Detection of circulating antigens of Pneumocystis carinii in human sera by a sandwich enzyme-immunoassay

A countercurrent immunoelectrophoresis test has been used for detection of circulating antigens of Pneumocystis carinii in humans; however, this study describes another experiment by sandwich enzyme-immunoassay. Antiserum was prepared by immunizing rabbits with P. carinii cysts which had been propagated in athymic nude rats. Profiles of time course in patients with the positive antigenemia show that P. carinii antigens are detectable prior to an onset of acute pneumonia. Since the sandwich enzyme-immunoassay has an ability of comparing serially monitored levels of the antigen in a quantitative value, the method is to be widely used as a clinical laboratory examination.

Action of 7-ethylcamptothecin on tumor cells and its disposition in mice

Some biological effects of camptothecin (CPT) and its new derivative 7-ethylcamptothecin (ECPT) were studied. The drugs were effective against murine leukemia; ECPT was more effective than CPT. Ip administration of ECPT or CPT gave maximum treated/control values of 325% and 232%, respectively. The drugs also inhibited the growth of KB cells in vitro, 50% effective doses of 3.5 ng/ml of ECPT and 8.6 ng/ml of CPT, indicating the stronger activity of ECPT. Pharmacokinetic studies of the drugs in mice showed that ECPT had a longer biological half-life in the terminal phase and a larger amount remained in the plasma compared with CPT. After iv administration of ECPT, the drug accumulated in the intestine, suggesting that the main route of excretion of the drug is through the biliary tract. The study on cell cycle progression by flow cytometry suggested that the main effect of both drugs on L1210 cells was the blocking of G2-M phase. These results suggest that the main reasons for the superior antitumor activity of ECPT compared with CPT are as follows: (a) ECPT had a stronger growth-inhibiting activity against tumor cells, and (b) ECPT remained in the intestinal tract for a longer time and in higher amounts when administered in vivo.

[Successful treatment of advanced gastric cancer by combined cisplatinum, mitomycin C and 5-FU administration. A case report]

A 55-year-old woman with gastric cancer underwent laparotomy and was found to have an unresectable tumor at the MC region, characterized by S3 (invasion into the pancreas), N3, P0, H0, Borrmann-II and moderately differentiated tubular adenocarcinoma. She was then treated by combined administration of cis-dichlorodiammine platinum (CDDP), mitomycin C and 5-fluorouracil (5-FU). A complete response was confirmed by upper gastrointestinal roentgenography and endoscopy. Upon reoperation 4 months after the initial laparotomy, a successful total radical gastrectomy with R2 (partially R3) lymph node dissection was performed. Histological examination of the specimens, including the stomach and lymph nodes, revealed no cancer cells in any region.

Independent occurrence of hepatocellular and cholangiocellular cancer nodules in the liver

We treated a patient in whom hepatocellular and cholangiocellular cancer nodules in the liver were of independent occurrence. A 57-year-old Japanese male was admitted with a diagnosis of liver tumour, detected by a scan on a follow-up study of chronic liver disease. Computed tomography and hepatic angiography demonstrated two nodules located on different sites of the right lobe of the liver and which were suggestive of primary liver cancers. He underwent hepatic resection and each tumour was histologically proved to arise independently from hepatocellular and bile duct origins. This may be the first report of patient surgically treated for two different types of carcinoma in the liver.

Intra- and inter-species transmission and antigenic difference of Pneumocystis carinii derived from rat and mouse

Pneumocystis carinii (Pc) derived from nude mice (MPc) and hypercorticonized rats (RPc) was subjected to transmission experiments via intranasal (i.n.) route into athymic nu/nu mice (BALB/c background) and run/rnu rats (Rowett hooded strain) and their euthymic heterozygotes rnu/+ rats. Although all these recipient animals received intensive cortisone treatment, MPc propagated only in nu/nu mice. In contrast, RPc strains from three different sources were transmitted successfully to both rats and mice irrespective of their athymicity. The MPc strain could not be transmitted to the other three rat strains used. When RPc organisms were successively propagated in nu/nu mice they lost their pathogenicity to rats after five passages. An antigenic difference between MPc and RPc was suggested by cross reaction of rabbit-raised antiMPc and antiRPc sera against MPc and RPc organisms. An absorption experiment of the sera with both MPc and RPc revealed cross reactivity as well as specific reactivity. The mouse passaged RPc seemed to change the antigenic characteristic to that of MPc.

Distribution of cholinesterase in canine venous system

Cholinesterase (ChE) activity was examined in 15 veins from dogs by pharmacological and histochemical procedures. Potentiation of acetylcholine (ACh)-induced contractile response by neostigmine was observed in helical and longitudinal strips of portal, mesenteric veins and middle segment of the inferior vena cava, but not in the other 12 veins. Histochemical studies with an electron-microscope (the method of Karnovsky-Roots) revealed that ChE activity was identified as high density granules around the smooth muscle cells only in the former three veins. The visible ChE activity was abolished by pretreatment with neostigmine.

Determination of stable isotopically substituted histidine in human plasma by gas chromatography-mass spectrometry

A gas chromatographic-electron-impact mass spectrometric method for the determination of stable isotopically substituted histidine in human plasma has been developed. Histidine was derivatized to alpha N-trifluoroacetyl-imN-carbethoxyhistidine n-butyl ester (TCB derivative) by a three-step reaction: an initial esterification by 3 M n-butanolic hydrochloric acid, followed by trifluoroacetylation with trifluoroacetic anhydride and then ethoxycarbonylation with diethyl pyrocarbonate. Quantitation was carried out by selected-ion monitoring on the molecular ions (m/z 379, 383 and 385) of the respective TCB derivatives of histidine, [1-15N,5,beta,beta-2H3]histidine (histidine-[M + 4]) and [1,3-15N2,5,alpha,beta,beta-2H4]histidine (histidine-[M + 6]). The sensitivity, specificity, precision and accuracy of the method were demonstrated to be satisfactory for application to a pharmacokinetic study of histidine after administration of a trace amount of stable isotopically substituted histidine (histidine-[M + 4]) in humans.

Growth of 9-L and RT-9 gliosarcoma in female rats

Published studies of 9-L and RT-9 gliosarcoma have been done only in male rats and it is widely assumed that these tumors do not grow in female rats. In this study 9-L and RT-9 gliosarcoma was inoculated into the brains of male and female Fisher CD rats. The tumors grew with essentially the same incidence and survival time in both sexes, confirming that female rats can be used as well as male rats in experiments using RT-9 and 9-L gliosarcomas.

The plasmin heavy chain-urokinase conjugate: a specific thrombolytic agent

Low molecular weight urokinase (LMW-UK) was coupled to the heavy chain of plasmin to make it able to bind to fibrin. The purified conjugate (PHC-UK conjugate), which consisted of equimolar concentrations of each starting material had a molecular weight of 93,600, bound tightly to fibrin-monomer-Sepharose and was not washed off with 1 M NaCl, but was eluted specifically with epsilon-amino caproic acid. The conjugate showed higher fibrinolytic activity than HMW-UK. A control conjugate prepared by coupling human serum albumin to LMW-UK (HSA-UK conjugate) showed the same fibrinolytic activity as HMW-UK. The half-lives of these two conjugates in rabbits were about 3 times that of HMW-UK. In an experimental pulmonary embolism model in rabbits, the PHC-UK conjugate showed about 10 times higher thrombolytic activity than HMW-UK, while the HSA-UK conjugate showed similar thrombolytic activity as HMW-UK, and moreover caused severe systemic fibrinogen breakdown. Thus the significant increase in thrombolytic activity after injection of PHC-UK conjugate into rabbits may be due to its newly acquired fibrin binding activity, and not to increase in its half-life. It is concluded that the PHC-UK conjugate may be useful in treatment of thrombosis.

[Dissociative sensory disturbance after removal of an arteriovenous malformation in the posterior thalamic region]

A 34-year-old male developed consciousness disturbance; semicoma, on December 15, 1984, and diagnosed as a thalamic hemorrhage perforating into the ventricular system after a computed tomographical (CT) examination. Angiography revealed an arteriovenous malformation (AVM) in the right posterior thalamic region, which was fed by a posteromedial choroidal artery. He was transferred to our neurosurgical clinic on February 18, 1985. On admission, he was alert, however, disorientation and slight mental retardation were seen as well as Parinaud's sign. Mild left hemiparesis was also detected with equivocal hypesthesia on the left lower limb. The AVM was subtotally removed on March, 12, via transventricular approach after right parietooccipital craniotomy. Consciousness disturbance (drowsy) and left hemiplegia developed after the operation, however, these deteriorations were transient, recovering to the preoperative or better status by 2 weeks after the operation. Postoperative repetitive examinations of the sensory perceptibility of various modalities revealed remarkable disturbance or complete loss of perception in joint and vibration senses (0-3/10 compared to the healthy left side). Touch sensation was also severely deteriorated (0-3/10) on the affected extremities. The disturbances in these modalities of the sensation did not show any trend to improve until the time of discharge on 57th postoperative day. On the other hand, pain and temperature sensations were less remarkably disturbed (5-8/10), and with tendency of gradual improvement. Estimation of the range of lesion by the CT scan with projecting on the Schaltenbrand & Bailey's atlas revealed that the nucleus ventralis caudalis, centre-median nucleus and pulvinar thalami were involved.(ABSTRACT TRUNCATED AT 250 WORDS)

Intracranial hypertension and cerebrospinal fluid production in dogs: effects of furosemide

A method using chronically prepared, anesthetized dogs was devised for studying the effects of treatments of intracranial hypertension induced by applying a reversible extradural mass lesion while simultaneously measuring production of cerebrospinal fluid. This was measured with a ventricular-cisternal perfusion technique in which the rate of cisternal outflow could be controlled by a pump and matched to the inflow, allowing intracranial pressure to fluctuate despite simultaneous measurement of cerebrospinal fluid formation. Elevations of intracranial pressure to the range 20 to 35 Torr were induced and maintained during perfusion, but elevations above 35 Torr would not permit continued perfusion. At normal intracranial pressure, 10 Torr or less, rates of cerebrospinal fluid formation were the same whether the outflow controlling pump or free outflow was used. Formation of cerebrospinal fluid decreased progressively as intracranial pressure increased above 20 Torr. It also decreased with time after the start of perfusion during the course of 5 h, but returned to the initial range during the control phase of subsequent experiments in the same animal. Furosemide, 3 mg kg-1, i.v., had no significant effect on rate of formation but did induce a small decrease in ICP in time-controlled experiments in which i.v. fluid replacement limited net fluid losses to 20 ml kg-1 with no change in mean arterial or central venous pressures.

Different types of relationship between beta-adrenergic relaxation and activation of cyclic AMP-dependent protein kinase in canine saphenous and portal veins

We examined the relationships between the relaxation mediated by beta-adrenoceptor and either the associated cyclic AMP production or the activation of cyclic AMP-dependent protein kinase (A-PK) in canine saphenous and portal veins. In the saphenous vein constricted with methoxamine, isoproterenol caused concentration-dependent relaxation (maximum relaxation 92.7%), and concomitant increases in cyclic AMP and A-PK activity ratio (from 52.8 to 73.5%). The portal vein was only slightly relaxed by isoproterenol (14.7% in the longitudinal strips) after constriction with methoxamine, while cyclic AMP and A-PK activation increased significantly. Isoproterenol markedly activated A-PK of the portal vein after KCl constriction (from 52.6 to 74.6%) but the maximum relaxation was only slight (13.3%). The portal vein also showed a smaller relaxation response to either forskolin or dibutyryl cyclic AMP than the saphenous vein. These results indicated that the relationship between the relaxation response to isoproterenol and either cyclic AMP production or A-PK activation was different in the saphenous and portal veins.

Quantitative estimation of quaternary ammonium neuromuscular blocking agents in serum by direct insertion probe chemical ionization mass spectrometry

A new method based on selected ion monitoring chemical ionization mass spectrometry was developed to measure the quaternary ammonium neuromuscular blocking agents, pancuronium and vecuronium, in serum. An ion-pair extraction procedure is utilized to separate the compounds of interest from biological fluids. The intensities of the ion currents produced by the bisamines formed from the drugs and the corresponding deuterated internal standards through thermolytic dequaternization are monitored. The assay shows good linearity over the range of 1-500 ng/ml. This assay has been utilized in a variety of clinical pharmacokinetic studies involving surgical pediatric, geriatric and obstetric patients requiring anesthesia.

Synergistic effect of methotrexate and radiation on gliosarcoma in tissue culture and in rats

In vitro and in vivo studies were performed on rat gliosarcoma cells (RT-9) to investigate the synergistic effect of methotrexate and radiation against malignant brain tumors. For in vitro study, RT-9 cells were cultured on microtiter plates and treated with methotrexate, radiation, or both. For in vivo study, the cells were implanted into the cerebrums of CD-Fischer rats, and intraperitoneal methotrexate, whole brain radiation, or both were given. Although synergistic suppression of cell growth with combined therapy was observed in the in vitro study, synergism was less clearly demonstrated in tumor-bearing rats because of systemic toxicity of the therapy.

[Left axis deviation investigated by body surface mapping and phase image analysis]

Relationship between left axis deviation and left anterior fascicular block (LAFB) was investigated by estimating the ventricular excitation and contraction sequence using body surface potential mapping and phase image analysis by radionuclide ventriculography. This study included seven normal persons, eight patients with complete right bundle branch block (RBBB) without left axis deviation (LAD), twelve with RBBB and unblocked axis (determined by the first half of the QRS complex) of 0 degrees or farther deviated to the left (RBBB with LAD), and three with isolated LAD. The isochrone ventricular activation maps (VAT maps) were obtained by body surface mapping technique. Planar phase images in the left anterior oblique projection and short-axis ventricular tomographic phase images using a seven-pinhole collimator were constructed by ECG-gated equilibrium blood pool scintigrams. On the VAT maps of RBBB, there was a markedly delayed conduction to the right ventricle, however, in the left ventricle, the excitation was initiated in the anterior paraseptal region, and it proceeded rapidly toward the lateral and posterior walls, and in the same direction as normal. The VAT maps of RBBB with LAD were categorized in three types according to the activation sequence in the left ventricle. Type I, the same as maps of RBBB, consisted of three cases. Type II, four cases, showed excitation starting from the apex and ascending in the anterior wall. There were five cases of type III, which showed the earliest excitation in the basal posteroparaseptal region, proceeding toward the apex and ascending in the anterior wall. Type II was considered compatible with block of the left anterosuperior fascicle, and type III was that of left anterosuperior and midseptal fascicles. In types II and III, the phase delay in the left anterior wall was recognized in tomographic phase images, and the difference between right and left ventricular mean phase angles in planar phase images was significantly smaller than in cases of isolated RBBB, These were thought to support the existence of LAFB. The range of the unblocked axis of RBBB with LAD was -3 degrees approximately 13 degrees (-7.7 +/- 5.0 degrees) in type I, -8 degrees approximately -30 degrees (-19.8 +/- 9.1 degrees) in type II, and -33 degrees approximately -60 degrees (-51.0 +/- 10.9 degrees) in type III. All cases with left axis deviation beyond -30 degrees were of type III, and suspected to have extensive damage, including the midseptal fascicle.(ABSTRACT TRUNCATED AT 400 WORDS)

Regional variation in beta-adrenoceptor-mediated relaxation of canine veins

Three types of vasorelaxants were used to test the responses of canine veins isolated from 13 different sites: isoproterenol, papaverine and nitroglycerin. Strips were preconstricted with methoxamine (5 X 10(-6)-10(-5) M), KCl (50 mM) and PGF2 alpha (1 microgram/ml), and were relaxed by cumulative addition of relaxants. Isoproterenol caused more than 80% relaxation after preconstriction with methoxamine in cephalic, external jugular, azygos, renal, femoral, lateral saphenous veins and the supradiaphragmatic and infrarenal portions of the inferior vena cava, all of which are veins of the body wall. Pulmonary and splenic veins also showed marked relaxation with isoproterenol. However, maximal relaxation responses of portal, mesenteric veins and segment C of the inferior vena cava (a portion between liver and renal veins), which are embryologically related to the digestive tube, were less than 30%. Similar regional differences in the relaxation responses to isoproterenol were obtained after preconstriction with KCl or PGF2 alpha. Papaverine and nitroglycerin caused nearly uniform relaxation in all veins, although relaxations of segment C of the inferior vena cava were slightly less than those of other veins. These results indicated that there is a regional difference in the relaxation responses of the canine venous system to isoproterenol, and such a difference may be related to its embryogenesis.

[Advanced gastric cancer successfully resected following cisplatin therapy. A case report]

A case of unresectable advanced gastric cancer (portion A, Min, S3 infiltrating into pancreas, N3, por., Borrmann III-type, hen's egg size) was treated with cis-dichlorodiammine platinum (CDDP) at a dosage of 30 mg/day for five days every month following surgery. After three courses of administration, examinations revealed that the tumor had disappeared and an evaluation of complete response was made. Four months later, a second-look operation was performed. It was found that the cancer was less than thumbsize and was able to be resected radically. No significant side effects were observed during CDDP therapy.

Acute liver failure in rats inhibited by intrasplenic administration of OK-432

Intrasplenic administration of OK-432, an immunostimulant derived from Streptococcus, prevented hepatic failure induced in rats by D-galactosamine. When OK-432 was given 1.0 K.E. (Group I) or 0.1 K.E. (Group II) into the subcutaneously transpositioned spleen three times prior to dosing with D-galactosamine, survival rates were 100 and 87%, respectively. On the contrary, with a splenic injection of saline (Group III), the survival rate was 47 and 32% in rats given OK-432 1.0 K.E. intraperitoneally (Group IV). The poisoned rats given no pretreatment (Group V) survived at a rate of 26%. These results show that intrasplenic administration of OK-432 leads to a significant enhancement of survival. Metabolic data and histological findings were compatible with survival rates, in each group. Activation of the reticuloendothelial function by the intrasplenic administration of this immunostimulant seems to have prevented acute liver failure.

Serological observations of Pneumocystis carinii infection in humans

Serological examinations of Pneumocystis carinii antigen and antibody were performed in adult patients with P. carinii pneumonia. The antibody titer was assayed by indirect immunofluorescence, and antigenemia was detected by counterimmunoelectrophoresis. Profiles of the time course of antibody levels in serum indicated that development of the antibody occurred at an early stage of pneumonia and that peak titers were obtained during the febrile stage.

[Immunohistochemical study of S-100 protein in the normal human brain and glioblastoma]

The authors investigated the immunohistochemical localization of S-100 protein in normal human brain and glioblastoma tissues by the peroxidase anti-peroxidase method of Sternberger. In normal human brain the positive immunoperoxidase reaction for S-100 protein was observed in astrocytes, oligodendrocytes, ependymal cells, Bergmann's glial cells and epithelial cells of choroid plexus. No positive staining was revealed in any cortical neurons. Immunoelectron-microscopically, the electron dense positive reaction for S-100 protein was seen throughout the cytoplasm, nucleoplasm and cell processes of astrocyte as well as oligodendrocyte. The positive reaction for S-100 protein was demonstrated occasionally in association with cytoplasmic membrane or the membrane constituting cell organelles. We suspect that this observation indicates the existence of membrane-bound form of S-100 protein. In glioblastoma cells, the positive reaction for S-100 protein was relatively weak in intensity as compared with astrocytes, and the degree of positive staining varied from cell to cell. Subcellular localization of S-100 protein in glioblastoma seemed to be essentially similar to that of normal astrocyte. There are some recent reports concerning immunohistochemical localization of alpha and beta subunits of S-100 protein. As compared with these reports, the present immunohistochemical results indicate that the rabbit anti-S-100 antibody embloyed in the present study is mainly against beta subunit of S-100 protein. Although there have been many reports concerning immunohistochemical localization of S-100 protein, the biological role of S-100 protein is still speculative. Some hypotheses are advocated in connection with the possible biological role of S-100 protein. For example, the modulation of synaptic transmission by S-100 protein, the participation of S-100 protein in hormonal secretion and in transport of cations through lipid membrane, the activation of protein kinase and the promotion of disassembly of microtubules by S-100 protein are postulated. It is hard to assume the biological role of S-100 protein based on the immunohistochemical results alone. The present study clearly indicates that S-100 protein exists widely in the cytoplasm, nucleoplasm, cytoplasmic membrane, outer membranes of cell organelles and cell processes of glial cells as well as glioblastoma cells. From these results we assume that S-100 protein plays an important role of intracellular transport of cations as one of the calcium binding proteins.

[A case of cerebellar ganglioglioma in an infant--immunohistochemical study]

Ganglioglioma is a rare brain tumor which occurs in an infant and young adult. The term "ganglioglioma" was originally proposed by Ewing in 1926 and subsequently adopted by Courville in 1930. Histogenesis of ganglioglioma is still speculative, but the hypothesis that ganglioglioma is derived from hamartomatous sympathetic neurons is generally thought to be probable. Gangliogliomas of the brain arise frequently from the temporal lobe, frontal lobe, cerebellum and spinal cord. Its growth is gradual and clinically it is a benign tumor, but its malignant transformation has been reported. Ganglioglioma is a tumor composed of both neuronal and glial cells, but the ratio of these two-cell components varies a great deal from case to case and in different areas even of the same tumor. The authors experienced a cerebellar ganglioglioma in an infant which was successfully removed. Histopathological and immunohistochemical studies of the biopsy specimen have been done. That is, histopathological staining with H-E (hematoxylin eosin), PTAH (phosphotangustic acid hematoxylin), cresyl-violet and Bodian, and electron microscopical studies were performed. Also the authors immunohistochemically examined the presence or absence of GFAP (glial fibrillary acidic protein), NSE (neuron specific enolase), S-100 alpha and beta subunits. Histopathologically, the authors could find nerve fiber, glial fiber and identify neuronal cells which had Nisslgranules in the cytoplasm. Electron microscopically the authors could distinguish the neuronal cells which had large nuclei and prominant nucleoli from the glial cells which had processes filled with intermediate glial filaments.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute portal hypertension associated with liver resection. Analysis of early postoperative death

Changes in portal pressure before and after hepatic resection were monitored in 65 patients. Significant increases in portal pressure, from 226 +/- 13 mm saline to 277 +/- 16 mm saline were noted in 17 cirrhotics undergoing major hepatic resection. In 14 noncirrhotics undergoing major resection of the liver, pressure in the portal vein changed significantly from 198 +/- 10 mm saline to 226 +/- 9 mm saline. Conversely, there were no differences in the 26 cirrhotic and eight noncirrhotic individuals who underwent minor hepatic resection. Clinical analysis of these patients showed that acute portal hypertension induced by liver resection was not linked to increases in early postoperative death.

7-Hydroxyguanine, a novel antimetabolite from a strain of Streptomyces purpurascens. I. Taxonomy of producing organism, fermentation, isolation and biological activity

Strain A-347, an actinomycete isolated from a soil sample, was found to produce a new antimetabolite, 7-hydroxyguanine. The aerial mycelium formed spiral spore chains with spiny spore surface. The chemical composition of strain A-347 indicated that it was an actinomycete of cell wall Type I. From its morphological, cultural, physiological characteristics and direct comparison with the type culture, this strain was classified as Streptomyces purpurascens. 7-Hydroxyguanine was purified from the broth filtrate by ion exchange chromatography and crystallized from hot 2 M NH4OH. 7-Hydroxyguanine inhibited the growth of experimental tumors such as L1210 leukemia.