The N-terminal sequence of Lactococcus lactis phosphoglucose isomerase purified by affinity chromatography differs from the other species

A specific monoclonal antibody, M3A, was produced to rapidly purify Lactococcus lactis phosphoglucose isomerase (PGI) for amino acid sequence analysis. M3A recognized the Lac. lactis PGI specifically and sensitively with both enzyme-linked immunosorbent assay and Western blot analysis. The enzyme was rapidly purified to a specific activity of 21.8 U/mg with a yield of 20% by a three-step procedure, including M3A-bound Sepharose chromatography. The specific activity of PGI was increased about 64.1-fold from the cell lysate. The molecular mass of Lac. lactis PGI was estimated to be about 50 kDa by SDS-PAGE. The N-terminal amino acid sequence of Lac. lactis PGI exhibited no significant similarity to other PGIs, except for a 52.6% identity to Bacillus stearothermophilus PGI A and PGI B. These results suggest that there might be some molecular types of PGI.

Possible application of transmitted laser light for the assessment of human pulpal vitality

The purpose of this study was to determine whether use of transmitted laser light would enable a better assessment of human pulpal vitality than back-scattered light does (LDF: laser Doppler flowmetry). The experiments were carried out on ten upper central incisors in six subjects aged 23-28 years; five of the teeth were vital with no restoration, and five were non-vital. For use with transmitted laser light, the fibers within the probe of a conventional LDF apparatus were used, one for transmitting light onto the buccal surface, the other for receiving it at the palatal surface of the same tooth. For LDF, the probe was fixed at the buccal surface. Blood flow was measured at three different locations on each experimental tooth: the incisal third, the center and the cervical third of the tooth crown. In non-vital teeth, 1) output signals with transmitted laser light all registered zero, and no oscillation could be seen in recordings from any location on the tooth, but 2) LDF signals were above zero, there were regular oscillations related to heart rate, and passive increases in blood flow (corresponding to blood pressure increases) were recorded from both the center and the cervical third of the tooth, indicating that LDF registered blood flow of non-pulpal origin. In vital teeth, LDF signals were significantly higher than in non-vital teeth at each location on the tooth. At the central site on vital teeth, the output signals for transmitted laser light were about twice those seen with LDF, and passive blood flow changes corresponding to blood pressure increases were more clearly observed. These results indicated that transmitted laser light would be useful for the assessment of tooth pulp vitality both because the blood flow signals did not include flow of non-pulpal origin, and because its output signals and response to blood flow changes were clear and could easily be monitored.

Effects of lactitol-oligosaccharides on calcium and magnesium absorption in rats

Lactitol-oligosaccharide (LO) was prepared from lactitol by transglycosylation reaction with Aspergillus oryzae beta-galactosidase. LO is resistant to metabolism in the small intestine but not in the large intestine. The effects of LO, lactose (Lac), lactitol (Lacol) and galactooligosaccharide (GL) on calcium and magnesium absorption were determined by feeding 8-week-old Sprague-Dawley male rats diets containing 5% of the above carbohydrates for two weeks. The results obtained were as follows. 1) A significant increase of calcium absorption was observed in the LO diet. 2) A significant increase of magnesium absorption was observed in the LO, GL and Lacol diets. 3) The concentration of total volatile fatty acids (VFA) in the cecal contents increased significantly in the LO, GL and Lacol diets. The main constituent of VFA in the cecal contents was found to be acetic acid. 4) The correlations between calcium and magnesium absorption ratios and total VFA concentration in the cecum were found to be significantly related. These findings suggest that LO is metabolized to VFA, among which acetic acid concentration seems to have the most stimulatory effect on the absorption of calcium.

[Contingent negative variations associated with vocalization in humans]

We investigated the late negative components of the contingent negative variations (CNVs) in the verbalization task. Six subjects were instructed to perform three different motor tasks, jaw opening, vocalization of a meaningless sound and that of a word, in response to a sound stimulus following a visual warning stimulus with interstimulus interval of 4.0 sec. The electroencephalograms (EEGs) were recorded from the midline-central (Cz), left and right temporal areas (T3 and T4) and frontal areas (F7 and F8). EEGs were averaged 16 times using the visual stimulus pulse as a trigger to obtain the CNVs in each motor task. There was no significant difference between the tasks of the jaw opening and vocalization of the sound in the CNV amplitudes at bilateral electrodes. However, the amplitudes of the CNVs at the left frontal and temporal areas were significantly larger in the case of vocalization of the word than in that of jaw opening (p < 0.05). On the other hand, there was no significant difference between these two tasks in the CNV amplitudes at the right frontal and temporal areas. Our results suggested that the CNVs generated over the left hemisphere might reflect the brain activities involved in language production.

A preadipocyte clonal line from bovine intramuscular adipose tissue: nonexpression of GLUT-4 protein during adipocyte differentiation

A clonal bovine intramuscular preadipocyte (BIP) line has been established from the intramuscular white adipose tissue of the M. longissimus thoracis in each of three Japanese Black cattle. Exponentially growing BIP cells exhibited a fibroblastic appearance. Adipocyte differentiation was initiated by treating confluent BIP cells with differentiation medium containing insulin and dexamethasone. Small lipid droplets appeared 5-6 days after stimulation and occupied a large fraction of the cell volume at 10 days and beyond. During the adipose conversion, the incorporation of acetate to the cells gradually increased by 10-fold and reached a maximum at day 5. However, incorporation of glucose increased only 3-folds prior to this conversion, even though GLUT-1 level increased by 13-fold at day 7. GLUT-4, on the other hand, was not detected during the course of differentiation. These results suggested that adipose tissue metabolisms in ruminants were different from that of non-ruminants.

Profile of nucleotides and nucleosides of human milk

The content of nucleotides and nucleosides of human milk was analyzed using a newly developed method for high performance liquid chromatography. By this method it is possible to analyze nucleotides and nucleosides simultaneously. Human milk was pooled according to season, lactation period, and geographical area. Three kinds of nucleosides--cytidine, uridine, and adenosine--and 6 kinds of nucleotides--5'-CMP, 5'-UMP, 5'-AMP, 5'-GMP, 5'-IMP, and 5'-CDP--were detected. Cytidine, 5'-CMP, and 5'-CDP predominated throughout lactation. Also there seemed to be geographical differences in nucleoside composition. The overall amounts of nucleotides and nucleosides were higher in winter than in summer. No nucleosides were detected in bovine milk, nor in bovine milk-based infant formula, and bovine milk contained much less nucleotides than human milk. These results suggest that nucleosides and nucleotides found in human milk may play some important roles in the development of infants.

Fast Fourier transform analysis of the masseter muscle EMG during reaction to a warning signal

Frequency changes of the masseter muscle EMG were examined in eight healthy subjects during the reaction time for unilateral jaw biting paradigm. The subjects were instructed to bite on a small piece of wood after the second of two visual signals two seconds apart. In five subjects, the EMG frequencies shifted to lower significantly in both the first (0-1 sec) and the second (1-2 sec) one-second periods after the first signal. In two subjects, the EMG frequencies shifted to lower significantly after the first signal in either the earlier or the later period. In one subject, the EMG frequencies did not change. This slowing of the EMG after the first signal might be related to recruitment of larger motor units. This phenomenon must be related to motor preparation for jaw biting.

Effects of dietary nucleotides on lipid metabolism and learning ability of rats

To investigate the effects of dietary nucleotides on lipid metabolism and learning ability, male Sprague-Dawley rats were fed with a nucleotides-supplemented diet or a nucleotides-free diet for 5 weeks. The content of nucleotides in the diet was 1.0% and their composition resembled that in human milk. The content of phosphatidylcholine (PC) and the ratio of PC to phosphatidylethanolamine (PE) in the cerebral cortex of rats fed the nucleotides-supplemented diet were significantly higher than that of rats fed the nucleotides-free diet. However, there was no difference in the content of PC and the ratio of PC to PE in the liver between the two groups. The levels of docosahexaenoic acid (C22:6n-3) and arachidonic acid (C20:4n-6) in the cerebral PC fraction were higher in rats fed the nucleotides-supplemented diet. The learning ability of rats fed the nucleotides-supplemented diet, which was evaluated by the water-filled multiple T-maze test and passive avoidance test, was superior to the of rats fed the nucleotides-free diet. The results presented here suggest that dietary nucleotides may influence lipid metabolism of the cerebral cortex and contribute to the rise in learning ability of rats.

Formation of oligosaccharides from lactose by Bacillus circulans beta-galactosidase

Eleven oligosaccharides formed by a transglycosylation reaction during lactose hydrolysis with Bacillus circulans beta-galactosidase were purified by gel permeation chromatography, charcoal chromatography, and HPLC. From the results of methylation analysis, and MS and NMR studies, it was concluded that these oligosaccharides were beta-D-Galp-(1-->3)-D-Glc, beta-D-Galp-(1-->6)-D-Glc, beta-D-Galp-(1-->2)-D-Glc, beta-D-Galp-(1-->4)-beta-D-Galp-(1-->4)-D-Glc, beta-D-Galp-(1-->6)-[beta-D-Galp-(1-->2)]-D-Glc, beta-D-Galp-(1-->6)-[beta-D-Galp-(1-->4)]-D-Glc, beta-D-Galp-(1-->4)-beta-D-Galp-(1-->3)-D-Glc, beta-D-Galp-(1-->4)-beta-D-Galp-(1-->2)-D-Glc, beta-D-Galp-(1-->4)-[beta-D-Galp-(1-->2)]-D-Glc, beta-D-Galp-(1-->4)-beta-D-Galp-(1-->6)-D-Glc, beta-D-Galp-(1-->6)[beta-D-Galp-(1-->3)]-D-Glc. The last five are newly observed oligosaccharides. The results of a use test (in vitro) by human intestinal bacteria showed that the oligosaccharides containing lactose units were predominantly used by human intestinal bifidobacteria.

Effects of lactitol-oligosaccharides on the intestinal microflora in rats

Lactitol-oligosaccharide (LO) was prepared from lactitol by a transgalactosylation reaction catalyzed by Aspergillus oryzae beta-galactosidase. The utilization of LO by human intestinal bacteria, the digestion of LO by rat jejunum mucosal homogenates and the effects of LO on the intestinal microflora in rats were compared with those of lactitol. 1) LO was utilized in vitro by Bifidobacterium, but lactitol was not utilized. 2) Neither LO nor lactitol were digested by rat jejunum mucosal homogenates. 3) A significant increase in the fecal counts of Bifidobacterium was observed in the LO diets. 4) The concentration of organic acids in feces and cecal contents significantly increased in the LO diets. 5) The concentration of fecal putrefactive products significantly decreased in the LO and lactitol diets. These findings suggest that LO is effective for improving intestinal conditions.

Tumor angiogenesis in human lung adenocarcinoma

BACKGROUND

Hematogenous metastasis requires angiogenesis within the tumor. Previous studies have shown that microvessel counts in histologic sections of the primary tumor, which reflect angiogenesis, are correlated with metastasis in breast, prostate and Stage I nonsmall cell lung carcinoma. In this study, the authors investigated the association between angiogenesis, hematogenous metastasis and lymph node metastasis in all stages of lung adenocarcinoma.

METHODS

Microvessels were highlighted by immunostaining endothelial cells for factor VIII. We counted microvessels within the tumors of 42 patients who had surgical resection (25 with relapse and 11 without relapse more than 5 years after surgical resection). Without knowledge of patient outcome, microvessels were counted on a 200x field (0.723 mm2) in the most active areas of neovascularization.

RESULTS

The microvessel counts from patients with relapse after surgical resection (mean +/- standard deviation, 75.4 +/- 64.3) were significantly higher than those without relapse more than 5 years after surgical resection (42.6 +/- 26.0) (P = 0.027). Analysis of regional lymph node metastases (factor N) revealed that the microvessel counts were 62.6 +/- 35.1 for N0 (no regional lymph node metastasis), 51.7 +/- 22.2 for N1 (metastasis in ipsilateral, peribronchial and/or ipsilateral hilar lymph nodes, including direct extension), 75.4 +/- 75.3 for N2 (metastasis in ipsilateral mediastinal and/or subcarinal lymph nodes), and 74.0 for N3 (metastasis in contralateral mediastinal, contralateral hilar, ipsilateral or contralateral scalene or supraclavicular lymph node[s]), and these values were not significantly different from each other.

CONCLUSIONS

Angiogenesis assessed by microvessel counts, correlated positively with relapse after surgical resection and hematogenous metastasis in all stages of lung adenocarcinoma; there was no correlation with lymph node metastasis in lung adenocarcinoma.

Effect of packed red cell and whole blood transfusion on liver-associated immune function

In order to clarify the effect of allogeneic blood transfusion on liver metastases from primary cancer, liver-associated immune function after blood transfusion was evaluated in a murine model. Hepatic sinusoidal lymphocytes (HSL) were strongly cytotoxic to conventional natural killer cell-sensitive target (YAC-1), as well as to natural killer cell-resistant solid adenocarcinoma cells (colon 26), compared with splenic lymphocytes. Allogeneic whole blood transfusion strikingly suppressed the cytotoxic activities of HSL. Red blood cell transfusions also suppressed cytotoxicity to the same degree. In an animal model, allogeneic transfusion increased the rate of liver metastases. Flow cytometric analysis showed that transfusion caused a temporary decrease in the class II antigen positive cell fraction, mainly Kupffer's cells. This phenomenon occurred in parallel with changes in hepatic antitumor activity, indicating the possible importance of the involvement of Kupffer's cell in the development of the killer activity of HSL. These results suggest that blood transfusion may be a significant risk factor for hepatic metastasis by transiently suppressing the immunocompetence of the liver.

Muscle strength and fall rates among residents of Japanese and American nursing homes: an International Cross-Cultural Study

OBJECTIVE

In Western society, aging if often associated with adoption of a sedentary lifestyle and associated disuse muscle atrophy and weakness. Recent studies suggest a relationship between quadriceps muscle weakness and falls in elderly residents of US nursing homes (NHs). We hypothesized that fall rates would be lower in Japanese NHs, where lifestyle differences such as squatting to toilet or sleeping on the floor may maintain quadriceps strength and result in fewer falls. Therefore, we examined the relationships between falls, muscle strength, lifestyle, and other clinical characteristics in residents of a Japanese and an American NH.

DESIGN

Cross-culture, prospective, cohort study.

MEASUREMENTS

We evaluated disease histories and current medications, quadriceps strength, and mobility of ambulatory American (n = 76) and Japanese (n = 89) NH residents, then followed these residents prospectively for the development of falls. Project staff from both sites trained together to assure uniform data ascertainment.

MAIN RESULTS

During a 6-month follow-up period, fall rates were nearly 4-fold higher in the American than in the Japanese residents (49% vs 13%, respectively; P < 0.0001). In the American sample, fall rates declined with increasing muscle strength, while in Japan there was no relationship between fall rates and quadriceps strength. Residents also differed in number of medical diagnoses and use of medications, which were greater among American residents. The Japanese had slower gait speeds. Very few Japanese residents practiced squatting behaviors while living in the NH.

CONCLUSIONS

The relationship between muscle weakness and falls is probably modified by multiple characteristics of the individual, their culture, and their environment. Information from cross-cultural studies may provide new insights into effective fall prevention strategies for nursing home residents.

Staining pattern of type IV collagen and prognosis in early stage adenocarcinoma of the lung

AIMS

To examine the prognostic value of basement membrane expression in early stage adenocarcinoma of the lung.

METHODS

Using antibodies to type IV collagen, basement membrane expression at the tumour-stromal border was immunohistochemically analysed in 30 patients with early stage adenocarcinoma of the lung (pstage I and pstage II). Two patterns of staining for type IV collagen were observed: in the first one the staining line was conserved or partially fragmented; in the second the staining line was widely fragmented or absent in more than 10% of the tumour area. The first staining pattern was categorised as continuous and the second as discontinuous.

RESULTS

Of the 24 patients with pstage I adenocarcinoma, 12 (50%) cases showed a continuous pattern. In only one (16.7%) of the six patients with pstage II adenocarcinoma was this pattern evident. Five year survival was greater in pstage I adenocarcinoma (65%) than in pstage II adenocarcinoma (17%), but the difference was not significant. When the analysis was restricted to the 24 patients with pstage I adenocarcinoma, five year survival was better in continuous pattern cases (88%) than in discontinuous pattern cases (20.5%) (p < 0.05). The survival curve of 12 patients with pstage I adenocarcinoma and a discontinuous pattern resembled that of the six patients with pstage II adenocarcinoma.

CONCLUSION

These findings suggest that patients with pstage I adenocarcinoma and a discontinuous pattern have histopathologically unrecognised micrometastasis when they come to surgery. The staining pattern of type IV collagen could help in the prognosis of pstage I adenocarcinoma of the lung after surgery.

Contingent negative variations associated with jaw opening in humans

We examined the relationship between contingent negative variation (CNV) amplitude and digastric muscle activity in jaw-opening motor task. Subjects were instructed to open their jaws in response to a sound stimulus following a visual warning stimulus. Electroencephalograms were averaged by using the visual stimulus pulse as a trigger. Bilateral CNVs were clearly recorded at several cortical locations, with a tendency for larger amplitudes at temporal placements.

Immunohistochemical distributions of cathepsin B and basement membrane antigens in human lung adenocarcinoma: association with invasion and metastasis

The distributions of cathepsin B (CB) a lysosomal cysteine proteinase, type IV collagen (CIV) and laminin (LM), which are main components of basement membranes (BMs) were studied in a series of 64 human lung adenocarcinomas using an immunohistochemical technique. Over-expression of CB (> 80% positive cells) was significantly associated with the grade of tumour differentiation (p < 0.01), with lymph node metastasis (p < 0.01) and with BM degradation (p < 0.01) detected by the staining pattern of CIV and LM. It was significantly associated with a prognostic disadvantage (p < 0.01). The immunohistochemical staining pattern of CB has a close relationship with degradation of BM, and may be used as a marker for tumour metastasis and prognosis in lung adenocarcinoma.

Complete remission of liver metastases from colorectal cancer by treatment with a hepatic artery infusion (HAI) of interleukin-2-based immunochemotherapy: reports of three cases

In an attempt to improve the therapeutic efficacy against liver metastases, a hepatic arterial infusion (HAI) of interleukin-2 (IL-2)-based immunochemotherapy for anticipating the regional potentiation of hepatic lymphokine-activated killer (LAK)/tumor-infiltrating lymphocytes (TIL) was initiated. We present herein the cases of three patients with multiple liver metastases from colorectal cancer in whom complete remission was achieved by treatment with an HAI of IL-2 in combination with mitomycin C (MMC) and 5-fluorouracil (5-FU). These patients received an HAI of IL-2 at 8 x 10(5) JRU, 5-FU at 250 mg daily, and MMC at 4 mg once weekly for 3 weeks, being the induction regimen, after which they were discharged on maintenance therapy consisting of IL-2 at 2 x 10(6) JRU, 5-FU at 250 mg twice weekly, and MMC at 4 mg once weekly. It was evident from the liver CT scan taken after 2-3 months that the metastatic foci seen before therapy had clearly disappeared, while the serum carcinoembryonic antigen (CEA) had decreased to normal levels in all three patients. Pancytopenia was seen in one patient, but other laboratory studies of the hepatic and renal parameters were normal. The total lymphocyte count in the peripheral blood showed a mild decrease, while the lymphocyte phenotype study showed a notable increase in CD4+ cells and a decrease in CD8+ cells, with an elevation of a 4/8 ratio, in all cases during therapy. One patient relapsed with pelvic recurrence 14 months after the initiation of therapy, but the other two patients are still in remission 25 and 22 months after the initiation of therapy.

A successful liver metastasis model in mice with neuraminidase treated colon 26

The aim of this study was to establish a reproducible and quantitative liver metastasis model in mice. The in vitro colon 26 (C-26) cultured cell line was initially taken from an in vivo transplantable C-26 adenocarcinoma tumor mass using the standard enzymatic treatments, collagenase and DNAse. In vitro cultured cells x 10(4) were introduced into the portal vein of syngeneic BALB/c mice to induce liver metastases and, 3 weeks later metastatic foci were found in approximately 50% to 70% of the mice. In contrast, C-26 cells desialylated by neuraminidase (Nase) treatment greatly increased the incidence of hepatic metastases with countable hepatic colonies being found in all mice (100%). This result seems to be related to the liver-characteristic D-galactose receptors, since pre-injection with an excess amount of galactocerebroside completely prevented tumor colonization in the liver. Thus, although we cannot disregard the involvement of other adhesion molecules in this system as yet, our experimental model may become a useful tool for the analysis of hepatic metastases from colon cancer in the future.

Thigh pain in cementless total hip replacement

The incidence of thigh pain was investigated in 51 joints implanted with model Y or YII cementless total hip system. The 51 patients were followed for one or more years after surgery. Twenty-six out of 51 implanted with the model Y, and the other 25 with the model YII. Thigh pain appeared in 11 out of 26 patients (43%) replaced by model Y and in only 2 out of 25 (8%) replaced by model Y II. The difference in the incidence of thigh pain was attributed to the difference in the extent of the press fit of the stem, stress distribution and postoperative activity. To prevent thigh pain, a favorable press fit must be achieved during surgery, and the excessive weight-bearing must be restricted in postoperative course. In our improved stem design, stress is distributed uniformly on the interface between the bone and the stem resulting in reduction of thigh pain.

Extramedullary plasmacytoma producing biclonal gammopathy

A case of extramedullary plasmacytoma presenting with biclonal gammopathy is reported. The patient was an 82-year-old man in whom monoclonal-protein (M-protein) was not noted during his first hospitalization. On his second hospitalization generalized lymph node swelling and biclonal gammopathy (IgG-kappa, IgA-kappa) were observed. Histological findings were compatible with those of extramedullary plasmacytoma. In the terminal stages, the patient became cachexic. The autopsy disclosed dissemination of the plasmacytoma. Only two other cases have been reported in the literature, and a review of these previous reports is included.

Enhanced activity against syngeneic murine tumors by intrasplenic injection of recombinant interleukin-2 (IL-2) and interleukin-1 (IL-1)

The antitumor activity of Interleukin-1 (IL-1), was assessed against the murine adenocarcinoma colon 26 tumor model in combination with Interleukin-2 (IL-2). Colon 26 tumor cells were inoculated on the back of syngeneic BALB/c mice. Fourteen days after inoculation, when the tumor nodule reached approximately 10 mm in diameter, tumor nodules were resected and Hank's solution, IL-2, IL-1, or IL-2 plus IL-1 were injected directly into the mouse spleen. One week after treatment, potent natural killer (NK) and enhanced lymphokine activated killer (LAK) cell activities were seen in the splenocytes treated by the combination of IL-2 plus IL-1. Furthermore the combination treatment by IL-2 plus IL-1 resulted in a significantly prolonged survival. Phenotypic analysis showed an increased number of percent positive cells expressing asialo GM 1 and IL-2 receptor after treatment with IL-2 plus IL-1. A possible role of IL-1 in augmentation of IL-2 dependent antitumor activity in vivo is discussed.

[A case of round atelectasis associated with spontaneous pneumothorax]

A 59-year-old female was admitted for spontaneous pneumothorax. After evacuation, the chest X-ray film showed a round mass lesion at the left hilum. Following curettage and bronchoalveolar lavage of the left B3c, the mass became smaller, suggesting the diagnosis of round atelectasis. This is the first report of round atelectasis complicated by spontaneous pneumothorax. The mechanism of this case is suggested to resemble that of round atelectasis associated with pleural effusion.

Nucleolar organiser regions as a marker of growth rate in squamous cell carcinoma of the lung

BACKGROUND

The numbers of nucleolar organiser regions (AgNORs) per cell has been considered as an indicator of the cellular proliferative activity. A study was carried out to examine whether AgNOR numbers relate to the growth rate in squamous cell carcinoma of the lung.

METHODS

AgNORs were stained by a one step silver method, and examined in representative paraffin sections from 45 cases of squamous cell carcinoma of the lung treated by surgical resection of the primary tumour.

RESULTS

The mean (SD) AgNOR numbers per cell in squamous cell carcinomas (5.3 (0.9)) were significantly higher than those in normal bronchial epithelium (1.2 (0.1)). There was no statistical difference among tumours of different post-surgical stages (stage I = 5.2 (0.8), II = 5.9 (1.4), III A = 5.5 (1.3)). The tumour volume doubling time in these cases ranged from 74 to 208 days (120.7 (40.4)). There was a high inverse correlation between the AgNOR numbers and doubling time.

CONCLUSION

The AgNOR numbers were related to the growth rate of squamous cell carcinoma of the lung. Thus the AgNOR count could be used as a useful marker for investigating the cellular proliferative activity.

[Evaluation of implantation of a cancer chemotherapeutic vascular access device: report of 91 cases]

Between April 1984 and December 1990, 91 patients with advanced cancer were implanted with vascular-access-devices 97 times. The results were as follows. When the patients were divided into two groups according to the implantation, namely the earlier (until December 1986) and later (from January 1987) periods, the earlier patency rate was higher than later due to improvement of instruments and progress in the implantation technique. There was no significant difference in the rate of patency or complications between the abdominal and femoral method, but the femoral method had some subcutaneous hematomas. The direct femoral pathway is less invasive, correct and effectively therapeutic method.

Correlation between nucleolar organizer regions visualized by silver staining and the growth rate in lung adenocarcinoma

BACKGROUND

The value of nucleolar organizer regions (NOR) visualized by silver staining (AgNOR) for the histologic differentiation, pathologic staging, and estimation of growth rate was assessed by the investigation of paraffin sections from 58 lung adenocarcinomas. AgNOR consist of NOR-associated proteins, and the number of AgNOR might be related to proliferative activity.

METHODS

In lung adenocarcinoma, the growth rate can be measured by means of chest radiographs. Using this technique, the authors studied the correlation between the mean number of AgNOR and growth rate.

RESULTS

The mean number of AgNOR ranged from 1.8 to 6.3 (mean +/- standard deviation, 4.0 +/- 0.8). Neither the degree of histologic differentiation nor the pathologic staging was related to the AgNOR count. The tumor growth rate was estimated on the basis of the doubling time in the chest radiographs of 13 patients. The doubling time ranged from 80 to 760 days. There was a high inverse correlation between the AgNOR count and the doubling time (r = -0.910; P less than 0.001).

CONCLUSIONS

Thus, it appears to be possible to use the mean number of AgNOR as an index of proliferative activity.

[A case of occult breast carcinoma with micronodular shadows on chest x-ray film]

A 57-year-old woman was admitted to our hospital for the evaluation of roentgenological micronodular shadows of the bilateral middle and lower lung fields. Physical findings were normal except for left axillary lymph adenopathy. The level of tumor marker NCC-ST-439 was markedly elevated (2800 U/ml). Histological examination of the transbronchial biopsy and the swollen lymph node biopsy specimens showed proliferation of identical tumor cells. Breast or lung carcinoma was suspected as the primary site. Echogram of the left breast showed microcalcification without a mass. The biopsy specimen obtained from the calcified lesion indicated occult breast carcinoma. From these findings the diffuse micronodular shadows on the chest roentgenogram were considered to be the metastatic lesions of occult breast carcinoma. This case indicates that occult breast carcinoma should be considered as a possible primary site for diffuse pulmonary metastatic lesions.

[A case of bronchial actinomycosis associated with bronchoscopically removed broncholith]

A 57-year-old woman with bronchial actinomycosis associated with broncholith is presented. She had suffered from fever and productive cough for 7 years. Her chest roentgenograms showed atelectasis of the middle lobe and calcification in the middle lobe bronchus. Bronchoscopic examination revealed a broncholith covered with pus and granulomatous tissue. The biopsy specimen revealed sulfur granules containing a partially calcified lesion, and it was diagnosed as actinomycosis. After treatment with antibiotics, the broncholith became movable, and it was removed bronchoscopically. Its shape was like a molding of the right middle lobe bronchus. We speculate that the growth of this broncholith partially resulted from chronic inflammation associated with actinomycelial infection.

Enhanced cell-mediated cytotoxicity by interferon-gamma and interleukin-2 against syngeneic murine mammary adenocarcinoma

The effect of murine recombinant interferon-gamma (IFN-gamma) on cell-mediated cytotoxicity against tumor cells in vitro and in vivo was investigated using a spontaneously developed, weakly immunogenic, syngeneic murine mammary adenocarcinoma, designated JC, as the target. Preincubation of JC tumor cells with IFN-gamma increased the susceptibility of lysis by both cytotoxic T lymphocytes and interleukin-2 (IL-2)-induced lymphokine-activated killer cells in an IFN-gamma dose-dependent manner. A direct injection of IFN-gamma (10,0000 U/d) daily for 5 consecutive days into the JC tumor nodule on the backs of BALB/c mice reduced the tumor growth in comparison with that of the control group. This antitumor activity was further enhanced by combination with a simultaneous intraperitoneal injection of IL-2 (300,000 IU/d) daily for 5 consecutive days. Phenotypic examination of tumor-infiltrating lymphocytes after injection of IFN-gamma plus IL-1 revealed an increased percentage of the cells expressing asialo GM1, L3T4, and IL-2 receptors. Additionally, an enhanced expression of major histocompatibility complex class I molecules on the JC tumor cells was detected. These results indicated that a direct injection of IFN-gamma into the tumor accompanied with the administration of IL-2, by enhancing cell-mediated immunity of the hosts and expression of major histocompatibility complex class I antigens on target cells, will be of potential clinical value.

[Operative risk of splenic repair for isolated but complex splenic injuries due to blunt abdominal trauma]

Surgical repair for complex splenic trauma is often controversial, because the operative risk of splenic salvage may exceed the risk of overwhelming postsplenectomy infection (OPSI). To determine the operative risk of splenic salvage for such injuries, 19 cases of isolated but complex injuries among 73 cases of blunt splenic trauma were examined retrospectively. Shattered spleens were excluded from the study. Splenic repair was accomplished successfully in all 10 attempted cases. Prior to the repair, vascular isolation and temporal occlusion of splenic artery was done to control the bleeding from injured spleen. In another 9 cases, splenectomy was immediately performed after laparotomy. Total amount of blood loss and operative morbidity in each group were not different, and no death occurred in both groups. Operative time was longer in group of splenic repair (112 +/- 20 min) in comparison to splenectomy group (71 +/- 23 min). Postoperative peripheral platelet count, serum IgM level, and finding of RBC scan showed adequate functional activity of the repaired spleen. In conclusion, it is felt that surgical repair should be attempted for isolated but complex splenic injury, and that the spleen should be preferably repaired even with associated injuries, unless prolonged operative time does not increase operative risk to more than that of OPSI.

Modified hemoglobin solution as possible perfusate relevant to organ transplantation

A modified hemoglobin solution (<pyridoxylated hemoglobin>-<polyoxyethylene> conjugate solution, PHP solution) has very interesting characteristics such as oxygen-carrying property without corpuscular components. Experimental use of the PHP solution has shown promising possibilities as a perfusate relevant to organ transplantations. 1) Elongation of warm ischemic time in canine kidneys: Dogs survived even with the unilateral kidneys which had been exposed up to 4.5 hour warm ischemia and, thereafter, perfused with the PHP solution. 2) Elongation of perfusion preservation period of canine livers: Dogs survived with the transplanted livers which had been perfused for 48 hours with the PHP solution. 3) Successful perfusion of rat small intestine: Lewis rat intestines perfused and preserved for 12 hours with the PHP solution showed a higher survival rate compared with those with Collins or UW solution. 4) Removal of antibodies: By exchange transfusion with a total of 30-60 ml of the PHP solution, a Lewis rat hematocrit lowered to 5% while IgG went down to nil from 8970 mg/dl, IgA to 28 mg/dl from 118 mg/dl and IgM to 190 mg/dl from 897 mg/dl. This technique is expected to be applicable for removal of the naturally existing antibodies in xenotransplantation.

[A case of bronchial artery aneurysm demonstrating a mass shadow on chest X-ray film]

A 66-year-old woman was admitted on May 13, 1989, because of an abnormal round shadow in the right hilum on chest X-ray film. Bronchoscopy revealed a stenosis of the right B8 caused by a bulging lesion. An aortogram showed a large meandering bronchial artery and a saccular aneurysm. The aneurysm was about 25 mm in diameter and associated with a bronchopulmonary anastomosis. It was surgically removed by right lower lobectomy. Pathological examination proved that the resected lesion was an arterial aneurysm. Patchy arteriosclerotic change was present in the intima of the aneurysm, but there was no evidence of inflammatory change in the arterial wall and the adjacent alveoli and bronchi. Twenty-six cases of bronchial artery aneurysm have been previously reported in the literature, but this is the first case that appeared as a solitary nodule on conventional chest X-ray.

[Nucleolar organizer regions, nuclear DNA content, and proliferative activity in adenocarcinoma of the lung]

The relationship between the quantity of silver-binding nucleolar organizer regions (AgNORs), nuclear DNA content, and proliferative activity was studied in 61 patients with adenocarcinoma of the lung. The proliferative activity of adenocarcinoma was estimated by tumor volume doubling time based on chest X-ray findings. There was a high, inverse correlation between the AgNORs and the tumor doubling time (p less than 0.001, r = -0.815), and the contribution rate was high value (2 = 0.664). However, the AgNORs value was an independent prognostic factor for survival time. A better 5-year survival rate was observed in patients with DNA diploidy than in DNA aneuploidy, but there was no statistical difference between the two groups. There was an inverse correlation between the DNA index and tumor doubling time (p less than 0.05, r = -0.565), but the contribution rate had a low value (r2 = 0.319). These results indicate that the AgNORs value is important in providing an estimate of the proliferative activity of adenocarcinoma.

[Splenic or hepatic arterial injections of interleukin-2 with chemotherapeutic agents for hepatic metastases]

Splenic or hepatic arterial injections of interleukin-2 (IL-2) with chemotherapeutic agents were performed in colorectal cancer patients with metastasis of the liver. LAK/NK activities in PBL from the patients receiving IL-2 plus cyclophosphamide (CY) splenic infusion were much potent than those of the patients receiving IL-2 alone. Twelve patients were treated with hepatic arterial infusions of IL-2 and mitomycin C (MMC)/5 fluorouracil (5FU). Ten patients were evaluable and remaining 2 cases were not evaluable because of having no measurable lesion; prophylactic infusion for occult metastasis after hepatectomy. Six out of 10 had a complete or partial response (60%), especially all patients receiving 6 months and more (3 cases) had a complete response (100%) and CEA level decreased to normal range. Lymphocyte phenotype study showed notable decrease in CD8+, 16+, 57+ cells and increase in CD4+ cells (elevation of 4/8 ratio) during the therapy. NK activity was closely related to the percentage of CD 16+, 57+ cells in peripheral blood lymphocytes (PBL). These results might be reflected the dramatic accumulation of cytotoxic cells to the liver by the direct activation of hepatic sinusoidal endothelium due to IL-2 perfusion.

Arthroscopic surgery of the hip joint

Hip arthroscopic examination of 196 joints was performed in 104 patients treated during the past 4 years. Of these, 11 joints were treated by arthroscopic surgery. We have developed a technique using a two-directional approach that facilitates a global view of joint areas and allows simpler performance of surgical procedures. Removal of loose bodies, joint debridement in osteoarthritis, and synovectomy in rheumatoid arthritis are good indications for arthroscopic surgery of the hip joint. Short-term follow-up was satisfactory, and a reduction of pain was obtained in all patients. Although the joint space of the hip is narrower and the operative technique is more difficult to perform than in the knee, we believe that arthroscopic surgery of the hip is a suitable method in selected cases.

[Immunohistochemical study of the extracellular matrix in non-small cell lung cancer: relation to lymph node metastasis and prognosis]

The distribution of type IV collagen and laminin in the basement membrane (BM), and fibronectin in the peritumoral stroma of 112 lung cancers (62 adenocarcinomas, 50 squamous cell carcinomas) was studied using immunohistochemical techniques to compare with tumor size, lymph node metastasis and prognosis. In normal lung tissues, type IV collagen and laminin stainings were continuously linear in bronchial BM, blood vessel BM, around bronchial gland and along alveolar septa. Immunoreactivity of fibronectin was shown in BM and stroma. In lung cancers, type IV collagen and laminin stainings were observed in continuous or discontinuous pattern around carcinoma cells, and partially unrecognizable. Staining patterns were divided into continuous (C) and discontinuous (D). And fibronectin patterns were divided into weakly and strongly positive. In relation between staining pattern and lymph node metastasis, in adenocarcinomas, C pattern of type IV collagen staining without lymph node metastasis occurred in 73.9% and with metastasis in 26.1%, on the other hand, D pattern without lymph node metastasis occurred in 25.6% and with metastasis in 74.4%. The correlation was statistically significant (p less than 0.01). And also, in squamous cell carcinomas, C pattern without lymph node metastasis seen in 71.4% and with metastasis in 28.6%, on the other hand, D pattern without lymph node metastasis seen in 27.6% and with metastasis in 72.4%. The correlation was statistically significant (p less than 0.01). But staining pattern of fibronectin didn't correlate to lymph node metastasis. In comparison between C and D patterns, C pattern was associated with longer survival than D pattern (p less than 0.01). In lung cancers without lymph node metastasis, C pattern tended to be higher in 5-year-survival than D pattern, but not significant. These findings suggest that staining pattern of type IV collagen and laminin might be correlated to cancer metastasis and useful to estimate the prognosis.

Cortical potentials associated with voluntary biting movement in humans

We compared the distribution of Bereitschaftspotentials (BPs) on both sides of the scalp preceding jaw biting movements in order to identify the relationship between the cortical regions and the activation of the masseter muscle in 10 healthy subjects. The BPs were recorded from the midline-central, central and temporal areas of the scalp according to the international 10-20 system, preceding self-paced biting on one side. The cortical negative potentials began 1.0 approximately 1.5 s before the EMG onset of the masseter muscle. All of these negative potentials could be considered to be BPs, and the additional negative slope component (NS) occurred 70 approximately 80 ms before the EMG onset of the masseter muscle. The BPs were detected from all the recorded regions of the scalp, while the NS was observed only from the bilateral temporal area. The amplitudes of BPs and NSs were largest in the temporal areas (T3 and T4) that were ipsilateral to the biting. The rates of occurrence of NS at T3 and T4 ipsilateral temporal areas were 80% and 60%, respectively. These results suggest that unilateral biting movements may be controlled mainly from the ipsilateral hemisphere.

[A long-term follow-up case of sarcoidosis with fibrosis and silicotic nodules in the lung]

An autopsy case of a 70-year-old woman with sarcoidosis followed up for 16 years is reported. She was admitted for examination of bilateral hilar lymphadenopathy on chest X-ray film and uveitis in 1971. Sarcoid granuloma was revealed by Daniels lymph node biopsy. After steroid therapy, bilateral hilar lymphadenopathy and uveitis disappeared. However, small nodular shadows appeared in bilateral lower lung fields on chest X-ray film in 1973. Gradually small nodular shadows increased and reticular shadows appeared. In 1980, chest X-ray film revealed fibrotic change in the bilateral lung fields and giant bulla in the left upper lung field. She developed acute pneumonia and died of acute progression of chronic respiratory failure in 1987. Autopsy revealed sarcoid granulomas and honeycomb lesions in bilateral lungs and also silicotic nodules near the sarcoid granuloma in the upper lobes. This case suggests that inhaled mineral particles may play an important role in the development of pulmonary fibrosis in sarcoidosis.

[Ureteral cancer resembling pulmonary edema induced by recombinant human tumor necrosis factor]

A 73-year-old woman with ureteral cancer and multiple systemic metastasis was admitted complaining of dyspnea on exertion after administration of recombinant human tumor necrosis factor (rH-TNF). On chest examination, coarse crackles were heard during inspiration throughout the lungs. Chest roentgenogram revealed a ground glass infiltration, an air bronchogram in the right lung field and an ill-defined right pulmonary artery. Her symptom and chest roentgenological finding improved and coarse crackles were not heard after discontinuation of rH-TNF. Neutrophils and lymphocytes of bronchoalveolar lavage fluid increased and transbronchial lung biopsy specimens showed slight thickening of alveolar septa with infiltration of inflammatory cells. The pulmonary edema was thought to be caused by rH-TNF which induces adherence of neutrophils to endothelium and stimulates them to increase lysosomal enzyme release and oxygen radical production. As a results, it is thought pulmonary permeability might be increased.

[Somatosensory evoked potentials by mechanical stimulation of tooth in humans]

We examined topographical analysis of the PM-SEP (periodontal mechanoreceptor-sensory evoked potential) inducing by mechanical stimulation of the tooth in eight subjects. Sensory evoked potential were recorded from various regions of the scalp by the mechanical stimulation of the normal tooth. Eleven electrodes were placed according to the International 10-20 system (T3, T4, C3, C4, T5, T6, F7, F8, Fz, Cz, Oz). The mechanical stimulation was applied to the right upper first incisor tooth. PM-SEPs were averaged 100 times following the mechanical stimulation of the tooth produced six waves of SEP at the ipsilateral temporal area (T4), but did not evoked any potential from the other regions. PM-SEP included I, II, III, IV, V and VI. The earliest latency (I wave) was approximately 11ms and latest latency (VI wave) was approximately 40 ms. These PM-SEP observed by intensity with 3 times of the threshold. In addition, the all components were abolished after local anesthesia of the periodontal ligament. These data suggests that the six waves of the PM -SEP were evoked the ipsilateral temporal region following mechanical stimulation of the tooth, and these regions were projected by afferent impulse from the periodontal mechanoreceptor.

Nucleolar organizer regions in precancerous and cancerous lesions of the bronchus

Using a silver staining technique, nucleolar organizer region-associated proteins (Ag-NOR) were studied in paraffin sections of five specimens of normal bronchial epithelium, eight of atypical squamous metaplasia, five of carcinoma in situ, and seven of microinvasive squamous cell carcinoma. The mean number of Ag-NOR in the nucleus were normal epithelium 1.2 +/- 0.1 (mean +/- SD), atypical squamous metaplasia (borderline lesion) 2.2 +/- 0.5, carcinoma in situ 3.8 +/- 0.6, and microinvasive squamous cell carcinoma 4.8 +/- 1.1. There was a highly significant difference between the Ag-NOR numbers in the atypical squamous metaplasia and those in the carcinoma in situ (P less than 0.01). The Ag-NOR staining is a useful technique for the differential diagnosis of difficult borderline lesions in the bronchial epithelium.

Synergistic antitumor activity of interleukin-2 and cimetidine against syngeneic murine tumor

Cimetidine, an H2 histamine receptor antagonist, is a potent immunomodulating agent, which acts by inhibiting suppressor T lymphocyte function. The present work investigated the effect, if any, of cimetidine on interleukin-2 (IL-2)-induced natural killer (NK) and lymphokine-activated killer (LAK) cell activities, and on in vivo antitumor activity using syngeneic colon 26 adenocarcinoma as the model. Mimicking the clinical conditions, all in vitro experiments were evaluated with the splenocytes prepared from tumor-bearing BALB/c mice. Ten days after subcutaneous inoculation of tumor cells (5 x 10(5)), animals were treated intraperitoneally daily with phosphate-buffered saline (PBS), cimetidine (2 mg kg-1 day-1), IL-2 (300,000 IU/day), or cimetidine plus IL-2 for 7 consecutive days. The treatment of IL-2 plus cimetidine increased NK and LAK cell activities significantly and synergistically at the end of the treatment (i.e. on day 18) as well as 1 week after the treatment (i.e. on day 25), in comparison with those of the control groups (PBS, cimetidine alone, IL-2 alone). Also, in vivo antitumor activity, as analyzed by a Kaplan-Meier life table with the log-rank test, revealed a significantly prolonged survival in the group treated with IL-2 plus cimetidine compared to the control groups. Phenotyping performed on the murine splenocytes on day 18 indicated a significant reduction in Lyt2-positive cells in the cimetidine-treated group in comparison with the PBS group. A significant increase in asialo GM1-positive cells and IL-2-receptor-positive cells was detected in the group treated with IL-2 plus cimetidine in comparison with the PBS and IL-2 control groups. Therefore, this study indicates a synergistic enhancement of IL-2-induced NK and LAK cell activities in tumor-bearing hosts by cimetidine, a noncytotoxic inhibitor of suppressor T function, and a significantly prolonged survival of tumor-bearing animals treated by IL-2 plus cimetidine. It also suggests the clinical potential of combination therapy of IL-2 with cimetidine.

Prostaglandin E2 from macrophages of murine splenocyte cultures inhibits the generation of lymphokine-activated killer cell activity

The present work investigated the association between prostaglandin E2 (PGE2) from macrophages and its inhibition of murine lymphokine-activated killer (LAK) cell generation. The coculture of indomethacin with interleukin-2 (IL-2) augmented LAK cell activity in an indomethacin dose-response manner, and diminished PGE2 content in the corresponding culture supernatant in a reverse dose-response manner. The correlation between the increase in LAK cell activity and the decrease in PGE2 content was highly significant. Identical results were obtained with diclofenac. A profound inhibition of LAK cell activity by exogenous PGE2 in a dose-response manner was detected. Polyclonal anti-PGE2 antiserum augmented in a dose-dependent manner the LAK cell activity, by neutralizing PGE2 in the medium. A reduction of PGE2 content in the culture supernatant was also detected when the macrophage subpopulations were cultured and was indomethacin dose-dependent. In comparison with that of normal mouse splenocytes, the incubation of whole splenocytes of tumor-bearing mice, which contained a greater subpopulation of macrophages (24% vs. 12%), produced a greater PGE2 content and a correspondingly depressed LAK cell activity. Additionally, PGE2 reduced protein kinase C (PKC) activity along with LAK cell activity generated from macrophage-depleted T cells and natural-killer-like cells. These results overall indicate that PGE2 from macrophages in murine splenocyte cultures inhibits the LAK cell generation, and PKC may be involved in the inhibition mechanism.

Prostaglandin E2-mediated suppression of murine lymphokine-activated killer cell activity generated from tumor-bearing hosts by interferon-gamma

The effect of mouse recombinant interferon-gamma (IFN-gamma) on murine lymphokine-activated killer (LAK) cell activity was investigated using a natural killer-resistant, LAK-sensitive, spontaneously developed, weakly immunogenic, syngeneic murine mammary adenocarcinoma, a tumor model mimicking that of human disease. When all of the splenocytes prepared from tumor-bearing mice were cultured with recombinant interleukin-2 (IL-2) and IFN-gamma, LAK cell activity was suppressed in an IFN-gamma dose-dependent manner. An increase in the prostaglandin E2 (PGE2) content in the corresponding culture media was detected, as was IFN-gamma dose dependent. The suppression of generation of LAK cell activity by IFN-gamma was abrogated, accompanied by the elimination of the increase in PGE2 content, when plastic dish and nylon wool-treated nonadherent macrophage-depleted splenocytes were used. These results indicated that IL-2-induced LAK cell activity generated from the splenocytes of tumor-bearing mice was suppressed by IFN-gamma, and that PGE2 secreted from the macrophages of the splenocyte cultures served as the mediator in this IFN-gamma dose-dependent suppression of IL-2-induced LAK cell activity.

[Immunomodulating effect of intratumoral (IT) injection of biological response modifiers (BRM) on tumor-bearing hosts]

Preoperative endoscopic intratumoral injection (IT) of biological response modifiers (BRM), such as OK432, a compound composed of attenuated Streptococcus pyogens, in gastric cancer patients has been tried and this method has been improving the prognosis compared to surgical resection only. We tried to clarify this mechanism using experimental mouse system and demonstrated here the preoperative IT of OK432 significantly prolonged the survival and induced the tumor-specific cytotoxic T lymphocytes (CTL) in the spleen. By contrast, tumor necrosis factor (TNF) IT failed to prolong the survival and to induce specific CTL response, although it reduced primary tumor size significantly. To analyze why OK432 IT induce the systemic CTL response, viable tumor cells and infiltrating dish-adherent cells from the OK432 injected tumor mass were harvested and examined the class I and class II antigen expression by flow cytometer. Class I and class II antigen expression of the tumor cells remained unchanged, however, the class II positive dish-adherent cells markedly increased by OK432 pretreatment. As same in these results, histological finding in gastric cancer specimen has shown prominent increase of Langerhans cells, possessing potent antigen-presenting function and positive class II antigen, by OK432 pretreatment. Taken together, these findings strongly suggest that the increased class II positive antigen-presenting cells (APC) activity by OK432 IT augment the CTL response via cascade reaction and finally, resulted in anti-tumor efficacy in vivo.