[A case of bronchogenic in situ carcinoma originating in fourth order bronchi]

A case of bronchogenic in situ carcinoma originating in forth order bronchi was reported. Sputum cytology showed class IV in lung cancer mass screening in a 69-year-old male, although X-ray was negative. Bronchofiber scopy was repeated twice, and fine granular change of spur between Blai and ii was found in the second time. Right upper lobectomy was underwent, and post-surgical histology was in situ squamous cell carcinoma. The literature on early lung cancer was reviewed, and implication for management of bronchofiberscopic early lung cancer in general rule for clinical and pathological record of lung cancer was discussed.

[A clinical study on the cases of ischemic colitis: comparison of clinical images based on time from onset of the disease to detection of bloody stool]

A study was performed on 28 cases of ischemic colitis. The patients were divided into three groups: Group A (9 cases with bloody stool detected within 2 hours after the onset of abdominal pain), Group B (7 cases with bloody stool detected in 2 to 6 hours), and Group C (12 cases with bloody stool detected after more than 6 hours). These cases were comparatively studied. Variables used were as follows: (1) age, (2) sex, (3) constipation, (4) vomiting, (5) peak value of WBC count (/microliter) after admission, (6) peak value of log CRP (microgram/dl), (7) presence of ulcerative lesion in endoscopic findings in acute stage. Using Group A B and C as classification variables, canonical discriminant analysis was performed. As a result, clear linearity was recognized in Group A-->B-->C, and the values (5), (6) and (7) were extracted as the corresponding variables. For these variables, significant difference was also noted in multivariate analysis of covariance. These results suggest that it is possible to predict the severity of the disease to some extent as represented by objective markers of inflammation by finding the time from onset of abdominal pain to detection of bloody stool.

The sensitivity to DNA single strand breakage in mitochondria, but not in nuclei, of Chinese hamster V79 and variant cells correlates with their cellular sensitivity to hydrogen peroxide

To investigate whether a relation exists between the level of DNA damage by and cytotoxicity of hydrogen peroxide, we measured the initial level of H2O2-induced nuclear and mitochondrial DNA single strand breaks in Chinese hamster V79 and H2O2-resistant variant cells (Hpr-4) with an alkaline elution technique and a quantitative Southern blot technique, respectively. The frequency of DNA single strand breaks in mitochondrial DNA induced by H2O2 was more than one hundred times that of nuclear DNA in the parent V79 cells. While a similar frequency of nuclear DNA single strand breaks was generated in V79 and Hpr-4 cells at an equidose of H2O2, a lower number of mitochondrial DNA single strand breaks were generated in Hpr-4 cells than in V79 cells by H2O2 in the range of 100 microM to 5 mM. The sensitivity to mitochondrial DNA single strand break-induction correlated with the cellular sensitivity to H2O2 in Chinese hamster V79 and variant cells.

Ectopic breast cancer: a case report and review of the Japanese literature

We report a rare case of ectopic breast cancer in a 68-year-old woman, successfully treated by surgery and chemotherapy. We found 37 cases including our case in the Japanese literature between 1933 to 1997. Our review demonstrated that the clinical features of Japanese patients who developed ectopic breast cancer was similar to previous foreign reports.

Mature and immature myeloid cells decrease the granulocyte colony-stimulating factor level by absorption of granulocyte colony-stimulating factor

We studied the effects of polymorphonuclear neutrophils (PMN) and immature myeloid cells on the granulocyte colony-stimulating factor (G-CSF) level in vitro to better understand the regulatory mechanisms of neutropoiesis. Intact normal PMN decreased the G-CSF level after incubation with recombinant human (rh) G-CSF in a time- and dose-dependent manner. The percent reduction decreased as the concentration of rhG-CSF increased. However, the cell-free PMN-conditioned medium (PMN-CM) did not decrease the G-CSF level. The intact PMN also decreased the granulocyte-macrophage (GM)-CSF level after culture with rhGM-CSF, but did not affect the monocyte (M)-CSF level after culture with rhM-CSF. Normal bone marrow (BM) immature neutrophilic cells and G-CSF-dependent acute myeloid leukemic cells (OCI/AML la) also decreased the G-CSF level, whereas K-562 cells, which have no detectable G-CSF receptors, did not affect it. Phenylarsine oxide (PhAsO), an inhibitor of endocytosis of ligand receptor complex, abrogated this decreasing effect of intact PMN and OCI/AML la cells. These findings suggest that mature and immature myeloid cells negatively regulate neutropoiesis by, at least in part, decreasing the G-CSF level probably through receptor-mediated continual absorption and metabolism of G-CSF.

[Molecular therapy for human cancer with tumor suppressor p53 gene transfer]

Molecular level approaches have demonstrated that tumor suppressor p53 gene, which is the most commonly mutated gene yet described in human cancers, plays an important role in the pathway of apoptosis triggered by DNA-damaging agents. In addition, defects in apoptosis caused by the inactivation of p53 resulted in resistance to treatment. Human gene therapy has become a reality with the development of effective techniques for delivering the gene to the target cells. These findings suggested a novel approach to cancer therapy with the direct delivery of wild-type p53 gene construct to cancer cells by using an adenoviral vector system. Restoration of wild-type p53 function markedly enhanced the antitumor effect of a common chemotherapeutic agent, cisplatin, in human non-small cell lung cancer cells as well as human colon cancer cells. The application of this technology to human cancer therapy is now in progress.

Total absence of protein 4.2 and partial deficiency of band 3 in hereditary spherocytosis

Unlike previously reported cases with total protein 4.2 deficiency due to mutations in the EPB42 gene, we describe a total deficiency in protein 4.2 with normal EPB42 alleles. Hereditary spherocytosis (HS) was observed in a Japanese woman (unsplenectomized) and her daughter (splenectomized). The mother showed a partial deficiency in band 3 and a proportional reduction in protein 4.2. She was heterozygous for a novel allele of the EPB3 gene, allele Okinawa, which contains the two mutations that define the Memphis II polymorphism (K56E, AAG-->GAG, and P854L, CCG-->CTG) and, additionally, the mutation: G714R, GGG-->AGG, located in a highly conserved position of transmembrane segment 9. The latter change was responsible for HS. In trans to allele Okinawa, the daughter displayed allele Fukuoka: G130R, GGA-->AGA, an allele known to alter the binding of protein 4.2 to band 3. The daughter presented with a more pronounced decrease of band 3, and lacked protein 4.2, resulting in aggravated haemolytic features. Although the father was not available for study, heterozygosity for allele Fukuoka has been documented in another individual who showed no clinical or haematological signs, and a normal content of band 3. We suggest that band 3 Okinawa binds virtually all the protein 4.2 in red cell precursors, band 3 Fukuoka being unable to do so, and that the impossibility of band 3 Okinawa incorporation into the membrane leads to degradation of the band 3 Okinawa protein 4.2 complex. In contrast, band 3 Fukuoka, free of bound protein 4.2, could then incorporate normally into the bilayer. Thus, protein 4.2 would not appear in the daughter's red cell membrane.

The effect of carnitine on ketogenesis in perfused livers from juvenile visceral steatosis mice with systemic carnitine deficiency

Juvenile visceral steatosis (JVS) mice have been reported to have systemic carnitine deficiency, and the carnitine concentration in the liver of JVS mice was markedly lower than that of controls (11.6 +/- 2.6 versus 393.5 +/- 56.4 nmol/g of wet liver). To evaluate the role of carnitine in mitochondrial beta-oxidation in liver, we examined the effects of carnitine on ketogenesis in perfused liver from control and JVS mice. In control mice, ketogenesis was increased by the infusion of 0.3 mM oleate, but not by L-carnitine. In contrast, although ketogenesis in JVS mice was not increased by the infusion of oleate, it was increased 2.5-fold by the addition of 1000 microM L-carnitine. Addition of 50, 100, and 200 microM L-carnitine increased ketogenesis in a dose-dependent manner. The infusion of 0.3 mM octanoate or butyrate increased ketogenesis in a carnitine-independent fashion in both control and JVS mice. These findings suggest that endogenous long chain fatty acids from accumulated triglycerides may be used as substrates in the presence of carnitine in JVS mice. The relationship between ketogenesis and free carnitine concentration was examined in livers from JVS mice. Ketogenesis increased as free carnitine levels increased until concentrations exceeded about 100 nmol/g of wet liver (340 microM). The free carnitine concentration required for half-maximal ketone body production in liver of JVS mice was 45 microM (13 nmol/g of wet liver), which corresponds to a K(m) value of carnitine palmitoyltransferase I. We conclude that carnitine is a rate-limiting factor for beta-oxidation in liver only when the carnitine level in liver is very low.

[Human gene therapy for lung cancer]

Lung cancer is one of the leading causes of cancer death in the world. The high mortality rate for lung cancer results from the absence of standard therapeutic strategies. Recent advances in molecular biology have demonstrated that multistep genetic alterations are involved in the carcinogenesis of human lung cancer. Human gene therapy has become a reality with the development of effective techniques for delivering the gene to the target cells. The efficacy of gene therapy for various types of genetic disease now being evaluated in clinical trials. These findings led us to develop a novel gene therapeutic strategy for human lung cancer that could either inhibit the oncogene expression or replace the tumor suppressor gene by using recombinant, replication-defective viral vectors. The article reviews recent highlights in this rapidly evolving field.

Absence of myocardial 123I-BMIPP uptake in the presence of a normal coronary angiogram and normokinetics on a left ventriculogram

We present the case of a 44-year-old man with abnormal myocardial fatty acid metabolism who exhibited no myocardial uptake of 123I-beta-methyl- iodophenyl pentadecanoic acid (123I-BMIPP). This patient presented to our hospital with an ECG abnormality detected during a medical check-up. He felt no chest discomfort, but a 12-lead ECG at rest showed flat T-waves in leads I, V5, and V6 with no marked ischemic changes during exercise. A left ventriculogram and coronary angiograms were normal. Thallium-201 single photon emission computed tomography imaging revealed a normal myocardial uptake, but 123I-BMIPP imaging showed no such uptake. However, 18F-labelled fluorodeoxyglucose positron emission tomography imaging after an overnight fast showed a marked increase in myocardial uptake. It appears that myocardial uptake of 123I-BMIPP was totally lacking and that energy production by the myocardium during fasting depended on the metabolism of glucose rather than of fatty acids.

Free radical chemistry of cigarette smoke and its implication in human cancer

Multiple components in cigarette smoke were analyzed for their ability to form active oxygen species using a spin trapping agent, 5, 5-dimethyl-1-pyrroline-N-oxide. The main source of O2 and H2O2 was ascribed to polyphenols in a particulate phase, whereas a synergistic effect was also observed between these polyphenols and nicotine. The vapor phase contained a factor which produced OH from H2O2 which was identified as carbonyl sulfide. Nitric oxide in the vapor phase did not show such reactivity. The formation of an active oxygen species in cigarette smoke could provide an important clue to elucidate the mechanism of tobacco carcinogenesis, since they show genotoxic effects to induce DNA strand breaks as well as epigenetic effects to act as cell proliferation signals.

Formation of free radicals from steroid hormones: possible significance in environmental carcinogenesis

In order to clarify the mechanism of environmental carcinogenesis, steroid hormones were checked for formation of free radicals and active oxygen species. In alkaline DMSO in vitro, glucocorticoids, progestines, androgens and estrogens exhibited distinct ESR signals with characteristic hyperfine structures. Accumulated data on a great number of steroid derivatives suggest that an unpaired electron is localized at position 20 in the case of glucocorticoids, whereas it is at position 3 in other steroid hormones. Since experimental conditions include oxygenation reactions and more or less reflect enzymatic reactivity, the results obtained suggest further study on the physiological formation of free radicals from steroid hormone is warranted. Although detection of the free radicals of steroid hormones in several enzyme systems was limited to estrogens, evidence suggests that glucocorticoids as well as androgens may also share the physiological formation of free radicals. The production of active oxygen species was confirmed in certain cases.

The production of colony-stimulating factors by thyroid carcinoma is associated with marked neutrophilia and eosinophilia

Cancers producing colony-stimulating factors and associated with marked leukocytosis are relatively rare. We report here a case of a thyroid cancer producing both granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF). A 72-year-old woman had a thyroid carcinoma with significant neutrophilia and eosinophilia without any evidence of infection. The serum concentrations of both G-CSF and GM-CSF were elevated significantly in this patient, which might have induced the leukocytosis. Furthermore, the G-CSF concentrations in thyroid tumor tissue and metastatic lesions in the lung and skin examined at autopsy also were extremely high.

Pivalate affects carnitine status but causes no severe metabolic changes in rat liver

To investigate the carnitine deficiency induced by pivalate, rats had free access to drinking water with or without pivalate. Consumption of 20 mmol/L pivalate for 1 wk decreased the levels of both free and total carnitine in plasma to approximately 20% of levels before treatment. After 4 wk, the concentrations of free carnitine in the liver, heart and muscle of pivalate-treated rats were approximately 60-80% of the control, and in the kidney, 26% of the control. Fractional excretion of free carnitine (FEFC) in pivalate-treated rats was measured; however, the treatment for 3 or 8 d did not affect the values relative to those obtained before treatment. Treatment with pivalate for 4 wk did not affect plasma concentrations of glucose, ammonia and free fatty acids (FFA) in the rats; however, the concentration of 3-hydroxybutyrate (3-OHB) was higher, and the FFA/3-OHB ratio was lower than those of controls. In a liver perfusion study, ketogenesis from oleate and gluconeogenesis from lactate and pyruvate in rats treated with pivalate for 4 wk were not different from controls. These results suggest that administration of pivalate did not induce the excessive excretion of free carnitine in urine, and secondary carnitine deficiency induced by intake of 20 mmol/L pivalate for 4 wk did not cause severe metabolic changes in rat liver.

Mitochondrial biosynthesis controls the sensitivity of Chinese hamster cells to hydrogen peroxide

The mechanism of H2O2-resistance of Hpr-4, a variant of Chinese hamster V79 cells, was investigated. The effect of H2O2 on the mitochondria of the parental and Hpr-4 cells was compared. First, both biochemical and ultrastructural results showed that mitochondria in the parental cells were damaged by exposure to H2O2, while those in Hpr-4 cells recovered from the damage. Second, the H2O2-resistance of Hpr-4 cells was reversibly reduced or recovered by the addition or removal of inhibitors of mitochondrial biosynthesis, respectively. Third, the parental cells were auxotrophic to pyruvate after exposure to H2O2. Fourth, H2O2-sensitivity of the parental cells was also enhanced by the inhibition of mitochondrial biosynthesis. From these results, it was concluded that the mitochondria of Hpr-4 cells apparently had a greater resistance to H2O2 than those of the parental cells and that functional mitochondria were involved in the recovery of Chinese hamster V79 cells from H2O2-induced damage.

Inverse relation of serum Helicobacter pylori antibody titres and extent of intestinal metaplasia

AIMS

To clarify the relation between the serum titre of anti-Helicobacter pylori (H pylori) antibody and the extent of intestinal metaplasia of the gastric mucosa.

METHODS

The serum anti-H pylori IgG titres of 95 asymptomatic individuals (mean age 65 years) undergoing an annual health examination were measured and compared with the extent of intestinal metaplasia (absent, moderate, or extensive), determined by examination of multiple endoscopic mucosal biopsy specimens. Serum pepsinogen I (PGI) levels, as a marker for gastric atrophy, were also measured.

RESULTS

The prevalence of seropositivity for H pylori antibody was high (> 80%), regardless of the extent of metaplasia. However, there was a negative association between the extent of metaplasia and the anti-H pylori titre: 75% of the subjects in the group without metaplasia had high (3+) antibody levels, as did 43% with moderate, and 37% with extensive metaplasia (absent v extensive). The inverse relation between the titre and the extent of metaplasia was evident when examined in those with normal PGI (> 30 ng/ml), whereas no such relation was apparent in subjects with low PGI (< or = 30 ng/ml).

CONCLUSIONS

The anti-H pylori titre correlates inversely with the extent of intestinal metaplasia, particularly in subjects with less marked gastric atrophy.

[A case of rheumatoid arthritis associated with multiple myeloma]

Previous reports have stressed the association between autoimmune disease and lympho-proliferative neoplasm. Here we report a patient in whom multiple myeloma developed about 30 years after the onset of rheumatoid arthritis. A 79 year-old woman with an about 30-year history of rheumatoid arthritis was admitted because of lumbago in December, 1993. Laboratory findings revealed M-proteinemia (IgA 2,380 mg/dl, IgG 728 mg/dl, IgM 51 mg/dl) and serum immunoelectrophoresis showed monoclonal IgA with lambda type light chain. Bone marrow aspirate contained 66.0% plasma cells. Serological tests of rheumatoid factor were positive. X-ray findings revealed radiolucent myelomatous foci in the skull and typical destructive changes of rheumatoid arthritis in multiple joint. From these findings, IgA lambda-type multiple myeloma with rheumatoid arthritis was diagnosed. Although the pathogenesis of the association between rheumatoid arthritis and multiple myeloma is unknown, prolonged antigenic stimulation manifested by rheumatoid arthritis is considered to be a possible pathogenetic factor in the development of multiple myeloma.

Case report: malignant haemobilia detected in the gallbladder--retrograde cholangiographic findings

Haemobilia caused by gallbladder cancer is a rare condition and cholangiography rarely detects gallbladder haemorrhage because cancer cells or blood clots obstruct the cystic duct. We describe a patient with haemobilia caused by gallbladder cancer, in whom retrograde cholangiography showed a cast-like filling defect in the common bile duct and, in addition, several string-like defects in the gallbladder. The string-like defects appeared to be streams of clotted blood flowing towards the common bile duct in this case of relatively minor haemorrhage.

Intraperitoneal administration of ascorbic acid delays the turnover of 3H-labelled cortisol in the plasma of an ODS rat, but not in the Wistar rat. Evidence in support of the cardinal role of vitamin C in the progression of glucocorticoid synthesis

The purpose of this investigation was to reproduce in rats the enhancing effect of vitamin C on adrenal glucocorticoid production, a phenomenon that has been repeatedly observed in our human experiments. Here, we tried to assess the impact of vitamin C pretreatment on the turnover of exogenous 3H-labelled cortisol tracer in rats. 500 mg ascobic acid in 15 ml isotonic liquid per rat was administered intraperitoneally into rats of the experimental group, and 15 ml physiological saline per rat was similarly introduced into rats of the control group. At various times after the loading of either vitamin C or saline, 3H-labelled cortisol, 20 muc/0.5 ml saline/rat, was injected subcutaneously into rats of both the experimental and control groups. Thirty minutes later, all rats were sacrificed by exsanguination, and the radioactivity content was measured in the lipophilic fractions as well as in the purified corticosteroid compounds of blood, adrenal, testis and liver samples. To test the specificity of vitamin C action, experimental results from scurvy-prone ODS rats were compared with those of scurvy-resistant Wistar rats. Results obtained are as follows: a) the practice of vitamin C loading markedly delayed the turnover of 3H-cortisol in both the plasma lipophilic fraction and the plasma cortisol fraction, a finding which indicates that the above vitamin C pretreatment enhanced the release of endogenous glucocorticoid in such as to delay the turnover of the tracer cortisol in plasma. b) The above "dilution" effect of endogenous glucocorticoid surge was very distinct in both the lipophilic fraction and the cortisol fraction of ODS rats, and was less distinct (lipophilic fraction) or insignificant (cortisol fraction) in Wistar rats, a finding to indicate that the observed effect of vitamin C was of physiological significance. c) The responses of the adrenal glands, testes and liver to vitamin C pretreatment were generally more distinct in ODS rats than in Wistar rats, but varied from one organ to another. The significance of the functional linkage between vitamin C and adrenal glucocorticoid, which has been confirmed both in both the humans and rats in our laboratory, was discussed in the light of the historical development of vitamino-endocrinology.

The localization of DMPO spin adducts of OH in endothelial cells exposed to hydrogen peroxide

Examination by electron spin resonance (ESR) spectroscopy revealed the localization of 5,5-dimethyl-l-pyrroline-N-oxide (DMPO) spin adducts of hydroxyl radicals (.OH) produced by bovine endothelial cells exposed to hydrogen peroxide. Addition of 10 mM chromium oxalate, a line-broadening agent, to the reaction mixture virtually abolished the signal of DMPO-OH spin adducts. Moreover, the spin adducts were recovered in the filtrated fraction of the cell suspension. We, therefore, concluded that the location of DMPO-OH due to .OH radicals produced by endothelial cells was extracellular. Contrastingly, the site of formation of DMPO-OH was confirmed to be intracellular by the effect of Desferal, an iron chelator, and the effect of poly(ethylene glycol), an extracellular scavenger of OH radicals, as previously reported. The DMPO-OH adducts in the cell suspension mixture were degraded by a cyanide sensitive pathway and they were apparently more unstable than in the extracellular fraction. The initial amount of DMPO-OH adducts formed in endothelial cells could potentially be monitored by the DMPO-OH signals in the extracellular reaction mixture better than those in the cell suspension mixture.

Changes of erythrocyte ouabain maximum binding after birth in neonates--in relation to erythrocyte sodium and potassium concentrations

Erythrocyte ouabain maximum binding (Vmax level) represents the number of molecules of Na-K ATPase on the erythrocyte membrane. Erythrocyte Vmax levels and sodium potassium concentrations were studied in 38 mature and 57 premature infants, including 40 very low birth weight infants, 41 children and 16 adults, in order to clarify the development of erythrocyte Na-K ATPase related to mineral balance and thermogenesis. Vmax levels were the highest (22.9 +/- 8.9 nmol/l cells) for premature infants; correlated negatively with gestational age (r = -0.77, P < 0.01). Vmax levels correlated positively with the ratio of erythrocyte potassium to sodium concentration (IC-K/Na) at < 20 nmol/l cells of Vmax levels (r = 0.72, P < 0.01), but not at > or = 20 nmol/l cells (r = 0.23). Vmax levels in very low birth weight infants, especially < 28 weeks postconception, decreased gradually with postnatal days. Ln(Vmax) levels correlated negatively with postconceptional age (r = -0.75, P < 0.01). Under 28 weeks postconception, Vmax levels were high, but not correlated with IC-K/Na. It is probable that individual Na-K ATPase molecules may be less active, and the large numbers of Na-K ATPase molecules may compensate for the individual lower activity.

[Intrathoracic giant tumor accompanied by hypoglycemia]

Some non-islet tumors can induce hypoglycemia. We report a case of an intrathoracic giant tumor accompanied by hypoglycemia. The patient was a 53-year-old woman who was found to have hypoglycemia. Chest X-ray film showed a giant tumor in the left hemithorax and rightward shift to the mediastinum. CT and MRI revealed that the tumor's border was clear. The tumor was removed by sternotomy with third and seventh inter-costal incisions. The tumor was lobulated but its border was clear. It seemed to have grown from the posterolateral thoracic wall. After the tumor was removed, re-expansion pulmonary edema occurred but was relieved by diuretics and respiratory management. Histologic findings indicated that it was probably a thymoma or a localised mesothelioma, but it could not be identified even with special stains. Solitary fibrous mesotheliomas are sometimes complicated by hypoglycemia, and some of them produce insulin-like growth factor (IGF). In this case, the pre-operative level of immuno-reactive insulin was low, so the tumor may have produced IGF.

Cerebral MRI and spectroscopy in Sjögren-Larsson syndrome: case report

We report MRI and MRS of the brain in a patient with Sjögren-Larsson syndrome (SLS) in whom fatty alcohol oxidoreductase (FAO) deficiency has been verified. MRI showed periventricular lesions, high intensity on T2-weighted and low intensity on T1-weighted images at trigones of the lateral ventricles. 1H-MRS of these lesions revealed high lipid and low N-acetyl aspartate peaks. We presume such lipids in periventricular lesions with high T2 signal may be pathognomonic of SLS.

18F-labeled octanoates as potential agents for cerebral fatty acid studies. The influence of 4-substitution and the fluorine position on biodistribution

In order to understand the structural features that might lead to an in vivo radiotracer for studying cerebral fatty acid metabolism, 8-[18F]fluorooctanoate derivatives with methyl or gem-dimethyl branching at the C4 position have been prepared. 3-[18F]Fluoro- and 4-[18F]fluorooctanoic acid have also been synthesized for studying the influence of the fluorine position on the in vivo behavior of 18F-labeled octanoic acid analogs. Radiochemical synthesis was achieved by the nucleophilic displacement of a tosylate or mesylate precursor with [18F]fluoride ion. Tissue distribution studies in rats showed low cerebral uptakes of these 18F-labeled fatty acid analogs with poor brain-to-blood ratios. 3-[18F]Fluorooctanoic acid showed considerable defluorination, evident as a high bone activity level. The initial uptake of activity in the brain after injection of ethyl 8-[18F]fluoro-4-methyloctanoate and 4-[18F]-fluorooctanoic acid remained virtually unchanged over an extended time period, similar to that previously observed for the unbranched analogs, ethyl 8-[18F]fluorooctanoate and its free acid. In contrast, the 4-gem-dimethyl branched analog was rapidly and preferentially taken up by the liver. It was shown in the metabolite analysis that labeled metabolites produced from 8-[18F]fluoro-4-methyloctanoic acid were found in blood, and that they could enter the brain to a significant degree. Thus, the present studies showed that radioactivity retention in the brain in the case of the 4-methyl branched analog was mainly attributable to its radioactive metabolites.

[Aggressive transformation of an indolent myeloma with abdominal extramedullary plasmacytoma after 6-year period of observation]

62-year-old female, who had been under observation for an indolent myeloma for six years without therapy, was admitted because of left flank pain. Various imaging modalities disclosed left pleural effusion, and a huge abdominal tumor involving the left crus of the diaphragm, spleen, stomach, pancreatic tail, left adrenal gland, left kidney and left posterior abdominal wall. Morphological and immunological examinations revealed extensive proliferation of more anaplastic myeloma cells within the tumor and in the pleural effusion than those in bone marrow on admission or at the beginning of the period of observation. Chemotherapy reduced serum M-protein, but LDH, the volume of the pleural effusion, and the size of the tumor increased. She died of pancreatitis associated with massive bleeding from the gastric tumor. Renal function was well preserved until her terminal phase. The clinical course showed the progression of indolent myeloma into an aggressive one without chemotherapeutic intervention, implying a rare subtype in terms of the natural history of multiple myeloma.

Bimodal pattern of killing of Chinese hamster V79 variant cells by hydrogen peroxide

To elucidate the mechanism of cytotoxicity of H2O2, we selected H2O2-resistant Chinese hamster V79 cells by single-step selection from a pool of spontaneous variants. The resistant cells showed bimodal sensitivity to H2O2 without exhibiting a significantly higher level of the detoxicating enzymes, catalase, glutathione peroxidase and superoxide dismutase. Mode-one and mode-two killing were observed at lower (< 300 microM) and higher (> 2 mM) H2O2 concentrations, respectively. Mode-one but not mode-two killing was prevented by iron chelators. Pretreatment with low concentrations of ascorbic acid preferentially enhanced the killing at higher H2O2 concentrations. These resistant cells were cross-resistant to t-butyl hydroperoxide and cumene hydroperoxide.

Plasma levels of insulin-like growth factor-I are reduced at one week of age in monosodium L-glutamate-treated mice

Administration of monosodium L-glutamate (MSG) to neonatal mice produces a hypothalamic syndrome consisting of stunted growth and later development of obesity. We assayed plasma insulin (IRI), thyroxine (T4) and insulin-like growth factor-I (IGF-I) to investigate their roles in the growth of the mice. Two mg/g body weight of MSG was injected into newborn male mice daily for five successive days after birth. Plasma IRI levels were increased on the after 8 weeks of age in MSG-treated mice. There was no significant difference between the plasma T4 levels in MSG-treated mice and those in controls at any age studied. In contrast to this, plasma IGF-I levels in MSG-treated mice were reduced at one week and after. These results suggest that a decreased plasma IGF-I level contributes to the retarded linear growth which develops soon after the administration of MSG, and hyperinsulinemia contributes to the later development of obesity in MSG-treated mice.

Formation of free radicals and active oxygen species from diethylstilbestrol and its derivatives

Diethylstilbestrol (DES), an estrogen analogue, was converted into a free radical in alkaline dimethyl sulfoxide as well as in an H2O2/peroxidase system. The presence of the hydroxyl group of the DES molecule was essential to free radical formation. Indenestrol A (IA), a microsomal metabolite of DES, showed a paramagnetic property without enzymatic activation. The electron spin resonance spectrum of IA seemingly corresponded to that of the enzymatically formed DES radical. In an NADH/peroxidase system, DES induced concomitant production of active oxygen species, which were also produced by IA. Related compounds of IA were also examined to compare with DES and IA. The significance of the free radical is discussed in relation to the process of carcinogenesis by DES.

[A case report of tracheal inflammatory pseudotumor]

The tracheal tumor is uncommon, and tracheal inflammatory pseudotumor seems to be rare with only four cases reported in the Japanese literature. We here in report a case of tracheal inflammatory pseudotumor in a 61-year-old Japanese man presenting with dyspnea and wheezing 2 weeks after a sub total gastrectomy Billroth I for gastric cancer in april 1991. At bronchofiberscopic examination a rounded tracheal mass 40 mm distal to the vocal cord was found. High vascular on the surface and obstruction of about 90% of the tracheal lumen was noticed. Surgery was attempted immediately and 25 mm of the trachea was excised. The histopathological findings revealed an inflammatory pseudotumor. We concluded that the tumor was caused by injury during tracheal intubation.

Lithocholic acid-sensitive mutant cells isolated from Chinese hamster ovary cells are cross-sensitive to cytoskeleton-disturbing agents

The lithocholic acid-sensitive mutant cells were isolated from CHO-9 cells mutagenized with ethylmethane sulfonate, through clonal selection on 96-well dishes. The isolated mutant cells (LSJ-11) were 3-fold more sensitive than controls in the survival to lithocholic acid and were also sensitive to other bile acids such as deoxycholic acid and cholic acid. As a preliminary characterization, it was found that the mutant cells were also sensitive to cytoskeleton-disturbing agents such as colchicine, colcemide, taxol and cytochalasin B. This is the first observation that a bile acid-sensitive mutant was isolated and was partially characterized.

Report of a Japanese girl with Marfan syndrome associated with insulin-dependent diabetes mellitus

A 3 year old girl was admitted to hospital in an emaciated condition and with polydipsia in October 1974. Following the diagnosis of diabetes mellitus, she received treatment with insulin. On the first admission, a systolic murmur was noted at the apex of the heart. In 1981, the murmur was found to be continuous with a systolic click, and echocardiography demonstrated a mitral valve prolapse. In 1982, electrocardiography revealed left ventricular hypertrophy, and the patient's X-ray showed vertebral kyphoscoliosis. Ophthalmological examination revealed slightly impaired visual acuity and a mild case of cataracts in 1986. The patient grew to be tall and thin with arachnodactylia of the hands, fingers, feet and toes. These symptoms and findings were compatible with Marfan syndrome, although the ophthalmological findings are not specific for this disease. This patient is the first case in Japan of Marfan syndrome associated with insulin-dependent diabetes mellitus, although the relation between Marfan syndrome and IDDM remains unclear.

[Cold agglutinin hemolytic anemia complicating mycoplasma pneumonia]

A case of Mycoplasma pneumonia complicated with severe hemolytic anemia, which occurred as a result of a high titer of cold agglutinin is presented. A 49 year-old male was admitted because of fever, jaundice and dyspnea. Chest x-ray showed diffuse small nodular infiltrates throughout both lung fields. Laboratory studies disclosed the following values: Hb 4.6 g/dl, Ht 13.9%, reticulocyte 11.5%, direct and indirect Coombs' test positive, haptoglobin 38 mg/dl, ESR 145 mm/hr, cold agglutinin titer 1:2,048 mycoplasma antibody titer 1:640, PPD negative. The diagnosis of autoimmune hemolytic anemia associated with Mycoplasma pneumonia was made, and treatment with minocycline and prednisolone observed striking clinical improvement. It was suggested that the cold exposure was possibly a major factor in the pathogenesis of hemolysis in this patient.

Purification and reconstitution of mu-opioid receptors in liposome

Opioid receptors solubilized from rat brain membranes with digitonin were partially purified with a newly prepared affinity resin, AF-Amino Toyopearl, coupled with a mu-antagonist Tyr-Pro-Tyr-Tyr at the C-terminus of the peptide. The purified materials were reconstituted with an inhibitory GTP-binding protein (Gi) in liposome. From displacement analyses, two binding states, with a high and a low affinities for the mu-agonist [D-Ala2,Me-Phe4,Gly-ol5]enkephalin, were observed in the reconstituted system with Gi, only a low-affinity state was observed in the reconstituted system without Gi. The results suggested that the purified materials contained the mu-opioid receptors and could functionally couple with Gi as observed in the cell membranes.

Comparative genetics of host response to N-methyl-N'-nitro-N-nitrosoguanidine. II. Inverse relationship between tumor susceptibility and salt-hydrocortisone conditioned acceleration of water turnover in rodents

The purpose of this study was to investigate the nature of the action of N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) as the modulator of gene expression. Practically, both the acceleration of daily liquid consumption following salt-hydrocortisone conditioning (sea water adaptation phenomenon) and the suppressive effect of MNNG on that gene expression were comparatively investigated among Wistar rats of both sexes, Buffalo rats of both sexes and Swiss/ICR mice of both sexes. Results obtained are as follows: 1) the responsiveness to the salt-hydrocortisone conditioning, as assessed in terms of weight-adjusted liquid consumption, decreased in the order of female Swiss mice greater than male Swiss mice greater than Buffalo rats of both sexes greater than female Wistar rats greater than male Wistar rats, a finding which indicates that an inverse relationship exists between the expression of the sea water adaptation gene and that of putative stomach proto-oncogene. 2) Additional MNNG conditioning (provision of MNNG drink) eradicated the accelerating effect of the salt-hydrocortisone conditioning on the water turnover of a rodent. 3) Evidence was presented to indicate that MNNG acted as an antiandrogen in expressing the above effect. In conclusion, our findings are taken as evidence to support the proposition that the sea water adaptation gene and the stomach proto-oncogene compete with each other in the possession of one common MNNG-sensitive (and/or steroid-sensitive) enhancer gene in their gene expressions.

Primary malignant lymphoma of the breast mimicking breast carcinoma: a case report

A case of primary malignant lymphoma of the breast in a 52 year old woman is described herein. She presented with a painless tumor of the right breast, which was elastic-hard and measured 2 X 1 cm, although there was no lymphadenopathy noted in the axilla or any other regions. Both the biopsy carried out prior to surgery and frozen sections revealed evidence of malignancy, however, histologically, it was difficult to differentiate between malignant lymphoma and carcinoma until staining with the monoclonal antibody MB1 was performed. This allowed a diagnosis of B cell malignant lymphoma of the diffuse large-cell type to be made. The patient remains alive and well 24 months after her mastectomy.

[Reduction of erythrocyte membrane band 4.2 protein in patients with obstructive jaundice]

Alteration of erythrocyte membrane proteins was studied in patients with obstructive jaundice in comparison with healthy controls. Analysis of the erythrocyte membrane proteins by SDS-PAGE revealed a slightly reduced protein 4.2 (MW 72 kDa). The erythrocytes with reduced protein 4.2 contained normal amounts of all other membrane proteins. In this study, it was demonstrated that the reduction of 4.2-protein is a common alteration in abnormal erythrocytes, target cells, and is observed in obstructive jaundice.

Self-limited neonatal familial hyperparathyroidism associated with hypercalciuria and renal tubular acidosis in three siblings

Three siblings with neonatal familial hyperparathyroidism diagnosed at age 4 months, 2 months, and 5 days, respectively, were treated. Hypercalciuria, nephrocalcinosis, and renal tubular acidosis were present in each child. In all three, there were higher responses of serum parathyroid hormone to serum calcium and higher elevation of serum calcium with oral calcium loading. The metabolism of vitamin D and calcitonin seemed to be intact. Hypercalcemia associated with the abnormal response of parathyroid hormone secretion disappeared when the children passed the age of approximately 2 years, although renal tubular acidosis and nephrocalcinosis remained. An autosomal recessive inheritance seems likely.