[Intensive 1-(4-amino-2-methyl-5-pyrimidinyl) methyl-3-(2-chloroethyl)-3- nitrosourea hydrochloride (ACNU) and cryopreserved autologous bone marrow transplantation]

High-dose ACNU followed by autologous bone marrow transplantation was administered alone or together with other agents such as cyclophosphamide, dacarbazine, carboquone or/and VP-16. The starting dose of ACNU was 200 mg/m2, with gradual escalation up to 400 mg/m2. Median duration of granulocytes of less than 100/mm3 and platelets of less than 30,000/mm3 was 4.5 days (range; 0-9) and 10.5 days (range; 0-43), respectively. Bacteremia occurred in 4 cases, but no case of pneumonia was encountered. Heart failure possibly due to the cyclophosphamide was noted in one case with arrhythmia. Out of 13 cases with measurable diseases, three patients with Hodgkin's disease, two patients with diffuse lymphoma, and one patient with follicular lymphoma attained a complete response. Partial response was obtained in two patients with non-Hodgkin's lymphoma. Two patients with melanoma and one with acute nonlymphocytic leukemia without measurable disease still remain disease-free.

Neuromuscular response in man to repetitive nerve stimulation

Paired stimulation has been used extensively in clinical neurophysiology. We studied change in the sizes of compound muscle action potentials (CMAPs) and compound nerve action potentials (CNAPs) in humans after a single electrical stimulus to the peripheral nerve. For the paired stimuli, potentials elicited by the first stimuli were used as the test responses. When the interstimulus intervals were varied, the second potentials underwent refractoriness and then were facilitated up to 20-30 ms, thereafter being depressed for 160-200 ms. When intensities were graded at fixed intervals for motor fibers the maximal effect was obtained with liminal stimulation, but was no longer observed at supramaximal stimulation. When the intensity used to obtain M-responses was half the maximum, maximal facilitations were 35% (CNAP) and 17% (CMAP) of the first potential, the respective maximal depressions being 13% and 42%. When the sizes of the two CNAPs were equalized by adjusting the second stimuli, the CMAP was facilitated (26%) up to 65 ms, thereafter being depressed (13%). These results must be taken into account when making clinical examinations that use paired stimulation.

Mouse mammary tumor virus with rearranged long terminal repeats causes murine lymphomas

Mouse mammary tumor virus (MMTV) is a slowly transforming retrovirus associated primarily with the induction of mammary tumors. It is widely accepted that T-cell lymphomas of various mouse strains are associated with extra proviruses of MMTV. These extra proviruses showed site-specific rearrangements in the U3 region of long terminal repeats (LTRs), consisting of about 400 nucleotide deletions and occasional substitution resulting in unique tandem repeats. However, the question of whether these mutant MMTVs cause lymphomas has not been experimentally resolved. Here we present distinct evidence that they do. We constructed chimeric MMTVs by replacing the LTR of the recently constructed pathogenic MMTV provirus clone with rearranged LTRs of MMTV proviruses obtained from two DBA/2 mouse lymphoma cell lines, MLA and DL-8, and inoculated them into BALB/c mice. These mice developed lymphomas, but no mammary tumors, 4 to 11 months postinoculation, whereas the original pathogenic MMTV clone alone induced mammary tumors. These results showed that the tissue specificity of MMTV tumorigenesis is determined by the LTR structures.

Presence of transplantable T-lymphoid cells in C57BL/6 mice infected with murine AIDS virus

The Duplan strain of murine leukemia virus induces murine AIDS in C57BL/6 mice. When spleen cells from C57BL/6 mice infected with the virus were transplanted into nude mice, subcutaneous solid tumors at the transplanted sites were formed and splenomegaly and lymphadenopathy were induced. These transplantable cells were Thy-1- CD4+ alpha-beta T-cell receptor-positive T cells and integrated with the pathogenic defective viral genome. These results indicate that neoplastic cells of T-cell lineage were induced by infecting C57BL/6 mice with murine AIDS virus.

Isolation and characterization of a restriction enzyme BspO4I from an alkalophilic bacterium

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Myotonic and repetitive discharges in hypokalemic myopathy associated with glycyrrhizin-induced hypochloremia

Electromyographic studies were performed in two patients with hypokalemic myopathy induced by the administration of glycyrrhizin, 270-273 mg per day for a period of two and eight months, respectively. Myotonic and repetitive discharges were observed when the serum chloride level fell below 90 mEq/l. Following the administration of potassium chloride, when the chloride level rose above 90 mEq/l, these discharges disappeared. These findings support the causal role of hypochloremia in myotonic discharges. A serum chloride level below 90 mEq/l appears to be critical in producing the myotonic and repetitive discharges.

Intraoperative radiation therapy for malignant glioma

Intraoperative radiation therapy (IORT) was used as part of the initial therapy for malignant glioma in 32 of 73 patients with histologically verified anaplastic astrocytoma (grade III astrocytoma) and glioblastoma multiforme. The initial treatment for all cases was subtotal or total tumor resection combined with external irradiation and chemotherapy. IORT was performed 1 week after tumor resection, with doses of 10-50 Gy (mean 26.7 Gy) in one session. Fourteen of 32 cases had IORT two times because of tumor recurrence. The IORT patients had survival rates at 24 and 36 months after initial treatment of 57.1 and 33.5% (median survival 26.2 months). The other 41 patients had 23.6 and 13.1% survivals (median survival 20.7 months), which were significantly lower (p less than 0.01). Tumor recurrence within the original lesion site was suspected because of clinical condition, computed tomography, and magnetic resonance imaging studies in 65.6% of the IORT group (21 cases) 12 months after initial treatment. Twenty cases of death in the IORT group, including five autopsy cases, demonstrated regional tumor recurrence with a high incidence of intraventricular tumor invasion. The authors consider IORT is beneficial for selected malignant glioma patients, including tumor recurrence, because of prolonged survival.

Identification of a novel mammary cell line-specific enhancer element in the long terminal repeat of mouse mammary tumor virus, which interacts with its hormone-responsive element

We analyzed the long terminal repeat (LTR) of mouse mammary tumor virus for sequences that influence its promoter activity by using the chloramphenicol acetyltransferase assay. A series of LTR deletion mutants and recombinants between LTR and simian virus 40 regulatory sequences were used for these studies. Through transfection experiments in three different human cell lines (T47D, MCF-7, and HeLa), we identified a novel mammary cell line-specific enhancer element on a 98-bp BanII fragment (from position -1075 to -978 upstream of the start site of transcription) which interacts with the hormone-responsive element of LTR. We also identified nuclear factors that specifically interacted with this BanII fragment in the nuclear extract from the mammary tumor cell line, T47D, but not from the HeLa cell line.

Increase in Ib inhibition by antagonistic voluntary contraction in man

1. Ib inhibition from gastrocnemius medialis (GM) muscle to soleus (Sol) muscle was studied at rest and at the onset of phasic voluntary contraction of antagonistic pretibial muscles in seventeen normal subjects. 2. In twelve out of seventeen subjects there was inhibition of Sol H reflex by GM conditioning stimulation at rest with a latency of 1.5-3.0 ms and a threshold of 0.85-1.00 times the motor threshold (MT). The amount of inhibition at 0.95-1.05 x MT, which was calculated by subtracting the size of the conditioned reflex from that of the unconditioned one, ranged from 0.8 to 5.6% of the maximal M-response or 2.9-18.3% of control H reflex. This inhibition was ascribed to Ib inhibition, taking into account its latency and threshold. 3. On weak pretibial contraction the inhibition either increased in amount or newly appeared in all the subjects. When the strength of voluntary contraction was graded from 1 to 20% of the maximum, the increment in the amount of inhibition decreased or almost disappeared at strengths of more than several per cent. These facts imply that at least some of the Ib interneurones are facilitated to fire by descending commands alone without peripheral Ib impulses. Contralateral ankle dorsiflexion did not modify the inhibition. 4. Soleus muscle H reflex was not modulated at all by cutaneous stimulation instead of GM stimulation at rest, nor was it affected by cutaneous stimulation on ipsilateral antagonistic contraction. 5. It is concluded that activity in the Ib inhibitory pathway is facilitated at the onset of antagonistic voluntary contraction. This suggests that control of the Ib inhibitory pathway may be utilized in ordinary voluntary movement, and is presumably beneficial for smooth execution of movement.

Fv-1 restriction of endogenous feline C-type RD114 virus genome phenotypically mixed with ecotropic murine leukemia viruses

Endogenous feline leukemia RD114 virus genome rendered capable of infecting mouse cells by phenotypic mixing with an ecotropic murine leukemia virus (MuLV) exhibited the Fv-1 restriction pattern of the ecotropic murine virus. However, RD114 genomes phenotypically mixed with ecotropic MuLV showed one-hit dose-response kinetics, even when titrated with murine cells with the restricted Fv-1 phenotype.

Extra mouse mammary tumor proviruses in DBA/2 mouse lymphomas acquire a selective advantage in lymphocytes by alteration in the U3 region of the long terminal repeat

We determined the nucleotide sequences of the long terminal repeats (LTRs) from mouse mammary tumor virus (MMTV) proviruses acquired in two DBA/2 mouse lymphoma cell lines, MLA and DL-8. Proviruses from MLA contained a 352-base-pair deletion from nucleotides 669 to 1020 in the U3 region of the LTR, whereas the LTR alteration of the DL-8 provirus involved both a similar 360-base-pair deletion and generation of a tandem repeat region consisting of sequences of flanking deletions. To assess the function of the rearranged LTRs, we constructed plasmids in which normal and rearranged LTRs drove the reporter chloramphenicol acetyltransferase gene and transfected them into T-cell lines (Jurkat, Molt-3, and DL-8) and the mammary tumor cell line T47D. Both rearranged LTRs were transcriptionally active, but normal LTRs were not active in either the presence or absence of glucocorticoids in all T-cell lines. In T47D cells, however, the MLA provirus LTR showed the same glucocorticoid- or progestin-dependent transcriptional activity as did normal LTRs. The DL-8 provirus LTR acquired a novel enhancer(s) by rearrangement and thus had a high basal transcriptional activity in T47D cells. The results of chloramphenicol acetyltransferase assays using plasmids with various chimeric MMTV LTRs revealed that the rearranged LTRs had lost their negative regulatory element and contained an enhancer element that was highly homologous to the enhancer A element of polyomavirus (from nucleotides 525 to 558). GR but not C3H mouse MMTV contained this enhancer. These results elucidate some of the molecular mechanisms involved in the selection of mutant MMTVs with rearranged LTRs in lymphoma cells.

[Delayed effects of radiation of patients with germ-cell tumor, with special to cerebral blood flow]

Delayed effects of radiation therapy (RT) on twenty patients with germ-cell tumors, including 17 cases of germinoma, were evaluated with special reference to cerebral blood flow (CBF). All patients except for one of germinoma had craniotomy to verify the tumor histology, then RT followed with a total dose of 39.6 to 60 Gy for each patient. A follow-up study with CT scans and MRI proved not any recurrence of the tumors during the past 14-year period between June, 1975 and April, 1989. On the other hand, CBF was measured by 133Xe inhalation 1 to 14 years after RT. 40% of all patients were below critical values of CBF with higher frequency in the younger. Statistically, the post-irradiated changes of CBF were not related to a total administered dose, grading of brain atrophy, or physical mental developments, but closely related to irradiated volume dose (product of absorbed dose and field, rad.cm3) only for the age ranging from 8 to 15 years at RT. These results suggested that late effects of RT on CBF were more strongly depend upon absorbed dose and field of irradiation to brain in children than in adolescents.

[Intraoperative radiation therapy for malignant glioma]

Intraoperative radiation therapy (IOR) is an ideal means of exterminating residual tumor after surgical resection. In this study, the clinical results of IOR using a Scanditronix Microtron MM-22 were evaluated in 14 patients with malignant glioma, five of whom had recurrent tumors. Between July, 1985 and October, 1986, 11 patients with glioblastoma multiforme (GB) were irradiated 18 times (mean, 1.6 times/case), and three with astrocytoma (Kernohan grade III) underwent IOR once each. The target-absorbed dose at 1 to 2 cm deeper than the tumor resection surface was 15 to 50 Gy. During irradiation, a cotton bolus was placed in the dead space after over 91% of the tumor had been resected. As a rule, external irradiation therapy was also given postoperatively at a dose of 30 to 52 Gy. One patient died of pneumonia and disseminated intravascular coagulation syndrome 1 month postoperatively. The 1- and 2-year survival rates of the remaining 13 patients were 84.6% and 61.5%, respectively; among the 10 with GB, they were 80% and 50%. Generally, the smaller the tumor size, the better the results. There were no adverse effects, despite the dose 15 to 50 Gy applied temporally to the tumor bed. IOR was especially effective against small, localized tumors, but was not always beneficial in cases of large tumors, particularly those with a contralateral focus. The improved survival rate in this series demonstrates that IOR is significantly effective in the "induction of remission" following surgical excision of malignant gliomas.

Structural and functional analysis of long terminal repeats of Suncus murinus mammary tumor virus

A 2.7-kilobase (kb) cDNA sequence complementary to Suncus murinus mammary tumor virus (Sm-MTV) genomic RNA [corrected] was prepared using purified virions produced by the Sm-MT cell line, which had been established from a spontaneous mammary tumor of S. murinus. It was found, by using this cDNA in Southern hybridization experiments, that Sm-MTV was endogenous to this animal and that some 50 copies of endogenous provirus were present per haploid cellular genome. In addition, a proviral Sm-MTV DNA sequence, 9.4 kb long (Sm-P-MTV10), was cloned from a Sm-MT cell genomic library, and its long terminal repeat was found to be 720 base pairs (bp) long, with the U3.R and U5 regions 574 and 146 bp long, respectively. The boundary between U3 and R was not determined with certainty, though in the cDNA, the U3 and R regions were 462 and 105 bp long, respectively. The overall homology between the U3.R regions in the cDNA and Sm-P-MTV was 75%. These two DNAs differed in such transcription regulatory signals as CCAAT and TATAA, the first being missing from the cDNA. Nevertheless, chloramphenicol acetyltransferase assays showed that the long terminal repeats of the cDNA and the Sm-P-MTV were transcriptionally active but not steroid hormone responsive. Like Mason-Pfizer monkey virus, Sm-MTV used tRNA(1,2Lys) as a primer for reverse transcription. In addition, the immunosuppressive peptide sequence common to many retroviruses was found in the env region of Sm-MTV. In these two points, Sm-MTV differed from mouse MTV.

Results of a non-controlled trial of hyperthermia combined with radiation for superficial tumours

Fifty-four patients with 65 superficial malignant lesions were treated by local hyperthermia combined with radiation therapy at the National Cancer Center Hospital, Tokyo. Hyperthermia was delivered with an Aloka Model HMS-020 (2450 MHz) or with a horn-type applicator of BSD-1000 (80-90 MHz). Relatively small tumours, those less than 4 cm in thickness, were treated by using 2450 MHz while 80-90 MHz delivered through the horn-type applicator was used for tumours exceeding 5 cm in thickness. The radiation dose was 4 Gy twice a week or 2 Gy five times a week, the total dose being 40-60 Gy. A total of six to 10 hyperthermia treatments ranging from 40 to 60 min each, with the tumour heated to more than 42.5 degrees C, were given twice a week within 1 h following radiation therapy. Complete response was achieved in 16 of the 30 patients (55 per cent) treated with the 2450 MHz microwave, and partial response in seven others (23 per cent). Tumours treated with the BSD-1000 achieved complete response in 10 out of 33 patients (30 per cent) and partial response in nine others (27 per cent). In five out of nine patients classified as partial responders, however, complete disappearance of tumour cells was noted by post-treatment histological examination. Complete plus partial response rates were thus essentially the same with the Aloka HMS-020 and the BSD-1000, though the rate of complete response was apparently higher with the Aloka unit, probably because it was used on smaller tumours.

Characterization of erythropoietin receptor of murine erythroid cells

Radioiodinated or biologically tritiated recombinant human erythropoietin was used to characterize receptors for this hormone on the surface of Friend erythroleukemic cells (745A and TSA8) and cells from mouse erythropoietic tissues (liver from fetus and spleen from animals made anemic by injection of Friend virus or phenylhydrazine). Specific binding of erythropoietin to these cells was time-dependent and dose-dependent. Binding studies at 37 degrees C showed that dissociation constants of erythropoietin-receptor complexes were in the range of 100-300 pM. The number of receptors on erythroleukemic cells increased after treatment with dimethylsulfoxide. Covalent binding of 125I-erythropoietin to its receptors with a cross-linking reagent, disuccinimidyl suberate or glutaraldehyde, resulted in the formation of two major radiolabeled products that migrated as 120-kDa and 140-kDa species on sodium dodecyl sulfate/polyacrylamide electrophoresis gels under reducing conditions. Under non-reducing conditions, both 120-kDa and 140-kDa species disappeared and two cross-linked products, a minor product with a molecular mass of 250 kDa and a major product of high molecular mass that kept it from migration into the separating gels, appeared. The relationship of the cross-linked products found under non-reducing conditions with those under reducing conditions remains to be clarified.

[Clinical use of combined radiation and hyperthermia therapy at the National Cancer Center Hospital]

At the National Cancer Center Hospital, Tokyo, hyperthermia combined with radiation was started in February 1982. At first BSD-1000 was introduced into clinical practice, followed by Thermotron RF-8 which utilizes radio frequency and then Aloka HMS-020 which utilizes microwaves. This study involved a total of 116 evaluable patients (128 lesions) from a series of patients treated by hyperthermia during a 4-year period up to March 1986. The sites of the tumors were the lower extremities in 7 patients, upper abdomen in 18, pelvic cavity in 18 patients and superficial in 82. Among 82 superficial lesions 34 were classified as showing CR and another 23 as showing PR, with a response rate of 69.5%. In 7 patients with tumors of the lower extremities none was classified as having CR or PR, the response rate being 0%. Eighteen upper abdominal tumors showed a response rate of 16.7%, with 1 of them being categorized as showing CR and 2 as showing PR. Eighteen pelvic tumors showed a response rate of 27.8%, with 1 of them being categorized as showing CR and 4 as showing PR. In 3 patients with tumors of thoracic cavity none was classified as having CR or PR, the response rate being 0%.

Radiotherapy of brain metastases

The effect of radiotherapy in 254 cases of brain metastases, treated between 1977 and 1984, were studied. The cases included 141 of lung cancer, 28 of mammary cancer, and 85 of other primary sites. The percentages of patients with improvement in clinical symptoms were 8, 39, and 66, respectively. These were groups of patients irradiated with less than 30 Gy, 30 Gy to 50 Gy, and more than 50 Gy. The 50% survival periods from the start of irradiation for the last group were as follows: for radiotherapy only, 4.1 months, radiotherapy and surgery, 4.2 months, radiotherapy and chemotherapy combined, 6.9 months, radiotherapy, surgery and chemotherapy combined, 12.1 months. The intervals between the initial diagnosis and brain metastases were different in lung cancer and mammary cancer, but the prognosis after brain metastases showed little difference between them.

Conjugating ability of bile acids in hepatic failure

A 5-month-old boy with giant cell hepatitis died of hepatic failure. Analysis of serum bile acids by high pressure liquid chromatography revealed a marked increase in total bile acid concentration and a decrease in the cholate to chenodeoxycholate ratio. However, contrary to expectation, the conjugating ability of bile acids with taurine or glycine was well preserved. This suggests that the amino acid conjugation can occur despite the presence of severe hepatocellular damage.

A case of advanced gastric cancer with long-term survival as the results of combined radiation therapy and chemotherapy

A case report on a long-term surviving patient with advanced gastric cancer with supraclavicular lymph node metastasis treated by radiation and chemotherapy is presented. The Borrman type 2 of advanced gastric cancer was found on the greater curvature of the antrum at the first radiological examination. Radiation was administered to the supraclavicular lymph node at 60 Gy and to the stomach at 64 Gy. The patient received mitomycin C (24 mg) and Tegafur (230 g). After completion of the combined therapy the endoscopy revealed an irregular mucosal change with erosion and hemorrhage. Radiological examination revealed atrophic and hyperplastic areas throughout the stomach. These findings lasted more than six years. The patient died of unknown cause in February 1983. She had survived nine years and seven months after her initial diagnosis. Radiotherapy may play a role as a means of radical treatment in certain cases of advanced gastric cancer.

[Interstitial irradiation with Ir-192 in carcinoma of the female genital tract--report of two cases]

Two patients treated with interstitial iridium-192 irradiation are presented. A patient with stage IV A adenocarcinoma of the uterine cervix was treated with external irradiation in combination with local hyperthermia prior to the interstitial irradiation. Another patient with stage III B squamous cell carcinoma of the vagina had a hysterectomy followed by irradiation 22 years prior to the treatment. Wires of Iridium-192 were put into place in the region of the tumor to give 40 Gy to the periphery of the tumor. The patient with carcinoma of the cervix died 15 months after the treatment. The patient with carcinoma of the vagina is well and has locally controlled disease 18 months after the treatment.

Origin of periodic acid-Schiff-reactive glycoprotein in human eccrine sweat

To evaluate the possible involvement of ductal blockade with periodic acid-Schiff (PAS)-positive materials in the mechanism of hidromeiosis in humans, skin slices were incubated with methacholine for 2 h and PAS-positive materials localized histologically in the ductal lumen. In 20% of the glands complete ductal blockade with PAS-positive materials was noted. The characteristics and origin of such PAS-positive glycoproteins in human sweat were then studied using various electrophoretic techniques. One-dimensional sodium dodecylsulfate-polyacrylamide gel electrophoresis (1-D SDS-PAGE) demonstrated considerable individual variation in the electrophoretic pattern; however, four major bands at 45, 28, 20, and 18K shared by different individuals, were PAS positive. Further studies using two-dimensional SDS-PAGE, immunodiffusion and immunoaffinity chromatography demonstrated that the PAS-positive glycoproteins are not derived directly from serum because they are electrophoretically and antigenically distinct from serum proteins, including alpha 1-glycoprotein, alpha 2-HS-glycoprotein, and alpha 1-antitrypsin. Since only dark cell granules are densely stained in the histochemical PAS staining, and because antiserum produced against the PAS-positive band selectively stained cells facing the secretory coil lumen (which are most likely dark cells), it is suggested that PAS-positive sweat glycoproteins are derived predominantly from the dark cells.