Analysis of the angiographic findings in cases of childhood moyamoya disease

Cerebral angiograms of 34 patients with childhood moyamoya disease have been analysed, this analysis having revealed the following findings. The blood flow to abnormal net-like vessels (ANV) in the base of the brain is mainly supplied from the internal carotid artery (ICA) in the early stage of this disease. In a later stage, however, the blood supply is mainly from the posterior cerebral artery (PCA). Though, no remarkable change was found in the volumes of ANV from the early to later stages of the disease, the leptomeningeal collaterals, the most prominent anastomoses in moyamoya disease, had a tendency to decrease during the later stage with the development of PCA stenosis. Eighteen occlusive PCA lesions were found in the proximal portion of the PCA in eight cases (44%), and in the distal in nine cases (50%). The incidence of aneurysm (1.5%) and intracranial bleeding was low as compared to cases of adult moyamoya disease.

[Results of radiation therapy in extranodal non-Hodgkin's lymphoma of the head and neck--a study of the Japan Lymphoma Radiation Therapy Study Group]

Extranodal non-Hodgkin's lymphoma (NHL) in the head and neck except Waldeyer's ring treated with radiation were analyzed. No definite difference was observed both in actuarial and relapse-free five-year survival rate between stage I and II. There was a high survival rate with orbital NHL in which most of the patients occupied with favorable histology. Prognosis of the disease was highly influenced by the histologic subtype; five-year survival was 91.4% in DWDL, 77.2% in the DM, 52.0% in DPDL and 51.7% in DH. Application of histologic classification with the Working Formulation was also recommended. There was a high incidence of extranodal relapses to bone and/or soft tissue from the lesions with nasal cavity, paranasal sinus and oral cavity.

Radiation injury in a patient with unusually high sensitivity to radiation

Radiation therapy is usually given with the assumption that interindividual variations in radiosensitivity are small, except for some patients with hereditary diseases associated with increased sensitivity. Recently, we observed radiation induced pericarditis in a breast carcinoma patient, in whom clinical signs, blood counts and chromosome analysis after in vitro irradiation of blood suggested a state of unusually high radiosensitivity. No evidence of constitutional chromosome abnormality was found in karyotypic analysis with the G-banding technique.

Multiple primary cancer risk in patients with squamous cell carcinoma of the oral cavity

During 6375 patient-years of observation, 136 new cancers developed in 117 of 1429 patients with squamous cell carcinoma of the oral cavity. The risk of multiple cancers was excessive in the upper digestive or respiratory tract in patients with squamous cell carcinoma of the oral cavity, accounting for 87 (64%) of the 136 later cancers. In addition, multiplicity of cancers was site-specific, being common in the oral cavity-esophagus-lung axis and uncommon in sites such as the maxillary sinus and epipharynx. In addition, the observed-to-expected ratio was different in each site of the oral cavity-esophagus-lung axis, i.e., 57.5 for the oral cavity and pharynx, 12.0 for the esophagus, 7.3 for the larynx, and 2.0 for lung cancers.

The chronic administration of dopamine antagonists and methamphetamine changed the [3H]-cholecystokinin-8 binding sites in the rat frontal cortex

The specific cholecystokinin (CCK) binding in the slide-mounted tissue sections of the rat frontal cortex was measured with [3H]-CCK-8. The binding was saturable, reversible, high in affinity, and inhibited by caerulein. The chronic administration of dopamine (DA) antagonists and methamphetamine (MAP) showed a tendency to increase the [3H]-CCK-8 binding sites (Bmax) in the frontal cortex. Long-term treatments with DA antagonists led to the depletion of CCK-8 and may have caused an observed proliferation of CCK-8 receptors in the frontal cortex.

Dopaminergic agents affected neuronal transmission of cholecystokinin in the rat brain

In order to study the interaction between cholecystokinin (CCK) and dopamine (DA), we prepared an anti-CCK-8 antibody with low cross reactivity, and observed effects of administered various dopaminergic agents on CCK-immunoreactivity (CCK-IR) in discrete brain regions of rats. CCK-8 IR (boiling water extraction) and CCK-33 IR (acetic acid extraction) were also measured in the same sample. A single administration of haloperidol decreased the CCK-8 IR in the corpus striatum and that of racemic sulpiride significantly decreased the CCK-8 IR in the frontal cortex and the limbic system. In contrast, a single administration of apomorphine or methamphetamine increased the CCK-8 IR in the same regions. These findings suggest that an acute response of the CCK system to administered dopaminergic agents may be due to a change in the rate of release of CCK-8, but not to a change in its synthesis in areas in which DA neurons originating in the midbrain innervate. After chronic administration of racemic sulpiride or methaphetamine, CCK-8 IR in various brain regions exhibited a tendency close to that of control.

[An autopsy case of a so-called carcinosarcoma of the pancreas]

A case of a "so-called carcinosarcoma" of the pancreas that occurred in a 48-year-old female is reported. At autopsy, the pancreatic tumor was seen to have deeply invaded the gastric wall, causing ulceration. The pancreatic tumor consisted of two different histological components: a squamous cell carcinoma and spindle-cell sarcomatous tumor cells. Transitional areas between the two different tumor cells were also present. Since there were transitional areas and a lack of definitive electron microscopic evidence favoring a sarcoma in the sarcomatous tumor cells, the pancreatic tumor was considered to represent a "so-called carcinosarcoma".

Ultrasonically guided staging splenic tissue core biopsy in patients with non-Hodgkin's lymphoma

Ultrasonically guided tissue core biopsy of the spleen was undertaken in eight patients with previously untreated non-Hodgkin's lymphoma in the staging procedure. In all cases, the tissue core specimens that were biopsied were sufficient to diagnose the presence of involvement of non-Hodgkin's lymphoma, and two of the eight were found to have histologic involvement. There was no complication in this series. It was concluded that this is a safe and reliable technique for the staging of malignant lymphoma.

The role of radiotherapy in the management of adenoid cystic carcinoma of the head and neck

Sixty-eight patients with adenoid cystic carcinoma (ACC) of the head and neck treated by radiation with or without surgery were reviewed. The tumors were located in the major salivary glands in 15 patients and in the minor glands of various sites, mostly in the palate and/or upper gum, in 53. The local control rate was naturally better in the patients with elective postoperative radiation and those with recurrent disease who underwent radiation after repeated surgery for the purpose of tumor reduction than in patients with residual and/or inoperable tumors. For localized tumors in the oral cavity or maxillary sinus, local control was excellent using brachytherapy or "trimodal" combined therapy (radiation, drugs, and minor surgery). The effectiveness of radiation seemed to be more significantly related to the size of the tumor than the dose of radiation. The prognosis of the patients with a predominantly "solid" histologic pattern was apparently worse and presented fulminating progression of the disease. Among patients with a histologically typical cribriform pattern and/or undetermined pattern, although distant metastasis developed frequently, the majority survived a relatively long period without functional or cosmetic disturbance to their normal activities associated with slow progression of the disease. In minor gland tumors, as long as the lesion was localized and a solid histologic pattern was unlikely, radical radiation could be considered an effective choice with the advantage of enhancing the quality of life for the patients.

[Results of radiation therapy of extranodal non-Hodgkin's lymphoma of the head and neck--a study of the Japan Lymphoma Radiation Therapy Study Group]

During the years 1972-81, 168 patients with extranodal Non-Hodgkin's lymphoma localized in the head and neck were treated with radiation. Five-year survival rates were 62% in stage I, 56% in stage II, and 91% in diffuse well-differentiated lymphocytic, 77% in diffuse mixed, 52% in diffuse poorly-differentiated lymphocytic and diffuse histiocytic each. Marginal relapse was rare after radiation therapy, but relapses were not infrequently noticed in distant extranodal sites. Bone and/or soft tissue relapses were frequently noticed in patients with lesions initially located in the nasal cavity, paranasal sinus and oral cavity.

Interferon-beta gene regulation: tandemly repeated sequences of a synthetic 6 bp oligomer function as a virus-inducible enhancer

Evidence is presented that virus-induced transcriptional activation of the human interferon-beta gene is mediated by repeated sequence units each consisting of 6 bp. The repeated units are present in the region between -65 and -109 relative to the cap site. We chemically synthesized the "consensus" DNA sequence units and tested their ability to confer virus inducibility on cognate and noncognate promoters. Most of such sequence units when tandemly repeated indeed mediate virus-induced activation of the promoter sequences. The most efficient sequence unit, AAGTGA, contributes incrementally in virus-induced activation of transcription and manifests properties of an inducible enhancer. Evidence is also provided that suggests that interaction of a positive regulatory factor(s) with this regulatory region.

Interferon-beta gene regulation: tandemly repeated sequences of a synthetic 6 bp oligomer function as a virus-inducible enhancer

Evidence is presented that virus-induced transcriptional activation of the human interferon-beta gene is mediated by repeated sequence units each consisting of 6 bp. The repeated units are present in the region between -65 and -109 relative to the cap site. We chemically synthesized the "consensus" DNA sequence units and tested their ability to confer virus inducibility on cognate and noncognate promoters. Most of such sequence units when tandemly repeated indeed mediate virus-induced activation of the promoter sequences. The most efficient sequence unit, AAGTGA, contributes incrementally in virus-induced activation of transcription and manifests properties of an inducible enhancer. Evidence is also provided that suggests that interaction of a positive regulatory factor(s) with this regulatory region.

[Experimental study on rat hepatic injury by copper--effect of copper overload on the cholestatic liver induced by bile duct ligation]

In the cases of protracted obstructive jaundice, it is reported that there was a positive correlation between the hepatic copper concentration and the severity of destruction of the bile ducts. The author produced the model of obstructive jaundice in rats by common bile duct ligation and investigated whether additional copper overload can cause injury on the liver. The simple ligating procedure induced a significantly increased level of the copper concentration (p less than 0.001). The copper concentration of the group with the additional copper overload showed about an eighteen-fold increase in comparison with the group of the only ligation (p less than 0.005). Histologically, the group with the overload alone exhibited no significant finding. The groups with the ligation showed bile duct proliferation with subsequent fibrosis around portal areas (pericholangiolar fibrosis); however, the fibrosis in the group with an additional overload was more prominent than that without an additional overload. By the orcein stain, the positive granules in the group with the ligation alone were preferentially present in the liver cells around the proliferated bile ducts. The group with the additional overload exhibited diffuse and more pronounced staining. Ultrastructurally, the liver cells in the group with the additional overload contained lysosomes with electron-dense material, some of which showed a feature consistent with focal interruption of their membranes. By X-ray microanalysis, these lysosomes were revealed to include copper as well as sulfur. The sulfur was considered to represent copper-binding protein.(ABSTRACT TRUNCATED AT 250 WORDS)

Cold and immobilization stress-induced changes in pain responsiveness and brain Met-enkephalin-like immunoreactivity in the rat

Pain responsiveness and Met-enkephalin-like immunoreactivity (MLI) were studied in the rat after cold (25 degrees C) and immobilization stress for different lengths of time (30 min, 90 min and 180 min). The 30-min stress-induced analgesia (as measured by the tail-flick method), which was partially antagonized by pretreatment with naloxone (5 mg/kg, SC), and the magnitude of this analgesia was less than that of the 90-min stress or 180-min stress. The 30-min stress resulted in a significant decrease in MLI in the mesolimbic area, striatum, hypothalamus and thalamus. After the 90-min stress, MLI was found to be significantly decreased in the prefrontal cortex, amygdaloid nuclei and piriform cortex, thalamus and hippocampus, while the 180-min stress failed to induce a significant change in any brain area tested. As such a change in MLI content was thought to be related to an increase in the activity of the endogenous Met-enkephalin neuronal system, the activation of this system by the stress, especially in the hypothalamus and thalamus, seemed to be associated with analgesia.

Stage I and II Waldeyer's ring and oral-sinonasal non-Hodgkin's lymphoma

Sixty-six patients with Ann Arbor Stage I and II Waldeyer's ring and oral-sinonasal non-Hodgkin's lymphoma are presented. Ten-year survival was better for the 32 patients with Waldeyer's ring non-Hodgkin's lymphoma (Stage I, 83%; Stage II, 75%) than for the 34 with oral-sinonasal non-Hodgkin's lymphoma (Stage I, 47%; Stage II, 50%). Diffuse large cell lymphomas were common in patients with Waldeyer's ring involvement (59%). In those affected in the oral-sinonasal region, 38% had high-grade lymphoma. There was a high incidence of extranodal relapses outside of the gastrointestinal tract in patients with oral-sinonasal lymphoma (10 cases). Gastrointestinal tract relapse occurred commonly in patients with Waldeyer's ring lymphoma and was found in five cases.

Evidence for aberrant activation of the interleukin-2 autocrine loop by HTLV-1-encoded p40x and T3/Ti complex triggering

In this study we provide evidence that distinct DNA sequences within the 5'-flanking regions of the genes for interleukin-2 (IL-2) and its receptor (IL-2R) are involved in human T-cell-specific activation of transcription by p40x, a product of human T cell leukemia virus type I (HTLV-1). The same DNA sequences appear to be responsible for induction of the genes in a T cell line, Jurkat, by mitogens. Although the IL-2 gene sequences are activated by p40x with much lower efficiency than the IL-2R gene sequences, they are synergistically activated by the p40x expression and subsequent extracellular stimulation by Concanavalin-A or anti-T3. We propose a model for two-step activation of the IL-2 autocrine loop in ATL development.

Primary saphenous venous aneurysms presenting in a child

Venous aneurysms are dilatations of localized venous segments having no connection with varicosities. They are most often found post-traumatically in adults. The case presented here was a rare case of primary saphenous venous aneurysms in an 8-year-old child which were well demonstrated by Tc-99m human serum albumin (HSA) angiography.