[Flow cytometric analysis of the effect of cAMP on the cell cycle of the 9 L rat glioma in vitro]

Perturbed cell kinetics in 9 L rat brain tumor treated with dibutyryl cyclic AMP (DBcAMP) and theophylline were studied. The methods include a procedure for simultaneous flow cytometric measurements of cellular DNA and amount of bromodeoxyuridine (BrdU) incorporated into cellular DNA and a procedure for flow cytometric measurements of cellular DNA and RNA. Propidium iodide and monoclonal antibody against BrdU were used as a fluorescent probe for total cellular DNA and for BrdU incorporated into cellular DNA, respectively. For analysis of cellular DNA and RNA, acridine orange staining was also applied. The results were as following; cells in S and G2 phase at the time of drug administration (1 mM, each) can undergo mitosis even though a considerable prolongation of G2 phase was apparent. However, cells in G1 at the time of drug administration were arrested in that phase, whereas those cells in S or G2 were able to complete one mitosis before becoming arrest in the G1 phase. These results have been inferred from the study by autographic method with 3H-thymidine. However, using these new methods, these were clearly demonstrated and furthermore, flow cytometric analysis with acridine orange revealed that DBcAMP induced 9 L cells into resting position (G0 cells).

[Application of NMR-CT in the staging of cancer of the digestive organs]

To assess the potential of NMR-CT for demonstrating cancer of the digestive organs, we examined a total of 232 patients (89 with esophageal cancer, 52 with liver cancer, 40 with colorectal cancer, 9 with pancreatic cancer, 9 with gastric cancer, and 33 with other diseases). NMR-CT has many features, but we use especially those features which it is possible to select not only in the transverse plane but also in the coronal and sagittal planes, and it has excellent soft tissue contrast resolution. Our machine is a Picker International NMR-CT using a superconducting magnet of 0.256 tesla. Diagnosis of lymph node involvement of esophageal cancer. Using only the coronal plane, each patient was scanned by the spin echo technique (TE = 40, TR = 400) from the plane of the descending aorta to the plane of the trachea 1 cm in thickness, at 1 cm intervals, continuously. All the vessels were clearly differentiated as no-signal regions, especially in coronal images, from areas of carcinomatous involvement. Lymph nodes were identified as intense grey masses in fat tissue of high intensity. Twenty cases were proved by surgery or autopsy, and it was possible to assess 160 lymph-node groups. A total of 25 patients were imaged as having positive lymph nodes, but 17 of them had metastasis-positive nodes. In other 135 nodes imaged as negative lymph nodes, only two had metastasis and 133 were negative for metastasis. Overall accuracy was 93.8%. Diagnosis of liver cancer. Intrahepatic vessels were clearly imaged without using contrast enhancement in NMR-CT, so it was easy to diagnose the segment containing the tumor and to detect tumor emboli in the portal vein. The capsule was imaged in 84% (16/19) using IR techniques, although only 37% (7/19) could be imaged by X-CT. Diagnosis of colorectal cancer. Using the sagittal plane, the sacrum, urinary bladder and other organs were imaged better parallel to their axis, so that the relationship between rectal cancer and surrounding organs could be clearly visualised with NMR-CT. With regard to lymphatic metastasis, coronal imaging was useful for picturing mesenteric and pelvic vessels, so that lymph nodes were imaged as low-intensity masses along the vessels. Lymph metastasis almost 1 cm size can be detected using coronal NMR-CT.

The proliferative potential of human pituitary tumors in situ

At the start of transsphenoidal microsurgery for removal of various types of pituitary adenomas, 21 patients received a 1-hour intravenous infusion of 5-bromodeoxyuridine (BUdR, 200 mg/sq m) to label tumor cells in the deoxyribonucleic acid (DNA) synthesis phase (S-phase). Excised tumor specimens were fixed in 70% ethanol and stained by the indirect peroxidase method using anti-BUdR monoclonal antibody as the first antibody. The percentage of BUdR-labeled cells, or S-phase fraction, was calculated for each specimen. The S-phase fraction was less than 0.1% in nine cases, 0.1% to 0.5% in seven, and greater than 0.5% in five. Except in two cases of Nelson's syndrome, in which it was greater than 1%, the S-phase fraction did not correlate with any other variable, including patient age, tumor size, or the duration of signs and symptoms. The small S-phase fraction of most of the pituitary adenomas correlates well with the clinical behavior of these tumors, which grow much more slowly than other kinds of brain tumors such as gliomas. However, the S-phase fractions varied by as much as one order of magnitude. The higher S-phase fractions may reflect aggressive and invasive growth. These results indicate that immunohistochemical studies of cell kinetics using BUdR and anti-BUdR monoclonal antibodies may provide information about the biological characteristics of pituitary adenomas which could lead to the design of appropriate treatment regimens (including surgery, radiation therapy, and chemotherapy) for individual patients.

In situ cell kinetics studies on human neuroectodermal tumors with bromodeoxyuridine labeling

Thirty-eight patients undergoing surgical removal of neuroectodermal tumors of the central nervous system were given a 1-hour intravenous infusion of bromodeoxyuridine (BUdR), 150 to 200 mg/sq m, to label tumor cells in the deoxyribonucleic acid (DNA) synthesis phase (S-phase). The excised tumor specimens were divided into two portions: one was fixed with 70% ethanol and embedded in paraffin and the other was digested with an enzyme cocktail to make a single-cell suspension. The paraffin-embedded tissues were stained by an indirect peroxidase method using anti-BUdR monoclonal antibody (MA) as the first antibody. Single-cell suspensions were reacted with fluorescein isothiocyanate (FITC)-conjugated anti-BUdR MA's for flow cytometric analysis. S-phase cells that had incorporated BUdR into their DNA were well stained by both methods. The percentage of BUdR-labeled cells, or S-phase fraction, was calculated in tissue sections by microscopic examination and in single-cell suspensions by flow cytometric analysis. The biological malignancy of the tumors was reflected in the S-phase fractions, which were 5% to 20% for glioblastoma multiforme, medulloblastoma, and highly anaplastic astrocytoma, but less than 1% in most moderately anaplastic astrocytomas, ependymomas, and mixed gliomas. Two juvenile pilocytic astrocytomas and two low-grade astrocytomas from children had high S-phase fraction despite the fairly benign and slow-growing nature of these tumors. These results indicate that the S-phase fraction obtained immunocytochemically with anti-BUdR MA's may provide useful information in estimating the biological malignancy of human central nervous system tumors in situ.

[Combination therapy of local administration of OK-432 and radiation on a murine fibrosarcoma (NFSa)--combination effect and histological examination]

The combined effect of radiation with local administration of OK-432 was studied using natural fibrosarcoma (NFSa) of C3H mice that are less immunogenic and resistant to radiation (TCD 50, 83, 15 Gy). When 2KE of OK-432 was administered together with 1 X 10(6) tumor cells, tumor survival was inhibited in 7/8 (87.5%) of mice. Single local administration of OK-432 (2KE, 4KE, 8KE) showed hardly any effect on tumor survival. Combined treatment of 2KE of OK-432 and 4-Gy radiation, however, not only controlled tumor growth but also eradicated 1/5 (20%) of them, compared with single application of 45-Gy radiation. OK-432 worked most effectively when administered just before or after the application of X-rays. The optimum dose of OK-432 was studied by administering 2KE, 4KE and 8KE of the agent together with the application of 55-Gy radiation. 8KE groups showed the best eradication rate but 4KE groups showed the best cure rate. Therefore, the optimum dose was considered to be between 4KE and 8KE. With regard to histological effects, both the single radiation treatment and its combined treatment with OK-432 were most effective on the 6th day. The degree of degeneration and necrosis of tumor cells together with lymphocyte exudation were much higher in the combined treatment than in single radiation application.

[A clinicopathological study of five cases of adenosquamous carcinoma of the stomach]

Five cases of adenosquamous carcinoma with resected stomach were subjected to this study, and the clinicopathological characteristics of this condition were described. The five patients represented 0.8% of 589 cases of resected stomach. There were two men and three women ranging in age from 40 to 70 (average, 62.8). Macroscopically, the adenosquamous carcinomas were all advanced gastric cancer situated in the lower body along the lesser curvature of the stomach, averaging 7.6 cm in size. The characteristic finding was the histologically differentiated type, invading to the serosa. Lymph node metastasis was most prominent.

[Metastatic intracerebral malignant fibrous histiocytoma from the lung]

Malignant fibrous histiocytoma usually develops in the extremities, peritoneal or retroperitoneal space and the thigh. The occurrence in the lung and brain is quite rare. We report two cases of metastatic intracerebral malignant fibrous histiocytoma from the lung. The first patient developed cerebral metastasis six years after treatment of the primary site, and the second one died two months after the diagnosis of generalized metastases. Both were quite resistant to radiation therapy.

[A cell kinetic study of human central nervous system tumors with 5-bromodeoxyuridine (BrdU)]

Sixty-six patients with various types of central nervous system (CNS) tumors were given 150-200 mg/m2 of 5-bromodeoxyuridine (BrdU) intravenously at the start of surgery, in order to label DNA synthesizing cells in the tumor with BrdU. The excised tumor specimens were fixed in chilled 70% ethanol for at least 12 hours, embedded in paraffin, and cut into 6-8 mu thick sections. The tissue sections were deparaffinized, denatured with HC1, and stained by indirect peroxidase method using anti-BrdU monoclonal antibody as the first antibody. The percentage of labeled cells among total cells (LI: labeling index) was calculated in each tumor specimen. The average of LIs was over 10% in glioblastoma multiforme, medulloblastoma, and metastatic tumor. On the other hand, the LIs were very low, i.e. less than 1% in most cases of ependymomas, mixed gliomas, and moderately anaplastic astrocytomas. In highly anaplastic astrocytomas, the average of LIs resulted in 7.4%. The LIs of slow-growing tumors, such as pituitary adenomas, meningiomas, acoustic neurinomas, were less than 1%, except in Nelson's syndrome and a few cases of meningiomas. The LIs obtained thus seem to correlate with the clinical behavior of each type of tumor. However, there was still a magnitude of differences in LIs between the tumors which were histopathologically alike. These results indicate that the LI obtained by the immunohistochemical method using anti-BrdU monoclonal antibody may supplement the current histopathological diagnosis in characterizing as well as estimating the biological malignancy of individual CNS tumors.

Cell kinetic studies of in situ human brain tumors with bromodeoxyuridine

At the time of surgery, 18 patients with various brain tumors were given a 1-h i.v. infusion of bromodeoxyuridine (BrdUrd), 150-200 mg/m2. At an infusion rate of 200 mg/m2/h, serum BrdUrd levels of 8 microM were achieved. After the infusion, tumor tissue was obtained and divided into two portions. One portion was fixed in 70% ethanol, embedded in paraffin, and sectioned; the sections were deparaffinized, denatured with 2 N HCl, and reacted with monoclonal antibodies against BrdUrd (anti-BrdUrd MAb). BrdUrd-labeled nuclei were demonstrated satisfactorily by an indirect peroxidase method. The other portion was dissociated into single cells with a DNase enzyme cocktail and reacted with FITC-conjugated anti-BrdUrd MAb to determine the percentage of BrdUrd-labeled cells or with chromomycin A3 for DNA analysis. The single-cell suspensions were analyzed by flow cytometry. The fraction of S-phase cells in the tissue sections was similar to both the percentage of BrdUrd-labeled nuclei and the S-phase fraction determined by flow cytometric analysis. The results obtained with BrdUrd-labeled nuclei were similar to those obtained from previous autoradiographic studies of various brain tumors exposed to a pulse of 3H-thymidine. Since BrdUrd is not radioactive and is nontoxic at the dosage used, these techniques, together with the histopathological diagnosis, may help to predict the biological malignancy of individual tumors.

Magnetic resonance imaging of experimental brain edema in cats

The authors observed the natural course of experimental brain edema in vivo using magnetic resonance (MR) imaging. To detect and qualify the edematous lesion, they obtained images by the spin echo technique (repetition time, 2100 ms; echo time, 80 ms). These showed the maximal brain edema on the 1st to 3rd days after the operation, as evidenced by a pixel density study and a finding of mass effect. On MR images enhanced with manganese, the inversion recovery technique (repetition time, 2100 ms; inversion time, 500 ms) demonstrated the edematous lesion as a high signal intensity area with good spatial resolution. Moreover, the follow-up inversion recovery images with manganese suggested that there was a system for absorption of edema fluid between blood vessels and the edematous lesion. The authors think that MR imaging is an important technique for observation of the dynamics of experimental brain edema.

Factors modifying cytotoxicity induced by 5-FU and hydroxyurea

Pretreatment of exponentially growing 9L cells for 24 hours with a nontoxic (0.77 microM) or moderately toxic (7.7 microM) concentration of 5-FU (5-FUra) enhanced cell kill induced by a subsequent 6-hour treatment with 1.3 mM hydroxyurea (HU) by a magnitude of 1 log. In confluent 9L cultures or 9L cells treated in serum-free medium that decreased the cycling population, however, the 5-FUra-HU combination did not enhance the cell kill. No recovery from potentially lethal damage was observed for up to 24 hours after treatment of 9L cells with 7.7 microM 5-FUra alone or with 0.77 or 7.7 microM 5-FUra followed by 1.3 mM HU. These results show that 5-FUra and HU in combination kill cycling cells effectively and that cytotoxicity is fixed on completion of the treatment. Although the number of sister chromatid exchanges per metaphase increased significantly with increasing length of exposure to a nontoxic (0.77 microM) or moderately toxic (7.7 microM) concentration of 5-FUra, subsequent treatment with HU that resulted in cell kills of 70%-80% and 99%, respectively, did not increase the number of sister chromatid exchanges per metaphase beyond that expected from 5-FUra treatment alone. Thus, the enhanced cell kill does not appear to be a result of direct DNA damage.

[Preoperative combination therapy involving local administration of a non-specific immunoactivated preparation (OK-432) and chemotherapeutic preparations for patients with stomach cancer]

OMF therapy, which is a combination therapy consisting of OK-432 administered locally, Mitomycin C and 5-Fluorouracil, was administered to 50 cases of stomach cancer (52 episodes) preoperatively. Judging the criterion for a positive (+) effect as being the existence of degeneration or necrosis in 1/3-1/2 of carcinomas visible within whole fields, the ratio of histological effectiveness shown by this therapy was 75%. As for its effect on metastatic foci of lymph nodes, when 70 case from an n1 group and 8 from an n2 group with metastatic positive lymph nodes, including 17 cases (4 in Stage II and 13 in Stage III) ablated for curing were studied, a greater than positive (+) effect was shown in 51 out of the total of 78. Consequently the effective ratio was 65%. The survival ratio of 16 cases in Stage III on the 48th month calculated by the Kaplan Meier method was 78.6%. The survival time of 50% of 9 cases in Stage IV (absolute non-curing ablation) was 15 months. Tissue samples were examined constantly after local administration of OK-432. Exudation of neutrocytes was shown on the 1st day, and that of histiocytes, lymphocytes and plasmacytes on the 4th day. At this stage, degeneration of the primary focus or necrotizing change was observed. Interstitial reaction peaked on the 14th day, but histiocytes tended to decrease.

Creatine kinase (CK)-linked IgA in Isaacs' syndrome. An immune complex disease?

Electrophoresis of serum from a patient with Isaacs' syndrome revealed an atypical creatine kinase (CK) isoenzyme pattern which contained an extra band migrating between CK2(MB) and CK3(MM). Immunofixation demonstrated that the extra band was a complex of CK3(MM) and IgA. The presence of this complex seemed to correlate with increased serum CK levels which were associated with the aggravation of symptoms. Immunofluorescence studies on muscle biopsy samples revealed the presence of the complex in the muscle fiber membrane and motor endplate. The existence of CK-linked IgA in an Isaacs' syndrome suggests that an immunological abnormality may play a role in the pathological process of this rare syndrome.

[Regional blood flow of experimental brain tumors with special reference to effects of chemotherapy and radiotherapy]

Regional blood flow and capillary permeability in the experimental brain tumors and their surrounding brain tissue of rats were measured with quantitative 14C-antipyrine and 14C-alpha-aminoisobutyric acid (AIB) autoradiographic method. The pharmacokinetic implications with respect to drug delivery to tumor tissue and the effect of ionizing irradiation were discussed in these physiological measurement. A suspension of 1 X 10(4) rat glioma cells (E239 RG 12) was stereotactically implanted into the right basal ganglia of CD-Fisher rats, and spherical brain tumors developed 10-17 days after implantation with a diameter of 1--5 mm. Autoradiographic investigations were performed for rats with small tumors (1--2 mm in diameter) and large tumors (4--5 mm in diameter). The uniform blood flow (91.7 +/- 13.1 ml/100 g/min: mean +/- S.E.) was observed in small tumors with the patchy low flow area (56.7 +/- 12.5 ml/100 g/min) surrounding the tumor. In large tumors, the blood flow was markedly decreased in the central part of the tumor (28.3 +/- 2.4 ml/100 g/min) with a ring shaped high flow area in the peripheral part (59.3 +/- 5.9 ml/100 mg/min). The blood flow in the brain adjacent to the tumor (30.5 +/- 2.5 ml/100 g/min) was lower than that in the peripheral part of the tumor. The uptake of 14C-AIB was quite similar to that of 14C-antipyrine suggesting the smaller permeability in the central part of the tumor. Neuropathological studies did not reveal necrotic foci, but viable cells in these areas.(ABSTRACT TRUNCATED AT 250 WORDS)

Rapid detection of S-phase cells by anti-bromodeoxyuridine monoclonal antibody in 9L brain tumor cells in vitro and in situ

FITC-conjugated anti-bromodeoxyuridine (BrdUrd) monoclonal antibody (anti-BU-MAb) was used to detect S-phase cells of 9L rat brain tumor cells in vitro and in situ. Monolayer 9L cells were treated with 0.625-20 microM of BrdUrd for 30 min, harvested, and reacted with a 1:100 dilution of FITC-conjugated anti-BU-MAb and analyzed with a flow cytometer. BrdUrd-treated cells stained satisfactorily with antibody. Values obtained for the labeling index using this method (48.6%) were 10%-20% higher than the fraction of cells in S-phase calculated from DNA histograms or as the labeling index calculated from autoradiographs of cells pulse-labeled with 3H-thymidine. BrdUrd (1-40 mg/kg) was administered by i.p. injection to rats bearing 9L brain tumors. Single cell suspensions obtained by disaggregation of excised tumors were stained with anti-BU-MAb. The percentage of fluorescent cells (15.9%) calculated using this method was similar to that of S-phase cells (17.2%) calculated from DNA histograms and from autoradiographics for tumor bearing rats pulse-labeled with 3H-thymidine in situ. The antibody staining technique is a rapid and accurate method for various cell kinetic studies both in vitro and in vivo in a rat model, and has promise as a technique for the study of cell kinetics in humans.

Immunocytochemical demonstration of S-phase cells by anti-bromodeoxyuridine monoclonal antibody in human brain tumor tissues

Five patients with various brain tumors received bromodeoxyuridine (BrdU), 150-200 mg/m2 i.v., at the time of craniotomy. Biopsied materials were fixed in 70% ethanol, sectioned, denatured with hydrochloric acid, and reacted with monoclonal antibodies against BrdU. Immunofluorescence and immunocytochemical methods were used to visualize BrdU-labeled nuclei. Our results showed that both methods demonstrated BrdU-labeled nuclei satisfactorily in tissue sections. Thus, BrdU can be used to measure the proliferative potential of human tumors in situ.

Clonazepam monotherapy for epilepsy in childhood

Sixty patients (age-range one month to 14 years) with other types of epilepsy than infantile spasms were treated with clonazepam. Disappearance of seizures and normalization of abnormal EEG with disappearance of seizures were recognized in 77% and 50%, respectively. Seizures disappeared in 71% of the patients with generalized seizures and 89% of partial seizures. Improvement of abnormal EEG was noticed in 76% of diffuse paroxysms and in 67% of focal paroxysms. In excellent cases, mean effective dosages were 0.086 +/- 0.021 mg/kg/day in infants and 0.057 +/- 0.022 mg/kg/day in schoolchildren, this difference was statistically significant (p less than 0.005). The incidence of side effects such as drowsiness and ataxia was only 5%.