[Therapeutic effects of a combination of intermediate-dose cytosine arabinoside, adriamycin and vincristine in relapsed acute leukemia]

Eleven cases of acute leukemia, 8 relapsed and 3 refractory to a conventional induction chemotherapy, were treated with a combination of intermediate-dose cytosine arabinoside (ara-C), adriamycin (ADM) and vincristine (VCR). They consisted of 9 ANLL and 2 ALL. The therapeutic regimen consisted of 1-hour infusion of ara-C of a dose of 500 mg/m2 every 12 hours for 6 days from days 3 to 8, ADM, 40 mg/m2, on day 1 and VCR, 1.4 mg/m2, on day 2. Among 11 cases in which an evaluation was possible, 7 obtained complete remission (CR). The CR rate was 77.8% in the 9 cases of ANLL. The toxicity of this regimen included the following: conjunctivitis in 4 of 11 cases (36%), nausea and vomiting in 9 of 11 cases (91%) and hair loss in all cases, although no toxicities of the central nervous system of liver were observed. The mean level of serum concentration of ara-C was above 10 microM at 15, 30 and 60 minutes after the initiation of infusion. The therapeutic effect of this regimen consisting of intermediate-dose ara-C is expected to be useful not only in induction of refractory and relapsed acute leukemia, but also in the postremission therapy of CR cases.

[Low-dose 4N-behenoyl-1-beta-D-arabinofuranosylcytosine (BHAC) in the treatment of atypical leukemia]

Four cases of hypoplastic leukemia, one of acute myelocytic leukemia (M2) and one of RAEB-t were treated with a low-dose 4N-behenoyl-1-beta-D-arabinofuranosylcytosine (LD-BHAC) regimen, in which 50 mg BHAC was administered daily intravenously by one-hour drip infusion for 14 days. Among the 6 cases, three (2 hypoplastic leukemia and one M2) obtained complete remission and one (hypoplastic leukemia), partial remission. Response rates were 66.6% of all cases, and 75% of cases of hypoplastic leukemia. During treatment, cytopenia was observed in all cases and a decrease in bone marrow nucleated cell counts was recognized in the aged M2 patient with remission. Although side effects of the drug on the digestive system such as anorexia and nausea were observed in some cases, they were all controllable by conventional treatments. The serum concentration of ara-C was measured in 4 cases. The peak level of serum ara-C concentration, 3.62-18.9 ng/ml (mean: 11.74 ng/ml), was observed at the time of cessation of infusion of BHAC, and an ara-C level of 2.75-4.89 ng/ml (mean: 3.54 ng/ml) was still present in the blood 6 hours after the cessation of infusion. It was concluded that LD-BHAC was useful in the clinical management of atypical leukemia and acute myelocytic leukemia in the aged.

Stable integration of woodchuck hepatitis virus DNA in transplanted tumors and established tissue culture cells derived from a woodchuck primary hepatocellular carcinoma

The fate of integrated woodchuck hepatitis viral (WHV) DNA was systematically investigated in DNA samples from primary hepatocellular carcinoma (HCC) of woodchucks, solid tumors transplanted in athymic mice derived from a primary HCC of woodchuck, and an established cell line of tissue culture originating from the transplanted tumor. In four of five woodchuck primary HCCs, WHV DNA integration was demonstrated in addition to various amounts of extrachromosomal replicative intermediate WHV DNA. The integration pattern of the primary HCCs does not indicate a common integration site on the host chromosome. The integration pattern in the established cells is identical to that in the transplanted tumor and similar but slightly different from that of the primary HCC. No extrachromosomal or replicative intermediates of WHV DNA were detected in the transplanted tumors or in the established cells of tissue culture. There are three integration sites on the chromosomes of the established cells. Results of Southern hybridization and restriction maps of cloned fragments suggest that all of these integrated WHV DNA sequences are not a complete genome but a part of the genome. A small portion corresponding to the cohesive region of the genome was not detected in all of these integrated WHV DNA. A positive role of WHV DNA integration on the generation of HCC is strongly suggested by the high incidence of WHV DNA integration in woodchuck primary HCCs and the stable maintenance of a certain mode of WHV DNA integration in the hepatoma-derived cell populations during passages of transplantation or serial growth of tissue culture.

Immunohistochemical characterization of inflammatory infiltrates at the site of bile duct injury in primary biliary cirrhosis

Surgically obtained liver specimens from four patients with primary biliary cirrhosis (PBC), Stages I-II, were studied immunohistochemically using a broad panel of monoclonal antibodies. At the site of bile-duct injury (CNSDC), the inflammatory cells were recognized to be Coulter T-11+ (directed against all T-cells) and OKT-8+ (directed against cytotoxic/suppressor: C/S T-cells) cells. The MHC-class I antigen (i.e. HLA-A, B, C) was expressed weakly in the cytoplasm of the minority of damaged bile-duct epithelial cells, and the MHC-class II antigen (i.e. HLA-DR) was not expressed. Thus, OKT-8+ cells may play an important role in the immunologically mediated destruction of ductular epithelium in PBC. Strong MHC-antigen expression and OKT-8+ cell infiltration in destructive bile-duct lesions were not simultaneously observed. In the portal lymphocyte-rich areas, OKT-4+ (directed against helper/inducer: H/I T-cells) predominated over OKT-8+ cells. B-lymphocytes were present predominantly in the peripheral zones of the lymphoid aggregates. The distribution of helper/inducer T-cells and B-lymphocytes indicates that they may play a role in the induction of immunoglobulin in the lymphocyte-rich areas. The inflammatory mononuclear cells within the granuloma observed in one patient were Coulter T-11+, OKT-8+ and Leu-3a+3b+ (directed against helper/inducer T-cells) cells.

Monocyte chemiluminescence and macrophage precursors in the aged

Age-related alterations in the host defense system have been vigorously investigated because of increased susceptibility to infection and neoplasms in the aged. Although monocyte-macrophages form a major part of the cellular defense against microorganisms, the majority of investigations has been limited to neutrophils and lymphocytes. The present study, designed to determine the influence of age on mononuclear phagocytes, revealed no significant decrease in the absolute number of blood monocytes, but did reveal a tendency for the chemiluminescence of blood monocytes to decrease (p less than 0.10) and a significant decrease in the numbers of macrophage precursors (p less than 0.05) in the aged (over 70 year old), in comparison with controls (under 40 years old). On the basis of these findings, functional alterations of monocyte-macrophages seem to participate in the increased susceptibility to infection in the aged.

[Effects of interferon and its inducers on neutrophil chemiluminescence]

In order to evaluate effects of interferon (IFN) and its inducers on neutrophil functions, neutrophil chemiluminescence (ChL) was assayed in 12 patients treated with IFN (human lymphoblastoid interferon, 3.0 X 10(6) units/day i.m. daily) or Ge-132 (2,250 mg/day p.o. daily). The peak levels of neutrophil ChL, assayed one week after the initiation of treatment, were increased in comparison to those before treatment, but one month after treatment they were decreased to pretreatment levels in spite of the daily administration of the agent. On the basis of these results, it was concluded that IFN and Ge-132 enhanced the host defence mechanism including the activation of neutrophils, which appeared at the early phase of the host reaction.

Effect of different passage histories of infectious bronchitis virus on the sensitivity to inhibitors in chick serum and their removal by trypsin

Sensitivity of the Beaudette strain of infectious bronchitis virus (IBV) to non-antibody inhibitors in neutralization tests depended on the passage history of the virus. The chick embryo kidney cell-adapted (E71 CEK11) virus was the most sensitive, but after one chick embryo (CE) passage (E71 CEK11 E1), this virus showed reversion to the sensitivity of the parent virus (E71). IBV inhibitors in chicken serum could be removed by treatment with trypsin but not with phospholipase C.

[Evaluation of the clinical effect of ceftazidime in the field of obstetrics and gynecology]

Ceftazidime (CAZ) was administered to patients with obstetrical and gynecological infectious diseases and we studied its clinical effect: CAZ was administered to 24 patients at a dose of 2--4 g per day (twice a day) by drip infusion over a period of 3--11 days (total 6--32 g). The subjects included 19 cases of intrauterine infection, 4 of adnexitis, and 1 of infection of the external genital organs. The overall clinical results were excellent in 6 cases and good in 18 cases, the efficacy rate being 100%. For bacteriological study, 26 strains were isolated from 16 patients. These included Gram-positive bacteria (10 strains), Gram-negative bacteria (6 strains) and anaerobes (10 strains). After CAZ treatment, 4 strains (S. mitis 1, E. coli 1, P. anaerobius 1, B. melaninogenicus 1) were eliminated, but as to the other 22 strains, the results were unknown, because we could not examine microbiology after administration. No clinical side effect or abnormality in laboratory findings was observed.

[Intrathoracic administration of adriamycin with closed tube thoracostomy drainage for malignant pleuritis: observation on the administration dosage]

The effect of intrathoracic administration of adriamycin with closed tube thoracostomy drainage was investigated on patients with various malignant pleural effusions (13 lung cancer and one each stomach, breast, ovarian cancer, respectively). The doses of adriamycin ranged from 50, 30, 20, to 10 mg given to four groups of 4 cases respectively. Comparative study on effective rates, survival period after the administration, side effects and histopathological changes in autopsied cases was performed. The results obtained were as follows: 1. With regard to effective rates and histopathological changes, no difference was observed in the four groups in term of dose escalation of Adriamycin. 2. 50% survival period was similar within the groups administered 20, 30 and 50 mg of Adriamycin. However, the group receiving 10 mg showed slightly shorter survival period. 3. Although serious side effects were not observed in any groups, minor toxicities were mostly encountered in the 50 mg group. 4. It was concluded that in the treatment of malignant pleural effusion, an appropriate dose of intrathoracic administration of adriamycin was about 20-30 mg.

[Laboratory and clinical studies on latamoxef in the field of obstetrics and gynecology]

Latamoxef (LMOX) is a new antibiotic synthesized by Shionogi Research Laboratory. Chemically LMOX is especially unique with a sulfur atom replacing the oxygen atom in the 1 position of the conventional cephalosporin nucleus, and in addition, this antibiotic has a cephamycin-like structure. The antibacterial activity of LMOX shows high potency against Gram-negative bacteria, but tends to be weak against Gram-positive bacteria. The tissue levels of LMOX in humans after intravenous injection of 1 g were examined. The levels in uterine and adnexa uteri tissue at 1 hour after administration were 25.4 and 27.4 micrograms/g respectively. LMOX was administered to 147 cases in infections of obstetric and gynecological field. The clinical effect according to disease was 94.6% for intrauterine infections, 95.0% for adnexitis, 87.0% intrapelvic infections, and 100% for external genital organ infections, making a total of 92.5%. The rate of occurrence of side effects or abnormal laboratory findings was similar to or slightly less than that seen with other beta-lactam antibiotics.

Influence of temperature of incubation on chicken embryo tracheal organ cultures and chick embryos infected with strains of avian infectious bronchitis virus

The ciliostatic and embryo lethal effect of four strains of avian infectious bronchitis virus (IBV) were observed at two different incubation temperatures. In organ cultures, nephrosis-producing IBV strains (GN-2 and M-41) were slightly more ciliostatic and respiratory strains (Beaudette and Kita-1/Tokushima) less ciliostatic at 40.5 degrees C than at 37 degrees C. Mortality of chicken embryos infected with the GN-2, M-41 and Kita-1/Tokushima strains was greater at 40.5 degrees C than at 37 degrees C, while the reverse was true of the Beaudette strain which caused no embryo mortality at 40.5 degrees C. The Beaudette strain of IBV was the only one which could not be recovered from the kidneys of young chickens four days after infection. These results indicate that the different IBV strains may show variation in virulence at different temperatures in ovo and in organ cultures and this may be a reflection of the virulence and tropism for chickens.