Factor VIII concentrate-responsive thrombocytopenia, hemolytic anemia, and nephropathy. Evidence that factor VIII:von Willebrand factor is involved in its pathogenesis

A 4-year-old Japanese girl had a congenital disorder that was characterized by recurrent thrombocytopenia, hemolytic anemia, hematuria, and proteinuria, which were repeatedly improved by the infusion of factor VIII concentrate. She developed the similar symptoms within 1 h after 1-desamino-8-D-arginine vasopressin (DDAVP) administration. Coagulation studies 30 and 60 min after DDAVP infusion showed a disappearance of large factor VIII:von Willebrand factor (VIII:vWF) multimers, which was the same abnormality that was observed at acute episodes. There were no significant changes in the plasma levels of 6-keto-prostaglandin F1 alpha and thromboxane B2 before and after DDAVP infusion. These results provide further support that VIII:vWF is directly involved in the pathogenesis of this congenital disorder.

[Clinical utility of tumor markers in gastric and colon cancer]

Serum TPA and CEA level were measured in patients with gastric or colon cancer during the course of surgical treatment, and those clinical utility was evaluated. Both markers level were shown to be highest in colon cancer, followed by gastric cancer, benign diseases, and healthy subjects. Late stage patients, especially inoperable patients or patients in recurrence showed significantly high TPA and CEA level compared to early stage patients. Both markers were considered to be useful not only postoperative following up for recurrence but also preoperative evaluation for resectability and prognosis and postoperative evaluation for the treatment itself.

Intrarectal hyperthermia of circumferential rectal cancer. Report of 2 cases

An intrarectal microwave (2,450 MHz) applicator was designed for hyperthermia of rectal cancer. Combined treatment of hyperthermia and irradiation was applied in two selected cases. The lesions of case 1 regressed completely, but cancer cells were still present after treatment in case 2. Such hyperthermia is useful for other circumferential cancers such as those of the esophagus and biliary tract. Combined hyperthermia and irradiation are an effective means of achieving therapeutic gains.

Effects of the ionophore monensin on type II collagen and proteoglycan synthesis and secretion by cultured chondrocytes

Detailed studies of the effects of the ionophore monensin upon avian chondrocyte ultrastructure, macromolecular synthesis, and macromolecular secretion have been carried out. Embryonic avian chondrocytes in suspension culture were incubated in concentrations of monensin ranging from 1 X 10(-7) to 1 X 10(-6) M for durations up to 8 h. Electron microscopy revealed that the treated chondrocytes developed abnormal Golgi structures and a markedly distended rough endoplasmic reticulum. Biochemical and immunoassay studies showed that while total protein synthesis was only slightly impaired by monensin, the ionophore had pronounced effects upon the secretion of both type II collagen and proteoglycans. These two macromolecules responded to monensin inhibition in a similar fashion and accumulated within the affected chondrocytes. The kinetics of response over the monensin concentration range used was virtually identical for type II collagen and proteoglycan. Undersulfation of proteoglycan, caused by monensin, was examined by ion exchange chromatography and analysis of the products of chondroitinase ABC digestion. The results indicated that undersulfation affected all glycosaminoglycan chains in a general fashion rather than affecting a specific population of chains.

Proteoglycan core protein is accumulated in cultured chondrocytes in the presence of the ionophore monensin

The nature of the proteoglycan antigen which accumulates in chick embryo chondrocytes that had been incubated in monensin was examined. Both the culture media and cell lysates were immunoprecipitated using antibody which primarily is directed against core protein. Gel filtration and electrophoresis of the immunoprecipitates showed that molecules corresponding to completed proteoglycan, core protein, and link protein were present in the immunoprecipitates. Monensin caused the cellular accumulation of core protein which was both underglycosylated and undersulfated. These results suggest that monensin affects early events of proteoglycan biosynthesis and that it may be useful for elucidating those events.

[Clinical trial of cisplatin in the treatment of ovarian carcinoma]

Cisplatin (cis-diamminedichloroplatinum) was administered to 20 patients with histologically proven ovarian cancer. Ten of 20 patients were evaluable. They consisted of 1 patient by single use and 9 by combined use. The dose of cisplatin in single administration was 50 mg/m2, and the schedule for combined administration was as follows: cisplatin (50mg/m2, i.v. day 1), adriamycin (40 mg/m2, i.v. day 1), cyclophosphamide (350 mg/m2, i.v. day 1) and 5-FU (350 mg/m2, i.v. day 1-5). This was repeated every three weeks. The side effects of cisplatin and in its combination use were relatively severe. All of 20 patients showed severe nausea and vomiting, but fortunately there were no signs of hepatotoxicity, bone marrow or renal impairments during these courses. As the result, according to the response criteria of Koyama-Saito's group, out of 10 evaluable patients, the response rate consisting of partial and complete responses was 50% (CR: 3 cases, RP: 2 cases). It is shown that cisplatin is effective and useful in chemotherapy for the patients with ovarian carcinoma.

Mammary tumorigenic effect of a new nitrosourea, 1,3-dibutyl-l-nitrosourea (B-BNU), in female Donryu rats

Four groups (groups 1-4) of female Donryu rats were given continuously 400, 200, 100, or 0 ppm solution of 1,3-dibutyl-l-nitrosourea (B-BNU) as their drinking water, and were studied for the development of tumors. The incidence of mammary tumors was 15/19 (79%), 20/24 (83%), 21/26 (81%), and 8/25 (32%) in groups 1, 2, 3, and 4, respectively. In addition, hematopoietic neoplasms, uterine tumors, and vaginal tumors developed in 13, 11, and six rats, respectively in 69 treated rats. Other tumors were infrequent.

Hepatic changes in male ACI/N rats on low dietary levels of sterigmatocystin

Three groups, each consisting of 36 male ACI/N rats, were fed a diet containing 10, 1, or 0.1 ppm sterigmatocystin for life span. There was no dose--effect relationship on tumor incidence or mean survival time. Toxic and preneoplastic changes of the parenchyma such as hyperplastic foci were observed in the liver of experimental groups with dose--effect relation, but hepatocellular carcinoma was observed only in one rat of 10 ppm group. In addition to these lesions, hemangiosarcomas of the liver were also observed in the highest and middle-dose groups, 3/26 and 1/29, respectively. There was not significant difference in the incidence of other tumors in experimental or control groups.

[Effect of D-penicillamine on vitamine B6 and collagen metabolism (author's transl)]

Although D-Penicillamine (D-PeA) administration is getting popular in the treatment of rheumatoid arthritis (RA), the mechanism by which D-PeA produced therapeutic effect has not been fully elucidated. D-PeA had been shown to exert an antivitamine B6 effect. However, it has not been precisely confirmed if clinical dose of D-PeA induces vitamine B6 (VB6) deficiency. In order to clarify these questions, biochemical analyses of bone and skin collagens and determination of VB6 content in soft tissues have been performed in the rats administrated therapeutic dose of D-PeA. VB6 deficiency was not observed in the brain and skin from rats fed on normal diet containing D-PeA (13.0--33.5 mg/kg wt). There were no significant changes in the stability of collagen from bone and skin. On the other hand, significant VB6 deficiency and reduced stability of collagen were observed in rats fed on VB6 deficient diet containing the same amount of D-PeA. Aldehyde formation of collagen molecule and cross-link formation of collagen were also found to be suppressed. The same results were obtained from analyses in rats fed on VB6 deficient diet without D-PeA administration. These data indicate that D-PeA is not capable of producing VB6 deficiency in the dosage employed in patients. However, in the treatment for patients who are not taking enough nutrition, the possibility of VB6 deficiency can not be neglected. Once VB6 deficiency is induced by D-PeA administration, severe connective tissue disorder may be produced, since VB6 is required for enzymic activity of lysyl oxidase. It is unlikely that the therapeutic effects of D-PeA in the treatment of RA are produced the the disturbance of collagen cross-link formation as discussed before. Immunologic reactions of D-PeA may play more important role in the improvement of clinical symptoms of this disease.

Functional alteration of islet cells after jejunal or ileal resection in dogs

Functional alteration of the islet cells was investigated in dogs after the resection of different parts of the small intestine. Three weeks after jejunal or ileal resection, when the dogs might still have been in a catabolic state, insulin and pancreatic glucagon release in response to intravenously infused glucose and arginine was reduced. Three months after jejunal resection, both intravenous glucose tolerance and insulinogenic index in the intravenous glucose tolerance test were significantly below the preoperative values (P less than 0.001, P less than 0.05), while pancreatic glucagon release in response to arginine infusion release. This functional alteration three months after jejunal resection was similar to that seen in diabetes mellitus. On the other hand, three months after ileal resection, insulin and pancreatic glucagon release was almost normal. We conclude that the jejunum plays a more important role in the enteroinsular system than the ileum and that prolonged interruption of this enteroinsular axis can cause insular disorder and what could hypothetically be called enterogenic chemical diabetes, in view of the altered glucose tolerance test and the alteration in insulin secretory response.

Effect of biliary diversion on exocrine pancreas

An experimental study was conducted on the effect of bile diversion on exocrine pancreatic function. Twelve dogs were divided into three groups, one group consisting of a choledochojejunostomy; one, a choledochoduodenostomy, and one, a choledochocholedochostomy. In each group, exocrine pancreatic function was observed before and two months after the operation. With combined secretin and pancreozymin infusion, a significant decrease in the rate of flow, bicarbonate concentration and amylase output was seen only after choledochojejunostomy. The function of the exocrine pancreas was markedly decreased late in the period of stimulation. Contrariwise, no pancreatic dysfunction was noted after choledochoduodenostomy or choledochocholedochostomy. The high incidence of peptic ulcer formation after choledochojejunostomy might be closely connected with the postoperative impairment of exocrine pancreatic function.

Effects of penicillamine on distribution of B6 vitamens in rat urine

The antivitamin B6 effect of DL- and D-penicillamine has been studied in rats. A considerable elevation in the urinary excretion of vitamin B6 activity (pyridoxal and its thiazolidine derivative) has been shown as a parameter of B6 antagonism. Both DL- and D-pencillamine have been shown to have an antivitamin B6 effect in rats, although that induced by the DL-form is considerably greater, as would be expected from previous studies. We suggest that B6 supplementation should be included in any long term penicillamine therapy, regardless of the isomer that is employed.

Follow-up study of gastrin response after resection of the jejunum and the ileum

An experimental study was conducted on the effect of resection of the jejunum and ileum on gastrin release. The intravenous infusion of L. arginine in a dose of 0.5 g per kg body weight for 30 minutes proved to be most practical in evaluating gastrin release in addition to insulin and glucagon release. Serum gastrin levels in response to this dose of arginine were determined before and three weeks, three months and one year after resection of the jejunum and of the ileum. At three weeks, a significant increase in gastrin levels occurred in bothe the fasting state and after stimulation in dogs with either jejunum or ileum resection. At three months, the elevated gastrin response persisted only in those with jejunum resection. By one year, the gastrin levels had fallen in almost all dogs to approximately the preoperative levels.

Electron spin resonance studies on the lipoxygenase reaction by spin trapping and spin labelling methods

The rate of oxygenation and that of trapping linoleic acid free radicals in the lipoxygenase [EC 1.13.11.12] reaction were measured in the presence of linoleic acid, oxygen, and nitrosobenzene at various concentrations, with a Clark oxygen electrode and ESR spectroscopy. The results were interpreted under the assumption that the free radical of linoleic acid, an intermediate of the lipoxygenase reaction, reacts competitively with oxygen or nitrosobenzene. The oxidation of the iron in the active site of lipoxygenase caused by the spin label reagent, 2-(10-carboxydecyl)-2-hexyl-4,4-dimethyl-3-oxazolidinyloxyl, was also observed by ESR- and fluorescence-spectroscopy.

Urine plasmin-like substances as an index of kidney allograft rejections

Using solid state radioimmunoassays developed by the first author, changes in the urine level of plasmin-like substances (PLS) and fibrin degradation products (FDP) before and after human kidney transplantation were determined in 49 transplant patients. Averages of urine PLS and FDP in a normal population of 51 persons were 0.13+/-0.10 (SD) and 0.14+/-0.07 microng/ml, respectively. In all transplant patients there was an initial rise of both PLS and FDP in urine immediately after transplantation. This elevation peaked on days 4 and 5 and the PLS and FDP levels returned to normal range within 2 weeks in patients without evidence of rejeciton. A secondary rise of urine PLS was detected before or with a rise in serum creatinine in all of the patients experiencing rejections. Of 11 patients who showed a rejection episode within 2 weeks of transplantation, the secondary rise of urine PLS was detectable in 55% of the patients slightly before the serum creatinine level changes; of 6 patients with a rejection episode more than 2 weeks after transplantation, 100% showed a secondary PLS rise 6.7+/-2.3 (SE) days before the serum creatinine increased. The appearance of the secondary rise of urine FDP in the rejecting recipients was slightly later than the rise of PLS. Serial determination of urine PLS levels following human kidney transplantation appears to be an early index of rejections which occurs more than 2 weeks after transplantation, although the clinical usefulness of this measurement is probably limited.

Kinetic study of lipoxygenase-hydroperoxylinoleic acid interaction

Interaction of lipoxygenase with hydroperoxylinoleic acid, which is the product of this enzyme reaction and acts as an activator, was studied kinetically by the fluorescence stopped-flow method. The kinetic features are consistent with a two-step mechanism involving a fast bimolecular association process followed by a slow unimolecular process. The dissociation constant of the bimolecular process was 3 (+/-2) - 10(-5) M, which was appreciably dependent on temperature and pH, in contrast to the rate constant of the latter process. The enthalpy and the entropy of activation for the unimolecular process were estimated to be 21 kcal/mol and 20 e.u., respectively. The pH dependence of the rate constant indicated that an ionizable group with pK of about 8.6 is involved in the interaction. Linoleic acid, the substrate of lipoxygenase, and oleic acid inhibited the interaction between the lipoxygenase and the hydroperoxylinoleic acid by reducing the rate. A series of saturated monohydric alcohols also reduced the rate of the interaction as the chain length of the alcohols increases, though methanol and ethanol increased the rate of the interaction.