Sarcomatoid carcinoma of the lung. Immunohistochemical and ultrastructural studies of 14 cases

The authors retrospectively reviewed data regarding 14 patients with sarcomatoid carcinomas of the lung seen and treated at M.D. Anderson Cancer Center from 1955 to 1986. The following were the histologic criteria for inclusion in the study: (1) the concurrent presence of malignant epithelial and sarcomatoid spindle cell components, and (2) positive immunoreactivity for antikeratin antibody or ultrastructural demonstration of epithelial differentiation in sarcomatoid tumors in which the epithelial component was inconspicuous. For the sarcomatoid components, the most frequent pattern was malignant fibrous histiocytoma, which was present in ten tumors. An unclassified sarcomatoid pattern was found in two cases and a fibrosarcomatous pattern in two remaining cases. Clinically, the median patient age was 59 years; 12 patients were male and 2 were female; 13 were smokers and 1 used snuff. Three patients had Stage I, ten had Stage III, and one had Stage IV disease. One patient with Stage I, seven with Stage III, and one with Stage IV disease died of their carcinomas 2 to 26 months after diagnosis (median survival time 12 months). All patients who had lymph node metastases at presentation died of disease. The authors concluded the following: (1) patients with sarcomatoid carcinoma of the lung usually presented at an advanced stage; (2) lymph node metastasis, as with a usual carcinoma of the lung, is an important prognostic factor; and (3) for all lung tumors with a sarcomatoid pattern, especially a malignant fibrous histiocytoma pattern, extensive samples should be obtained and immunoperoxidase or ultrastructural studies done to identify epithelial differentiation.

Immunization strategies for the production of rat monoclonal anti-idiotope antibodies

Anti-idiotypic antibodies are powerful reagents for the study of immunoregulation, and have potential interest as vaccines against tumors and infectious diseases. Three immunization strategies for the production of rat monoclonal anti-idiotope antibodies have been compared in this paper. Male Wistar rats were immunized i.p. and at multiple subcutaneous sites with 750 micrograms of purified monoclonal antibody against Plasmodium falciparum for three times and subsequently boosted by (1) intraperitoneal injection with 750 micrograms of the immunogen, (2) intravenous inoculation with 400 micrograms of the IgG, and (3) intrasplenic immunization with 200 micrograms of the idiotype. With the intraperitoneal boost method, the frequency of hybrids with anti-idiotope activity was 0.3-0.9% with 62.8-85.2% of the seeded wells containing hybrids. In the intravenous boost group, the percentage of hybrids demonstrating anti-idiotope activity increased to 11.0-13.3% with 80.2-97.9% of the hybrid efficiency. When immunized by the intrasplenic boost route, the frequency of anti-idiotope hybrids generated rose to 12.9-16.4% with 82.3-96.6% of the hybrid efficiency. There was no obvious effect of the boost immunizing methods on the generation of rat monoclonal anti-mouse IgG antibodies. These results indicated that the multiple-site immunization followed by intravenous or intrasplenic boost injection was an appropriate immunizing method for the production of monoclonal anti-idiotope antibodies.

The renal excretory activity of atrial natriuretic factor is independent of renal prostaglandins in humans

Since renal prostaglandins may contribute to natriuresis induced by endogenous atrial natriuretic factor (ANF), acute volume expansion (AVL), a known stimulus of ANF and prostaglandins, was induced in 8 healthy women in order to test whether the consequent sodium and water diuresis is altered by prostaglandin inhibition. AVL (i.v. infusion of a 2 liter 5% glucose solution in 1 h) was infused after placebo and after inhibition of prostaglandins with diclofenac (200 mg/day orally for 4 days), in a double blind randomized cross-over fashion. Urinary eicosanoids (PGE2, PGF2 alpha, 6-ketoPGF1 alpha, TXB2--RIA), plasma ANF (RIA) and urinary electrolytes were determined before, during and after AVL under both placebo and diclofenac regimes. During placebo, AVL induced sustained increases in plasma ANF (174% at peak, p less than 0.001 ANOVA), excretion of the four eicosanoids (149%-1172%, p less than 0.005-0.001), urinary volume (UV, 815%, p less than 0.001), natriuresis (UNa, 98%, p less than 0.005) and in kaliuresis (UK, 90%, p less than 0.001). Cyclooxygenase inhibition resulted in a reduction of over 70% in both baseline values and AVL-induced increase of eicosanoids. It did not alter either baseline levels or AVL-stimulated ANF, UV, UNa and UK in relation to placebo. The present results suggest that the diuretic and natriuretic activity of ANF is not mediated by renal PGs in humans.

Fatty acid inheritance in microspore-derived Populations of spring rapeseed (Brassica napus L.)

The inheritance of major fatty acids in seed triglycerides was studied in three homozygous microspore-derived populations of spring rapeseed (Brassica napus L.). Crosses were made among parents with contrasting amounts of erucic, oleic, linoleic and linolenic acids. Microspores from F1 plants were cultured, and haploid plants were colchicine-doubled to provide homozygous populations reflecting F1 gametic arrays for fatty acid genotypes. Segregation ratios of the gametic arrays for specific fatty acid contents were compared to hypothetical models by the Chi-square test. Segregation pattern confirmed that erucic acid levels were controlled by two major loci, each having two alleles with additive effects. Oleic acid segregation indicated control of accumulation by at least two segregating genetic systems, one acting on chain elongation and the other involving desaturation. Accumulations of erucic acid and oleic acid were influenced by the same two loci, which control the chain elongation steps leading from oleic acid to erucic acid. Oleic acid was further influenced by at least two additional segregating loci involved in control of desaturation of oleic acid to form linoleic acid. Segregating alleles at loci involved in desaturation had a much smaller influence on oleic acid content than alleles segregating at loci controlling, the elongation of oleic acid to erucic acid. In a population free of erucic acid, the segregation pattern of linoleic acid levels fit a model involving segregating alleles at two loci. In contrast, segregation for linolenic acid content fits a three-locus additive model. In this study, microspore culture technology provided a rapid method of defining F1 gametic segregation for inheritance analyses.

Repeated sympathetic stimuli elicit the decline and disappearance of prostaglandin modulation and an increase of vascular resistance in humans

To investigate the role of prostaglandins I2 and E2 in modulating the vasoconstrictor response to sympathetic stimulation, repeated and proximate cold pressor tests were performed in 23 healthy young volunteers. Limb vascular resistance (blood flow measured by venous occlusion plethysmography), prostaglandin I2 (as 6-ketoprostaglandin F1 alpha) and prostaglandin E2 plasma levels (detected by radioimmunoassay), and plasma catecholamines (detected by high-performance liquid chromatography and electrochemical detection) were measured. A progressive increase in the duration of the vasoconstrictor response was observed with repetition of cold applications (p less than 0.001, by analysis of variance for trends). This increase was associated with a progressive decrease in cold-induced elevation of 6-ketoprostaglandin F1 alpha and prostaglandin E2 plasma levels until, after five stimulations, neither prostaglandin was detectable. The maximum detected concentration of norepinephrine did not significantly change, but its area under the curve in time showed a trend toward an increase. Epinephrine levels did not significantly change. The increase of vascular resistance was significantly correlated with the decrease of both prostaglandins (r = 0.93, p less than 0.05 for prostaglandin E2 and r = 0.89, p less than 0.05 for 6-ketoprostaglandin F1 alpha), whereas no significant correlations were found between variations of vascular resistance and catecholamines. Prostaglandin blockade induced by diclofenac sodium administration caused, from the first cold application, a pattern of the vasoconstrictor response and plasma prostaglandin and norepinephrine changes similar to that observed at the fifth cold application in untreated subjects, when prostaglandins are no longer detectable in plasma. We conclude that an increased vasoconstrictor response to sympathetic stimulation in humans may result from a diminished inhibitory influence of prostaglandins on adrenergic transmission.

[Change in serum growth hormone in aged men and effect of kidney-warming and yang-restoring drugs]

Basal and sleeping levels of serum growth hormone (GH) were measured in aged men and young men. GH levels after an intravenous bolus of growth hormone releasing hormone (1 microgram/kg) were also determined in healthy aged men with mild Kidney-Yang deficiency. The effect of Chinese herbs with Kidney-warming and Yang-restoring function was observed. The basal GH value in aged men was not significantly different when compared with young men, but the GH value during sleep evidently decreased (P less than 0.05). The response of GH to GRF was obviously decreased as compared with young people. The GH level following GRF stimulation was significantly different from that of young men. The Kidney-warming and Yang-restoring Chinese herbs could alleviate the symptoms of Kidney-Yang deficiency in aged men. The sleep value of GH and response of GH to GRF were increased after taking Chinese herbs. It suggested that the decrease of pituitary reserve might probably be the pathogenesis of Kidney deficiency. Together with the results of another animal experiments, the authors presumed that the Chinese herbs with Kidney-warming and Yang-restoring characteristics might effect through the increase of hypothalamic dopamine and the subsequent improvement of pituitary hormone reserve.

Nuclear 3,5,3'-triiodothyronine receptors (T3R) of circulating human lymphocytes in hyper- and hypothyroidism and nonthyroidal diseases

The clinical implications of nuclear T3R alterations of circulating lymphocytes in hyperthyroidism, hypothyroidism and nonthyroidal diseases were investigated. Nuclear T3R in lymphocytes was determined by radio-ligand binding analysis. The results showed that in hyper- and hypothyroid patients the nuclear affinity (Ka) for T3 was similar to that of normal subjects. In hyperthyroidism nuclear T3 maximal binding capacity (MBC) was unaltered, whereas in hypothyroidism the MBC was significantly increased. In the patients with diabetes mellitus, chronic renal failure and hepatic cirrhosis, the nuclear T3R MBC of lymphocytes was about 1.5-1.6 times of the normal controls. It was concluded that there existed hormonal regulation of nuclear T3R, and up-regulation was seen in hypothyroidism and low T3 syndrome.

Haemodynamic and cerebrovascular responses to glycerol infusion in dogs

1. The response of cerebral blood vessels to hyperosmolar agents in vivo remains controversial, and little is known about the effect of glycerol on cerebral vessels. In this study we investigated the cerebrovascular response to intravenous administration of glycerol (1 g/kg, infused over 25 min) in dogs under pentobarbital anaesthesia. 2. intracranial pressure, systemic arterial pressure, mean arterial blood pressure, serum osmolarity and packed cell volume were continuously monitored, and blood gases were checked frequently. Through a parietal cranial window, pial vessel diameter was measured by means of a surgical microscope and a video image-analyser. 3. Pial vessel diameter increased gradually with a maximum at 30 min after the beginning of glycerol infusion. The maximum increase in diameter in small (less than or equal to 100 microns) vessels was 14.3%, whereas that in large (greater than 100 microns) vessels was 10.3%. There was only a slight increase (less than 4%) in pial vessel diameter in vehicle-infused animals. The intracranial pressure decreased drastically after glycerol infusion, whereas the mean arterial blood pressure remained constant. There were correlations between the rise in serum osmolarity, fall in packed cell volume and vasodilatation, indicating that glycerol caused vasodilatation accompanied by plasma volume expansion. 4. Our data suggest that glycerol produces cerebral vasodilatation, which might be beneficial in cerebral ischaemia and vasospasm, in addition to its intracranial pressure-reducing effect on normal or oedematous brain. The degree of vasodilatation was not sufficient to affect the predominant intracranial pressure drop resulting from cerebral dehydration.

The antihypertensive and renal activities of potassium canrenoate are associated with increased renal prostaglandin excretion

1. In a double-blind, randomized, cross-over study the effects of potassium canrenoate administration (100 mg twice daily for 10 days orally) on renal prostaglandin synthesis (prostaglandin E2 and prostaglandin F2 alpha) were evaluated in 10 normotensive females and in 10 females with essential hypertension. 2. When compared with normotensive subjects, hypertensive patients in baseline conditions showed a reduced excretion of urinary prostaglandin E2 associated with an excessive prostaglandin F2 alpha production. 3. Potassium canrenoate significantly reduced mean blood pressure in hypertensive patients [from 118.9 +/- 8.7 mmHg (1.62 +/- 0.12 kPa) to a peak minimum value of 104.7 +/- 9.8 mmHg (1.42 +/- 0.13 kPa) on the seventh day of treatment; P less than 0.01 for the whole period] but not in control subjects [from 88 +/- 9.4 mmHg (1.20 +/- 0.13 kPa) to 84.3 +/- 8.3 mmHg (1.15 +/- 0.11 kPa) on the eighth day, NS] even though potassium canrenoate significantly increased sodium excretion in both groups. Renal prostaglandin excretion was affected differently in the two groups: in control subjects excretion of both prostaglandin E2 and prostaglandin F2 alpha was increased after drug administration, whereas in hypertensive patients only prostaglandin E2 excretion was enhanced.

[Changes of the sex hormones in female type II diabetics, coronary heart disease, essential hypertension and its relations with kidney deficiency, cardiovascular complications and efficacy of traditional Chinese medicine or qigong treatment]

In this study 31 normal child-bearing women, 62 postmenopausal women, 93 cases of female type II diabetes (18 child-bearing and 75 postmenopausal cases), 53 cases of coronary heart disease (11 child-bearing and 42 postmenopausal cases) and 38 cases of essential hypertension (8 child-bearing and 30 postmenopausal cases) were investigated. The average score of Kidney deficiency was 22.9-8. 5 before treatment with the combination of TCM and WM. With the treatment of TCM in diabetes and coronary heart disease and of Qigong in essential hypertension, the score decreased to 11.5-4. 4 (P less than 0.001). Serum/saliva estradiol (E2), the ratio of E2 to testosterone (T, E2/T) and progesterone (P) decreased before treatment of TCM or Qigong. After treatment E2 and P value increased; the ovarian endocrine function was improved; the special symptoms of the diseases relieved, fasting blood glucose levels in diabetics, the frequency and severity of angina pectoris in coronary heart disease and the blood pressure in essential hypertension significantly decreased respectively (P less than 0.01). The study suggested that there are certain relations between ovarian endocrine disfunction and Kidney deficiency. The more severe the "Kidney deficiency" was, the more significant the changes of sex hormone were.

Spontaneous dissection of the vertebral artery: MR findings

Spontaneous (nontraumatic) dissection of the carotid and vertebral arteries, once thought to be rare, is being recognized and reported more frequently. We report one case of spontaneous dissection of the vertebral artery initially diagnosed by magnetic resonance imaging and subsequently confirmed by angiography.

[On the types and distribution of crystals in medical plants]

Crystals in medical plants are classified into organic and inorganic according to their chemical components. This paper gives an account of the types, chemical compositions, appearances structures and existing ways in plant tissue and distribution patterns in plant kingdom of various kinds of crystals.

[Influence of yang-restoring herb medicines upon metabolism of thyroid hormone in normal rats and a drug administration schedule]

Large dose of Yang-restoring herb medicines. (Radix Codonopsis Pilosulae, Astragalus membranaceus, Radix Aconiti Praeparata, Epimedium brevicornum, Cortex Cinnamomi and Herba Cistanchis) may exert an unfavorable effect on normal rats, i. e. natural weight gain reduced (P less than 0.01), serum T3 decreased (P less than 0.05), rT3, TRH levels raised (P less than 0.01) and TSH showed a raising tendency. Lower T3 and higher rT3 levels may be the effects of Yang-restoring herb medicines on the peripheral metabolism of thyroid hormones, i. e. more thyroxine was degraded to rT3 with little biological effect and less was transformed to T3 with strong hormonal effect. This unfavorable effect, however, can be avoided by Forward-Backward method. It was advised that large dose of Yang-restoring herb medicines could not be given to the organisms without symptoms of Yang-deficiency. If it were tried to do so, Forward-Backward method might be recommended.

Epidemiologic study of workers exposed to titanium dioxide

The objective of this study was to determine whether workers exposed to titanium dioxide (TiO2) had significantly higher risks of lung cancer, chronic respiratory disease, pleural thickening/plaques, or pulmonary fibrosis than referent groups. A total of 1,576 employees exposed to TiO2 were observed from 1956 through 1985 for cancer and chronic respiratory disease incidence, and from 1935 through 1983 for mortality. A cross-sectional sample of 398 employees was evaluated for chest roentgenogram abnormalities. Cohort analyses suggested that the risks of developing lung cancer and other fatal respiratory diseases were no higher for TiO2-exposed employees than for the referent groups. Nested case-control analyses found no statistically significant associations between TiO2 exposure and risk of lung cancer, chronic respiratory disease, and chest roentgenogram abnormalities. No cases of pulmonary fibrosis were observed among TiO2-exposed employees.

Cancer incidence of workers exposed to dimethylformamide and/or acrylonitrile

This study was to determine whether exposure to dimethylformamide (DMF) and acrylonitrile (ACN) separately or in combination, was associated with increased cancer incidence. Workers exposed to DMF and/or ACN were observed from 1956 through 1984 for cancer incidence. The workers exposed to DMF but not ACN showed significant excesses in incidence for buccal cavity and pharynx cancer and malignant melanoma. A significant excess of prostate cancer incidence was observed among workers exposed to DMF and ACN. No dose-response relationships were observed between DMF or ACN exposure and cancer incidence. The significant excesses in cancer incidence among employees exposed to DMF and/or ACN could be due to statistical chance or other factors, such as tobacco and alcohol consumption. Further studies are warranted.

Mortality study of workers exposed to dimethylformamide and/or acrylonitrile

Workers exposed to dimethylformamide (DMF) and/or acrylonitrile (ACN) were observed from 1950 through 1982 for mortality. The wage-roll workers exposed to DMF showed significant excess in total deaths attributable mainly to ischemic heart disease and external causes when compared with rates from E. I. Du Pont de Nemours & Co. However, there were no significant excesses in mortality when expected numbers were based on US or local statistics. No dose-response relationships were observed between DMF or ACN exposure and mortality. The significant excesses in mortality among employees exposed to DMF and/or ACN could be due to statistical chance or life-style factors

Cytotoxic, fungicidal nucleosides from blue green algae belonging to the Scytonemataceae

Tubercidin, toyocamycin, and the corresponding 5'-alpha-D-glucopyranose derivatives of the nucleosides are frequently responsible for much of the cytotoxicity and antimycotic activity associated with extracts of cultured cyanophytes belonging to the family Scytonemataceae. The 5'-alpha-D-glucopyranoses of tubercidin and toyocamycin, for example, are the major cytotoxic and fungicidal nucleosides in Fijian Plectonema radiosum and Hawaiian Tolypothrix tenuis, respectively.

Measurement of basilar artery diameter in dogs: CT evaluation correlated with arteriography

In this study we have used a computed tomographic (CT) method using profile analysis to measure the diameter of the basilar artery. In a search for a noninvasive and repeatable method to substitute for the traditional arteriography in the evaluation of the degree of cerebral vasospasm, we employed both CT and arteriography to measure the diameter of the basilar artery in eight adult mongrel dogs weighing between 7 and 12 kg. In three of these animals, assessments were made before and after subarachnoid hemorrhage (SAH) induced by injecting autologous arterial blood into the cistern magna. It was found that the basilar artery diameter as evaluated by CT was 47% larger than that measured by arteriography. However, there was a very good correlation (n = 63, r = 0.75, p less than 0.001) between the two methods. This paper presents a new model for the measurement of the basilar artery diameter, one which may also provide a safer method for the evaluation of vasospasm in humans.

Computed tomography and pathologic correlations of thymic lesions

Computed tomographic and pathologic correlations of the thymus gland were assessed in 69 patients. The sensitivity of computed tomography (CT) for undifferentiated thymic pathology is 87.1%; the specificity is 85.7%. The sensitivity of CT for neoplasm or mass is 97.1%, the specificity is 97.1%. The sensitivity of CT for lymphoid follicular hyperplasia (LFH) is 71.4%, the specificity is 97.6%. Therefore, a normal-sized thymus gland on CT does not exclude LFH. Completely preserved fat planes between thymic mass and adjacent structures on CT usually indicate a benign (noninvasive) neoplasm; completely absent fat planes usually indicate a malignant (invasive) neoplasm; partially preserved fat planes are indeterminate in assessing invasiveness. CT is also useful in showing recurrence or remnants of thymic tissue in patients who have had a previous thymectomy.