Cell-cycle manipulation of human leukemic progenitor cells with humoral adjustment in vitro

The cell-cycle change of human leukemic colony-forming cells was studied using a new agar culture method featuring daily feeding of new culture medium with or without leukocyte conditioned medium (LCM). Leukemic cells could be kept out of cycle by withholding LCM from daily feeding and put back into cycle by adding LCM to the daily feeding.

A clinical trial with cefoperazone in pneumonia and pyelonephritis

15 cases of pneumonia and 15 cases of pyelonephritis were included in a clinical trial of parenteral cefoperazone. The organisms isolated from patients with bacterial pneumonia were: Staphylococcus aureus (6), Klebsiella pneumoniae (5), Diplococcus pneumoniae (3), Pseudomonas species (2), and 6 others. Amongst those with pyelonephritis, Escherichia coli (12), Enterobacter (1), and 3 other pathogens, were isolated. All were sensitive to cefoperazone. The efficacy of cefoperazone in patients with pneumonia was: good in 11 (73%), fair in 3, and poor in 1. In pyelonephritis, 12 (80%) responded well and in the other 3 response was fair. There were no significant side effects or hypersensitivity reactions.

"Hot spot" on liver scan due to tricuspid insufficiency

A patient with a diagnosis of tricuspid insufficiency was found to have a small focal area of increased activity, or "hot spot," in the liver on a Tc-99-sulfur colloid scan. This "hot spot" was in the superior central portion of the liver in the region of the junction of the hepatic veins and inferior vena cava. Its presence was confirmed on a dynamic study of the liver, which showed appearance of the activity in the abnormal area at the same time as in the right atrium. The finding was thought to be the result of reflux of blood from the right atrium into the vena cava and hepatic veins due to tricuspid insufficiency.

Analysis of the growth enhancing effect of L-ascorbic acid on human leukemic cells in culture

The effect of L-ascorbic acid (LAA) on the in vitro colony growth of leukemic cells from the marrows of patients with acute nonlymphocytic leukemia was studied using a modified agar culture method featuring daily feeding. In 10 of 31 patients (32%) the growth was enhanced with supplementation of LAA in culture. The average number of colonies was reduced to 26% if LAA was deleted from culture. This growth enhancing effect appears to be specific to LAA: neither glutathione which has redox potential similar to LAA nor the acidification of culture medium with HCI to the pH of medium containing LAA is effective. This effect is also selective for leukemic marrows, and normal marrow colonies are not affected over wide range of LAA concentrations (0 to 300 microM) which are achievable in human in vivo.

Adenocarcinoma of the colon with choriocarcinoma in its metastases

A 49-year-old woman died from metastases from a colon carcinoma. This was predominantly an ordinary tubular adenocarcinoma but it included arease of much less differentiated appearance with giant cells, while the hepatic and pulmonary metastase were poorly differentiated and contained choriocarcinoma, as established by means of morphologic and immunocytochemical examination. The choriocarcinoma appeared to be due to metaplasia within the carcinomatous tissue. This and other similar cases of mixed tumours suggest that unexpected trophoblastic differentiation may result from aberrant differentiation of locally proliferating cells, rather than originating in ectopic germ cells or in foci of embryonic totipotent cells. Implications for possible origin and for classification of tumors are briefly discussed.

Prediction of chemotherapy response in human leukemia using an in vitro chemotherapy sensitivity test on the leukemic colony-forming cells

An in vitro test system to quantitatively assess the chemotherapy sensitivity of human acute leukemic colony-forming cells (L-CFU) in relation to normal granulocytic precursor cells (CFU-C) has been developed. After simultaneous exposure of leukemic and normal bone marrow cells to individual drugs in vitro, cells were grown using an improved agar culture method with daily feeding. A sensitivity index (SI) was determined as the ratio of survival fraction of CFU-C to that of L-CFU, L-CFU being more (or less) sensitive than CFU-C if the SI were higher (or lower) than unity. Thirty SI were determined for 6 single drugs actually given in various combinations to a total of 9 patients (8 with acute nonlymphocytic leukemia and 1 with chronic myelomonocytic leukemia). A highly significant correlation was observed between high (or low) SI and achievement of (or failure to achieve) complete remission, with only 6 false correlations (p = 0.0013). Also, the mean of these SI (MSI) for the multiple single drugs given to each patient as components of a combination chemotherapy was used to indicate an overall sensitivity for each trial of the chemotherapy. Among the 10 chemotherapy trials (1 trial each for 8 patients and 2 trials for 1 patient), 4 trials resulting in complete remission had MSI higher than 1.0, and 6 trials not resulting in complete remission had MSI lower than 1.0 (p = 0.0048). This assay system appears useful in predicting the response of patients to chemotherapy and in the selection of the most effective drugs for use in individual patients.

Growth suppression of human leukemic cells in vitro by L-ascorbic acid

The suppressive effect of L-ascorbic acid on the growth of bone marrow cells from patients with acute nonlymphocytic leukemia was studied using a modified agar culture method featuring daily feeding to allow the growth of leukemic cell colonies. In seven of 28 patients (25%), the numbers of leukemic cell colonies grown in culture were reduced to 21% of control by the addition of L-ascorbic acid (0.3 mM) to the culture medium. Glutathione did not suppress leukemic cell colonies although it has a similar oxidation-reduction potential to that of L-ascorbic acid. The addition of L-ascorbic acid reduced the pH of the medium. However, a comparable reduction of pH by the addition of HCl did not suppress leukemic cell colonies. In simultaneous cultures for leukemic and normal marrow cells, the suppression of leukemic cell colony was noted with a concentration of L-ascorbic acid as low as 0.1 mM (a concentration achievable in vivo), but normal myeloid colonies were not suppressed until the concentration of L-ascorbic acid reached an extremely high level (1 mM). In conclusion, growth of leukemic cells in culture was suppressed by L-ascorbic acid in a substantial proportion of patients with acute nonlymphocytic leukemia. This suppression was a specific effect of L-ascorbic acid and was not due to its oxidation-reduction potential or pH change. Leukemic cells were selectively affected at an L-ascorbic acid concentration attainable in vivo while normal hemopoietic cells were not suppressed.

Successful therapy of crystalcryoglobulinemia: a case report

Successful therapy for a case of multiple myeloma with a spontaneously crystallizing cryoglobulin of the IgG2-kappa light chain variety was achieved, using both continuous-flow cell centrifugation plasmapheresis to rapidly lower the M component and combination chemotherapy with phenylalanine mustard, prednisone, procarbazine, and vincristine to control the myeloma process. This resulted in resolution of incapacitating large and small necrotic cutaneous ulcerations of the extremities. Physicochemical studies of the crystalcryoprotein demonstrated that cryoprecipitation was rapid and accompanied by the formation of needle-shaped crystals, yet was completely reversible at 37 degrees C. Cryocrit determinations varied depending upon relative centrifugal forces and temperature and did not always relate linearly to the amount of abnormal protein, thus making these alone unreliable in assessing response to therapy.

The value of radionuclide myelography in the evaluation of spinal arachnoiditis

On the basis of myelographic findings, spinal adhesive arachnoiditis was classified into three types: type I (peripheral or marginal), type II (central), and type III (advanced). Depending on its location and extent, it may be divided into group A (lumbar), group B (thoracic), and group C (cervical). In view of the fact that intrathecal injection both of oily and of water-soluble contrast media tends to produce spinal arachnoiditis, we have been using radionuclides for pre- and postoperative myelography to evaluate arachnoiditis. Radionuclide myelography with 131I-HSA or 111In-DTPA is a safe modality which provides useful information regarding spinal arachnoiditis.

Evaluation of cerebral infarction by computed tomography with special emphasis on microinfarction

Computed tomography has proved to be the most effective mode of evaluating cerebral infarction in 143 documented cases. This was especially true when multiple focal infarcts were present. The incidence of contrast enhancement in acute infarcts was 88%. Concomitant acute and old infarcts were observed in 20% of cases. In the acute stage of stroke, radionuclide studies are preferable to contrast angiography since the latter may aggravate the pre-existing focal ischemia. Follow-up CT and radionuclide scans were extremely useful in confirming the diagnosis and demonstrating various postinfarction sequelae.

Acidometric agar plate method for ampicillin susceptibility testing of Haemophilus influenzae

The need for an accurate and rapid method of testing ampicillin susceptibility of Haemophilus influenzae, especially strains isolated from patients with meningitis and septicemia, is indisputable. Various methods have been employed for this purpose. Each has advantages and disadvantages. This report describes a modification of the capillary acidometric procedure in which an agar plate is substituted for a tube. All beta-lactamase results obtained by this modified technique correlated with minimal inhibitory concentrations determined in liquid media and the chromogenic cephalosporin substrate method. This modified acidometric agar procedure is a simple, inexpensive, accurate, and rapid way to determine H. influenzae susceptibility to ampicillin.

Improved growth of in vitro colonies in human acute leukemia with the feeding culture method

Bone marrow cells freshly aspirated from the 10 consecutive untreated adult patients with acute nonlymphocytic leukemia were cultured by 2 different methods: the conventional agar culture method for myeloid colony formation and its modification by daily feeding with culture medium. In 5 patients, colonies grew in much higher numbers (4.7-to 330-fold) with feeding than without. Three patients grew colonies only with feeding. Two of these 3 patients required L-ascorbic acid in the fed medium for colony growth. Colonies did not grow from the remaining 2 patients by any method. In 7 patients the number of colonies grown with feeding were much higher, up to 170 times higher, than were those from normal control marrows, which grew the same number of colonies regardless of feeding or L-ascorbic acid. Peroxidase and Wright's stains indicated the myeloid differentiation of the cells in the leukemic marrow colonies. The leukemic origin of the colonies was proven by chromosomal analysis. The wide range of linearity between the number of cells plated and the number of colonies grown permits quantitative assay of colony-forming leukemic cells. This assay should be valuable for studies of chemotherapy, growth regulation, and differentiation of leukemic cells.

A simple method for maintaining fastidious organisms

Many strains of nutritionally fastidiuos organisms and anaerobes have been maintained in glycerol broth at-50 C for at least two years without loss of viability. This method of preservation offers convenience and reduces cost.

Gallium scanning in sarcoidosis

This study of 36 patients, 27 with sarcoidosis, confirms the avidity of mediastinal and pulmonary sarcoidosis for gallium-67. This procedure may prove useful in distinguishing enlarged hilar vessels from lymph nodes. Gallium scanning proved unsuccessful, however, in detection of clinically important extrathoracic sarcoidosis and appears to have limited applicability in the diagnosis of thoracic sarcoidosis.

Incidentally detected thrombosed vein during 67Ga citrate scanning

A patient with stage IVA Hodgkin's disease developed thrombosis of the right cephalic vein at the site of an indwelling catheter. A few weeks later, 72 and 96 hr scans after injection of 67Ga citrate revealed an increased linear uptake where the thrombosed vein was palpated. As far as we know, this is the first case showing abnormal uptake of this agent in a thrombosed vein. It is postulated that residual chronic inflammatory cells are responsible for 67Ga citrate uptake in this case.

Unusual calcification in mixed papillary and follicular carcinoma of the thyroid gland

An unusual egg-shell calcification was found in the thyroid gland on a routine radiograph. The 99mTc-pertechnetate thyroid image showed a cold nodule in the inferior pole of the left lobe which proved to be mixed papillary-follicular carcinoma. There was no characteristic pattern of calcification in the thyroid gland which would permit precise diagnosis of cancer; however, psammomatous calcification frequently occurs in papillary carcinoma of the thyroid.

Pseudodefect in 99m-Tc sulfur colloid liver scan caused by hepatodiaphragmatic interposition

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