Results of reoperation for failed microvascular decompression

Among 64 patients with hemifacial spasm (HFS) and 60 with trigeminal neuralgia (TN) treated by microvascular decompression (MVD), repeated MVD performed on 3 cases with HFS resulted in the absence of spasm in all cases. In 7 cases with TN, this technique resulted in complete remission in 2, recurrence in 3, and no pain relief in 2 cases. MVD was more effective on HFS than on TN in repeated procedures as well as for initial treatment. The cause of recurrence of HFS was attributed to the inadequate cushion effect of muscle as a prosthesis, while that for TN was suspected to be related more to post-operative fibrotic adhesions formed around the fifth nerve.

Pathological study of diffuse axonal injury patients who died shortly after impact

It is generally considered that axonal injury is apparent only on electron microscopy in the very early stage after a closed head injury. To clarify the pathological findings in head injury patients dying very shortly after the impact, we analyzed 8 fatal cases of diffuse axonal injury (DAI) who underwent medicolegal autopsy at the Department of Forensic Medicine of Kyoto Prefectural University of Medicine. Seven cases died within one hour after injury and another one case died 3 days after injury. We studied these cases macroscopically, microscopically, and electron microscopically. Macroscopically all cases showed the typical findings of diffuse axonal injury. Microscopical study of the cases who died within one hour revealed no characteristic findings of DAI such as appearance of retraction balls or microglia. On the other hand, in the case who died only 3 days after injury it showed the typical retraction balls. Electron microscopic study showed the remarkable destruction of cytoskeletal structure of axons in all cases. From our results, it is reasonable to speculate that DAI may be common among head injury patients who die very soon after the impact.

Vascularized omentum graft for the reconstruction of the skull base after removal of a nasoethmoidal tumor with intracranial extension: case report

A 16-year-old boy with rhabdomyosarcoma occupying the nasal cavities and the ethmoid sinus with intracranial extension underwent transcranial surgery. The intradural tumor was resected first with the affected dura of the anterior skull base, and the dural defect was repaired with fascia harvested from the sheath of the rectus abdominis muscle. The remaining tumor contiguous to the nasal cavities was completely extirpated. The cranial cavity was then exposed to the opened nasal cavities, where a revascularized omental graft was used to separate these compartments. Lyophilized dura was placed beforehand beneath the omental graft, as a roof to the nasal cavity, and was removed 3 weeks later through the nostril. A bony skull base repair was performed over the omentum using the inner table of the bone flap. Subcutaneous fat from the abdomen was placed on the bone graft for fixation and as an additional seal for the dural defect. Reconstruction of the anterior skull base with a vascularized omental transfer provides an efficient barrier to the nasal cavity. It also serves as an excellent supporting structure for regeneration of the mucosal epithelium of the nasal cavities.

Shaping and reshaping of salmonid genomes by amplification of tRNA-derived retroposons during evolution

Three families of tRNA-derived repeated retroposons in the genomes of salmonid species have been isolated and characterized. These three families differ in sequence, but all are derived from a tRNA(Lys) or from a tRNA species structurally related to tRNA(Lys). The salmon Sma I family is present in the genomes of two species of the genus Oncorhynchus but not in other species, including five other species of the same genus. The charr Fok I family is present only in four species and subspecies of the genus Salvelinus. The third family, the salmonid Hpa I family, appears to be present in all salmonid species but is not present in species that are not members of the Salmonidae. Thus, the genome of proto-Salmonidae was originally shaped by amplification and dispersion of the salmonid Hpa I family and then reshaped by amplification of the Sma I and Fok I families in the more recently evolved species of salmon and charr, respectively. We speculate that amplification and dispersion of retroposons may have played a role in salmonid speciation.

Conversion of big endothelin-1 by membrane-bound metalloendopeptidase in cultured bovine endothelial cells

We propose a candidate for the "putative" endothelin (ET) converting enzyme in the cultured endothelial cells (ECs) of bovine carotid artery. The enzyme is membrane-bound, soluble in 0.5% Triton X-100, and capable of converting human big ET-1 to ET-1 by a specific cleavage between Trp21 and Val22. The conversion reached 90% after a 5-hr incubation in the presence of DFP, PCMS and pepstatin A, but it was inhibited by EDTA, omicron-phenanthroline or phosphoramidon. The enzyme is very sensitive to pH, and active only between pH 6.6 and pH 7.6. Conversion of big ET-3 by this enzyme was only 1/9 that of big ET-1. From these results, ET-1 converting enzyme in the bovine EC is most likely to be a membrane-bound, neutral metalloendopeptidase, which is much less susceptible to big ET-3.

The heterogeneity of target recognition by lymphokine-activated killer precursor cells

Lymphokine-activated killer (LAK) cells were generated from peripheral blood lymphocytes (PBL) that were depleted of mature cytotoxic natural killer (NK) cells. PBL NK activity was abolished by pretreatment of effector cells with the toxic lysosomotropic agent L-leucine methyl ester (LME) or by depletion of effector cells by K562 monolayer absorption (MA). Both treatments markedly reduced the proportion of cells expressing NK-associated markers such as CD 16 (Leu 11b, B73.1), Leu 7, and NKH-1 (Leu 19), whereas these treatments had minimal effects on cells expressing T cell markers (CD 3, CD 4, and CD 8). LME and MA also drastically decreased the proportion of K562 target-binding lymphocytes. LAK activity against NK-sensitive and NK-resistant targets can be generated from the NK cell-depleted PBL by incubation with interleukin-2. Peak LAK activity generated from MA-treated PBL was later than the peak of LAK activity generated from either untreated or LME-treated PBL. Although MA of PBL on NK-resistant S4 sarcoma targets had little effect on NK activity, LAK activity against both K562 and S4 targets was reduced. These results suggest that there are at least three LAK precursor subpopulations in PBL: mature NK cells that can bind and kill K562 targets (LME-sensitive and MA-sensitive); "pre-NK" cells that can bind but cannot kill (LME-resistant and MA-sensitive); and non-NK cells that cannot bind and cannot kill K562 targets (MA-resistant).

Impairment of CO2 reactivity in severe head injury patients: an investigation using thermal diffusion method

For measurement of the cerebral blood flow (CBF) the thermal diffusion method is quite convenient and allows the chronological measurement of CBF and CO2 reactivity of cerebral vessels. We investigated the CO2 reactivity of fifteen head injury patients. The results showed that in head injury cases, the disturbance of the CO2 reactivity correlates well to poor outcome. Using thermal diffusion method, investigations of CO2 reactivity are useful for further understanding of the physiological state of head injury patients.

Positron emission tomographic studies on cerebral hemodynamics in patients with cerebral contusion

Positron emission tomography is currently one of the most useful methods for measurements of cerebral hemodynamics and oxygen metabolism, because it facilitates accurate analysis of the local cerebral circulation in three-dimensional quantitative images. In this study, we performed positron emission tomography studies to measure cerebral circulation in a total of 11 patients who sustained head injuries with contusion. Several parameters were measured including regional cerebral blood flow, regional cerebral blood volume, permeability, and regional cerebral metabolic rate for oxygen. Data from brains both with and without contusion were analyzed for chronological changes, in the subacute stage from the 8th to 29th day and in the chronic stage until 360 days after the injury and compared with similar data in a group of normal subjects. It was concluded that in the subacute stage, regional cerebral blood flow decreased (26 +/- 7 and 39 +/- 10 ml/100 g/min) and regional cerebral blood volume increased (5.6 +/- 1.8 and 5.4 +/- 0.9 ml/100 g) both in areas of cerebral contusion and in areas remote from cerebral contusion and that permeability increased in areas of contusion but not in remote brain areas. In the chronic stage, these parameters showed a tendency for recovery.

Double intracranial tumours of maldevelopmental origin--teratoma at the pineal region and an epidermoid cyst in the fourth ventricle

A 21-year-old man with double intracranial tumours of maldevelopmental origin, teratoma at the pineal region and an epidermoid cyst in the fourth ventricle, is reported. The tumours were removed totally by multiple operations; the epidermoid cyst was resected by suboccipital craniectomy with the patient in prone position and the teratoma was removed via occipital transtentorial approach with the patient in sitting position. Maldevelopmental tumours located within the cranial cavity with different histological types such as the present case have not sofar been described. Histogenesis of these tumours is confusing because teratoma often contains tissues of epidermoid cyst. Etiological considerations for these tumours are presented and appropriate operative procedures for tumours simultaneously occurring in the pineal and the fourth ventricle are also discussed.

Treatment of multiple intracranial aneurysms in the anterior circulation--case report

A 69-year-old female underwent surgery for subarachnoid hemorrhage due to a ruptured intracranial aneurysm. Nine additional aneurysms were found. Four of the latter nine aneurysms were clipped in a second operation, and two were wrapped.

Intimal fibroelastic thickening--its etiological significance in juvenile cerebral infarction. Case report

Recurrent occlusive stroke of the vertebrobasilar system is reported in a 16-years-old man. Multiple arterial occlusions, segmental stenosis, or irregular dilatation were found in the angiography involving both the intra- and extracranial vertebro-basilar arteries. Surgical specimen of the extracranial vertebral artery with localized irregular lumen disclosed fibroelastic thickening of the intima with mural thrombus, which were thought to be an embolic source. Etiological significance of this intimal lesion in juvenile cerebrosvascular accident is discussed.

Stimulation of rat liver growth by a 1,3-dithiole derivative, KZ-1026

The oral administration of 2-(1,3-dithiol-2-ylidene)-1-phenyl-1,3-butanedione (KZ-1026) to normal rats at doses of 50, 100 and 200 mg/kg/day for 3 days accelerated liver enlargement in association with a dose-dependent increase in the total amounts of protein, RNA and DNA in the liver. The liver weight at 24 hr after the third dose of 200 mg/kg reached 174% of the control. With respect to the effect on liver enlargement, KZ-1026 differed from phenobarbital, since KZ-1026, unlike phenobarbital, increased hepatic DNA content without significant effects on P-450 and aminopyrine-N-demethylase. Incorporation of [3H]thymidine into liver DNA was stimulated by a single dose of KZ-1026 (200 mg/kg), and it peaked at 24 hr post dose (18 times the control), followed by an increase in the number of liver nuclei. Liver growth was also accompanied by an increasing hepatic reserve cell mass, expressed by the capacity of eliminating exogenous galactose from the blood stream. Pretreatment with KZ-1026 (200 mg/kg/day) for 3 days significantly improved the survival rate of subtotally hepatectomized rats from 39% to 78%. These findings indicate that KZ-1026 accelerates hepatocyte proliferation, resulting in an enhancement of liver functional mass in normal rats.

Magnetic resonance imaging of brain contusion

In this study we investigated the time course of brain contusions using magnetic resonance imaging and compared the findings with those of a computed tomography scan. The lesions, which were demonstrated as homogeneous density areas on the computed tomography scan were demonstrated as different intensity areas in the magnetic resonance image. The intensity of the images varied according to the time at which the images were obtained. The findings indicated changes in the nature of the contusions including hematoma hemoglobin, perifocal edema extension, and so on. In conclusion, magnetic resonance imaging is important in the follow-up of chronological change as well as in original diagnosis of brain contusions.

CT demonstration of massive cerebral air embolism from pulmonary barotrauma due to cardiopulmonary resuscitation

A 77-year-old man with loss of consciousness, circulatory collapse, and apnea caused by myocardial infarction underwent cardiopulmonary resuscitation with intratracheal intubation and manual bag ventilation. Computed tomography of the head demonstrated massive air embolism in the entire cerebral circulation. The patient was diagnosed as brain dead the next day. Demonstration of massive cerebral air embolism on head CT is presented.

[Preventive effect of KZ-1026 on acute liver injury induced by CCl4 in rats: histochemical, enzyme-histochemical and ultrastructural studies]

The preventive effect of KZ-1026 on acute liver injury induced by CCl4 in rats was evaluated histochemically, enzyme-histochemically and ultrastructurally. Rats that received 50% CCl4 (2 ml/kg) intraperitoneally were sacrificed at 3, 7 and 24 hr. Remarkable reductions in hepatic glycogen, RNA and G-6-Pase activity were observed in the centrilobular area at 3 hr, and ballooned cells appeared in the mid-zone at 7 hr. At 24 hr, the above histochemical parameters in the hepatocytes of the centrilobular area and mid-zone were extensively reduced, while the number of ballooned cells in the mid-zone was increased. KZ-1026 (200 mg/kg) was given orally at 24 and 4 hr before, simultaneously with or 3 hr after CCl4 treatment, and each rat was sacrificed at 24 hr after CCl4 administration. Pretreatment with KZ-1026 24 hr before CCl4 administration prevented reduction of RNA, glycogen and G-6-Phase activity, as well as disruption of rER and proliferation of sER due to CCL4 toxicity. This preventive effect of KZ-1026 was reduced by posttreatment; however, only the decrease in cytoplasmic RNA was well prevented. These results suggested that KZ-1026 is protective against CCl4-induced acute liver injury.

Extensive spinal necrosis with spinal leptomeningeal dissemination of cerebral astrocytoma. Case report

A 58-year-old male with malignant astrocytoma in the right parietal lobe developed ascending spinal dysfunction 15 months after subtotal resection of the primary lesion. He was treated by postoperative radiation and combined chemotherapy. Autopsy revealed extensive spinal necrosis affecting the level below the lower cervical region. Microscopic examination demonstrated diffuse leptomeningeal metastasis of glioma cells to the whole spine. There was no previous report in the literature of massive myelomalacia attributable to leptomeningeal dissemination an astrocytic supratentorial tumour. Clinical and neuropathological findings suggested that disturbance of venous drainage of the spinal cord might be responsible for myelomalacia in this case.

Immunotherapy of solid tumor by intratumoral infusion of lymphokine-activated killer cells

Fifty million lymphokine-activated killer (LAK) cells were infused into rat T9 gliosarcoma tumors for 1 hr at an infusion rate of 0.1 ml/hr. Cultured normal spleen cells were infused into similar tumors as a control. The LAK cell-treated tumors began to regress at approximately 3 weeks after infusion and disappeared by 6 weeks, while the cultured normal spleen cell-treated tumors grew progressively. Immunohistochemical analysis demonstrated prominent infiltration of cytotoxic/suppressor T cells in the LAK cell-treated tumors, while few lymphocytes were recognized in the control tumors. These data suggested that LAK cells infused intratumorally might be capable of mediating tumor regression by inducing host immunity against the tumor.

Functional analysis of mononuclear cells infiltrating into tumors. III. Soluble factors involved in the regulation of T lymphocyte infiltration into tumors

We have analyzed the mechanisms controlling the accumulation of T lymphocytes in tumor tissues. Spleen cells, left or right popliteal lymph node cells, and tumor-infiltrating cells were obtained from tumor-inoculated rats and were cultured for 24 h. Culture supernatants were obtained and assessed for lymphocyte migration factor (LMF) activity with the use of a modified Boyden chamber. We found that tumor-infiltrating cells derived from T-9-sensitized rats produced LMF. Two waves of LMF production were observed. The first wave of LMF production was detected between 6 and 12 h (LMF-a) and the second wave of LMF production was detected between 4 and 6 days (LMF-4d and -6d) after tumor inoculation. The tumor-infiltrating cells consisted of heterogenous cell populations. We found that only tumor-infiltrating neutrophils of T-9-sensitized rats produced LMF-a. Five peaks of LMF (A through E) were detected upon fractionation of LMF-a using Mono Q anion exchange column chromatography. Peak D exhibited the strongest activity. The action of peak D was chemotactic, but not chemokinetic. The m.w. of peak D was 33,000 and 70,000. Only W3/25 (+) (helper/inducer) T cells were found to be sensitive to peak D. The production of LMF-a by purified tumor-infiltrating neutrophils in vitro is in agreement with the histologic observation that the infiltration of neutrophils precedes the appearance of W3/25 (+) T cells in tumor tissues of T-9-sensitized rats. It is thus likely that peak D of LMF-a is responsible for the infiltration of T lymphocytes into tumor tissues.

Functional analysis of mononuclear cells infiltrating into tumors. III. Soluble factors involved in the regulation of T lymphocyte infiltration into tumors

We have analyzed the mechanisms controlling the accumulation of T lymphocytes in tumor tissues. Spleen cells, left or right popliteal lymph node cells, and tumor-infiltrating cells were obtained from tumor-inoculated rats and were cultured for 24 h. Culture supernatants were obtained and assessed for lymphocyte migration factor (LMF) activity with the use of a modified Boyden chamber. We found that tumor-infiltrating cells derived from T-9-sensitized rats produced LMF. Two waves of LMF production were observed. The first wave of LMF production was detected between 6 and 12 h (LMF-a) and the second wave of LMF production was detected between 4 and 6 days (LMF-4d and -6d) after tumor inoculation. The tumor-infiltrating cells consisted of heterogenous cell populations. We found that only tumor-infiltrating neutrophils of T-9-sensitized rats produced LMF-a. Five peaks of LMF (A through E) were detected upon fractionation of LMF-a using Mono Q anion exchange column chromatography. Peak D exhibited the strongest activity. The action of peak D was chemotactic, but not chemokinetic. The m.w. of peak D was 33,000 and 70,000. Only W3/25 (+) (helper/inducer) T cells were found to be sensitive to peak D. The production of LMF-a by purified tumor-infiltrating neutrophils in vitro is in agreement with the histologic observation that the infiltration of neutrophils precedes the appearance of W3/25 (+) T cells in tumor tissues of T-9-sensitized rats. It is thus likely that peak D of LMF-a is responsible for the infiltration of T lymphocytes into tumor tissues.

Diurnal changes in vasopressin and oxytocin levels in cerebrospinal fluid of post-operative patients with intracranial aneurysms

Diurnal changes in vasopressin and oxytocin levels in cerebrospinal fluid were investigated under normal diurnal conditions. The patients examined had ruptured intracranial aneurysms, and underwent neck-clipping operations and continuous drainage from the basal cistern. All of the patients recovered consciousness without signs of neurological deficit. The investigations were conducted for 2 days starting 5-9 days after the neck-clipping operations were performed. The oxytocin concentration decreased as night fell, remained low during this period and then increased during the day. The vasopressin level demonstrated no definite rhythmic tendency. No correlation was revealed between the changes in the concentrations of either vasopressin or oxytocin in the cerebrospinal fluid and the osmolality.

[Traumatic posterior fossa hematoma]

The traumatic posterior fossa hematoma was regarded as relatively rare thing, but recently, as the result of the prevalence of CT scanners, the number of reported cases is increasing. We report nine cases of traumatic posterior fossa hematoma. We divided into two categories: one was the acute epidural hematoma, the other was the acute subdural hematoma with cerebellar contusion. Five were cases of the acute epidural hematoma, three were cases of the acute subdural hematoma with cerebellar contusion and a case had both an epidural and a subdural hematoma. All the cases had struck the occipital region and had the occipital bone fracture. The prognosis of the five cases of the acute epidural hematoma was excellent, but that of the four cases of the acute subdural hematoma with cerebellar contusion was poor and they all died inspite of the removal of the hematoma executed in three cases. We estimated that the hitting forth was extremely strong in cases of the subdural hematoma with cerebellar contusion, and that the momentary deformity of the occipital bone might injure the cerebellum directly. Once a hematoma was produced in the posterior fossa, it oppresses the brainstem and causes the acute hydrocephalus, so the state of consciousness and respiration deteriorate suddenly. In cases of the acute epidural hematoma, appropriate surgical intervention could save the patients and resulted in good outcome. But in some cases of the fulminant type acute epidural hematoma of the posterior fossa caused by tearing the sinuses, though we have not experienced, patients die before the diagnosis and treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of rat T cell subset antigen by monoclonal antibody

6B2-B8 T cell hybridoma cells were used to immunize mice, and immune spleen cells were fused with NS/1 myeloma cells. One clone, designated RTH-7, reacted with 89.5% of rat thymocytes, 30.2% of rat spleen cells, and 42.3% of rat lymph node cells. The RTH-7 reacted with a subset of rat T cells but not with B cells. Double staining analysis demonstrated that RTH-7 stained a rat T cell subset distinct from R1-10B5-positive cells that were known to be equivalent to mouse Lyt-2. It was revealed that RTH-7 and W3/25 recognize different antigenic epitopes on the same molecule. The RTH-7 as well as W3/25 substantially inhibited the production of interleukin 2 by cells in mixed lymphocyte reaction and the lymphocyte proliferation induced by mixed lymphocyte reaction. The RTH-7 inhibited the lymphocyte proliferation induced by Con A whereas W3/25 failed to do so. The RTH-7 defined antigen has a molecular weight of 53,000 under reducing condition and 47,000 under nonreducing condition. The RTH-7 defined antigen showed a wide range of heterogeneity in pI (6.2-8.8). The associated molecule of approximate molecular weight of 27,000 was occasionally detected with the RTH-7 defined antigen in 6B2-B8 T cell hybridoma cells as well as peripheral T cells but not in thymocytes. Thus, RTH-7 detects a cell surface antigen of a functional T cell subset of rat origin.

[A case of persistent trigeminal artery aneurysm treated by proximal obliteration of feeding vessels in both intra- and extracranial compartments]

The authors described a case with a saccular aneurysm of the persistent trigeminal artery (PTA) treated with intra- and extracranial proximal obliteration of the feeding arteries. PTA aneurysm is a rare disorder found only 14 cases in the literature. There have been only 4 cases treated by surgical procedure; 2 underwent direct surgery and the remaining 2 had carotid ligation. Both of the cases treated by direct obliteration of the aneurysm sustained diplopia and sensory disturbance around the orbit as postoperative neurological deficits. We thought another choice of treatment to reduce the risk of rupture of the aneurysm avoiding postoperative complications. Clinical presentation of the present case was rt-oculomotor palsy, which disappeared before the operation. Cerebral angiography disclosed an intracavernous sinus aneurysm with a broad neck arising from the rt-internal carotid-PTA junction. Bilateral posterior cerebral arteries were perfused by the rt-internal carotid artery was compressed manually, lt-vertebral angiography showed the aneurysm and the internal carotid artery simultaneously via the PTA as retrograde filling. Because the direct surgery might cause damage to the cranial nerves passing through the cavernous sinus, we employed proximal obliteration of the feeding vessels. The operation was done by the following steps: ligation of the cervical portion of the rt-internal carotid artery, rt-superficial temporal artery-middle cerebral artery anastomosis, clipping of the PTA at the basilar side.(ABSTRACT TRUNCATED AT 250 WORDS)

Value of high-resolution computed tomography in diagnosis of petrous bone fracture

High-resolution computed tomography (CT) was performed on 31 patients clinically suspected of having petrous bone fracture. The location of the fracture was demonstrated accurately in 28 patients (90.3%), whereas it could be diagnosed by plain skull film in only 17 patients (54.8%). The anatomic location of fractures demonstrated by high-resolution CT clearly corresponded to the clinical symptoms and signs. We have classified petrous bone fracture into five types according to the anatomic levels demonstrated on CT images. The findings indicate that high-resolution CT is extremely useful for diagnosing petrous bone fracture.

Rapidly growing aneurysm

A rare case of rapidly growing intracranial aneurysm is reported. The enlarged aneurysmal wall was extirpated and studied histologically. The cause of the rapid growth of the aneurysm is discussed.

Construction of rat-mouse T cell hybridomas that express regulatable rat interleukin 2 receptor

Spleen cells obtained from Lewis rats were cultured with 4 micrograms/ml Con A for 96 hr, and activated cells were fused with BW5147 mouse T lymphoma cells. Seven clones obtained by fusion expressed rat IL 2R. The expression of rat IL 2R on those hybrid cells could be up-regulated by IL 2 itself, ATL-derived factor, and TPA and CA++ ionophore. Those IL 2R could be down-regulated by murine MoAb ART-18 that detects rat IL 2R. All hybrid clones produced IL 2 constitutively. IL 2 produced by hybrid cells bound to its receptor and promoted the proliferation of hybrid cells in some clones. Incubation of cells with exogenous IL 2 resulted in the proliferation of hybrid cells, whereas the proliferation of some clones was inhibited by exogenous IL 2, indicating that IL 2 had bifunctional properties on cell growth. Rat IL 2R from 6H2-F9 hybrid cells was studied by both one- and two-dimensional SDS-PAGE with ART-18. The IL 2R derived from 6H2-F9 cells had 72,000 to 77,000 and 40,000 to 48,000 m.w. major components under nonreducing conditions, and had 50,000 to 56,000 m.w. major and 35,000 to 38,000 m.w. minor components under reducing conditions. The 110,000 m.w. component, the third component of IL 2R, was constantly observed in 6H2-F9 hybrid cells.

Construction of rat-mouse T cell hybridomas that express regulatable rat interleukin 2 receptor

Spleen cells obtained from Lewis rats were cultured with 4 micrograms/ml Con A for 96 hr, and activated cells were fused with BW5147 mouse T lymphoma cells. Seven clones obtained by fusion expressed rat IL 2R. The expression of rat IL 2R on those hybrid cells could be up-regulated by IL 2 itself, ATL-derived factor, and TPA and CA++ ionophore. Those IL 2R could be down-regulated by murine MoAb ART-18 that detects rat IL 2R. All hybrid clones produced IL 2 constitutively. IL 2 produced by hybrid cells bound to its receptor and promoted the proliferation of hybrid cells in some clones. Incubation of cells with exogenous IL 2 resulted in the proliferation of hybrid cells, whereas the proliferation of some clones was inhibited by exogenous IL 2, indicating that IL 2 had bifunctional properties on cell growth. Rat IL 2R from 6H2-F9 hybrid cells was studied by both one- and two-dimensional SDS-PAGE with ART-18. The IL 2R derived from 6H2-F9 cells had 72,000 to 77,000 and 40,000 to 48,000 m.w. major components under nonreducing conditions, and had 50,000 to 56,000 m.w. major and 35,000 to 38,000 m.w. minor components under reducing conditions. The 110,000 m.w. component, the third component of IL 2R, was constantly observed in 6H2-F9 hybrid cells.

Immunobiological and biochemical characterization of solubilized rat gliosarcoma cell tumor-associated transplantation antigens

Tumor-associated transplantation antigen (TATA) was solubilized with n-butanol from rat gliosarcoma cells (T-9). Under the conditions used for the solubilization of TATA, the viability of T-9 cells was maintained above 85%, suggesting that the contamination of TATA with cytoplasmic protein is minimal. Normal Fischer rats were treated with 500 micrograms of n-butanol extract and inoculated with 2 X 10(6) viable T-9 cells. At 8 weeks after the inoculation of viable tumor cells, the tumor diameter was significantly smaller than that in control untreated rats. Rats treated with 770 micrograms of n-butanol extract from T-9 cells were inoculated with 1 X 10(7) syngeneic FTL-13 thymic lymphoma cells or T-9 cells. The rats rejected the T-9 cells, whereas the FTL-13 cells grew gradually until the host died, indicating that the n-butanol extract from T-9 cells contained T-9 cell-specific TATA. The n-butanol extract was characterized by chromatographic separation on a TSK gel G3000SW gel filtration column and a Mono Q anion exchange column with the fast protein liquid chromatography system (FPLC). The TATA of T-9 cells was found to have a molecular weight of approximately 40,000-70,000 and was eluted at 0.6-0.9M NaCl from the Mono Q column. The cellular mechanisms responsible for the rejection of T-9 cells in the rats treated with the n-butanol extract were also examined. Adoptive transfer and in vitro experiments demonstrated that helper T cells for the generation of cytotoxic T lymphocytes were generated in the rats treated with n-butanol extract.

[A simple bioassay method of urinary indoleacetic acid, a cancer growth factor]

Indoleacetic acid (IAA) is produced in cancer tissue and promotes the growth of cancer cells and of the surrounding cells which become cancerous. It was shown that the urine of cancer patients contains larger amounts of IAA than that of healthy persons (except diabetics). This increased IAA level may be derived from the cancer tissue. The measurement of urinary IAA can thus be used to screen cancer patients. Various assay methods for IAA were tested, but 15 min. are required even with the modified HPLC used in this laboratory directly with unpurified urine. Hence it is unsuitable for measuring large numbers of samples within short period. The present work reports on a simple, easy and rapid method for determining urinary IAA in large numbers of samples by using Avena coleoptile sections. Ten sections are floated for 3 hr. on 1/50 diluted urine with 0.5 ppm gibberellic acid (GA). Up to a certain limit their elongation is proportional to the IAA concentration in the diluted urine. Persons whose urine causes coleptile section to elongate more than 1.3 mm require detailed clinical examination to determine whether or not they suffer from cancer.

Acute brain edema in fatal head injury: analysis by dynamic CT scanning

Dynamic computerized tomography (CT) was performed on 42 patients with acute head injury to evaluate the hemodynamics and to elucidate the nature of fatal diffuse brain bulk enlargement. Patients were divided into two groups according to the outcome: Group A included 17 nonfatally injured patients, eight with acute epidural hematomas and nine with acute subdural hematomas; Group B included 25 fatally injured patients, 16 with acute subdural hematomas and nine with bilateral brain bulk enlargement. Remarkable brain bulk enlargement could be seen in all fatally injured patients with acute subdural hematoma. In 29 (69%) of 42 patients, dynamic CT was performed within 2 hours after the impact. In the nonfatally injured patients with brain bulk enlargement, dynamic CT scans suggested a hyperemic state. On the other hand, in 17 (68%) of the 25 fatally injured patients, dynamic CT scans revealed a severely ischemic state. In the fatally injured patients with acute subdural hematoma, CT Hounsfield numbers in the enlarged hemisphere (hematoma side) were significantly lower than those of the opposite side (p less than 0.001). Severe diffuse brain damage confirmed by follow-up CT scans and uncontrollable high intracranial pressure were noted in the fatally injured patients. Brain bulk enlargement following head injury originates from acute brain edema and an increase of cerebral blood volume. In cases of fatal head injury, acute brain edema is the more common cause of brain bulk enlargement and occurs more rapidly than is usually thought.

A soluble factor distinct from interleukin 2 is involved in the generation and differentiation of cytotoxic T cells

The involvement of cytotoxic cell-generating factor (CGF) in the generation of cytotoxic cells against syngeneic tumor (T-9) cells and in the rejection of the tumor cells has been investigated. It was found that Con A-sup (culture supernatant of concanavalin A-stimulated rat spleen cells) contained CGF, which was distinct from interleukin (IL) 2 and interferon. It should be noted that spleen cells produced CGF upon inoculation of syngeneic tumor cells into tumor-sensitized rats. Production of CGF preceded the appearance of cytotoxic cells against inoculated tumor cells. In these rats, the inoculated tumor was rejected. In contrast, spleen cells failed to produce CGF upon inoculation of tumor cells into normal rats; in these rats, cytotoxic cells were not detected and the inoculated tumor grew. These data suggested that CGF was produced as an in vivo response of the host immune system and was involved in the generation of cytotoxic T cells. CGF obtained from sensitized spleen cells was chromatographically separated from IL 1, IL 2, and colony-stimulating factor, and the chromatographically separated CGF did not contain IL 3 activity.

Immunocytochemical demonstration of carcinoembryonic antigen in cerebrospinal fluid with carcinomatous meningitis from rectal cancer

The case presented illustrates the application of the immunoperoxidase technique to cerebrospinal fluid (CSF) cytology. The cytologic findings in a Papanicolaou-stained slide of the CSF permitted the diagnosis of a metastatic carcinoma. Positive reactions to carcinoembryonic antigen (CEA) were demonstrated in the tumor cells in the CSF sample as well as in the paraffin-embedded section of the primary rectal cancer. Rising CEA levels were also detected in both CSF and serum. The determination of cancer-associated antigens, such as CEA in the CSF specimen, may be useful in establishing the presence of metastatic tumor in the CSF.

Preparation of specific antisera to estrone-3-glucuronide and estriol-3-glucuronide

The preparation and antigenic properties of estrone-3-glucuronide- and estriol-3-glucuronide-bovine serum albumin conjugates in which the hapten is linked to the carrier protein through an (O-carboxymethyl)oxime bridge at the C-6 position on the steroid nucleus, have been described. Antibodies raised against the two immunogens in the rabbit possessed high specificity to estrone-3-glucuronide and estriol-3-glucuronide, respectively, exhibiting little cross-reactivities with other estrogen conjugates and no cross-reactions with related steroids except for free estrogens, their 3-methyl ethers and 3-sulfates. The cross-reactive antibodies were eliminated by partial immunoadsorption on affinity chromatographic media using the estrone-3-methyl ether 17-(O-carboxymethyl)oxime- and estriol-3-methyl ether 16 (or 17)-hemisuccinate-aminohexyl Sepharose conjugates, respectively. The purified antisera exhibited no cross-reactivities with free estrogens and ring A conjugates of estrone and estriol.

[Extravasation of contrast media demonstrated during cerebral angiography in the giant aneurysm of the brain]

The authors report a case of giant aneurysm in which extravasation of contrast medium was demonstrated during cerebral angiography and confirmed by computed tomography. A 33-year-old man suddenly lost consciousness and vomited frequently. Three hours later, he was admitted to our hospital in semicomatose state with left hemiplegia. Within two hours after admission, plain CT scan, enhanced CT scan, left carotid angiography and post-angiographic CT scan were performed. CT scan showed marked subarachnoid hemorrhage, left temporal intracerebral hematoma and oval mass which was remarkably enhanced in the left Sylvian fissure. First left carotid angiogram demonstrated a giant aneurysm of the middle cerebral artery which was measured 4.5 cm in maximum diameter. Second left carotid angiogram demonstrated an extravasation of contrast medium around the aneurysm. The patient immediately underwent CT scan, which showed enlargement of intracerebral hematoma and intraventricular high density area as added lesion. By regulation of window level, the presence of contrast medium due to intra-angiographic rupture of the aneurysm was confirmed. The patient expired fifteen hours after admission. At autopsy, the thrombus in the aneurysmal sac was hardly present and the wall of the sac was made mainly of collagen fibers. From the following two points this case was very interesting. However this aneurysm was very large, the thrombus in the aneurysmal sac was hardly present. Extravasation of contrast medium was clearly demonstrated during cerebral angiography with confirmation by computed tomography in the giant aneurysm.

[A rapid method for determining urinary indoleacetic acid concentration and its clinical significance as the tumor-marker in the diagnosis of malignant diseases]

A rapid method for determining urinary indole-3-acetic acid (IAA) is introduced as the tumor-marker for the screening and diagnostic purpose of cancer patients by means of high performance liquid chromatography (HPLC). Its clinical significance is discussed along with a review of literatures. The IAA concentration and creatinine level of optionally collected urine samples were measured and used for the calculation of IAA amount per unit creatinine (microgram IAA/mg creatinine) in urine. Thus, an amount of 24-hours urinary IAA could be calculated without collecting a whole day's urine supply. Analysis of urinary IAA was performed within 10 minutes by HPLC. Urinary IAA level is usually high in the patients with the upper G-I tract cancers such as gastric cancer, esophageal cancer and hepato-biliary tract cancer, and also malignant hematopoietic disorders. But it is also high in non-cancer patients such as liver cirrhosis, diabetes mellitus and cholelithiasis occasionally. The patients with high urinary IAA level also showed high urinary levels of 5-hydroxy indoleacetic acid (5-HIAA) and monoamine oxidase activity (MAO). It was characteristic that hepatocellular carcinoma showed slight elevation of urinary IAA with normal levels of 5-HIAA and MAO. It is conclusive that the positive rate of elevated urinary IAA level was high in the patients with gastric cancer with ulcer-forming type in its morphological classification, and its level tends to elevate as the disease progresses. Therefore, the measurement of urinary IAA level in an optionally collected urine sample, as the tumor-marker, can be useful to check the progression and regression of gastric cancer.

Meningitis with Acinetobacter calcoaceticus in cerebrospinal fluid. A case report

A case of meningitis due to Acinetobacter calcoaceticus occurred after neurosurgery. The cerebrospinal fluid cytology showed intracellular diplococci that strongly resembled Neisseria meningitidis. However, subsequent bacteriologic studies revealed a bacterium identical to A. calcoaceticus. It is of practical importance for cytology laboratories to recognize this diplococcal form of organism.

[Artificial embolization with cyanoacrylate for the treatment of the extracranial arteriovenous malformation]

Two cases of the extracranial arteriovenous malformation (AVM) were treated by intra-arterial injection of cyanoacrylate (Aron alpha A). The first case was a 31-year-old man who had an AVM in the left temporal muscle. At operation, the feeders, the left anterior and posterior deep temporal arteries, were exposed and Aron alpha A was injected into these feeders. The pulsation of the AVM disappeared and the AVM became a hard mass. The mass was totally removed with remarkably little amount of bleeding. No complication was noted. The second case was a 23-year-old man who had an AVM in the scalp, and its feeder was the left occipital artery. The treatment was done in the same manner as in the first case. After operation the regional scalp became necrotic, but the epithelialization was completed in 3 weeks. No signs of recurrence of AVM were noted 20th and 21th month after operation in each of the cases. The recent literature were briefly reviewed.

Calmodulin and acidic compounds alter basic protein phosphorylation by the protein kinase from human platelets

A cyclic nucleotide-independent protein kinase of human platelets, which phosphorylated histones, myelin basic protein and protamine and did not catalyze the phosphorylation of acidic proteins such as casein, phosvitin and myosin light chain, has been purified approx. 1,500-fold from the crude extract by steps of DEAE-cellulose, Sephadex G-200, hydroxylapatite and phosphoryl cellulose column chromatography. The substrate phosphorylation by this kinase was markedly enhanced by calmodulin even in the absence of Ca2+, when mixed histone was used as a substrate. The interaction of the kinase with mixed histone resulted in an irreversible inactivation of the enzyme. Calmodulin prevented this inactivation, and this compound produced an apparent increase in histone phosphorylation by the kinase. It should be noted that acidic polypeptides such as troponin-C, phospholipids and nucleic acids have a similar ability. The addition of Ca2+ reduced the effect of calmodulin more than the effects of other acidic compounds.