[Postoperative hypophosphatemia in patients with cancer of the thoracic esophagus]

Postoperative phosphate dynamics were studied in 30 patients who underwent radical surgery for thoracic esophageal cancer and who were postoperatively nourished by total parenteral nutrition. There was a significant fall in the serum phosphate level on the 2nd and 3rd postoperative days in all patients. Postoperative hypophosphatemia was due to an increase in urinary phosphate excretion which was indicated by the fall in TRP% and TmPO4/GFR. A highly significant positive correlation was observed between the increase in urinary phosphate loss and the enhanced secretion of parathyroid hormone which was possibly triggered by surgical stress, a decrease in the serum level of calcium, the action of phosphate buffer or diuretics. All the patients except for those with postoperative pulmonary complications responded to the drop in serum phosphate by renal conservation of phosphate. A slight decrease in the serum level of phosphate was also found on the 6th postoperative day in most patients who were receiving parenteral hyperalimentation. The second fall in phosphate was due to transcellular shifts of phosphate. It is concluded that patients with postoperative pulmonary complications develop severe hypophosphatemia which should be prevented by replacement therapy with phosphate in the immediate postoperative period.

Correlation between tumor proliferation and tumor tissue level of urokinase-type plasminogen activator

We established a xenotransplanted human colon cancer strain, TK-3, which produces urokinase-type plasminogen activator (U-PA) and carcinoembryonic antigen (CEA) simultaneously. Immunohistochemical staining of U-PA revealed that U-PA was located in the cytoplasm of cancer cells. Using TK-3, we investigated whether the tissue level of U-PA changed when the tumor proliferated locally. The mice were divided into three groups: mice of group A, B and C were sacrificed at 4, 5 and 6 weeks after tumor inoculation, respectively. The tissue level of U-PA was 0.78 +/- 0.183 ng/mg protein in group A, 0.95 +/- 0.189 in group B and 1.13 +/- 0.311 in group C. The values of groups B and C increased significantly compared with those of group A, and the tumor weight in each group showed a similar increase. The level of plasminogen activator inhibitor type 2 also increased (0.14 +/- 0.078 ng/mg protein in group A, 0.17 +/- 0.096 in group B, 0.24 +/- 0.172 in group C). On the other hand, the tissue level of CEA did not change significantly (78 micrograms/g tissue in group A, 88 in group B, 76 tissue in group C), and no correlation was observed between the tissue levels of U-PA and CEA. These results suggest that U-PA plays an important role not only in metastasis, but also in local tumor proliferation, and that its biological action in the autocrine system is independent of CEA.

The coexistence of abdominal aortic aneurysm and early gastric cancer: report of three cases

The surgical approach for patients with abdominal aortic aneurysm (AAA) and coexistent abdominal malignancy remains controversial. We report herein three cases of coincident AAA and early gastric cancer, all of whom were treated by a two-stage operation and underwent curative surgery for their gastric cancer. The principles of our surgical approach are as follows: (1) the lesion which requires urgent surgery should be operated on first, and if both lesions show absolute indications, a one-stage surgical procedure should then be performed; (2) a two-stage surgical procedure in which aneurysmectomy is performed first should be undertaken when no absolute indications for urgent surgery exist for either lesion; (3) a one-stage surgical procedure should only be performed when surgery on one lesion makes the other lesion highly dangerous; and (4) in patients with a poor prognosis because of far advanced cancer in whom the AAA shows no sign of rupturing, only a gastrectomy should be performed.

Effects of phenothiazine on contractions induced by prostaglandin F2 alpha and 5-hydroxytryptamine in normal and spastic canine cerebral artery

We have investigated the effect of phenothiazine, a compound known to inhibit calmodulin, on the responses of normal and spastic cerebral arteries, using the canine "two hemorrhage" model of cerebrovascular spasm. Ring preparations from control vessels or vessels removed three or seven days after injection of blood, were contracted with either 5-hydroxytryptamine (5-HT) or prostaglandin F2 alpha (PGF2 alpha) and then exposed to increasing concentrations of phenothiazine. In normal arteries, low concentrations of phenothiazine enhanced the response to PGF2 alpha, while higher concentrations caused relaxation. Responses to 5-HT were inhibited by all concentrations of phenothiazine tested. When normal arteries were compared with arteries from animals injected with blood, in the case of 5-HT, phenothiazine was a less effective antagonist at low doses, but equieffective at higher doses. Similar experiments conducted with PGF2 alpha showed that phenothiazine was a more effective antagonist in spastic vessels. We conclude that 5-HT and PGF2 alpha have significant differences in the mechanism by which they produce contraction of cerebral vessels, that phenothiazine has secondary effects on contraction independent of inhibition of calmodulin, and, finally that the effects of phenothiazine in clinical vasospasm may be insufficient to reverse the condition, despite the observation that vessels in spasm may be more sensitive to this agent.

The complete amino acid sequence of yam (Dioscorea japonica) chitinase. A newly identified acidic class I chitinase

The complete amino acid sequence of acidic chitinase from yam (Dioscorea japonica) aerial tubers was determined. The protein is composed of a single polypeptide chain of 250 amino acid residues and has a calculated molecular mass of 27,890 Da. There is an NH2-terminal domain, a hinge region, and a main structure, typical for class I chitinases (Shinshi, H., Neuhaus, J.-M., Ryals, J., and Meins, F., Jr. (1990) Plant Mol. Biol. 14, 357-368). We have obtained the first evidence for an acidic class I chitinase. Comparison with sequences of other class I chitinases revealed approximately 40% sequence similarity, a value lower than that for other class I chitinases (70-80%). We assume that there is a local conformational change in the molecule; cysteine residues that probably form disulfide bonds are completely conserved, with the exception of Cys-178. The difference in structure between this chitinase and other basic class I chitinases suggests that acidic and basic isoforms should be grouped into subclasses; this protein is an ethylene- or a pathogen-independent chitinase produced by a gene that is inherent in the tuber.

Effect of liposomal interleukin-2 on ascites-forming rat hepatoma

Interleukin-2 was entrapped in liposomes (Lip-IL-2) and injected into rats. The intraperitoneal injection of Lip-IL-2 into rats bearing an ascites-forming rat hepatoma (AH-66) significantly increased the survival time when compared with rats administered free IL-2 or saline-containing liposomes. The number of peritoneal exudate cells (PEC) increased markedly after intraperitoneal injection of Lip-IL-2 and consisted mainly of macrophages. The level of tumor necrosis factor alpha (TNF-alpha) and the intensity of free radicals increased in the ascites at 48 hrs after Lip-IL-2 administration, whereas TNF-alpha was not detected and the intensity of free radicals did not increase after free IL-2 administration. Our findings suggested that entrapment of IL-2 into liposomes enhanced its potential for cancer therapy, presumably by activating macrophages to produce TNF-alpha and free radicals.

[The comparison of postoperative multiple organ failure with arterial disease to that with gastrointestinal cancer]

The clinical features of 22 postoperative multiple organ failure (MOF) patients, comprised of 8 with arterial disease (A-MOF) and 14 with gastrointestinal cancer (G-MOF), were investigated. Differences in the operative time, blood loss, and mortality were not significant. The initial organ impaired was the lungs in 78.6% of G-MOF patients and the heart or kidneys in all A-MOF patients. Infection developed in over 80% of both groups. In many A-MOF patients, the pneumonia or septicemia developed secondary to organ failure, while intraabdominal infection triggered respiratory failure in many G-MOF patients. Our organisms in infected specimens and their antibiotic sensitivities was valuable for the early administration of effective antibiotics. Upper gastrointestinal tract bleeding was important in the prognosis of both groups and occurred more frequently in A-MOF than in G-MOF patients. Consumption coagulopathy in A-MOF patients and DIC induced by infection in G-MOF patients mainly caused such bleeding. Preoperative administration of heparin was effective in improving coagulopathy. Furthermore, measurement of intramural pH with tonometer in the stomach and gastric irrigation with oxygenated perfluorochemicals were effective in the prediction and prevention of gastrointestinal bleeding.

Breakdown of hepatic tight junctions during reoxygenation injury

We investigated whether reoxygenation following anoxia increased biliary permeability and whether or not allopurinol had a protective effect. Isolated rat livers were perfused for 30 min in a one-pass system with buffer equilibrated with 100% nitrogen after stabilization, and then for 60 min with the oxygenated buffer. Hepatic tight junction permeability was assessed by quantifying the early appearance in the bile of horseradish peroxidase (HRP) injected with the perfusate. This early peak represents paracellular passage of HRP, whereas a later second peak results from transcellular passage. In the control livers, 7% of the total HRP passage (93 +/- 50 pg/g liver) was paracellular and 93% was transcellular. After 30 min of reoxygenation following anoxia, however, 516 +/- 20 pg/g liver of HRP passed paracellularly. Addition of allopurinol (5 micrograms/ml) to the perfusate from the start of perfusion reduced paracellular passage of HRP to 219 +/- 49 pg/g liver after anoxia and reperfusion (P less than 0.01). Allopurinol also reduced the cumulative lactate dehydrogenase (LDH) release during the first 30 min of reoxygenation from 2.1 +/- 0.3 x 10(4) to 1.4 +/- 0.4 x 10(4) units/g liver (P less than 0.01). Reduction of the anoxic period from 30 min to 25 min significantly reduced the change in tight junction permeability and the extent of cellular injury: Paracellular passage of HRP was 336 +/- 20 pg/g and LDH release was 0.7 +/- 0.1 x 10(4) units/g liver, both significantly lower than those at 30 min (P less than 0.01). No significant difference in hepatic ATP levels after 60 min of reoxygenation was noted among the experimental groups, but all had lower levels than the control group. The protective effect of allopurinol suggests that the mechanism of biliary reoxygenation injury involves free radical generation. Susceptibility of tight junctions suggests a pattern of injury similar to that involved in anoxic damage of the vascular endothelium.

Possible role of plasminogen activator inhibitor 2 in the prevention of the metastasis of gastric cancer tissues

The concentrations of urinary type plasminogen activator (u-PA), plasminogen activator inhibitor 1 (PAI-1), and PAI-2 were measured in gastric cancer tissues and adjacent healthy mucosal tissues. Levels of u-PA, PAI-1 and PAI-2 were higher in cancer than in control tissues. PAI-1 levels were higher together with the progression of cancer however there were no differences in u-PA or PAI-2 levels. Tumors with higher PAI-1 and lower PAI-2 levels tend to metastasize to remote lymph nodes. When the numbers of involved lymph nodes were analyzed, tumors with the large number of metastatic lymph nodes showed higher PAI-1 and lower PAI-2 level. No difference was shown in u-PA levels among these groups. These tendencies were more significant in patients with progressed gastric cancer. These results suggest that tumor with higher PAI-2 levels tend to localize or have less tendency to metastasize to lymph nodes. On the other hand PAI-1 was generally higher in tumor with invasion into nearby tissue or with nodal metastasis.

Therapeutic effects of liposomal adriamycin in combination with tumor necrosis factor-alpha

Liposomes as drug carriers in cancer chemotherapy have attracted considerable interest. To enhance the therapeutic effect of Adriamycin entrapped in liposomes (Lip-ADM) on human solid tumors, we investigated the therapeutic effects of Lip-ADM in combination with recombinant human tumor necrosis factor-alpha (rTNF-alpha), which is known to have specific effects on tumor vasculature. rTNF-alpha or saline solution was injected intravenously into nude mice bearing a human colon cancer strain, HC-1, at 1 hour before intravenous administration of Lip-ADM. The significant therapeutic effect of Lip-ADM in combination with rTNF-alpha was demonstrated by the evaluation with tumor growth curve and the actual tumor weights, in comparison with groups of mice treated with saline solution, rTNF-alpha alone, or with a Lip-ADM after saline. Levels of Adriamycin in tumor tissue in the Lip-ADM in combination with rTNF-alpha-treated group were higher than those in Lip-ADM with saline solution-treated group.

Advanced gastric cancer associated with acute myelocytic leukemia--report of a case

A case of advanced gastric cancer associated with acute myelocytic leukemia (AML) is reported. Synchronous double malignancies of gastric cancer and AML are very rare. Combination chemotherapy (BHAC-DMP) was used as the method for induction and consolidation therapy for AML and a complete remission was obtained. However, it failed to show any therapeutic effect on the gastric cancer. A radical subtotal gastrectomy was performed with lymphadenectomy. During the postoperative course, both respiratory failure and severe thrombocytopenia progressed. Fortunately, the patient responded well to mechanical ventilation and the administration of heparin. She was discharged on day 52 after surgery, and no sign of recurrence of either gastric cancer or AML has been observed over the one-year period following the gastrectomy. In principle, in order to achieve a good prognosis, a radical resection should be carried out for gastric cancer associated with AML. However, chemotherapy for AML might make the patient vulnerable to surgical stress, although we could not demonstrate any concrete evidence which could prove the impairment of host immunity in this case. It is, therefore, possible that not only the relapse of AML but also the impairment of host immunity may cause some other difficulties during the post-gastrectomy course.

Bleeding peptic ulcer after abdominal aortic aneurysm surgery

A retrospective study of 112 patients with abdominal aortic aneurysm (AAA) and 232 with arteriosclerosis obliterans (ASO) demonstrated that 16.7% of those with AAA and 1.6% of those with ASO had a history of gastroduodenal ulcer; 83% of these lesions with AAA were gastric ulcers. Ulcer bleeding after vascular reconstruction developed in seven patients with AAA and one with ASO. Serum fibrinogen levels and platelet counts were significantly lower in patients with AAA than in those with ASO or controls. A prospective study showed that 25 (52.1%) of 48 patients with AAA and six (20.0%) of 30 patients with ASO had endoscopically proved gastroduodenal lesions before vascular reconstruction. None of them developed postoperative bleeding after treatment of both their gastroduodenal lesions and coagulopathy. Furthermore, the significant decrease in blood flow and prostaglandin content of gastric mucosa was demonstrated in patients with AAA.

Inhibition of growth of rat hepatoma by local injection of liposomes containing recombinant interleukin-2. Antitumor effect of IL-2 liposome

Human recombinant interleukin-2 (IL-2) was entrapped in liposome, consisting of egg phosphatidylcholine (PC) and cholesterol. The peri-tumor injections of IL-2 liposome inhibited significantly the growth of solid tumor and prolonged the survival time of rats with solid tumors which were induced by a subcutaneous (s.c.) inoculation of AH-66 cells. Immunohistochemical staining of peritoneal exudate cells and tumor tissues revealed a marked accumulation of activated macrophages in and around the tumor tissues induced by the local injections of IL-2 liposome.

The formation of gastric ulcers with a tendency to hemorrhage in association with aortic aneurysms

It is widely accepted that patients with aortic aneurysm (AA) show a higher incidence of peptic ulcers than those without. However, the pathogenesis of peptic ulcers associated with AA remains obscure. We measured the gastric mucosal blood flow (GMBF) endoscopically and also determined the gastric mucosal prostaglandin (PG) levels of these AA patients to investigated the mechanism behind gastric ulcer formation. Moreover, we investigated the consumption coagulopathy (CC) of AA responsible for inducing the hemorrhage from ulcers. The GMBF values of 7 AA cases, taken at the antrum, angle and corpus, were significantly decreased compared with those of control cases, while the PGE2 levels of the gastric mucosa were also significantly reduced. With regard to CC, the serum levels of fibrinogen or platelets were significantly lower than those of the control group. These results indicate that the decrease in GMBF, followed by the reduction in endogenous PG, might contribute to the gastric ulcer formation in AA patients, and that CC associated with AA could be an important factor causing the hemorrhage from these ulcers. AA patients should therefore be treated with focusing attention on the possibility of an associated ulcer and ulcer bleeding.

Reoxygenation injury following anoxic perfusion preferentially impairs bile acid-independent bile flow

We perfused isolated rat livers with Krebs-Ringer buffer, with no recirculation. Bile flow virtually stopped during 30 min of anoxia and resumed following reoxygenation to reach a plateau of 44% of the control level. When taurodehydrocholic acid (TDHC, 50 nmol/min/g liver) was administered during reoxygenation, bile flow increased three-fold (16.1 +/- 1.3 to 45.3 +/- 6.3 microliters/g liver). The increase in bile output with TDHC was 27.8 microliters/g liver, which was 89% of the control output. Bile acid output during this period was 1.4 mumol/g liver, which was 93% of the control level. Addition of allopurinol (50 nmol/min/g liver) without TDHC increased bile flow significantly (16.1 +/- 1.3 to 21.3 +/- 1.2 microliters/g liver), but the change was not significant when allopurinol and TDHC were given. The addition of allopurinol also reduced the cumulative release of lactate dehydrogenase from the liver during the reoxygenation period, but had no effect on hepatic adenosine triphosphate levels. Our data suggest that the bile acid-independent bile flow is sensitive to reoxygenation injury following anoxia whereas bile acid output and bile acid-dependent bile flow are resistant.

Targeting of adoptively transferred experimental allergic encephalitis lesion at the sites of wallerian degeneration

To clarify the implication of the major histocompatibility complex class II (Ia) antigen induction in microglia following Wallerian degeneration in the central nervous system (CNS), experimental allergic encephalitis (EAE) was adoptively transferred to Lewis rats in which Ia antigens had been induced in microglia at the sites of Wallerian degeneration. In addition to randomly distributed typical EAE lesions, the recipient rats developed distinct inflammatory lesions in accord with the distribution of Ia-positive microglia; i.e., in the ipsilateral thalamus after cortical cryoinjury, and in the ipsilateral optic nerve, the contralateral optic tract and superior colliculus after unilateral eye ball enucleation. Thus, the EAE locus may be targeted by this approach. The inflammatory response was inducible by transfer of myelin basic protein-stimulated lymphocytes but not by transfer of phytohemagglutinin-stimulated or non-stimulated lymphocytes. When examined using monoclonal antibody surface markers; OX-6 for Ia antigen, W3/13 for pan T lymphocyte and OX-8 for cytotoxic/suppresser T lymphocyte, the types of lymphocytes in these lesions did not differ from those in ordinary EAE lesions in the spinal cord. The potential role of non-immunologically induced Ia-positive cell clusters that serve as a target for autoimmune CNS diseases was discussed.

Cytotropism of Theiler's murine encephalomyelitis viruses in oligodendrocyte-enriched cultures

The cytotropism of two strains, GDVII and DA, of Theiler's murine encephalomyelitis viruses (TMEV) was studied in the oligodendrocyte-enriched murine neural cell cultures. Both GDVII and DA caused cytopathic effects in the neural cell cultures, and double immunostaining for galactocerebroside (Gal-Cer), a marker molecule for oligodendrocyte, and viral antigens disclosed a dual expression of Gal-Cer and viral antigens in over 80% of cells in both cultures 24 h after infection with either GDVII or DA. The kinetics of cell-free and cell-associated infectivity were not significantly different between two cultures. These in vitro observations suggest that neither replication in oligodendrocyte nor cell-associated infectivity is a sole factor in discriminating those two subgroups of TMEV with regard to the demyelinating activity, and that virus cell binding may play an important role in virus persistence and TMEV-induced demyelination.

The antitumor effects of adriamycin entrapped in liposomes on lymph node metastases

Adriamycin (ADM) entrapped in liposomes (Lip-ADM) was prepared and its therapeutic effects studied using the mouse leukemia cell line, P388, which metastasized to axillary lymph nodes after inoculation into the foot pads of CDF1 mice. Lip-ADM injections (7.5 mg/kg) were given into the foot pad at two-day intervals. Two series of experiments were performed; one in which Lip-ADM was administered on days 1,3 and 5 following tumor inoculation, and the other in which it was administered on days 5 and 7. Both Lip-ADM injection regimens significantly inhibited metastases to the lymph nodes as compared with mice given injection of saline solution. Furthermore, the therapeutic effects of three Lip-ADM injections were significantly greater than the effects of free ADM. Histological examinations of lymph nodes revealed that three injections of Lip-ADM completely eliminated tumor cells, whereas viable tumor cells were still observed in the lymph nodes after treatment with free ADM. The results of this study suggest that Lip-ADM is useful for the treatment of lymph nodes metastases and that the local injection of Lip-ADM, through such means as endoscopy, would be recommended as a clinical mode of application.

Intraneuronal laminin-like immunoreactivity in the human central nervous system

Because laminin possesses potent neurotrophic activity, laminin-like immunoreactivity was investigated in formalin-fixed human brains, using affinity-purified anti-human placental laminin rabbit serum. Distinct laminin-like immunoreactivity was observed in neuronal soma of certain nuclear groups, and a 180-kDa band was noted in an immunoblot study of the supernatant of brain homogenate. These observations imply that many but not all central neurons have laminin-like immunoreactive molecules. Their functional role, however, remains to be clarified.

Wallerian degeneration induces Ia-antigen expression in the rat brain

Strong expression of class II major histocompatibility (MHC II, Ia) antigens was observed in areas of Wallerian degeneration following either a cryoinjury to the cerebral and cerebellar cortex or unilateral eye enucleation in adult Wistar and Lewis rats. The Wallerian degeneration was disclosed by the Fink-Heimer method but not by routine histological examination. The Ia antigens were localized exclusively to the cells labeled with OX-42 antibody and mistletoe-1 lectin (ML-1) and possessing the morphological identity of microglia. Development of Ia-expressing microglia at the sites of Wallerian degeneration was accompanied by neither tissue permeation of serum components as assessed by immunohistochemistry for autologous albumin nor tissue migration of hematogenous inflammatory cells.

Neurotoxic activity in HTLV-I carrier lymphocyte culture

A close association between human T-lymphotropic virus type I (HTLV-I) infection and a group of chronic myelopathies of unknown etiology has recently been established and the name "HTLV-I associated myelopathy" (HAM) has been coined. Although the mechanism of neural tissue damage in HAM remains virtually unknown, several lines of evidence suggest the involvement of a soluble factor(s) including cytokines and viral proteins in the disease process. In this study, we examined cytopathic effects of the supernatants from 6 HTLV-I carrier human T lymphocyte cell lines on 4 human and one murine neuroblastoma cell lines, and 2 human glioma cell lines. Among 6 lymphocyte cell culture supernatants, only 1 from MT-2 cell culture repeatedly exerted cytopathic effects on human neuroblastoma cells, particularly on IMR-32 cells: marked retraction of neurites leading to cellular clumping. This activity was neither abolished by treatment of the medium at 80 degrees C for 30 min or by UV-irradiation, nor was it neutralized by anti-HTLV-I antibodies. The MT-2 supernatant also induced mild cytopathic changes in 2 other human neuroblastoma cell lines and 2 human glioma cell lines. This activity was abolished by treatment of the medium at 80 degrees C for 30 min but not at 56 degrees C for 30 min. Myelinated murine cerebellum explants and other cell lines showed no morphological changes when incubated with the MT-2 supernatant. In addition, the growth of THP-1 cells, a monocyte/macrophage lineage cell line, was remarkably suppressed when maintained in the MT-2 conditioned medium, accompanied by enhancement of phagocytic activity. The THP-1 conditioned medium, on the other hand, suppressed tumor necrosis factor (TNF) activity detected in the MT-2 culture. These observations suggest that HTLV-I induced cytokines may directly act on neural cells, but their action appears to be regulated by the intricate interactions of lymphocytic and monocytic cells.

[Hemorrhagic gastric ulcer associated with consumption coagulopathy in the dissecting aortic aneurysm--a case report]

A case of the hemorrhagic gastric ulcer and post-operative stomal ulcer associated with the consumption coagulopathy in the dissecting aortic aneurysm is presented. A 68 year old man, who had diagnosed as having the dissecting aortic aneurysm (DeBakey III) in 1985 and had been attending to our hospital as an outpatient since then, was admitted to our hospital because of the hemorrhagic gastric ulcer on July 3rd, 1987. Although the wide resection of stomach was performed after the admission, the hemorrhagic stomal ulcer was developed 4 weeks after the operation. The administration of heparin in addition to antacids to improve the consumption coagulopathy, having been caused by thrombus formation in the aneurysm, was effective in control of the hemorrhage and also making the stomal ulcer scarred. It is suggested that ischemia of the stomach mucosa, which seemed to have been induced by the dissecting aortic aneurysm, was responsible for the development of the ulcers in this case and the hemorrhage from them was caused mainly by the consumption coagulopathy derived from thrombus formation in the aneurysm.

[Importance of the conjugated antibody for the induction of selective effect of adriamycin conjugated with anti AFP monoclonal antibody and entrapped in liposomes against AFP producing tumors]

We investigated experimentally the effect of adriamycin (ADM) conjugated with anti alpha-fetoprotein (AFP) monoclonal antibodies and entrapped in liposomes (Lip-ADM = AbAFP) in vitro or in vivo. In the present study, we examined the importance of the conjugated antibody for the induction of selective therapeutic effect of Lip-ADM = AbAFP against AFP producing tumors. As the target tumors, AFP producing human hepatoma strain, Li-7, and AFP non-producing human breast cancer strain, MX-1 maintained in BALB/c nu/nu male mice were used. In order to evaluate the importance of the conjugated antibody, we prepared also ADM conjugated with normal mouse IgG, and entrapped in liposomes Lip-ADM = NIgG, of which therapeutic effects were compared with that of Lip-ADM = AbAFP. Judging from the tumor growth curve and the tumor weight, the therapeutic effect of Lip-ADM = AbAFP was greater against Li-7 than that of Lip-ADM = NIgG. On the other hand, both conjugates showed similar effects against MX-1. As the results it is suggested that the antibody which recognizes the antigen expressed on the target tumor cells can solely increase the therapeutic effect of ADM entrapped in liposomes (Lip-ADM) and that the main factors which contribute to the efficient therapeutic effect of the conjugate were the sensitibility to ADM, the affinity of the tumor cells to liposomes and the superiority of the conjugated antibody.

Forebrain ischemia induced by temporary bilateral common carotid occlusion in normotensive rats

Ischemic brain lesions were induced in adult Wistar and Fischer rats by temporary occlusion of the bilateral common carotid artery. The severity of ischemic lesions depended on the duration of carotid occlusion. While 2 h occlusion resulted in 15 deaths among 40 rats and the development of ischemic lesions in 16 of 25 asymptomatic survivors, none died after 0.5 h occlusion and yet 13 of 30 apparently asymptomatic rats had ischemic lesions when examined on day 7. Histological examination combined with immunohistochemistry of autologous albumin for assessing the integrity of the blood-brain barrier (BBB) revealed two distinct lesions: (1) ischemic neural damage with extensive tissue permeation of serum albumin, (2) death of individual neurons sparing other neural elements in the absence of the BBB breakdown. Ischemic neural damage with BBB breakdown was common in animals dying within 48 h after reflow. The lesions without BBB breakdown, on the other hand, were found solely in asymptomatic animals in which groups of severely degenerated neurons were preferentially located in the CA 1 region of the hippocampus, the caudoputamen and deeper layers of the neocortex. The sequential measurements of regional cerebral blood flow (rCBF) in the bilateral hippocampus by the hydrogen clearance method disclosed a steady decrease in rCBF after the occlusion, 51% of the pre-occlusion state at 10 min, 35% at 25 min and 32% at 40 min. The simplicity of procedure could make this model suitable for the study of the pathogenesis of ischemic neuronal damage in a critically low perfusion state.

Ia-expressing microglial cells in experimental allergic encephalomyelitis in rats

Monoclonal antibodies (MRC OX-6 and OX-17) recognized three types of cells expressing Ia antigen during the course of acute experimental allergic encephalomyelitis (EAE) in rats. In earlier stages of the disease, in animals with or without paralysis, Ia antigens were mostly localized to subarachnoidal and perivascular lymphocytic and histiocytic cell infiltrates, possibly serving as antigen-presenting cells. On the other hand, in convalescent rats, Ia antigens were expressed in a large number of cells with dendritic processes heavily populating the spinal gray matter. The appearance of these Ia-expressing cells in the convalescent stage coincided with the development of degenerating axon terminals in the spinal gray matter. These Ia-expressing cells possessed morphological features characteristic of microglia and were positive for ML-1 lectin but did not express glial fibrillary acidic protein. Immune electron microscopy disclosed the presence of Ia reaction products in the Golgi apparatus, endoplasmic reticulum and plasma membrane of these cells with dendritic processes, indicating active synthesis of Ia molecules in microglia. In addition, Ia antigens were localized to the cells with ultrastructural features of macrophages. Thus, Ia-expressing cells in EAE seems to play dual roles: the induction of immunological reactions during earlier stages and the participation in reparative processes during convalescence.

[Antitumor effect of IL-2 entrapped in liposomes on rat hepatoma, AH-66]

The human recombinant interleukin 2 (IL-2) was entrapped in liposomes, and the therapeutic effects of the liposomes containing IL-2 (Lip-IL-2) were experimentally studied using the rat hepatoma strain, AH-66, maintained in donryu rats and challenged subcutaneously in the inguinal region. The peri-tumor injections of Lip-IL-2 (15 X 10(4)/kg units for the IL-2 dose) significantly inhibited the tumor growth as determined from the relative mean tumor weight, although no therapeutic effects were observed when the unentrapped IL-2 or liposomes containing saline was administered rats in the same way as the injections of Lip-IL-2. They also prolonged the survival time of rats. The studies of serum IL-2 values after i.v. or s.c. injections of Lip-IL-2 revealed that IL-2 was released gradually from the liposomes containing IL-2 into the circulation. As the result of the tumor tissue staining of the immunoperoxidase 18 hrs after the peri-tumor injection of IL-2, it was shown that a number of macrophages infiltrated into the tumor tissue and degenerated tumor cells were observed adjacent to those macrophages. It is suggested that Lip-IL-2 is useful as an antineoplastic agent in the immunotherapy and that the therapeutic effects of Lip-IL-2 would be related to both the slow release of IL-2 and the cytotoxicity on the tumor cells mediated by the macrophages.

Astrocytic pathology of methionine sulfoximine-induced encephalopathy

To investigate the roles imposed on astrocytes for glutamate metabolism, a specific inhibitor of glutamine synthetase (GS), methionine sulfoximine (MSO), was repeatedly administered to rats and histopathological changes were correlated with glycogen accumulation and the immunocytochemistry of GS and glial fibrillary acidic protein (GFAP). Prolonged MSO-loading (every 12 h up to three times, 100-150 mg/kg body weight) brought about the appearance of astrocytes with swollen, watery nuclei reminiscent of Alzheimer II glia chiefly in the neocortex, hippocampus and lateral thalamus after 24 h. Concomitantly, profound accumulation of glycogen ensued in the superficial three layers of the neocortex, hippocampus and pyriform cortex. GS immunoreactivity appeared enhanced in the cortex, hippocampus and lateral thalamus with parallel increase in GFAP immunoreactivity after prolonged treatment. Oligodendrocytes in the diencephalon and brain stem also normally contained GS immunoreactivity. Some animals developed necrotic lesions in the dorsolateral neocortex. The area of glycogen accumulation coincided with the known distribution of N-methyl D-aspartate (NMDA) glutamate receptors and, thus, GS may play important roles in NMDA receptor-mediated glutamate metabolism. The Alzheimer II type changes, however, did not correlate with NMDA-receptor distribution. These results indicate certain regionalizations in the roles of astrocytes and oligodendrocytes in glutamate and ammonia metabolisms.

Sequelae of the osmotic blood-brain barrier opening in rats

Histopathological sequelae of the osmotic blood-brain barrier opening were studied in 69 adult Wistar rats sacrificed between 2 minutes and 6 days after infusion of 1.6 M mannitol into the unilateral internal carotid artery. The results were correlated with immunohistochemical localization of autologous albumin in the brain parenchyma on paraffin sections. Extravasation of serum albumin was evident in all rats, and the albumin immunoreactivity, commonly localized to the territories of the ipsilateral anterior, middle, and posterior cerebral arteries and contralateral anterior cerebral artery, showed maximum intensity in the rats sacrificed 30 minutes after infusion. The albumin immunoreactivity remained macroscopically visible in the brain parenchyma for 24 to 48 hours, and then gradually faded out. Serum extravasation was accompanied by widening of the perivascular space and focal edema, which largely subsided within 48 hours as the albumin immunoreactivity of the tissue diminished. Although no overt neurological sequelae were seen in the present experiment, minute but definite foci of infarction with focal accumulation of albumin were found in 23 (38%) of 61 rats surviving more than 30 minutes. In addition, ischemic neuronal death of delayed onset was encountered among neurons in the CA-1 region of the hippocampus, in the cerebellum, and in the thalamus in five (25%) of 20 rats sacrificed between Days 4 and 6. Thus, care should be exercised in the practice of this procedure.

Intraoperative imprint cytology of the thyroid gland with computer-assisted morphometric analysis of cell clusters

Imprint preparations were used in addition to frozen sections in the intraoperative diagnosis of 37 cases of benign and malignant lesions of the thyroid gland, including adenomatous goiter, follicular adenoma, follicular carcinoma and papillary carcinoma. In the imprints, the cytologic features specific for carcinoma, as compared with benign lesions, were (1) the folding of the nuclear contour, (2) the increased density of the cytoplasmic matrix and (3) the frequent appearance of cell clusters of larger size. The size and frequency of cell clusters were morphometrically analyzed by a computer image analyzer. There was an increasing number of large clusters, plus the appearance of clusters of more than 300 micron in diameter, in both follicular and papillary carcinoma. In benign lesions, on the contrary, the majority of cells were isolated or in small clusters, the diameter of which never exceeded 300 micron in diameter. These results demonstrate that (1) the imprint cytology of the thyroid gland is useful in making a rapid intraoperative diagnosis and (2) the introduction of computer-assisted quantitative analysis is of practical value in the diagnosis of malignancy.

Identification of the normal microglial population in human and rodent nervous tissue using lectin-histochemistry

Mistletoe lectin-1 (ML-1) and Ricinus communis agglutinin-120 (RCA-1) both possess D-galactose-specific surface-binding sites. They were used to selectively identify microglial populations in aldehyde-fixed normal brain tissue by lectin immunohistochemistry on paraffin and frozen sections. Mistletoe lectin-1 was superior to RCA-1 in labelling microglia in the rat brain, whereas RCA-1 labelled human microglia better than ML-1. Thus, RCA-1 and ML-1 supplement each other for identifying microglial in human and rodent central nervous system tissues. The high reproducibility of the results and the applicability of the technique to routine histology, using formalin-fixed tissue, should facilitate study of the histogenesis and role of microglia in the CNS.

[Repeated intra-abdominal administration of CDDP in carcinomatous peritonitis due to gastric cancer--a case report]

Two years and 10 months after gastrectomy, a 38-year-old man was diagnosed as having carcinomatous peritonitis due to gastric cancer. He was treated by intra-abdominal administration of 100 mg CDDP three times in addition to UFT. After each administration of CDDP, the amount of ascites and the serum value of CEA were decreased. Subjective symptoms, such as epigastric pain or sensation of fullness, were also improved. Although one year and 8 months has passed since the first administration of CDDP, the performance status of the patient remains 0. Nausea or vomiting was noted within 2 days after each administration. However, severe complications, like renal failure or intra-abdominal hemorrhage, were not observed. These findings suggest that repeated intra-abdominal administration of CDDP may be a useful therapy for carcinomatous peritonitis due to gastric cancer.

Intraneuronal laminin-like molecule in the central nervous system: demonstration of its unique differential distribution

Laminin, an extracellular matrix glycoprotein rich in basement membrane, is a multifunctional molecule of approximately 1000 kDa and is known to possess a potent neurotrophic activity. Laminin-like immunoreactivity (LLI) was for the first time demonstrated in mouse and rat CNS neurons by a sensitive immunohistochemical technique. Transblotting of SDS-PAGE of the supernatant of the mouse and rat brain homogenate identified distinct 180 kDa and weak 380 kDa bands immunoreactive to anti-laminin and these molecules differed from authentic laminin subunits. The intraneuronal distribution of LLI disclosed two distinct patterns; LLI-1 (diffuse perikaryal stain) and LLI-2 (coarse granular stain). By immunoelectron microscopy, LLI was localized to the ERs in LLI-1 neurons, whereas it appeared to be confined to lysosomes in LLI-2 neurons. LLI-1 neurons were found predominantly in hippocampal pyramidal, granule and neocortical layers 1-3, 6 neurons, in most of the striatal and thalamic neurons, and Purkinje cells. The majority of neurons in neocortical layers 4-5, medial septal and Meynert neurons, somatic motor neurons, and neurons of the deep cerebellar nuclei were classified as LLI-2 cells. No LLI was found in hypothalamic mammillary, habenular and vagal dorsal motor neurons (LLI-3). These observations may indicate intraneuronal production of laminin-related molecules in central neurons. We speculate that the laminin-related molecules (neurolaminin) play important roles in trophic or servo mechanisms in the CNS.

Sarcoidosis presenting as progressive myelopathy

A case of intramedullary spinal cord sarcoidosis with slowly progressing symptoms and signs attributable solely to the spinal cord is reported. Biopsy disclosed granulomatous foci but was not diagnostic of sarcoidosis. However, autopsy showed numerous minute granulomas compatible with those of sarcoidosis disseminated in the lower cervical and upper thoracic cord in addition to a few in the hilar lymph nodes and papillary muscle of the heart. Clinical and pathological features of eight cases of sarcoidosis without symptoms other than those of the spinal cord are reviewed from the literature and clues to the diagnosis are discussed.

Antitumor effect of adriamycin entrapped in liposomes conjugated with anti-human alpha-fetoprotein monoclonal antibody

The monoclonal antibody, 19-F-12 (IgG2b), against human alpha-fetoprotein was conjugated to liposomes containing Adriamycin, and the therapeutic effects of the conjugate were experimentally studied using the alpha-fetoprotein-producing human hepatoma strain, Li-7, maintained in BALB/c nu/nu male mice. Three i.v. injections of liposomes containing Adriamycin (7.5 mg/kg) into tumor-bearing mice significantly inhibited the tumor growth, and the therapeutic effect of the antibody-conjugated liposomes was greater than that of unconjugated liposomes, as judged from the tumor weights and histological findings. Furthermore, the experiments were repeated with Adriamycin (4-5 mg/kg) in free form, since administration of Adriamycin (7.5 mg/kg) in free form was highly toxic for the mice. The results still indicated that the therapeutic effect of Adriamycin in 19-F-12 conjugated liposomes was superior to that of free Adriamycin or Adriamycin in unconjugated liposomes. In contrast to the treatment for Li-7 in nude mice, the therapeutic effect of Adriamycin in 19-F-12 conjugated liposomes was not much different from that of Adriamycin in normal mouse IgG (IgG2b fraction) conjugated liposomes against alpha-fetoprotein-negative human breast cancer strain MX1. Tissue distribution studies after i.v. injection of Adriamycin in various forms into mice revealed that preferential delivery of Adriamycin to tumors occurred to some extent with antibody-conjugated liposomes as compared to the unconjugated liposomes. In addition, reduction of the distribution of Adriamycin to the heart was achieved by administering the drug in the liposome-entrapped form, and this enabled the use of a higher dose (7.5 mg/kg) of Adriamycin without toxic side effect.

Glutamine synthetase of the human brain: purification and characterization

Glutamine synthetase (GS) isolated from human brain formed a single band on sodium dodecyl sulfate-polyacrylamide gel with a molecular weight of 44,000. The enzyme had a specific activity of 179.2 U/mg protein when assayed by measuring the rate of the formation of gamma-glutamylhydroxamate using hydroxylamine as a substrate. In the presence of manganese ions, the relative activity of human brain GS was much lower than that of the sheep brain enzyme. The suppression of activity by increasing the ADP concentration, however, was less marked in the human enzyme than that in the sheep enzyme. Antibodies were raised in rabbits against the purified enzyme. The double-immunodiffusion technique disclosed cross-reactivities among GSs isolated from human, sheep, and rat brains, but the enzymes were not immunologically identical. Immunohistochemically, GS was localized in the cytoplasm of astrocytes in the human and rat brains and in pericentral hepatocytes of the liver.

Retrograde transport and differential accumulation of serum proteins in motor neurons: implications for motor neuron diseases

We found immunocytochemical evidence of serum albumin and immunoglobulin G in motor neurons of rats under physiologic conditions, but not when axoplasmic flow was abolished. The amount of serum proteins was highest in somatic motor neurons of the spinal anterior horn, nucleus ambiguous, and trigeminal motor nucleus; less in hypoglossal and facial neurons; and sparse in preganglionic autonomic, oculomotor, and hypothalamic neurons. Toxic or trophic substances, bound to serum proteins, could also be incorporated into motor neurons. Quantitative differences in accumulation paralleled the selective vulnerability of somatic motor neurons in motor neuron diseases.