Carcinosarcoma of the bladder

We present 2 cases of carcinosarcoma of the bladder. These tumors are considered as true admixtures of epithelial and mesenchymal neoplastic cells rather than 2 separate neoplasms that touch or marginally invade each other. Although the etiology of this tumor is unclear it tends to be aggressive and probably requires an early radical operation with adjuvant radiotherapy and chemotherapy.

Fluorescence properties of o-phthaldialdehyde derivatives of amino acids

The fluorescence properties of the products formed by reaction of o-phthaldialdehyde with amino acids and their derivatives, in the presence of thiol compounds, have been studied. The emission spectra, quantum yields, and lifetimes depend on the primary amine and thiol compound used; the observations confirm the report (Simsons, S.S., Jr. and Johnson, D.F. (1978) J. Org. Chem 43, 2886--2891) that the product incorporates molecules of all three types of compounds. The fluorescence quantum yields of o-phthaldialdehyde derivatives of the naturally occuring amino acids ranged from 0.33 to 0.47, using 2-mercaptoethanol as the thiol compound. The fluorescence lifetimes were about 18--20 ns. Lower quantum yields were obtained when mercaptoethanol was replaced by dithiothreitol or ethnethiol. Derivatives of amino acid amides and peptides had quantum yeilds as low as 0.03, due to quenching by the carboxamide group. The intramolecular quenching was relieved by the detergent, sodium dodecyl sulfate, and by dimethylsulfoxide. Monosubstituted lysine exhibited a normal fluorescence, but the di-substituted product was largely quenched, presumably due to interaction between the two isoindole fluorophors. Fluorscence stopped-flow experiments showed that the alpha- and epsilon-amino groups reacted at different rates, with the epsilon-amion group reacting 10 times faster, with a t 1/2 of about 6 s under pseudo first order conditions at pH 9.0 with 10(-3) M o-phthaldialdehyde. The amount of instability shown by the o-phthaldialdehyde derivatives depended on the thiol compound used, the primary amine involved, and the solvent. Cysteine and o-phthaldialdehyde reacted to give an unstable, weakly fluorescent product; but cysteine could be assayed normally if its sulfhydryl was blocked. The o-phthaldialdehyde reagent was discussed in relation to fluorescamine, another reagent for primary amines.

A new assay for the measurement of mediator release from rat peritoneal mast cells

In this report, we describe a new in vitro experimental system for monitoring the release, and inhibition of release, of [3H]-serotonin from rat peritoneal mast cells, which can be used as a novel screen for evaluation of compounds effective in immediate hypersensitivity reactions. This assay is an improvement on existing assays since the cells are not required to be exposed to hormones at any time during the procedure. In this assay, 1 microgram/ml of compound 48/80 consistently produced a 6- to 8-fold-increase in release of serotonin with a low background release of 4-5%. Disodium chromoglycate (DSCG), a standard inhibitor of histamine release, effectively inhibited compound-48/80-stimulated serotonin release with an average I50 of 2.1 X 10(-4) M. Several other potential antiasthmatic agents were far more potent than DSCG.

Persistent measles virus infection in vitro and in man

The characteristics of cell lines persistently infected with measles virus are described. Molecular mechanisms for measles virus-persistence in vitro as well as in human disease include defective interfering particles, mutant virus strains, proviral DNA, and nonpermissive cell types. The role of measles virus in subacute sclerosing panencephalitis and evidence for measles virus infection in multiple sclerosis, Paget's disease, and systemic lupus erythematosus are discussed.

Retrograde aortic dissection during cardiopulmonary bypass: "nonoperative" management

Seven patients are reported in whom retrograde aortic dissection occurred, 2 during valve replacement and 5 during coronary artery bypass, among 770 patients perfused through the common femoral artery. Successful management included : (1) immediate cessation of cardiopulmonary bypass; (2) removal of the arterial cannula and its replacement in the ascending aorta, usually through both lumens of the dissection; (3) completion of the operation by suturing the proximal ends of saphenous vein grafts to both lumens of the dissection in the ascending aorta; and (4) no treatment of the dissection itself. One patient died of other causes 30 days postoperatively. Follow-up from 2 to 3 1/2 years in 6 long-term survivors has revealed no complications related to the dissection. Saphenous vein graft function is apparently satisfactory.

The action of nitroglycerine and dipyridamole in normal and ischaemic dog heart

1 Network and post-network resistances were measured together with heat clearance and heat production in the myocardium. 2 Nitroglycerine dilated all resistance vessels but was twice as effective on network as compared with post-network vessels. 3 Dipyridamole dilated network and post-network vessels equally. 4 Nitroglycerine had no effect on heat clearance or heat production in ischaemic myocardium. 5 Dipyridamole increased heat clearance in normal but not in ischaemic myocardium. 6 Dipyridamole depressed heat production in normal and ischaemic myocardium. 7 That the clinical effectiveness of nitroglycerine does not depend entirely on its coronary vasodilator properties is confirmed. 8 It is suggested that the action of dipyridamole in depressing myocardial heat production may be due to an action on the efficiency of oxygen utilization during cardiac contraction.

Cardiac valve replacement. The rationale for earlier operation

Cardiac valve replacement (single or double) was carried out in 138 consecutive patients with valvular heart disease over a six-year period at the Wadsworth Veterans Administration Hospital. All but a few had functional class III or IV disease. Hospital mortality was 3.6 percent.Normothermia, coronary perfusion and beating of the heart were maintained throughout the procedure. All patients were followed at least one year and the average follow-up was four and a half years. The late mortality was 27 percent. Seventy-five percent of the late deaths were due to progressive cardiac disease. The mortality due to prosthetic valve dysfunction was 4 percent. Subjective evaluation of survivors revealed that a high percentage remained symptomatic. Only 50 percent of the total group of patients were significantly improved. The high incidence of late mortality and poor long-term functional results are contrasted to the low operative risk and improved reliability of prosthetic valves. The rationale of delaying operation until functional class III limitation develops is questioned. Earlier operation is recommended before irreversible myocardial hypertrophy and fibrosis develop.