Clinicopathologic study of adenosquamous carcinoma of the uterine cervix

The 22 adenosquamous carcinoma cases were studied clinicopathologically. The tumor provides many difficulties such as: rapid spreading properties, delayed detection as advanced carcinoma because of the presence of endophytic growth, frequent prevalence of vessel permeation, and radioresistance. Adenosquamous carcinoma was categorized histochemically and histomorphologically into two types--adenosquamous carcinoma (AC) and mucoepidermoid carcinoma, with a comparison being given. As a result, adenosquamous carcinoma (AC) was found inferior to mucoepidermoid carcinoma in radiosensitivity and prognosis, so that categorization into the two types has been considered to be clinically meaningful.

[High risk factors in the spread of cervix carcinoma]

The author studied clinicopathological parameters in patients with uterine cervical carcinoma in order to find the useful factors which would enable pretreatment estimation of the cancer spread. The following results were obtained. Histologically characteristic features of the primary lesions in the majority of the patients with Virchow's node metastases were lobular type according to the classification used in our department, L form in CPL classification, slight stromal reaction, large cancer nest, and loose connectivity between the cancer nest and stroma. In addition, they had a high incidence of clinical signs and data such as febrile condition, and increased ESR and CRP value. The percentage of comedo type gradually increased as the cancer spread (23.4%) in primary lesions, 40.5% in pelvic lymph nodes, 73.3% in Virchow's nodes). In the operated cases (stages Ib, IIa and IIb) with pelvic lymph node metastases, histological factors such as comedo type, L form, and loose connectivity, and at least one of the clinical characteristics were found more frequently than in cases without the metastases. In the irradiated cases (stages Ib, IIa and IIb) that died within 5 years, factors such as lobular type, loose connectivity and more than one clinical characteristics were seen more frequently than in cases that survived for more than 5 years. By giving appropriate points to items in the 3 most important histological factors (type, CPL classification and connectivity), grading of each group of cases was made; the high risk groups in both operated and irradiated cases scored significantly higher than the respective control groups. These suggests that some of the above parameters may be useful in evaluating the spread of carcinoma of the cervix.

[Significance of serum immunosuppressive substance (IS) levels in the field of gyneco-obstetrics]

To investigate the immune responses of patients with cancer, we assayed a newly found immunosuppressive substance (IS) by the single radial immunodiffusion method. This substance is extracted from ascites of colon cancer. The IS average level in 46 healthy women was 555.4 +/- 112.1 micrograms/ml. The normal upper limit should be 800 micrograms/ml. Seventy cases with uterine cervical cancer had a significantly higher IS level (667.0 +/- 189.8 micrograms/ml) than healthy women (t=3.57, p less than 0.001), especially in Stages III & IV. All 28 patients except one with recurrent cancer showed an IS level higher than 800 micrograms/ml. (1431.7 +/- 480. 9 micrograms/ml). Before recurrence was found clinically, the IS level became higher. In ovarian tumors, assay of the IS level yielded an interesting result: In 16 cases with benign tumors the level was 568.8 +/- 109.7 micrograms/ml. On the other hand, nine patients with ovarian cancer had levels over 800 micrograms/ml. These data suggest that the assay of IS substance may be useful for the staging of uterine cervical cancer, early detection of the recurrence, differentiation between benign and malignant ovarian tumors and so on.

Determination of molecular weight of membrane proteins by the use of low-angle laser light scattering combined with high-performance gel chromatography in the presence of a non-ionic surfactant

An assessment study was carried out to evaluate the performance of the low-angle laser light scattering technique combined with high-performance gel chromatography in the presence of a nonionic surfactant, octaethyleneglycol n-dodecyl ether, precision differential refractometry and ultraviolet photometry. It was found that the combined technique is highly promising as a method for the determination of the molecular weight of a membrane protein solubilized by the surfactant. For trial, molecular weights of the following membrane proteins of Escherichia coli, both solubilized in oligomeric forms, were measured; porin that forms the transmembrane diffusion pore in the outer membrane, and lambda-receptor protein that facilitates the diffusion of maltose-maltodextrins across the outer membrane. The result obtained indicates that both porin and lambda-receptor protein exist as trimers in the surfactant solution.

Study on the histogenesis of ovarian tumors--with special reference to five clinical cases with common epithelial tumors detected during the preclinical stage

Common epithelial tumors of the ovary, which were found during the preclinical stage in the 5 cases were described, and the histogenesis of ovarian tumors was discussed. 1. All the ovaries in the 5 cases maintained a nearly normal external appearance. As regards the cut surface, 3 cases showed gross-observable tumor mass, and 2 cases had microscopically detectable tumor tissues. All of these tumors were solid, and the cyst formation was not evident to the macroscopical examination. 2. Three cases were serous tumors, and the other 2 cases were of the endometrioid type. Two cases were malignant, and 3 cases were LPM. In two of the cases, the pictures which appeared to correspond to the early stage picture of the unclassified tumor were observed. 3. Non-tumoral inclusion cysts were observed in 4 cases, and the majority of them showed some growth activities. In 2 cases out of these 4, the transient pictures from the active inclusion cyst to the tumor were observed. 4. Tumorgenesis was multicentric based on inclusion cysts, and the tumor proliferated with spreading inside the lymph space in the ovary. The formation of the small cyst and the proliferation in a papillary form were the basic pattern of the tumor.

A study on prognostic factors of uterine cervical cancer

Prognostic factors of cancer of the cervix were studied in 286 cases treated by radiotherapy. The four items stated below relating to morphological characteristics and found to be comparatively easy to determine clinically were selected as prognostic factors. The factors are (1) clinical stage, (2) morphology of the uterine cervix, (3) histological type of cancer and (4) radiosensitivity. Each prognostic factor and prognosis indicated in every case by chi-square test (chi 2 test) a risk rate lower than 0.1%, a significant difference. Furthermore, every prognostic factor was given points according to their grade, and the total points were expressed as a prognostic index. The prognostic index was classified into the mold zone (from 1 to 8 points), the moderate zone (from 9 to 10 points), and the severe zone (from 11 to 18 points), and the five year survival rate of each zone was observed to be 91.5%, 56.1% and 18.9% respectively. Thus, at a risk of less than 0.1%, a significant difference was observed. By setting up the prognostic index, it was possible to estimate the prognosis of every case of cervical carcinoma, which to date had been nearly impossible to estimate by each prognostic factor alone.

A clinicopathological study on glassy cell carcinoma of the cervix

From the present investigation, it was verified that glassy cell carcinoma is a clinicopathologically independent tumor. As a result, the following conclusions are drawn: 1. The frequency of glassy cell carcinoma is 1.3% of all cervical carcinomas. 2. The prognosis of this type of tumor is poor. Death occurred in 13 of 14 cases studied. The survival period was an average of 16.1 months. 3. The following factors contribute to poor prognosis of this type of tumor: rapid growth, readiness for distant metastasis, and resistance to irradiation. 4. Histologically, undifferentiated tumor cells with distinct nucleoli, including many mitotic figures, form a mantle-like layer around small blood vessels. Cells characterized by the presence of cytoplasm with a ground-glass appearance are found outside this layer. 5. The authors have proposed a form of carcinoma possessing the characteristics of both squamous cell carcinoma and adenocarcinoma, and called it an intermediate group. Glassy cell carcinoma seems to be classified into a subtype of this group. Some other subtypes closely related to this carcinoma were noticed. 6. Tumors to be distinguished from glassy cell carcinoma, large cell, non-keratinizing squamous cell carcinoma and lobular type carcinoma were pointed out in this report.

A histological study on immune reaction of advanced uterine cervical carcinoma with regard to the effect of a low-dose irradiation and PS-K

Histopathological studies were carried out to determine whether or not an immunological reaction was involved in the treatment of cervical carcinoma. The following conclusions could be drawn from them. (1) A low-dose irradiation on the primary cancer-nest intensified the interstitial reaction. (2) When PS-K was administered after low-dose irradiation, the interstitial reaction was intensified more remarkably than with irradiation alone. Moreover, it was possible for PS-K administration to restore the responsiveness of lymph nodes which had been inhibited by the irradiation. (3) Some of the observed morphological changes suggested the local occurrence of an immunological reaction. The following findings could be pointed out: (a) In the primary lesion of the uterine cervix, exudative cells consisting mainly of lymphocytes, plasma cells, and macrophages formed a barrier-like layer surrounding the cancer-nest. Granuloma accompanied by foreign-body type giant cells were formed in the interstitial tissue. Moreover, lymphoid tissues with a germinal center were formed. (b) In lymph nodes of the region involved, responsiveness was enhanced in the paracortical area, or a germinal center formed with its responsiveness enhanced. (4) There was a correlation between the degree of interstitial reaction of the primary lesion and the survival results of a follow-up survey. There was also a correlation between the degree of enlargement of lymph nodes and the survival results of this survey.

The role of gastric glucagon immunoreactivity in pancreatectomized dogs

Immunoreactive glucagon (IRG) or glucagon immunoreactivity is known to be increased in the plasma of insulin-deprived pancreatectomized dogs, most of it originating in the stomach. We attempted to clarify the extent to which gastric IRG is involved in glycogenolysis in the liver of insulin-deprived, pancreatectomized dogs. Mongrel dogs underwent total pancreatectomy. IRG levels in portal vein blood increased to 760 +/- 186 pg/ml on the 4th postoperative day while the insulin levels were negligible. On the 4th postoperative day some of the dogs underwent total gastrectomy. IRG levels in the portal vein blood of pancreatectomized dogs decreased from 760 +/- 186 pg/ml to 135 +/- 44 pg/ml one hour after gastrectomy. Glucose containing insulin was then infused into both pancreatectomized and pancreatectomized-gastrectomized grups of dogs. Glycogen synthesis in the liver during glucose and insulin infusion was much the same in both groups. However, glycogen degradation after glucose and insulin infusion was completely suppressed in pancreatectomized dogs without a stomach while pancreatectomized dogs alone showed marked glycogenolysis in the liver. No difference in portal IRI and blood sugar level was found in both groups while a marked difference in portal IRG were observed. These findings indicate that the IRG released from the stomach plays a significant role i glycogen metabolism in pancreatectomized dogs.

Determination of ion permeability through the channels made of porins from the outer membrane of Salmonella typhimurium in lipid bilayer membranes

The three types of porin (matrix-proteins) from Salmonella typhimurium with molecular weights of 38,000, 39,000 and 40,000 were reconstituted with lipid bilayer membranes either as a trimer or as an oligomer (complex I). The specific conductance of the membranes increased several orders of magnitude after the addition of the porins into the aqueous phase bathing the membranes. A linear relationship between protein concentration in the aqueous phase and membrane conductance was found. In the case of lower protein concentrations (10)(-12)M), the conductance increased in a stepwise fashion with a single conductance increment of 2.3 nS in 1 M KC1. For a given salt the conductance increment was found to be largely independent of the particular porin (38 K, 39 K or 40 K) and on the state of aggregation, although porin oligomers showed an up to 10 times smaller conductance increase in macroscopic conductance measurements. The conductance pathway has an ohmic current voltage characteristic and a poor selectivity for different alkali ions. Further information on the structure of the pores formed by the different porins from Salmonella was obtained from the selectivity for various ions. From the permeability of the pore for large ions (Tris+, glucosamine+, Hepes-) a minimum pore diameter of 0.8 nm is estimated. This value is in agreement with the size of the pore as calculated from the conductance data for 1 M KC1 (1.4 nm for a pore length of 7.5 nm). The pore diameter may well account for the sugar permeability which has been found in reconstituted vesicles. The findings reported here are consistent with the assumption that the different porins form large aqueous channels in the lipid bilayer membranes and that the single conductance unit is a trimer. In addition, it is suggested that one trimer contains only one pore rather than a bundle of pores.

Permeability properties of Escherichia coli outer membrane containing, pore-forming proteins: comparison between lambda receptor protein and porin for saccharide permeation

Outer membrane permeability conferred by lambda receptor protein and porins to maltose-maltodextrins and other oligosaccharides was studied in vitro with reconstituted vesicle membranes and in vivo with mutant strains lacking either one of these proteins. The vesicle membranes reconstituted from phospholipids, lipopolysaccharide, and purified lambda receptor allowed rapid diffusion of maltose and maltose-maltodextrins of up to six glucose residues, but the membranes acted essentially as a molecular sieve for sucrose, raffinose, stachyose, and inulins of molecular weights 800, 920, and 1,380. The vesicle membranes containing porins allowed rapid diffusion of maltose but not of maltose-maltodextrins larger than maltose. The apparent transport Km values for maltose-maltodextrins of up to six glucose residues from the strain carrying lamB+ ompB (lambda receptor+, porin-) were similar (about 5 X 10(-6) M), whereas the transport Km values for maltose- and maltotriose of the strain carrying lamB ompB+ (lambda receptor-, porin+) alleles appeared to be 300 and about 20,000 X 10(-6) M. These results suggest that lambda receptor protein forms permeability pores that facilitate the diffusion of maltose-maltodextrins and function as a molecular sieve for other saccharides.

The physicochemical nature and biological function of extrapancreatic immunoreactive glucagon

The physicochemical nature and biological function of extrapancreatic immunoreactive glucagon in the plasma of totally pancreatectomized dogs were studied. The experimental animals were divided into two groups. Group A received only total pancreatectomy while group B had total pancreatectomy plus total gastrectomy. The blood was taken from both groups of dogs and glucagon was extracted using acid alcohol. The amount of IRG contained in the plasma extract was measured and the glycogenolytic activity of the plasma extract was studied using a rat-liver perfusion. The plasma extract from group A showed almost the same glycogenolytic activity as a commercial beef-pork glucagon but the plasma extract from group B manifested no glycogenolytic activity. The plasma from both groups were fractionated using column chromatography and their physicochemical nature was compared. The IRG in the plasma from group A was fractionated into 3 types, molecular weight 9000, 7000 and 3500, while the IRG in the plasma from group B was found to be of M.W. 9000 and 7000. These results lead to the following conclusions: 1) Extrapancreatic IRG in the plasma is fractionated into three types. 2) The glycogenolytic activity of extrapancreatic IRG is assumed to depend on the IRG fraction of molecular weight 3500. 3) Most of the extrapancreatic IRG fraction of M.W. 3500 originates in the stomach.

Subunit constituent of the porin trimers that form the permeability channels in the outer membrane of Salmonella typhimurium

The polypeptide composition of the functional porin trimers that produced the permeability channels in the outer membrane of Salmonella typhimurium was examined on two-dimensional slab gels. The results suggested that the majority of porin trimers from strains producing mixed species of porin polypeptides consisted of homologous subunit polypeptides. The present results do not exclude the possibility that a small fraction of porin trimer is constructed from heterologous subunit polypeptides.