Detection of low copy numbers of Epstein-Barr virus by in situ hybridization using nonradioisotopic probes prepared by the polymerase chain reaction

A highly sensitive in situ hybridization procedure was established using digoxigenin-11-dUTP-labeled probes that were prepared by the polymerase chain reaction (PCR). By using 12 sets of primers, BamHI-W fragment of the Epstein-Barr Virus (EBV) was amplified with labeled substrate in individual PCRs. Then the 12 probes (average size, 120 base pairs) were mixed and hybridized with cultured and RNase-treated Namalwa cells, which contain two copies of EBV genomes per cell. The strength of the signals was much stronger as compared with random-primed probe. Our results indicate that the size-averaged PCR probes magnified the sensitivity for detecting low copy numbers of virus genomes by in situ hybridization and that this technique has the potential for investigating latent virus infection in other clinical situations.

[Radiotherapy for vulvar cancer]

Fifteen patients who had primary vulvar cancer treated with radiotherapy as an initial treatment at Hyogo Medical Center for Adults and Hyogo Cancer Center from January 1971 to December 1990 are presented. Two patients were stage 0, one stage I, three stage II and nine stage III. Nine patients received electron irradiation with or without interstitial irradiation and intracavitary vaginal irradiation. Five patients received megavoltage X-ray irradiation using AP/PA parallel opposed fields including the pelvic nodes and perineum followed by boost irradiation of electrons, interstitial irradiation and intracavitary vaginal irradiation. The total dose delivered to the primary tumor ranged from 50 to 100 Gy (73 Gy on average). The actuarial 5-year survival rate of the patients was 43.6%. Complete regression (CR) was achieved in 60% of the patients. However, CR was not achieved in any of five patients with palpable inguinal nodes. In contrast, all the patients who had tumors of less than 2 cm in diameter achieved CR. Five of nine CR cases relapsed. First sites of failure were vagina, groin and vulvar region. Recurrence occurred more than four years after treatment in three cases. Necrosis occurred in five of nine CR cases.

Synthesis of galactose derivatives that render lectin-induced agglutinating ability to liposomes

Three galactose (Gal) derivatives, Gal beta 1-n-C16H33 (1), Gal beta (1-4)-Glc beta 1-n-C16H33 (2), and Gal beta 1-(CH2CH2O)3-n-C16H33 (3), were synthesized and incorporated into liposomes prepared from egg yolk lecithin. Agglutination of these liposomes with Ricinus communis agglutinin was examined by following the change of turbidity. Liposomes containing 3 were effectively agglutinated in contrast to the cases of 1 and 2, suggesting that the oxyethylene groups act as a favorable spacer to extrude Gal groups into the water. Differential scanning calorimetry showed that 3 was mixed with egg yolk lecithin at room temperature, but 1 and 2 were in the gel state, resulting in the phase separation that makes the recognition of Gal residue with Ricinus communis agglutinin difficult.

Regulation of basophilic and erythroid-differentiation of a human chronic myelogenous leukemia-cell line, ku812f, by interleukin-3 and stem-cell factor

We have investigated the effects of c-kit ligand (stem cell factor [SCF]) and interleukin-3 (IL-3) on proliferation and differentiation of a human chronic myelogenous leukemia cell line, KU812F, which can differentiate toward erythroid and basophilic lineages. When purified c-kit-positive cells (approximately 20% of KU812F cells) were used as a target, SCF induced not only proliferation but also augumented erythroid differentiation of the cells, while IL-3 did promote basophilic differentiation. Further, analyses of in situ hybridization and cell sorting with anti-c-kit antibody showed that the expression of c-kit decreased along with differentiation from immature to mature basophils and erythroid cells.

[Experimental study of indirect lymphography with iodinated starch]

Opacification of lymph nodes on CT was attempted by means of indirect lymphography with iodinated starch (IS). Sixty percent solutions of two different molecular weights of IS were prepared (5,000 mol wt and 70,000 mol wt in average). After subcutaneous injection of IS solutions to the pedal area of dogs, CT scans were performed to evaluate opacification of the popliteal lymph nodes. The lymph nodes began to be opacified from 10 min after the injection of each solution. The high molecular weight IS showed higher attenuation and longer duration of opacification than did the low molecular weight IS. Homogeneity of opacification was better with latter. The optimum molecular weight for this purpose is considered to be between 5,000 and 70,000 mol wt.

Localization and developmental expression of a novel protein kinase C delta gene

The expression and localization of a novel protein kinase C delta (nPKC delta) mRNA were investigated using Northern blotting and in situ hybridization in the developmental process of mouse brain. In adult mice, nPKC delta was abundantly expressed in the thalamus, moderately in the pons and the cerebellum, but faintly in the cerebral cortex and the spinal cord. By in situ hybridization, the signals were observed specifically at the sensory and motor relay nuclei of the thalamus, the dorsal cochlear nuclei of the pons, and the molecular layer of the cerebellum. When developmental changes in the expression of nPKC delta gene were analyzed by in situ hybridization, it was not detectable in embryonic and neonatal brains, very weakly expressed in the thalamus in the first week, and highly expressed at two weeks of age. These results suggest that the gene expression of nPKC delta is strictly controlled by both the cell type and the developmental process.

Localization of mRNA for c-kit receptor and its ligand in the brain of adult rats: an analysis using in situ hybridization histochemistry

Localization of mRNA for the c-kit receptor and its ligand (Sl factor) in the brain of adult rats was studied using in situ hybridization histochemistry. The mRNA for the c-kit receptor was detected in the forebrain, the lower brain stem and the cerebellum. In the forebrain, the c-kit mRNA signals were detected in the olfactory bulb, the caudate-putamen, throughout the superficial cortex, the accumbens nucleus, the nucleus of vertical limb diagonal band, the bed nucleus of anterior commissure, Ammon's horn, the entopeduncular nucleus, the subthalamic nucleus, the dorsal raphe nucleus, the parasubiculum, the presubiculum, the ventricular nucleus of lateral lemniscus, and the entorhinal cortex. In the lower brain stem, the signals were detected in the inferior colliculus, the spinal vestibular nucleus, the spinal tract nucleus of trigeminal nerve, and the pyramidal tract. In the cerebellum, the signals were detected in the molecular layer of the cortex and cerebellar nuclei. By contrast, the signals of mRNA for Sl factor were detected in the forebrain and the cerebellum. In the forebrain, the signals were detected in the olfactory bulb, the endopiriform nucleus, the septohippocampal nucleus, the habenular nuclei, and most of the thalamic nuclei. In the cerebellum, the signals were detected in Purkinje cells. Several pairs of structures were found in which mRNA of either the c-kit receptor or the Sl factor was expressed and between which the synaptic connection had been reported, suggesting that the interaction between the c-kit receptor and the Sl factor may play some roles in the development of such synaptic connections.

[Transcatheter embolization for huge pulmonary arteriovenous fistula using metallic "spider" and spring embolus--application of hand-made metallic "spider" using partial monorail technique]

We performed transcatheter embolization in two cases with huge pulmonary arteriovenous fistula (AVF) using a metallic "spider" and spring embolus. Conventional spring embolus or detachable balloon could not be used in these cases. Metallic spider was indicated for pulmonary AVF with a feeding artery diameter of more than 16 mm to prevent embolus passing through the AVF. In the first case, we used large handmade metallic spiders of 25 mm in diameter followed by embolization by numerous spring coils. At that time, a partial monorail technique was newly devised to carry the large metallic spider into the feeding artery, otherwise the spider could not pass into a 9F catheter. After embolization, symptoms and PaO2 in arterial blood improved remarkably in both cases. In the second case, a spring coil migrated into the normal pulmonary artery, but no infarction resulted. In conclusion, the metallic spider was very useful for embolization of hugee pulmonary AVF to avoid the embolus passing through and to tangle spring coils together with it. If commercially available "spiders" are too small, ones can be made easily.

[Experimental and clinical study of arterial damage induced by anti-cancer drug infusion]

In order to reduce the arterial damage following arterial chemo-infusion, arterial reaction to anti-cancer drugs and Corticosteroid were studied experimentally and clinically. In experiment, chemo-infusions (Mitomycin C, Adriamycin, Cisplatin) with or without Corticosteroid were carried out into the auricular and femoral arteries of rabbits, and the arterial changes were examined angiographically and histopathologically. The histologic examination showed the damages of various degrees characterized by intimal edema with pyknosis of endothelial cells, thrombus formation and detachment of intimal layer. The degree and frequency of the damage increased as the drug dose and concentration increased. However, higher blood flow and Corticosteroid could reduce the damages in some degrees. Clinically, bronchial arterial infusion of Cisplatin with or without Corticosteroid were studied. In conclusion, when angiography following ACI reveals narrowing and/or irregularity of the target artery, reduction of drug concentration and dose as well as elongation of infusion intervals are advised.

[New puncture technique for TIPSS (transjugular intrahepatic portosystemic stent shunt)]

To establish a safer puncture method for TIPSS (Transjugular Intrahepatic Portosystemic Stent Shunt), we developed a new percutaneous puncture technique to penetrate portal and hepatic vein trans-hepatically under ultrasonography (US technique). Experimentally we compared this technique with conventional transjugular technique puncturing portal vein through hepatic vein using Ross needle (Ross Needle technique). Success rate is 100% in US technique and 50% in Ross needle technique. Seven complication including intraperitoneal bleeding occurred in Ross needle technique, but no complication in US technique. Conclusively, US technique is a safer and more reliable method than that using Ross needle in the puncture method for TIPSS.

Spatial expression of genes encoding c-kit receptors and their ligands in mouse cerebellum as revealed by in situ hybridization

Expression of mRNA for c-kit receptors and their ligands was examined in the cerebellum of mice by in situ hybridization technique. The c-kit receptors were expressed in the molecular layer of the cerebellum and the ligands for the c-kit receptors were detected at the boundary of molecular and granular layers. The expression of the c-kit ligands was not detectable in the cerebellum of lurcher (Lc/+) mutant mice that lack Purkinje cells, indicating the cells expressing the c-kit ligands were Purkinje cells. The cells expressing c-kit receptors decreased but were present in the cerebellum of Lc/+ mice. The c-kit mRNA-positive cells appeared to represent basket cells and stellate cells from their appearance and location. Since neurons in the molecular layer construct suppressive neurojunctions with Purkinje cells, the present result suggests that c-kit receptors and their ligands may play an important role for the construction of their junctions.

[Enhanced MRI of breast cancer smaller than 3 cm]

Twenty-two patients with breast cancers were studied using magnetic resonance (MR) imaging with a cylindrical surface coil at 1.5 Tesla. All were examined with the FE sequence and Gd-DTPA as a contrast medium. These images were compared with micrographs of the specimens. All cancers were enhanced clearly, and demarcated margins or spiculations of the tumors were seen as clearly on MR images as on micrographs of the specimens. In 12 patients (9 carcinomas, 2 fibroadenomas and 1 benign phyllodes tumor), dynamic studies were performed after the intravenous injection of Gd-DTPA. All nine carcinomas showed enhancement characterized by a sudden increase in signal intensity on the order of 100% or more within the first 2 minutes after injection. Two fibroadenomas were enhanced slowly. Thirteen patients with breast cancers were examined with several sequences (FE, T1-weighed SE, T2-weighed SE and STIR) with or without Gd-DTPA. The most clearly delineated images of the tumors were those of FE images with Gd-DTPA enhancement. A phantom constituted of various concentrations of Gd-DTPA in 20% albumin solution was measured by signal intensities with T1-weighted SE sequence and FE sequence. The ratio of enhancement of the 20% albumin solution relative to the Gd-DTPA concentration was higher with the FE sequence than with the SE sequence. The sensitivity of the FE sequence to Gd-DTPA enhancement was 1.5 times that of the SE sequence under the usual concentration of Gd-DTPA.

Characterization of Ws mutant allele of rats: a 12-base deletion in tyrosine kinase domain of c-kit gene

Homozygous mutant rats at the newly found white spotting (Ws) locus were anemic and deficient in mast cells and melanocytes. Because the phenotype of Ws/Ws rats resembled the phenotype of mice possessing a double-gene dose of mutant alleles at the W locus and because the c-kit gene was mapped at the W locus of mice, we characterized the c-kit gene of Ws/Ws rats. The authentic sequence of the rat c-kit cDNA was determined by using a cDNA library prepared from the hippocampus of Sprague-Dawley rats. The c-kit cDNA of Ws/Ws and normal (+/+) control rats was obtained by reverse transcriptase modification of the polymerase chain reaction. When compared with the authentic sequence, a deletion of 12 bases was found in the c-kit cDNA of Ws/Ws rats. This change was shown to be a result of the deletion of the genomic DNA. Four amino acids encoded by the deleted 12 bases (ie, Val-Lys-Gly-Asn) were located at two amino acids downstream from the tyrosine autophosphorylation site in the c-kit kinase and were conserved not only in mouse and human c-kit kinases but also in mouse and human c-fms kinases (ie, receptors of colony-stimulating factor-1). Taken together, the Ws/Ws rat is the first characterized mutant of the c-kit gene in an animal species other than the mouse.

[Lymphoscintigraphy with 99mTc-DTPA-HSA: detection of metastases to iliopelvic lymph nodes]

The purpose of this study was to evaluate 99mTc-DTPA-HSA as an iliopelvic lymphoscintigraphic agent in 5 normal volunteers and 10 patients with metastases of malignant tumors (cancer, 9; and malignant lymphoma, 1) to the iliopelvic lymph nodes. The subjects underwent intradermal injection of 185 MBq of 99mTc-DTPA-HSA into digital web spaces of the feet. Massage was applied at the injection sites for 30 sec; the subjects then walked around for 2 min. Whole-body scintigrams were obtained 5 min after injection. The whole-body scanning speed was 20 cm/min. The tracer transport was prompt. Within 15 min after injection, the tracer reached the termination of the thoracic duct in all normal volunteers. Normal whole-body images of excellent quality delineated the lymph nodes and channels almost without background radioactivity. The images of 9 patients with metastases of cancer showed clearly the following abnormal patterns: a) obstruction of lymphatic system (5/9, 55.6%); b) absence of visualization of the thoracic duct (44.4%); c) decreased uptake in lymph nodes (88.9%); d) visualization of collateral circulation (44.4%); e) tracer extravasation into more proximal soft tissue (22.2%). The image in the patient with malignant lymphoma showed increased uptake in the enlarged lymph nodes in addition to the all abnormal findings mentioned above. We concluded that 99mTc-DTPA-HSA is an excellent radiopharmaceutical for iliopelvic lymphoscintigraphy.

[Clinical results of N0 tongue cancer treated with interstitial brachytherapy and management of occult cervical node metastases]

One hundred patients with T1-2NO squamous cell carcinoma of the oral tongue were treated with interstitial brachytherapy at the Hyogo Medical Center for Adults between 1962 and 1983. These patients were followed for more than two years. The cumulative five-year survival rate was 89% in T1N0 and 66% in T2N0. The relapse-free survival rate was 88% in T1N0 and 51% in T2N0. The two-year local control rate in the primary site was 100% in T1N0 and 73% in T2N0. Cervical node metastases developed in 41% (T1N0: 33%, T2N0: 43%) of the patients. The five-year survival rate of the patients with subsequent cervical node metastases was 42%, while that of patients without subsequent cervical node metastases was 92% (p less than 0.001). Twenty-seven patients also received prophylactic neck irradiation (average dose: 33.8 Gy). In patients treated with prophylactic neck irradiation, the rate of subsequent cervical node metastases was 37% and the cumulative five-year survival rate was 62%. In the patients without prophylactic neck irradiation, these figures were 41% and 73%, respectively. There was no statistically significant difference between the two groups. Between 1984 and 1986, 28 patients with T1-2 N0 squamous cell carcinoma of the oral tongue were treated with interstitial brachytherapy. These patients were prospectively examined for the ability of chemotherapy to prevent the development of cervical node metastasis. In 13 patients treated with chemotherapy (CDDP 80 mg/m2 + PEP 6 mg/m2 x 5 days), the two-year local control rate was 90%, the incidence of cervical node metastases was 38% and the incidence of distant metastases was 15%.(ABSTRACT TRUNCATED AT 250 WORDS)

[Clinical value of Gd-DTPA enhanced MRI of pulmonary and mediastinal tumors]

Gd-DTPA (Gd) enhanced Magnetic Resonance (MR) early images and delayed images of 28 patients with pulmonary or mediastinal tumors were analyzed and compared with the computed tomography scans and the plain MR images. Numbers of relative signal intensity of the tumors, secondary lesions (adjacent pneumonia or collapse) and pleural effusions were calculated and graphed on time intensity curves. Gd-enhanced MR early images were more useful than other methods in delineating viable areas from necrotic areas. However, Gd-enhanced MR delayed images better delineated margins of necrotic areas than Gd-enhanced MR early images did in some cases. In distinguishing tumors from secondary lesions, Gd-enhanced MR early images were the most useful, too. We considered Gd gradually penetrated into pleural effusions after intravenous administration, just in the same way into necrotic areas. Therefore pleural effusions showed very high intensity on Gd-enhanced MR delayed images. Time intensity curves of the tumors and pleural effusions showed characteristic patterns, but those of secondary lesions showed different patterns among the individual cases. We presumed this was due to the variances of the water and fibrous components among them.

Possibility of heat sterilization of liposomes

Several kinds of liposomes were sterilized at 121 degrees C for 20 min. They tended to aggregate after heat sterilization (HS) in saline, while no aggregation was observed in an isotonized sugar or polyol solution. The dispersions containing egg phosphatidylcholine (EggPC) with a high peroxide value (POV) turned slightly yellowish after HS. This color change was prevented by using EggPC with a low POV, hydrogenated EggPC (H-EggPC) or dipalmitoylphosphatidylcholine (DPPC). Nitrogen gas bubbling at neutral pH also prevented the color change, but vitamin E did not. The particle size of the EggPC liposomes extruded through a 0.4 micron membrane filter did not change significantly after HS, whereas the H-EggPC or DPPC liposomes extruded through a 0.8 micron membrane filter tended to be reduced in size. On this change the type of medium had a considerable influence. The anionic 6-carboxyfluorescein leaked from the negatively charged liposomes (EggPC/cholesterol (Chol)/egg phosphatidylglycerol) during HS, while no leakage was observed from the positively charged liposomes (EggPC/Chol/stearylamine) not only during HS but also during a long period of storage. It was suggested that sterilization of liposomes by heating was practicable as well as that by filtration, if the liposomes were prepared as follows: the charged liposomes made of lipids with low POV's were dispersed in a sugar or polyol solution adjusted to nearly pH 6.5, where the amount of dissolved oxygen was minimized. An ionic water-soluble drug had to be encapsulated in the oppositely charged liposomes.

Appearance of a carcinoid-like pattern in rat hepatic tumors induced by 3'-methyl-4-dimethyl-aminoazobenzene

This study investigated the histological distribution of argyrophilic cells in experimental hepatic neoplasms, the number of these cells, and the proportion of neoplasms with such cells. Seventy 6-week-old male Donryu rats were given a 0.06% 3'-methyl-4-dimethyl-aminoazobenzene (3'-MeDAB) diet for 10 weeks, followed by an ordinary diet for an additional 10 weeks. Of the 70 rats, 50 were used for this investigation; 29 had hepatic tumors, 18 had cholangiofibrosis, and the other three had oval cell proliferation only. Hepatic tissues were stained with Grimelius and Fontana-Masson stains as well as routine hematoxylin-eosin stain. Argyrophilic cells were found in the hepatic neoplasms of 8 rats without argentaffin cells, while cholangiofibrosis was associated with argentaffin cells in almost all cases. Of the 8 rats with argyrophilic cells, three had an abundant population of these cells. The argyrophilic cells were found in areas of the neoplasms with a glandular, trabecular, tubular, or poorly differentiated pattern. Electron microscopy revealed that the neoplastic cells with a positive argyrophil reaction contained small round electron-dense endocrine granules. In addition, in the areas of cholangiofibrosis, two different types of gut endocrine cells were present (G and EC cells). These results suggest that 3'-MeDAB might induce hepatic carcinoid under certain conditions, though we have yet to confirm the development of a pure hepatic carcinoid due to this substance.

Bone marrow-derived cultured mast cells and peritoneal mast cells as targets of a growth activity secreted by BALB/3T3 fibroblasts

When fibroblast cell lines were cultured in contact with bone marrow-derived cultured mast cells (CMC), both NIH/3T3 and BALB/3T3 cell lines supported the proliferation of CMC. In contrast, when contact between fibroblasts and CMC was prohibited by Biopore membranes or soft agar, only BALB/3T3 fibroblasts supported CMC proliferation, suggesting that BALB/3T3 but not NIH/3T3 cells secreted a significant amount of a mast cell growth activity. Moreover, the BALB/3T3-derived growth activity induced the incorporation of [3H]thymidine by CMC and the clonal growth of peritoneal mast cells in methylcellulose. The mast cell growth activity appeared to be different from interleukin 3 (IL-3) and interleukin 4 (IL-4), because mRNAs for these interleukins were not detectable in BALB/3T3 fibroblasts. Although mast cells are genetically deficient in tissues of W/Wv mice, CMC did develop when bone marrow cells of W/Wv mice were cultured with pokeweed mitogen-stimulated spleen cell-conditioned medium. Because BALB/3T3 fibroblast-conditioned medium (BALB-FCM) did not induce the incorporation of [3H]thymidine by W/Wv CMC, the growth activity in BALB-FCM appeared to be a ligand for the receptor encoded by the W (c-kit) locus. Because CMC and peritoneal mast cells are obtained as homogeneous suspensions rather easily, these cells may be potentially useful as targets for the fibroblast-derived mast cell growth activity.

Fixed drug eruption due to pipemidic acid

A 71-year-old woman with fixed drug eruption caused by pipemidic acid is reported. The patient developed typical lesions on rechallenge with pipemidic acid, but not with nalidixic acid, an analogue of pipemidic acid.

[Application of an angiographic catheter with side holes to intra-arterial drug infusion--improvement of drug distribution by occlusion of the catheter tip]

To improve distribution of drug by intraarterial infusion a new catheter system with sideholes, tip of which was able to be occluded by an embolus, was developed. Inner diameter of the catheter was 0.038 inch. Tip of the catheter was so smoothly tapered to 0.025 inch in inner diameter that it could be occluded by an embolus of 0.038 inch in diameter. After occlusion of the tip, drug flowed out rectangly to catheter axis from only sideholes, resulting that drug flowed out was mixtured by blood stream to make a uniform distribution of it.

[Experimental study of ferromagnetic induction heating combined with hepatic arterial embolization for treatment of liver tumors]

The induction heating to ferromagnetic implants (Ferromagnetic Induction Heating: FIH) has been developed for the purpose of selective hyperthermia on deep-seated tumors. In this investigation, the procedure of FIH combined with hepatic arterial embolization (HAE) was experimentally studied on VX2 liver tumor of rabbit. The induction heating unit is composed of radiofrequency generator (500 KHZ, 6-12 KW) and circular applicator (60 cm in diameter). Ferromagnetic implant used was pure iron particles (100 mu in size), which were suspended in tenacious polysaccharide solution to be injectable through a needle. After HAE with gelatin sponge powder had been made, iron particle suspension was injected into the cavity of tumor with subsequent exertion of induction heating (9KW) for 15 minutes. The measurement of temperature was made on the tumor and the liver parenchyma by fluoroptic thermometer with thin, flexible probe which readily passed through a needle. The temperature measured at peripheral area of tumor elevated at range from 2.5 to 7.1 degrees C, corresponding to the dose of iron particles injected; 2.5 degrees C with 1 g, 4.9 degrees C with 2 g, 7.1 degrees C with 3 g. In contrast, the temperature of liver parenchyma elevated at range of less than 2.5 degrees C, to indicate a successful selective heating of liver tumor. An additional experiment for the effect of heat on normal liver of rabbit were made using a microwave heating system. The histological and serologic examinations after heating of below 40 degrees C did not show any abnormal findings. After heating of 42-43 degrees C, however, serum GOT and GPT transiently elevated more than 3 times to that of before heating. Histologically, there were extensive degeneration and necrosis of liver tissue. From the results we concluded that FIH combined with HAE could provide an intensive therapeutic effect for treatment of well-localized liver tumors with minimal damages to the liver parenchyma, because of selective heating of the tumor.