Effects of voltage ripple and current mode on diagnostic x-ray spectra and exposures

The voltage-ripple dependence relationship on x-ray energy-spectral values (energy fluence per unit interval of photon energy) and exposures at 70-kV peak were obtained theoretically by using the semiempirical formula of emission spectra given by Birch and Marshall [Phys. Med. Biol. 24, 505 (1979)]. The calculations were performed with and without various thicknesses of aluminum. As the ripple increases, the energy-spectral values decrease as expected. When the ripple is large, however, energy-spectral values (per mAs) take the minimum values; therefore, the exposure (per mAs) also reaches the minimum value for the unsaturating current modes, contrary to expectation. The reasons for this phenomenon were clarified. Exposures clearly take the minimum value in 2-pulse units. This phenomenon was experimentally verified.

The effect of 1-hydroxyvitamin D3 for prolongation of leukemic transformation-free survival in myelodysplastic syndromes

Leukemic transformation (LT) free survival was studied in 30 patients with myelodysplastic syndromes (MDS). In 15 cases, 4-6 micrograms/day of 1-hydroxyvitamin D3 was administered, for a median duration of 17 months (D-group), other subjects had no therapy (N group). LT free survival of the D group had significant advantage over that of the N group according to the Kaplan-Meier method (P less than 0.001). In addition, 7 cases in the N group developed acute leukemia, in contrast to only one in the D group (P less than 0.05). These results suggest that oral administration of 1-hydroxyvitamin D3 prevents the progression of MDS to overt leukemia under the effect of differentiation capacity from blasts to monocytes.

The transient appearance of small blastoid cells in the marrow after bone marrow transplantation

Of 14 patients who underwent allogeneic or syngeneic bone marrow transplantation, 6 had a transient appearance of small blastoid cells in the bone marrow after transplantation. Most of these patients (11) had leukemia, although 3 had severe aplastic anemia. The cells were 8-18 micron in diameter and had scant cytoplasm and dense nuclei with smooth, homogeneous chromatin. They often had distinct nuclear clefts. These cells constituted 4.0-21.3% of the total number of bone marrow cells. They were not reactive with peroxidase, alpha-naphtyl butylate esterase, naphthol AS-D chloroacetate esterase, or periodic acid-Schiff stains. Immunocytochemical analysis revealed that the small blastoid cells expressed terminal deoxynucleotidyl transferase, Ia-like, CD19, and CD10 antigens and cytoplasmic mu heavy chains, indicating a precursor B-cell phenotype. CD20 antigen was not expressed on these cells. The data suggest that cytoplasmic mu may be expressed earlier than CD20 antigen in the differentiation of B-cell lineage. The morphologic, cytochemical, and immunophenotypic characteristics did not distinguish these nonneoplastic cells distinctly from leukemic lymphoblastic cells. The increase of small blastoid cells was a transient and self-limited phenomenon, in contrast to that of neoplastic blasts. These cells should be recognized as a common component of the bone marrow of marrow transplant recipients. The significance and role of these cells in immune recovery and hematopoiesis remain uncertain.

Donor-HLA-incompatible marrow transplantation with an anti-donor cytotoxic antibody in the serum of the patient

A 42-year-old female with acute mixed lineage leukemia received a marrow transplantation from an HLA non-identical sibling. The serum of the patient showed a positive crossmatch for anti-donor lymphocytotoxic antibody and exhibited a complement-mediated cytotoxicity to donor hematopoietic progenitor cells. In an attempt to reduce the risk of graft rejection, a large volume plasma exchange was performed, which was followed by an infusion of irradiated donor lymphocytes to eliminate remaining antibodies from her serum. The level of anti-donor antibody fell below the sensitivity of the anti-human immunoglobulin lymphocytotoxicity test after the infusion of donor lymphocytes. The cytotoxic activity against donor progenitor cells also disappeared from the serum. Cyclosporin had been administered for 2 weeks before marrow infusion, and methylprednisolone and prednisolone for 1 week before the initiation of conditioning chemoradiotherapy. Conditioning comprised cytosine arabinoside 5.6 g/m2, cyclophosphamide 4500 mg/m2 and fractionated total body irradiation with 15 Gy followed by an infusion of 4.0 x 10(8) cells/kg of unmodified marrow cells. Engraftment of donor cells was documented by HLA typing of peripheral lymphocytes. A sustained engraftment may be obtained in a donor-incompatible HLA non-identical marrow transplantation with anti-donor antibody by elimination of the antibody and achieving an intensive immunosuppression in the recipient before marrow infusion.

The nucleolar localisation signal of the HTLV-I protein p27rex is important for stabilisation of IL-2 receptor alpha subunit mRNA by p27rex

In this study we investigated the mechanism of stabilisation of IL-2 receptor alpha subunit mRNA by the HTLV-I protein p27rex. We tested the role of the nucleolar targetting signal in rex by introducing mutations. Three deletion mutants could not express rex protein in the nucleolus and although protein was still expressed in the nucleoplasm none of the mutants could stabilise IL-2R alpha mRNA. A substitution mutant could be expressed in the nucleolus and could also stabilise IL-2R alpha mRNA. The data show that the nucleolar targetting signal is crucial for stabilisation of IL-2R alpha mRNA by rex and raise the possibility that transport of mRNA from nucleus to cytoplasm can involve the nucleolus.

[Clinical effects of low-dose Ara-C in acute nonlymphocytic leukemia and myelodysplastic syndromes]

Forty-eight patients with acute nonlymphocytic leukemia (ANLL) and myelodysplastic syndromes (MDS) were treated with low-dose Ara-C regimen (LDAC) (10 mg/m2 or 10 mg/body subcutaneously every 12 hours). Complete remission (CR) was obtained in sixteen patients (33%) and partial remission (PR) in six (16%). Seven of eight patients with hypoplastic leukemia entered CR. However, LDAC was not effective in MDS and ANLL developing from MDS. The rate of CR was 20% in relapsed or refractory ANLL. Relapse was occurred in thirteen patients until now. The median duration of remission was 7 months (range: 3-20 months). Seven of the sixteen patients who achieved CR were received LDAC at the same dose for 10 days every month as a maintenance therapy. The duration of CR of these patients was shown to be longer than that of the patients without any maintenance therapy. Myelosuppression was observed in nearly all of them and the other clinical findings including cytogenetic analysis indicated cytotoxicity rather than differentiation as the mechanism of LDAC. LDAC was effective especially in hypoplastic leukemia and the maintenance therapy was found to prolong the duration of CR.

HTLV-1 p27rex stabilizes human interleukin-2 receptor alpha chain mRNA

Expression of the pX gene products (p40tax, p27rex and p21X-III) of human T cell leukemia virus type 1 (HTLV-1), which is known to be a causative agent of adult T cell lymphoma/leukemia, induces expression of the interleukin-2 receptor alpha chain (IL-2R alpha) on infected T cells. Comparison of IL-2R alpha promoter activities has revealed that the transcriptional activation of the promoter alone cannot explain the large numbers of IL-2R alpha expressed on HTLV-1 infected cells. We found that the rates of the IL-2R alpha mRNA degradation were greatly reduced in pX-positive cells as compared with pX-negative cells. Simultaneous transfection of the expression vector plasmid containing IL-2R alpha cDNA and similar plasmids containing various pX sequences showed that p27rex elongated the half life of IL-2R alpha mRNA. As p27rex did not affect the transport of the IL-2R alpha mRNA from nucleus to cytoplasm, prolongation of the IL-2R alpha mRNA half life by p27rex is ascribed to stabilization of the mRNA. Experiments using deletion mutants and chimeric constructs of the IL-2R alpha cDNA demonstrated that the coding sequence but not the 5' or 3' untranslated region of the IL-2R alpha mRNA sequence is responsible for its protection by p27rex.

Human macrophage scavenger receptors: primary structure, expression, and localization in atherosclerotic lesions

Two types of cDNAs for human macrophage scavenger receptors were cloned from a cDNA library derived from the phorbol ester-treated human monocytic cell line THP-1. The type I and type II human scavenger receptors encoded by these cDNAs are homologous (73% and 71% amino acid identity) to their previously characterized bovine counterparts and consist of six domains: cytoplasmic (I), membrane-spanning (II), spacer (III), alpha-helical coiled-coil (IV), collagen-like (V), and a type-specific C-terminal (VI). The receptor gene is located on human chromosome 8. The human receptors expressed in CHO-K1 cells mediated endocytosis of modified low density lipoproteins. Two mRNAs, 4.0 and 3.2 kilobases, have been detected in human liver, placenta, and brain. Immunohistochemical studies using an anti-peptide antibody which recognizes human scavenger receptors indicated the presence of the scavenger receptors in the macrophages of lipid-rich atherosclerotic lesions, suggesting the involvement of scavenger receptors in atherogenesis.

Control of IL-2 receptor-alpha expression by IL-1, tumor necrosis factor, and IL-2. Complex regulation via elements in the 5' flanking region

We have analyzed the mechanisms by which IL-1, IL-2, and TNF regulate expression of IL-2R alpha chain in a rodent T cell line. All three cytokines induce detectable IL-2R alpha mRNA by themselves, but there is strong synergy between IL-1 or TNF, on the one hand, and IL-2, on the other. The earliest phase of induction by IL-1 is independent of protein synthesis. IL-1, but not TNF, also stimulates transient secretion of IL-2. This leads to an autocrine stimulation of a further increase in IL-2R alpha mRNA levels. When IL-2 secretion has dropped off, continued IL-2R alpha expression requires both IL-2 and IL-1. Most or all of this regulation is due to changes in the rate of transcription of the IL-2R alpha gene. The response to IL-1 and IL-2 depends on a segment in the IL-2R alpha 5' flanking region, upstream of all cis-acting regulatory elements previously identified in the human gene.

Control of IL-2 receptor-alpha expression by IL-1, tumor necrosis factor, and IL-2. Complex regulation via elements in the 5' flanking region

We have analyzed the mechanisms by which IL-1, IL-2, and TNF regulate expression of IL-2R alpha chain in a rodent T cell line. All three cytokines induce detectable IL-2R alpha mRNA by themselves, but there is strong synergy between IL-1 or TNF, on the one hand, and IL-2, on the other. The earliest phase of induction by IL-1 is independent of protein synthesis. IL-1, but not TNF, also stimulates transient secretion of IL-2. This leads to an autocrine stimulation of a further increase in IL-2R alpha mRNA levels. When IL-2 secretion has dropped off, continued IL-2R alpha expression requires both IL-2 and IL-1. Most or all of this regulation is due to changes in the rate of transcription of the IL-2R alpha gene. The response to IL-1 and IL-2 depends on a segment in the IL-2R alpha 5' flanking region, upstream of all cis-acting regulatory elements previously identified in the human gene.

[Allogeneic bone marrow transplantation as primary treatment in acute myelofibrosis]

A 20-year-old man with acute myelofibrosis received ablative chemotherapy consisting of busulfan, Ara-C and cyclophosphamide followed by bone marrow transplantation from his histocompatible sister. There was a prompt engraftment with a rising WBC and platelet count and with donor karyotype in specimen of marrow. A bone marrow examination on day 29 showed a prominent decrease in marrow fibrosis. However, fibrosis was again exacerbated with leukemic relapse as overt acute megakaryoblastic leukemia on day 110, The patient died on day 126. Marrow fibrosis was found to be reversible by ablation of malignant cells and repopulation of normal hemopoietic cells after bone marrow transplantation.

Transcriptional regulation alone does not explain the constitutive expression of the interleukin 2 receptor (Tac/L-chain) in HTLV-1 infected cells

We have identified a suppressive element in the upstream region of the interleukin 2 (IL-2) receptor L chain (Tac) promoter. The inhibitory activity of this element was retained in human T cell leukemia virus type-1 (HTLV-1)-infected T cell lines which express constitutively a large number of IL-2 receptors on the cell surface. The promoter activities of the IL-2 receptor gene did not always correlate with the strong expression of the receptor and its mRNA in the HTLV-1-infected T cell lines we analysed. The results indicate that the constitutive up-regulation of the IL-2 receptor in HTLV-1-infected T cells may be ascribed to not only the transcriptional but also post-transcriptional regulation.

[Sepsis in patients with hematological diseases]

Sepsis is one of the important complications on the treatment of severe hematological diseases. In this report, we analyzed sepsis in 309 patients with hematological diseases who were admitted to the First Department of Internal Medicine of Yokohama City University Hospital from 1979 to 1986. Positive blood culture were found in 17.8% (55/309 cases) and total positive cases were 73 including recurrent patients. Positive rate by underlying diseases was 30.3% in acute leukemia, 20.8% in chronic myelocytic leukemia, 17.2% in aplastic anemia, 8.0% in multiple myeloma, 6.0% in malignant lymphoma and 6.5% in others. The organisms causing sepsis were as follows; gram negative bacilli 56.4%, gram positive organisms 34.6%, fungus 6.4% and anaerobic bacteria 2.6%. Pseudomonas aeruginosa was found in 19.2%. The mortality rate of patients with sepsis was 34.2% (25/73 cases). The significant prognostic factors in patients with sepsis were the degree of neutropenia, duration of neutropenia (500 less than microliters), the species of organisms, simultaneous complication with shock and the site of other infections.

Production of sterile transcripts of C gamma genes in an IgM-producing human neoplastic B cell line that switches to IgG-producing cells

A human neoplastic B cell line SSK41 that expresses IgM on its surface switches spontaneously to IgG-producing cells. The SSK41 line contains a single immunoglobulin heavy-chain locus, the constant region (C) genes of which retain the germline configuration. The IgG-producing SSK41 line was purified by sorting, and shown to have undergone S-S recombination with deletion of the C mu gene. This line produced secretory and membrane-bound forms of gamma-chain mRNA. From cDNA libraries of a mixed population of IgM+/IgG+ SSK41 cells, we have isolated cDNA clones encoding the mature membrane-bound and secretory forms of the mu and gamma 1 heavy chains, all of which share the same variable region sequence. cDNA clones containing the mature gamma 3 chain were identified as well. We also isolated cDNA clones containing C gamma 1 and C gamma 3 sterile transcripts from the SSK41 line. These sterile transcripts contained additional exon sequences designated 'I' which were localized upstream of the C gamma 1 and C gamma 3 switch regions and homologous to murine counterparts. The I sequences were precisely spliced to the 5' ends of the corresponding C gamma exon sequences. These features of germline CH transcripts, i.e. the isotype specificity to class switching, location of exons, and sequences per se, are highly conserved between man and mouse.

A case of ACTH-producing pheochromocytoma

A woman with sustained hypertension, facial roundness, hirsutism, marked sweating, and generalized tremor was found to have a right adrenal pheochromocytoma. Elevated levels of serum cortisol, plasma ACTH, and serum catecholamines returned to normal after the tumor was removed. It was confirmed that enzymatically dispersed tumor cells produced ACTH and catecholamines concomitantly during in vitro incubation.

Transcription of IL-2 receptor gene is stimulated by ATL-derived factor produced by HTLV-I(+) T cell lines

In HTLV-I transformed T-cell lines established from the patients with adult T-cell leukemia (ATL), there is a constitutive activation of the normal IL-2 receptor (IL-2-R) gene. These cell lines continuously produce an ATL-derived factor (ADF), an IL-2-R inducing factor without IL-2 activity. ADF enhances the expression of the IL-2-R through the augmentation of the IL-2-R mRNA in the HTLV-I(+) T-cell line (ED) as well as the NK cell line cells (YT). In YT cells, the transcriptional initiation of the promoter of the IL-2-R gene was enhanced by ADF but not by IL-2. Production of ADF by HTLV-I(+) T-cell lines may be involved in the abnormal expression of IL-2-Rs on these cells.

The human IL-2 receptor gene contains a positive regulatory element that functions in cultured cells and cell-free extracts

The 130-base pair fragment located between 220 and 90 base pairs upstream of the major transcription initiation site of the human interleukin 2 (IL-2) receptor gene had positive regulatory effect on the early promoter of simian virus 40 as well as its own promoter. This fragment seems to be responsible for not only cell-specific but also lymphokine-induced expression of the IL-2 receptor gene as assessed by DNA transfection. The same DNA fragment directed cell-specific transcription of the IL-2 receptor gene in extract of HTLV-I-infected T cells, MT-1, but not of Epstein-Barr virus-transformed B cells, CESS. The addition of small amounts of MT-1 extract to CESS extract resulted in specific expression of the IL-2 receptor gene, indicating that cell-specific expression is regulated by trans-acting molecules in MT-1 extract.

Mutagenic activities of dictamnine and gamma-fagarine from dictamni radicis cortex (Rutaceae)

A methanol extract of Dictamni Radicis Cortex exhibited a mutagenic effect on Salmonella typhimurium TA100 and TA98 with S9 mix. Two mutagenic compounds in Dictamni Radicis Cortex were isolated on a Sephadex LH 20 column and silica gel column chromatography and by preparative TLC. These were identified as dictamnine and gamma-fagarine by UV, EI-Mass, 1H-NMR. Dictamnine and gamma-fagarine were mutagenic in strain TA100 and TA98 with S9 mix. The dose-response curves were linear in the range 10-40 micrograms. Dictamnine and gamma-fagarine had specific activities (His+/microgram) of about 50-70 revertant colonies in strain TA100, while in strain TA98 there were about 30-50 revertant colonies.

Molecular cloning and structure of the human interleukin 2 receptor gene

We have cloned the IL-2 receptor gene from human genomic DNA libraries using IL-2 receptor cDNA as probe. The genomic DNA segments that hybridized with cDNA were subcloned in M13 phages and their sequences were determined. The nucleotide sequences showed that the IL-2 receptor gene was encoded by eight exons and that the coding region sequences agreed completely with that of the IL-2 receptor cDNA cloned from a cell line derived from adult T cell leukemia (ATL), in which IL-2 receptors are expressed abnormally. The nucleotide sequence of the 5'-flanking region had a putative promotor region, which had some homology with the human IL-2 gene. Transcription initiation sites were clustered about 25 bp 3' to the TATA box as assessed by primer extension analysis. These sites for normal and ATL T cells were the same. Exons 2 and 4 encoding the extracytoplasmic portion had significant homology, suggesting that the two exons are derived by duplication of an ancestral exon. Exon 2 contained six cysteine residues, four of which are conserved at the corresponding positions in exon 4.

A case of biliary cystadenocarcinoma with recurrent jaundice. Diagnostic evaluation of computed tomography

A 73-year-old male patient with biliary cystadenocarcinoma and episodes of recurrent jaundice is reported. This very rare tumor was suggested as a possible diagnosis by the computed tomographic findings showing intrahepatic cystic masses with septations and papillary projections. The diagnosis of the mucin-producing tumor was supported by aspiration of mucinous bile with a cannule inserted endoscopically via the major duodenal papilla. The computed tomographic findings and the diagnosis were verified by pathologic studies made on the material obtained surgically. The mucinous bile is assumed to have been responsible for the recurrent jaundice.

[Clinical studies on excretion in biliary tract with the antibiotic cefotiam]

Cefotiam (CTM) was administered through 1 hour intravenous drip infusion for the patients performed biliary tract surgery. The concentration of CTM in serum, gallbladder tissue and the excretion in bile of the choledochus were measured. Twenty-one patients performed cholecystectomy were followed the concentration of CTM in the gallbladder tissue and the results were studied with pharmacokinetic analysis. The simulation curve, which was described by computer system in two-compartment open model, showed the maximal concentration of CTM in the serum was 60.3 micrograms/ml at 1 hour after infusion and that in the gallbladder tissue was 27.1 micrograms/g at 1.07 hours. The concentration of CTM in the gallbladder tissue was presumed to be in proportion to that of CTM in the serum. Six patients performed bile drainage were followed the concentration of CTM in bile of the choledochus for 6 hours after infusion. The maximal concentration was 215.2 +/- 62.7 micrograms/ml at 3 hours after injection, and the mean biliary recovery was 1.66 +/- 0.55% through 6 hours. Neither any side effects nor any abnormal values in the laboratory analysis of samples were observed for CTM.

Effects of scattered X-rays on CT images

Scatter to primary radiation ratios at detector positions were calculated for uniform cylindrical water phantoms in both third and fourth generation x-ray CT scanners using the Monte Carlo simulation method. A rapid method for determining the scattering angle is given. In the process of image reconstruction, the effect of scatter was isolated by applying our new calculation technique. The decrease in CT number due to scatter was found to be less than 10. In the third generation CT scanner the rate of scatter is larger at the centre than at the edge because of the effect of the collimator at the detectors. As a result the cupping artefact occurs in the CT image. The collimator cannot be used in the fourth generation CT scanner and, therefore, the rate of scatter is almost uniform, leading to the appearance of rounded-off edges.

[Early esophageal cancer concomitant with leiomyoma of the esophagus--a case report]

Benign esophageal tumors concomitant with esophageal cancer are sometimes observed, however, it is rare that esophageal cancer is associated at the surface of the leiomyoma as a submucosal tumor. We report a 59-year-old man with a polypoid esophageal cancer. The polypoid tumor, 0.6 X 0.7 X 1.3 cm in size, was removed in 1976; histological findings showed that a large amount of the tumor was leiomyoma and that squamous cell cancer was associated at the surface of the leiomyoma. After polypectomy, he experienced recurrence and radical surgery was performed in 1981; histologically, the resected specimen showed early esophageal cancer.

Sclerosing hepatic carcinoma: a report of a case treated with a transcatheter arterial embolization

Sclerosing hepatic carcinoma (SHC) is one of the variant primary liver carcinomas and is characterized by intense fibrosis which surrounds slender cords of neoplastic cells. We report on a 53-year-old male patient with SHC describing the radiological findings and clinical course after a transcatheter arterial embolization. To our knowledge, this was only the second reported case of SHC in Japan.

The information spectrum as a measure of radiographic image quality and system performance

The spectrum (spatial-frequency component) of the information capacity of a radiograph, which we call the information spectrum, is offered as a measure of image quality and system performance. The information spectrum is a much more practical expression than information capacity by itself: it combines synthetically the contrast, the latitude, the sharpness and the granularity, and is expressed as a function of spatial frequency. The information spectrum can be readily calculated by using the dynamic density range and the MTF and noise Wiener spectrum at medium density range. A practical example is given. The appropriate system for each object can be selected by comparing the information spectral values of various imaging systems at the significant spatial frequency range predetermined for each object.

Time-course of mutagenicity due to flavonols in a pickled vegetable

The mutagenicity of the leafy vegetable, Takana (Brassica juncia var. integrifolia), pickled with salt for various durations was examined. The mutagenicity increased with increasing duration of pickling time, and analysis by HPLC showed that is was caused by mutagenic flavonols. The flavonols contained in the fresh Takana as glycosides were found to be freed by pickling. This was confirmed by acid hydrolysis.