[An in vitro chemotherapy sensitivity test on leukemic colony-forming cells (L-CFU) and its clinical evaluation]

The sensitivity of leukemic progenitor cells (L-CFU) to cytosine arabinoside (Ara-C) and daunomycin (DM) in vitro was studied using PHA -LCM two step assay for L-CFU. Continuous exposure of leukemic and normal bone marrow cells to DM as well as Ara-C in vitro appeared to be more effective than pulse exposure because colony formation was suppressed by a dose dependent fashion. The relationship between in vitro sensitivity to DM and Ara-C and that of in vivo to chemotherapy was investigated in 17 untreated and 5 relapsed patients with acute nonlymphocytic leukemia. The sensitivity of L-CFU to the two chemotherapeutic agents varied from patient to patient. These studies indicated a clear-cut relationship between in vitro drug sensitivity and in vivo response to patients whose L-CFU were sensitive to both agents and entered complete remission, whereas patients whose L-CFU were insensitive to one or both drugs in vitro failed to enter remission. This assay system appears to be useful in predicting response of patients to chemotherapy and in selecting the most effective drugs for an individual patient use.

[Therapeutic results of DCMP therapy (2M-80) in acute non-lymphocytic leukemia--the relationship between the residual leukemic cells and duration of remission]

In this study the duration of complete remission by daunomycin, cytosine arabinoside (Ara-C), 6MP and prednisolone (DCMP) therapy using a large dose of Ara-C (200 mg) (protocol 2M-80) was compared with that of DCMP therapy with a low dose of Ara-C (80-160 mg) in acute non-lymphocytic leukemia (ANLL). In protocol 2M-80, the chemotherapy was continued until leukemic blasts in marrow were attained below 3%. Complete remission was induced in about 80% of ANLL patients in both chemotherapies. However, the duration of remission in protocol 2M-80 appeared to be much longer than that of DCMP therapy with a low, dose of Ara-C. This difference was dependent not on the consolidation and maintenance therapy, but on the total dose of Ara-C used and leukemic blasts left in marrow at the end of chemotherapy. This suggests that it is important to reduce leukemic blasts in marrow as low as possible by induction chemotherapy to obtain a long-term remission in ANLL.

Distribution of hepatitis B surface and core antigens in human liver cell carcinoma and surrounding nontumorous liver

The distribution of hepatitis B surface antigen (HBsAg) and core antigen (HBcAg) in surgically removed liver cell carcinomas of 60 Japanese patients was studied by an immunohistochemical method. HBsAg was localized in the cytoplasm, and HBcAg was mainly in the nuclei of normal-appearing liver cells, dysplastic liver cells, and tumor cells. In some instances both HBsAg and HBcAg were contained in the tumor cells and liver cells. HBsAg was found in the nontumorous liver tissue of 30 patients (50%); nine of the HBsAg-containing nontumorous livers also contained HBcAg. HBsAg and/or HBcAg was detected in tumor cells in 7 (23%) of 30 cases with HBsAg-positive liver diseases.

Radiographic study of mandibular nutrient canals

The appearance of nutrient canals in the mandibular anterior region was studied by evaluating the complete-mouth dental radiographs of 1,586 patients who were subdivided into four groups. The incidence of nutrient canals was very high in patients with periodontal disease, in patients of advanced age, and especially in endentulous patients. Nutrient canals appeared most frequently in radiographs demonstrating "above average" bone density with small diminutive trabecular spaces. Other factors influencing the presence of nutrient canals included the thickness of the alveolar bone, the quality of both cortical and cancellous bone, and the loss of mandibular teeth.

[Infections during induction chemotherapy of acute leukemia and their control V. Clinical evaluation of a large dose of amikacin injected intravenously]

In this study, we treated severe infections (21 cases) accompanied with induction chemotherapy in 20 patients with acute leukemia by the combination of a large dose (600 approximately 1,200 mg/day) of amikacin with other antibiotics. Infections during induction chemotherapy of acute leukemia consisted of sepsis (8 cases), pneumonia (7) and others (6), and most of causative organisms were Gram-negative bacteria, such as Ps. aeruginosa (7 strains), Flavobacterium (5), Serratia (3), Ps. cepacia (2), E. coli (2) and others. The combination chemotherapy of a large dose of amikacin with other antibiotics was found to be effective (71.4%) for such infections. Side effects were negligible except for drug eruption. Therefore, a large dose of amikacin should be given for the treatment of severe infections accompanied with induction chemotherapy of acute leukemia.

Metastatic brain tumor. A clinical and pathologic analysis of 101 cases with biopsy

A clinical and pathologic analysis was made of 101 patients with surgically treated metastatic brain tumors. The most common primary site was the lung (58.4%), followed by th breast (11.9%), gastrointestinal tract (6.9%), and uterus (5.)%). In 14 patients, the disease began with cerebral symptoms. The overall average survival after craniotomy was 8.0 months, the longest survival being 8l/2 years; patients with one-year survivals composed 18.8% of the cases. The histologic features were almost the same in primary and metastatic tumors. The undifferentiated tumor metastasized most frequently to the brain, and adenocarcinoma of the papillary type also seemed to find the brain fertile ground for metastatic growth.

Investigation of genetic markers in a true hermaphrodite with chi 46,XX/46,XY

We documented a new case of chi 46,XX/46,XY true hermaphroditism substantiated by the evaluation of chromosomal heteromorphism in banded preparations. The patient, a 12-year-old Japanese boy with ambiguous external genitalia, was seen because of abnormal breast development. Surgical exploration showed the right gonad to be an ovotestis and the left gonad to be an ovary. Cytogenetic studies revealed cell admixtures of 46,XX and 46,XY karyotypes in peripheral lymphocytes, skin fibroblasts, and gonadal fibroblasts. From the pedigree studies, the paternal double genetic contributions were evidenced by the differences of sex chromosomes and the blood group types for the ABO and MNSs systems in the two cell lines of the patient. The maternal double genetic contributions were confirmed by the inheritance of Q-fluorescent markers on chromosomes 13 and 22 and by alleles for the Kidd blood group system.

Constancy of net protein intake in rats on self-selection regimen with proteins of various qualities

Voluntary intake of proteins of various qualities in relation to dietary protein utilization was investigated in growing and adult rats. The rats were given two diets, one containing high protein and the other no protein, and were allowed to self-select protein and energy intakes freely from both diets. The results showed that total food intake (protein diet plus protein-free diet) and body weight gain were similar among five proteins tested. However, the amount of protein consumed by the growing rats per 100 g of total food intake (i.e., dietary protein level) was different depending upon the protein qualities, that is, wheat gluten (WG) 44 g, casein (CA) 30 g, soy protein (SP) 21 g, lactalbumin (LA) 19 g, and amino acid mixture simulating egg protein (AA) 11 g. Net protein utilization (NPU), estimated as the proportion of protein intake that is retained in the body, was as follows: WG, 20%; CA, 33%; SP, 44%; LA, 50%; and AA, 74%. From the above figures, net dietary protein value, which is a measure of utilizable protein in the diet, was calculated by multiplying the dietary protein level by NPU. In contrast to the difference in protein intake, net dietary protein value was quite constant in spite of large differences in the dietary protein quality, being 8 to 10%. A similar relationship between protein intake and protein utilization was obtained also with adult rats, except that the net dietary protein value was smaller in adult rats than in growing rats. These results may suggest that the animals can regulate the intake of dietary protein to keep the amount of protein available for the body constant.

Synthesis of ABH blood group substances in bladder tumours

A specific red cell adherence test which can detect the cell surface ABH blood group antigens was performed on formalin-fixed frozen sections of 38 bladder tumours. In 27 tumours decreased glycosyltransferase activity was suggested, but the site and the degree of the blockade did not seem to be identical in every tumour. Blood group A and B tumours could be grouped into 4 types according to the presence of these 3 isoantigens. One group which showed A or B but no H activity (Type I) consisted only of grade 1, superficial tumours. All of the invasive tumours belonged to other types. For blood group O tumours no clear-cut correlation could be found between malignancy of the tumour and the presence of H activity. Eight of 22 grade 2 or 3 tumours and 9 of 21 invasive tumours retained the isoantigen, which seemed to invalidate the use of this test as a predictive indicator. Only where blood group A or B patients were concerned, and the presence of H activity was regarded as abnormal as well as the absence of A and B, could all grade 2 or 3 tumours and all invasive tumours be detected by this test.

[The control of prolactin surge by ovarian steroids in the early phase of pseudopregnancy in rats (author's transl)]

The secretory patterns of prolactin and progesterone and the participation of ovarian steroids for their secretion in the early phases of delayed-pseudopregnancy (D-PSP) were studied in rats. D-DSP or immediate pseudopregnancy (I-PSP) was induced by vaginal stimulation (VS) given at 14:00 on diestrus 2. Blood for prolactin and progesterone analyses was obtained by decapitation performed every 2 hours between 13:00 on diestrus 2 and 13:00 on proestrus of the estrous cycle and during the corresponding stages of PSP. After the VS given on diestrus 2, concentrations of plasma prolactin and progesterone in D-PSP rats were the same as those of normal cyclic rats. In the rats given VS on estrus (Day 0) to produce I-PSP, a nocturnal surge of prolactin was obvious in the morning of Day 3. Plasma progesterone levels were also high in these rats. However, in the ovariectomized-adrenalectomized (OVX-ADX) rats, on which the operation was performed at various stages of the estrous cycle, a nocturnal surge of prolactin was clearly observed after the VS given at 14:00 on diestrus 2. The appearance of a nocturnal prolactin surge by the VS in the OVX-ADX rats was inhibited by the administration of estradiol-17 beta (1 microgram/rat). The nocturnal surge of prolactin in the early phase of I-PSP was also diminished by the administration of the steroid. Concomitant administration of progesterone with estrogen, however, overcame the inhibition of the nocturnal surge of prolactin by estrogen. These results indicate that the stabbing secretion of prolactin observed in the early phases of pregnancy or pseudopregnancy is modulated by the ovarian steroids and also suggests that the increasing secretion of estrogen from diestrus 2 to proestrus in the normal estrous cycle suppresses the prolactin surge expected by VS and resulting in D-PSP.

Pulmonary function before and after abdominal surgery in the aged

In patients 70 years or older, pulmonary function tests were performed before and after abdominal surgery to correlate the results with the development of postoperative pulmonary complications which developed in 48% of these patients, compared to 15% in the control group. To predict the development ot PPC, preoperative analysis of the flow-volume curve is useful and 4 (V50-V25)/forced vital capacity is a valuable parameter for the analysis of the flow-volume curve. Postoperatively, pulmonary function was reduced and there was a delay in the restoration of pulmonary function in cases with postoperative pulmonary complications. The administration of appropriate analgesics may be useful to improve postoperative ventilatory disturbances.

Effects of glycine on serum gonadotropins and estradiol and on concentrations of free amino acids in the middle hypothalamus in female rats

The effects of glycine on serum gonadotropins and estradiol (E2) and on concentrations of free amino acids in the middle hypothalamus have been studied in diestrus-1 rats. 20 min after intraperitoneal administration, glycine in doses of 50 and 100 mg had no significant effect on serum luteinizing hormone (LH) levels, but 200 mg significantly elevated serum LH levels. Glycine in doses of 50-200 mg had no effect on serum follicle-stimulating hormone levels at 20 min after intraperitoneal injection. 200 mg of glycine significantly elevated serum LH levels at 20 and 50 min and serum E2 levels at 50 and 80 min after intraperitoneal injection. The effects were maximal at 20 min after injection for LH and at 50 min after injection for E2. 20 min after intraperitoneal injection, 200 mg of glycine significantly increased the concentration of glycine in the middle hypothalamus, but had no effect on the concentrations of the other free acidic and neutral amino acids in the middle hypothalamus. These results suggest that glycine may play a role in the neural regulation of LH secretion.

Carcinoma of the bladder: a clinical and pathological analysis of 87 autopsy cases

A clinical and pathological analysis was done on 87 autopsy cases of carcinoma of the bladder. Of the 87 cases 68 were men and 19 were women, with a mean age of 64 years. The average survival time was 39 months from the onset of symptoms to death. The patients with multiple tumors had a longer average survival time than the patients with single tumors (51 compared to 40 months), and the average survival times were definitely more favorable for men than for women (43 compared to 23 months). Histological examination revealed transitional cell carcinoma in 77 patients, squamous cell carcinoma in 4, vesical adenocarcinoma in 3 and urachal adenocarcinoma in 3. Squamous cell carcinoma and vesical adenocarcinoma seemed to be more malignant neoplasms. Metastasis was noted in 58 of 87 cases (66.7 per cent) and occurred most frequently in lymph nodes (37.9 per cent), liver (29.9 per cent), lungs (29.9 per cent) and bones (24.1 per cent). Of the 87 cases of bladder carcinoma 11 had primary carcinoma in organs other than the bladder.