Androgen deprivation and radiation therapy: sequencing studies using the Shionogi in vivo tumor system

PURPOSE

To test the relative effect of neoadjuvant and adjuvant androgen deprivation on the radiation response of an androgen dependent tumor.

METHODS AND MATERIALS

The transplantable, androgen dependent, Shionogi adenocarcinoma was grown as allografts in the hind limbs of NCr/Sed (nu/nu) athymic nude mice. Bilateral orchiectomy was the chosen form of androgen deprivation. Groups of tumors were irradiated to graded tumor doses and then studied for durable tumor control. The radiation response was expressed as the radiation dose required to control 50% of the tumors (TCD50). The sequence of radiation and orchiectomy was studied.

RESULTS

When radiation was combined with orchiectomy the Shionogi tumor was significantly more likely to be controlled than when radiation was used alone. Orchiectomy 12 days prior to radiation (neoadjuvant therapy) produced a significantly greater decline in the TCD50 than when orchiectomy was used 1 day or 12 days after radiation (adjuvant therapy). If, before radiation, tumors were allowed to regrow after orchiectomy to their original size in an androgen independent fashion then the advantage was largely lost. Those tumors responding well to neoadjuvant orchiectomy (>50% volume decrease) were significantly more likely to be eradicated by radiation than those with a lesser response.

CONCLUSION

When using combinations of androgen deprivation and radiation in the treatment of the Shionogi tumor, sequence and timing of the therapies are crucial to maximize the effect.

Neurogenesis and cell migration into the sexually dimorphic preoptic area/anterior hypothalamus of the fetal ferret

A sexually dimorphic male nucleus (MN) of the preoptic area/anterior hypothalamus (POA/AH), comprising large, estradiol-receptor containing neurons, is formed in male ferrets due to the action of estradiol, derived from the neural aromatization of circulating testosterone, during the last quarter of a 41-day gestation. Two experiments were conducted to compare the birthdates and the migration pattern of cells into the sexually dimorphic portion of the dorsomedial POA/AH as well as the nondimorphic ventral nucleus (VN) of the POA/AH of males and females. In experiment 1 the thymidine analog, bromodeoxyuridine (BrdU), was injected into the amniotic sacs of fetuses of different mothers between embryonic (E) days 18 and 30. Kits from all mothers were sacrificed on E38, and brains were processed to localize BrdU immunoreactivity (IR) for determining the birthdates of neurons in the POA/AH. Cells in the MN-POA/AH of males and in a comparable region of females were born between E22 and E28; cells in the nondimorphic VN-POA/AH of both sexes were born between these same ages. These results suggest that cells in the sexually dimorphic as well as the nondimorphic subdivision of the ferret POA/AH are born during the same embryonic period. This is well before the ages (E30-E41) when administering testosterone to females can stimulate, and blocking androgen aromatization in males can inhibit, MN-POA/AH differentiation. In experiment 2 BrdU was injected on E24, and kits from different litters were perfused on E30, E34, or E38. Brains were processed for BrdU-IR as well as glial fibrillary acidic protein (GFAP), which served as a marker for radial glial processes. The orientation of radial glial processes in fetal brains of both sexes suggested that cells migrate into the dorsomedial POA/AH from proliferative zones lining the lateral as well as the third ventricles. Quantitative, computer-assisted image analysis of BrdU-IR in groups of male and female brains supported this hypothesis. There were no significant sex differences in the distribution of BrdU-IR over the three ages studied, suggesting that formation of the MN-POA/AH in males cannot be attributed to an effect of estradiol on the migration of those cells born on E24 into this sexually dimorphic structure. Finally, total BrdU-IR did not change significantly in the POA/AH of male and female kits killed at E30, E34, or E38 while the area of the POA/AH increased more than 2.5-fold over this period, suggesting that few of the POA/AH cells born on E24 die during this period in either sex. In the absence of evidence that formation of the male ferret's MN-POA/AH depends on steroid-induced changes in neurogenesis, cell migration, or death, we suggest that the specification of a particular neuronal phenotype (e.g., large somal size; capacity to produce some undetermined neurotransmitter or neuropeptide) may be responsible.

Comprehensive pharmaceutical care in the chain setting

A controlled, randomized study was conducted in two chain pharmacies to determine the clinical value of comprehensive pharmacy services for hypertensive patients in a chain pharmacy setting. Twenty-seven patients were enrolled as intervention participants with 26 control subjects. Monthly services for the intervention group included blood pressure and heart rate assessments and counseling on lifestyle modifications and drug therapy. Control patients received initial and final blood pressure measurements and minimal counseling. Both study and control groups completed quality-of-life questionnaires upon entering and completing the study. Results showed that blood pressure control was significantly improved in the study group. Compliance rates as well as energy/fatigue scores (a quality-of-life scale) improved in the study group compared with the control population. Community pharmacists in chain stores could have a beneficial effect on the health care of large numbers of patients if pharmaceutical care programs were developed.

Partial purification and characterization of an esterase from Fusarium sporotrichioides

Kinetics analysis of the growth of Fusarium sporotrichioides T-424 at 15 degrees C and 25 degrees C in liquid culture for 35 days revealed that production of deacetylated trichothecenes was associated with an increased activity in fungal esterases. High temperature (25 degrees C) favored enzyme production and enhanced esterase activity. Electrophoresis of crude extracts from the mycelia of F. sporotrichioides T-424 with carboxylesterase staining revealed that several esterases were produced by the fungus. Four carboxylesterase isoenzymes (I-IV) were separated on a DEAE-Sephadex anion exchange column. Type (III) esterase, having activities with the substrate 4-nitrophenylacetate and acetanilide, as well as hydrolytic activity for T-2 toxin and acetyl-T-2 toxin, was partially purified with ammonium sulfate precipitation, immunoaffinity column chromatography, and DEAE-Sephadex A-50 chromatography. The esterase (III) had a molecular weight around 68 kDa in SDS-PAGE. For the deacylation of T-2 toxin and acetyl-T-2 toxin, type (III) esterase had a high specificity for the acetyl group at the C-3 and C-4 positions. The Km values for acetyl-T-2 and T-2 toxin were found to be 41.35 microM and 0.38 microM, respectively. The Km value for the acetyl group at C-3 is 110 times greater than for that at C-4.

Natural occurrence of Fusarium mycotoxins in field samples from the 1992 Wisconsin corn crop

Analysis of 98 moldy corn samples collected in Wisconsin between November 1992 and January 1993 for Fusarium toxins by various immunochemical assays revealed overall average mycotoxin concentrations of 305.6, 237.7, and 904.3 ng/g for type A trichothecenes (TCTCs), deoxynivalenol (DON)-related type B TCTCs (total DON), and zearalenone (ZE), respectively. A small portion (5.1%) of the samples was found to be contaminated with high levels ( > 1 microgram/g) of type A TCTCs and total DON during the whole survey. Over 40% of the samples had 100 to 1,000 ng of total DON per g, while 17% of the samples had the same levels of type A TCTCs. The analytical data were consistent with those from mycological examinations for the samples in which various toxic Fusarium spp., including F. sporotrichioides, F. poae, and F. graminearum, were found. The samples received in November 1992 had relatively low concentrations of toxin; the average levels of type A TCTCs and total DON were 9.9 and 79 ng/g, respectively. The toxin concentrations became progressively higher in the samples received in December. The average levels for the type A TCTCs and total DON increased to 920 and 335 ng/g, respectively. However, the levels of ZE were higher in the samples collected earlier. The average levels for samples collected in November and late December were 1,195 and 242 ng/g, respectively. Analysis of selected samples by high-performance liquid chromatography monitoring with an enzyme-linked immunosorbent assay revealed that T-2 toxin, HT-2 toxin, diacetoxyscirpenol, neosolaniol, and T-2 tetraol (T-2-4ol) were common in these samples. Statistical analysis revealed a weak correlation between the levels of total type A TCTCs and total DON in the samples (r = 0.18, P = 0.09), but a strong correlation between the levels of ZE and total type B TCTCs (r = 0.75, P < 0.0001) was found. The mycotoxin levels of total type A TCTCs, total DON-related type B TCTCs, and ZE in the cobs (5.2, 3.9, and 21 micrograms/g, respectively) were considerably higher than those in the kernels (1.0, 0.5, and 0.5 microgram/g, respectively). The type A toxin levels increased from a range of 14 to 35 ng/g to a range of 110 to 538 ng/g after the moldy corn samples were held at 5 degrees C for 8 days in the laboratory.

Pseudoaneurysm and splenic infarction in chronic pancreatitis--a case report

Peripancreatic pseudoaneurysm and splenic infarction are rare but life-threatening complications of chronic pancreatitis. The incidence of pseudoaneurysm in patients who undergo angiography for pancreatitis is about 10%. Clinically, pseudoaneurysm is hard to discover until rupture occurs. The authors have recently experienced a case of intact pseudoaneurysm and splenic infarction in chronic alcoholic pancreatitis. A bolus enhanced CT scan and angiography were essential to confirm these complications of pancreatitis. We managed these complications successfully by distal pancreatectomy and splenectomy.

Assessment of immunochemical methods for the analysis of trichothecene mycotoxins in naturally occurring moldy corn

The efficacy of various immunochemical methods for simultaneous analysis of different trichothecene mycotoxins in corn samples naturally contaminated with various Fusarium molds was evaluated. Antibodies against either T-2 tetraol tetraacetate (T-2-4ol-4Ac) or deoxynivalenol triacetate (Tri-Ac-DON) were used in the enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) for total type A and total DON-related trichothecenes (TCTCs), respectively. Specific antibodies against T-2 toxin were used in an RIA for analysis of T-2 toxin alone. Analytical recoveries of T-2 toxin analyzed as T-2-4ol-4Ac by ELISA and T-2 toxin by RIA at 10-200 ppb were 83.5-123% and 81.8-110.6%, respectively. T-2 toxin accounts for about 30% of total type A TCTCs by both liquid chromatography (LC)-ELISA and RIA methods. The correlation coefficients (r) of total type A TCTC levels versus T-2 toxin level by RIA was 0.725 (p < 0.0001). A good correlation (r = 0.84 and p = 0.04) also was found for T-2 toxin levels obtained by LC-ELISA and RIA methods. In addition to T-2 toxin, HT-2 toxin, diacetoxyscirpenol, and T-2 tetrol were found in samples containing high levels of type A TCTCs by LC-ELISA. For analysis of DON alone, samples were treated with a Sep-Pak C18 cartridge to remove other acetylated DONs before RIA. Recovery of DON after the C18 cartridge treatment was 90%. Overall analytical recoveries of DON as Tri-Ac-DON (sample with no C18 treatment) and DON alone (with C18 treatment) at 10-500 ppb were 81.3-94% and 72.7-104%, respectively. RIA revealed that DON accounts for about 50% of total DON-related TCTCs. The coefficient of correlation between total DON-related TCTCs and DON levels was 0.84 (p < 0.0001).

The first human case of Diplogonoporus balaenopterae (Cestoda: Diphyllobothriidae) infection in Korea

The first human case of Diplogonoporus balaenopterae infection is reported in Korea. The patient was a 41-year old male who passed a part of cestode strobila, about 1 m long, spontaneously in his stool. He used to eat raw marine fish when he drank alcohol. The worm was identified as D. balaenopterae after morhological observations and literature review. Results of laboratory examination were within normal limits except for slight eosinophilia (6%) and extraordinarily high serum Ig E level (10,182 IU/ml).

An autologous fibrin tissue adhesive with greater bonding power

OBJECTIVE

To describe and evaluate an autologous fibrin tissue adhesive (AFTA) that uses a combination of ethanol and freezing to precipitate fibrinogen (AFTA-E).

DESIGN

The bonding power of AFTA-E was compared with that of a conventional AFTA based on ammonium sulfate precipitation of fibrinogen (AFTA-A). In this study, Silastic, porcine dermis, and human dura mater blocks were bonded together for 10 and 30 minutes with AFTA-E or AFTA-A. The blocks were then separated and the bonding power was measured. The efficacy of AFTA-E was also evaluated after a 24-hour refrigeration.

SETTING

The Department of Otolaryngology Research Laboratory at the University of Illinois Eye and Ear Infirmary, Chicago, Ill.

PARTICIPANTS

Blood was drawn from 86 healthy volunteers and AFTA-E and/or AFTA-A was manufactured.

RESULTS

The AFTA-E was shown statistically to bond stronger than the AFTA-A. In addition, it was found that the efficacy of AFTA-E was unchanged after a 24-hour refrigeration.

CONCLUSIONS

The improved AFTA, AFTA-E, is a superior alternative to the conventional AFTA-A. Furthermore, AFTA-E can be manufactured before surgery and stored, thus minimizing preparation time during surgery.

Ethanol enhances growth factor-induced neurite formation in PC12 cells

Ethanol can injure the nervous system by disturbing the growth of neural processes. PC12 cells, which form neurites in response to nerve growth factor (NGF), fibroblast growth factor (FGF), and cAMP analogues, were used to study mechanisms by which ethanol alters process outgrowth. Ethanol potentiated NGF-induced neurite outgrowth in cells cultured on different substrata and in serum-containing or defined medium. Ethanol did not increase NGF receptor binding or internalization of NGF. Neurite outgrowth induced by basic FGF was also increased by ethanol but outgrowth induced by forskolin was not. Ethanol potentiated NGF-induced expression of Thy-1, but not of neural cell adhesion molecule (N-CAM), indicating that some, but not all actions of NGF are enhanced by ethanol. In some brain regions, chronic exposure to ethanol increases the growth of dendrites. This has been explained as a compensatory response of surviving neurons to the loss of neighboring cells, and not as a direct effect of ethanol. The present findings suggest that, in some cells, ethanol directly promotes growth factor-mediated neurite formation. This could harm the nervous system by disturbing the balanced development and organization of synapses.

Postoperative respiratory complications in patients with Hodgkin's disease: relationship to the size of the mediastinal tumor

Postoperative respiratory complications were investigated in patients with Hodgkin's disease, stages I-III, presenting with a mediastinal mass. By measuring the ratio between the widest diameter of the mediastinal mass and the width of the thorax at T5-6 (mediastinal thoracic ratio, MTR) in a PA chest X-ray, patients were divided into three groups: I: MTR less than 0.35 (41 patients); II: MTR 0.35-0.49 (33 patients); and III: MTR greater than 0.50 (23 patients). Five patients of group II and eight of group III received preoperative radiation therapy (RT) to the mediastinum due to severe clinical or radiological findings associated with the mediastinal mass. No patient of group I received preoperative RT. Without preoperative RT, group III had a significantly higher incidence of respiratory complications (7/15) compared to groups I (7/41) and II (2/28). Respiratory complications were not significantly different after preoperative RT in group III (1/8) compared to that observed in groups I plus II without preoperative RT (9/69).

Unusual complications of central venous catheterization in thrombocytopenic patient

An unusual complication from subclavian venous catheterization is reported. A 63 year old white female with thrombocytopenia following chemotherapy for erythroleukemia developed mediastinal haematoma after inserting a left subclavian central catheter. Subsequent bilateral pleural effusion and right sided pneumothorax supervened and led to respiratory distress requiring multiple therapeutic thoracenteses.

Metachromatic activity of heparin and heparin fragments

Heparin of an average molecular weight of 13,000 was fractionated on the basis of size into five fractions of different weight-average molecular weight ranging from 8500 to 20,000. The heparin was also degraded using microbial heparinase resulting in products ranging from a disaccharide of molecular weight 500 to an oligosaccharide of molecular weight 3100. These products were also size fractionated. The individual heparin fractions and products were tested for metachromatic activity with Azure A. The metachromatic activity of the heparin fractions was independent of molecular weight, while the metachromatic activity of the products was dependent on molecular weight. Metachromatic activity was found in a fragment as small as a tetrasaccharide. Anticoagulant activity was found in fragments of tetrasaccharide or larger by a Factor Xa clotting assay and in fragments of hexasaccharide or larger by a Factor Xa amidolytic chromogenic assay.

Large mediastinal mass in Hodgkin's disease. Results of two treatment modalities

Sixty-eight untreated patients with Hodgkin's disease (HD), stages I-III, presenting with a large mediastinal mass were treated as follows: patients with "good-risk HD" (lymphocyte predominant or nodular sclerosis and no "B" symptoms) stages I and II were treated by randomization with involved field radiotherapy (IF RT) or IF RT plus six cycles of combination chemotherapy (CT). Those with "poor-risk HD" (presence of B symptoms or with other histologic types) stages I and II and all patients with stage III were treated by randomization with total nodal radiation (TNR) or TNR + CT. Complete remission (CR) was achieved in 66/68 patients (97%) with the initial RT. A significantly longer duration of remission (p = 0.001), but not of survival (p = 0.08) was observed in patients treated with RT + CT compared to RT alone. Significantly longer duration of remission (p = 0.01), but not of survival, was observed in patients with good-risk stages I-II treated with RT + CT. In this category, remission and survival was better with RT + CT than with RT alone in stage III, but these differences were not statistically significant. In poor-risk patients stages I-II, a trend for longer remission and survival (not significant) was observed in patients treated with RT + CT; in stage III, both treatment modalities gave similar poor results. Both treatment modalities were well tolerated by most patients. One patients died with radiation pneumonitis shortly after completion of TNR. One patient developed a malignant schwannoma after treatment with IF RT, and another one developed acute nonlymphocytic leukemia after TNR + CT. Decrease in the transverse diameter of the heart without overt manifestations of cardiac disease was observed in 59% of the patients evaluated for this parameter.

Heart size and function after radiation therapy to the mediastinum in patients with Hodgkin's disease

Changes in the transverse heart diameter and cardiothoracic ratio were determined by comparing the pretreatment and last follow-up posteroanterior chest x-rays of 96 patients with stage I-III Hodgkin's disease who had received radiation therapy (RT) to the mediastinum, with the same parameters observed in 20 similar patients whose mediastinum was not irradiated. A significantly higher proportion of patients who had received RT to the mediastinum had a decrease in transverse heart diameter and cardiothoracic ratio. Among patients presenting with a large mediastinal mass, these changes were more pronounced as compared to the other groups; however, this difference was not of statistical significance. First-pass left ventricular ejection fraction (LVEF) performed with 99mTc pertechnetate (obtained in 55 of these patients 30-120 months after RT to the mediastinum) was compared with the LVEF of 20 normal controls. The control group had a significantly higher LVEF than the group of patients who had received RT to the mediastinum. No correlation was observed between changes in these parameters and the use of adjuvant, salvage, or no chemotherapy after mediastinal RT. None of these patients presented congestive heart failure or constrictive pericarditis, but our findings indicate a subclinical cardiomyopathy in more than one-half of the patients who received RT to the mediastinum, suggesting that the incidence of heart damage after mediastinal RT might be higher than expected. Prospective studies are necessary to elucidate the incidence and implications of this potentially serious complication.

Transabdominal fine needle aspiration of retroperitoneal lymph nodes in staging of genitourinary tract cancer (correlation with lymphography and lymph node dissection findings)

Percutaneous fine needle aspiration of retroperitoneal pelvic and abdominal lymph nodes was done in 100 patients with clinically localized bladder, prostatic, testis and penile cancer. A diagnosis of metastases to regional lymph nodes was detected by this method in 20 patients. Fine needle aspiration revealed evidence of regional lymph node involvement in 6 of 40 patients (15 per cent) with negative findings on lymphography and computerized tomography scan. Lymph node aspiration was followed by lymph node dissection in 50 patients. The correlation between aspiration and dissection was 68 per cent. The accuracy of obtaining representative material from the lymph node aspiration was 83 per cent. Negative results of lymph node aspiration cannot be used in clinical management. However, positive aspiration results provide the clinician with valuable information obtainable otherwise only by laparotomy or lymph node dissection. Positive aspiration results may spare patients with prostatic and bladder cancer an unnecessary radical operation, and may indicate early chemotherapy or surgery in patients with testis and penile cancer.

Fine-needle aspiration of metastatic lesions and regional lymph nodes in genitourinary cancer

A percutaneous fine-needle aspiration biopsy of metastatic tumor and/or retroperitoneal, pelvic, or abdominal lymph nodes was accomplished in 101 patients. A diagnosis of metastatic disease was confirmed by this method in 49 patients. In 26 patients, surgical excisional biopsy or exploratory laparotomy was avoided. An unknown pelvic mass causation was diagnosed in 3 patients. In 15 of 57 patients with localized bladder, prostate, or testis cancer, involvement of regional lymph nodes was confirmed by transabdominal find-needle aspiration. All 57 transabdominal aspirations were performed without complications. The method is inexpensive, safe, and can have a high accuracy in diagnosing a local tumor spread or distant metastases.

Chordomas: diagnosis and management

Six patients with chordomas, five in the sacral and one in the craniocervical region, are reported along with review of the literature. Two of the patients treated with radiation for macroscopic tumor had palliation of their symptoms and an apparent prolongation of survival. Two other patients with sacral chordomas had resection of the gross tumor and radiation due to inadequate proximal margins. They both remain free of recurrence at 2.5 and 5 years, respectively, suggesting the potential usefulness of combination of modalities in the management of these tumors.

Poly(U)-agarose affinity chromatography: specific, sensitivity selectivity, and affinity of binding

These studies were done to determine four basic intrinsic properties of poly(U)-agarose affinity columns. Specificity of binding studies demonstrated that binding to these columns is highly specific with greater than 90% complementary binding and less than or equal to 3% noncomplementary binding. Sensitivity of binding studies indicated that a minimum sequence of 10 adenylates is required for detectable complementary binding. Selectivity of binding studies revealed that nonsequential adenylates in native RNAs and randomly distributed adenylates in synthetic poly(A)-poly(C) co-polymers did not bind to poly(U)-agarose affinity columns. Whereas, affinity of binding studies demonstrated that A=U complementary base pairing is independent of chain-lengths of greater than or equal to 25 adenylates and dependent of chain-lengths of less than 25 adenylates. Thus the data demonstrates that poly(U)-agarose affinity chromatography is scientifically sound and expedient for the detection and isolation of poly(A)-containing cellular and viral RNAs.

Leiomyosarcomas of the extremities: angiography as a diagnostic aid

Thirteen cases of leiomyosarcomas of the extremities are reported. Most of the cases were operated on without information concerning benignancy or malignancy. Plain radiographs showed amorphous calcification in two cases. Three cases had angiographic study and all revealed malignant neovascularity. In no literature that we reviewed was angiography mentioned in the cases of leiomyosarcomas of the extremities. Venography alone has been done in many reported cases. The leiomyosarcoma of the extremities looks often benign but is notorious for local recurrences and distant metastases.

Polyriboadenylate sequences at the 3'-termini of ribonucleic acid obtained from mammalian leukemia and sarcoma viruses

The location of poly(A) sequences in the RNA of mammalian RNA-tumor viruses was determined by enzymatic analyses. The 56-64S viral genomic RNAs, the 20-40S viral subunit RNAs, and the 4-5S poly(A) sequences excised from these viral RNAs were subjected to either hydrolysis with a 3'-OH specific exoribonuclease from Ehrlich ascites tumor cells or phosphorolysis from the 3'-termini with polynucleotide phosphorylase from Micrococcus luteus. Purified adenosine-labeled poly(A) fragments, excised from genomic viral RNAs by RNase A and T(1) digestion, were hydrolyzed with the 3'-OH specific exoribonuclease for various periods of time. Poly(U) filter binding studies of the residual poly(A) indicated that 97% of the poly(A) fragments were hydrolyzed. Adenosine-labeled genomic and subunit viral RNAs and excised poly(A) fragments were phosphorolyzed from their 3'-termini for various periods of time with polynucleotide phosphorylase. The degree of phosphorolysis was monitored by poly(U) filter binding studies, and CCl(3)COOH insolubility and solubility determinations. There was an initial preferential rate of phosphorolysis of the poly(A) sequences of genomic and subunit viral RNAs as compared to the total adenosine-labeled viral RNAs. The data from these two different enzymatic mechanisms of action indicated conclusively that the poly(A) sequences were located at the 3'-termini of genomic and subunit viral RNAs.

Uranium-Platinum System

The phase diagram of the uranium-platinum system was constructed from data obtained by thermal analysis, metallographic examination, and X-ray diffraction. The system is characterized by four intermetallic compounds: UPt, formed peritectoidally at 961° C; UPt₂, formed peritectically at 1,370° C; UPt₃, melting congruently at 1,700° C; and UPt₅, formed peritectically at 1,460° C. One eutectic occurs at 1,005° C and 12 a/o platinum, and a second at 1,345° C and 87.5 a/o platinum. The maximum solubilities are 4.5 a/o uranium in platinum and 5 a/o platinum in gamma-uranium. Platinum lowers the gamma-beta uranium transformation to 705° C and the beta-alpha transformation to 589° C.