Endocapillary proliferative glomerulonephritis with crescent formation and concurrent tubulointerstitial nephritis complicating retroperitoneal fibrosis with a high serum level of IgG4.

Renal lesions of IgG4-related disease have been reported recently. Most of them are tubulointerstitial nephritis, and a definite glomerulonephritis complicating IgG4-related disease is very rare. We report here a case of definite glomerulonephritis and concurrent tubulointerstitial nephritis complicating retroperitoneal fibrosis with a high serum level of IgG4. A 68-year-old Japanese woman was referred to our hospital for investigation of anasarca. We diagnosed her disease as a nephrotic syndrome and left hydroureteronephrosis due to retroperitoneal fibrosis. Her laboratory data revealed a high serum level of IgG4, renal injury, hypoproteinemia, hypocomplementemia, a positive finding of circulating immunocomplex (CIC), and negative findings ofautologous antibodies suggesting systemic lupus erythematosus (SLE) or Sjögren's syndrome (SS). A diagnosis of SLE or SS could not be made clinically. Right renal biopsy revealed endocapillary proliferative glomerulonephritis with crescent formation and concurrent tubulointerstitial nephritis. Infiltration of plasma cells in interstitium was more conspicuous than seen with ordinary tubulointerstitial nephritis, and in most of them IgG4 was positive. We placed a percutaneous nephrostomy catheter in her left kidney, and prescribed prednisolone and cyclosporine. The responses to prednisolone and cyclosporine therapies were very good. Further studies are needed to clarify the relationship between glomerulonephritis and IgG4-related disease. However, when considering renal lesions of IgG4-related disease, we think that hypocomplementemia, a positive finding of CIC, negative findings of autologous antibodies suggesting SLE or SS, conspicuous interstitial infiltration of IgG4-positive plasma cells, and a good response to steroid or immunosuppressant therapy are key points.

The relationship of genetic aberrations detected by comparative genomic hybridization to DNA ploidy and tumor size in human oral squamous cell carcinomas.

We have examined genetic alterations in 11 surgically removed oral squamous cell carcinomas (OSCCs) using comparative genomic hybridization (CGH) and laser scanning cytometry (LSC), which allow quantitative analysis of chromosomal abnormalities. CGH analysis revealed gains and/or losses of DNA sequence copy number in all tumors. Gains in DNA sequence copy number were detected frequently for chromosome arms 3q25-28 (6/11), 5p (6/11) and 8q (5/11), and losses in chromosome arms 18q (4/11), 19q (4/11), 17p (3/11), and 19p (3/11). Amplification of 5p was observed in two tumors. LSC detected DNA aneuploidy with DNA indices ranging from 1.30 to 1.82 in 6 of 11 tumors. The number of chromosomal aberrations was higher in DNA aneuploid tumors than in diploid tumors (8.17 vs 3.60/tumor, P<0.05). Furthermore, the average number of chromosomal aberrations was significantly higher in stage T2 tumors and larger tumors than in stage T1 tumors (7.71 vs 3.25/tumor, P<0.05). Our results suggest that DNA aneuploidy and large tumor size reflect an underlying chromosomal instability.

Identification of genetic aberrations in cell lines from oral squamous cell carcinomas by comparative genomic hybridization.

We detected genetic alterations in 14 cell lines established from 14 human oral squamous cell carcinomas (OSCCs) using comparative genomic hybridization (CGH), which allows a comprehensive analysis of chromosomal imbalances and identification of nonrandom genetic aberrations specific to OSCCs. All cell lines showed gains and losses of DNA copy number. DNA losses were detected for chromosomes 18q (10/14) and 4q (9/14) with minimal overlapping regions of 18q12-32 and 4q31-qter, respectively. In contrast, the common sites for increased copy number were chromosomes 5p (12/14), 8q23-ter (11/14), 20p (8/14), 20q (8/14), and 3q25-ter (7/14). These results suggest that losses of 18q12-22 and 4q31-ter and gains of 5p and 8q23-ter play important roles in the development and/or progression of OSCC.

Expression of ICAM-1 in implanted primary and metastatic squamous cell carcinomas in rats.

FF6 tumor cells are derived from a spontaneous rat squamous cell carcinoma (SCC) which originally arose in the facial skin of a DA rat. In this study, FF6 tumor cells were implanted into rat oral mucosa to establish an ex vivo metastatic model. We analyzed the expression of intercellular cell adhesion molecule-1 (ICAM-1) in the implanted primary and metastatic FF6 tumors by immuno-staining with a monoclonal antibody (mAb) against ICAM-1. The implanted primary FF6 cells showed strong expression of ICAM-1, whereas the tumor cells of metastatic lesions showed weak or negative expression of ICAM-1. By immunostaining with mAb OX6, a number of MHC class II-positive macrophages were detected in tumor mesenchyme and surrounding the metastatic foci. These results suggested that the local immune reaction in the lymph node influenced the expression of ICAM-1 on tumor cells, and that MHC class II-positive macrophages may play a role in transplanted tumor growth and metastases.

Detection and analysis of human papillomavirus 16 and 18 homologous DNA sequences in oral lesions.

The prevalence of human papillomavirus (HPV) 16 and 18 was investigated in oral lesions of the population of northeast China including squamous cell carcinomas (SCCs), candida leukoplakias, lichen planuses and papillomas, by southern blot hybridization with polymerase chain reaction (PCR). Amplified HPV16 and 18 E6 DNA was analyzed by cycle sequence. HPV DNA was detected in 14 of 45 SCCs (31.1%). HPV18 E6 DNA and HPV16 E6. DNA were detected in 24.4% and 20.0% of SCCs. respectively. Dual infection of both HPV 16 and HPV 18 was detected in 6 of 45 SCCs (13.3%), but not in other oral lesions. HPV 18 E6 DNA was also detected in 2 of 3 oral candida leukoplakias, but in none of the 5 papillomas. Our study indicated that HPV 18 infection might be more frequent than HPV 16 infection in oral SCCs in northeast Chinese, dual infection of high risk HPV types was restricted in oral SCCs, and that HPV infection might be involved in the pathogenesis of oral candida leukoplakia.

Recognition of a special membrane antigen of squamous cell carcinoma in rats with a monoclonal antibody UB23.

This article describes the recognition of a special membrane antigen of the rat squamous cell carcinoma (SCC) by a monoclonal antibody (mAb), UB23, and the characterization of the UB23 antigen expression in the implanted primary and metastatic SCC in rat models. The mAb UB23 was raised against the FF6 tumor, a well-differentiated rat SCC, and it recognized the 120- to 130-kD cell surface antigen in FF6 tumor cells. The UB23 antigen was found in frequently observed small 'basal' cells but not in keratinocytes, and an increased expression was seen in the cells at the interface with peritumoral stroma in both the implanted primary FF6 tumors and metastases. These results indicated that the UB23 antigen is closely related with the cell differentiation and invasion of FF6 cells, and could be useful for analyzing the mechanism of differentiation, invasion and metastasis of SCC in animal models.

[Hereditary gingival fibromatosis].

Fibromatosis may be defined as diffuse poorly circumscribed overgrowth of the fibrous tissue that infiltrates adjacent normal tissues. They are difficult to eradicate surgically, and recur but not metastasize. Gingival fibromatosis is generally regarded as a disease that leads to an extensively diffuse and remarkable hyperplasia of the maxillo-mandibular gingiva. Occasionally, this lesion covers all teeth. The histogenesis of the fibromatosis remains unexplained. Trauma, endocrine, idiopathic factors and genetic factors have been implicated, but it is uncertain whether any of then play a major role in the development of the disease. Occasional cases with familial history have been reported. The treatment of choice would appear to been block resection of the tumor and surrounding normal structures. Although, this lesion has a high recurrent rate. For this reason, in many of the case reports, that it has been recommended that the follow up period is considerably less than three years.

Electrical burns of lip and mouth in children. Report of 2 cases.

2 cases of electrical burns of the oral cavity in young children are reported. Both cases were treated conservatively. 1 of the patients, now that 3 years have passed, has a slight scar with a slight deformity of lower and upper lips. We are planning reconstructive surgery within a short time. There are no functional or developmental disturbances. The main cause of electrical burns in young children is biting or sucking the free end of live extension cords or placing sockets into the mouth. Since most of these injuries are from low-voltage, electric circuits are localized to the surroundings of the mouth. However, the injuries are small or narrow, but reach much deeper than initially appear. Therefore, the scar may be small but the deeper tissue may sustain more extensive damage than expected.

Potassium contracture in the tonic bundle isolated from the enlarged flexor carpi radialis muscle of the frog.

The flexor carpi radialis muscle (FCRM) of the frog was divided into phasic and tonic bundles, and the properties of the potassium contracture in the tonic bundle were examined. The potassium contracture was tonic and the contracture induced by K higher than 75 mM consisted of the initial phasic component and of the following sustained component. Both components were abolished by the transverse tubule disruption. The curve relating the peak tension to the log[K]o (activation curve) started at about 15 mM K and reached maximum at about 75 mM K. By reducing [Ca]o, the activation curve shifted downward at higher [K]o, being little affected near the mechanical threshold. The time course of inactivation induced by 20 mM K was slow and monophasic, and was markedly accelerated by reducing [Ca]o. The spontaneous relaxation of the contracture induced by high K was little affected by reducing [ca]o.