[Lipid-secreting carcinoma of the breast]

Lipid secreting carcinoma is a very rare tumor of the breast. This is regarded as a special type of breast carcinoma, which is characterized by abundant intracytoplasmic neutral lipid stained with Sudan IV. Two cases (75 and 42 year old females) of lipid secreting carcinoma of the breast are presented. No other reports of lipid secreting carcinoma have been available in the Japanese literature. In this report, the physical, mammographic and ultrasonographic diagnosis and pathological findings are described and discussed.

Possible cancerous change of intraductal papillomas of the breast. A 3-D reconstruction study of 25 cases

Surgical specimens from 25 patients with intraductal papilloma were subjected to 3-dimensional (3-D) reconstruction studies of their mammary ducts. Papillomas of the multiple type (15 cases) always originated in the terminal duct lobular units (TDLU), whereas all papillomas of the solitary type (10 cases) originated in the large ducts except for one. In 6 of the 25 (24%) patients ductal carcinomas were accidentally found during specimen reconstruction. Two of the six patients harbored microscopic carcinoma as small as 3 mm or less. Three-D reconstructions revealed that carcinomas with multifocal origins in the TDLUs were connected with peripheral papilloma. Papilloma preceding carcinoma was of the multiple type in five patients, and of the solitary type in one. This study also showed that 6 of the 16 (37.5%) patients with papilloma originating in the periphery had carcinomas, whereas none of the nine patients originating in the center did. This observation strongly suggests that the peripheral papilloma is highly susceptible to cancerous change.

[Prevention of 5-FU induced toxicity in C3 H/HE mice with interferon or with interferon inducers (poly 1: C, OK-432, Lentinan)]

It is well known that all cell lines, normal as well as malignant, have a sensitivity to the growth-inhibitory effect of Interferon, or Interferon inducers. 5-FU is a widely used anticancer drug considered to be a cell cycle-specific agent. We speculated that the antiproliferative effect of Interferon or Interferon inducers might affect the activity of 5-FU and diminish the uncomfortable side-effects of this agent. Initially this experiment, we observed the mortality rate in mice after administration of 5-FU alone, or 5-FU plus Interferon (alpha inducers). We then carried out cytofluorometric observation of bone marrow cells, and finally studied the influence of Interferon (or inducers) on the anticancer effects of 5-FU against MM48 tumors in C3/He mice. Findings were as follow: 1) Administration of beta-type Interferon for 2 days, following the administration of a toxic dose (140 mg/kg/w) of 5-FU, revealed significant protection from mortality in C3H/He mice. This effect was also observed when Interferon inducers (Poly I: C, OK-432, Lentinan) were administered with 5-FU. Body weight loss was 10.4% at nadir in mice treated with 5-FU alone, while there was a body weight gain of 36.3% in mice treated with 5-FU plus Interferon. 2) Cytofluorometry of bone marrow cells obtained from mice femur at timed intervals after the administration of OK-432, or Lentinan indicated that these drugs inhibited the entry of cells into the S-phase, causing then to accumulated in the G0.G1-phase during the first 48 hours. 3) Histological findings of intestinal mucosa in mice showed prominent destruction after bolus injection of 350 mg/kg of 5-FU alone, while these findings were not observed in mice after the bolus injection of 350 mg/kg of 5-FU combined with Interferon. 4) The tumor volume ratio (T/C) was significantly reduced in the group treated with 5-FU alone as well as that treated with 5-FU combined with Interferon (or inducers) in C3H/He mice bearing MM48 tumors. All mice were dead about 2 weeks after administration of 5-FU alone, while all mice treated with 5-FU plus Interferon (or inducers) were alive in the same period. From these results, we speculate that Interferon, or Interferon inducers play an important role in the prevention of side effects of cell cycle-specific cytotoxic drugs like 5-FU, without decreasing their anticancer activity.

Origin and extension of intraductal papillomas of the breast: a three-dimensional reconstruction study

Surgical specimens from fifteen patients with intraductal papilloma were reconstructed three-dimensionally from semi-serial sections to visualize the intraductal distribution of papillomas. Our results showed two basically different papillomas. In five patients, the papillomas were single and originated in the large ducts such as the segmental or subsegmental duct, but did not involve the terminal ductal-lobular units (TDLU); this type corresponded to the so-called solitary papilloma. In the remaining ten specimens, the papillomas were multifocal three-dimensionally; each had a root in the TDLU and spread into the large ducts, suggesting its purely peripheral origin. In view of this striking difference, and of possible canceration of ductal peripheries, a nomenclature of peripheral vs central papillomas is proposed instead of the conventional multiple vs solitary. Duct papillomatosis, invariably situated within the TDLU, was shown to be a continuation of peripheral papilloma and was regarded accordingly as a prepapillomatous condition.

Magnetic microcapsules for targeted delivery of anticancer drugs

To achieve targeted distribution of anticancer drugs with sustained activity, ferromagnetic ethylcellulose microcapsules containing an anticancer drug, mitomycin C (FM-MMC-mc), were prepared by a method based on phase separation principles. Two prototypes of FM-MMC-mc were made: one with the drug as the core and zinc ferrite on its capsular surface (outer type); the other with both the drug and zinc ferrite as the core (inner type). Both preparations provided a sustained-release property and a sensitive response to conventional magnetic force, although certain differences in the release rate of drug, magnetic responsiveness, and particle size were found between the two dosage forms. Animal studies showed that the magnetic microcapsules could be magnetically controlled in the artery and urinary bladder. VX2 tumors in the rabbit hind limb and urinary bladder were successfully treated with magnetic control of FM-MMC-mc. Pharmacokinetic study revealed that the targeting of the microcapsules markedly enhanced the drug absorption into the surrounding tissues for a prolonged period of time. The results indicate the feasibility and effectiveness of the magnetic microcapsules as a targeted drug delivery system.

[Susceptibility of intraductal papillomas to carcinogenesis based on 3-dimensional reconstruction study]

Surgical specimens from 16 patients with intraductal papilloma were subjected to 3-dimensional reconstruction studies of mammary ducts in order to detect early cancerous foci developing in papilloma, to analyze growth behavior of papilloma and to establish morphological features of papilloma particularly prone to cancerous change. Papilloma of the multiple type (10 cases) originated in the terminal duct lobular units (TDLU), while papilloma of the solitary type (6 cases) originated in the large ducts except for one. In 4 out of the 16 patients small foci of intraductal carcinoma were found during specimen reconstruction. Two of the four patients harbored minimal cancer as small as 3 mm or less. The carcinomas with multifocal origins in the TDLUs were anatomically connected with peripheral papilloma so far as to take the form of "cancer in papilloma". Papilloma preceding carcinoma was of the multiple type in 3 cases and of the solitary type in one. But according to the sites from which papillomas originated, 4 out of the 11 cases originating in the TDLU had cancerous foci, whereas none of the 5 cases originating in the large ducts did. This suggests that the peripheral papilloma is highly susceptible to cancerous change. From a clinical point of view, we proposed a nomenclature of peripheral vs. central papillomas instead of the conventional multiple vs. solitary.

Regulation of allotype-linked NPb idiotype by an idiotype-positive soluble factor derived from a T cell hybridoma. Coupling of the circuit regulation to the network concept

We reported in this paper genetic requirements for the suppression of anti-4-hydroxy-3-nitrophenylacetyl (NP) antibody response induced by an NP-specific, Igh-1 linked idiotype (NPb) positive T suppressor factor (NPb-TsF) derived from a T cell hybridoma 7C3-13 of B10.BR (Igh-1b, H-2k) mouse origin. NPb-TsF could suppress the responses mounted by primed spleen cells of all IgVH compatible strains regardless of their H-2 haplotypes. The majority of the anti-NP antibody response suppressed by NPb-TsF was idiotype positive (Id+). NPb-TsF was also capable of suppressing the responses of H-2 compatible but Igh incompatible strains where responding cells do not produce NPb idiotype. NPb-TsF was incapable of suppressing the responses of mouse strains who are incompatible both in IgVH and H-2 loci, indicating that the identity in either IgVH or H-2 genes between NPb-TsF and responding cells was necessary for the initiation of the suppression by NPb-TsF. It was further found that the NPb-TsF utilizes anti-idiotypic Lyt-1+2+3+ T cells (transducer cells), which are present only in IgVH compatible strains, to ultimately suppress the Id+ antibody production by B cells. These results indicate that there exists a pathway where an idiotypic NPb-TsF activates a suppressor circuit mediated via the idiotype-antiidiotype interactions apart from the previously described carrier-specific and H-2 restricted suppressor circuit. Both pathways involve the 'transduction' step utilizing Lyt-1+2+3+ intermediary T cells. Our experiments provide important clues for coupling the two major immunological concepts, network and circuit.

Mass screening for breast cancer

The mass screening for detection of breast cancer has been conducted in Miyagi Prefecture since 1977. The main activities comprise the itinerant screening in the residential districts and the group screening of female workers at the vocational sites. The routine examination at the Cancer Detection Center is also an integral part of the activities. In the present paper, the data from the above three procedures were compared. The examinees were 49,114 in the residential districts, 6,725 at the vocational sites and 3,055 at the Center. The breast cancer was detected in 51 cases (0.1%) by the itinerant residential screening, 14 (0.2%) at the vocational sites and 73 (2.4%) at the Center. The problems of the first-stage mass screening to detect breast cancer at the early stage were discussed.

Induction of T cell responses in nonresponder mice by abolishing suppression with monoclonal antibodies recognizing A region-controlled, T cell-specific determinants

Mouse strains carrying the kappa allele at loci A beta, A alpha, E beta, and E alpha are nonresponders to lactate dehydrogenase B (LDHB) and to allotypic determinants of IgG2a myeloma proteins (for example, UPC10 used in this study). The nonresponsiveness to these antigens is caused by T suppressor (Ts) cells that prevent antigen-primed T helper (Th) cells from proliferating. We demonstrate here that monoclonal antibodies specific for an A region-controlled molecule selectively expressed on T cells (A-T) are capable of inducing anti-LDHB and anti-UPC10 responses of primed T cells from nonresponder strains. A monoclonal anti-J antibody that cross-reacts with the A-T molecule also induces responsiveness, whereas another J-specific antibody that lacks this cross-reactivity fails to do so. The mechanism of response induction is blocking of the interaction between the Ts cell or its factor (TsF) and the target of suppression, the antigen-specific Lyt-1+2- (Th) cell. The blocking occurs at the level of the Ts cell and the TsF. The data indicate that Ts cells and TsF carry a unique, A region-controlled molecule that is not only functionally analogous but also serologically similar to the J molecule.

Induction of T cell responses in nonresponder mice by abolishing suppression with monoclonal antibodies recognizing A region-controlled, T cell-specific determinants

Mouse strains carrying the kappa allele at loci A beta, A alpha, E beta, and E alpha are nonresponders to lactate dehydrogenase B (LDHB) and to allotypic determinants of IgG2a myeloma proteins (for example, UPC10 used in this study). The nonresponsiveness to these antigens is caused by T suppressor (Ts) cells that prevent antigen-primed T helper (Th) cells from proliferating. We demonstrate here that monoclonal antibodies specific for an A region-controlled molecule selectively expressed on T cells (A-T) are capable of inducing anti-LDHB and anti-UPC10 responses of primed T cells from nonresponder strains. A monoclonal anti-J antibody that cross-reacts with the A-T molecule also induces responsiveness, whereas another J-specific antibody that lacks this cross-reactivity fails to do so. The mechanism of response induction is blocking of the interaction between the Ts cell or its factor (TsF) and the target of suppression, the antigen-specific Lyt-1+2- (Th) cell. The blocking occurs at the level of the Ts cell and the TsF. The data indicate that Ts cells and TsF carry a unique, A region-controlled molecule that is not only functionally analogous but also serologically similar to the J molecule.

Kappa and lambda immunoglobulin expression associated with abnormalities of chromosomes #2 and #22 in lymphoma and leukemia

The types of surface immunoglobulins on Burkitt lymphoma (BL) cells correlate with the specific chromosomes that are altered in the tumor. For example, BL with a t(2;8) translocation expresses kappa (kappa) light chains, whereas BL with a t(8;22) translocation expresses lambda (lambda) light immunoglobulin chains; these correspond with the locations of the kappa chain genes on chromosome #2 and the lambda chain genes on chromosome #22, respectively (1-5). In order to explain this close correlation between specific translocations and light chain expression in BL and BL-type acute lymphocytic leukemia (ALL) (L3 type), Hecht et al. [6] proposed the concept of position effect, which is reviewed herein.

A case of idiopathic fatty liver detectable only by ultrasonography

A 40-year-old man was diagnosed as fatty liver according to our ultrasonographical criteria for fatty liver, i.e., liver-kidney contrast in the ultrasound mass screening of the liver, biliary tract and pancreas. He lacked any signs or symptoms, nor any known causes of fatty liver, i.e., obesity, diabetes, hyperlipidemia, ingestion of alcohol or drugs. Liver biopsy of this patient revealed fatty change of about 50% of the hepatic lobules. It has been difficult to suspect the presence of latent fatty liver which lacked both the abnormality in the liver function test and hepatomegaly, and even impossible when it lacked any risk factors. In the future as the ultrasonography becomes more generally used as a primary screening examination, "idiopathic latent fatty liver", like this patient, will be more frequently found and this, in turn, will contribute to the progress of the epidemiology and etiology of fatty liver.

[Intra-arterial infusion through 2 routes in liver (primary and metastatic cancer]

Patients with unresectable liver cancer (primary and metastatic) were treated with a newly-devised arterial infusion chemotherapy using Cis-DDP and its antidote Sodium thiosulfate (STS). The patients consisted of 4 with primary hepatoma and 1 with metastatic liver cancer originated from intestinal cancer. For the purpose of reducing unfavourable side effects without changing anticancer effect, Cis-DDP was infused into hepatic artery through the catheter while STS being administered systemically. According to Koyama and Saito's criteria, 2 of 5 patients showed partial response (PR) and the others showed no change (NC). The median survival time after onset of therapy was 6.6 months ranging from 2 to 11 months in all the patients. The myelosuppression and renal toxicity, which were considered to be the most serious side effects of Cis-DDP, were not found and liver function was not affected in all the patients. However, all the patients complained of nausea and vomiting. Thus, our experience has indicated that this newly devised infusion chemotherapy is a promising method for treating unresectable liver cancer, although further efforts are necessary for reducing the gastrointestinal toxicity.