Hemorrhagic complications after the lumbar injection of chymopapain

There are few reports of hemorrhagic central nervous system complications after chymopapain injection in humans. Two patients are reported who developed hemorrhagic complications after the lumbar injection of chymopapain. The first developed a hemorrhagic encephalomyelopathy followed by clinically suspected acute arachnoiditis, which responded to high doses of dexamethasone. The second patient developed subarachnoid hemorrhage secondary to vertebral artery aneurysm rupture after the injection of chymopapain.

Cancer of nasopharynx in young patients

From 1961 to 1980 17 patients with nasopharyngeal carcinoma who were less than 30 years old at time of diagnosis were treated at the two oncologic hospitals in Puerto Rico. Fourteen of the tumors were lymphoepitheliomas and the remaining three were anaplastic carcinomas. Ninety-four percent of the patients were found to have neck adenopathy at the initial examination and in 65% of them the adenopathy was bilateral. The 5-year actuarial survival was 14. The main cause of failure was the distant metastasis. Seventy-one percent of our patients developed distant metastasis sometime during the course of their disease. Carcinoma of the nasopharynx is uncommon in Puerto Rico as in other western countries. The post-adolescent age incidence peak reported from different countries is also present among Puerto Ricans.

[Stability and distribution of oxytetracycline HCI during manufacture and storage of pig feed under field conditions]

The distribution of oxytetracycline hydrochloride in two batches of 4,000 kg of pig-rearing pellets (400 ppm) was studied. The stability of oxytetracycline in this feed was also determined. The concentration of oxytetracycline in the feed was determined by high pressure liquid chromatography. The premix contained more oxytetracycline (27 per cent) than the proportion stated. The results show that the first 1,000 kg of feed contained less (350 mg/kg) oxytetracycline than the other 7,000 kg (435 mg/kg). After producing 8,000 kg of feed with oxytetracycline, 4,000 kg of feed not containing oxytetracycline was produced. Still, this feed was found to contain 13 mg/kg of oxytetracycline. When the feed was stored for 150 days at a temperature of from 1 to 2 degrees C and again for 270 days at 20 to 25 degrees C, it contained 86.5 per cent of the oxytetracycline present after production of the feed.

A routine method for contrasting elastin at the ultrastructural level

A reliable, simple, and inexpensive method for ultrastructural investigation of elastin is described. This method uses uranyl acetate dissolved in absolute methanol, followed by an optional lead citrate counterstain. The procedure was tested on a number of animal and human tissues that had been fixed and processed differently.

Compensation of cyclophosphamide immunosuppression by a bacterial immunostimulant (Broncho-Vaxom) in mice

The compensatory effect of a bacterial lysate, Broncho-Vaxom (BV) on the immunosuppressive action of cyclophosphamide (CY) was investigated. In CY immunosuppressed mice, BV treated animals recovered to normal levels of IgM and IgG in serum as well of IgA and IgG in gut secretions significantly earlier than controls. Furthermore, normal cell proliferation in thymus, as estimated by measuring the relative size of this organ was achieved earlier in BV treated mice than in control mice. Oral treatment with BV restores the number of IgM anti SRBC producing cells in spleen, in CY immunosuppressed mice. Since immunosuppression induced by CY increases the susceptibility to various infections, we tested in immunosuppressed animals the protective effect of BV towards IP challenge infections with Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae var ozaenae, Pseudomonas aeruginosa and Candida albicans. BV led to an enhanced resistance towards both pneumococci and staphylococci challenge infections but not to the other challenge microorganisms.

Bacterial immunostimulant (Broncho-Vaxom) versus levamisole on the humoral immune response in mice

A comparative study on the enhancement of humoral immune response in mice after oral treatment with levamisole or a lyophilized bacterial lysate (Broncho-Vaxom) is presented. The latter proves to be more effective at therapeutic doses than levamisole on the induction of immunoglobulin formation and particularly that of IgA in secretions.

Viral pollution of seawater at Barcelona

A virological study of sea water was carried out at Barcelona (Spain) in June and September 1979. Three beaches were sampled in June; the September samples were taken in front of an outlet at 2, 5, 20 and 1,000 m offshore. All of the samples from the 3 beaches contained viruses, at rates varying from 0.12 to 1.72 MPNCU/l. Vaccinal poliovirus type 3 and coxsackie B5 predominated. For the offshore samples, 55% were positive with rates ranging from 0.15 to 0.36 MPNCU/l. Vaccinal poliovirus type 3 was clearly predominant. There was no significant difference in viral pollution rates between 2m and 1,000 m offshore.

Juvenile nasopharyngeal angiofibroma

Seven cases of juvenile nasopharyngeal angiofibroma were seen in the Division of Radiation Oncology of the Department of Human Oncology, University of Wisconsin Hospitals from 1961 to 1977. The method of treatments and the end results are discussed. The clinical manifestations and the biological nature of this tumor are analyzed in detail, along with treatment recommendations.

Regulation of gene expression in primary cultures of adult rat hepatocytes on collagen gels

The studies described in this paper demonstrate rather conclusively the efficacy of the study of the regulation of gene expression in primary cultures of adult rat hepatocytes. The utilization of these cells in completely defined medium allows one to determine the exact environmental conditions for the regulation of the expression of specific genes. In the studies described in this work, we have demonstrated that the regulation of glucokinase involved three hormones, insulin, corticosteroids, and T3. In contrast, the regulation of an enzyme involved primarily in fatty acid metabolism, ATP-citrate lyase, required only insulin and T3 for its full expression. Cyclic GMP appeared to be involved in the regulation of glucokinase, but not ATP-citrate lyase, a fact that would be extremely difficult to demonstrate clearly in vivo. The regulation of the gluconeogenic enzyme, ornithine aminotransferase, in vitro involved only a single hormone, glucagon, the inhibition of induction by corticoid steroids demonstrable in vivo being absent in cell culture. However, the repressive effect of glucose on the induction of this enzyme was quite comparable to that seen in vivo and was not mediated through cyclic AMP or insulin, based on findings in cell culture. Thus, the requirements for and the mechanisms involved in enzyme induction and repression by hormones and glucose may be much more easily studied in primary cultures of rat hepatocytes than in vivo, or even in hepatoma cell lines, where relatively few genes are expressed as compared with adult liver. In addition to the regulation of enzyme levels, the characteristics of protein secretion may be investigated in primary cultures of rat hepatocytes and compared with the biochemical and physiological parameters in the whole organism. This was exemplified by the study of the synthesis and secretion of alpha 2u-globulin that was secreted into the culture medium in both glycosylated and nonglycosylated forms but was maintained in the circulation in vivo, principally as the glycosylated form. Furthermore, the function of glycosylation in this particular instance may be deduced from a combination of the in vivo and in vitro approaches. The advantages of the use of primary hepatocyte cultures for the study of the regulation of gene expression in mammalian tissue has only recently been explored. Future investigations of the regulation of a variety of enzymes in these cultures as well as a study of the regulation of the synthesis of their messenger RNA are now possible and should provide an exciting system in which to understand at a molecular level the regulation of the expression of a number of genes.

Lymph node metastases in adenoid cystic carcinoma of the submaxillary gland

The incidence of neck metastases in adenoid cystic carcinoma of the head and neck is considered low and reported incidence range from 0 to 18%. If tumors of the submaxillary gland are considered separately, the incidence of neck metastases reported ranges from 0 to 100%, with a pooled incidence of 34%, significantly higher (P less than 0.001) than that reported for the parotid gland, which ranges from 0 to 21% with a pooled incidence of 10%. It may be suggested that the high incidence of neck metastases in adenoid cystic carcinoma of the submaxillary gland is due, in some cases, to direct extention of the tumor from the gland to the adjacent nodes or from infiltrated surrounding soft tissues rather than by a classic embolic metastasis. In our series of 10 cases, 4 cases showed lymph node metastases. In 3 of these, slides of the radical neck dissection were available for review and showed direct extension of the tumor from surrounding involved soft tissues, although the possibility of embolic metastasis could not be excluded. In the 3 patients with neck metastases at the time of initial diagnosis, distant metastases also developed early in the course of the disease.

Adenocarcinoma of the esophagus

The relevant literature is reviewed in an attempt to clarify the true frequency of intraesophageal adenocarcinoma and to evaluate the different treatment modalities and survival of this uncommon type of tumor. The incidence of intraesophageal adenocarcinoma in reported clinical series is about 1%, and data from cancer registries show the incidence to be about 2% for upper and the middle thirds, a more reliable figure than that for the lower third in which lesions of cardia, or stomach infiltrating the lower esophagus have been included. The benefits of any particular treatment modality are difficult to evaluate in view of the rarity of this type of tumor, and the treatment results are as poor as those obtained in the treatment of squamous cell carcinoma.

Autopsy findings in carcinoma of the esophagus

At autopsy of 82 cases of carcinoma of the esophagus over a period of 25 years metastatic tumor was found in 42 cases (51%) and residual tumor in the esophagus in 56 cases (86%). The most frequent site of metastases was in the lymph nodes, followed by liver, lung, and adrenal gland. Direct extension of the tumor to adjacent structures was established in 30 cases (36%), and the most frequent structure involved was the trachea. Five cases had a second primary and two cases a second separate lesion at another level of the esophagus.

Sequential hemi-body radiotherapy in advanced multiple myeloma

Eleven patients with advanced multiple myeloma refractory to standard chemotherapy were treated with a regimen of sequential hemi-body radiotherapy consisting of 800 rad midplane in a single dose to each half. 9/10 patients experienced significant relief of skeletal pain and there were 5/11 objective tumor responses with one complete remission. Treatment-related morbidity was significant and consisted primarily of nausea and emesis, bone marrow suppression, and pneumonitis. This therapy is helpful in the management of advanced myeloma, and should be studied earlier in the course of the disease.

Metastasis to neck from unknown primary tumor

The records of 54 consecutive patients who were irradiated for metastatic disease in the neck from an unknown primary tumor were reviewed. The overall survival results are comparable to those of other reported series. Patients with high or posterior cervical lymph node involvement were irradiated with fields including the nasopharynx and oropharynx. Patients with high neck nodes had a better survival rate than those with low neck nodes. The size of the neck tumors and the local control after treatment also have prognostic significance.

Failures after irradiation in early vocal cord cancer

Radiation therapy for early laryngeal cancer offers an excellent probability of cure as well as preservation of vocal function. Reported failure rates range from 9 to 21% in patients with T1 lesions, and from 28 to 44% in those with T2 lesions, the majority of whom are subsequently salvaged by surgery. Results obtained at the Radiotherapy Center of the University of Wisconsin Hospitals in 44 patients during the period from 1960 to 1972 yielded failure rates of 21% in patients with T1 tumors and 38% in patients with T2 tumors at 5 years. Five of the eight recurrences were salvaged with surgery yielding an overall tumor control rate of 93%. The larynx was preserved in 82% of the cases. Determinate 5-year survival was 91% in T1 cases and 86% in T2 cases. Failure rates at 3 years were 18% for T1 tumors and 30% for T2 lesions. These results are in conflict with those reported by Brandenburg and Rutter as being 46% and 60% respectively. Ultimate success in the treatment of laryngeal cancer rests in the full cooperation between surgeons and radiotherapists.

The genetic basis of susceptibility to leukemia induction in mice by 3-methylcholanthrene applied percutaneously

Susceptibility to leukemia induction in mice by skin painting with 3-methylcholanthrene (MCA) is strain-specific, occurring only in strains relatively resistant to MCA-induced skin tumors. The Ah locus, which has a dominant allele (Ahb) for inducibility of the aryl hydrocarbon hydroxylase (AHH) enzyme system and a recessive allele (Ahd) for noninducibility, appears to be the major determinant of this trait. MCA-painted mice of strains and crosses carrying the Ahb allele usually show a high incidence of skin tumors (papillomas which may evolve into malignant tumors) and little or no leukemia, whereas in mice homozygous for the Ahd allele the treatment usually induces a high incidence of leukemia and few or no skin tumors. Among mice of a segregating backcross generation including both Ahb/Ahd heterozygotes and Ahd homozygotes, the occurrence of skin tumors was correlated directly with AHH inducibility and inversely with the leukemic response. Mice of Ahb strains with a high level of endogenous murine leukemia (MuLV) expression (C58, PL) show a much weaker skin tumor response than expected but no increase in leukemia incidence, and this observation tends to confirm the previous finding that MuLV infection of mice of low-MuLV strains results in reduced susceptibility to MCA tumorigenesis.

Carcinoma of the pinna

Ninety-seven consecutive cases of carcinoma of the pinna are reviewed in this report. Fifty-six of the tumors were basal cell and thirty-nine squamous cell carcinoma. Fifty patients were surgically treated and forty-five irradiated. Small and/or peripheral lesions were excised and the large and/or centrally located lesions referred for irradiation. Analysis of the results shows no difference in tumor control rate, and the complication rate was also comparable with both modalities. Although chondritis was seen in three cases after irradiation, it also occurred in one case after excision. Our results indicate that neither modality should be used with total exclusion of the other. Initial resection would seem preferable in small lesions where primary closure is possible and in extensive lesions where a good cosmetic result is precluded by the destruction of normal tissue. Radiotherapy seems of value in those lesions in which resection would result in objectionable cosmetic defect.

Anaplastic seminoma

Eight patients with the diagnosis of anaplastic seminoma of the testicle were treated during the megavoltage era from January 1959 to January 1976. Two patients with Stage I disease and one patient with Stage IV disease have died from their malignancy. By contrast, 57 patients with typical seminoma were treated during the same interval and with the same treatment methods. However, only two patients with typical seminoma have died. One of these patients had Stage II disease and one had Stage IV disease. There were no deaths among patients with Stage I typical seminoma. These results suggest that anaplastic seminoma has a poorer prognosis than typical seminoma even when the diseases are compared stage for stage. Implications for therapy are discussed.

Staging laparotomy and survival in carcinoma of the uterine cervix

Pretreatment staging laparotomy in carcinoma of the uterine cervix has been advocated because surgical staging may detect disease not apparent clinically. An analysis of survival and local control data from previously reported large series of patients with carcinoma of the uterine cervix shows that surgical staging does not increase survival rates. It is likely that surgical staging may also increase morbidity from therapy.

Complications after radiation therapy for cervical carcinoma

A series of 1 139 patients with invasive carcinoma of the cervix uteri who received a complete course of treatment by means of external irradiation followed by intracavitary curietherapy was evaluated in order to assess the results of treatment and, in particular, the radiation complications induced. Complications developed in 145 instances (12.7%). Severe complications occurred in only 3 per cent. Twenty-four cases had more than one complication. Rectosigmoidal injuries accounted for 72 per cent of all complications, and appeared earlier than did bladder complications and within the first two years after treatment. No apparent correlation between age and the occurrence of complications was found. The rate was higher in early stages. The radiation complications did not adversely affect the survival results.

Cancer of the nasal cavity

The experience with 40 consecutive cases of cancer of the nasal cavity seen over a period of 15 years is presented. Males outnumbered females in a ratio or 5 to 3. Age ranged from 35 to 88 years, and the median age was 67 years. Epidermoid carcinoma accounted for 78% of the cases. Smoking from early age was a noticeable habit among these patients. The median length of smoking history was 51 years. Most lesions were diagnosed in an advanced stage of the disease, 58% of the cases being T3 lesions. Regional lymph nodes metastases were infrequent; only 12% of the patients presented nodes on admission; another 5% developed metastatic nodes during the follow-up period. An overall 5-year survival of 56% was obtained. The survival of cases with T1N0 lesions was 91%. Radiation therapy was the treatment of choice employed in 85% of the cases. A 5-year survival of 50% was obtained in these patients. Irradiation offers an additional means of salvaging recurrences after surgery. The special characteristics of tumors of the nasal cavity merit the evaluation of such lesions separately from tumors of the paranasal sinuses.

The preparation of C-1 and C-2 methylated acenaphthenes

The syntheses of 1-methyl-, 1,1-dimethyl-, cis(?)-1,2-dimethyl-, 1,1,2-trimethyl-, and 1,1,2,2-tetramethylacenaphthene have been accomplished by standard reactions from the two compounds 1-acenaphthenone and 2-methyl-1-acenaphthenone. These two ketones were in turn obtained from 1-naphthaleneacetic acid.