Deoxycoformycin treatment for childhood T-cell acute lymphoblastic leukemia early in second remission: a Pediatric Oncology Group Study

2-Deoxycoformycin (DCF) was added to an intensive Pediatric Oncology Group protocol (#8303) for children with T-cell acute lymphoblastic leukemia or T-cell lymphoblastic lymphoma in first relapse. Twenty-seven patients received one or more courses of DCF at 15 mg/m2/day as a 3-day continuous infusion immediately after achieving a second remission with a four-drug reinduction regimen. Renal and neuromuscular toxicities were frequent and occasionally severe despite the provision of a source of adenosine deaminase by means of a packed red cell transfusion 1 day following the infusion of DCF. Hepatic toxicity, manifested by transaminase elevations, accompanied 62% of the courses. The median duration of the second complete remission was 4 months (range 2-16+ months), with only two of the 27 patients still in remission at 13+ and 16+ months. Plasma concentrations of deoxyadenosine (dAdo) and the ratio of red cell deoxyadenosine triphosphate to adenosine triphosphate (dATP:ATP) were measured prior to the DCF infusion and on day 4. A dATP:ATP ratio of 1.0 or greater was seen in two patients with acute renal failure. There was no apparent correlation between toxicity or response and the plasma dAdo concentrations. DCF administered according to this dose and schedule was excessively toxic and did not appreciably prolong the duration of the second complete remission in children with T-cell lymphoblastic malignancies.

Anti-peptide antibodies detect oncogene-related proteins in urine

Antisera to a number of synthetic peptides predicted from nucleic acid sequences of oncogenes have been used to screen 483 urine samples of cancer patients, pregnant women, and normal controls for the presence of immunologically related proteins. Increased levels of oncogene-related proteins are found during neoplasia and pregnancy. The differential detection of these oncogene-related proteins indicates that panels of monoclonal antibodies may provide a convenient noninvasive means of detecting, classifying, and staging a wide variety of malignancies and may be useful in following fetal development during pregnancy.

Chronic allyl chloride poisoning. An epidemiology, clinical, toxicological and neuropathological study

It was previously reported that chronic exposure to allyl chloride resulted in liver and kidney damage. No neurotoxic effect of allyl chloride had been noticed until two outbreaks of polyneuropathy without liver and kidney dysfunction due to exposure to allyl chloride in China in the early 1970's. Epidemiological and clinical studies done within 1973-1982 revealed that the main risk of industrial exposure to allyl chloride is damage to the peripheral nervous system. Polyneuropathy is thought to be the main clinical manifestation of chronic allyl chloride poisoning. Electroneuromyography is essential and valuable for early diagnosis and biological monitoring. Toxicological and neuropathological studies in rabbits and mice have given the evidence of a pattern of central-peripheral distal axonopathy in peripheral nervous system which has further confirmed the neurotoxicity of allyl chloride found in man. Based on the above results, the maximum allowable concentration of allyl chloride and diagnostic criteria for chronic allyl chloride poisoning are proposed.

Detection of ganglioside GD2 in tumor tissues and sera of neuroblastoma patients

A murine monoclonal antibody (monoclonal antibody 126) produced against cultured human neuroblastoma cells (LAN-1) was found to be specifically directed to a disialoganglioside (GD2) antigen preferentially expressed on both cell lines and tissues derived from melanoma and neuroblastoma. In enzyme-linked immunosorbent assays, monoclonal antibody 126 failed to react with leukemic and lymphoblastoid cells as well as with a variety of carcinoma and sarcoma cell lines. Immunohistological analysis by the immunoperoxidase technique revealed strong reactivity of monoclonal antibody 126 with frozen and formaldehyde-fixed neuroblastoma and melanoma tissues. Tissues from patients with glioma or with small cell cancer of the lung showed faint staining, whereas those from individuals with sarcoma, lymphoma, and a variety of other neoplasms proved to be negative. Sera of neuroblastoma patients showed significantly elevated GD2 levels compared to normal children (p less than 0.001) and children with other tumors (p less than 0.001) as determined by a quantitative competitive enzyme-linked immunosorbent assay. Furthermore, the GD2 serum level of one neuroblastoma patient, when followed serially, was found to correlate with progression of disease, suggesting the potential usefulness of this assay for the diagnosis and monitoring of neuroblastoma.

Portal film quality: a multiple institutional study

The variation in quality of the several thousand portal films submitted to the Quality Assurance Review Center (QARC) has been substantial. To ascertain the nature and severity of this problem, a detailed study of "whole brain" portal films which were taken at 23 different radiotherapy departments for patients entered on three national leukemia studies was performed. Each film was analyzed in two ways: (a) independent subjective evaluation by four experienced radiotherapists and (b) measurement of objective parameters. Scores from 416 evaluations together with measured parameters were stored in a data base system for easy statistical manipulation. The dependence of perceived film quality on these objective parameters has been correlated and is the subject of this report.

Hodgkin's disease presenting in epitrochlear nodes

Two cases of Hodgkin's Disease (HD) presenting in epitrochlear nodes are described, and compared to four similar cases gleaned from the literature. The nodular sclerosis type of HD was present in 5 of the 6 patients. Of the four patients staged with laparotomy, two had infradiaphragmatic disease. A treatment approach using radiation alone for patients with disease limited to the epitroclear region is presented, and anatomical considerations of the treatment technique are given.

Specific toxicity of 2-chlorodeoxyadenosine toward resting and proliferating human lymphocytes

2-Chlorodeoxyadenosine (CdA), an adenosine-deaminase-resistant purine deoxynucleoside, is markedly toxic toward human T-lymphoblastoid cell lines in vitro and is an effective agent against L1210 leukemia in vivo. The present studies have examined the toxicity, and in some cases, metabolism, of CdA in (1) multiple established human cell lines of varying phenotype, (2) leukemia and lymphoma cells taken directly from patients, (3) normal bone marrow cells, and (4) normal peripheral blood lymphocytes. Nanomolar concentrations of CdA blocked the proliferation of lymphoblastoid cell lines with a high ratio of deoxycytidine kinase to deoxynucleotidase. The drug had virtually no effect on the growth of cell lines derived from solid tissues. The CdA inhibited the spontaneous uptake of tritiated thymidine by many T and non-T, non-B acute lymphoblastic leukemia cell specimens at concentrations less than or equal to 5 nM. The same concentrations did not impair either thymidine uptake or granulocyte-monocyte colony formation by normal bone marrow cells. In common with deoxyadenosine, but unlike several other agents affecting purine and purine metabolism, CdA was lethal to resting normal T lymphocytes and to slowly dividing malignant T cells. In both resting and proliferating lymphocytes, the CdA was phosphorylated by deoxycytidine kinase and entered a rapidly turning over nucleotide pool. Dividing lymphocytes also incorporated abundant CdA into DNA. The selective toxicity of CdA toward both dividing and resting lymphocytes may render the drug useful as an immunosuppressive or antileukemic agent.

In-vitro measurement of static pressure distribution in synovial joints--Part II: Retropatellar surface

This second part of a two-part paper is concerned with the measurement of static pressure distribution on the retropatellar surface. The study has been performed in a loading apparatus designed to simulate individually the lines of action and the magnitudes of the tensions in the components of the quadriceps femoris muscle group. Results have been obtained using 24 specimens in the knee flexion range 0 to 130 deg and employing a net quadriceps tension of 734 N. Particular emphasis has been placed on the evaluation of the sensitivity of the results to variations in the characteristics of the simulated quadriceps tension. The pressure distribution results have been interpreted in terms of variation of the normal force and the average contact stress on the retropatellar surface as a function of flexion angle. It has been shown that the "pulley" model of the patella consistently overestimates the actual patellofemoral joint reaction force throughout the range of flexion. Clinical implications of the results, in terms of etiology of degeneration of patellar cartilage, have been discussed.

Age-related changes in hepatic triacylglycerol content and phosphatidate phosphohydrolase activities in fasting male and female rats

Hepatic microsomal phosphatidate phosphohydrolase (PPH) showed minor fluctuations with age in male and female rats. In males, hepatic cytosolic PPH rose to a peak at day 58 and then declined. In female rats, the activities of this enzyme were much lower than those of the male to day 35, but then increased fivefold by day 50 to values approximating those of males, and thereafter gradually declined. The hepatic triacylglycerol (TG) content of male rats was fairly constant, but in females the values rose to a peak on day 50 and then declined in parallel with the cytosolic PPH activity, but remained substantially higher than values for male rats. A significant correlation between cytosolic PPH and hepatic TG was obtained. The microsomal PPH did not correlate with hepatic TG. These results suggest that in the rat cytosolic PPH may play a role in modulating age-related changes in hepatic TG metabolism, and that it is functionally more important than the microsomal enzyme in this species.

Modulation by phenobarbital of lipolytic activity in postheparin plasma and tissues of the rat

Male rats injected with phenobarbital at a dose of 100 mg/kg for 5 days manifested increased postheparin lipolytic activity of fasting plasma. Inhibition studies with protamine sulphate, 1 M NaCl, and sodium dodecyl sulphate revealed that the activities of both lipoprotein lipase and hepatic triacylglycerol lipase were increased in the postheparin plasma of the drug-treated rats. Adipose tissue lipoprotein lipase activity was also increased in the phenobarbital-treated rats. The triacylglycerol lipase activity elutable by heparin from liver slices and the residual activity of liver microsomes increased significantly in the drug-treated rats. Lipoprotein lipase of cardiac muscle and red skeletal muscle was unaltered by phenobarbital treatment. The increased postheparin lipolytic activity of fasting phenobarbital-treated rats seems to be accountable through increased lipoprotein lipase activity of adipose tissue and increased triacylglycerol lipase activity of liver, both of which may contribute to the lowered fasting concentrations of serum triacylglycerol mediated by the drug, as previously reported.

Enzyme induction and hepatic glycerolipid synthesis in rats treated with 3-methylcholanthrene

Fasting male rats fed 3-methylcholanthrene in a daily dose of 40 mg . kg body weight-1 gave evidence of hepatic microsomal enzyme induction after 3 days through significantly increased hepatic aryl hydrocarbon hydroxylase activity, cytochrome P448 content, and characteristic changes in microsomal proteins analysed by sodium dodecyl sulfate--polyacrylamide gel electrophoresis. Concomitantly, activities of aminopyrine N-demethylase and microsomal gamma-glutamyltransferase, which are increased in phenobarbital-treated rats, significantly declined. In contrast to phenobarbital, which has been previously shown to increase hepatic triacylglycerol content and in vitro glycerolipid synthesis, 3-methylcholanthrene did not affect hepatic triacylglycerol content, but did inhibit glycerolipid synthesis by cell-free preparations of rat liver and significantly reduced serum triacylglycerol concentration. Thus, the two prototypical drugs inducing characteristically different changes in microsomal enzyme and hemoprotein response also seem to differ in their effect upon another important microsomal function, hepatic glycerolipid synthesis.

Triacylglycerol metabolism in the phenobarbital-treated rat

1. Various aspects of triacylglycerol metabolism were compared in rats given phenobarbital at a dose of 100mg/kg body wt. per day by intraperitoneal injection; controls were injected with an equal volume of 0.15m-NaCl by the same route. Animals were killed after 5 days of treatment. 2. Rats injected with phenobarbital demonstrated increased liver weight, and increased microsomal protein per g of liver. Other evidence of microsomal enzyme induction was provided by increased activity of aminopyrine N-demethylase and cytochrome P-450 content. Increased hepatic activity of gamma-glutamyltransferase (EC 2.3.2.2) occurred in male rats, but not in females, and was not accompanied by any detectable change in the activity of this enzyme in serum. 3. Phenobarbital treatment increased the hepatic content of triacylglycerol after 5 days in starved male and female rats, as well as in non-starved male rats; non-starved females were not tested in this regard. At 5 days after withdrawal of the drug, there was no difference in hepatic triacylglycerol content or in hepatic functions of microsomal enzyme induction between the treated and control rats. 4. After 5 days, phenobarbital increased the synthesis in vitro of glycerolipids in cell-free liver fractions fortified with optimal concentrations of substrates and co-substrates when results were expressed per whole liver. The drug caused a significant increment in the activity of hepatic diacylglycerol acyltransferase (EC 2.3.1.20), but did not affect the activity per liver of phosphatidate phosphohydrolase (EC 3.1.3.4) in cytosolic or washed microsomal fractions. A remarkable sex-dependent difference was observed for this latter enzyme. In female rats, the activity of the microsomal enzyme per liver was 10-fold greater than that of the cytosolic enzyme, whereas in males, the activities of phosphohydrolases per liver from both subcellular fractions were similar. 5. The phenobarbital-mediated increase in hepatic triacylglycerol content could not be explained by a decrease in the hepatic triacylglycerol secretion rate as measured by the Triton WR1339 technique. Since the hepatic triacylglycerol showed significant correlation with microsomal enzyme induction functions, with hepatic glycerolipid synthesis in vitro and with diacylglycerol acyltransferase activity, it is likely to be due to enhanced triacylglycerol synthesis consequent on hepatic microsomal enzyme induction. 6. In contrast with rabbits and guinea pigs, rats injected with phenobarbital showed a decrease in serum triacylglycerol concentration in the starved state; this decrease persisted for up to 5 days after drug administration stopped, and did not occur in non-starved animals. It seems to be independent of the microsomal enzyme-inducing properties of the drug, and may be due to the action of phenobarbital at an extrahepatic site.

Effects of phenobarbital upon triacylglycerol metabolism in the guinea pig

The association between hepatic microsomal enzyme induction and triacylglycerol metabolism was examined in fasting male guinea pigs injected intraperitoneally with 50 mg phenobarbital x kg-1 for 7 days. Enzyme induction was established by a significant increase in hepatic aminopyrine N-demethylase activity, cytochrome P450 content, and hepatic gamma-glutamyl-transferase activity. Increased activity of gamma-glutamyltransferase was also observed in the blood serum of treated animals. The phenobarbital-treated guinea pigs manifested increased hepatic triacylglycerol content and serum triacylglycerol concentration, accompanied by enhanced ability of cell-free fractions of liver to synthesize glycerolipids in vitro from sn-[14C]glycerol 3-phosphate and fatty acids. Microsomal phosphatidate phosphohydrolase accounted for 97% of the total liver activity of this enzyme, and its specific activity was 50-fold higher than that of the cytosolic enzyme when each was measured under optimal conditions. Activity of the cytosolic phosphohydrolase per liver doubled and that of the microsomal phosphohydrolase increased by 40% in the phenobarbital-treated guinea pigs. The microsomal, but not the cytosolic enzyme, showed a significant correlation with hepatic triacylglycerol content. Significant correlation was observed between the various parameters of hepatic microsomal enzyme induction and hepatic triacylglycerol content, suggesting that enzyme induction may promote triacylglycerol synthesis and consequent hypertriglyceridaemia in the guinea pig.

Effects of phenobarbital upon triacylglycerol metabolism in the rabbit

1. The association between hepatic microsomal enzyme induction and triacylglycerol metabolism was examined in fasting male rabbits (2kg body wt.) injected intra-peritoneally with 50 mg of phenobarbital per kg for 10 days. 2. Occurrence of enzyme induction was established by a significant increase in hepatic aminopyrine N-demethylase activity and cytochrome P-450 content, as well as a doubling of microsomal protein per g of liver and a 54% increase in liver weight. Parallel increments in hepatic gamma-glutamyltransferase (EC 2.3.2.2) activity occurred; these were more pronounced in the whole homogenate than in the microsomes, which only accounted for 12.5% of the total enzyme activity in the controls and 17.0% in the animals given phenobarbital. Increased activity of gamma-glutamyltransferase activity was also observed in the blood serum of the test animals. 3. The rabbits given phenobarbital manifested increased hepatic triacylglycerol content and the triacylglycerol concentration of blood serum was also elevated. These changes were accompanied by a significantly enhanced ability of cell-free fractions of liver from the test animals (postmitochondrial supernatant and microsomal fractions) to synthesize glycerolipids in vitro from sn-[14C] glycerol 3-phosphate and fatty acids, when expressed per whole liver. Relative to the protein content of the fraction, glycerolipid synthesis in vitro was significantly decreased in the microsomes, presumably consequent upon the dramatic increase in their total protein content, whereas no change occurred in the postmitochondrial supernatant, possibly due to the protective effect of cytosolic factors present in this fraction and known to enhance glycerolipid synthesis. 4. Microsomal phosphatidate phosphohydrolase accounted for 85% of the total liver activity of this enzyme and its specific activity was 20-fold higher than that of the cytosolic phosphatidate phosphohydrolase (EC 3.1.3.4), when each was measured under optimal conditions. A significant increase in the activity of both enzymes per whole liver occurred in the rabbits given phenobarbital. A closer correlation between hepatic triacylglycerol content and and microsomal phosphatidate phosphohydrolase, as well as the above observation, suggest that this, rather than the cytosolic enzyme, may be rate-limiting for triacylglycerol synthesis in rabbit liver. 5. Significant correlations were observed between the various factors of hepatic microsomal-enzyme induction (aminopyrine N-demethylase and gamma-glutamyltransferase activity as well as cytochrome P-450 content) and hepatic triacylglycerol content, suggesting that that microsomal enzyme induction may promote hepatic triacylglycerol synthesis and consequently hypertriglyceridaemia in the rabbit.

Absence of preferential glutamine uptake into neurons--an indication of a net transfer of TCA constituents from nerve endings to astrocytes?

Uptake kinetics for glutamine were studied in several different neuronal preparations (perikarya prepared by gradient centrifugation, cultured cortical neurons, cultured, presumably glutamatergic cerebellar neurons, and brain prisms). In no case were any indications found of a high affinity uptake but a rather efficient low affinity uptake did occur. A similar, equally efficient low affinity uptake is, however, found in astrocytes. Thus, no preferential glutamine uptake occurs into neurons. It is, therefore, not likely that a net flow of glutamine takes place from astrocytes to neurons, compensating for the loss of TCA constituents when glutamate and GABA are released.

Immobilization of intra-oral interstitial radioactive-needle implants using an intravenous catheter

A method of immobilizing intra-oral needle implants using an intravenous catheter is described. A loop formed by the catheter immobilizes the tongue and serves as an anchor for the needles. The technique is simple, flexible, and well tolerated.

Concomitant presence of tumor-specific cytotoxic and inhibitor lymphocytes in patients with osteogenic sarcoma

The lack of detectable tumor-specific cytotoxicity by the peripheral blood lymphocytes of patients with cancer may be due to a lack of cytotoxic lymphocytes or the presence of suppressor lymphocytes that inhibit cytotoxic cells. Unfractionated peripheral blood lymphocytes from 12 of 28 patients with osteogenic sarcoma were cytotoxic to osteogenic sarcoma cells in vitro (P less than 0,001). When the peripheral blood lymphocytes from patients whose lymphocytes were not cytotoxic underwent fractionation, a tumor-specific cytotoxic subpopulation was isolated from 11 of 13 patients (P less than 0.0001). Lymphocytes that inhibited cytotoxic activity of autologous tumor-specific cytotoxic lymphocytes were found in four of 10 patients with osteogenic sarcoma but not in six normal controls. Inhibitor lymphocytes form rosettes with sheep erythrocytes and adhere to nylon, whereas cytotoxic lymphocytes have a receptor for C3 but no surface immunoglobulin. The lack of tumor-specific lymphocytotoxicity in some patients can be due to inhibitor lymphocytes.

Detection of a TL(+) murine leukemia cell line that resists the cytotoxic effects of guinea pig complement and specific antiserum

RADA-1 cells [H-2a thy-1b; thymus-leukemia (TL) 1, 2, 3], a radiation-induced murine leukemia cell line maintained by serial transfer in histocompatible recipients, resisted lysis by guinea pig complement (GPC) and TL 1, 3; TL 2; or TL 1, 2, 3 antiserum. The cells expressed TL antigenic specificities as determined by indirect fluorescent antibody methods, the direct isolation of TL antigens from the cells, and the capacity of the cells to reduce known titers of TL antisera. GPC was consumed to the same extent during the reaction of resistant cells and TL antisera as occurred in the reaction of sensitive cells (killed under similar conditions) and TL antisera. RADA-1 cells were not nonspecifically resistant to complement (C)-mediated lysis; they were killed in the presence of H-2a antiserum and GPC. The TL antisera contained antibodies for TL determinants. They stimulated the C-mediated lysis of ASL-1 cells (TL 1, 2, 3) and thymocytes from strain A mice (TL 1, 2, 3). The TL antigens of resistant RADA-1 cells underwent antigenic modulation, the reversible disappearance of TL antigens from the cells stimulated by specific antiserum. After the cells were treated with neuraminidase, they became susceptible to the cytotoxic effects of aliquots of the same TL antisera and GPC used previously.