[Immunologic phenomena in patients with proliferative retinopathy in diabetes mellitus type 1]

As a rule, in long-lasting diabetes type 1 there appear vascular complications in a form of proliferative retinopathy. While looking for the causes of fast vascular changes, the authors considered the possibility of immunological disorders. They started prospective examinations of patients with diabetes type 1 and proliferative retinopathy changes in the fundus of the eye. The authors evaluated the activity of angiogenic factors released by mononuclear cells isolated from peripheral blood of the patients examined. The authors found a significantly higher activity of these factors in patients with proliferative retinopathy in comparison with a control group of healthy persons and a group of patients with diabetes type 1 and simple retinopathy. The results obtained may indicate to immunological changes in the pathogenesis of proliferative retinopathy.

[Therapeutic problems of patients with diabetes mellitus after total pancreatectomy]

Followed were 11 patients after total pancreatectomy (for carcinoma--6 patients, for sequelae of the chronic pancreatitis--5 patients), aged 52-62 years. The follow-up period ranged 5 months up to 4 years. All pacreatomized patients had diabetes needing insulin administration, although the need for insulin decreased with time down to 16-40 units/24 hours after one year. The diabetes was rather brittle with high incidence of hypoglycaemia. In 7 patients keeping exact records the incidence of hypoglycaemic events was 16-24 within the first month, 9-16 in the third month following pancreatectomy. In two patients death was due to the severe hypoglycaemia developing in the later postoperative period. The observations call for a necessary "intensive metabolic care" of every patient, totally pancreatomised. This intensive metabolic care must include not only careful instructing the patients but also his or her family how to behave in a totally different metabolic condition of the patient. Self-control, including blood sugar estimation several times a day gets special importance.

Induced multidrug resistance in murine leukemia L1210 and associated changes in a surface-membrane glycoprotein

The aim of this study was to find out whether only resistant cells of the "multidrug-resistant" phenotype show the described changes of plasma membrane glycoprotein (170 kDa) or whether resistant cells that do not express this phenotype reveal corresponding results. Doxorubicin-resistant (L1210dox) and daunorubicin-resistant L1210 ascites tumor cells (L1210dnr) (multidrug-resistant tumor cells) were therefore compared with cytosine-arabino-side-resistant (L1210AraC) and cyclophosphamide-resistant L1210 ascites tumor cells (L1210ctx) (not multi-drug-resistant tumor cells). The resistant cell lines were generated in vivo in tumor-bearing mice and the resistance to cytostatic agents was evaluated in vivo and in vitro. Using the accumulation assay with rhodamine-123, the multidrug resistance can be detected. In order to determine alterations in the plasma membranes we used the monoclonal antibodies 265/F4 and C219, which were prepared against the membrane glycoprotein P170 (170 kDa) in colchicin-resistant Chinese hamster ovary cells. The results demonstrate that L1210dox and L1210dnr tumor cells show an intense immunostaining by the streptavidin/biotinylated-peroxidase-complex method and by the streptavidin/biotin/phycoerythrin immunofluorescence method. In contrast no specific immunostaining was observed in parental (sensitive) and L1210AraC or L1210ctx tumor lines. The results were confirmed by immunoblotting. To determine whether multidrug-resistant DNA sequences were expressed in the multidrug-resistant tumor cells, Northern blots with RNA od sensitive and resistant cells were performed using the clone pcDR1.5. Elevated RNA levels were detected only in resistant cells with the multidrug-resistant phenotype. Thus, the results of this study demonstrate that only resistant cells with the multidrug-resistant phenotype show an increased expression of the membrane 170-kDa glycoprotein.

Detection of drug resistance in human ovarian carcinoma

Drug-resistant cancer cells with the multidrug-resistance phenotype show overexpression of P-glycoprotein, and we therefore tested carcinoma tissue from five patients with stage III or IV ovarian cancer for P-glycoprotein using 265/F4 and C 219 monoclonal antibodies, prepared against membrane glycoproteins in colchicine-resistant CHO cells. Using immunofluorescence and immunoblotting techniques, one of the tumors showed a positive reaction. Using the pcDR 1.5 clone we found that the same cancer tissue had elevated expression of the genes responsible for multidrug resistance. The demonstration of elevated P-glycoprotein in ovarian carcinomas indicates that P-glycoprotein overexpression is not limited to experimental tumor models.

Human tumor xenografts as model for drug testing

This paper reviews the history of xenografts, the endpoints commonly used to evaluate response and chemotherapeutic results obtained with serially maintained human tumor xenografts from different laboratories, and discusses the potential clinical relevance of the heterotransplant model for cancer chemotherapy. Specifically, an attempt is made to correlate the published xenograft data with the clinical data. Drug testing with different types of xenotransplanted tumors has shown that the response of xenografts obtained in immune-deficient animals is comparable to that in clinical practice. In addition, xenografts of a particular tumor type are able to identify agents of known clinical activity against that disease.

Induced multidrug-resistance in murine sarcoma 180 cells grown in vitro and in vivo and associated changes in expression of multidrug-resistance DNA-sequences and membrane glycoproteins

The aim of this investigation was to analyze the resistance to doxorubicin and daunorubicin of murine sarcoma 180 cells grown in vitro (monolayer) and in vivo (ascites form). The colchicine-resistant CHO cells were used as controls. A multidrug-resistant phenotype was found in all investigated cell lines. Multidrug resistant cells grown in tissue culture or as ascites tumor cells needed more time to accumulate rhodamine 123 than their sensitive parental cells. In order to evaluate whether the resistant cells show alterations in the plasma membranes, different methods were applied (immunocytochemistry, immunofluorescence, immunoblotting) using the monoclonal antibodies 265/F4 and C 219. These methods all revealed an increased expression of the glycoprotein Mr 170 kd in the multidrug-resistant cell lines. To determine whether multidrug DNA sequences were expressed in the resistant cell lines, slot blots and Northern blots with RNA of sensitive and resistant cells were performed using the clones pDR 7.8 and pcDR 1.5. Elevated RNA levels were detected in all resistant cell lines.

Adenocarcinoid of the vermiform appendix. A clinicopathologic study of 20 cases

Adenocarcinoid of the appendix is a tumor that shares the histologic features of both carcinoids and adenocarcinomas. The metastatic ability of the tumor is uncertain. Twenty consecutive cases of adenocarcinoids were compared with 88 cases of conventional appendiceal carcinoids. Metastatic tumor spread was found in six of 20 cases of adenocarcinoids, but in none of the conventional carcinoids. Metastasizing tumors were characterized by a moderate to severe nuclear atypia and a high mitotic count. These features were present in only two of the nonmetastasizing tumors, one of which was treated by hemicolectomy. Adenocarcinoids showing moderate or severe nuclear atypia, a mitotic count of two or more mitoses/10 high power fields, or spread beyond the appendix should be treated by hemicolectomy. If these features are not present, simple appendectomy is adequate.

Intrinsic drug resistance in a human lung carcinoma xenograft is associated with overexpression of multidrug-resistance DNA-sequences and of plasma membrane glycoproteins

The purpose of this study was to examine whether multidrug resistance can be detected in human lung tumors not previously treated with chemotherapy. Therefore, the intrinsic sensitivity or resistance of 8 human epidermoid lung cancer xenografts grown in nude mice has been examined. The tumor lines responded differently to vincristine and the other cytostatic agents. When the effects of vincristine on the 8 tumor lines are correlated with the effect of dactinomycin (actinomycin D), a close relationship could be found (r = 0.96). These results demonstrate that xenografts derived from human lung tumors not previously treated with chemotherapy exhibited a similar pattern of cross-resistance as is observed in sublines of murine and human tumors which were resistant to various drugs following repeated exposure of the cells to a sublethal concentration of these drugs. The resistant lung tumor HXL 54 also shows an overexpression of the P170-membrane glycoprotein (detected by Mab 265/F4). To determine whether multidrug genes were expressed in resistant lung tumors, slot blots and Northern blots were performed using the probes pDR 7.8 and pcDR 1.5. The level of expression can be correlated with the degree of drug resistance.

Development of drug resistance in a human epidermoid lung carcinoma xenograft line

The development of resistance to vincristine, actinomycin D and cisplatin has been examined in a human epidermoid lung carcinoma xenograft line (HXL 55) growing in nude mice. Treatment of HXL 55 with 1 mg kg-1 vincristine or 0.5 mg kg-1 actinomycin D once in each in vivo passage resulted in a rapid reduction in tumour responsiveness to these drugs. A partial resistance was already acquired at the 2nd transplant generation. In contrast, a gradual decrease in therapeutic response was observed with 10 mg kg-1 cisplatin. Irradiation with a local dose of 10 Gy induced no resistance. The three induced drug-resistant sublines were characterized in terms of the time course of development of resistance, the degree of induced resistance, cross-resistance, growth rate and stability of the phenotype.

Immunocytochemical detection of a resistance-associated glycoprotein in tissue culture cells, ascites tumors and human tumor xenografts by Mab 265/F4

The aim of this investigation was to find out whether resistant cells of different tumors can be detected immunocytochemically by the streptavidin-biotin-peroxidase-complex method using the monoclonal antibody 265/F4. This antibody was prepared against the membrane P-glycoprotein of Mr 170 kd from colchicine-resistant CHO cells. For this purpose the acquired resistance of tissue culture cells, ascites tumors and the acquired and inherent resistance of human lung carcinoma xenografts were analyzed. Doxorubicin-resistant S180 cells, daunorubicin-resistant L1210 cells and vincristine-resistant human epidermoid lung carcinoma xenografts showed an intense positive reaction with the monoclonal antibody. In contrast, no specific immunoreactivity was observed with parental (sensitive) tumor cells. These data could eventually provide a prognostic tool for the detection of resistant human tumor cells.

DNA and S-phase distribution and incidence of metastasis in human primary lung carcinoma

The aim of the study was to investigate the relationship between DNA and S-phase distribution in primary non-small-cell lung carcinomas with the incidence of metastasis. Patients with non-small-cell lung carcinomas were divided into two groups depending on whether at time of surgery there were metastases or not, and these groups were correlated with the data obtained by flow cytometry or autoradiography. As expected from other studies, survival time was significantly longer for those patients without metastases at time of surgery (P = .0002) and the incidence of metastasis was significantly higher when the primary tumor was greater than or equal to 70 cm3 (P = .026). In this study, a total of 185 fresh specimens of lung carcinomas were investigated by flow cytometry. Patients with aneuploid tumors had a higher tendency to have metastases (P = .016). Patients with tumors with a higher proportion of S-phase cells measured by either flow cytometry or autoradiography demonstrated significant increase in the formation of metastases (P = .02 and P = .05). We feel that these results warrant further investigation with other primary tumors. A comparison of primary tumors that are known to rapidly metastasize vs. those that either slowly or rarely metastasize may prove to yield valuable insight into the important factors associated with metastatic potential.

Influence of insulin on plasma concentration and renal excretion of sodium and potassium in normal, electrolytes depleted and aldosterone treated dogs

Effects of insulin on plasma concentration and renal excretion of sodium and potassium were compared in conscious dogs 1) maintained in water and electrolytes balance (Series 1, 10 dogs), 2) depleted of electrolytes by repeated i.v. loading with 20% mannitol (Series 2, 10 dogs), and 3) aldosterone treated (0.8 micrograms.kg-1.h-1 i.v., Series 3, 10 dogs). In each Series intravenous infusion of insulin at a rate of 0.05 U.kg-1.h-1 elicited transient increase in plasma sodium concentration and prolonged hypokalemia. Repeated loading with mannitol in Series 2 elicited significant elevation of plasma sodium, ADH and aldosterone concentrations, as well as decrease in extracellular fluid volume. Infusion of insulin in this Series elicited smaller decrease in plasma potassium concentration and longer lasting hypernatremia than in dogs in water-electrolytes balance. Aldosterone infusion in Series 3 did not change hypokalemic effect of insulin but attenuated hypernatremia. Infusion of insulin in Series 1 elicited increase of sodium excretion and decrease in potassium excretion. These effects were absent in Series 2 and 3. The results indicate that depletion of electrolytes and blood aldosterone elevation modify the effects of insulin on plasma concentration and renal excretion of sodium and potassium.

Occurrence of a multidrug-resistant phenotype in human lung xenografts

The intrinsic sensitivity of a panel of 8 human epidermoid lung cancer xenografts to vincristine and actinomycin D has been examined and the cross-resistance patterns of the most vincristine-resistant and vincristine-sensitive tumour line were tested to a variety of other drugs, including radiation. The results demonstrate that xenograft lines derived from human lung tumours not previously treated with chemotherapy exhibit a similar general pattern of cross-resistance to the drugs vincristine, actinomycin D and adriamycin as is observed in human cell lines and in animal models selected for resistance to these drugs. It is also shown that intrinsic resistance to vincristine can be partially overcome by verapamil. This may indicate a potential role of this substance in circumventing clinically observed drug resistance.

Maintenance of morphology and tumour marker production in human epidermoid lung carcinoma xenografts

The histopathology and the expression of various marker substances including cytokeratin, epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) of ten human epidermoid lung carcinoma xenograft lines were compared with the corresponding donor patient tumours. It was found that the histological structure and the tumour markers were maintained by the xenografts. Neoplastic cells were more effectively detected using anti-keratin antibodies as compared to antibodies against EMA. CEA immunoreactivity was more common in well differentiated tumours. With the aid of electron microscopy, the known cellular heterogeneity of epidermoid lung carcinomas in man was also confirmed in these xenografts.

Crohn's disease limited to the vermiform appendix

Thirteen cases of Crohn's disease confined to the vermiform appendix were seen during a 12-year period. They constituted 16.9% of patients with primary resection of the bowel for Crohn's disease in the same period, but only 0.4% of the cases of acute appendicitis. In 10 of the 13 cases there was marked fibrous thickening of the appendiceal wall, and in 11 there were epithelioid cell granulomas. Appendectomy was performed in all cases. None had postoperative fistula or later manifestations of the disease within the observation time averaging 6.3 years. The recurrence rate was previously believed to approach that of recurrence after resection in other parts of the intestines. Collective review of this and three other relatively large case series gave an estimated recurrence rate of 3.5%. We conclude that in Crohn's disease initially confined to the appendix the course appears to be indolent.

Adenocarcinoid of the appendix presenting with metastases to the liver

A case of hepatomegalia due to multiple metastases of unknown origin to the liver is described. At autopsy the primary tumor, an adenocarcinoid tumor of the appendix, was identified along with multiple metastases to the lymph nodes and widespread peritoneal carcinoidosis. Hepatic metastases from an appendiceal adenocarcinoid tumor has not been described previously. In the liver and lymph nodes the tumor had an insular growth pattern and was composed predominantly of cells of carcinoid type, whereas the carcinoidosis was composed almost entirely of signet-ring cells. It is suggested that differentiation of the metastases of appendiceal adenocarcinoids is modulated by factors in the recipient organ.

[Use of aspiration biopsy for the cytodiagnosis of non-Hodgkin's lymphoma]

The data on application of fine-needle aspiration biopsy followed by cytologic investigation in the diagnosis of non-Hodgkin's lymphomas are reported. Changes in cell population and presence of proliferating cells, characteristic of non-Hodgkin's lymphomas, can be detected by this method. Since the procedure is simple, painless, complication-free and assures a more than 90% accuracy, its application is indicated for diagnosis of non-Hodgkin's lymphomas.

[Ultrastructure of malignant non-Hodgkin lymphomas]

Ultrastructural characteristic features of non-Hodgkin malignant lymphomas-based on the analysis of 51 cases are dealt with. It is concluded, that ultrastructural changes of lymphomas can be correlated with the light microscopic findings and tumours arising from T and B cells can be distinguished also on the ultrastructural level. Electron microscopy should be regarded as an additional method in classification and differential diagnosis of non-Hodgkin malignant lymphomas. It contributes to a more exact diagnosis and clarifying the histogenesis of these tumours.

[Angioimmunoblastic lymphadenopathy]

Cytological, histological and ultrastructural characteristics of a cose of an extranodal and nodal angioimmunoblastic lymphadenopathy persisting during several years are given. Angiomatous proliferation in the case reported seemed to be identical both in the lymph node and in the cutaneous infiltration. Types of cells seen in the angioimmunablastic lymphadenopathy did not differ from those of other immunoreactive processes. In the extranodal infiltrates in addition to other phenomena thickening of the immunological techniques decrease of the natural cytotoxicity and the number of T-lymphocytes could be observed.

Verrucous carcinoma of the larynx

Verrucous carcinoma of the larynx in a middle-aged male patient is reported. The related diagnostic problems are described in detail and clinical and morphological differentiating features from other variants of squamous cell carcinoma are outlined on the basis of literary data and our own experience.