Mutsuo Ishikawa

Bilateral Oophorectomy in Asymptomatic Women over 50 Years Old Selected by Ovarian Cancer Screening

The purpose of this study was to evaluate bilateral oophorectomy in women over 50 years old found to have an adnexal mass using transvaginal ultrasonography (TVS) as a mass screening. With TVS a total of 23,451 women without symptoms were examined for ovarian cancer at annual screening for uterine cervical cancer. Two hundred fifty-eight women over 50 years old persistently had abnormal TVS results and 95 women gave informed consent for surgical tumor removal. In the 95 women operated, 7 malignant ovarian cancers were found. Especially adnexal masses which were thought to be benign were treated by laparoscopic surgery.

Analysis of the p53 gene in human choriocarcinoma cell lines

In the present study, we analysed human choriocarcinoma cell lines for abnormalities in the tumour-suppressor gene p53 by Southern blotting, Northern blotting, non-radioisotopic single-stranded conformational polymorphism (SSCP) and complementary DNA sequencing. In all cell lines (Bewo, GCH-1, GCH-2, SCH, JAR, JEG-3, NUC-1 and HCCM-5), no p53 gene abnormality was detected by using Southern blotting. p53 mRNA of the expected size was detected in all cell lines tested by Northern blotting. SSCP analysis revealed abnormalities of p53 cDNA in the SCH cell line. Sequencing analysis of the entire coding region of the p53 gene revealed that both alleles were expressed in the JEG-3 cell line, and one of the alleles contained a point mutation (G to T) in codon 167 (Gln to His). In the NUC-1 cell line both alleles were point mutated. One allele had a point mutation (A to T) that resulted in a codon 17 change (Glu to Asp), and another had a point mutation (A to T) that caused a codon 24 change (Lys to Asn). In the SCH cell line, AGG was inserted between codon 249 and 250; this insertion resulted in an abnormal structure of the p53 protein. In three out of eight human choriocarcinoma cell lines, a p53 gene abnormality was detected. Therefore our data demonstrate that p53 gene abnormalities are associated with choriocarcinoma cell lines.

Relaxation of insulin-like growth factor-II gene imprinting in human gynecologic tumors

To test for the existence of genomic imprinting in human gynecologic tumors, we analyzed the allelic expression of human insulin-growth factor-II (IGF-II) genes. Genomic imprinting is the parental allele-specific expressions of genes, and recently imprinting of IGF-II gene has demonstrated that parental IGF-II was monoallelically expressed. To study whether IGF-II gene imprinting occurs in human gynecologic tumors, we examined allele-specific expression using an ApaI polymorphism in the 3 untranslated region of IGF-II gene exon 9. We used 19 gynecologic tumor cell lines, and 66 human gynecologic tumors. Four of 19 cell lines (21%) were informative, and three of these four cell lines (75%) revealed loss of imprinting (LOI). For gynecologic tumors, 24 of 66 were informative (36%), and 5 of the 24 (21%) had LOI. We have reported here that the IGF-II gene is expressed biallelically in some gynecologic tumors. We suggest that LOI of the IGF-II gene is involved in the development of some gynecologic tumors.

Expression of superoxide dismutase (SOD) in adenomyosis.

OBJECTIVEnTo assess the expression of Cu,Zn-SOD and Mn-SOD in peritoneal fluid and ectopic endometrium from women with adenomyosis.nnnSTUDY DESIGNnThe levels of Cu,Zn-SOD and Mn-SOD were measured in peritoneal fluid from infertile women who did not have endometriosis (n = 27), women with adenomyosis (n = 22), and women with endometriosis (n = 15). The expression of Cu,Zn-SOD and Mn-SOD messenger ribonucleic acids in ectopic endometrium was investigated by Northern blot analysis. Mn-SOD in ectopic endometrium was investigated by immunohistochemical staining.nnnRESULTSnThe levels of Cu,Zn-SOD and Mn-SOD were significantly higher in the peritoneal fluid from women with adenomyosis than in those with endometriosis or infertile women. Mn-SOD was highly expressed in ectopic endometrium, but Cu,Zn-SOD was not. Mn-SOD was detected in ectopic endometrium of women with adenomyosis.nnnCONCLUSIONSnThese data show that reactive oxygen produced in adenomyosis may induce Mn-SOD in ectopic endometrium, which results in the release of relatively large amounts of this protein into the peritoneal fluid. These results suggest that free radicals may play a role in the pathogenesis of adenomyosis, the same as they do in other inflammatory processes.

Prospective Randomized Study of Antibiotic Prophylaxis for Nonlaparotomy Surgery in Benign Conditions

Background: Although postoperative infections continue to be a major problem in gynecologic surgery, there is still no consensus on the efficacy of antibiotic prophylaxis. Methods: This prospective randomized trial was conducted to investigate the prevention of major operating site infections after nonlaparotomy surgery, with treatment regimens as follows: the first group of patients received 2 g of intravenous cefotiam dihydrochloride (CTM) on the induction of anesthesia, while the second group received 100 mg of oral cefpodoxime proxetil (CPDX- PR) twice daily, from day 0 to day 2. Results: Nineteen of the 207 patients enrolled developed postoperative infections diagnosed by our simple criteria for postoperative infection. The frequency of febrile morbidity was not significantly less in patients who received CTM (9 cases; 8.6%) as compared with those in the CPDX-PR group (10 cases; 9.8%) (p = 0.56). Conclusion: The administration of oral CPDX-PR (100 mg, twice daily, for 3 days) appears to be a safe, cost-saving, convenient prophylaxis which reduces overall expense.

Immunohistochemical analysis of ras oncogene product p21 in human endometrial carcinoma.

Monoclonal antibody rp-28 directed against the ras gene product p21 has been used to evaluate ras p21 expression in endometrial lesions. Endometrial cancer showed a variable reactivity according to histological type: in well differentiated adenocarcinoma 63% were positive (12/19); in moderately differentiated adenocarcinoma 53% were positive (8/15); in poorly differentiated adenocarcinoma 40% were positive (2/5). The staining intensity of ras p21 seemed to be stronger in the more differentiated types of endometrial carcinoma. In endometrial carcinoma with premenopausal women, 27% were positive (3/11), and with postmenopausal women 71% were positive (20/28). The difference between premenopausal and postmenopausal groups was statistically significant (Mantel-Haenszel procedure, M-H chi 2 = 6.765, P < 0.01). The results suggest the existence of different carcinogenetic mechanisms in these two groups of endometrial cancer.