Magnetic resonance angiography of arteriovenous malformation in the brainstem

The magnetic resonance (MR) angiography appearance of arteriovenous malformation (AVM) in the tegmentum and pons is described. The interpeduncular perforating branches of the posterior cerebral artery and median pontine branches of the basilar artery were seen more clearly by MR angiography than by conventional angiography. MR angiography was very useful for the follow-up of AVM after stereotactic radiosurgery.

[Prognosis of periventricular echodensities--its relationship with periventricular leukomalacia]

We studied periventricular echodensities (PVE) in 154 premature infants under 33 weeks of gestational age. PVEs were classified into four groups due to Pidcock's description, and its relation with periventricular leukomalacia (PVL) was examined as a cause of cerebral palsy. Twelve (11%) of 112 infants with PVE 2 and all of 10 infants with PVE 3 were developed cystic PVL. PVE 3 was therefore considered to be the same as the pathological PVL. Infants of PVE 2 - 3 groups were more premature and lower in birth weight, and they were more often complicated with respiratory distress syndrome, asphyxia, recurrent apneic episode, patent ductus arteriosus and hypocarbia than those of PVE 0 - 1 groups. PVE 2 disappeared in patients with PVL later than in those without PVL.

Gastric adenocarcinoma with differentiation to sarcomatous components associated with monoclonal Epstein-Barr virus infection and LMP-1 expression

A case of gastric adenocarcinoma with sarcomatous differentiation in a 65-year-old male was investigated for possible association with the Epstein-Barr virus (EBV). The presence of EBV-DNA could be proven by the polymerase chain reaction (PCR), and EBERs signals were detected in tumour nuclei, strongly in sarcomatous areas and weakly elsewhere. Monoclonal EBV infection was evident in terms of a single band of lymphocyte determined membrane antigen demonstrated by the PCR method. Latent membrane protein 1 was strongly positive in cells of sarcomatous components but very weakly positive in carcinoma components. EBV-determined nuclear antigen-2 was absent in both. This case of adenocarcinoma suggests that EBV plays an important role in tumorigenesis, contributing in particular to sarcomatous differentiation.

Silver-binding argyrophilic nucleolar organizer regions (AgNOR) in gall-bladder cancer: correlations with malignant grading and prognosis

Silver-binding nucleolar organizer regions (AgNOR) were investigated and compared in 43 cases of gall-bladder cancers and 10 normal gall-bladder samples using an image analyzer. The mean numbers of AgNOR per nucleus (AgNOR number) were 3.28 +/- 1.38 in the gall-bladder cancers and 1.86 +/- 0.20 in the normal gall-bladder cases. The respective mean areas of AgNOR per nucleus (AgNOR area) were 6.96 +/- 3.78 microns2 and 1.89 +/- 0.21 microns2. The differences were statistically significant (P < 0.0001) for both parameters. In addition, increased frequency and enlargement were both apparently correlated with poor prognosis (P < 0.011 and P < 0.046, respectively), with AgNOR number and AgNOR area showing tendencies for increase in cases of histologically high grade malignancy, advanced cancer and regional lymph node involvement. In conclusion, AgNOR number and AgNOR area appear to be useful indicators for the grading of malignancies and for the prediction of gall-bladder cancer prognosis.

[A case of pulmonary aspergillosis by immunodiagnosis during remission induction therapy of acute myelocytic leukemia]

The frequency of a visceral mycosis grows definitely higher with an immunocompromised host. Invasive fungal infection can be controlled by means of development of early diagnosis and antifungal therapy. In these types of cases, it is difficult to establish an antemortem diagnosis of invasive pulmonary aspergillosis and most of them were diagnosed postmortem. A patient was diagnosed as aspergillosis from the clinical and serological features. This patient underwent successful therapy during remission induction therapy of acute myelocytic leukemia (AML). A 26-year-old male was admitted to our hospital because of leukocytosis with a diagnosis of AML made by reviewing peripheral blood smears and bone marrow aspirate. After remission induction therapy, he was still febrile in spite of treatment with a broad spectrum antibiotics and empiric therapy of fluconazole. Unfortunately shadowing appeared on the chest radiograph and aspergillus antigen was detected from the serum and the sputum. Consequently, the patient who suffered from invasive pulmonary aspergillosis was diagnosed and treated with intravenous amphotericin B and flucytosine. The radiological shadow improved but AML relapsed, therefore, remission induction therapy of AML was started again but he died of sepsis caused MRSA. In the postmortem histopathological examination the lung tissues, the hyphae could not be confirmed while, in immunohistochemical examinations of the lesion at the left S8, aspergillus antigens were detected around the small necrotic lesions and in the polymorphologic giant cells. We emphasize that invasive pulmonary aspergillosis is very difficult to diagnose whereas active examinations and clinical early diagnosis may lead to more effective therapy and the prognosis.

Spinal arachnoid cyst in a newborn infant

A male infant was born with asphyxia following a prolonged breech delivery at 39 weeks of gestation. He had a chylohemothorax from birth. Soon after birth he exhibited flaccid paraplegia with an absence of deep tendon reflexes in the lower extremities. At 17 days of age, magnetic resonance imaging (MRI) disclosed a hypodense area in the thoracic cord between C7 and Th4 in T1-weighted images, and spinal sonography revealed an echo-free space compressing the spinal cord in the same region observed with MRI. A spinal cyst was removed surgically at 24 days of age. The cyst was confirmed by pathology to be a true arachnoid cyst between C7 and Th4. The cause of this cyst may have been a spinal cord injury during the perinatal period.

Increase in cardiac muscle fructose content in streptozotocin-induced diabetic rats

To evaluate the activation of the sorbitol pathway in cardiac muscle in diabetic rats, we measured sorbitol, fructose, and myo-inositol content in cardiac tissue obtained from control and streptozotocin-diabetic rats, with or without an 8-week insulin treatment, using gas chromatography-mass spectrometry (GC-MS). Cardiac fructose and sorbitol content in 10-week diabetic rats increased by 60-fold and 3.9-fold of those of control rats, respectively (P less than .001). In contrast, cardiac myo-inositol content in 10-week diabetic rats decreased to 56% (P less than .025) of the control value. The abnormalities in cardiac fructose, sorbitol, and myo-inositol content were completely normalized by the 8-week insulin treatment, which was initiated 2 weeks after the induction of diabetes. There was no difference in cardiac aldose reductase activity between control and diabetic rats. However, cardiac sorbitol dehydrogenase activity in diabetic rats was 151% (P less than .005) higher than that of control rats, although hepatic sorbitol dehydrogenase activity was not different between the two groups. These results indicate that the sorbitol pathway is significantly activated in cardiac tissue obtained from streptozotocin-induced diabetic rats, which results in the marked cardiac accumulation of fructose.

Experimental metastasis of oncogene-transformed NIH 3T3 cells in chick embryo

By means of a highly sensitive and quantitative assay for specific detection of metastasized tumor cells in chick embryonic organs using the polymerase chain reaction (PCR), we have examined the experimental metastatic ability of individual clones of NIH 3T3 cells, transformed with oncogenes: v-Ki-ras, v-Ha-ras, v-src, v-fos, and v-abl. Such a transformed clone had different metastatic abilities in different embryonic organs. Among them, two clones of NIH 3T3 cells transformed with ras-oncogenes (v-Ki-ras or v-Ha-ras) metastasized to liver and lungs of chick embryo, and grew there more rapidly than the other clones. The parental NIH 3T3 cells were detected as slight bands of PCR products after iv injection, indicating some cells were trapped in chick embryonic organs, but did not grow. These findings indicate that the transformed cells are able to invade the organ tissues and grow in embryonic chick organs, but non-metastatic cells such as the untransformed-NIH 3T3 cells are not able to grow in the secondary sites. These experiments clearly demonstrate the usefulness of this assay system to study genes involved in malignant transformation.

Defective insulin response of phosphorylase phosphatase in insulin-resistant humans

Insulin-stimulated glycogen synthase activity in human muscle is reduced in insulin-resistant subjects. Insulin regulation of human muscle glycogen synthase may require activation of a type-1 protein phosphatase (PP-1). We investigated the change of phosphorylase phosphatase and glycogen synthase activities in muscle biopsies obtained during a 2-h hyperinsulinemic euglycemic clamp in 12 insulin-sensitive (group S) and 8 insulin-resistant (group R) subjects. Fasting phosphorylase phosphatase activity was lower in group R than in group S, and did not increase significantly with insulin infusion in group R until 20 min. In group S, phosphorylase phosphatase was significantly stimulated by 10 min, remaining significantly higher than in group R at all time points. The insulin-mediated changes in phosphatase activities were not decreased by 3 nM okadaic acid but were completely inhibited by 1 microM okadaic acid, thereby verifying that insulin-stimulated phosphorylase phosphatase is accounted for by a PP-1. Subcellular fractionation demonstrated reduced fasting PP-1 activities in both the glycogen and cytosolic fractions of muscle obtained from subjects in group R compared to those in group S. These results suggest that insulin activation of PP-1 could contribute to the stimulation of glycogen synthase by this hormone in human muscle. Lower fasting PP-1 activity in cytosol and glycogen fractions plus lower insulin-stimulated PP-1 activity could explain, in part, reduced insulin-stimulated glycogen synthase in skeletal muscle of insulin-resistant subjects.

Interstitial hyperthermia of malignant brain tumors by an implant heating system using stereotactic techniques

Interstitial hyperthermia of malignant brain tumors has been produced by a heated ferromagnetic implant with a low Curie point. Induction heating of the implant, which is stereotactically implanted in a tumor, is obtained by eddy currents in a high-frequency magnetic field. Safe, repeated and long-term treatment of 35 cases of malignant brain tumors has been done using this system. The overall response rate was 31.4%, but the rate for metastatic brain tumors, deep-seated gliomas and others were 50.0, 36.8 and 33.3%, respectively. Deep-seated gliomas were more effectively treated than superficial gliomas by combination with radiation therapy. The common pathological finding was a clearly demarcated coagulative necrosis of ellipsoid shape around the implant.

Expression of genes encoding type IV collagen-degrading metalloproteinases and tissue inhibitors of metalloproteinases in various human tumor cells

Uncontrolled expression of matrix metalloproteinases 2, 3 and 9 (MMP-2, -3 and -9) is believed to be a critical part of the invasive potential of tumor cells because of their ability to degrade type IV collagen, a major structural component of basement membranes. Availability of proteolytic activity in the vicinity of the cell surface is further affected by a local balance between the enzymes and their inhibitors produced by the cell. To determine how frequently deregulated expression of the MMPs and tissue inhibitors of metalloproteinases (TIMPs) is associated with tumor cells, 26 human tumor cell lines were examined by Northern blotting. Transcripts for MMP-2 and MMP-9 were more frequently expressed in mesenchymal tumor cells (9/9 for MMP-2 and 6/9 for MMP-9) than in epithelial tumor cells (4/17 for MMP-2 and 2/17 for MMP-9). Although expression of MMP-2 mRNA was clearly cell type-specific, MMP-9 mRNA expression in mesenchymal cells correlated well with the reported tumorigenicity of the cells. Enhanced expression of MMP-9 mRNA was also associated with the tumorigenic transformation of cells by an activated c-H-ras gene in human embryonic fibroblasts. Only 3 of the 26 tumor cells expressed MMP-3 mRNA, and 2 of the 3 were epithelial tumor cells which coordinately expressed MMP-9 and TIMP-1 mRNAs. TIMP-1 mRNA was almost undetectable in 50% of the tumor cells, but TIMP-2 mRNA was expressed in the majority of the cells. These findings provide comprehensive information about mRNA expression of the MMPs and TIMPs in tumor cells, the deregulation of which is thought to be an integral part of the invasive potential of tumor cells.

Argyrophilic nucleolar organizer regions in human adrenocortical neoplasms

Argyrophilic nucleolar organizer regions (AgNOR) in human adrenocortical neoplasms, including five carcinomas and ten adenomas, were studied using a semi-automatic image analyzer. Both the number and total area of AgNOR per nucleus in the carcinomas were found to be statistically greater than in adenomas and control tissues. However, there were no statistically significant differences in total AgNOR area per nuclear area or in the mean area of individual AgNOR dots. The AgNOR of neoplastic and normal cells were of four morphological types: type 1 had a few dots at the periphery of the nucleus, type 2 a few dots at the center, type 3 a large round dot along with several small ones at the center, and type 4 numerous diffusely distributed polymorphic dots. Most type 3 and 4 cells were found in carcinoma cases. Type 1 cells decreased in proportion to the severity of biological malignancy. It follows from these findings that careful observation of AgNOR should facilitate the distinction of malignant from benign adrenocortical neoplasms.

[Evaluation of the measurement of plasma fructosamine concentration in aged subjects]

Recently, plasma fructosamine concentration has been used as an indication of mean plasma glucose level preceding at last 1 to 2 weeks. In the present study, to characterize the clinical significance and problems of plasma fructosamine concentration in aged subjects (greater than or equal to 65 yrs), we determined plasma fructosamine concentration as well as serum albumin, total protein, HbA1, AbA1c and fasting plasma glucose concentrations in 81 (less than 65 yrs) non-diabetic subjects (group A), 161 aged (greater than or equal to 65 yrs) non-diabetic subjects and 26 aged diabetics (group D). Aged non-diabetic subjects were further classified into 75 subjects with good ADL (group B) and 86 with poor ADL (group C). The normal limit of plasma fructosamine concentration (mean +/- 2SD) in group A was 24% higher (3.1 mmol/l) than that in group B (2.5 mmol/l) but the plasma fructosamine/serum albumin ratio (F/ALB) was similar in these two groups. Plasma fructosamine correlated negatively (p less than 0.01) with age. This aging effect was explained by the reduced serum albumin in aged subjects. However, in group C, reduced plasma albumin was not associated with reduced plasma fructosamine. Plasma fructosamine corrected by albumin (F/ALB) is a useful parameter of blood glucose control in aged subjects. In aged subjects with poor ADL, HbA1, HbA1c and plasma glucose should be determined with fructosamine.

[Cerebral blood flow changes in a patient recovered from hypocarbia]

The changes of cerebral blood flow velocity (CBFV) and pulsatility index (PI) in anterior cerebral artery were examined by cranial color Doppler ultrasonography while a patient recovered from hypocarbia. As arterial PCO2 was elevated, PI was decreased and color imaging of CBF from basilar artery to anterior cerebral artery were improved in sagittal view. Hypocarbia is considered to induce the constriction of the cerebral vessels and the decrease of CBF in premature infants.

Interstitial hyperthermia of malignant brain tumors by implant heating system: clinical experience

An implant heating system using a ferromagnetic implant with low Curie temperature has been developed for treating human brain tumors. Safe and repeated hyperthermia was possible over periods averaging ten weeks in 23 out of 25 patients with malignant brain tumors without development of major side effects. Evaluation of the effects of this new treatment is still preliminary. Overall response rate was 34.8%. However, five of thirteen cases of malignant glioma and two of five cases of brain metastasis were responded well to interstitial hyperthermia given with or without irradiation. Pathological findings common to the treated tumors were circumscribed, ellipsoid shape of coagulation necrosis around the implant. Degeneration of tumor cells, hemorrhage, vascular stasis and thrombosis were found adjacent to the necrosis. In the future, a combination of interstitial hyperthermia with brachytherapy and chemotherapy may offer improved local control of brain tumor.

Origins and conducting pathways of motor evoked potentials elicited by transcranial (vertex-hard palate) stimulation in cats

Spinal cord evoked potentials were elicited in cats by transcranial electrical stimulation with electrodes on the vertex and hard palate. Vertex motor evoked potentials (V-MEP) were also recorded. An extracellular microelectrode recording technique was then used to analyze the results by isopotential mapping. The relationship between the distribution of field potentials and the stimulation polarity was studied using the field potential distribution of the V-MEP in the lower thoracic spinal cord that had been represented on the isopotential maps. The first negative wave of the V-MEP showed maximal amplitude distribution in the anterior funiculus, which corresponds to the extrapyramidal tracts. This pattern was seen with both stimulation polarity arrangements: 1) stimulation with the cathode at the vertex and the anode at the hard palate, and 2) stimulation with the anode at the vertex and the cathode at the hard palate. When the cathode was at the vertex, the stimulation threshold was lower, and the response had higher amplitude than when the anode was at the vertex. Recording V-MEPs elicited by vertex cathode stimulation could provide an excellent method of monitoring the extrapyramidal tracts in cats.

Defective insulin response of cyclic adenosine monophosphate-dependent protein kinase in insulin-resistant humans

Insulin-stimulated glycogen synthase activity in human muscle correlates with insulin-mediated glucose disposal and is reduced in insulin-resistant subjects. Inhibition of the cyclic AMP-dependent protein kinase (A-kinase) is considered as a possible mechanism of insulin action for glycogen synthase activation. In this study, we investigated the time course of insulin action on human muscle A-kinase activity during a 2-h insulin infusion in 13 insulin-sensitive (group S) and 7 insulin-resistant subjects (group R). Muscle biopsies were obtained from quadriceps femoris muscle at times 0, 10, 20, 40, and 120 min. Insulin infusion resulted in significant inhibition of A-kinase activity at 20 and/or 40 min using 0.2, 0.6, and 1.0 microM cyclic AMP in group S. A-kinase activities both before and after insulin administration were lower in group S than in group R using 0.6 microM cyclic AMP. The decrease in apparent affinity for cyclic AMP during insulin infusion was larger for group S compared with group R. Glycogen synthase activity increased significantly after insulin infusion in both groups and was higher in group S compared with group R. The data suggest that a defective response of A-kinase to insulin in insulin-resistant subjects could contribute to their reduced insulin stimulation of skeletal muscle glycogen synthase.

Vascular responsiveness to various vasoactive substances after exchange transfusion with pyridoxalated hemoglobin polyoxyethylene conjugate (PHP) solution in anesthetized rats

Vascular responsiveness to various vasoactive substances after exchange transfusion with a modified hemoglobin (pyridoxalated hemoglobin polyxyethylene conjugate; PHP) was examined in anesthetized rats. The hindlimb region of the rat was perfused through the abdominal aorta with autologous blood at a constant flow rate, using a perfusion pump. Perfusion pressure (PP), systemic blood pressure (SBP), and heart rate were measured. Exchange transfusion with a 6% PHP solution (20 ml/kg) was performed and effects of intra-arterial injections of norepinephrine (NE), angiotensin-II (A-II), serotonin (5-HT), acetylcholine (ACh), and nitroglycerin (NG) on PP and SBP were examined. The NE and A-II induced a dose-dependent increase in PP, while ACh and NG induced a decrease in PP. There was no difference in vascular responsiveness to ACh, NG, A-II, and 5-HT before and after exchange transfusion with PHP solution, but NE-induced responses were augmented after exchange transfusion with PHP. Results suggest that the presence of PHP moiety in circulation would not alter vascular responsiveness to ACh, NG, A-II, and 5-HT in a significant manner.

Arteriovenous malformation associated with moyamoya disease--case report

The authors report a case of moyamoya disease accompanied by arteriovenous malformation (AVM). Angiography demonstrated typical moyamoya vessels on the right and early changes of moyamoya disease on the left. A small AVM in the left frontal lobe supplied by a distal branch of the middle cerebral artery (MCA) was also revealed. The AVM was surgically resected simultaneously with contralateral encephaloaponeurotic synangiosis for the moyamoya vessels. One month after surgery, left MCA occlusion at the origin occurred probably due to hemodynamic changes after the resection of the AVM.

[Interstitial hyperthermia of malignant gliomas with implant heating system]

Twenty four cases of malignant gliomas, histologically 12 glioblastomas, 10 astrocytoma GIII and 2 astrocytoma GII, were treated by interstitial hyperthermia with Implant Heating System (IHS). IHS has three major parts, generator of high frequency (240KHz), magnetic coil and metal implant manufactured from FePt alloy. Theoretically the brain tumor can be heated by heat conduction through the heated implants. Several implants were placed inside the brain tumor directly by operation, or by CT stereotactic procedure. The patients were divided into two groups according to the tumor location as (A) in cortical or subcortical region (13 cases) and (B) in thalamus or basal ganglia (11 cases). Hyperthermia, 60 minutes each, 2 to 3 times per week, was safely repeated in all the cases. External irradiation was always combined with hyperthermia in most of the cases and with chemotherapy in some of them. Follow-up CTs demonstrate a remarkable response in many cases of B group. In fact ICR, 4PR and 3MR were achieved in this group, resulting in 45.5% of the response. In contrast gliomas in A group showed a less favorable response, resulting in 23.1% of the response (3 PRs in 13 cases). Although the overall response rate was not so high, it seems to be encouraging that gliomas in thalamus and basal ganglia, those which are usually unresectable, showed a good response. More favorable results can be expected by further improvement of the system and related techniques.

Myristoylated src-oncogene products are potently detected by the monoclonal antibody to the NH2-terminal myristoyl-Gly-Ser-Ser-Lys src-peptide

Monoclonal antibodies were raised against a synthetic NH2-terminal myristoyl tetrapeptide (N-myristoyl-Gly-Ser-Ser-Lys) which is characteristic of an NH2-terminal portion of pp60src, the transforming protein of src-oncogene. The antibody reacted with the albumin conjugated with both the N-myristoyl and N-lauroyl-tetrapeptides, but concentrations at which 50% of the immunoreaction was inhibited were 5 pmol for the N-myristoyl and 830 pmol for N-lauroyl tetrapeptidyl albumin. On the other hand, N-palmitoyl tetrapeptidyl and underivatized albumin, and Gly-Ser-Ser-Lys-Ser-Lys-Pro-Lys octapeptide had no effects. These results suggest a high affinity of the antibody for an N-myristoyl-Gly-Ser-Ser-Lys moiety. src-Oncogene products in Rous sarcoma virus-transformed cells and human colon carcinoma tumor cells were selectively identified as myristoylated pp60src by immunoprecipitation analyses with the antibody.

[Hyperthermia of metastatic brain tumor with implant heating system: a preliminary clinical results]

Metastatic brain tumors were treated by interstitial hyperthermia with an Implant Heating System, which consists of three major parts: ferromagnetic implant (thermoseed), generator of high frequency (240 KHz) and induction coil (30 cm in diameter). The implant is made of Fe-Pt alloy, 1.8 mm in diameter and 15 to 20 mm in length, whose Curie point is 68 - 69 degrees C. Seven cases of metastatic brain tumor, 5 from lung cancer, one from breast cancer and another from colon cancer, were involved in this study. One or several implants were placed inside the tumor by CT guided stereotaxis, or manually inserted at craniotomy. Interstitial hyperthermia at 44 - 46 degrees C was made by IHS for 30 to 60 minutes twice or three times a week. External irradiation was simultaneously combined with hyperthermia in 6 cases. Repeated, longterm hyperthermia (8 - 45 times) was possible in all cases except one, whose treatment was discontinued due to migration of the implant. No other serious side effect was found in any cases during and after the treatment. Repeated CT scans reveal complete response in 2, minor response in one and progression in 3 cases. Therefore this preliminary clinical study indicates that interstitial hyperthermia with IHS is very useful and promising method for treating intracranial metastases.

[Interstitial hyperthermia of malignant brain tumors using implant heating system (IHS)]

We have developed an implant heating system (IHS) for interstitial hyperthermia of brain tumors. IHS consists of three compartments: ferromagnetic implant with low Curie point, induction coil and generator to produce high frequency magnetic field. The device works as follows: It is heated up to a Curie temperature (Tc) by Eddy current under the magnetic field. Heat generated in the implant is conducted to the tumor tissue into which it has been implanted. To evaluate the effect of this hyperthermia, a brain tumor model was produced by innoculation of VX2 tumor cells and treated either by hyperthermia with IHS alone, chemotherapy with ACNU alone, or with a combination of both. The longest survival was obtained by the combined treatment, and significant prolongation of survival was found in the single treatment groups. In the Phase I clinical trial, one or several implants (1.8 mm X 15 mm, Tc = 68 degrees C) made of Fe-Pt alloy were placed in the tumor by CT guided stereotactic procedure, or manually during craniotomy. Hyperthermia of above 42 degrees C for 30 to 60 minutes twice a week was brought about in ten cases of malignant brain tumor. CT evaluation was made in nine cases treated for more than ten times in this way. Five out of the nine cases responded to this hyperthermia with irradiation. In conclusion, a safe, repeated and longterm treatment was possible without significant side effects. The hyperthermia with IHS may also be applicable to benign intracranial tumors and neoplasms in other part of body as well.

Insulin resistance is associated with reduced fasting and insulin-stimulated glycogen synthase phosphatase activity in human skeletal muscle

Insulin-stimulated glycogen synthase activity in human skeletal muscle correlates with insulin-mediated glucose disposal rate (M) and is reduced in insulin-resistant subjects. We have previously reported reduced insulin-stimulated glycogen synthase activity associated with reduced fasting glycogen synthase phosphatase activity in skeletal muscle of insulin-resistant Pima Indians. In this study we investigated the time course for insulin stimulation of glycogen synthase and synthase phosphatase during a 2-h high-dose insulin infusion (600 mU/min per m2) in six insulin-sensitive caucasians (group S) and in five insulin-resistant Pima Indians (group R). Percutaneous muscle biopsies were obtained from the quadriceps femoris muscle after insulin infusion for 0, 10, 20, 40, and 120 min. In group S, insulin-stimulated glycogen synthase activity increased with time and was significantly higher than in group R. In group S, synthase phosphatase activity increased significantly by 25% at 10 min and then decreased gradually. No significant change in synthase phosphatase was seen in group R and activity was lower than group S at 0 to 20 min. These data suggest that a low basal synthase phosphatase activity and a defect in its response to insulin explain, at least in part, reduced insulin stimulation of skeletal muscle glycogen synthase associated with insulin resistance.

Interstitial hyperthermia of brain tumors by stereotactically implanted heating system

Interstitial hyperthermia of brain tumors has been made by an implanted heating system using a metal implant with low Curie temperature, which was stereotactically implanted in a tumor. Induction heating of the implant was obtained by eddy current in a magnetic field. Safe, repeated and long-term treatment of 25 cases of brain tumor has been made with this system. Among 22 evaluable cases, 10 responded to hyperthermia alone or in combination with radiation therapy. There were 3 complete remissions, 5 partial remissions and 2 minor responses. The effectiveness of this treatment has also been evaluated by pathological examination.

A novel antibody against a synthetic NH2-terminal myristoyl glycyl src peptide can detect pp60v-src, the transforming protein of Rous sarcoma virus

Novel antibodies were raised against a synthetic NH2-terminal myristoyl(Myr-) tetrapeptide(N-Myr-Gly-Ser-Ser-Lys) which is characteristic of an NH2-terminal portion of pp60v-src, the transforming protein of Rous sarcoma virus. Antisera raised against N-Myr-Gly-Ser-Ser-Lys-haemocyanin reacted with 125I-albumin conjugates with N-Myr-Gly-Ser-Ser-Lys. The immunoreaction was competed for by haemocyanin as well as albumin conjugated with this N-Myr-peptide, while underivatized proteins or an NH2-terminal octapeptide (Gly-Ser-Ser-Lys-Ser-Lys-Pro-Lys) had no effect. N-Myr-Gly-Ser-Ser-Lys-(125I)tyramine was also recognized by the antibody. The reaction was competed for by N-Myr-Gly-Ser-Ser-Lys, but not by Gly-Ser-Ser-Lys-Ser-Lys-Pro-Lys. These results suggest a high affinity of the antibody for an N-Myr-peptide moiety. The major (3H)myristate-labelled protein of an apparent molecular weight of 60,000 was detected from chick embryo fibroblasts transformed by Rous sarcoma virus (tsNY68). This protein was demonstrated to possess N-Myr-Gly-Ser-Ser-Lys by the immunoprecipitation and HPLC analyses. Furthermore, the entire circumference of the transformed cells was stained by the antibody upon an immunofluorescent microscopic observation. Thus, these results taken together indicate that the haptenic antibody raised against the myristoyl peptide is useful to detect pp60v-src protein.

Plasma membrane-specific deficiency in cardiac beta-adrenergic receptor in streptozocin-diabetic rats

Cell surface [3H]CGP 12177 binding sites in 10-wk streptozocin-diabetic rats decreased by 41% (P less than 0.01) compared with that in the control rats. In contrast, there was no difference in the total cell receptor concentration between the control and the diabetic rats, which was measured by hydrophobic antagonist [125I]-iodocyanopindolol binding. Forty-eight-hour in vivo insulin treatment significantly (P less than 0.05) increased cell surface beta-adrenergic receptor concentration by 37% above that in diabetic rats without any change in total receptor concentration in the cells. However in vitro treatment of 8 nM insulin, 33 mM glucose, or 10 mM 3-hydroxybutyrate for 2 h showed no effect on [3H]CGP 12177 binding. In contrast, 10 microM isoproterenol-dependent decrease and the recovery of cell surface receptors after the removal of the agonist were significantly (P less than 0.01) impaired in diabetic rats compared with those of control rats. These results indicate that only cell surface beta-adrenergic receptors decrease in diabetic rats, which may be associated with abnormalities in the receptor distribution. The decrease in cell surface receptor number closely associates with the diabetic state and is reversed by the short-term insulin treatment.

Antibodies to an NH2-terminal myristoyl glycine moiety can detect NH2-terminal myristoylated proteins in the retrovirus-infected cells

Novel antibodies were raised against a synthetic NH2-terminal myristoyl glycine moiety which is characteristic of N-myristoyl-proteins. Antisera raised against N-myristoyl-Gly-hemocyanin reacted with N-myristoyl-Gly-[125I]albumin. The immunoreaction was competed for by albumin conjugated with N-myristoyl-glycine, while underivatized albumin had no effect. Of the [3H]myristate-labeled proteins detected, pp60v-src, which is a transforming protein of Rous sarcoma virus, and p19gag and p17gag, which are core proteins in the human T-cell leukemia virus and the human immunodeficiency virus, were identified as N-myristoylated proteins by the radioimmunoprecipitation analyses with the antibody.

Interstitial hyperthermia of experimental brain tumor using implant heating system

New experimental system of induction hyperthermia for brain tumor using ferromagnetic implant with low Curie point has been developed. The metal implant is cylindrical needle and made of Fe-Pt alloy with low Curie point suitable for hyperthermia (50-60 degrees C). Induction coil and generator which produce maximum power of 200W and variable frequency of 100-500kHz, yielding magnetic power of 16.7Oe, have been developed. Interstitial hyperthermia was made on rat brain tumor model (T9 gliosarcoma) by this system. Significant effects of single hyperthermia (45 degrees C for 30 minutes) were observed by the extension of life span and morphological changes of the tumor.

Contraction-mediated inactivation of glycogen synthase is accompanied by inactivation of glycogen synthase phosphatase in human skeletal muscle

Activities of glycogen synthase (GS) and GS phosphatase were determined on human muscle biopsies before and after isometric contraction at 2/3 maximal voluntary force. Total GS activity did not change during contraction (4.92 +/- 0.70 at rest versus 5.00 +/- 0.42 mmol/min per kg dry wt.; mean +/- S.E.M.), whereas both the active form of GS and the ratio of active form to total GS decreased by approximately 35% (P less than 0.01). GS phosphatase was inactivated in all subjects by an average of 39%, from 5.95 +/- 1.30 to 3.63 +/- 0.97 mmol/min per kg dry wt. (P less than 0.01). It is suggested that at least part of the contraction-induced inactivation of GS is due to an inactivation of GS phosphatase.

Combination chemotherapy with cisplatin and etoposide for malignant intracranial germ-cell tumors. An experimental and clinical study

Antitumor activity against intracranial malignant teratoma by combination chemotherapy with cisplatin and etoposide was evaluated in experimental and clinical studies. A human teratoma cell line (Tera 2) was exposed in vitro to cisplatin and/or etoposide, after which cell growth inhibition and alterations of deoxyribonucleic acid (DNA) histograms were observed. The results indicated that a synergistic cytotoxic effect was achieved by use of both agents in combination. Four cases of recurrent intracranial germ-cell tumor (three malignant teratomas and one germinoma) were treated with cisplatin and etoposide. With this combination therapy, regression of the tumor was observed in all four cases (three complete and one partial), for a total response rate of 100%. During a follow-up period of 9 to 22 months, no recurrence or progression has been noted in three of these cases.

Bilateral germ cell tumors involving the basal ganglia and thalamus

Two cases of a human chorionic gonadotropin-producing germ cell tumor originating bilaterally in the basal ganglia and thalamus are reported. The biological behavior and clinical characteristics were similar to those of unilateral germinomas involving the basal ganglia and thalamus. Common clinical features were slowly progressive unilateral pyramidal signs and bilateral and/or unilateral extrapyramidal signs which occurred either concomitantly or sequentially. Bilateral symmetrical lesions were demonstrated by computed tomography and/or magnetic resonance imaging at an early stage of illness. Serum and cerebrospinal fluid human chorionic gonadotropin levels were elevated (116 and 141 mIU/ml, respectively) but decreased and remained within normal limits after radiation therapy alone. Radiosensitivity was confirmed by repeated computed tomographic scans and tumor marker measurements. Multiple concomitant germ cell tumors is a rare, but interesting lesion, especially considering its pathogenesis and oncogenesis.

[Brain abscess following cerebral infarction: a case report]

The authors report a case of brain abscess following cerebral infarction. A 73-year-old man was admitted to our clinic with symptoms of right hemiparesis and total aphasia. CT scan revealed abnormal low density area in the left fronto-temporo-parietal region. Cerebral angiography demonstrated occlusion of the left middle cerebral artery at the M1 portion. On the 16th hospital day, an episode of generalized seizure with high fever appeared, and intermittent high fever persisted thereafter. Two months after admission, CT scan revealed several cystic lesions with marked ring enhancement at the site of cerebral infarction, suggesting multiple abscesses. Aspirations of left frontal and parietal abscesses were accomplished and the cultures of the pus disclosed Proteus vulgaris. Due to progressive hydrocephalus, a ventriculoperitoneal shunt was constructed one month later. Repeated CT scans showed a gradual diminution of the abscesses. It is considered that the blood-brain barrier is broken and the local immunological system against bacteria may be weakened when the brain is damaged by ischemia. Brain abscess seems to be developed in such circumstances even under the influence of transient bacteremia which originates in other parts of the body. Therefore the possibility of cerebral abscess should be suspected if patients with cerebral infarction suffer from the symptoms such as fever, neck stiffness or disturbance of consciousness.

Deficiency of cardiac beta-adrenergic receptor in streptozocin-induced diabetic rats

The number of beta-adrenergic receptors in cardiac myocytes isolated from rats made diabetic with streptozocin (STZ) for 10 wk was measured by use of a hydrophilic nonselective antagonist [3H]CGP 12177 and was found to decrease to 59% of the number in control rats (P less than .05), without any change in affinity. Similarly, using [125I]iodocyanopindolol as a ligand, we found a decrease in the beta-adrenergic-receptor number on cardiac plasma membrane isolated from the diabetic rats [29% decrease (P less than .05) at 1 wk, 50% (P less than .01) at 3 wk, and 49% (P less than .01) at 10 wk compared with control rats]. However, the serum triiodothyronine level that had been known to modulate the beta-adrenergic-receptor-adenylate cyclase system was decreased in the 1-wk-diabetic rats but not in the 10-wk-diabetic rats compared with each control group. Furthermore, there was no difference in urinary catecholamine excretion between diabetic and control groups. In the 10-wk-diabetic rats, the response of adenylate cyclase to isoproterenol was significantly defective (56% decrease compared with control rats; P less than .05), although both the basal and the forskolin-stimulated maximum adenylate cyclase activities and a half-maximum concentration of isoproterenol for the stimulation of adenylate cyclase were similar in control and diabetic rats. On the other hand, both cholera toxin-dependent and islet-activating protein-dependent [32P]NAD incorporations into cardiac plasma membrane were markedly increased in the diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS)

[Combined chemotherapy with cisplatin and aclarubicin hydrochloride for metastatic brain tumors]

Thirteen patients with metastatic brain tumors were treated by combined chemotherapy with cisplatin and aclarubicin hydrochloride. Initial response to this therapy was evaluated by the changes of tumor size on CT scan and clinical state during and after the treatment. The side effects and the causes of death were also studied. Nine cases demonstrated complete remission and 3 cases revealed partial response on CT scan. In short, over all response rate was 92%. Clinical state evaluated by Karnofsky scale was improved in 9 out of 13 cases. As the side effects, there were mild myelosuppression, nausea and vomiting, which didn't persist for a long time. The cause of death was mainly due to recurrence of primary lesion. The tissue concentration of aclarubicin hydrochloride was measured in 6 patients, of which mean value was 0.558 microgram/g at 15 min. The concentration was thought high enough to kill tumor cells.

[The effect of combined chemotherapy with UFT, cis-platinum and aclarubicin in metastatic brain tumors]

Thirteen patients with metastatic brain tumors were treated with two different chemotherapy regimens. Six patients were treated with three antitumor drugs, UFT, CDDP and ACR (Group A) and the other seven patients were treated with two antitumor drugs, CDDP and ACR (Group B). Initial response to each therapy was compared with the changes in tumor size on CT scan and clinical state before and after treatment. Five cases in Group A demonstrated complete remission and one case revealed partial response on CT scan. The residual tumor on CT scan at one month in one case of partial response also completely disappeared after three months. It was thought that there might have been an effect of UFT in this case. Four cases in Group B showed complete remission and three cases revealed partial response on CT scan. However, the CT findings in the three cases of partial response were unchanged on follow-up CT scan. Clinical state evaluated by Karnofsky scale did not deteriorate in Group A, while three cases showed a deteriorated Karnofsky scale in Group B. As side effects, there were mild myelosuppression, nausea and vomiting in both Groups, which did not persist for a long time. The cause of death in both Groups was mainly recurrence of the primary lesion or metastasis to other organs. It was thought that the effect in Group A was better than that in Group B as a result of these findings. The tissue concentration of ACR was measured in six patients, and the mean value was 0.558 micrograms/g at 15 min. This concentration was thought high enough to kill tumor cells.

[The effect of hyperthermia and antitumor drugs on brain tumor cell lines]

The effects of heat and antitumor drugs on malignant brain tumor cell lines were studied. A human glioblastoma cell line (SKMG1) and rat malignant brain tumor cell lines (T9, EB 679 and TR 481) were used in this experiment. Five different modalities of treatment with heat and drugs were used as follows: (Group 1) exposure to heat alone at 42 degrees C for one hour; (Group 2) exposure to antitumor drug alone for one hour (ACNU 2.5 or 5 micrograms/ml, ACR 0.02 micrograms/ml and CDDP 1 microgram/ml); (Group 3) simultaneous exposure to heat at 42 degrees C and drug for one hour; (Group 4) heat at 42 degrees C given first for one hour, followed by one hour exposure to drug one hour later ("preheating"); (Group 5) drug given first for one hour, followed by one hour exposure to heat at 42 degrees C one hour later ("postheating"). After each treatment, the inhibition rate at 4 days was evaluated and compared for each group. A synergistic effect was observed in Group 3. For example, when T9 cells were exposed to ACNU and to heat at 42 degrees C at the same time for one hour, inhibition rate was 78%, while the rates for Group 1 and Group 2 were 7% and 21%, respectively. The cytotoxicity of simultaneous treatment with antitumor drugs (ACNU, ACR and CDDP) and hyperthermia at 42 degrees C was apparently superior to that of other treatment modalities.

Chemotherapy with cisplatin for AFP-secreting germ-cell tumors of the central nervous system

Therapeutic results in 17 cases of alpha-fetoprotein (AFP)-secreting tumors of the central nervous system are reported. Twelve of the patients were male and five female. The patients' ages ranged from 5 years to 25 years (mean 13.6 years). The tumors originated in the pineal region in 10 cases, in the suprasellar region in four cases, and in both regions in one case; of the other two tumors, one originated in the basal ganglia and one in the sacrococcygeal region. Extraneural metastases or subarachnoid dissemination occurred in seven cases. Increased AFP titer in the serum or cerebrospinal fluid was verified in 13 cases. The patients were divided into two groups: those treated before (Group A) and those treated after (Group B) the introduction in 1980 of cisplatin as a chemotherapeutic agent. All seven Group A patients died, even after extensive therapy consisting of surgery, radiotherapy, and chemotherapy (ACNU or adriamycin) in some of the cases. The mean survival time following diagnosis for Group A was 23.7 months. Six of the 10 Group B patients died an average of 25.8 months after diagnosis; however, the other four were still alive and well an average of 25.3 months after diagnosis. The tumors responded well to chemotherapy consisting of cisplatin either alone or combined with bleomycin and vinblastine. The initial response rate to treatment in Group B was 100% and five cases had a complete remission, verified by computerized tomography or the serum AFP level. Once the tumor recurred, the response to cisplatin was markedly decreased. It is suggested that an effective therapy must still be sought for recurrent tumors.