Lymph node metastasis and retroperitoneal lymphadenectomy in ovarian cancer

While clinicians are devoting themselves to the study of the behaviour of ovarian cancer as well as to the search for more effective therapeutic modalities, little attention has been paid to an important route of metastasis in this group of diseases: retroperitoneal spread through the lymphatic pathway. The purpose of this report is to present a 5-year experience of a prospective study on lymph node metastasis in patients with ovarian cancer through retroperitoneal lymphadenectomy at the Peking Union Medical College Hospital. From June 1982 through May 1987, retroperitoneal lymph node dissection was performed in 105 cases of ovarian cancer. Seventy-seven (73.3%) were histologically diagnosed as cancer of epithelial origin, and 28 (26.7%) as germ-cell tumours. The overall incidence of retroperitoneal positive nodes was 54.3% (57/105). The incidence of positive pelvic nodes was 46.7% (49/105), and that of positive para-aortic nodes was 37.5% (30/80). In 69 patients who underwent systemic lymphadenectomy, 39 were found to have glandular involvement; in these 39 patients both aortic and pelvic nodes were positive in 19 cases (48.7%), aortic nodes were positive and pelvic nodes negative in 7 cases (18.0%), and pelvic nodes were positive and aortic nodes negative in 13 cases (33.3%). Preoperative lymphography was performed in 30 cases. The positive and negative correspondence rates with the pathological findings were both 83.3%. In 38 cases in which the primary cancer originated in the left ovary, 17 (44.7%) were found to have positive pelvic nodes, whereas in 25 cases with primary cancer arising in the right ovary only 2 (8%) had metastasis of the ipsilateral pelvic nodes. The lymph nodes obtained from 22 patients with positive nodes and sufficient preoperative chemotherapy were carefully examined under the microscope for the effects of the drugs. Some cellular degeneration of the lymph node metastasis was observed in only one of the 15 cases of epithelial cancer, and no response at all was noted in three cases of immature teratoma. Cellular degeneration accompanied by extensive necrosis was demonstrated in the metastatic tumours of the lymph nodes in all four cases of endodermal sinus tumour. Seventy-two patients were followed-up for at least 2 1/2 years. The rate of complete remission was 46.7% (14/30) in patients with negative nodes, but only 33.3% (14/42) in those with positive nodes. However, the difference was not statistically significant.

[BCG-polysaccharides-nucleic acid and its effect in the prophylactic treatment of the common cold]

The polysaccharides-nucleic acid fraction extracted from BCG was found out to be a good adjuvant. Through the activation and protective of the suppressed body immune system, particularly the macrophages and T cells, it gave good protection to the Sendai virus airway infection of C57BL mice, and clinical effect on the common cold susceptible.

Reversible inhibition of ethylene action and interruption of petal senescence in carnation flowers by norbornadiene

The inhibitory effects of the cyclic olefin 2,5-norbornadiene (NBD) on ethylene action were tested in carnation (Dianthus caryophyllus L. cv White Sim) flowers. Treatment of flowers at anthesis with ethylene in the presence of 500 microliters per liter NBD increased the concentration of ethylene required to elicit a response (petal senescence), indicating that NBD behaves as a competitive inhibitor of ethylene action. Transfer of flowers producing autocatalytic ethylene and exhibiting evidence of senescence (petal in-rolling) to an atmosphere of NBD resulted in a rapid reduction in ethylene production, petal 1-aminocyclopropane-1-carboxylic acid synthase activity, 1-aminocyclopropane-1-carboxylic acid content, and ethylene forming enzyme activity. Removal of NBD resulted in recovery of ethylene biosynthesis. These results support the autocatalytic regulation of ethylene production during the climacteric stage of petal senescence and suggest that continued perception of ethylene is required for maintenance of ethylene biosynthesis. The inhibition of ethylene action by NBD after the flowers had reached the climacteric peak was associated with interruption of petal senescence as evidenced by reversal of senescence symptoms. This result is in contrast to the widely held belief that the rate of petal senescence is fixed and irreversible once petals enter into the ethylene climacteric.

The CO adduct of yeast cytochrome c oxidase. Mössbauer and photolysis studies

Mössbauer spectra of 57Fe-enriched NADH-reduced yeast cytochrome c oxidase reveal two quadrupole doublets of unequal intensity; one (approximately 33%) is typical of high-spin ferrous heme with histidine coordination and is assigned to heme a3, while the other (approximately 67%) is typical of low-spin heme with two nitrogeneous axial ligands as expected from heme a. The excess intensity (approximately 17%) of the low-spin doublet must therefore be assigned to heme a3 in a modified environment. The Mössbauer spectra of the same sample exposed to CO show that 50% of the heme iron forms a CO adduct, consistent with heme a3 being inhibited by CO. While low-spin hem a has the same Mössbauer parameters as in the reduced sample, its intensity has dropped to 35%. A distinctly new high-spin species (approximately 15%) is observed and assigned to heme a in a modified environment. The comparable size of the unexpected high-spin heme a fraction in the CO adduct and the low-spin heme a3 fraction in the reduced enzyme suggest that they arise from the same material. This material is likely to be the inactive fraction that has been found in all preparations of resting yeast cytochrome c oxidase (Siedow, J.N., Miller, S., and Palmer, G. (1981) J. Bioenerg. Biomembr. 14, 171-179). The kinetics of CO recombination following photolysis of the CO complex further confirms the coexistence of two distinct fractions associated with active and inactive protein. The majority (approximately 74%), presumably active protein, recombines exponentially from 160 to 270 K following an Arrhenius law. The large activation enthalpy, delta H approximately 35 kJ/mol, is comparable to that found in the beef heart enzyme, suggesting that the flashed-off CO is bound by the nearby CuB as in the mammalian system (Fiamingo, F.G., Altschuld, R.A., Moh, P.P., and Alben, J.O. (1982) J. Biol. Chem. 250, 1639-1650). In the minority, presumably inactive, fraction the CO recombination has fast nonexponential kinetics with a distribution of activation enthalpies peaking near delta Hp = 13 kJ/mol reminiscent of CO binding to myoglobin. In this inactive fraction CuB is apparently not accessible to the flashed-off CO.

Separation of Cucurbitacins by Overpressure Layer Chromatography from Hemsleya gigantha1

Mixtures of cucurbitacins were obtained from an ethanol extract of H. GIGANTHA tubers. Purification was achieved by using the over-pressure layer chromatographic (OPLC) technique to yield cucurbitacin-F, 23,24-dihydrocucurbitacin-F, cucurbitacin-F-25- O-acetate, and 23,24-dihydrocucurbitacin-F-25- O-acetate.

Purification and characterization of an incompletely glycosylated form of human chorionic gonadotropin from human placenta

A small form of hCG (SP-hCG) was purified from an acetone powder preparation of human first trimester placenta by repeated gel filtration and ion exchange chromatography on a Q-Sepharose or FPLC Mono Q column. The estimated mol wt (Mr) of the small hCG by gel filtration is 43K compared to 58K for authentic hCG. The pI of SP-hCG is 10.0, suggesting deficiency of sialic acids. SP-hCG dissociates into subunits when treated with 6 M guanidine-HCl or analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Two beta-subunits of SP-hCG were found with estimated Mr of 23K and 20K. Both are distinctly smaller than authentic hCG beta. A single alpha-subunit was found, with an estimated Mr of 21 K. The immunoactivity (8,900-10,000 IU/mg) of highly purified SP-hCG was comparable to that of reference hCG (CR119) determined by a RIA method using anti-hCG antibodies. The hCG/LH receptor-binding activity of SP-hCG is equivalent to that of reference hCG (CR119). Its biological activity is lower than that of reference hCG (approximately 30% or more) assayed by the in vitro stimulation of rat Leydig cells to produce testosterone and cAMP. A high dose is required to attain the same level of stimulation as reference hCG. The amino acid composition of SP-hCG is similar to that of reference hCG, whereas its hexsamine content is significantly lower. Its glucosamine content is about half that in reference hCG, while it completely lacks galactosamine. These findings suggest that SP-hCG is deficient in O-linked oligosaccharide chain in the beta-subunit, and that the N-linked oligosaccharide chains of both subunits are shortened. SP-hCG is one of the principal forms of the hormone present in first trimester placenta and may be a key intermediate in the posttranslational biosynthesis of hCG. Although it lacks O-linked sugar chains and shortened N-linked sugar chains, it possesses substantial biological activity. To have full biological activity, the hCG molecule must contain the complete complement of sugar chains.

Unusual structures of Sporothrix schenckii

A series of environmental and clinical isolates of Sporothrix schenckii being studied in our laboratories under standard conditions of temperature, humidity and media, displayed, in some of the isolates, large dematiaceous hyphae. The large hyphae could be seen to produce the fine hyphae associated with S. schenckii on which typical microconidia developed. Typical microconidia also developed occasionally on the large hyphae, and strands of the unusually large hyphae also were seen to form arthroconidia. Some strains formed large, thin-walled cells on thin and/or thick hyphae resembling the 'balloon cells' seen in mature colonies of Trichophyton tonsurans. All strains which have demonstrated these various and unusual structures histopathologically produced typical sporotrichosis in laboratory animals. When reisolated from these animals, the cultures again exhibited the unusual structures, as well as those typical of S. schenckii.

Localization of the gene encoding human factor V to chromosome 1q21-25

The gene encoding human coagulation Factor V (FV), one of the cofactors in the blood clotting process, has been mapped to chromosome 1 by both Southern hybridization to DNA from human-hamster somatic cell hybrids and in situ hybridization. The whole plasmid pUC3A containing a 1.5-kb cDNA sequence for FV was 32P-labeled for Southern analysis and 3H-labeled for in situ hybridization to metaphase chromosomes. The results localized the FV gene to the region of 1q21-25.

Further in vitro studies with oxiconazole nitrate

Oxiconazole nitrate was compared in vitro with ketoconazole and econazole nitrate in tests with 96 dermatophytes, 18 isolates of Malassezia furfur, and seven isolates of Exophiala werneckii. An agar dilution procedure was used employing either Kimmig's agar or Sabouraud's dextrose agar supplemented with Olive oil and Tween 80. Econazole was the more active compound in tests with Microsporum species (41 isolates) and most isolates of Trichophyton species (45 isolates). Oxiconazole was the more active compound in tests with T. tonsurans and T. rubrum. However, differences between results for oxiconazole and econazole and the dermatophytes were only marginal. Ketoconazole was the most active compound in tests with M. furfur; some cross resistance on the part of several isolates of M. furfur between oxiconazole and econazole was noted. All three compounds were active against E. werneckii with MIC90 values of either 0.25 or 0.5 microgram/ml. Epidermophyton floccosum was the most susceptible of all organisms tested with all MIC values for all three drugs being less than or equal to 0.063 microgram/ml, the lowest concentration tested.

Seizures following myelography with iopamidol

Iopamidol, a water-soluble contrast medium, has been rarely associated with seizures. We describe 3 patients (from a series of 785) who had generalized tonic-clonic seizures after iopamidol myelography. Two of the patients underwent lumbar and one cervical myelography. There was a history of seizures in 2 patients, and the dose of iopamidol used in the patients who convulsed was high, ranging from 3,000 to 4,500 mg iodine. Despite the reported low incidence of complications with iopamidol, seizures may occur, especially in patients with previous seizures and also in those receiving higher doses of iopamidol.

[Electron microscopy of 300 tumors in the nervous system]

The results of 300 nervous system tumors observed by electron microscopy are reported. Of them, 12% depended on electron microscopy for diagnosis; 14% was further classified and typed by electron microscopy; 59% could be diagnosed by either electron or light microscopy but the former played an important role in confirming the diagnosis by light microscopy; 10% still could not be diagnosed even by electron microscopy; 5% failed in diagnosis due to faulty technique. The results indicate that the electron microscope is a useful tool in diagnosis of the nervous system tumor, particularly, in those whose diagnosis is difficult by light microscopy and in classification and typing of the tumor. In this paper, the pathognomonic ultrastructural features are described.

Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis

Four patients who had had grade-III or grade-IV symptomatic spondylolisthesis and a failed posterior or posterolateral arthrodesis were treated with transperitoneal anterior lumbosacral interbody arthrodesis and fixation with a fibular graft; the procedure was sometimes followed by posterolateral arthrodesis of the spine. The patients were examined ten to twenty-two years after the salvage operation. At follow-up, all had a solid fusion of the fifth lumbar to the first sacral vertebra. No neurological deficits had worsened and no iatrogenic neurological deficits had developed. The slip angle had improved by an average of 23.2 degrees (range, 12 to 35 degrees).

Pseudopseudohypoparathyroidism with spinal cord compression

We describe a patient with pseudopseudohypoparathyroidism who had an osseous tubercle on the anterolateral margin of the foramen magnum causing compression of the spinal cord. This patient had no evidence for any endocrinopathies and had no other spinal canal anomalies. We suggest that the morphologic phenotype found in patients with pseudopseudohypoparathyroidism, also known as Albright's hereditary osteodystrophy, has an associated risk for spinal cord compression due to congenital vertebral anomalies. The poor recovery of neurologic function following spinal decompression mandates prompt recognition and therapy of this condition in patients with Albright's hereditary osteodystrophy.

Localization of the processed gene for human ceruloplasmin to chromosome region 8q21.13----q23.1 by in situ hybridization

A processed gene for human ceruloplasmin has been localized to 8q21.13---q23.1 by in situ hybridization. This result confirms the assignment of this locus to chromosome 8 by Southern blot analysis using human x hamster somatic-cell hybrids and localizes the gene to the long arm of chromosome 8.