External radiotherapy for biliary decompression of hilar cholangiocarcinoma

Obstructive jaundice due to hilar cholangiocarcinoma is difficult to decompress because of the location of the tumor. We used external radiation alone for biliary decompression and reviewed its efficacy in this study. Subjects comprised 14 patients diagnosed as having inoperable hilar cholangiocarcinoma by ultrasonography, percutaneous transhepatic cholangiography, and CT scanning. The total bilirubin level on admission ranged from 0.4 to 34.6 mg/dl (mean: 11.0 mg/dl). These patients were irradiated with a 4MeV linear accelerator using parallel opposing fields measuring from 7 x 7 cm to 8 x 10 cm. The total radiation dose ranged from 50 Gy to 60 Gy and in fractions of 1.8-2.0 Gy per day. No patient underwent further biliary decompression after percutaneous transhepatic cholangiography, and irradiation was performed immediately after diagnosis. Eleven of the 14 patients received the full dose of external radiation. Three patients discontinued radiotherapy because of severe vomiting and nausea, pneumonia, and a hemorrhagic gastric ulcer. In 10 of the 11 patients, the serum total bilirubin level returned to normal (p < 0.005) and no cholangitis occurred. Obstructive jaundice recurred in one patient, and serum total bilirubin returned to normal again after further irradiation. Eight of the 11 patients could be discharged from hospital and returned to society. The survival time of the 11 patients ranged from 3 to 25 months and the 12-month survival rate was 50% (Kaplan-Meier method). This study suggests that external radiation therapy is an effective treatment for biliary decompression in patients with unresectable hilar cholangiocarcinoma.

Determination of the affinity constants of concanavalin A for monosaccharides by fluorescence affinity probe capillary electrophoresis

Dissociation constants between a legume lectin, concanavalin A (Con A), and unlabeled neutral monosaccharides were determined by affinity probe capillary electrophoresis (APCE). An affinity probe was synthesized by coupling Lissamine rhodamine B and p-amino-phenyl-alpha-D-mannopyranoside, with glutathione as a negatively charged linker. Electrophoresis of the affinity probe was carried out at neutral pH in a fused silica capillary coated with succinylpolylysine on its inner surface, using laser-induced fluorescence detection. In the presence of Con A, the mobility of the affinity probe decreased and this decrement was analyzed as a function of the concentration of Con A. In the presence of a mixture of Con A and an unlabeled monosaccharide, APCE can thus measure the concentration of Con A unoccupied by the unlabeled monosaccharide, and this allows the determination of the dissociation constant of the Con A-monosaccharide complex. The method should be useful for the analysis of a wide range of molecular interactions on a microscale.

Clinical evaluation of pulmonary nodules with single-exposure dual-energy subtraction chest radiography with an iterative noise-reduction algorithm

PURPOSE

To compare the clinical usefulness of the single-exposure dual-energy subtraction method with an iterative noise-reduction algorithm.

MATERIALS AND METHODS

Fourteen radiologists read three sets of images from 44 patients: original computed radiographic images only, original computed radiographic images plus conventional bone-subtracted images, and original computed radiographic images plus iterative noise-reduced bone-subtracted images. Twenty-two patients had one or more (maximum, five) pulmonary nodules; 22 had no pulmonary nodules. Observer performance was evaluated by means of calculation of the average area under the alternative free-response receiver operating characteristic curves (A1).

RESULTS

Compared with the original computed radiographic image only, detection of nodules was significantly better with both the original computed radiographic image plus iterative bone-subtracted image (A1 = 0.72 +/- 0.02 and 0.66 +/- 0.02, respectively; P = .01) and the original computed radiographic image plus conventional bone-subtracted image (A1 = 0.66 +/- 0.02 and 0.61 +/- 0.01, respectively; P = .03).

CONCLUSION

The iterative noise-reduction algorithm is superior to conventional methods in detection of pulmonary nodules.

Involvement of protease inhibitors in staphylokinase-induced fibrin-specific fibrinolysis

We compared the fibrinolytic properties of recombinant staphylokinase (SAK), a fibrin-specific plasminogen activator, with those of streptokinase and tissue-type plasminogen activator (t-PA) by means of the amidolytic method. We also investigated the involvement of alpha 2-macroglobulin, C1-inactivator and alpha 1-antitrypsin in SAK-induced fibrin-specific fibrinolysis. Both SAK and t-PA activated plasminogen efficiently in the presence of fibrin in human plasma. Although t-PA activated plasminogen dependently on fibrin in the reconstituted plasma system, SAK activated plasminogen independently of fibrin without alpha 2-plasmin inhibitor (alpha 2-antiplasmin, alpha 2-PI). These findings suggest that fibrin and alpha 2-PI play important roles in plasminogen activation by SAK but not by t-PA. Furthermore, protease inhibitors such as alpha 2-PI, alpha 2-macroglobulin, C1-inactivator and alpha 1-antitrypsin inhibited plasminogen activation by SAK and the inhibitory actions of these protease inhibitors disappeared in the presence of fibrin. This shows that alpha 2-macroglobulin, C1-inactivator and alpha 1-antitrypsin, other than alpha 2-PI, contribute to the fibrin-specificity of SAK.

Fibrin-specific fibrinolysis induced by recombinant staphylokinase

We compared the thrombolytic properties of recombinant staphylokinase (SAK) with those of streptokinase (SK), a tissue-type plasminogen activator (t-PA) and a urokinase-type plasminogen activator (u-PA) in the jugular vein thrombosis model in the rabbit in vivo and a circulating human plasma system in vitro. 50% thrombolysis was observed at 360 min after intravenous infusion into rabbits of 150 micrograms/kg of SAK or 500 micrograms/kg of t-PA, respectively. And the fibrinogen level in the blood was not affected by either agent. 50% clot lysis in vitro was observed at 120 min with 1.8 micrograms/ml of SAK, 22.1 micrograms/ml of SK, 2.1 micrograms/ml of t-PA, or 4.7 micrograms/ml of u-PA, respectively. All the plasminogen activators with the exception of SAK decreased the residual fibrinogen level in the circulating plasma at their moderate concentration for clot lysis. SAK had less influence on the plasminogen and alpha 2-plasmin inhibitor (alpha 2-antiplasmin) levels than the other plasminogen activators. These findings suggest that SAK is a potent fibrin-specific thrombolytic agent.

IL-1 induces intracisternal type A virus and retrovirus type C in pancreatic beta-cells of NOD mice

Recent observations have suggested a role for interleukin 1 (IL-1), a macrophage-derived cytokine, in the autoimmune beta-cell destruction, that is associated with type 1 diabetes. In this study, we investigated the effects of human recombinant IL-1 beta on pancreatic beta-cells from NOD and NON mice (diabetes-resistant NOD-related strain), focussing upon the appearance of intracisternal type A virus (IAP) and retrovirus type C. NOD mice pancreatic islets were incubated with or without IL-1 (0.1, 1, 10, 100 U/ml) for 10 days. Thereafter, the islets were examined using an electron microscope. When the islets of NOD mice were incubated with the IL-1 (10, 100 U/ml) under condition of high glucose, IAP and endogenous retrovirus type C frequently appeared in the beta-cells. Retrovirus type C was present as a cluster. In contrast, IAP and retrovirus type C were rarely found in beta-cells from the control group. When the islets of NON mice were incubated with or without IL-1 (10 U/ml) in the presence of high glucose, IAP was rarely found in beta-cells and retrovirus type C was undetectable in beta-cells. This study indicated that IL-1 is an important effector that leads to insulitis or aggravates insulitis in NOD mice.

The character of endogenous retrovirus in pancreatic beta-cells of NOD mice

The character of retrovirus type C in NOD mouse pancreatic-beta-cells was investigated. First, the in vitro response of retrovirus type C to glucose stimulation was examined. When the pancreatic islets of control NON mice were observed with an electron microscopy retrovirus types C could not be detected in the beta-cells with or without glucose stimulation. Retrovirus type C particles and intracisternal type A particles (IAPs) in NOD mouse pancreatic beta-cells increased by glucose stimulation, but the increase in retrovirus type C differed from that of IAPs. The clusters of retrovirus type C were found in some beta-cells, whereas IAPs were scattered in beta-cells. Next, we investigated the expression of retrovirus type C transcript in NOD mouse pancreatic islets. From polymerase chain reaction analysis using two primers of retrovirus type C designed from a conserved U3 region, a major product was found to be endogenous polytropic retrovirus (Pmv). The subcloned PCR probe and oligonucleotide probes specific for Pmv and modified polytropic retrovirus were used for Northern blot analysis. Pancreatic islets from NOD and NON mice (control mice) contained 8.4-kb and 3.0-kb Pmv transcripts. The quantity of transcripts of Pmv in NOD mouse pancreatic beta-cells were the same as that in NON mice. The transcript level of islets was much higher than those of thymus and liver. The appearance of retrovirus type C particles in beta-cells of NOD mice may involve the mechanisms by which diabetes is generated in NOD mice.

Affinity probe capillary electrophoresis: analysis of recombinant human growth hormone with a fluorescent labeled antibody fragment

A new highly sensitive microscale analytical procedure called affinity probe capillary electrophoresis (APCE) is presented. One of the two species, which can form a biospecific complex, is labeled with a fluorescent dye. The affinity probe is used to detect the analyte as a complex after the separation of the excess free probe by capillary electrophoresis. As an example of this approach, an FAB' fragment of a mouse monoclonal antibody (anti-human growth hormone) was labeled with tetramethylrhodamine-iodoacetamide at a hinge region thiol group. Samples were mixed with the purified labeled antibody fragment, and the associated complex was separated by capillary isoelectric focusing with detection by laser-induced fluorescence. In these preliminary results, methionyl recombinant human growth hormone (met-rhGH) could be successfully determined down to detection levels of approximately 5 x 10(-12) M. Mono- and dideamidated variants of met-rhGH were detected simultaneously with the nondeamidated form of the antigen as separate peaks.

Genetic transformation of industrial yeasts using an amino acid analog resistance gene as a directly selectable marker

Prototrophic and often polyploid yeasts of industrial use require some dominant genes as directly selective markers for the transformation. We examined the applicability of a dominant gene, ARO4-OFP, which causes the resistance to PFP plus tyrosine, to direct selection of the transformants from 2 laboratory and 6 industrial strains, including bakers', distillers', winery, and saké yeasts. Although the transformation rates were low and seemed different among strains, the ARO4-OFP gene was applicable to all strains tested for direct selection of the transformants.

Study on the efficacy of biodegradable poly(L-lactide) mesh for supporting transplanted particulate cancellous bone and marrow: experiment involving subcutaneous implantation in dogs

Poly(L-lactide) (PLLA) mesh sheets, monofilaments and mesh cylinders filled with fresh autogenic particulate cancellous bone and marrow (PCBM) were implanted subcutaneously into the back of 22 adult dogs for 1 yr. Polypropylene (PP) was used as a control. The inflammatory response to PLLA mesh sheets was slight, similar to PP mesh sheets. However, 3 months after implantation, histiocytes and multinucleate giant cells appeared on the surface of the monofilaments of PLLA mesh sheets and gradually increased in number as the monofilaments were degraded and absorbed. Almost no inflammatory cellular infiltration was seen in the tissue around PLLA mesh sheets or between the monofilaments. When a PLLA mesh cylinder filled with PCBM was implanted subcutaneously, the bone formation reached its peak 1 month after implantation, as in the case of a similar PP mesh cylinder, and bone formation was observed along the inner wall of the cylinder. In addition, a vascular net was abundant within the cylinder. The mechanical strength of the test material (PLLA monofilaments) did not change for almost 2 months after implantation, and 80% of its initial strength was retained for 3 months. These observations suggest that a PCBM graft supported by PLLA mesh would be very effective in the reconstruction of damaged maxillofacial bones, since histological tissue reactions associated with biodegradation of the PLLA mesh are mild and the PLLA mesh does not interfere with bone formation of PCBM. It was also found that the PLLA mesh retains its mechanical strength long enough to allow the PCBM transplant to develop sufficient strength to sustain the damaged region.

Reduction in tumour formation on porous polyethylene by collagen immobilization

After surface modification with collagen immobilization through covalent bonding, porous polyethylene pieces with an average pore size of 400 microns were implanted subcutaneously into the back of rats for 1 yr. It was found that connective tissues with abundant blood vessels were formed clearly, filling more than 90% of the pore volume and bound firmly to the pore walls. A tumour was found in only one of 24 implanted pieces (4.2%). On the other hand, the virgin porous polyethylene pieces without collagen immobilization exhibited inflammatory reactions within the pores and the connective tissues produced filled only 15% of the pore volume. Formation of a malignant histiocytoma was observed in 11 of the 24 pieces which had been implanted (45.8%). Thus, immobilization of collagen on the surface of an artificial material through covalent bonding proved to be very effective not only for firm bonding with soft connective tissues but also for a reduction of tumour formation.

Single-exposure dual-energy chest images with computed radiography. Evaluation with simulated pulmonary nodules

RATIONALE AND OBJECTIVES

Dual-energy subtraction radiography using computed radiography (CR) can aid in the detection of pulmonary abnormalities such as nodules, but the subtracted image requires higher x-ray exposure than usual to reduce quantum mottle. To reduce quantum mottle without increasing x-ray exposure, a new dual-energy subtraction algorithm was investigated that included an edge-adaptive smoothing process and a subtraction process. The signal-to-noise ratio and the image quality of this new subtracted image was significantly superior to that of conventional subtracted images.

METHODS

Observer performance of the subtracted digital radiography in detecting simulated pulmonary nodules was compared with original CR images and conventional subtracted digital radiography of 50 patients.

RESULTS

A combination of an original CR image and a new subtracted CR image was significantly superior to a single original CR image or a combination of an original CR image and a conventional subtracted CR image (P < .01).

DISCUSSION

The single-exposure dual-energy subtraction method is superior to the conventional subtraction method in the detection of pulmonary nodules.

Antitumor activity of a new low immunosuppressive derivative of podophyllotoxin (GP-11) and its mechanisms

The spin-labeled derivative of podophyllotoxin, N'-podophyllic acid-N-[3-(2,2,5,5-tetramethyl pyrrolinenyloxy)] semicarbazide (GP-11), was synthesized and tested for its antitumor activity against mouse transplantable tumors, Sarcoma-180, Hepatoma-A, P388 leukemia and Ehrlich ascites carcinoma. At an equitoxic dose, the antitumor activity of GP-11 was similar to that of etoposide (VP-16). However, the immunosuppressive effects of GP-11 were weaker than that of VP-16. In vitro, GP-11 and VP-16 inhibited the proliferation of human lymphoid leukemia Molt 4B cells and suppressed DNA and protein syntheses, but the effect of GP-11 and VP-16 on cell cycle progression was different. The mitotic index was increased by GP-11 and reduced by VP-16. On the basis of flow cytometric bromodeoxyuridine (BrdU)/DNA analysis, GP-11 and VP-16 resulted in the accumulation of cells in the S and G2/M phases. G2/M arrest by GP-11 on cell cycle progression was stronger than that of VP-16, while S arrest was weaker than that of VP-16. After the removal of drugs, the arrest by GP-11 and VP-16 still existed and was irreversible. These results may provide insights into the structure-activity relationships and the design of novel derivatives of podophyllotoxin useful in cancer chemotherapy.

Soft tissue reaction to collagen-immobilized porous polyethylene: subcutaneous implantation in rats for 20 wk

Collagen-immobilized porous polyethylene, in which the immobilization was through covalent bonding, and virgin porous polyethylene were implanted subcutaneously in rats from 1 to 20 wk. The results were the ingrowth of the connective tissue into collagen-immobilized porous polyethylene was rich and contained a low level of inflammatory cellular infiltration compared with that of virgin porous polyethylene. The material-tissue interface showed that the living body-originated collagen fibres were firmly anchored into the immobilized collagen layer. These results suggested that covalent immobilization of collagen on to the biomaterial surface is useful in promoting the ingrowth of soft tissue and the tissue adhesion.

Improvement of detection in computed radiography by new single-exposure dual-energy subtraction

It is reported that the use of the dual-energy subtraction method enhances the abnormal shadow detection capability. However, because the subtracted image is significantly inferior to the original in signal-to-noise ratio (SNR), the x-ray dosage normally used for chest x-rays has not yielded subtracted images with adequate SNRs. Under these circumstances, we focus on the fact that there is a correlation between the noise contents of bone-and soft-tissue-subtracted images although there is no correlation between the signal contents of these images. We propose an algorithm that improves SNRs of subtraction images by reducing the noise only.

Biochemical and morphological alterations of macrophages and spleen cells produced by antitumor polysaccharide from Acanthopanax obovatus roots

Acanthopanax obovatus polysaccharide (AOPS) administrated intraperitoneally (i.p.) resulted in the augmentation of phagocytosis and the chemiluminescence in peritoneal macrophages of mice. Binding of the third component of complement (C3) cleavage products to the receptors on peritoneal macrophages was enhanced by AOPS. The C3 conversion in human serum was increased by AOPS in vitro treatment. When given i.p., AOPS led to the enhancement of spleen weight, spleen cell number, and plaque-forming cells. It was also found that after in vivo administration AOPS not only enhanced the synthesis of DNA and protein but also promoted the mitogenic responses of spleen cells. The morphological observation of spleens indicated that AOPS augmented the transformation from lymphocytes to plasma cells. AOPS inhibited the growth of mouse solid Sarcoma-180 and prolonged the survival time significantly. These results suggest that AOPS is an effective biological response modifier and its antitumor activity is related to its immunopotentiating effects.

Resistance of chicks against reinfection with Leucocytozoon caulleryi

Chickens were inoculated with five to 40 sporozoites of Leucocytozoon caulleryi at 1 to 9 days of age. Mortality, parasitemia, appearance of serum-soluble antigen, and antibodies were examined. Chickens that survived primary infection were reinoculated with 3 x 10(3) to 1 x 10(4) sporozoites and examined for resistance against reinfection by the same criteria used in primary infection. After primary infection, up to 80% of chickens died of leucocytozoonosis. Surviving chickens showed parasitemia from 13 days to 23 or 24 days after inoculation. Serum-soluble antigen and antibodies were detected in most chickens, except for some chickens that were infected at 1 to 3 days of age. After secondary infection, only a few chickens that received primary infection at 1 to 7 days of age showed a small number of parasites in their peripheral blood. Most of the other chickens were resistant to reinfection. Resistance to reinfection was recognized in some chickens that had not showed antibody production before secondary infection.

[A 13-week percutaneous toxicity study of prednisolone farnesylate (PNF) gel in beagle dogs with a recovery period of 5 weeks]

The toxicity of Prednisolone farnesylate (PNF) gel, a synthetic glucocorticoid, was investigated in the Beagle dog. PNF gel was administered percutaneously at doses of 0.2, 0.8 and 3.2 mg/kg/day for 13 weeks, then the drug was withdrawn for 5 weeks to evaluate the reversibility. In addition, 2 mg/kg/day prednisolone gel (PN gel), which is approximate to 3.2 mg/kg/day PNF gel in prednisolone molarity, was also administered for comparison. The results are summarized as follows: 1. No deaths were observed in any of the PNF gel test groups or the PN gel group, nor were there any abnormal findings in the clinical signs of the animals. 2. In the hematology, a tendency toward a decrease in the lymphocyte ratio was observed in males from the PNF gel 0.8 mg/kg/day and above groups. In the PN gel group, a significant decrease or a tendency toward a decrease in the lymphocyte ratio was observed, as well as an increase in the white blood cell count in some animals. 3. In the blood biochemistry, a significant decrease or a tendency toward a decrease in total cholesterol and phospholipid was observed in males from the PNF gel 3.2 mg/kg/day group and a tendency toward an increase in triglyceride in females from the PNF gel 3.2 mg/kg/day group was observed. In the PN gel group, a tendency toward an increase in AIP activity, a tendency toward an increase in triglyceride were observed. 4. In the histological examinations, a decrease in the weight of the thymus and adrenal glands, vacuolation of hepatocytes in the middle zone of the liver, atrophy of zona fasciculata of the adrenal glands, hypertrophy of zona glomeruli, swelling of cortical cells of zona faciculate and atrophy of the thymus were observed in the PNF gel 0.8 mg/kg/day and above groups. In the PN gel group, atrophy of submandibular lymph nodes and mesenteric lymph nodes was observed in addition to the same changes as observed in the PNF gel groups. Furthermore, thinning, atrophy or a decrease in the weight of the adrenal glands was also observed both in the PNF gel 3.2 mg/kg/day group and the PN gel group at the end of the 5-week recovery period. 5. As described above, a decrease in the lymphocyte ratio, in the weight of the thymus and adrenal glands and vacuolation of hepatocytes were observed in the PNF gel 0.8 mg/kg/day and above groups.(ABSTRACT TRUNCATED AT 400 WORDS)