[Cellular changes in malignant pleural effusion induced by intrapleural injection of BCG-CWS]

The intrapleural injection of BCG cell wall skeleton (BCG-CWS) is thought to be beneficial in the treatment of malignant pleural effusion. The study of cancer cells in pleural effusion after the intrapleural injectin of CWS showed that nuclear damage to cancer cells was slight and delayed compared to findings obtained after the intrapleural injection of Mitomycin C. After the intrapleural injection of CWS, the ratio of granulocytes in pleural effusion was rapidly elevated. This suggests that CWS induces an inflammatory response in the pleural cavity. After the inflammatory reaction, adhesive pleuritis was induced, the pleural space was reduced, leading to the disappearance of effusion. On the other hand, after the intrapleural injection of CWS, no elevation of the ratio of macrophages, and no increase of macrophage and cancer cell adherence were observed. This suggests that the immunopotentiating effect of CWS is not high.

Long-term follow-up study on gastric adenoma and its relation to gastric protruded carcinoma

A total of 191 gastric adenomas in 178 patients was studied macroscopically by endoscopy and histopathologically by endoscopic biopsy. Among the lesions, 85 in 74 patients were followed-up for six months to 12 years. Gastric adenomas were found to be more frequent in the aged, with a rate of 0.1% in the third decade but 3.7% in the ninth decade, on gastroscopic examination. Gastric cancers coexistent with the gastric adenomas were seen in 14 cases (8%), and were more frequent in male than in female patients (sex ratio, 12:2). Only eight of the 85 lesions (9%) revealed macroscopic changes. Four of these showed a reduction in size, while the other four lesions showed enlargement. In 21 of the 85 lesions (25%), histologic changes were observed. Four (5%) changed from moderate dysplasia (Group III) to nondysplastic or intestinal metaplasia (Group I), eight lesions (9%) revealed histologic changes (Group III to IV, or vice versa) without malignant transformation, and nine lesions (11%) showed malignant changes. Neither submucosal invasion nor lymph node metastasis was found. These lesions consisted of carcinoma in situ with small foci in the lesions exhibiting moderate dysplasia, and a gradual transition from severe dysplasia to cancer was seen in resected lesions obtained by endoscopic polypectomy or surgical resection. In addition, a gradual increase in dysplasia of tissue from moderate to severe was revealed by repeated gastroscopic biopsy. These findings suggest that the gastric adenomas underwent malignant changes with gradual transformation from moderate through severe dysplasia.

Long-term follow-up study on gastric adenoma and its relation to gastric protruded carcinoma

A total of 191 gastric adenomas in 178 patients was studied macroscopically by endoscopy and histopathologically by endoscopic biopsy. Among the lesions, 85 in 74 patients were followed-up for six months to 12 years. Gastric adenomas were found to be more frequent in the aged, with a rate of 0.1% in the third decade but 3.7% in the ninth decade, on gastroscopic examination. Gastric cancers coexistent with the gastric adenomas were seen in 14 cases (8%), and were more frequent in male than in female patients (sex ratio, 12:2). Only eight of the 85 lesions (9%) revealed macroscopic changes. Four of these showed a reduction in size, while the other four lesions showed enlargement. In 21 of the 85 lesions (25%), histologic changes were observed. Four (5%) changed from moderate dysplasia (Group III) to nondysplastic or intestinal metaplasia (Group I), eight lesions (9%) revealed histologic changes (Group III to IV, or vice versa) without malignant transformation, and nine lesions (11%) showed malignant changes. Neither submucosal invasion nor lymph node metastasis was found. These lesions consisted of carcinoma in situ with small foci in the lesions exhibiting moderate dysplasia, and a gradual transition from severe dysplasia to cancer was seen in resected lesions obtained by endoscopic polypectomy or surgical resection. In addition, a gradual increase in dysplasia of tissue from moderate to severe was revealed by repeated gastroscopic biopsy. These findings suggest that the gastric adenomas underwent malignant changes with gradual transformation from moderate through severe dysplasia.

Long-term follow-up study on gastric adenoma and its relation to gastric protruded carcinoma

A total of 191 gastric adenomas in 178 patients was studied macroscopically by endoscopy and histopathologically by endoscopic biopsy. Among the lesions, 85 in 74 patients were followed-up for six months to 12 years. Gastric adenomas were found to be more frequent in the aged, with a rate of 0.1% in the third decade but 3.7% in the ninth decade, on gastroscopic examination. Gastric cancers coexistent with the gastric adenomas were seen in 14 cases (8%), and were more frequent in male than in female patients (sex ratio, 12:2). Only eight of the 85 lesions (9%) revealed macroscopic changes. Four of these showed a reduction in size, while the other four lesions showed enlargement. In 21 of the 85 lesions (25%), histologic changes were observed. Four (5%) changed from moderate dysplasia (Group III) to nondysplastic or intestinal metaplasia (Group I), eight lesions (9%) revealed histologic changes (Group III to IV, or vice versa) without malignant transformation, and nine lesions (11%) showed malignant changes. Neither submucosal invasion nor lymph node metastasis was found. These lesions consisted of carcinoma in situ with small foci in the lesions exhibiting moderate dysplasia, and a gradual transition from severe dysplasia to cancer was seen in resected lesions obtained by endoscopic polypectomy or surgical resection. In addition, a gradual increase in dysplasia of tissue from moderate to severe was revealed by repeated gastroscopic biopsy. These findings suggest that the gastric adenomas underwent malignant changes with gradual transformation from moderate through severe dysplasia.

Lymphatic role in the pathogenesis of fat malabsorption in liver cirrhosis in rats

Intestinal fat absorption was examined in rats with CCl4-induced liver cirrhosis. Marked lymphangiectasia of the small intestine was observed in rats after CCl4 was given subcutaneously biweekly for 10--12 weeks. Intestinal epithelial uptake of linoleic acid administered in the loop was not impaired, but accumulation of lipid droplets in the intestinal epithelial cells and disturbed lymphatic transport of absorbed fat were observed in these rats. These data suggest that lymphostasis of the intestine may play an important role in fat malabsorption in liver cirrhosis.

An aetiological study on spondylolysis from a biomechanical aspect

The authors report clinical studies on lumbar disorders (clinical symptoms, X-ray findings) in athletes in various sports. The sport items were divided into three groups according to the main dynamic load applied to the lumbar region. As a result, over 60% of the athletes suffered from "lumbago", and among them spondylolysis reached the high rate of 27%. Arising from these clinical observations, we performed biomechanical laboratory analyses on human cadaver material, axial compression and rotational bending. Our results suggest that the incidence of spondylolysis depends upon the extent and direction of the loads.

Changes in intestinal alkaline phosphatase activity in cholera toxin-treated rats

It is conceivable that brush border enzyme activities of the intestinal mucosa will change when bacterial toxins are exposed to the intestinal microvillous membranes. The effect of cholera toxin on the activity of intestinal alkaline phosphatase in rats was therefore determined in the intestinal mucosa by the histochemical method as well as in intestinal lymph by using lymph fistulated-rats. Activity of intestinal alkaline phosphatase in the intestinal mucosa and lymphatics changed biphasically after the oral administration of cholera toxin to rats. For the first three hours after the administration of cholera toxin it was depressed; it then increased and at eight hours reached a maximum. These changes in the activity of intestinal alkaline phosphatase were prevented by the administration of chlorpromazine, a known inhibitor of adenylate cyclase activity.

Effect of colchicine on intestinal alkaline phosphatase activity during linoleic acid absorption in rats

The purpose of this study is to examine whether intestinal alkaline phosphatase (IAP) plays a role in transporting lipoproteins to lymphatics during fat absorption. In control rats, the increased activity of IAP in intestinal lymph was observed parallel with the amount of absorbed linoleic acid. In colchicine-treated rats, lymphatic absorption of intraduodenally administered linoleic acid was decreased and administered lipid was transported slowly to lymphatics, mostly in the form of free fatty acid. However, the equal or slightly larger amount of output of IAP to lymphatics was observed in spite of the decrease in lipid absorption in colchicine-treated rats. Histochemically, prolonged activity of IAP in stroma and submucosal lymphatics was found in colchicine-treated rats fed with fat. These results suggest that microtubules are not involved in IAP transport into lymphatics, and these data do not necessarily rule out that IAP plays a role in lipoprotein transport.

Abnormal fatty acid composition of plasma lipids in patients with protein-losing enteropathy

This study was performed to clarify how disturbance of lipid metabolism occurred in patients with protein-losing enteropathy (PLE) as compared with that of control individuals and patients with malabsorption syndrome. Analysis of plasma lipids at fasting state showed a decreased proportion of essential fatty acid, especially linoleic and arachidonic acid fractions in patients with malabsorption syndrome as well as in patients with PLE group A, which was due to proven disorders of intestinal lymphatics. An increase in percentage of oleic acid fraction and a percentage increase in plasma triglyceride levels after an oral administration of olive oil was depressed in patients with malabsorption syndrome and PLE group A when compared with that of normal subjects. Patients with PLE group B, which was not due to major lymphatic disorders, were similar to normal in these parameters. These abnormalities were found to be marked when remarkable abnormalities of lymphatics were accompanied.

Multiple nutritional requirements of lactobacilli: genetic lesions affecting amino acid biosynthetic pathways

Genetic lesions responsible for amino acid requirements in several species of multiple auxotrophic lactobacilli were investigated. Systematic attempts were made to isolate mutants that could grow in the absence of each of the amino acids required by the parental strains of Lactobacillus plantarum, L. casei, L. helveticus, and L. acidophilus. After treatment with appropriate mutagens, such mutants could be obtained with respect to many but not all required amino acids. Successful isolation of mutants for a given amino acid means that a minor genetic lesion reparable by single-step mutations affects its biosynthesis; a failure to isolate mutants suggests the involvement of more extensive lesions. Analysis of these results as well as the specific requirements exhibited by the parental strains revealed certain regularities; some of the biosynthetic pathways for individual amino acids were virtually unaffected by more extensive lesions in at least species tested, whereas others were affected by more extensive lesions in at least some species. Both the number and the kind of pathways affected by extensive lesions differed appreciably among different species. Furthermore, the growth response of the parental strains to some putative amino acid precursors revealed a clear correlation between the extent of genetic lesions and the occurrence and location of a genetic block(s) for a given pathway. These findings are discussed in relation to the phylogeny, ecology, and evolution of lactic acid bacteria.

Endoscopic and histopathological study on primary and secondary intestinal lymphangiectasia

Jejunal endoscopy and histopathological study of biopsied specimens were performed to clarify states of jejunal mucosa and the mechanism of enteric protein loss in six patients with protein-losing enteropathy, including four patients with intestinal lymphangiectasia, one patient with constrictive pericarditis associated with dilated lymphatics of the intestine, and one patient with Budd-Chiari syndrome. Three cardinal endoscopic findings, scattered white spots, white villi, and chyle-like substances covering the mucosa, were demonstrated in protein-losing enteropathy. Scattered white spots indicated markedly dilated lymphatics in the stroma of the villi. White villi seemed to be due to fats including chylomicrons or fat droplets in the absorptive cells, interepithelial spaces, and/or stroma, even though the biopsies were obtained in the fasting state. Therefore, white villi suggest impaired transport of fats from intestinal epithelial cells to intestinal lymphatics. These three cardinal findings are thought to be characteristic for protein-losing enteropathy secondary to lymphatic disorders.

Histoclinical long-standing follow-up study of hyperplastic polyps of the stomach

In a series of 2,013 gastric polyps in 1,201 patients, morphological and histopathological studies have been performed. Ninety-three hyperplastic polyps in 56 patients have been followed-up endoscopically and histopathologically for five to 12 years. The incidence of detection of gastric polyps has increased: 1.4% in 1967 to 8.7% in 1979 year by year. Thirty patients (54%) among the 56 showed changes in number, size or shape of polyps during follow-up. Twenty patients (37%) revealed numerical changes (increase in 16 patients, reversion in three patients and vanishing in two patients). Twenty-eight polyps (30%) showed morphological changes, six of them showed continuous enlargement, 18 lesions repeated enlargement, stationary or reduction stages, three lesions were reversed and two polyps disappeared. Histopathologically, three lesions showed transformation from the hyperplastic type to adenoma while demonstrating morphological enlargement. Two of these showed increase in cellular atypia, from the hyperplastic type through adenoma with severe atypia and finally to carcinoma in the polypectomy specimens. From this study, it was concluded that although hyperplastic polyps show changes in size, shape or number with passage of time, malignant changes occur in only a few cases.

Improvement of the preparation method for vaginal smears for the auto-cyto-screener

An improved method of preparing vaginal smears for use in the Auto-Cyto-Screener is reported. The main alterations from the previous technique were the substitution of 2% formaldehyde phosphate buffer (pH 7.4) for 50% ethanol as the preservative fluid, the use of homogenization in place of sonication for cell aggregate dispersion and the introduction of Ficoll-gradient sedimentation, which not only removes leukocytes and other elements from the suspensions but also concentrates the cancer cells to some extent. An examination of cell deposition techniques showed that optimal results were achieved with the use of filter paper, not rubber, and with centrifugation performed immediately after loading the suspension into the chambers.