[2,450MHz hyperthermia for malignant stenosis of the bile duct--development of a new biliary drainage tube united with a thermocouple]

We have developed new biliary drainage tubes (10 Fr and 12 Fr size) united with a thermocouple, through which we could apply 2,450MHz hyperthermia more exactly monitoring the tissue temperature in 3 cases with biliary obstruction than intracatheter hyperthermia methods already reported. One patient was discharged asymptomatic without jaundice after the removal of the drainage tube.

[Computed tomography of postoperative pelvic lymphocele]

Computed tomography (CT) was obtained in seven patients with postoperative pelvic lymphocele. The CT appearance of the lymphocele was nodule or oval cystic mass of low attenuation. Most of lymphoceles located laterally in the external iliac region. They were identified on the first CT, mean 2.5 months after surgery. They became small (2 cases) or disappeared (4 cases, mean 7 months after surgery). Infection was noted in one case, and another patient had lower abdominal pain. One of different diagnoses is recurrence.

[Thin-section computed tomography of the bronchi: right middle lobe, left lingular division, and lower lobes]

Thin (2 mm) section contiguous computed tomographic (CT) scans were obtained through the bronchi of the right middle lobe, the left lingular division, and the lower lobes in 24 patients. All segmental bronchi were identified except subsuperior and medial basilar segmental bronchi. Subsegmental bronchi of the left inferior lingula were seen in only 17%, but other subsegmental bronchi in greater than 75%. Variations in branching patterns were discussed.

Separation into two major forms of beta(1-3)N-acetylglucosaminyltransferase from human serum

The major beta(1-3)N-acetylglucosaminyltransferase [beta(1-3)GlcNAc-transferase] activity in human serum was isolated by DEAE- and CM-Sepharose column chromatography. This enzyme fraction consisted of two forms of the enzyme, which were separated from each other on a DEAE-Sepharose column and designated as GNAc-TI and GNAc-TII, respectively. They have the same molecular weights (about 90,000), optimum pH values (between pH 7.5 and 8.5) and apparent Km values for N-acetyllactosamine and lactose (7.1-8.8 mM and 10.9-11.5 mM, respectively). Glycosidase and methylation analyses of the reaction products demonstrated that both the enzyme catalyze exclusively the transfer of one N-acetylglucosamine to position C-3 of the terminal galactose of lactose in the beta linkage.

P blood group and proneness to urinary tract infection in Japanese children

The globoseries of glycolipids are antigens in the P blood group system as well as epithelial cell receptors for uropathogenic Escherichia coli. The P1 blood group is overrepresented in Swedish girls with recurrent pyelonephritis. In this study, Japanese children with urinary tract infection (UTI) were analyzed for P blood group phenotype. Out of 26 children with recurrent UTI, 50% were of the P1 blood group compared to the 31% of P1 individuals in the Japanese population at large (p less than 0.05). Of children defined as having febrile UTI 62% were P1. The P1 blood group was thus significantly enriched (3.5 times) in the children with febrile UTI. These results support the hypothesis that individuals of blood group P1 run an increased risk for recurrent pyelonephritis.

Contribution of methylsulfonyl metabolites of m-dichlorobenzene to the heme metabolic enzyme induction by the parent compound in rat liver

In the present study, we investigated the contribution of methylsulfonyl metabolites derived from m-dichlorobenzene (m-DCB) on the heme metabolic enzyme induction by the parent compound in rats. The time courses of the effects of a single ip administration of m-DCB (200 mg/kg, 1.36 mmol/kg) and 2,4- and 3,5-dichlorophenyl methyl sulfones (2,4- and 3,5-DCPSO2Mes) (each 50 mumol/kg) on hepatic microsomal cytochrome P450 content were almost in parallel with those on the total heme content in liver microsomes. m-DCB significantly increased the heme oxygenase activity, but 2,4- and 3,5-DCPSO2Mes did not. On the other hand, m-DCB and both methyl sulfones markedly enhanced the delta-aminolevulinic acid (ALA) synthetase activity. No change was observed in percentage saturation of the tryptophan pyrrolase activity after administration of m-DCB, whereas this ratio at 6 hr after injection of 3,5-DCPSO2Me was increased. In the liver of the DL-buthionine-(S,R)-sulfoximine (BSO)-treated rats dosed with m-DCB, both of 2,4- and 3,5-DCPSO2Mes were present at significantly lower concentrations than in non-BSO-treated rats. Additionally, the m-DCB did not elevate the ALA synthetase activity in the BSO-treated rat. On the other hand, the administration of either 2,4- or 3,5-DCPSO2Mes to BSO-treated rats resulted in induction of ALA synthetase. m-DCB and 2,4- and 3,5-DCPSO2Mes produced a dose-related increase in liver levels of methyl sulfones. The changes in the ALA synthetase activity after the administration of varying doses of m-DCB were similar to those after the administration of 2,4- or 3,5-DCPSO2Mes, whereas the sum of the concentration of two methyl sulfones in the liver of rats dosed with m-DCB was almost the same as the concentration of methyl sulfone after the administration of either 2,4- or 3,5-DCPSO2Mes. The results strongly suggest that the methyl sulfones derived from m-DCB, i.e., 2,4- and 3,5-DCPSO2Mes, contribute highly to the induction of the ALA synthetase activity by the parent compound.

Effects of chlorobenzenes and their methyl sulfone metabolites on microsomal enzymes associated with drug metabolism in rat liver

The effects of m- and o-dichlorobenzenes (DCBs), 1,2,4-trichlorobenzene (TCB) and their methylsulfonyl metabolites on the activities of hepatic microsomal reduced nicotinamide adenine dinucleotide phosphate (NADPH)-cytochrome c reductase, reduced nicotinamide adenine dinucleotide (NADH)-cytochrome b5 reductase and uridine diphosphate (UDP)-glucuronyltransferase (UDPGT) were studied. The treatment of rats with m-DCB, 1,2,4-TCB, 2,4-, 3,5- or 3,4-dichlorophenyl methyl sulfone (DCPSO2Me) or 2,4,5-trichlorophenyl methyl sulfone (TCPSO2Me) significantly increased NADPH-cytochrome c reductase activity, but o-DCB had no effect on this enzyme activity. All three chlorinated benzenes slightly reduced NADH-cytochrome b5 reductase activity, whereas the methylsulfonyl compounds elicited no change in the enzyme activity. Treatments with m- and o-DCBs, 1,2,4-TCB and 2,4,5-TCPSO2Me enhanced UDPGT activities toward both chloramphenicol (CP) and p-nitrophenol (NP). 2,4-, 3,5- and 3,4-DCPSO2Mes increased the activity of UDPGT toward CP but not toward p-NP. These findings concerning the effects of 2,4-, 3,5- and 3,4-DCPSO2Mes on the activities of NADPH-cytochrome c reductase and UDPGT support our hypothesis that the methylsulfonyl metabolites derived from m- and o-DCBs are phenobarbital-type inducers of the hepatic microsomal drug-metabolizing enzymes. It is concluded that the methyl sulfone derivatives of m- and o-DCBs and 1,2,4-TCB are inducers of phase I reactions in hepatic microsomal drug metabolism, and they have increasing effects on the phase II enzyme activities, such as UDPGT. Thus, the methyl sulfones seem to play an important role in the inducing effects of their parent compounds, m- and o-DCBs and 1,2,4-TCB, on the drug-metabolizing enzyme systems.

Purification and characterization of N-acetyl-D-galactosamine-binding lectin from Falcata japonica

An N-acetyl-D-galactosamine-binding lectin from Falcata japonica seeds was purified by affinity column chromatography of N-acetyl-D-galactosamine coupled to epoxy-activated Sepharose 6B. A 1000-fold purification of lectin was obtained from the crude extracts. The purified lectin agglutinated blood group A red cells, but neither blood group B nor O red cells. Polyacrylamide gel electrophoresis of the lectin showed one diffuse band. Molecular weights of 125,000 and 117,000 were estimated by gel filtration and ultracentrifugal analysis, respectively. SDS-polyacrylamide gel electrophoresis of the lectin also showed a single band which has a molecular weight of 34,000. Therefore, the lectin molecule was estimated to be a tetramer composed of four identical non-covalently bound subunits. F. japonica lectin was a glycoprotein containing 5% total carbohydrate, and the amino acid composition was characterized by a high content of aspartic acid, serine and glycine, a low content of methionine and the absence of cysteine.

Treatment of brain tumors with iridium-192 seeds

Interstitial radiation therapy of brain tumors requires positioning of the radioactive sources with good precision in order to achieve a sufficient dose in the tumor without too much damage to surrounding tissues. A method for application of 192Ir seeds in brain tumors is described and preliminary results in seven patients reported. The method, which uses CT-guided stereotactic localization and computerized dose planning, is at present fairly complicated. The preliminary results are promising and no serious complications have so far been observed.

Aberrant blood group activities of ABH substances from human gastric linings

Recently it was shown that enzymes specific to blood groups A and B have an inherent function overlapping each other and that under certain in vitro conditions they exhibit a weak activity to synthesize aberrant blood group substance. In an attempt to examine the results of the in vivo activities of these enzymes, we investigated the activities of blood group substances from human materials. After partial purification and concentration of blood group substances, weak B activities were shown in some materials from group A individuals, especially from gastric linings, and weak A activities in group B materials. Weak A and/or B activities in substances from group O persons were recognized. The reciprocal activities were specifically destroyed by blood group-decomposing enzymes with enhancement of H activity. These results suggest that the A and B enzymes can utilize the reciprocal nucleotide substrate even under in vivo conditions. The results support the inference that blood group O gene-mediated proteins exist and have activities to synthesize A and B structures.

Identification and characterization of UDP-GalNAc: NeuAc alpha 2-3Gal beta 1-4Glc(NAc) beta 1-4(GalNAc to Gal)N-acetylgalactosaminyltransferase in human blood plasma

Normal human plasma was found to contain beta 1-4N-acetylgalactosaminyltransferase catalyzing the transfer of N-acetylgalactosamine from UDP-GalNAc to 3'-sialyl-lactose, NeuAc alpha 2-3Gal beta 1-4Glc. The transferred N-acetylgalactosaminyl residue was cleaved from the desialylated reaction product by the beta-N-acetylhexosaminidase from jack beans. Methylation and hydrolysis of the desialylated reaction product yielded only 2,3,6-tri-O-methylgalactose and 2,3,6-tri-O-methylglucose as neutral sugars, indicating that the N-acetylgalactosaminyl residue was introduced at position C-4 of the galactosyl residue of 3'-sialyllactose. The enzyme required Mn2+ ions for its activity and showed a pH optimum between 6.5 and 8.5. By using a wide variety of oligosaccharides and glycoconjugates, the acceptor specificity of the beta 1-4N-acetylgalactosaminyltransferase was investigated. No detectable amount of N-acetylgalactosamine was transferred to either 6'-sialyllactose or lactose. The enzyme did not act on ganglioside GM3, NeuAc alpha 2-3Gal beta 1-4Glc-ceramide, suggesting that the hydrophobic ceramide portion of GM3 interferes with the enzyme reaction. On the other hand, glycoproteins carrying terminal NeuAc alpha 2-3Gal beta 1-4GlcNAc structures on their N-linked oligosaccharide chains, e.g. Tamm-Horsfall glycoprotein, were efficient acceptors.

Clinical course of acute middle cerebral artery occlusion

Knowledge of the natural course of stroke patients has become increasingly important since new therapeutic methods have been proposed for patients with cerebral infarction in the acute stage. In order to clarify the acute stage of this disease, 188 patients admitted within 24 hours after onset of middle cerebral artery (MCA) occlusion were followed for 2 months, and data relating to mortality and changes in disturbances of consciousness and motor function were investigated. It was shown that the prognosis for MCA occlusion cases is poor, and about 80% of these patients are unable to return to their previous lifestyle. The level of consciousness in the acute stage is a good index for estimating the patients' quality and time of survival, and motor function in the acute stage is a good indicator of functional recovery. Thus, when evaluating the effectiveness of a new therapy for cerebral infarction, rapid improvement in the acute stage before and after treatment should be carefully noted.

Evidence that methylsulfonyl metabolites of m-dichlorobenzene are causative substances of induction of hepatic microsomal drug-metabolizing enzymes by the parent compound in rats

This study was undertaken to clarify the relationship between the formation of 2,4- and 3,5-dichlorophenyl methyl sulfones, metabolites of m-dichlorobenzene (DCB), and their inducing effect on hepatic microsomal drug-metabolizing enzymes in rats. When m-DCB was injected ip into bile duct-cannulated rats, little or no methyl sulfones were detected in blood, liver, kidneys, adipose tissue, or bile. In the antibiotic-pretreated rats dosed with m-DCB, metabolite concentrations in the blood and the three tissues markedly decreased. These findings suggest that the formation of methylsulfonyl metabolites from m-DCB depends largely upon the metabolism of some precursor(s) excreted in the bile by intestinal microflora. The increasing effects of m-DCB administration on the activities of aminopyrine and aniline metabolizing enzymes and the contents of cytochromes P-450 and b5 in hepatic microsomes were scarcely observed in the bile duct-cannulated and antibiotic-pretreated rats, in which the drug-metabolizing enzymes were able to be induced by phenobarbital treatment. On the other hand, in rats administered 2,4- or 3,5-dichlorophenyl methyl sulfone hepatic distribution of each methyl sulfone was similar to that in intact rats, and the degree of increase of the above four parameters was nearly the same as that in the intact rats. These findings provide evidence that the induction of drug-metabolizing enzymes by m-DCB is not due to the action of m-DCB but is due to its methylsulfonyl metabolites.

[Damage to the heart from tumor irradiation in the thorax--an echocardiographic study]

The authors give a review of 74 patients with radiation-induced heart disease which could be easily detected by echocardiography. In almost all of the patients a pericardial effusion (P.E.), with relative sinus tachycardia was found 3 to 4 weeks after onset of radiation and this was transient in some cases. This phenomenon was interpreted as an early radiation-induced reaction of the heart. 6 to 12 months after radiation, late damage of the heart occurred depending on field and total radiation dose. This manifested as massive P.E. with changes in ECG. Later there was damage to the myocardium caused by coronary sclerosis. The tendency to constrictive pericarditis was manifested not earlier than 3 years or later after radiation. The authors advise follow up of the irradiated patients case by case, checked by echocardiography, especially those who received more than 5000 rad to the heart area and therefore have high risk of late heart damage.

The presence of N-acetyllactosamine and lactose: beta (1-3)N-acetylglucosaminyltransferase activity in human urine

Normal human urine was found to contain beta (1-3)N-acetylglucosaminyltransferase catalyzing the transfer of N-acetylglucosamine from UDP-GlcNAc to N-acetyllactosamine and lactose. Lacto-N-tetraose which carries the terminal Gal beta (1-3)GlcNAc structure was a poor acceptor. The product of the transferase reaction with N-acetyllactosamine as acceptor was identified by methylation analysis as GlcNAc beta (1-3)Gal beta (1-4)GlcNAc. The beta-linkage of the GlcNAc in the synthesized trisaccharide was confirmed by the action of the specific beta-N-acetylhexosaminidase. The enzyme requires Mn2+ ions for its activity, shows a broad pH optimum from 7 to 9, and appears to have a molecular weight of about 200,000 as estimated by Sephadex gel filtration.

Human serum contains N-acetyllactosamine: beta 1-3 N-acetylglucosaminyltransferase activity

Human serum was shown to contain N-acetyllactosamine: N-acetylglucosaminyltransferase activity. The reaction product was hydrolyzed by beta-N-acetylglucosaminidase and released [14C]N-acetylglucosamine, indicating that the N-acetylglucosaminyl residue was beta-linked to N-acetyllactosamine. Methylation and hydrolysis of the reaction product yielded 2,4,6-trimethyl[3H]galactose, indicating that the N-acetylglucosaminyl residue was introduced at position C-3 of the terminal galactose of N-acetyllactosamine. In our experiments, 2,3,4-trimethyl[3H]galactose was not detected. Substrate competition studies between N-acetyllactosamine and lactose showed that this enzyme also catalyzed the transfer of N-acetylglucosamine from UDP-N-acetylglucosamine to lactose. Since the Km value for N-acetyllactosamine, which was 7.0 mM, was approximately a fourth of that for lactose (29.8 mM), N-acetyllactosamine was more effective than lactose as an acceptor.

Identification of sulfur-containing metabolites of m-dichlorobenzene and their disposition and relationship with glutathione in rats

The sulfur-containing metabolites of m-dichlorobenzene (m-DCB) were identified by using gas chromatography-mass spectrometry and disposition of these metabolites was studied. In the blood, urine and feces of rats dosed with m-DCB, 2,4- and 3,5-dichlorophenyl methyl sulfoxides and 3,5- and 2,4-dichlorophenyl methyl sulfones emerged, while their possible precursors, 3,5- and 2,4-dichlorophenyl methyl sulfides (Me' and Mf', respectively), were not detected in the blood, urine and feces. However, after heating the alkalinized urine and feces, the methyl sulfides appeared. Each cumulative amount of the methyl sulfoxides and methyl sulfones excreted in both the urine and feces for 120 h was less than 0.3% of the dose, while the amounts of Me' and Mf' excreted were about 0.9 and 0.2%, respectively. The amounts of 2,4- and 3,5-dichlorophenyl mercapturic acids excreted in the urine were 2.3 and 1.2%, respectively. However, the former was increased to 27.3% and the latter to 4.3% after heating the acidified urine. The cystein conjugates were not detected. The administration of m-DCB decreased the glutathione level in liver of fasted rats but it was not further reduced by diethyl maleate (DEM)-pretreatment. The kidney glutathione level was not altered by the administration of m-DCB. The blood level of methyl sulfoxides and methyl sulfones and their excretion in urine were markedly decreased in DEM-pretreated rats, while the mercapturic acids in acid-treated urine of DEM-pretreated rats were not significantly decreased. These results suggest that the methyl sulfoxides and methyl sulfones were derived from glutathione in liver and the formation process of mercapturic acids was somewhat what different from that of methyl sulfoxides and methyl sulfones.

[Synchronous double cancer of the esophagus and the urinary bladder: report of two cases]

An 82-year-old man was seen with the complaints of gross hematuria and dysphagia in September 1979. An invasive bladder tumor was found and TUR-Bt (Transitional cell carcinoma, G2, pT3NXMO ) was performed. Fluoroscopic examination revealed a large esophageal cancer (Undifferentiated squamous cell carcinoma, T2NXMO ) and irradiation was performed (Linac 4,600 rads). The patient's condition aggravated rapidly and he died in February 1980. A 76-year-old man irradiated for an esophageal cancer (Linac 6,540 rads) (undifferentiated squamous cell carcinoma, T1NXMO ) in March 1981. Eleven months later, bladder cancer was found and treated with TUR-Bt (Transitional cell carcinoma, G2, PTlmNXMO ) followed by intravesical instillation of carboquone and adriamycin. The patient was alive 1 year and 9 months after the diagnosis of the esophageal cancer. Sixteen cases of double cancer of the esophagus and urinary bladder were found in the Japanese literature. Eighteen cases including the above 2 cases were males and their ages ranged from 51 to 82 years. Sixteen bladder cancers were transitional cell carcinoma and 15 esophagus cancers were squamous cell carcinoma. Of 9 cases whose clinical course were described in detail, 3 were synchronous and 6 were metachronous. Radical surgery was performed for one or both of the two cancers in 5 cases, 4 of which were metachronous. Indication of surgery for the metachronous second cancer does not differ significantly from sporadic cancer when the first cancer has been managed successfully. However, the treatment for the synchronous double cancer of this type of combination is often forced to be restricted, since the prognosis of esophageal cancer is poor and surgical risk may be increased by two radical surgeries in such elderly patients.