Staging of renal cell carcinoma by computed tomography

To evaluate the efficacy of computed tomography (CT) in the diagnostic workup of renal cell carcinoma, CT findings were correlated with surgical and pathological findings in 40 cases. Fifteen cases without obliteration of perinephric fat or thickening of Gerota's fascia were confined within the renal capsule. Eighteen lesions showing anatomic contact with adjacent organs were either within the renal capsule or Gerota's fascia but never beyond Gerota's fascia. Two cases (Stage II) showed thickening of Gerota's fascia and two cases (Stage IV) showed tumor infiltration into the spleen. Computed tomography was found to be a useful method for the investigation of tumor thrombosis and lymph node metastasis.

[Clinical evaluation of diagnostic methods of nodular goiter]

In 47 patients who had undergone roentgenography, ultrasonography, 201 Tl-scintigraphy, and aspiration cytology and on whom a pathological diagnosis had been made, the diagnostic value of the above-mentioned 4 examinations was evaluated. The correct diagnosis rate for aspiration cytology and 201 Tl-scintigraphy was 76.6%; for ultrasonography and roentgenography it was 70.2%. The false-negative rate of cancer for aspiration cytology was 14.9%; for the other examinations it was 10.6%. The false-negative rate upon combining 3 examinations, except roentgenography (soft tissue technique), proved to be 0% and 24 patients with thyroid cancer were preoperatively correctly diagnosed as "malignant" by means of the combination method.

[Long-term results of curative operation of breast cancer]

Follow-up studies on 172 patients who had undergone curative surgery for breast cancer, were done. 1) There was no significant difference in the 5-year-survival rate between stage I and stage II, however, this survival rate was lower in stage III. 2) The survival rate of patients with metastasis to fewer than 3 lymph node tended to be higher than in patients with metastatic involvement of 4 or more lymph nodes. 3) Patients with papillo-tubular type cancer had the best prognosis followed by medullo-tubular type and scirrhous type. 4) The operative procedures used made no significant difference on the long-term results, although extended operation for stage II cancer showed better result than typical operation in terms of 10-year-survival. 5) The chemotherapy group showed better results than the radiation-treated group in terms of 5-year-survival.

[Carcinoma of the esophagus with hepatic metastasis]

Six patients with esophageal cancer with liver metastasis are reported and the clinicopathological features are discussed based on collected autopsy cases. 1) The incidence of liver metastasis was higher when the primary site was in the lower part of the esophagus. 2) There were many cases without abdominal lymphnode metastasis. 3) Metastasis was noted primarily as small nodules in the left lobe of the liver. 4) The prognosis was poor; liver metastasis was rarely the cause of death. In esophageal cancer, liver metastasis seems to occur via the portal route and combined liver resection is indicated when possible.

The incidence of simple renal cyst by computed tomography

Five hundred and forty-two abdominal computed tomography (CT) scans, including the kidneys, were reviewed to investigate the incidence of simple renal cysts. Increasing frequency with age was clearly demonstrated. The incidence in patients 50 years of age and over was at least 27%. Two thirds of simple renal cysts were 2 cm or less in diameter. Cysts were usually observed as exo-endoparenchymal or endoparenchymal lesions on CT.

Species and strain differences in mepirizole-induced duodenal and gastric lesions

Species and strain differences in mepirizole-induced duodenal and gastric lesions were studied. Mepirizole at 200 mg/kg given orally induced deep duodenal ulcers and gastric erosions in nonfasted Sprague-Dawley, Fisher, Wistar, and Donryu rats at an incidence of over 75%. Mepirizole at 300 mg/kg given orally also induced penetrating duodenal ulcers in nonfasted rabbits at an incidence of 50%. There was little or no damage to the duodenum and stomach in mice and dogs given 200-300 mg/kg of mepirizole orally or subcutaneously. The stomachs of fasted guinea pigs given 200 mg/kg of mepirizole had superficial erosions at a high incidence (93.3%). Mepirizole at 200 mg/kg given intraduodenally significantly reduced the volume of gastric juice but increased the acidity and pepsin activity in both pylorus-ligated and acute fistula rats. In chronic fistula rabbits, however, the agent at 200 mg/kg given orally reduced the volume and acidity, but increased the pepsin activity. The mechanism of duodenal ulceration by mepirizole differs slightly in rats and rabbits.

Structure of rice ferricytochrome c at 2.0 A resolution

The crystal structure of ferricytochrome c from rice embryos has been solved by X-ray diffraction to a resolution of 2.0 A, applying a single isomorphous replacement method with anomalous scattering effects. The initial molecular model was built on a graphics display system and was refined by the Hendrickson and Konnert method. The R factor was reduced to 0.25. Rice cytochrome c consists of III amino acid residues. In comparison with animal cytochromes c, the peptide chain extends for eight residues at the N-terminal end, which is characteristic for plant cytochromes c. These additional residues display a collagen-like conformation and an irregular reverse turn, and are located around the C-terminal alpha-helix on the surface or the rear side of the molecule. Two hydrogen bonds between the carbonyl oxygen of the N-terminal acetyl group and O eta of Tyr65, and between the peptide carbonyl oxygen of Pro-1 and O epsilon 1 of Gln89, are involved in holding these eight residues on the molecular surface, where Tyr65 and Gln89 are invariant in plant cytochromes c. Except for the extra eight residues, the main-chain conformations of both rice and tuna cytochromes c are essentially identical, though small local conformational differences are found at residues 24, 25, 56 and 57.

Enzyme-induced aziridine formation by isolated hepatocytes

The metabolism of 2-bromoethylaminonaphthoquinone in hepatocytes isolated from rats was studied. This compound was chemically inert in the reaction system used. However, in buffer solution containing isolated hepatocytes, it was gradually converted into aziridinylnaphthoquinone. Under the same reaction conditions, 4-chlorobutylaminonaphthoquinone also gave the cyclization products, pyrrolidinylnaphthoquinone. Cellular GSH decreased in both reactions.

Enzyme-induced aziridine formation by rat liver microsomes

The metabolic reaction of 2-chloroethylaminobenzoquinone derivatives with rat liver microsomes was studied. In buffer solution containing cellular macromolecules such as DNA or protein, 2-chloroethylaminobenzoquinones were usually stable and could be recovered quantitatively after an appropriate period of incubation. However, in microsomal solution, they were gradually converted into aziridinobenzoquinones via elimination of hydrogen chloride by NADPH-dependent enzyme action. Based on the study of the enzymatic cyclization reaction of 4-chlorobutylaminonaphthoquinone, we concluded that the hydroquinone derivative is an important intermediate for aziridine formation.

The usefulness of Holter monitoring in the evaluation of antiarrhythmic drug efficacy for tachycardia

Using Holter monitoring tachycardia was found in 145 out of 2058 patients suffering from various underlying diseases. Three thousand seven hundred and forty monitorings were performed. The mean age of patients was 54.5 years with a range of 19 to 83 years. The observed tachycardia was classified into three types: tachycardia with short duration, tachycardia with long duration and tachycardia with complex form. The attacks of tachycardia were more frequently observed during periods of physical activity than during sleeping periods. The relationship of the number of tachycardia with short duration between 24-hour Holter monitorings was examined in order to establish day to day variability of the attacks. The 95% confidence interval about the resultant regression line was calculated and the percent reduction required for the evaluation of drug efficacy to avoid the chances of interference of spontaneous variation was found to be about 44.0, 55.0 and 82% when the total number of attacks during a 24-hour period were 50, 100 and 1,000, respectively. Holter monitoring showed higher positive results as compared to exercise testing for detection of tachycardia. Higher correlation coefficients between numbers of premature ventricular contractions (PVCs) and the plasma concentrations of procainamide or N-acetylprocainamide were observed in 3 or more successive PVCs than in individually occurring PVCs. Using repeated 24-hour Holter monitorings a significant reduction in the number of tachycardia was observed when the therapeutic concentration was reached after the combined or single administration of the drug. These results suggest that repeated Holter monitorings, exercise testing and determination of plasma level of the drug may be useful for the evaluation of antiarrhythmic drug efficacy for tachycardia.

Establishment of an experimental model of human hepatoblastoma

Establishment of xenografts or cell culture lines in which the alpha-fetoprotein (AFP) characteristic of clinical hepatoblastoma persists have been difficult. The serially transplantable strain (HB-3) of highly AFP-producing hepatoblastoma was successfully established in nude mice. And a highly AFP producing cell line (c-HB-3) is easily obtained by HB-3. This strain and line give us an ideal experimental model of hepatoblastoma in vivo and in vitro.

Serum lipid and lipoprotein profiles in patients with xanthomas: a correlative study on xanthoma and atherosclerosis (I)

In an attempt to correlate xanthomas with atherosclerosis, the characteristics of serum lipid and lipoprotein profiles are explored in xanthoma patients. Xanthomas are classified into 5 subtypes: xanthelasma, planar xanthoma, papulo-eruptive xanthoma, tuberous xanthoma and tendon xanthoma. The clinical characteristics of xanthoma patients are summarized in the following. 1) Xanthelasma in 2 different types: one normolipemic and the other hyperlipidemic; of 30 xanthelasma patients, 5 were normolipemic, one of them had low HDL-cholesterol. 2) Tuberous and tendon xanthomas were all hypercholesterolemic, with serum cholesterol above 300 mg/dl and LDL-cholesterol above 255 mg/dl, while HDL-cholesterol was within normal range. 3) The xanthoma patients were generally not obese. 4) Their laboratory findings often showed such abnormalities as elevated levels in serum fibrinogen, LDH, CPK and uric acid. The resemblance of the clinical characteristics between xanthomas and atherosclerotic vascular disease, e.g., myocardial infarction, was striking. If the causation of their common tissue alterations by lipid accumulation is pathologically and biochemically defined, the correlation between those 2 kinds of disease can be established.

Alphafetoprotein in congenital biliary atresia and neonatal hepatitis

Alphafetoprotein (AFP) production was investigated clinically and histologically in cases of congenital biliary atresia and neonatal hepatitis. While serum AFP levels were all higher than 16,000 ng/ml in seven patients with neonatal hepatitis, they were less than 10,000 ng/ml in 50 per cent of 12 patients with biliary atresia. Therefore, serum AFP levels below 10,000 ng/ml were suggestive of a diagnosis of biliary atresia. A number of AFP granules were identified in the liver cells and multinucleated giant cells in patients with neonatal hepatitis and biliary atresia, using an immunoperoxidase method. The serum AFP levels paralleled the number of cells with AFP granules. However, no characteristic differences in distribution of these granules occurred in the hepatic cells and giant cells. The AFP producing mechanism was qualitatively the same in neonatal hepatitis and biliary atresia. These phenomena suggest that congenital biliary atresia and neonatal hepatitis may have the same pathogenesis.

Usefulness of 24-hour recordings of electrocardiogram for the diagnosis and treatment of arrhythmias with special reference to the determination of indication of artificial cardiac pacing

Twenty-four-hour recordings of electrocardiogram (ECG) were obtained from 1528 subjects. Sick sinus syndrome (SSS) was observed in 34 and advanced or complete AV block (CAVB) in 13 subjects. During the period studied 21 patients had died, who showed complicated ventricular premature contractions in 9 (multiform 6, short run 2, repetitive 2). Seventy-three patients with artificial cardiac pacing who were admitted at three different institutions were analyzed. The discrepancy of degree of block was observed between His bundle electrocardiographic findings and 24-hour ECG recordings. In 15 patients there was no correlation between sinus node recovery time following overdrive suppression and pauses following the termination of tachycardia (r = 0.0896, N. S.). In 49 normal subjects 24-hour heart rate ranged from a high of 170 to a low of 36 beats/min. Longest R-R interval ranged from 2.08 to 0.86 sec (mean 1.25 +/- 0.22 sec). The critical level of longest R-R interval to differentiate between normal group and groups with SSS or CAVB was about 1.6 sec. Above results suggest that Holter monitoring permits a precise diagnosis of arrhythmias and that both HBE and Holter monitoring should be used for the determination of pacemaker implantation especially in those with syncope or dizziness but without evidence of marked bradycardia.

Accessory scrotum

A case of rare accessory scrotum has been presented. Previous literature is reviewed and the cause has been discussed. Surgery was performed successfully.

Cholesteryl ester-rich lipid inclusions from human aortic fatty streak and fibrous lesions of atherosclerosis. II. Physical properties of swelling, resiliency and lyotropy as liquid crystal

The physical properties of the lipids accumulating as spherical inclusions in human atherosclerotic lesions were explored both in vivo and in vitro conditions. They were mostly anisotropic within the cytoplasma of cells and in an average diameter of 1.96 mu. When suspended in hydrophilic media, say of physiological saline solution, in 4 hours they swelled 2.4 times in volume and changed into isotropic form. They were resilient and deformable in three dimensional configuration, and lyotropic in polar media. When dried they underwent a phase shifting from liquid crystal to true solid crystal. These physical properties of lipid inclusions gained in a new significance for their role in metabolic deterioration of intima cells, rupture and necrosis of foam cells, and destruction of the intimal and medial architectures, which set on mesenchymal reactions leading eventually to thickening and hardening of the arteries.

Low resolution crystal structure of lipase from Geotrichum candidum (ATCC34614)

Lipase from Geotrichum candidum (ATCC34614) is a glycerol ester hydrolase which has a molecular weight of 55,000 with about 7% carbohydrate, displaying a high affinity for triolein. The enzyme was crystallized from more than 2% protein solution without using any salt or organic solvent. The crystals were cross-linked by soaking in 0.37% glutaraldehyde solution (0.1 M acetate buffer solution, pH 5.6). The structure was determined by X-ray diffraction using the isomorphous replacement technique. Two heavy-atom derivatives [K2PtCl4 and UO2(CH3COO)2] were obtained by the soaking method. The electron density map calculated at 5 A resolution clearly showed the molecular boundary. A balsa wood model was made on the basis of the 6 A electron density map. The molecular has an ellipsoidal shape with dimensions of 70 A X 50 A X 50 A. Several columns of density corresponding to alpha-helix and a few clefts were found in the molecule. The active site is presumably located in the vicinity of one of the Pt sites in the Pt-derivative crystal, judging from the inactivation of the enzyme by K2PtCl4.

Structure of bonito heart ferricytochrome c and some remarks on molecular interaction in its crystalline state

The structure analysis of bonito heart ferricytochrome c was carried out at 2.8 A resolution by X-ray diffraction. The overall features of the molecule are virtually identical with those of bonito ferrocytochromes c and other cytochromes c. In the present work, the modes of molecular packing among cytochromes c were also compared by means of intermolecular distance maps. Some differences in the structures of ferro- and ferricytochrome c may exist on the surface of the molecules.

Stage IVS neuroblastoma

This is a review of the findings in 10 cases of stage IVS neuroblastoma, that have been observed in the First Surgical Department of Hokkaido University Hospital. The patients under the age of 1 yr in stage IVS neuroblastoma have a favorable prognosis; the survival rate was 70%. The regressions were histologically confirmed as maturation of the neuroblastoma cells to ganglioma cells. The lymphocyte counts and T-cell function were well maintained in the surviving patients but both were markedly reduced in the patients who later died. The treatment should be conservative so that immune mechanisms are not inhibited and should be withheld until respiratory failure or progressive signs toward stage IV are identified.

Thyroid cancer in childhood

Thyroid cancer in childhood is a relatively rare condition. Often it shows biological characteristics different from those seen in adults. Based upon 10 cases in our clinic and 57 cases collected from the Japanese literatures, clinical features, pathology, treatment and prognosis of thyroid cancer in childhood are discussed. Pathogenesis is most likely to be related to hormonal changes during adolescence and previous radiation of the neck region. Cervical lymph nodes swelling was the chief complaint in 84.6 per cent of the cases. On the other hand, pulmonary metastases were recognized in the early stages in 33.5 per cent of the cases. Radical excision of the tumor with modified radical neck dissection is the treatment most frequently employed even in the presence of lung metastases. However, hypoparathyroidism and recurrent nerve injuries should be avoided at all cost in view of long life expectancy and the difficulty in treating them satisfactorily. Prognosis could be as good for children as it is for adults except in cases with early lung metastases.

A xerographic method for the quantitative assessment of atherosclerotic lesions

A new method has been developed for the quantitative assessment of atherosclerotic lesions, in which a conventional xerox machine is the sole equipment used. As an example, the aorta from a cholesterol-fed rabbit was removed in toto, opened longitudinally along its anterior margin, flattened in a transparent polypropylene bag and then xeroxed. The outlines of the atherosclerotic lesions were traced on translucent graph paper ruled into 1 mm squares. The squares within those outlines were counted and expressed as a percentage of the whole surface. This xerographic method is rapid and reproducible and is achieved without changing the magnification; it gives comparable or better results than other staining methods. As the aortic specimen is undamaged by fixation or staining, the specimen can be used for subsequent morphological or biochemical studies. Thus, the degree of surface involvement can be correlated with other morphological or biochemical changes in the same arterial samples.

Recording of the fourth heart sound by the signal averaging method. Preliminary report

The fourth heart sound was clearly recorded by using the signal averaging method. Furthermore, the simultaneous recording of the Doppler signal with the fourth heart sound was performed. Thus, it was demonstrated that the Doppler signal started after the P wave and followed by the fourth heart sound. In 2 cases, the effect of the double Master's test and taking a bath was studied on the computer averaged phonocardiogram. After the exercise, the amplitude of the fourth heart sound was increased, whereas after taking a bath it was almost unchanged. The above results show that the simultaneous recordings of a computer averaged phonocardiogram and Doppler signal that is associated with cardiac activity can greatly facilitate the interpretation of small vibrations such as the fourth heart sound.

Dormancy and Impotency of Cocklebur Seeds: VII. Inability of Dormant Cotyledons to Form Chlorophyll

Dormant seeds of cocklebur (Xanthium pennsylvanicum Wallr.) were characterized by the lack of ability to form chlorophyll. Such an inability of cotyledons of the dormant seeds was improved by the application of various factors and reagents which were capable of breaking the dormancy and of increasing cotyledon enlargement. Of these, ethylene, benzyladenine, and high temperature treatments were particularly effective, and, in turn, oxygen enrichment, gibberellic acid, thiourea, carbon doxide, and potassium nitrate were also promotive to the greening of the dormant cotyledons. The effects of benzyladenine, oxygen enrichment, and high temperature were reduced in the presence of absorbents for endogenously evolve carbon dioxide and ethylene. delta-Aminolevulinic acid could not restore their greening ability.