External beam irradiation of prostate cancer. Experience in 163 patients

From 1973 to 1979, 163 patients with biopsy proven adenocarcinoma of the prostate were treated with a curative intent utilizing megavoltage external beam irradiation at Rush-Presbyterian-St. Luke's Medical Center or Lutheran General Hospital. The actuarial survival at 5 years for the whole group is 78%. Survival was found to depend on initial stage and grade of disease. Local failure alone occurred in 3% of the patients, yet represented a component of failure in 7%. The effects of stage, grade, dose and field size on survival, patterns of failure and complications are discussed.

A novel method for radiolabeling antigen-binding receptors of lymphocytes

Antigen-binding receptor (ABR) molecules have been selectively radiolabeled and isolated from immunized chicken spleen cells. The specific radiolabeling of the receptors has been accomplished by utilizing a novel technique employing lactoperoxidase (LPO) covalently linked to antigen (Ag) for which human gammaglobulin was used. The cell surface ABRs were first bound to the Ag-LPO conjugates through specific recognition sites on the Ag portion of the conjugates. The bound LPO portions were then allowed to catalyze the radioiodination of the ABRs. After radiolabeling, cells were solubilized with detergents. ABRs still bound to Ag-LPO conjugates were directly isolated from the lysates via immunoaffinity chromatography utilizing an immunoaffinity reagent directed toward the antigen portion of the ABR-Ag-LPO complex. The radioactive materials isolated in this way were then analyzed via SDS-PAGE under reducing conditions. It appears that as expected, most of the specifically-labeled and isolated materials were immunoglobulin (Ig). Both the membrane-bound form of the heavy chain (mol. wt 77 K) as well as the secreted form (mol. wt 67 K) were detected, along with the light chain (mol. wt 25 K). An additional polypeptide of mol. wt 55 K was also selectively labeled and isolated along with the Ig. This may be a molecule closely associated with the membrane immunoglobulin on B-cell surface.

The influence of surgery and radiation therapy on patients with brain metastases

The place for operation and for radiation therapy in the management of brain metastases is reviewed from the experience of 1895 patients treated in two studies of the Radiation Therapy Oncology Group. Operative removal may be of benefit to patients with solitary peripheral lesions in non-critical brain locations. Operation is also appropriate when the diagnosis is in doubt. Radiation therapy with appropriate steroid management is of benefit to patients with multiple metastases or where operative intervention is not reasonable. Short course low-dose treatment has been as beneficial as more aggressive prolonged radiation therapy.

The common idiotypic specificity of anti-a2 allotype antibodies: contribution of H and L chains to idiotype expression

Previously an idiotypic specificity common to anti-a2 allotype Ab from 15 rabbits was detected and characterized. The contribution of H and L chains to the expression of this common idiotypic specificity was determined. Two types of recombinant IgG were prepared: (1) H chains from anti-a2 Ab with L chains from normal a3b4 IgG, and (2) L chains from anti-a2 Ab with H chains from normal a3b4 IgG. By inhibition of binding radioimmunoassay, recombinant IgG having either H or L chains from anti-a2 did not inhibit the binding between anti-a2 Ab and anti-idiotype Ab. By direct binding radioimmunoassay, recombinant IgG of H chains from anti-a2 Ab with L chains from a3b4 IgG reacted with anti-idiotype Ab whereas recombinant IgG with H chains from normal a3b4 IgG and L anti-a2 Ab is determined primarily by the H chain; however, the full expression of the common idiotypic specificity requires the interaction of both H and L chains from anti-a2 Ab.

Prostaglandin H synthase-mediated reaction of carcinogenic arylamines with tRNA and homopolyribonucleotides

Prostaglandin H synthase mediates the reaction of an extensive series of carcinogenic arylamines with tRNA. Structure-activity relationships suggest that benzidine is especially reactive due to extended conjugation between the 4,4'-diamino groups. In trapping experiments with homopolyribonucleotides, benzidine reacts with polyguanylic acid but 4-aminobiphenyl reacts with polycytidylic acid. The nitrenium ion of 4-aminobiphenyl (formed by N,O-acyltransferase activation of N-hydroxy-4-acetylaminobiphenyl) reacts primarily with polyguanylic acid and to a lesser extent with polyadenylic acid. The results suggest that arylamine activation by prostaglandin H synthase does not involve nitrenium ion formation.

Induction of unscheduled DNA synthesis in primary culture of dog, rat, and mouse urothelial cells by arylamine and nitrofuran derivatives

The induction of unscheduled DNA synthesis in primary cultures of urothelial cells from rats, mice, and dogs by nitrofurans and arylamines and their derivatives was examined. Electron microscopy of the culture from rat cells showed the characteristics of epithelial cells. The cultured cells were exposed to the test chemicals in a serum-free medium containing 10 mM hydroxyurea and [3H]thymidine for 24 hr, and unscheduled DNA synthesis was determined by autoradiography. N-Hydroxy-2-aminofluorene, N-hydroxy-2-acetylaminofluorene, N-hydroxy-4-amino-biphenyl, and N-hydroxy-4-acetylaminobiphenyl were active in inducing unscheduled DNA synthesis in the urothelial cells of rats, mice, and dogs. 2-Aminofluorene, N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide, and 2-amino-4-(5-nitro-2-furyl)thiazole were active only in dog cells. 2-Acetylaminofluorene and 4-aminobiphenyl were not active. These results demonstrate that urothelial cells contain enzymes that can selectively activate bladder carcinogens and their metabolites.

Relationship of metabolic activation of N-hydroxy-N-acylarylamines to biological response in the liver and mammary gland of the female CD rat

Intraperitoneal injection of the N-formyl, N-acetyl, or N-propionyl derivatives of N-hydroxy-4-aminobiphenyl, N-hydroxy-2-acetylaminofluorene, or N-(4-biphenyl)glycolamide disclosed that the ability of these compounds to induce mammary tumors in the female CD rat was greater if the compound was able to be metabolized to a reactive product by one of two soluble enzymes obtained from both the liver and mammary gland. A similar but weaker association between the formation of gamma-glutamyltranspeptidase-positive foci and cellular altered foci of the liver was also observed. The enzyme related to the tumorigenicity of these compounds was characterized by a highly specific capacity to form adducts from the acetyl and propionyl derivatives. The other enzyme exhibited greater activity with N-formyl substrates. The two enzyme activities were separable by ion-exchange chromatography on DEAE-cellulose and by gel filtration on Sephacryl. Liver microsomes also possessed the capacity to activate both the formyl and acetyl derivatives to reactive species; formyl substrates were 7 to 8 times more active than acetylated compounds. The microsomal activities and the formyl-preferring soluble enzyme were inhibited by diethyl-p-nitrophenylphosphate, a microsomal deacylase inhibitor. The cytosolic enzymes that are most active with the acetyl and propionyl substrates were little affected by this organophosphate compound. The microsomal activation was not due solely to deacylation of the hydroxamic acid, since formylated and acetylated substrates were hydrolyzed at approximately the same rates.

Activation of N-hydroxyphenacetin to mutagenic and nucleic acid-binding metabolites by acyltransfer, deacylation, and sulfate conjugation

N-Hydroxyphenacetin was activated to a mutagen in the Salmonella-Ames test by rabbit liver acyltransferase, rat liver cytosol, and rat liver microsomes. N-[ring]3H]-Hydroxyphenacetin was bound to transfer RNA when activated by acyltransferase from rabbit or rat liver or rat liver microsomes. The acyltransferase-catalyzed binding was not inhibited by paraoxon, a deacetylase inhibitor. The use of N-hydroxyphenacetin radioactively labeled in the acetyl group, as well as the ring, indicated that deacetylation was involved in the microsome-catalyzed binding reaction. In addition, the microsome-catalyzed binding was inhibited 90% by paraoxon. p-Nitrosophenetole, a deacetylated derivative of N-hydroxyphenacetin, was synthesized and bound to transfer RNA without enzymatic activation. Activation of N-hydroxyphenacetin by sulfate conjugation was also found to lead to binding to transfer RNA. The data implicated acyl transfer, deacetylation, and sulfate conjugation as possible routes for the activation of N-hydroxyphenacetin.

Characterization of a macromolecular aggregate of ovine pituitary corticotropin-beta-lipotropin common precursor

A macromolecular aggregate of corticotropin-beta-lipotropin common precursor had been observed in ovine pituitary preparations as an excluded fraction of Sephadex G-200 gel filtration. This fraction could not penetrate a 10% gel during sodium dodecyl sulfate-polyacrylamide gel electrophoresis, when 2-mercaptoethanol or other disulfide-cleaving agents were not present in the buffer used to solubilize the protein preparation prior to the electrophoresis. On a 4.6% gel (acrylamide:bisacrylamide, 20:1), the material migrated as a diffuse band to a position between those of beta-galactosidase (Mr 130 000) and myosin (Mr 200 000). Both observations were consistent with an apparent Mr greatly in excess of that of the corticotropin-beta-lipotropin common precursor reported by many investigators. Neither 5% SDS nor 1% Triton X-100 could dissociate the macromolecular aggregate, but 2-mercaptoethanol and urea, either alone or in combination, were able to dissociate it to two main protein components, one of which was identified as corticotropin-beta-lipotropin with an apparent Mr of 34 000. The fact that urea alone could dissociate this macromolecular aggregate led us to believe that it might be a non-covalent aggregate and that 2-mercaptoethanol probably did not achieve the dissociation through the cleavage of an interchain disulfide bond but by bringing about conformational changes as a result of reduction of intrachain disulfide bonds so that aggregation became unfavorable. Moreover, the dissociation by urea or by 2-mercaptoethanol was found to be irreversible. The origin of the macromolecular aggregate of corticotropin-beta-lipotropin common precursor remains obscure.

Effects of partial hepatectomy and dietary phenobarbital on liver and mammary tumorigenesis by two N-hydroxy-N-acylaminobiphenyls in female CD rats

The objective of this study was to investigate the induction of liver tumors by arylhydroxamic acids. The potential involvement of sulfate conjugation was minimized by the administration of a N-hydroxy-4-acylaminobiphenyl to female CD rats. This experimental design provided for the exposure of a target organ that has only a low capacity for activation of hydroxamic acids by sulfate conjugation, with a carcinogen that does not induce tumors in liver that possess a high sulfotransferase activity. A single dose of the N-formyl or N-acetyl derivatives of N-hydroxy-4-aminobiphenyl was given i.p. at 0.4 mmol/kg body weight to 34-day-old animals. In attempts to amplify the hepatocarcinogenic potential of the compounds, partial hepatectomy 24 hr before the chemical injection and subsequent long-term treatment with phenobarbital in the diet were carried out. For comparative purposes, other animals were subjected to three additional partial hepatectomies subsequent to the carcinogen administration instead of the phenobarbital treatment. The experiments were terminated 64 weeks after injection. Both the N-formyl and N-acetyl derivatives of N-hydroxy-4-aminobiphenyl, in conjunction with partial hepatectomy and subsequent treatment of dietary phenobarbital, induced a high incidence of neoplastic nodules and gamma-glutamyltranspeptidase-positive foci in the liver. Only one hepatocellular carcinoma was observed in each treatment group. Repeated partial hepatectomies enhanced the yield of gamma-glutamyltranspeptidase-positive foci but were ineffective in producing neoplastic nodules. In addition to the liver lesions, mammary tumors were also induced. Importantly, an inhibitory effect of the subsequent administration of phenobarbital was observed on mammary tumor formation, possibly because of alterations in hormone metabolism resulting from the induction of microsomal enzymes by phenobarbital, which resulted in a decreased promoting effect. There was no difference in the tumorigenicity of the formyl and acetyl derivatives in these experiments.

New syntheses of N-(guanosin-8-yl)-4-aminobiphenyl and its 5'-monophosphate

N-Acetoxy-4-trifluoroacetylaminobiphenyl (N-acetoxy-TFAABP) reacted readily with Guo and GMP at neutrality in a one-step fashion to yield N-(guanosin-8-yl)4-aminobiphenyl (Guo-ABP) (I) and N(guanosin-8-yl)-4-aminobiphenyl-5'-monophosphate (GMP-ABP) (II), respectively. GMP-ABP could also be formed in much lower yield from the reaction of N-acetoxy-4-formylaminobiphenyl (N-acetoxy-FABP) with GMP (pH 7.0) under more rigorous conditions. Enzymatic hydrolysis of GMP-ABP with alkaline phosphatase in Tris buffer (pH 8.0) at 37 degrees C yielded Guo-ABP. Guo-ABP showed a brilliant blue fluorescence on exposure to 366 nm UV light and its UV absorption spectrum was identical to that of Guo-ABP prepared by Kriek via a different route. Elemental analysis and nuclear magnetic resonance (NMR) data further confirmed the identity of this compound.

Arylhydroxylamine-induced ribonucleic acid chain cleavage and chromatographic analysis of arylamine-ribonucleic acid adducts

Reaction of N-hydroxy-2-aminofluorene (N-OH-AF) with rRNA at pH 5.0 decreased the molecular weight of the polynucleotide. Toluene-soluble aryl derivatives were released on hydrolysis of fluorenylamine- and biphenylamine-substituted RNA by treatment with venom phosphodiesterase and alkaline phosphatase. These data suggested that arylhydroxylamines, activated by incubation at pH 5.0 or by enzymatic O-acetylation, might react with the phosphate group of RNA to give unstable phosphate triesters. Spontaneous hydrolysis of these triesters would result in cleavage of the polynucleotide chain. Further enzymatic hydrolysis of the phosphate esters would yield nonpolar arylamine derivatives. Enzymatically degraded 4-aminobiphenyl(ABP)-RNA adducts were examined by high performance liquid chromatography (HPLC) for the presence of a putative phosphorylated adduct. Synthetic standards of the C-8-guanosine monophosphate-ABP adduct (ABP-GMP) and o-aminobiphenyl-O-phosphate were used as markers in the analysis of the digested RNA. A phosphate adduct of ABP was undetectable by these methods. The data also indicated that the ABP-GMP formed in the acyltransferase-mediated binding of N-hydroxy-4-acetylaminobiphenyl (N-OH-AABP) to RNA is readily degraded during the enzymatic digestion of the RNA adduct.

O-esters of N-acylhydroxylamines: toxicity and enhancement of sister-chromatid exchange in Chinese hamster ovary cells

2-Naphthohydroxamic acid, 4-n-butoxyphenylacetohydroxamic acid, and their O-sulfonate, O-formate, O-acetate, and O-propionate derivatives were studied for cytotoxicity and sister chromatid exchange (SCE) induction in Chinese hamster ovary (CHO) cells. 2-Naphthylisocyanate, 2-aminonaphthalene (2 Lossen rearrangement products of the O-sulfonate derivative of 2-naphthohydroxamic acid), and N-methyl-2-naphthohydroxamic acid were also studied. All of these chemicals were cytotoxic and significantly increased SCE frequency, although there was a lack of correlation between these 2 effects. 2-naphthylisocyanate and 2-aminonaphthalene were not as cytotoxic nor as active in inducing SCEs as the O-sulfonate ester of 2-naphthohydroxamic acid suggesting that the cytotoxicity and SCE induction of the latter are not due to its decomposition products.

Late effects of para-aortic irradiation in carcinoma of the uterine cervix and endometrium

Twenty-one patients with cervical or endometrial carcinoma and metastases to the para-aortic lymph nodes were treated with extended-field para-aortic irradiation. The late effects of this treatment were evaluated in 16 patients who had a minimum follow-up of six months. All of the patients with massive pelvic tumours died of active disease in the pelvis with or without metastases. Three patients had small-bowel complications; none of the patients who underwent exploratory laparotomy for lymph node biospy had bowel complications. The results indicate that patients with central lesions and minimal para-aortic disease benefit most from para-aortic irradiation. It is concluded that metastases to the para-aortic lymoh nodes do not necessarily indicate more distant spread, and can be cured with irradiation. The late complication rate can be minimized by reducing the dosage to the small bowel with a combination of anterior-posterior fields and 360 degree rotation or opposing lateral 120 degree arc fields, and by using the extraperitoneal approach for lymph node biopsy.

Pattern of recurrences in endometrial carcinoma and their management

During the period 1961-1971, 177 surgical candidates with clinical Stage I adenocarcinoma of the endometrium were treated. The pattern of recurrence according to the initial mode of treatment and the high risk factors predisposing to recurrence are presented. The incidence of vaginal vault recurrence was reduced from 7.4% with surgery to 1.2% by the use of adjunctive radiotherapy. Management of recurrence according to site is outlined. The local control rate for patients with local recurrence was 44% and the five-year survival rate after recurrence was 33%.

Analysis of pattern of recurrence in non-seminomatous testicular tumor

In non-seminomatous testicular tumor, 60% of failures are seen within the first three months after diagnosis. The most common site of metastasis is the lung. Occasionally, bone, liver and brain metastases are seen. In this series of 33 cases, the definitively treated Stage I patients are alive and well for an average of 6.3 years (12 patients); one was lost to follow-up. The 20 more advanced patients have not done well--16 are dead from disease with an average survival of 17 months, 3 are alive with disease for an average of two years, and one was lost to follow-up. In Stages II and III, the best results were obtained with an aggressive multimodality approach of surgery, postoperative irradiation and chemotherapy.

Free floating pigment cyst of the anterior chamber ten years after miotic therapy

A free-floating pigment cyst has been present in the anterior chamber of the eye of a 14-year-old patient with numerous pigment nodules on the border of both pupils for about ten years. As a small child this patient has been treated very successfully with miotics for accommodative esotropia.

Purification and characterization of high-molecular-weight forms of adrenocorticotropic hormone of ovine pituitary glands

A highly purified preparation of high-molecular-weight adrenocorticotropic hormone (ACTH) was prepared from ovine pituitary glands by dilute acetic acid extraction, oxycellulose fractionation. Sephadex gel filtration, and affinity chromatography on immobilized alphap(1-39)ACTH antibodies. Two ACTH peptides of molecular weights of 24 000 and 34 000 were detected by sodium dodecyl sulfate-acrylamide gel electrophoresis in this preparation. It appeared that the immobilized antibodies adsorbed two forms equally well and could not distinguish between them under the conditions used. These two ACTH peptides were found to be present in crude extracts of ovine pituitary glands, indicating that they were not artifacts produced by the purification procedure. The high-molecular-weight forms of ACTH were found to be susceptible to degradation by tissue enzymes. They could be easily destroyed during the extraction, if precautions were not taken. Moreover, they were poorly adsorbed by oxycellulose which had been used for the adsorption of ACTH activity from crude preparations by most investigators. These properties probably accounted for the fact that high-molecular-weight forms of ACTH remained undetected until very recently.

Effect of alpha-MSH on the tyrosinase activity and the rate of melanin accumulation of melanoma cells in vitro

A stimulation of the tyrosinase activity was observed when melanoma cells isolated from transplantable mouse melanomas were incubated at 37 degrees C for 6 h in the presence of 1-10 X 10(-6) M alpha-MSH. All strains of mouse melanomas studied (B-16, Cloudman S-91 and Harding-Passey), exhibited similar responses. It was also observed that the intact cellular structure of melanoma cells was not required for the ability to respond to alpha-MSH. The stimulation of the enzymic activity was accompanied by an increase of the rate of incorporation of radioactivity into melanin from L-[U-14C]tyrosine, indicating an enhanced melanogenesis of tumour cells under in vitro conditions.

PHrmonal specificity of the melanotropin-sensitive adenylate cyclase of mouse melanoma and effect of cyclic AMP on the tyrosinase activity of mouse melanoma cells, in vitro

Transplantable mouse melanomas possess a melanotropin-sensitive adenylate cyclase system which is responsive to alpha-melanotropin, beta-melanotropin, adrenocorticotropin (ACTH) and prostaglandin E1. It was found that sensitivity to ACTH was not directed towards the ACTH activity but to the intrinsic melanotropin activity of the ACTH molecule. Therefore, the melanotropin-sensitive adenylate cyclase system is hormonally specific to the intrinsic melanotropin activity of peptide hormones and is unique in the melanoma tissue. The significance of the sensitivity to prostaglandin E1 is obscure at present. The melanotropin-sensitive adenylate cyclase requires the presence of Mg2+ or Mn2+, for its enzymic activity. Ca2+ inhibit the enzyme in the presence of a wide range of concentrations of Mg2+. The enzymic activity is ATP concentration-dependent and the saturation concentration appears to be 1 mM. The enzyme is very labile in the unfractionated tumor homogenates. A washed 11000 X g particulate fraction, representing about 30-60% of the total enzymic activity, was found to be more stable and could be stored at 5 degrees C for 2 h without appreciable loss of the activity. This fraction retained sensitivity to melanotropin, prostaglandin E1 and NaF. About 20% of the activity of the tumor homogenate could not be sedimented by centrifugation at 105000 X g for 60 min. This "soluble" fraction was not responsive to melanotropin, prostaglandin E1 and NaF and might be a degradative product produced by the fractionation. Cyclic AMP and alpha-melanotropin were able to increase the tyrosinase activity of isolated mouse melanoma-cells in vitro under the same conditions.

A modified screening method for estimating erythrocyte glucose phosphate isomerase

A fluorimetric method to estimate erythrocyte glucose phosphate isomerase is described. Five mul of blood is added to 100 mul of water. Ten mul of the resulting hemolysate is incubated with a reaction mixture (200 mul) containing Tris-HCl buffer pH 8.0, 20 mumoles, MgCl(2) 2 mumoles, nicotinamide adenine dinucleotide phosphate 0.08 mumoles, glucose-6-phosphate dehydrogenase 0.2 EU and fructose-6-phosphate 0.12 mumoles. After ten minutes of 25 degrees C 20 mul of the mixture is added to 2 ml of 0.01 M phosphate buffer pH 7.4 and the nicotinamide adenine dinucleotide phosphate fluorescence determined. Two ml of water was added to the remaining reaction mixture and the hemoglobin concentration determined at 410 nm. The technique is primarily designed for use with small amounts of blood, of widely varying activity, from various animal species.