Characteristic changes of DNA stemlines during hepatocarcinogenesis in rats

DNA stemlines of hepatocellular carcinoma (HCC) model of adult Wistar rats established by diethylnitrosamine were quantitatively measured by flow cytometry. The cancer-inducing course was divided into four stages, eg, precirrhosis stage, cirrhosis stage, early cancer stage and cancer progression stage. The advantageous DNA stemline of hepatocytes of normal adult Wistar rats was tetraploid (4C). It was from the cirrhosis stage that atavistic proliferation of hepatocytes with diploid (2C) DNA stemline started and replaced 4C hepatocytes, resulting in a new advantageous population. The features of early cancer stage were formation of HCC with 2C DNA stemline, whereas during the cancer progression stage, HCC cells with aneuploid (AN) DNA stemline presented the advantageous growth. The study clearly shows the change pattern of DNA stemline during the course of hepatocarcinogenesis from 4C-2C-AN, which is believed to be the biokinetic mechanism of the development and progression of HCC.

Stimulation of macrophage colony-stimulating factor synthesis by interleukin-1

Interleukin-1 (IL-1), which plays an important role in the inflammatory response, was found to induce colony-stimulating factor-1 (CSF-1) expression in the MIA PaCa-2 cells. IL-1-induced CSF-1 production was markedly suppressed (70%) by pertussis toxin. This inhibition by pertussis toxin was reversed by benzamide, an inhibitor of ADP-ribosylation reactions. Similarly, IL-1-induced CSF-1 production was inhibited by cholera toxin and this inhibition was reversed by an arginine analog, p-methoxy-benzylaminodecamethylene guanidine sulfate. Dibutyryl-cAMP as well as other cAMP elevating agents such as theophylline and forskolin also suppressed IL-1-induced CSF-1 production, suggesting that cAMP concentrations inversely regulate the biosynthesis of CSF-1. Measurement of cAMP concentration indicated that IL-1 treatment of MIA PaCa-2 cells did not change the cAMP level. IL-1-induced CSF-1 production was not suppressed by the protein kinase C (PKC) inhibitor, H7, under conditions in which 12-O-tetradecanoylphorbol-13-acetate-induced CSF-1 production was completely abolished. These data suggest that IL-1-induced CSF-1 production is not mediated via the activation of PKC. Analysis of oncogene c-fos and c-jun expression has shown the enhancement of expression of both protooncogenes prior to CSF-1, suggesting that the expression of these two oncogenes may be the mechanism which triggers CSF-1 gene expression.

Hepatic arterial chemoembolization with CDDP microcapsules. Experimental studies

After cis-diamminedichloroplatinum ethylcellulose microcapsules (CDDPmc) and unencapsulated CDDP were infused into the hepatic arteries of New Zealand rabbits, both CDDP concentrations in the circulating blood and in hepatic tissue were measured at different time intervals. In the rabbits infused with CDDPmc, the CDDP concentration was maintained at a high level for a significantly longer time in the hepatic tissue and the maximum CDDP level in the circulating blood was greatly reduced, as compared with those in the rabbits infused with unencapsulated CDDP. The tumoricidal effects of arterial infusion of CDDPmc were also evaluated in a model of liver tumor in rats. The therapeutic effects on rat liver tumor of CDDPmc were superior to those of unencapsulated CDDP and blank ethylcellulose microcapsules. The rats treated with CDDPmc showed a significantly lower tumor growth ratio, more extensive tumor necrosis and longer survival time. The results of this study indicate that CDDPmc is a more potential dosage from than conventional CDDP for hepatic arterial infusion in the treatment of liver cancer.

[Risk factors related to the use of amphetamines in adolescent students]

The prevalence of amphetamine abuse among school children was studied by asking 3548 adolescent students (aged 12-15, response rate 98.6%) to complete a questionnaire anonymously, which was developed and evaluated by the authors. A complete set of data was collected for 3200 (90.2%) students. Eighty-five (2.7%) of them who admitted that they had used amphetamines constituted the case group. Non-users with negative urine tests formed the control group. Six independent factors were found to be related to amphetamine use when the answers were analyzed by stepwise logistic regression. The prevalence odds ratio estimation was elevated in: males compared females, students who did not live with both parents compared to those who lived with both parents, students with amphetamine-user friends compared to those with no-user friends, smokers compared to non-smoker, betel nut chewers compared non-chewers, and in students with positive attitudes compared to those with negative attitudes. The average starting age for smoking was 12.5 +/- 0.1 years; later this was followed by alcohol abuse, chewing of betel-nuts, and use of amphetamines. The average age of starting to use amphetamines was 13.5 +/- 0.2 years; a common reason given for using amphetamines was curiosity (65.4%). Many students (54.2%) obtained the amphetamine from their friends and most of them (85.2%) used it six months before responding to the questionnaire.

A phorbol diester resistant monocytic leukemia cell line is PKC deficient

MIA C51 is a rat monocytic leukemia cell line which exhibits undifferentiated monocytic phenotype in culture. The proliferation of MIA C51 cells was not inhibited by the addition of 12-O-tetradecanoyl-phorbol-13-acetate (TPA, 1 microgram/ml) or phorbol 12, 13 dibutyrate (PDBu, 10 micrograms/ml). Comparison of MIA C51 cells to a phorbol diester-sensitive human monoblastoid U-937 cell line demonstrated that MIA C51 cells contained significantly lower number of PDBu receptors, protein kinase C (PKC) activity, and PKC protein level. Further experiments demonstrated that addition of TPA to MIA C51 cells did not induce the expression of c-fos proto-oncogene; whereas incubation of MIA C51 cells with N6, O2-dibutyryl cyclic adenosine 3',5' monophosphate (Bt2cAMP) resulted in a rapid increase of c-fos mRNA level. Thus, this cell line provides a new system for studying the signal transduction mechanisms in induced monocytic differentiation.

The biopathologic characteristics of DNA content of hepatocellular carcinomas

A gross morphologic classification of 66 small hepatocellular carcinomas (SHCC, less than or equal to 3 cm in diameter) was made and DNA content of 30 SHCC and 26 large hepatocellular carcinomas (LHCC, greater than 3 cm in diameter) was determined by image analysis technology. The three types of SHCC are as follows: type I, noncapsule type; type II, capsule type; and type III, infiltrative type. Of the SHCC, 73.3% had diploid DNA content, and 84.6% of LHCC had aneuploid DNA content. The postoperative 5-year survival rate of patients with SHCC was 62.1%, which is higher than the rate of 27.7% of patients with LHCC. There was no correlation between tumor size and serum alpha-fetoprotein (AFP) levels. The results suggest that the period when SHCC are 3 cm in size may be important as the changes of DNA stemlines and biological characteristics would occur then. The SHCC of less than 3 cm reflect relatively benign biological behavior of early hepatocellular carcinoma and this period is the best opportunity for the clinician to get the best prognosis. Currently determination of serum AFP is still one of the possible and effective methods to early finding SHCC.

The biopathologic characteristics of DNA content of hepatocellular carcinomas

A gross morphologic classification of 66 small hepatocellular carcinomas (SHCC, less than or equal to 3 cm in diameter) was made and DNA content of 30 SHCC and 26 large hepatocellular carcinomas (LHCC, greater than 3 cm in diameter) was determined by image analysis technology. The three types of SHCC are as follows: type I, noncapsule type; type II, capsule type; and type III, infiltrative type. Of the SHCC, 73.3% had diploid DNA content, and 84.6% of LHCC had aneuploid DNA content. The postoperative 5-year survival rate of patients with SHCC was 62.1%, which is higher than the rate of 27.7% of patients with LHCC. There was no correlation between tumor size and serum alpha-fetoprotein (AFP) levels. The results suggest that the period when SHCC are 3 cm in size may be important as the changes of DNA stemlines and biological characteristics would occur then. The SHCC of less than 3 cm reflect relatively benign biological behavior of early hepatocellular carcinoma and this period is the best opportunity for the clinician to get the best prognosis. Currently determination of serum AFP is still one of the possible and effective methods to early finding SHCC.

Aspects of treatment in alpha 1-antitrypsin deficiency: insights derived from a Swedish PiZZ series

Data were analysed on 158 adult Swedish alpha 1-antitrypsin deficient individuals homozygous for the proteinase inhibitor allele (PiZZ), followed from 1963-1982. The initial forced expiratory volume in one second (FEV1) increased from 1.4 l in the early cohort to 1.9 l (p less than 0.001) in the late cohort of the study period but mean age (47 yrs) and the percentage of smokers (72%) remained unchanged. Smokers were found to have significantly lower FEV1 levels (p less than 0.01) and higher (p less than 0.005) mortality than non-smokers. The differences between current and ex-smokers in mortality and FEV1 level, however, were not significant. Longitudinal analysis of FEV1 rates of decline in 80 cases with follow-up FEV1 measurements failed to detect any significant difference between current and ex-smokers but investigations were performed late in the disease process. Low initial FEV1 value was found to be significantly associated with increased mortality (p less than 0.005). In order to detect a 40% difference in the rate of FEV1 decline as an outcome variable, 253 patients plus controls must be included in follow-up studies of replacement therapy. With mortality of severely affected patients as outcome variable only, 144 treated and untreated patients would be required. The need for earlier diagnosis and intervention against smoking in these cases is emphasized.

Experience with orthotopic rat liver transplantation

300 orthotopic liver transplantations in rats were performed for a variety of reasons. Male rats including Lewis, ACI, Wistar, and SD, with a body weight of 150 to 400 g, were used as liver donors and recipients. A midline abdominal incision was performed in both donor and recipient animals. The donor's liver was perfused through the aorta abdominalis. The recipient's liver was flushed via the protal vein (PV) with 2 ml of lactated Ringer's solution immediately after occlusion of the PV to make intrahepatic blood enter the circulation. The bile duct was reconstructed by end-to-end anastomosis via a Teflon catheter. The cuff technique was applied to anastomoses of the infrahepatic vena cava (VC) and PV. The suprahepatic VC was anastomosed using either suture or cuff technique. The operative success rate was 92.7% (278/300) on the average and 1-week survival rate 88.4% (199/225) in isografting. The model proved reliable for studies of liver transplantation.

Respiratory function in patients with spinal cord injuries: effects of posture

The purpose of this study was to evaluate the respiratory function of spinal cord injuries (SCI) during different postures. Measurements were performed with a Fukuda PM 80 spirometer on 31 chronic stable SCI and 22 normal controls. Among the SCI patients, there were 12 quadriplegics and 19 paraplegics. The respiratory parameters, including forced vital capacity (FVC) and forced expiratory volume during first second (FEV1.0) were collected in each subject during supine, sitting and standing postures. The results revealed that SCI patient had impaired FVCs (p less than 0.05), the degree of impairment depending upon the level of cord injury (r = 0.81). The FEV1.0/FVC ratio of SCI was normal. For quadriplegics, the FVC during sitting and standing fell on 30 to 50% of normal values. The FVCs of paraplegics during all postures were around 80% of the predicted values. The FVC in the control group was reduced by 5 to 7% when changing postures from erect to supine. This study concludes that respiratory impairment does occur in SCI. The results obtained display a typical pattern of restrictive pulmonary impairment. The severity of the impairment is affected by the level of cord damage and is posturally dependent.

Lipoperoxidation and T-cell leukemia of childhood. Effects of indomethacin

Serum thiobarbituric acid (TBA) reactivity for lipoperoxidation products was assessed at diagnosis in children with T-cell and common acute lymphocytic leukemia (ALL) and T-lymphoblastic lymphoma. Comparisons were made among these groups and with healthy controls. Mean TBA reactivity (mumol malondialdehyde/L serum) was increased (P less than 0.01) in the T-cell leukemia group versus common ALL and T-lymphoblastic lymphoma patients and controls, respectively. The increase in lipoperoxidation products in T-cell ALL appeared to bear a positive relation to peripheral leukocyte counts, and was accompanied by increased serum prostaglandin E2 (PGE2) levels in most representative cases. Indomethacin added to a childhood T-cell ALL line (SUP-T3), at a concentration known to inhibit prostaglandin synthesis in vitro (i.e., 3 micrograms/mL), effected significant increases in the numbers of natural killer (NK; Leu-11+ and Leu-19+) cells (P less than 0.01) and B-lymphocytes (P less than 0.05), and significant decreases in cell viability (P less than 0.01). Indomethacin may be a useful agent for enhancing the antileukemic immune response in T-cell ALL.

Small hepatocellular carcinoma. DNA content and biological characteristics

The DNA content of 12 small hepatocellular carcinomas (SHCC, less than 3 cm in diameter) and 26 large hepatocellular carcinomas (LHCC) was quantitatively determined by means of TV-image analysis. The results showed that 8 patients (66.7%) with SHCC had DNA stem lines in diploid (2C), and 24 (92.3%) with LHCC had DNA stem lines in aneuploid (AN) (P less than 0.01). The incidences of tumor capsule breaking and cancerous thrombosis were 16% and 20% respectively in SHCC, significantly lower than 84% and 80% in LHCC (P less than 0.01). The 5-year survival rate was 75% in patients with SHCC after operation, much higher than 46.2% in patients with LHCC. No relations were found between DNA content, tumor size, pathological grading and serum AFP values of HCC. The results suggest that SHCC less than 3 cm in diameter reflects the early changes of biological characteristics; HCC of 3 cm in size may be at an important period when the changes of DNA stem lines and biological characteristics would occur; SHCC is possible to be determined by serum AFP values; and that the survival rate of the patients can be further improved by early finding and treatment of SHCC less than 3 cm in diameter.

Estimation and comparison of changes in the presence of informative right censoring: conditional linear model

A general linear regression model for the usual least squares estimated rate of change (slope) on censoring time is described as an approximation to account for informative right censoring in estimating and comparing changes of a continuous variable in two groups. Two noniterative estimators for the group slope means, the linear minimum variance unbiased (LMVUB) estimator and the linear minimum mean squared error (LMMSE) estimator, are proposed under this conditional model. In realistic situations, we illustrate that the LMVUB and LMMSE estimators, derived under a simple linear regression model, are quite competitive compared to the pseudo maximum likelihood estimator (PMLE) derived by modeling the censoring probabilities. Generalizations to polynomial response curves and general linear models are also described.

The response pattern of patients with chronic airway obstruction to bronchodilators

To investigate the response pattern of patients with chronic airway obstruction (CAO) to bronchodilators, 128 subjects consisting of 80 men and 48 women with a mean age of 52.6 years were randomly tested with three inhalant bronchodilators: a non-selective beta-agonist (isoproterenol), a beta 2-selective agonist (terbutaline) and an anticholinergics (ipratropium) plus placebo. All patients had a baseline FEV/FVC of less than 65% and their clinical diagnosis were classified as either COPD or bronchial asthma according to the criteria of the ACCP-ATS Joint Committee on Pulmonary Nomenclature. The drugs were delivered to the patient via a metered dose inhaler (MDI) using the conventional inhalation technique. Spirometry was measured at regular intervals with a computerized pulmonary function analyzer CHESTAC-65(Japan). A more than 15% increase in FEV1 and/or FVC after treatment was regarded as responsive. While 108 patients were tested with a single drug, the remaining 20 patients were tested sequentially with terbutaline, ipratropium and placebo in a randomized cross-over manner for studying additivity. Our results showed that the response rates of asthmatic patients to isoproterenol, terbutaline and ipratropium were 50%, 87% and 67%, respectively. Only 27% of COPD patients responded to isoproterenol and 60% to terbutaline. On the other hand, ipratropium possessed a 61% response rate in the treatment of COPD and showed a bronchodilator effect independent to that of terbutaline. Combined use of both drugs resulted in additional improvement. Once patients responded to the drugs, apparent changes in FEV1 and/or FVC occurred within 30 minutes and reached the maximum usually at 60 minutes post-inhalation.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of initial length of uterus per embryo on fetal survival and development in the pig

Influence of initial length of uterus available to each embryo on its subsequent survival and development was determined by systematic restriction of the length available to each potential embryo. Fifty-seven pregnant crossbred gilts were laparotomized at d 3 of gestation, length of uterine horns was measured in situ and corpora lutea (CL) were counted. In Exp. 1, uterine space available to each potential embryo was restricted by ligating one uterine horn 5 cm from the tip per CL. Uteri were examined at d 20, 25 or 50. In Exp. 2, one uterine horn was ligated on d 3 at 10, 20 or 30 cm from the tip per CL and uteri were examined at d 50. Embryos in the restricted section (RS) had a specific mean uterine length available to each potential embryo of 5, 10, 20 or 30 cm. Embryos in the nonrestricted section (NRS) had a variable mean uterine length available to each potential embryo of 44 +/- 4 cm. When embryos were restricted to 5 cm, the proportion of surviving fetuses at d 20, 25 and 50 was 61, 12 and 8%, respectively, whereas in combined NRS it was 82%. When the uterus was examined at d 50 after restricting embryos to 10, 20 or 30 cm/CL, 25, 33 and 52% of fetuses survived; in combined NRS survival was 71%. Each fetus surviving to d 50 in RS was associated with 36 cm of initial uterine length but fetal survival was not associated with number of CL. In RS, 59% were female fetuses and in NRS 50% were females.(ABSTRACT TRUNCATED AT 250 WORDS)

Characteristics of the distribution of lectin receptors in intrahepatic cholangiocellular carcinoma

The receptors of peanut agglutinin (PNA), Dolichos biflorus agglutinin (DBA) and Ulex europaeus agglutinin I (UEA-I) were localized in intrahepatic cholangiocellular carcinoma, hepatocellular carcinoma, intrahepatic bile ducts and normal, cirrhotic and pericarcinomatous liver using the avidin-biotin-peroxidase complex method. It was found that epithelial cells of normal bile ducts had many UEA-I receptors, fewer DBA receptors and no PNA receptors. The positive rates of PNA, UEA-I and DBA receptors in 18 cases of intrahepatic cholangiocellular carcinoma were 88.9%, 61.1% and 33.3% respectively, which were significantly higher than those in hepatocellular carcinoma (16.0%, 4.0% and 4.0% respectively). Hepatocytes in normal, cirrhotic and pericarcinomatous liver had no receptors for these three lectins. It is suggested that lectin receptor distribution in intrahepatic cholangiocellular carcinoma is obviously different from that in normal bile duct cells and in hepatocellular carcinoma, and might be used as an auxiliary index in its clinical diagnosis.

Retrospective analysis of 97 patients with infective endocarditis seen over the past 8 years

The medical records of 97 consecutive patients (101 episodes) of infective endocarditis seen from January 1979 through January 1987 were reviewed. Only 30% of the patients were over 50 years of age and the majority (69%) of infecting organisms were streptococci (mainly of the viridans group), which were similar to those reported from the West in the early antibiotic era. Pseudomonas organisms and enterococci accounted for 6% and 5%, respectively. Fungal infections were noted in 2 patients. There was a high incidence (38%) of predisposing rheumatic valvular disease; approximately half of these patients had prosthetic valve infections. Mitral valve prolapse was also an important predisposing disease (11%). One-third (34%) of the patients had febrile illness for longer than 8 weeks before the diagnosis was established. The hospital morality rate was 22%; cerebral embolism and ruptured mycotic aneurysm, congestive heart failure, and sudden death were the major causes of death. Echocardiography disclosed vegetations on the cardiac valves and preexisting lesions in 75% of the episodes. Early recognition and proper treatment should be the focus of efforts to reduce mortality from infective endocarditis.