[Case of primary double lung cancer in the same lobe]

In a 70-year-old male complaining chiefly of cough and expectoration, an abnormal shadow was detected in the left upper lobe by chest X-ray. Therefore, he was admitted for further examination. A tumorous shadow, 5 X 4.5 X 2.5 cm was noted; it corresponded to S1 + 2b on the left side. Left upper lobectomy was performed. Histologic findings of the excised lung were giant cell cancer in the tumorous part, and squamous epithelial cancer at the cut end of the bronchus, i.e. the cut end of the left upper bronchi. This is a rare case with primary double cancer in the same lobe.

The proposed Japanese TNM classification of primary liver carcinoma in infants and children

The TNM classifications of neuroblastoma, nephroblastoma and soft tissue sarcoma were adopted at the International Conference for TNM Classification (UICC) held in May 1980. There is no TNM system under contemplation, however, for primary liver carcinoma in childhood. Accordingly, we have formulated the proposed Japanese TNM system for this carcinoma in children and examined its validity in 136 cases of hepatoblastoma seen in the listed 14 institutions. The basic policy of the Committee on the Japanese TNM Classification is not to include the resectability of the tumor and regional lymph nodes or any other status of the disease resulting from therapeutic intervention as a component of the pTNM system. This is a feature which makes our proposed system widely divergent from the accepted classification scheme for the three types of tumor cited above.

[Combination chemotherapy with neocarzinostatin (NCS) and other antitumor agents for advanced carcinoma of the digestive organs--improved clinical effect with NFO therapy]

We have previously reported the clinical effect of NF therapy (NCS 5,000 units and 5-FU 500 mg intravenously; twice a week) on patients with advanced carcinoma of the digestive system. In the present study, NFO therapy (NCS 2,000 units and 5-FU 500 mg intravenously, Picibanil 1-2K. E. intramuscularly; twice a week) was applied for those patients to take advantage over NF modality. Treated were 62 patients with NFO and 48 were evaluated for its clinical effects. In comparison of NFO and NF, the antitumor effects were noted in 9 of 48 patients (18.8%) for NFO, and 2 of 27 (7.4%) for NF therapy judged by Koyama & Saito's criterion. If the Karnofsky's criterion was applied, I-A category or more were obtained in 10 of 48 patients (20.8%) for NFO and in 2 of 27 (7.4%) for NF therapy. In particular, NFO therapy resulted in the advantageous clinical effects on patients with hepatic and pancreatic carcinomas irrespective of primary or metastatic. The adverse effects of NFO were not more frequent than those of NF therapy. From these results, a new combination regimen, NFO, is thought to bring about a considerable benefit in the treatment of advanced carcinoma of the digestive organs.

Free amino acid content of lymphocytes nd granulocytes compared

For extracting free amino acids from human leukocytes, we find that disruption of the cells by ultrasonication is more reliable than freezing and thawing. The amount of free amino acids extracted by the latter method depends on the temperature and duration of thawing. We extracted free amino acids from leukocytes of healthy men by ultrasonication and compared their concentrations in lymphocytes and granulocytes. The amino acid content of granulocytes significantly (p less than 0.001) exceeded that of lymphocytes. Of the amino acids extracted from granulocytes, 76% was taurine; for lymphocytes taurine, aspartic acid, and glutamic acid were predominant, respectively composing 44%, 17%, and 26% of the total. Taurine is proposed as an index of cell disruption.

Free amino acid content of lymphocytes nd granulocytes compared

For extracting free amino acids from human leukocytes, we find that disruption of the cells by ultrasonication is more reliable than freezing and thawing. The amount of free amino acids extracted by the latter method depends on the temperature and duration of thawing. We extracted free amino acids from leukocytes of healthy men by ultrasonication and compared their concentrations in lymphocytes and granulocytes. The amino acid content of granulocytes significantly (p less than 0.001) exceeded that of lymphocytes. Of the amino acids extracted from granulocytes, 76% was taurine; for lymphocytes taurine, aspartic acid, and glutamic acid were predominant, respectively composing 44%, 17%, and 26% of the total. Taurine is proposed as an index of cell disruption.

Simultaneous recording of early and middle components of auditory electric response

The auditory brain stem response (ABR) and the auditory middle response (AMR) were simultaneously recorded in 19 normal adults and 29 patients with hearing loss. The test was performed using tone pips at 0.5, 1, 2, and 4 kHz with intensity levels of 0, 10, 20, and 30 dB above the individual's behavioral threshold. A wide pass-band of 0.5 Hz to 3 kHz was used for recording the response. The typical waveform of the response provided six peaks that were successively labeled as P10, N15, P20, N25, P35, and N45. P10 was a large positive deflection in the ABR. N15-P20-N25, P35, and N45 corresponded to the Na peak complex, Pa, and Nb of the AMR, respectively. Of all components recorded, P10 was detected most consistently. However, because N25 and P35 of the AMR also gave important information for the assessment of hearing, simultaneous recording of the ABR and AMR is considered a useful clinical technique for estimating hearing in normal as well as in hearing-impaired subjects.

Total parenteral nutrition in low-birth-weight neonates with complicated surgical disorders; effects and difficulties

Twenty low-birth-weight, surgical neonates were given total parenteral nutrition (TPN). They were divided into two groups according to birth-weights. Group A consisted of 8 patients weighing less than 2,000 gm, and group B consisted of 12 patients weight between 2,000 and 2,500 gm. The infusate of TPN consisted of 15% glucose and 3% amino acids solution, and 10% fat emulsion. The dosage administered was usually 120 ml/kg/day in the amino acid glucose solution and 15 ml/kg/day in the fat emulsion, but varied depending on the clinical condition of the patients. The duration of parenteral nutrition was from 3 to 76 days with an average of 34.3 days. Four patients in group A survived. Three of the four who died had already been in severe septicemia due to the original disease before the initiation of parenteral nutrition. Ten in group B survived. The intake of 500 mg/kg/day of nitrogen as crystalline amino acids and calories of more than 80 Cal./dg/day produced a gain of body weight and a positive nitrogen balance. However, the weight gain in the patients in group A lagged behind. Furthermore, severe hepatic dysfunction was induced in four in group A. We conclude that TPN will improve the general condition, weight gain and positive nitrogen balance, even in low-birth-weight neonates with complicated surgical disorders.

Regulation of expression of a family of cross-reactive idiotypes

It has recently been shown that anti-p-azophenylarsonate antibodies of A/J mice, which share a common idiotype, are not homogeneous but actually comprise a family of idiotypically related molecules. To obtain additional insight into the degree of relatedness of antibodies within this family, we have determined whether inoculation of any idiotype-positive hybridoma product, conjugated to thymocytes, can activate a regulatory mechanism capable of controlling the entire cross-reactive idiotypic response. In addition anti-idiotypic antibodies were prepared against individual hybridoma products, and their suppressive effects on the idiotypic component of the humoral response were determined. Inoculation of each of the idiotype-positive hybridoma products or anti-idiotypic antisera caused virtually complete suppression of the idiotypic component of the immune response. Furthermore, it was shown that the state of suppression induced by the inoculation of a hybridoma products could be adoptively transferred with T cells to mildly irradiated syngeneic recipients. The results indicate that there are sufficient structural similarities among the family of antibodies comprising the major cross-reactive idiotype to permit their recognition by the same set of elements involved in idiotypic regulation.

Regulation of expression of a family of cross-reactive idiotypes

It has recently been shown that anti-p-azophenylarsonate antibodies of A/J mice, which share a common idiotype, are not homogeneous but actually comprise a family of idiotypically related molecules. To obtain additional insight into the degree of relatedness of antibodies within this family, we have determined whether inoculation of any idiotype-positive hybridoma product, conjugated to thymocytes, can activate a regulatory mechanism capable of controlling the entire cross-reactive idiotypic response. In addition anti-idiotypic antibodies were prepared against individual hybridoma products, and their suppressive effects on the idiotypic component of the humoral response were determined. Inoculation of each of the idiotype-positive hybridoma products or anti-idiotypic antisera caused virtually complete suppression of the idiotypic component of the immune response. Furthermore, it was shown that the state of suppression induced by the inoculation of a hybridoma products could be adoptively transferred with T cells to mildly irradiated syngeneic recipients. The results indicate that there are sufficient structural similarities among the family of antibodies comprising the major cross-reactive idiotype to permit their recognition by the same set of elements involved in idiotypic regulation.

Studies on peptides. XCVIII. Synthesis of a wasp venom, Polistes mastoparan

The tetradecapeptide amide corresponding to the entire amino acid sequence of a wasp venom (polistes mastoparan), isolated from Polistes jadwagae, was synthesized using the trifluoroacetic acid-thioanisole deprotecting procedure.

An enteral elemental diet for infants and children with surgical disorders

Sixty-nine infants and children with surgical disorders were fed an enteral elemental diet consisting of synthetic L-amino acids, dextroglucose, soybean oil, electrolytes and vitamins. Satisfactory clinical results were achieved in 55 patients, whose average positive nitrogen balance was approximately 578 mg/day in neonates, 1,518 mg/day in infants and 2,452 mg/day in children; average weight gain was approximately 16 g/day in neonates, 23 g/day in infants, and 21 g/day in children during total enteral nutrition with the diet. Elevation of serum transaminase values was noted in 5 patients receiving total enteral nutrition with the diet. Liver toxicity may have been caused by the composition of amino acids of the diet, solely free amino acids as protein component. However, the diet provided a valuable therapeutic alternative to total parenteral nutrition in selected infants and children requiring surgery.

[Experimental studies on administration method of chemotherapeutic agents. 16. Effect of polymyxin B against Pseudomonas aeruginosa (author's transl)]

The most effective administration method of polymyxin B (PL-B), a peptide antibiotic, has been studied in the experimental mice infection with Pseudomonas aeruginosa. 1) Pseudomonas aeruginosa damaged by PL-B, when the drug was free, immediately began to regrow in vitro. 2) the therapeutic efficacy of PL-B on multiple administration was less effective than its single administration. 3) An important factor to decide the therapeutic efficacy of PL-B was the high drug concentration in plasma and peritoneal fluid.

Selective suppression of the major idiotypic component of an antihapten response by soluble T cell-derived factors with idiotypic or anti-idiotypic receptors

Evidence is presented for the selective suppression of the major idiotypic component of the humoral response to the phenylarsonate hapten by soluble factors derived from T cells (TsF). The existence of TsF with anti-idiotypic receptors was also demonstrated. It was found that TsF with idiotypic and anti-idiotypic receptors coexist in cultures of spleen cells prepared from idiotypically suppressed, hyperimmunized mice. By gel filtration the molecular weight of each factor was found to be 50,000-100,000. Each is sensitive to trypsin and is bound to a column containing anti-H-2a antibodies. Evidence is discussed which suggests the possibility of mutual stimulation of suppressor T cells with idiotypic and anti-idiotypic receptors.

Alteration in phospholipid composition of Staphylococcus aureus during formation of autoplast

The phospholipid composition of autoplasts (protoplasts made by autolysis of Staphylococcus aureus 209P was examined. The autoplasts were prepared by incubation of 209P cells in 1.2 M sucrose--0.33 M acetate buffer (pH 5.8). Cardiolipin comprised nearly half the total phospholipid in these autoplasts. Autoplasts had a lower phosphatidylglycerol content than intact cells but similar lysylphosphatidylglycerol content. The increase in cardiolipin content during release of autoplasts was not affected by pH or temperature. The result indicates that removal of the cell wall caused the increase in cardiolipin content. The total amount of phospholipids increased slightly during autoplast formation, but there was no significant increase in fatty acids or diglycerides. The changes of phospholipid composition during formation of the autoplast was due to de novo synthesis of cardiolipin from phosphatidylglycerol.

Serum ferritin concentration and isoferrtin patterns detected by immunoradiometric assay

Two-site immunoradiometric assay for serum ferritin was developed by anti-human liver ferritin antiserum applied on polyvinyl V-bottom microtiter plates. The coefficient of variation was 4.4-5.9% of liver ferritin dissolved in 1/4 diluted human serum at a concentration of 0.625-125 ng/ml. The lowest concentration (0.625 ng/ml) was statistically distinguishable from the background by Student's t test (p < 0.05). Isoferritin patterns of serum ferritin and tissue ferritins were examined by the combination of gel isoelectric focussing and 2-site immunoradiometric assay in order to explore any similarities in pIs within these ferritins. Although serum ferritin had wide range of pIs, its basic isomers corresponded well to those of liver and spleen ferritin. Geometric means and their 95% confidence limits in serum ferritin concentration were 70 ng/ml and 12-411 ng/ml, respectively, in sera of 205 healthy males (16-25 years), and 12 ng/ml and 1-211 ng/ml, respectively, in 421 healthy females (16-59 years).

A template matching model for pattern recognition: self-organization of templates and template matching by a disinhibitory neural network

A template matching model for pattern recognition is proposed. By following a previously-proposed algorithm for synpatic modification (Hirai, 1980), the template of a stimulus pattern is self-organized as a spatial distribution pattern of matured synapses on the cells receiving modifiable synapses. Template matching is perfomed by the disinhibitory neural network cascaded beyond the neural layer composed of the cells receiving the modifiable synapses. The performance of the model has been simulated on a digital computer. After repetitive presentations of a stimulus pattern, a cell receiving the modifiable synapses comes to have the template of that pattern. And the cell in the latter layer of the disinhibitory neural network that receives the disinhibitory input from that cell becomes selectively sensitive to that pattern. Learning patterns are not restricted by previously learned ones. They can be subset or superset patterns of the ones previously learned. If an unknown pattern is presented to the model, no cell beyond the disinhibitory neural network will respond. However, if previously learned patterns are embedded in that pattern, the cells which have the templates of those patterns respond and are assumed to transmit the information to higher center. The computer simulation also show that the model can organize a clean template under a noisy environment.

A new hypothesis for synaptic modification: an interactive process between postsynaptic competition and presynaptic regulation

Based on recent physiological observations, a new hypothesis for the algorithm for synaptic modification is proposed: an interactive process between postsynaptic competition and presynaptic regulation controls the synaptic modification, and both functions obey the same competitive rule. A fundamental algorithm for the competitive rule is proposed and analysed. The interactive process is deomposed into two procedures. The first one is a postsynaptic competition, in which all synapses making contact with the same postsynaptic cell compete for their terminal sites, and the postsynaptic cell makes demands for synaptic modification upon the presynaptic cells. The second one is a presynaptic regulation, in which the presynaptic cell regulates the postsynaptic demands and determines the net amount of the modification for each snyapse originating from it. The performance of the alforithm has been simulated on a digital computer. The initial structure of the simulated neural network consists of randomly-connected presynaptic and postsynaptic cells, with no other structures assumed. After repetitive presentations of a uniform stimulus, the basic configurations of neural connections (one-to-one, one-to-many, many-to-one and many-to-many connections) are organized in dependence on the parameters of the algorithm.

Regulation of antibody response in different immunoglobulin classes. VI. Selective suppression of IgE response by administration of antigen-conjugated muramylpeptides

The suppressive effect of antigen-conjugated muramylpeptides or 6-O-mycoloyl muramylpeptides selectively on the induction of IgE antibody response was demonstrated. Preadministration of DNP-mycoloyl muramylpeptides completely inhibited the induction of the anti-DNP IgE antibody response with DNP-ovalbumin (DNP-OA). The selective suppression of the IgE response was due to the induction of DNP-specific suppressor T cells by DNP-mycoloyl muramylpeptides, and the suppressor cells were shown to be radiosensitive. Preadministration of OA-conjugated muramylpeptides partially inhibited the primary and secondary induction of an anti-OA IgE antibody response. The suppressor effect was also due to the induction of OA-specific suppressor T cells. Application of allergen-conjugated muramylpeptides as therapeutic agents in human allergic diseases was suggested.

Effect of glucose and oxygen on the structure of the plasma membrane of Staphylococcus aureus

The effects of glucose and oxygen on the formation of the plasma membrane of Staphylococcus aureus were studied. Phospholipids were consistent components of the membrane and were not affected by glucose or oxygen. Phospholipid fatty acids in cells grown in glucose containing media were rich in Ceven (C18, C20) fatty acid chains, whereas cells grown in glucose deficient media (normal broth) had anteiso Codd (C15,C17) fatty acid chains in place of Ceven chains. This may indicate increased membrane rigidity of the cells grown in glucose containing media. Cytochromes and ATPase were present in the membrane from cells grown in normal broth, but were deficient in the cells grown in glucose containing media. Polypeptide analysis of the membrane proteins showed a deficiency of the bands corresponding to these enzymes. They were not induced by the additionof oxygen to cells grown in glucose containing media. It was concluded that glucose was the dominant factor inhibiting the formation of these membrane enzymes.

The development of mesosomes of Staphylococcus aureus during autolysis

Mesosomes of Staphylococcus aureus were examined morphologically under the electron microscope. Three different methods of specimen preparation (thin section, freeze-fracture, and negative staining) were used to eliminate artifacts due to sample processing. Mesosomes were rarely seen in intact cells but were quite distinct in autolysed cells incubated in 1.2M sucrose -0.33M acetate buffer (pH 5.8) at 25 degrees C. The phospholipid content increased by 20% of the control as autolysis proceeded. Since the plasma membrane did not show any other significant changes, the development of mesosomes during autolysis was shown to be a real event. Most of the well-developed mesosomes were found at the septum in negatively stained specimens. Initial wall-lysis occurred at this site, suggesting a close relationship between autolysis and the development of mesosomes in S. aureus.

Z shaped primary colorectal anastomosis using the GIA autosuture for Hirschsprung's disease

The Duhamel operation for Hirschsprung's disease has won wide acceptance throughout the world. However, this procedure is not without difficulties, and the usual technique of employing various crushing clamps for division of the colo-rectal septum is inelegant, inconvenient and uncertain. This paper presents an operative technique with particular reference to the use of the GIA autosuture surgical stapling instrument in the Z shaped primary colorectal side-to-side anastomosis for Hirschsprung's disease advocated by Ikeda. This is a single and primary procedure, and makes the postoperative care easier and more comfortable for the patients. Experiences with twenty-five patients are reported.

High calorie infusion-induced hepatic impairments in infants

Hepatic impairments have been reported sporadically in infants receiving long-term high calorie infusion. Some characteristic hepatic impairments induced with high calorie infusion at the Juntendo University Hospital, Tokyo, are studied in 18 surgical infants, with discussion of the possible etiology of this complication in the context of high calorie infusion. The hepatic dysfunctions were classified into 3 types by sequential liver function determinations: Type I with a transient and slightly elevated serum transaminase without elevation of alkaline phosphatase; Type II, an elevation of alkaline phosphatase and total and direct bilirubin without elevation of serum transaminase; Type III, a marked and prolonged elevation of aklaline phosphatase, total and direct bilirubin, and serum transaminase. The etiology of these hepatic impairments during high calorie infusion is unknown.

Regulation of antibody response in different immunoglobulin classes. IV. Properties and functions of IgE class-specific" suppressor factor(s) released from DNP-mycobacterium-primed T cells

IgE class-specific suppressor factors (IgE-TsF) released from DNP-Myc-primed T cells showed their suppressor effect in an antigen nonspecific manner, although DNP-specific stimulation was required for their induction. The suppressor activity of IgE-TsF was absorbed with the alloantiserum directed to the subregions between I-A and I-E of the H-2 complex. IgE-TsF from BALB/c mice did not show their suppressor effect on the IgE response of C57BL/6J and vice versa. The suppressor activity of IgE-TsF was removed with a DNP-OA-primed B lymphocyte population including an increased number of IgE-B cells, but not with T cells. Incubation of hapten-primed B cells with IgE-TsF for 3 hr at 37 degrees C selectively abolished the anti-hapten IgE antibody response in the adoptive transfer experiment, indicating that the target cells of IgE-TsF were IgE-B cells.