Effect of granulocyte colony-stimulating factor on neutropenia due to chemotherapy for non-Hodgkin's lymphoma

The authors administered recombinant human granulocyte colony-stimulating factor (rhG-CSF) to 16 patients with advanced non-Hodgkin's lymphoma treated with combination chemotherapy. Groups of three to five patients were treated with 50, 100, 200, and 400 micrograms/m2 per day of rhG-CSF by intravenous infusion for 14 days, beginning 3 days after chemotherapy. There was a strong linear relationship between the dose and the area under the curve over this dose range. The rhG-CSF was rapidly cleared from serum, with a mean half-life of 5.97 hours for the second phase (t1/2). In patients treated with a dose of more than 100 micrograms/m2 per day, the duration of neutropenia (P less than 0.01) and the duration of fever (P less than 0.05) were significantly decreased. The rhG-CSF was well tolerated and the only clinical observation that appeared relating to rhG-CSF administration was slight bone pain. This study strongly suggests that an optimum dose of rhG-CSF in patients after chemotherapy is 100 to 200 micrograms/m2. Our study shows that rhG-CSF is a clinically useful drug for patients treated with myelosuppressive chemotherapy.

Relationship between intracranial pressure and the carotid sinus baroreceptor reflex

The effects on cerebral circulation and intracranial pressure (ICP) of the carotid sinus nerve stimulation were examined in mongrel cats anesthetized with alpha-chloralose. In 214 trials with stimulation at normal ICP (less than 20mm Hg) in seven cats, mean arterial blood pressure (mABP), heart rate (HR), and ICP decreased significantly (p less than 0.05 in paired Student's t-tests), and the decreased magnitudes for mABP, HR and ICP were 29.9mm Hg, 32 beats/min and 0.9mm Hg, respectively. Correlation was linear between changes in the ICP and mABP (r = 0.61). After spinal ligation at the second cervical segment, bradycardia and depressor responses to the stimulation were observed. However, after vagosympathectomy of the cats with ligated cords, sinus nerve stimulation did not change the ABP, HR, ICP, CBF, or cerebral blood volume. This suggested that carotid sinus baroreceptor reflexes had no direct effect on cerebral vasodilation. When the levels before stimulation of the ICP were increased without evocation of Cushing's response by gradual inflation of a balloon placed extradurally, the ABP and the HR still decreased after stimulation. When Cushing's response was brought about, the responses in ABP and HR caused by the stimulation were not apparent at the peak of arterial hypertension. However, the amplitude of the decrease in the ICP caused by stimulation was enhanced with an increase in the levels of ICP before stimulation. Thus, the arterial baroreflex is preserved at increased levels of ICP without Cushing's response, and works more effectively to cancel the possible increase of ICP that can arise when there is a pulsatile increase in the ABP for one of several reasons.

Ultrastructural localization of plasma retinol-binding protein in rat liver

Immunocytochemical studies were carried out to examine the subcellular localization of plasma retinol-binding protein (RBP) in rat liver. The studies used normal, retinol-deficient, and retinol-repleted retinol-deficient rats with or without colchicine pretreatment. Affinity-purified monomeric Fab' fragments from the IgG fraction of rabbit anti-rat RBP were conjugated to horseradish peroxidase. This conjugate effectively penetrated into tissue sections and enabled RBP to be localized by high resolution immunoelectron microscopy. In the normal liver parenchymal cell, RBP was found to be localized in the synthetic and secretory structures including endoplasmic reticulum (ER), Golgi complex (GC), and secretory vesicles. With the method used, significant localization of RBP was not observed in hepatic cells other than parenchymal cells. The distribution of RBP-positive areas within parenchymal cells changed markedly with retinol depletion. Thus, a heavy accumulation of RBP in the ER, accompanied by a marked decrease of the RBP-positive GC and secretory vesicles, was demonstrated in liver parenchymal cells from retinol-deficient rats. After repletion of deficient rats with retinol, the RBP that accumulated in the ER appeared to move rapidly from the ER through GC and secretory vesicles to the cell surface. Pretreatment with colchicine led to marked increase in RBP-positive secretory vesicles in retinol-repleted rat liver parenchymal cells. The results reported here demonstrate that the specific block in hepatic RBP secretion seen in retinol deficiency involves an inhibition of the movement of RBP from the ER to the GC in the parenchymal cell.

Effects of insulin on vasoconstrictor responses to alpha agonist and tilting

The effects of insulin on vasoconstrictor response were studied in diabetics without autonomic neuropathy. Vasoconstrictor response to phenylephrine was measured before and after insulin injection in 10 diabetics. Mean blood pressure, forearm blood flow, and forearm vascular resistance remained unchanged after insulin administration. But the increase in forearm vascular resistance to phenylephrine decreased significantly and heart rate increased significantly after insulin injection. In 9 diabetics, vasoconstrictor response to tilting was measured before and after insulin injection. Mean blood pressure, cardiac index, and the total peripheral resistance index remained unchanged after insulin administration. However, the increase in the total peripheral resistance index to tilting decreased significantly and heart rate increased significantly after insulin injection. Furthermore, a significant fall in mean blood pressure following tilting was observed only after insulin administration. Although blood glucose levels decreased significantly, no hypoglycemic symptoms occurred. The present study suggests that insulin inhibits vasoconstrictor responses to both alpha agonist and tilting in diabetics.

Treatment of intraventricular hemorrhage using urokinase

Four patients with severe intraventricular hemorrhage (IVH) were treated using urokinase administered into the lateral ventricles via a ventricular drainage catheter. All patients were female and of ages ranging from 24 to 53 years. The primary diseases were hemorrhagic infarction, moyamoya disease, sinus thrombosis, and thalamic bleeding. Urokinase administration was initiated at 1.3 days average after occurrence of IVH and continued for 3.3 days average in doses of 12,000-96,000 IU per day. Average clot lysis times from IVH, as assessed by computed tomography, were 5.0 +/- 0.8, 5.0 +/- 1.4, and 6.0 +/- 0.8 days for the fourth, the third, and the lateral ventricles, respectively. All patients suffered from meningitis which was probably caused by urokinase administration through a ventricular catheter. However, this was successfully treated by changing the antibiotics. There was no general bleeding tendency or intraventricular rebleeding due to urokinase administration, and none of the ventricular catheters were obstructed by clots throughout the course. The final outcome was good recovery in two patients, severe disability in one, and persistent vegetative state in one. These results correlated well with the consciousness level seen before ventricular drainage in each patient. Consequently, we are convinced that urokinase administration can prevent the harmful effects of IVH and that urokinase is useful not only for lysing ventricular clots but also for maintaining the patency of the ventricular catheter, which is important for control of intracranial pressure in the acute stage of severe IVH.

Griffonia simplicifolia agglutinin-2-binding glycoprotein as a novel carbohydrate antigen of human colonic carcinoma

Griffonia simplicifolia agglutinin-2-binding glycoprotein (GBG) in human colonic carcinoma was examined immunochemically and histochemically, GBG was extracted from colonic carcinoma as a serum-type glycoprotein of 160 kilodaltons. GBG was not identical with carcinoembryonic antigen (CEA), since its molecular weight and localization in tissue sections were different from those of CEA. The non-reducing terminals of GBG probably carry N-acetylglucosamine, but not blood group determinants. Furthermore, GBG was released by phosphatidylinositol-specific phospholipase C from cell membrane. GBG was suggested to be anchored to the membrane via linkage to a glycosyl-phosphatidylinositol molecule. Among colonic carcinoma-associated antigens, serum-type glycoproteins having N-acetylglucosamine at non-reducing terminals have not previously been reported. GBG is a novel carbohydrate antigen of human colonic carcinoma.

Purification and partial characterization of a novel cellular retinol-binding protein, type three, from the piscine eyes

A novel cellular retinol-binding protein, termed type three (CRBP III), was isolated from eyes of the bigeye of tuna. CRBP III showed a molecular weight of 15,400, an isoelectric point of 4.80, alpha 1-mobility in electrophoresis, and a lambda max of 350 nm. All-trans-retinol, the endogenous ligand, could be competitively displaced by retinoic acid but not by retinal. CRBP III was differentiated from purified piscine and rat cellular retinol-binding proteins (CRBP) and cellular retinoic acid-binding proteins (CRABP) by its amino-acid composition, electrophoretic mobility, fluorescence spectra and ligand-binding specificity.

[Analysis of cross-linked fibrin and fibrinogen degradation products with SDS-PAGE and immunoblot]

SDS-PAGE and immunoblot technique with anti-FDP-D, -FDP-E, -fibrinogen antibody or anti-FDP-DD monoclonal antibody were applied to analyze FDP fragments prepared from cross-linked fibrin and fibrinogen with plasmic digestion in vitro. FDP fragments of DY(260K), DD(187K), X(245K), Y(166K), D(77K, 97K), E1(58K), E2(46K) and E3(40K) were identified from data of molecular weight and reactivity to four antibodies referred to reports of other investigators. Serum FDP fragments from five DIC suspected patients were analyzed by the same methods. In two patients' sera, DD fragment was a main component, and in the other three patients' sera, D fragment was a main fraction. Proportions of high molecular weight fragments of FDP were considerably different in patients' sera. Appearance of D fragment in our cases was considered to be derived from unstable fibrin (fibrin monomer and dimer) rather than from fibrinogen. Molecular weight of DD fragments from patients' sera had heterogeneity (160 approximately 180K), and the values were different from that (187K) prepared from cross-linked fibrin. In conclusion, SDS-PAGE and immunoblot analysis of serum fragments of FDP will be an useful technique to investigate the clinical and pathological condition of DIC.

[A study on LH- and FSH-RIA kits by immunoradiometric assay]

An evaluation of LH- and FSH-RIA BEAD kits based on IRMA was carried out. The results obtained with the methods characterized by the use of monoclonal antibodies, i.e., one is linked to solid phase, and another is isotopically labeled, were compared with those determined by the Daiichi LH- and FSH-kits. Intra- and inter-assay precision, recovery, linearity, and specificity of both methods were favorable without exceptions. The cross reactivity of the LH kit to 5,000 mIU/ml hCG revealed within the range of less than 3 mIU/ml. Significant correlations were observed between the results derived from conventional Daiichi LH- and FSH-kits. The results from the conventional kits exhibited 30 to 40% of those from the Daiichi kits, considered to be mainly due to the difference in standard calibrations used. Among the individuals within the normal menstrual cycle, the serum LH- and FSH-levels determined by the present kits gave a typical pattern with a peak in the preovulatory phase. On the other hand, the LH- and FSH-values of individuals in normal pregnancy revealed strikingly decreased in comparison with those of non-pregnant women.

Effects of intravenous injection of butyrate, valerate and their isomers on endocrine pancreatic responses in conscious sheep (Ovis aries)

1. The effects of intravenous injection of n-butyrate, iso-butyrate, n-valerate and iso-valerate on insulin and glucagon secretion was examined in conscious sheep. 2. Each sodium salt of the short chain fatty acids increased plasma insulin and glucagon concentrations in a dose-dependent manner (312-1250 mumol/kg body wt). 3. Both butyrate and valerate isomers with branched carbon chains had larger insulin releasing activity than isomers with straight carbon chains. 4. The glucagon responses to butyrate or valerate did not differ between the isomers with straight carbon chains and those with branched carbon chains. 5. Our results suggest that the receptive mechanism to short chain fatty acids, which may involve the nervous system, differs between the A cell and the B cell in sheep in vivo.

[Spontaneous spinal epidural hematoma diagnosed by MRI: a case report]

Appropriate diagnostic procedure for spinal epidural hematomas has not been established yet. The authors reported a case of spontaneous epidural hematomas at the thoracic level, in which correct diagnosis was made with MRI and good results were obtained by surgery. A 63-year-old female experienced a severe back pain which appeared suddenly during a walk and was followed by motor weakness in both legs deteriorating quickly to paraplegia. The patient had no history of hypertension, trauma or bleeding tendency. The laboratory data were normal. On admission, neurological examination revealed flaccid paraplegia, total sensory loss below the level of Th 6 and urinary and fecal incontinence. Myelograms showed incomplete block at the Th 6 level and postmyelographic CT scan showed an isodense mass, which was suspected to be an epidural tumor located behind the spinal cord. Emergent MRI confirmed an epidural hematoma as a high intensity area extending from Th 3 through Th 11. Sixty-five hours after onset, laminectomy of Th 4 through Th 11 and the evacuation of epidural hematoma were performed without identification of the origin of the bleeding. Neither vascular malformation nor tumor was recognized during operation. Neither was it noticed on histological examination. The patient made favorable progress after the surgery. During the first two weeks in the postoperative period, she regained muscle strength enough to do standing exercise, and satisfactory improvement was made in sensory function including urination and defecation. We emphasize that MRI is indispensable to make a differential diagnosis of thoracic lesions. In the reported case, a correct diagnosis was made with MRI, and an extremely good result was obtained by an emergency operation.

Stimulated rat liver mitochondrial biogenesis after partial hepatectomy

In order to elucidate the response of mitochondria to the increase in cellular energy demand after hepatectomy, we have examined the effects of partial hepatectomy and hepatic artery ligation on the energy-transducing system of rat liver mitochondria. Specific content of DNA in the mitochondria increased on the first day after the hepatectomy and reached 150% of the original value. Oxidative phosphorylation capacity of the mitochondria started to increase on the first postoperative day. In contrast, specific enzymic activities, specific cytochrome contents, and subunit contents of the energy-transducing complexes in the isolated mitochondria were significantly increased only from the second postoperative day. The ligation of the hepatic artery did not inhibit the amplification of the mitochondrial function. The immunostain for ubiquinol-cytochrome c oxidoreductase was increased predominantly in the portal area of the hepatic lobules of the hepatectomized rats. These results suggest that enhancement of the mitochondrial oxidative phosphorylation system after hepatectomy is based on the increase of the amount of the complexes in the inner membrane, which is closely related to replication of mitochondrial DNA, and that the blood supply from the hepatic artery is not an important factor in the mitochondrial amplification in rats.

Sialyl SSEA-1 antigen as a carbohydrate marker of human natural killer cells and immature lymphoid cells

The distribution of a carbohydrate antigen, the sialyl SSEA-1 (sialyl Lex-i), in human lymphoid cells was investigated by flow cytometry with a specific monoclonal antibody, MoAb FH-6. We concluded that the lymphocytes positive for the sialyl SSEA-1 antigen present in normal peripheral blood (PB) are natural killer (NK) cells since the positive cells had an NK activity toward K562 cells, and most of the sialyl SSEA-1+ cells were simultaneously positive for Leu-11 (CD-16) and Leu-19. Essentially, no T and B cells, defined by Leu-4 (CD3) and Leu-16 (CD20), were positive for the sialyl SSEA-1 antigen in PB samples taken from healthy donors and patients with disorders unrelated to lymphoid malignancies. Among the malignant lymphoid cells, many sialylated SSEA-1+ cells were observed in large granular lymphocyte (LGL) leukemia cells and some acute lymphoblastic leukemia (ALL) blasts, but not in CLL cells or malignant lymphoma cells. Sialyl SSEA-1 was also positive in some cultured human lymphoid cell lines. We conclude that expression of the sialyl SSEA-1 antigen is strictly limited to a distinct population of NK cells among the mature lymphocytes in normal PB, but the antigen is present in a wide range of immature lymphoblasts of T- and B-cell lineages as well as the NK-cell lineage. The sialyl SSEA-1 antigen disappears from the surface of immature lymphocytes of T- and B-cell lineages during the course of maturation.

[Inhibitory effect of inositol hexasulfate and inositol hexaphosphoric acid (phytic acid) on the proliferation of the human immunodeficiency virus (HIV) in vitro]

The monosaccharide substances inositol hexasulfate (IHS) and inositol hexaphosphoric acid (Phytic acid, IHP) were investigated for their antiviral effect on the human immunodeficiency virus (HIV) in vitro. In MT-4 cells IHS completely inhibited the cytopathic effect of HIV and the HIV specific antigen expression at a concentration of 1.67 mg/ml. IHP moderately inhibited both of HIV effects as mentioned above.

[Ventriculoperitoneal shunt for hydrocephalus secondary to tuberculous meningitis: a case report]

A case of hydrocephalus secondary to tuberculous meningitis is reported. A 6-month-old baby was admitted to our hospital with a 10-day history of high fever. Neurological examination revealed no abnormal findings other than neck stiffness. Cerebrospinal fluid findings suggested tuberculous meningitis, because of pleocytosis (608/mm3, 100% lymphocytes) and reduced sugar content (19 mg/dl). Mycobacterium tuberculosis was found in cerebrospinal fluid culture. Although anti-tuberculous therapy was administered for 2 weeks, deterioration of consciousness and papilledema appeared. CT scan demonstrated enlargement of the entire ventricular system, indicating communicating hydrocephalus. After a ventricular drainage was performed, consciousness disturbance improved, but the high fever persisted. Judging by cerebrospinal fluid findings, the meningitis seemed to be in the active stage. Therefore an Ommaya reservoir was installed instead of a cerebrospinal fluid shunt for fear of disseminating the tuberculous infection through the shunt tube. However, the hydrocephalus was not well controlled. Consequently, a ventriculoperitoneal shunt was placed, despite the fact that the disease was still active. The fever then gradually subsided, and cerebrospinal fluid findings normalized. The patient was discharged without any neurological deficits one month after emplacement of the ventriculoperitoneal shunt. The antituberculous therapy has been continued, and there is no sign of infection propagated through the shunt 13 months following discharge from the hospital. The result suggests that a cerebrospinal fluid shunt can be placed for hydrocephalus even in the active stage of tuberculous meningitis under antituberculous therapy.

[Fundamental studies, reference values and relationship to menstrual cycle of prolactin RIA BEAD II]

We have tried fundamental studies, reference values and relationship to menstrual cycle on Prolactin RIA BEAD II kit which has a method of IRMA using monoclonal antibody. On clinical studies, we investigated change of serum prolactin level during the menstrual cycle and relationship to other hormones (LH, FSH, estradiol, progesterone). It was the result that prolactin level of follicular phase was lower than that of preovulatory phase and luteal phase. We conclude that change of prolactin level during the menstrual cycle is related with change of estradiol level.

Ultrastructural and biochemical studies of lipolysis by lipolysosomes in chick hepatocytes

Lipolysosomes in chick hepatocytes were studied by biochemical and electron-microscopic techniques. Their lipolysis was investigated in vitro using the floating lipid fraction isolated from chick liver homogenates. Many lipid droplets were noted to be enveloped by a unit membrane with a partially thickened electron-dense layer containing some myelin-like structures, electron-dense material or electron-lucent droplets, close to the inner leaflet of the membrane. Cytochemically, the dense layer showed acid phosphatase activity, and thus the lipid droplets were identified as lipolysosomes. The lipolysosomes isolated in a floating lipid fraction retained the characteristic dense layer and the surrounding membrane, and the fraction showed little contamination by other organelles. Free fatty acids were released in the fraction after incubation at 37 degrees C, but not at 0 degree C. The reaction was completely inhibited by HgCl2, p-chloromercuribenzoate and esterastin, a potent inhibitor of acid lipase. These results suggest an involvement of acid lipase in lipolysis of the lipolysosomes.

[Purification of the Ro/SSA antigen and enzyme-linked immunosorbent assay for quantitation of the antibody]

Antibodies to the Ro/SSA antigen occur in patients with Sjögren's syndrome and other collagen diseases. In this study, we used ammonium sulfate precipitation, anti-Ro/SSA immunoaffinity chromatography and gel filtration to purify the Ro/SSA antigen from pig spleen. In addition, the normal human IgG affinity column chromatography was also used to adsorb nonspecific reacting materials as heterophile antigens which contaminated in preparations after immunoaffinity chromatography. On SDS-PAGE the purified Ro/SSA antigen migrated as 60K and 53K polypeptides bands and the antigenicity was observed on 60 K band. An enzyme-linked immunosorbent assay (ELISA) using the purified antigen was developed for quantitation of the antibody which was found to be sensitive, precise and specific. By the method, anti-Ro/SSA antibodies were detected in SLE (44%), MCTD (71%), PSS (50%), SjS (83%), RA (16%), PBC (23%), lupoid hepatitis (23%) but only 4% in normal controls. The purified antigen and ELISA method will provide beneficial tools for the investigation of autoimmune diseases.

Salvage chemotherapy of refractory non-Hodgkin's lymphoma with aclacinomycin, behenoyl ara-C, etoposide, and prednisolone

A total of 40 patients with recurrent non-Hodgkin's lymphoma were treated with ABEP combination chemotherapy (aclarubicin, N4-behenoyl-1-beta-D-arabinofuranosylcytosine, etoposide, and prednisolone). A complete remission (CR) was achieved in 37.5% of the patients and partial remission, in 15.0%. The ABEP regimen proved to be effective in T-cell as well as B-cell lymphoma. It appears that the ABEP regimen may be partially non-cross-resistant with front-line doxorubicin-containing combinations. Survival for 39 months was achieved in 42.0% of the CR responders compared with 6.7% of partial responders (PRs) and nonresponders (NRs) (P less than 0.01). Disease-free survival for 45 months was seen in 66% of the CR patients. The ABEP regimen was effective in the treatment of patients with recurrent or refractory lymphoma, enabling hope for long-term survival in the majority of CR cases.