Histochemical and biochemical aspects of lectin binding glycoproteins in primary and metastatic adenocarcinoma in the lung

It is often difficult to differentiate between primary adenocarcinoma and metastatic adenocarcinoma in the lung. At least three lectins-peanut treated with neuraminidase, Ricinus communis-I and succinylated wheat germ-showed highly positive glycoprotein binding pattern along the plasma membrane of primary and metastatic adenocarcinoma in the lung. In order to distinguish primary pulmonary adenocarcinoma from metastatic adenocarcinoma in the lung with the three lectins, 40 pulmonary adenocarcinomas, seven extrapulmonary metastatic adenocarcinomas, and 16 metastatic adenocarcinoma in the lung were studied. Extracts from fresh tissue homogenate, after fractionation by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, were transferred by Western blotting and stained with lectin, and the lectin-bound glycoconjugates were read by a densitometer. The results showed all three lectin-bound glycoconjugate of primary pulmonary adenocarcinoma cases to be concentrated at about 200 Kd, but those of normal lung tissue had different molecular weights. Metastatic adenocarcinoma in the lung had lectin-bound glycoconjugate of about 120 Kd as well as 200 Kd. The amount of lectin binding high molecular weight substance was lower in metastatic adenocarcinoma in the lung than in primary pulmonary adenocarcinoma, especially succinylated wheat germ (P < 0.001). Therefore, decreased expression of the lectin binding high molecular weight glycoprotein may be a biochemical change associated with metastatic potential.

[Lung residuals following chemotherapy in patients with stage III nonseminomatous testicular cancer. Report of 4 cases]

Since 1989, 4 patients with Stage III nonseminomatous germ cell tumor of the testis underwent thoracotomy for persistent radiographic masses after systemic chemotherapy. They were treated with multi-drug regimen including cisplatin, vincristine, methotrexate, peplomycin, and etoposide until normalization of tumor markers was obtained. Residual masses of the 4 patients consisted of viable cancer cells in 1 patient, immature teratoma in 1, mature teratoma in 1 and necrosis in 1. Of the 4 patients 3 achieved complete remission and are doing well with no evidence of disease, while the other case with residual viable cancer cells died of renal failure. The key to successful treatment of advanced testicular cancer was considered to be a favorable response to chemotherapy and complete resection of any residual tumors.

[A case of malignant lymphoma of the thyroid accompanied by interstitial pneumonitis during radiation therapy after systemic chemotherapy]

We reported a case of malignant lymphoma of the thyroid accompanied by interstitial pneumonitis during radiation therapy after systemic chemotherapy. Thyroid malignant lymphoma is a rare malignant tumor, which usually responds well to irradiation and systemic chemotherapy. Interstitial pneumonitis occurred during radiation after systemic chemotherapy. In this case, irradiation was simultaneously done with the chemotherapy. The radiation field included the neck and upper mediastinum. Chest X-ray showed multiple patchy shadows in both the middle and lower lung field, and it changed to contraction shadows after steroid pulse therapy. 67Ga scintigram showed multifocal increase of uptake, when chest X-ray patchy shadows were seen only in the middle and lower lung fields. 67Ga scintigraphy and CT were considered useful for evaluation of drug-induced interstitial pneumonitis.

Exposure monitoring and health effect studies of workers occupationally exposed to cyclohexane vapor

A survey was conducted in the second half of a working week on 33 women who either applied glue (with cyclohexane as an almost exclusive solvent component) or worked in the vicinity of glue application. Carbon cloth-equipped diffusive samplers were used for personal measurement of time-weighted average intensity of exposure to the solvent. The geometric mean and the highest cyclohexane concentration observed in air were 27 ppm and 274 ppm, respectively. Concentrations of cyclohexanol in urine samples and cyclohexane in whole blood and serum collected at the end of a shift showed significant correlations with the solvent exposure levels. Urinary cyclohexanone also correlated, but with a smaller correlation coefficient. The observation suggests that cyclohexanol in urine and cyclohexane in blood or serum collected at the end of a shift are useful indicators of occupational exposure to cyclohexane vapor. Quantitative estimation of balance at the end of the shift suggested that only a minute portion (< 1%) of cyclohexane absorbed is excreted in the urine as cyclohexanol, almost exclusively as a glucuronide. A survey of subjective symptoms revealed an increase in the prevalence of "dimmed vision " and "unusual smell", but hematology and serum biochemistry testing did not indicate any specific signs.

Diagnostic and prognostic significance of plasma endotoxin determination in febrile patients with haematological malignancies

We evaluated the clinical utility of a new endotoxin-specific chromogenic limulus test in febrile patients with haematological malignancies. The specificity is assured by the removal of factor G, which is sensitive to (1-->3)-beta-D-glucan, from horseshoe crab amoebocyte lysate. The sensitivity and specificity of the test to systemic gram-negative bacterial infections were 69.7 and 96.3%, respectively. Meanwhile, gram-negative bacteria grew in only 39.7% of endotoxaemic samples. Thus, it seems appropriate to consider gram-negative bacteraemia and endotoxaemia as different entities. Endotoxaemia was significantly associated with septic shock and infectious death, especially in patients with neutropenia. The new test, the results of which are available within 3 h, should help physicians to recognise this ominous sign early and to initiate a prompt countermeasure to endotoxaemia.

Ultrasonography of thymoma with pathologic correlation

Preoperative ultrasonograms of 11 surgically proved thymomas and ex vivo ultrasonograms of 3 resected specimens were compared with pathologic findings of resected specimens. Among 11 thymomas 7 appeared solid, 3 were solid with several cystic regions, and the remaining one was unilocular cystic in appearance. Cystic regions on ultrasonograms corresponded to cystic changes on pathologic specimens. Six malignant thymomas showed a typical lacy appearance on ultrasonograms, which corresponded to the lobulated configuration separated by fibrous septa shown on the pathologic specimens.

[Autopsy case of amyloidosis with marked cardiac and pulmonary lesions associated with myeloma, initially presenting with muscle weakness]

A 69-year-old man presented initially with muscle weakness of the bilateral lower limbs. Chest roentgenogram showed diffuse reticulonodular shadows, bilateral hilar lymphadenopathy, and dullness of bilateral costophrenic angles. Chest CT showed thickening and irregularity of vascular shadows, and thickening of bronchial walls. On the first admission we could not diagnose pulmonary or muscle lesions. He was subsequently admitted for the deterioration of congestive heart failure, but there was no improvement. Myocardial biopsy demonstrated deposition of amyloid in the cardiac muscular tissue. Autopsy revealed amyloid deposition in pulmonary vasculature, alveolar septal walls and pleura. Amyloid deposition was also recognized systemically in skeletal muscles, lymph nodes, liver, kidney, spleen, stomach, and intestines. We recognized about 20% IgA lambda-positive plasma cells with atypia, and myeloma-associated amyloidosis diagnosed. This case was classified as diffuse alveolar septal form and pleural form of pulmonary amyloidosis. We could find only a few reports of pleural form, which exhibits an interesting distribution.

Absence of mutagenicity in peripheral lymphocytes of workers occupationally exposed to methyl methacrylate

Chromosome aberration rates and sister chromatid exchange frequency were examined in the peripheral lymphocytes of 38 male workers who were engaged in organic glass production and exposed to methyl methacrylate (MMA) vapors at the concentrations of 0.9 ppm to 71.9 ppm. The results were compared with the findings in the concurrent nonexposed male subjects. Comparison of the exposed group with the nonexposed controls showed that there were no exposure-related changes in chromosome aberration rate. SCE frequency was higher in the exposed group than in the controls, but this was considered to be due to higher ages of the former group than that of the latter. In fact, selection of nonsmokers and further classification of the exposed nonsmokers into two groups of those with exposure below and above a median MMA concentration (ca. 4 ppm) failed to show any difference among the three nonsmoking groups in cytogenetic parameters, or any dose-dependency. The present results, although in a limited number of subjects, indicate that occupational methyl methacrylate exposure under the conditions studied is not associated with mutagenicity. This conclusion confirms the absence of mutagenicity of methyl methacrylate in humans, and is in general agreement with a majority of the results of studies on mutagenicity in vitro, animal carcinogenicity and occupational cancer epidemiology of methyl methacrylate.

Sex-associated differences in protein 1 values in urine: immunochemical detection of protein 1 in genital tissues

Immunochemical methods were used to analyse sex-associated differences in urinary protein 1 concentration. Spot urine from seven normal men and seven women of reproductive age was collected in four sequentially divided fractions, and protein 1 concentration in each fraction was measured by an enzyme immunoassay using the sandwich method: protein 1 values in the first of the sequential urine samples from the male subjects were remarkably high (81.4 +/- 80.4 micrograms/l; mean +/- 1 SD), but were much lower in the remaining three fractions. In females, on the other hand, protein 1 values were low (0.7 +/- 0.4 microgram/l), were uniform in all four sequential fractions, and were close to those of the last three fractions of urine from male subjects. Based on this finding, protein 1 concentration was measured in 14 specimens of seminal plasma, where concentration of protein 1 was high (1259.1 +/- 1716.5 micrograms/l; range, 201.9 to 6580.0 micrograms/l). On Western blotting, protein 1 in seminal plasma had a molecular mass of M(r) 14,000, the same as that of protein 1 purified from the urine of patients with chronic renal failure of probable plasma origin, and of concentrated male urine collected at the initiation of voiding, which is thus thought to come mainly from genital tissue. Protein 1 was found to be in high concentration (434.8 +/- 504.6 micrograms/l) in five aspirated fluids collected at the ejaculatory duct after squeezing the prostate. Three prostate tissue extracts contained protein 1 concentrations ranging from 8.6 to 50.1 micrograms/l. Protein 1 is also present in seminal vesicle fluids (7.1 +/- 2.8 micrograms/l; range, 2.3 to 9.5 micrograms/l).(ABSTRACT TRUNCATED AT 250 WORDS)

Induction of tyrosine phosphorylation in human B lineage cells by crosslinking MB-1 molecule of B cell receptor-related heterodimer complex

B cell antigen receptor is composed of immunoglobulin and associated MB-1 and B29. Here, we found that anti-human MB-1 stimulation induced tyrosine phosphorylation in immature B cells (FL4.4 and Nalm-6) but not in mature B cells (Daudi). Coprecipitated complex with the heterodimer component in Daudi and Nalm-6 contained the kinase molecule(s) which act on the heterodimer protein, while the complex in early lymphoid cell with germ line antigen receptor genes (FL4.4) did not. Candidate Fyn and Lyn are expressed in Nalm-6 and Daudi but are not expressed in FL4.4. These results suggested that src-type tyrosine kinases as Fyn and Lyn are responsible for the phosphorylation of MB-1 and B29 heterodimer, but anti-MB-1 stimulation can induce tyrosine phosphorylation reaction mediated by other kinase molecule(s) in the progenitor type cells.

Biological monitoring and possible health effects in workers occupationally exposed to methyl methacrylate

Monitoring by means of blood and urine analysis for methanol was successfully applied in 32 male workers who were exposed to methyl methacrylate (MMA) monomer at 6 ppm as a geometric mean and at 112 ppm as the maximum. Measurement of time-weighted average (TWA) intensity of the vapor exposure was successfully conducted with a diffusive sampler with activated carbon cloth as an adsorbent. Methanol concentrations in whole blood, serum, and urine samples were measured by headspace gas chromatography. The methanol concentrations in the three biological samples collected at the end of 8-h workshifts related linearly with the TWA MMA vapor concentrations, with correlation coefficients of 0.8-0.9. Quantitative evaluation of MMA in vapor and of methanol in urine suggests that only 1.5% of MMA inhaled will be excreted in urine as methanol. There were no significant clinical symptoms or abnormal hematological or serum biochemical findings at this exposure level, except that some workers complained throat irritation and frequent cough and sputa. The results indicate that biological monitoring by analysis for methanol is sensitive enough to detect MMA exposure at levels at which no serious health effects are to be expected.

[A case of stage IIIB2 infantile yolk sac tumor of testis achieved complete remission by "COMPE" chemotherapy]

A case of metastatic infantile yolk sac tumor of testis is reported herein. The patient was 23 months old with a painless swelling of the right scrotal contents. Histological examination revealed yolk sac tumor. Six months later, the serum alpha-fetoprotein (AFP) was re-elevated and solitary lung metastasis had developed. After 4 courses of chemotherapy with cisplatin (CDDP), vincristine (VCR), methotrexate (MTX), peplomycin (PEP) and Etoposide (COMPE), serum AFP was normalized and lung metastasis disappeared. He has shown no evidence of disease for 5 years with normal physical growth. Aggressive chemotherapy including CDDP might be used for Stage III infantile testicular cancer.

[Establishment and characterization of a CA125-producing human ovarian clear cell carcinoma cell line]

A human ovarian cancer cell line designated "KK" was established from ascites of a patient with ovarian clear cell carcinoma. This cell line was grown for more than 2 years and over 140 passages in medium RPMI1640 containing 10% FCS. Doubling time of this cell line at passage 70 was approximately 4 days and saturation density was 1.1 x 10(5)/cm2. Plating efficiency was approximately 23%. Chromosome analysis revealed aneuploidy with a model number of 67. PAS-positive substances were present in the cytoplasm. CA125 and SLX were detected in both the original tumor and the cultured cells. This cell line is less sensitive to cisplatin than KF cells and IC50 was 0.95 microM.

[A case of mitral valve re-replacement with radical correction of Bland-White-Garland syndrome]

A case of an 8-year-old girl with Bland-White-Garland syndrome (BWG) who successfully underwent a second mitral valve replacement is reported. The patient had a past history of mitral valve replacement under the diagnosis of mitral regurgitation and pulmonary hypertension at one year and 3 months of age. Cardiac catheterization at 6 years and 3 months of age revealed an anomalous origin of the left coronary artery from the pulmonary artery but she was asymptomatic. One year and 7 months later, she was admitted to our institution with a sudden onset of chest pain and respiratory distress. Right heart pressure study using a Swan-Ganz catheter showed severe pulmonary hypertension and elevated mean pulmonary wedge pressure (38 mmHg). Echocardiogram revealed severe mitral stenosis and moderate regurgitation. She was diagnosed under fluoroscopy as acute left cardiac failure due to stuck valve and suspected having myocardial damage due to BWG, thus, emergency surgery was performed. Under cardiopulmonary bypass, aorto-left coronary arterial continuity was established by intrapulmonary arterial tunnel using Hamilton's technique. After resection of the prosthetic valve, of which one of two leaflets had been fixed in pannus, re-MVR was done with a St. Jude. Medical valve (25 mm). Postoperative angiogram demonstrated satisfactorily reconstructed two coronary artery systems. Postoperatively, she has been doing well without complaint for the last eighteen months.

A collaborative study for the evaluation of lectin-reactive alpha-fetoproteins in early detection of hepatocellular carcinoma

Lectin-affinity electrophoretic separation of serum alpha-fetoprotein (AFP) was carried out using AFP Differentiation Kits, which used Lens culinaris agglutinin-A (Kit L) and erythroagglutinating phytohemagglutinin (Kit P). Separated AFP bands were detected with a sensitive antibody-affinity blotting technique and determined quantitatively by densitometry, and the results were expressed as percentages of the intensity of total AFP bands. Sera from 424 patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, and extrahepatic tumors were assayed for proportion of AFP present as Lens culinaris agglutinin-A-reactive AFP (AFP-L3) and erythroagglutinating phytohemagglutinin-reactive AFPs (AFP-P4+P5). From the maximum Youden indices determined, cutoff levels were set at 15% for both AFP-L3 and AFP-P4+P5 to discriminate between patients with chronic hepatitis and liver cirrhosis and patients with hepatocellular carcinoma. AFP-L3 and AFP-P4+P5 showed sensitivities of 55.3 and 61.0% at specificities of 93.9% and 82.3%, respectively. Thirty-eight % of tumors that measured less than 20 mm in diameter were positive for AFP-L3 and AFP-P4+P5. AFP-L3 exceeded the cutoff level of 15% 4.0 +/- 4.9 months before detection of hepatocellular carcinomas by imaging techniques with a sensitivity of 48% and a specificity of 81%. Thus, these tests are useful for the early detection of hepatocellular carcinomas in patients with hepatitis or liver cirrhosis.

The development and practical use of information systems in the pharmaceutical industry

To provide information on the efficacy, safety, and quality of medicine promptly and accurately, we have developed two databases: a literature database with numerical data, and a Drug Information database. By an easy-to-use, company-wide information network system, over 1,000 medical representatives in more than 80 offices throughout Japan can retrieve information. Information derived from the system is displayed on the terminal and the original documents are automatically output through a facsimile.

Reduction of endotoxin contamination of various crude vaccine materials by gram-negative bacteria using aminated poly(gamma-methyl L-glutamate) spherical particles

We describe a method for the removal of endotoxins from various crude antigen solutions originating from gram-negative bacteria using aminated poly(gamma-methyl L-glutamate) (PMLG) spherical particles. The aminated PMLG adsorbents showed high affinity for various purified endotoxins at an ionic strength of mu = 0.1. The endotoxin-adsorbing capacity of the adsorbent increased with increase in the amino-group content of the adsorbent. The adsorbent (3.2 meq/g amino-group content) showed the highest affinity for endotoxin at ionic strengths ranging from mu = 0.025-0.8. The adsorption of Bordetella pertussis antigen to the adsorbent decreased with increasing amino-group content of the adsorbent at an ionic strength of mu = 0.2. The adsorption of B. bronchiseptica protein to the adsorbent increased with increasing amino-group content of the adsorbent, but decreased with increasing ionic strength. The adsorbent (3.2 meq/g of amino-group content) selectively reduced endotoxin in crude antigen solutions originating from gram-negative bacteria, B. pertussis, B. bronchiseptica and Pasteurella multocida, even at a high ionic strength (mu = 0.2-0.4) without affecting the recovery of the protective antigens.

[Palliative radiotherapy for bone pain in hormone refractory prostate cancer]

From 1970 to 1992, 23 patients were treated with irradiation for palliation of pain caused by bone metastases from hormone refractory adenocarcinoma of the prostate at Cancer Institute Hospital. External beam irradiation was delivered to painful bony metastatic sites using linear accelerator. Numbers of irradiated sites were 1, 2, 3 in 6 patients, 4 in 3 patients and 5 or 7 in one patient. To evaluate the pain relief at the irradiated sites, severity and frequency of pain were measured quantitatively before and 1 month after the treatment. Overall efficacy of palliation was evaluated by summing up results of the irradiated sites in each patient. Pain relief was obtained in all the irradiated sites. Minimal relief, partial relief and complete relief of pain were achieved in 10%, 15% and 75% of the 60 irradiated sites, respectively. No significant dose-response relationship was observed. Complete pain relief was attained less frequently at the sites with severe and constant pain that those with moderate and intermittent pain. Minimal, partial and complete palliation of pain was attained in 9%, 17% and 74% of 23 patients, respectively. In patients with highly extensive bone metastases, many irradiated sites, or many irradiated bones, complete palliation was difficult to obtain. Recurrence of pain was observed in one site. In other 59 irradiated sites, pain relief lasted until patient's death or throughout the follow-up period (maximum 51 months, median 9 months). We concluded that external beam irradiation is an effective palliation therapy for pain of bone metastases from hormone refractory prostate cancer and will play a considerable role in the management of advanced disease.