and 10 non-metastasizing cases (tumor size: 0.3-8 cm) were studied. Tumors with a high level of COX-2 expression were placed in the H group, and the remaining tumors were placed in the L group. The H group was comprised of 13 tumors: all 10 of the metastasizing cases and three of the non-metastasizing cases. There were significant differences in tumor size between the two groups (H group 46.5 mm; L group 0.9 mm). There were significant differences in the presence of the following histological criteria for malignancy: pleomorphism (H group 13/13; L group 1/7), mitotic activity (H group 2.9; L group 0) and/or angioinvasion (H group 13/13; L group 1/7); and there were also significant differences in the number of cases that expressed ectopic hormones (gastrin, vasoactive intestinal peptide, serotonin and calcitonin; H group 12/13; L group 2/7) and in the Ki-67 LI (H group 8.3%; L group 0.4%). The distribution of COX-2-positive cells tended to be similar to the distribution of Ki-67-positive cells. Our data show that COX-2 is frequently upregulated in malignant PET and that there is a close relationship between COX-2 expression and tumor progression/proliferative activity.

Expression of cytokeratin 1, 5, 14, 19 and transforming growth factors-beta1, beta2, beta3 in osteofibrous dysplasia and adamantinoma: A possible association of transforming growth factor-beta with basal cell phenotype promotion.

To elucidate the precise origin and characteristics of the epithelial components of osteofibrous dysplasia (OF) and adamantinoma (AD), the expression of transforming growth factor (TGF)-beta1, beta2 and beta3 and cytokeratin (CK) subtypes were studied in five cases of AD and 18 cases of OF by immunohistochemistry. CK1 was expressed in 10 out of 18 OF cases; CK5 was expressed in one OF case; CK14 was positively stained in 10 cases of OF; CK19 was positively stained in 16 OF cases; CK1 was expressed in three out of five AD cases; CK5 was expressed in one case of AD; CK14 was positively stained in four AD cases; and CK19 was positively stained in five AD cases. In OF, TGF-beta1, beta2 and beta3 were expressed in both fibroblasts and osteoblasts. In AD, TGF-beta1, beta2 and beta3 were expressed in both epithelial and fibrous components. These results suggest that epithelial components of AD and OF share epidermal characteristics, CK1, express basal cell phenotype and cytokeratins 5, 14 and 19. In addition to these epithelial characteristics, strong immunoreactivity for TGF-beta poses the possibility of TGF-beta promotion of basal cell phenotype expression for the epithelial components in OF and AD.

Expression of osteopontin messenger RNA by macrophages in ovarian serous papillary cystadenocarcinoma: a possible association with calcification of psammoma bodies.

Calcified psammoma bodies often appear in human ovarian serous papillary cystadenocarcinoma. Osteocalcin (OC), osteonectin (ON) and osteopontin (OPN) are three members of non-collagenous bone-related proteins known to be related with mineralization of bone. To clarify possible involvement of these bone matrix proteins in the calcification of the psammoma bodies, the expression of OC, ON and OPN was analyzed by immunohistochemical and in situ hybridization studies using 15 surgical specimens. OPN protein was detected in the calcified area of the psammoma bodies which was positively stained by von Kóssa's staining, while OC and ON proteins were not. OPN protein was not detected in any cells in tissues, but OPN messenger ribonucleic acid (mRNA) was detected in CD68-positive macrophages, indicating that OPN was produced and promptly secreted by macrophages. These results suggest that OPN produced and promptly secreted by macrophages and subsequently translocated to psammoma bodies may be causally related with the calcium phosphate deposition in the psammoma bodies of the ovarian serous papillary cystadenocarcinomas.

Histological evaluation of allograft bone after acetabular revision arthroplasty: report of two cases.

We recently had the opportunity to take histological sections from two patients who underwent acetabular reconstruction in which allograft and ME Müller acetabular roof reinforcement rings were used. In one patient (case 1), histological sections of the chipped allograft were taken on two separate occasions from the same area, at 7 months, and at 3 years and 11 months after the bone graft. The histology of the chipped allograft showed necrosis at 7 months, but almost normal morphology of trabecular bone formation at 3 years and 11 months after the bone graft. In the other patient (case 2) histological sections of the block allograft and chipped allograft were taken at 1 year and 8 months after the bone graft. The block allograft showed only a small amount of admixture of newly formed bone with the necrotic bone, while the chipped allograft showed a large amount of newly formed bone, with only a small amount of necrotic bone remaining. Therefore, we principally use chipped allograft for acetabular reconstruction, in order to achieve early and complete graft incorporation. If a block allograft is used in a weight-bearing area, it should be protected from excessive load by using an acetabular reinforcement device.

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.

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.

[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.

Endobronchial hamartoma treated by an Nd-YAG laser: report of a case.

Endobronchial hamartomas are only rarely encountered. They cause irreversible lung damage due to bronchial obstruction if not diagnosed early and treated properly. Among the various treatments for this rare disease, a surgical resection remains the most popular. We herein report a case of a 53-year-old man presenting with an endobronchial hamartoma which was successfully excised by laser irradiation via a rigid bronchoscope, along with a review of 113 patients with this disease reported in the literature.

Time course of changes in the intestinal permeability of food-sensitized rats after oral allergen challenge.

Rats were sensitized with ovalbumin (OVA) with a molecular weight of 45 kd, challenged with OVA orally, followed by orally administered beta-lactoglobulin (BLG) as an intestinal permeability marker. BLG is a macro-molecular protein with a molecular weight of 18 kd. Blood BLG concentrations were measured (by ELISA) serially over 4 hours following BLG administration, which in turn was given 1 hour after OVA challenges. The maximum BLG concentration was at 2 hours. BLG was then administered orally 1, 3, 6, 12 and 24 hours after oral OVA challenge, and the serum BLG concentration at 2 hours after BLG administration was compared among the five groups. BLG appeared in the circulation of the animals 1, 6 and 24 hours after allergen challenge, but not after 3 and 12 hours. The serum BLG concentration was not significantly different at 1, 6 and 24 hours. Histopathological examinations of the intestines showed mast cell infiltration of the intestinal mucosa at 1 hour, remarkable edema of villi at 3 hours, eosinophil infiltration at 6 hours, an increase of goblet cells at 12 hours and villous atrophy and lymphocyte infiltration at 24 hours. The appearance in the serum of three BLG peaks of comparable heights suggested that the intestinal absorption of BLG may be related to a late and delayed phase as well as the immediate IgE-dependent phase response.

[A case report of concomitant UFT-E and CDDP against lung epidermoid carcinoma].

A 52-year-old male with the chief complaint of hemo-sputum was diagnosed after detailed examination as epidermoid carcinoma in the right upper lobe bronchus through the bifurcation. Thoracotomy revealed infiltration of carcinoma into the right main pulmonary artery and the superior vena cava, which could not be excised. Subsequent postoperative radiotherapy (69 Gy) showed NC. Then concomitant administration of UFT-E and a low dose of CDDP was started on an outpatient basis. After the third course of treatment (six weeks per course), a significant reduction was noted in the size of the carcinoma. Bronchoscopy revealed CR with the elimination of carcinoma to mere traces. Besides the myelosuppression seen at the end of the second course of treatment, which resulted in a two-week hospitalization for blood transfusion, no adverse effect prevented the patient from continuing the outpatient treatment courses and from returning to work. We consider that the treatment was very successful not only for its effectiveness in reducing the carcinoma but also for the high QOL achieved.