Distribution of tissue bile acids in the human alimentary tract and colon polyps

To determine the characteristic distribution of tissue-bound bile acids in the human alimentary tract and colon polyps, we measured the concentration of bile acids in the mucosal tissues of the alimentary tract obtained at autopsy and polyps obtained by endoscopic polypectomy, using enzymatic fluorimetry and gas-liquid chromatography. The concentration of tissue-bound bile acid, especially chenodeoxycholic acid, was significantly higher in the ileum or ascending colon than in the other portions of the alimentary tract. The bile acid level of polyps was also higher in the ascending colon than in the other portions of the colon. These results suggest that the high concentration of tissue-bound bile acids is obtained at the site of absorption of bile acids in the alimentary tract.

Acute nonlymphocytic leukemia (M2) with chromosome abnormality trisomy 4 developing eight years after radiation therapy for breast cancer

We report here the development, 8 years after radiation therapy for breast cancer, of acute nonlymphocytic leukemia (ANLL), type M2 of the FAB classification, in which trisomy 4 was detected as the only chromosomal abnormality. Simultaneous observation of cytologic and cytogenetic features of individual colonies derived from leukemic progenitor (L-CFU) and early progenitor (CFU mix) cultures in this patient revealed that all colonies examined had a normal karyotype, although the clone with trisomy 4 was predominant in the direct bone-marrow culture. These findings suggest that progenitor cells with trisomy 4 were less predominant in colony growth when stimulated by colony-stimulating factors (CSFs) than were stem cells with a normal karyotype.

Simultaneous existence of double minute chromosomes and a homogeneously staining region in a retinoblastoma cell line (Y79) and amplification of N-myc at HSR

We observed double minute chromosomes (dmin) and a homogeneously staining region (HSR) in the same metaphase cells obtained from a retinoblastoma cell line, Y79. All of the 132 metaphases examined contained an HSR on the short arm of chromosome 1(1pHSR) and five cells (3.8%) had two to four dmin. To determine whether 1pHSR and dmin carried amplified N-myc sequences, we performed an in situ hybridization using an N-myc probe. Silver grains clustered on and along the 1pHSR, but not on the dmin. These findings indicate that the HSR on chromosome 1 is associated with amplification of N-myc in Y79 cells.

A clone with a chromosome abnormality, i(17q), in the myeloid crisis of chronic myeloid leukemia is able to differentiate into neutrophil, basophil and eosinophil lineages

Simultaneous cytogenetic and morphologic observations of single colonies derived from granulocytic precursor cells were performed on a patient with chronic myelogenous leukemia (CML) during the myeloid crisis. Colonies having a Ph1 chromosome and i(17q) were found to consist of neutrophilic/basophilic, eosinophilic/basophilic or basophilic granulocytes. These findings led to the conclusion that cells having the additional abnormality, i(17q), are still able to differentiate into neutrophil, basophil and eosinophil lineages. In other words, this chromosome abnormality does not give a proliferative advantage to a restricted cell lineage.

Alteration of amino acid content of cerebrospinal fluid from patients with epilepsy

The alteration of amino acids content in cerebrospinal fluids (CSF) from 31 cases of epilepsy and 10 cases of headache (as control) was studied using high performance liquid chromatography (HPLC). In patients with epilepsy, it was found that the CSF levels of GABA and aspartic acid had a tendency to decrease, but these changes were not statistically significant. In simple partial seizures, the CSF levels of glutamic acid and glycine also showed a tendency to decrease. The decrease of CSF GABA found in epileptics had a tendency to normalize following treatment with valproic acid. At the same time, administration of valproic acid induced a decrease of aspartic acid in the CSF of epileptics. These results suggest that administration of valproic acid may induce an increase in GABA and a decrease in aspartic acid in the CSF of epileptics.

Demonstration by light and ultrastructural immunoperoxidase study of alpha-fetoprotein-positive non-hepatoma cells and hepatoma cells during 3'-methyl-4-dimethylaminoazobenzene hepatocarcinogenesis

Immunoreaction of alpha-fetoprotein (AFP) has been described in cholangiolar "oval" cells in the early stage of 3'-methyl-4-dimethylaminoazobenzene hepatocarcinogenesis. The subcellular location of AFP in the oval cells was in the perinuclear space, rough endoplasmic reticulum and Golgi apparatus. In livers with hyperplastic nodules there were two different types of foci containing AFP-positive cells. One type had a normal nucleocytoplasmic ratio and was seen in well-preserved hepatic trabecular structures, and the other had less cytoplasm and occurred in trabecular structures in disarray. AFP-immunoreactivity in the former type was visible in the perinuclear space and rough endoplasmic reticulum but scarce in the Golgi apparatus, and in the latter type it was present in the proliferative smooth endoplasmic reticulum and in several parts of Golgi apparatus in the submembranous or pericanalicular areas. In livers with hepatocarcinoma, AFP immunoreaction was detected in well-differentiated hepatocellular carcinomas, and the subcellular location of AFP was in the perinuclear space, rough endoplasmic reticulum and many developed Golgi complexes. Therefore, AFP-positive cells in livers with hyperplastic nodules are a new cell population in hepatocarcinogenesis, and each type is morphologically different from the oval cell.

Autoradiographic study on healing process of cysteamine-induced duodenal ulcer in rat. Possible importance of Brunner's glands in ulcer healing

The healing process of cysteamine-induced duodenal ulcer was studied by [3H]thymidine autoradiography. After the development of ulcer in the duodenum, cell proliferation was markedly activated not only in the crypts but also in the Brunner's glands near the ulcer. In the initial stages of ulcer healing, they both contributed to form the surface covering regenerating epithelium. Granulation tissue also proliferated at the base of the ulcer. In later stages of ulcer healing, new crypts were formed in the floor of the ulcer. New villi regenerated from these crypts and Brunner's glands regenerated by proliferation in situ. The ulcer base then was completely covered with new villi and granulation tissue was replaced by dense fibrous connective tissue. The present study suggested that the Brunner's glands, together with the crypts of Lieberkühn, play an important role in the healing process of cysteamine-induced duodenal ulcer.

Intermediate filaments of hepatocytes and biliary epithelial cells in bile duct obstruction: transmission and scanning electron microscopy study

The cytoskeletons of hepatocytes and biliary epithelial cells in bile duct ligated rate livers were investigated by transmission and scanning electron microscopy. The three dimensional organization of the intermediate filaments (IFs) of hepatocytes and biliary epithelial cells was clearly demonstrated by scanning electron microscopy. Cell borders and dilated bile canaliculi were well preserved after perfusion with detergent solution. A very dense filamentous network of IFs was seen throughout the cytoplasm, especially around the dilated bile canaliculi and at the cell borders. IFs in biliary epithelial cells were more numerous compared with hepatocytes. Morphometric analysis showed that the IFs of hepatocytes significantly (p greater than 0.001) increased in amount in bile duct ligated rats. The IFs of biliary epithelial cells showed no significant changes in bile duct ligated rats compared to controls. These results suggest that the increase in IFs in hepatocytes results from the adaptation of the hepatocytes to the stress imposed by bile duct ligation. It may be that the resulting intracanalicular pressure and back diffusion of bile induces a metaplastic change in hepatocytes so that they acquire more IFs to function like the bile duct epithelium to conduct bile flow.

Scanning electron microscopy of the hepatocyte cytoskeleton in human liver tissue

Portions of eight human livers taken by wedge biopsy or needle biopsy were extracted with 0.5% Triton X-100 and then studied by scanning electron microscopy and immunoelectron microscopy. The wedge-biopsy specimens were perfused with the detergent solution. Needle-biopsy specimens were quickly frozen and cracked and then the cracked tissue was immersed in the detergent solution. The three-dimensional filament network of hepatocytes was visualized. A dense network which consisted of intermediate filaments and microfilaments was observed within the cytoplasm of hepatocytes. These filaments were better preserved in the needle biopsies which were quick-frozen and cracked before extraction than in the wedge biopsies. Variation in the amount of the cytoskeletal filaments was less prominent in the hepatocytes treated by rapid freezing. It is concluded that freeze-cracking is the most favorable method for the study of cytoskeletal pathology in various liver diseases in man.

[Clinical evaluation of a combination treatment with cefmenoxime and cefsulodin of severe infections in leukemia and related disorders]

A combination of cefmenoxime (CMX) and cefsulodin (CFS) which has a broad spectrum on various bacteria including Pseudomonas aeruginosa was evaluated for severe infections associated with hematological malignancies. Seventy one patients were treated with the combination therapy. Among them, 57 patients were evaluable for the effectiveness. Fourteen patients were not evaluable because 10 patients were subjected to additional therapy such as gamma-globulin, interferon, radiation and pulse therapy of a large dose of methylprednisolone, 3 were prophylactically treated and the remaining one was a patient with disseminated bone marrow metastasis of prostatic cancer and not a patient with a hematologic malignancy. Excellent responses were obtained in 24 (42.1%) patients and good response in 12 (21.1%) patients, with a total rate of effectiveness of 63.2%. Three patients who were treated prophylactically and one patient who suffered from prostatic cancer with metastasis to bone marrow, were included in the final evaluation of side effects. Side effects were observed in only one patient (1/61, 1.6%). Mild neutropenia was identified in a patient of 78 years of age in 4 days after the combined regimen was started. Neutropenia disappeared soon after the cessation of the treatment. These results showed that a combination of CMX and CFS was an effective and safe regimen for the treatment of severe infections in patients with hematological disorders.

Immunocytochemical investigation of hepatitis B virus-associated antigens in cases of liver cirrhosis and HBsAg antigenemia and their relationship to development of hepatocellular carcinoma

Using light and ultrastructural immunoperoxidase techniques, we examined the distribution of hepatitis B virus (HBV)-associated antigens and the subcellular localization of hepatitis B surface antigen (HBsAg) in liver biopsies of HBsAg-positive patients with cirrhosis. The localization patterns of HBsAg in hepatocytes were membranous, cytoplasmic, festoon and inclusion body types. Cytoplasmic and festoon types were seen more often than the membranous type in pseudolobules, and hepatitis B core antigen (HBcAg)-positive cells with cytoplasmic type were distributed in the periphery of pseudolobules with active inflammation. Immunoelectron microscopy in the cytoplasmic or festoon type of HBsAg showed immunoreaction in the cisternae and on virus-like particles in the cisternae in patients with hepatitis B e antigen (HBeAg) antigenemia. Simultaneous staining of HBsAg and HBcAg revealed that hepatocytes with cytoplasmic or festoon type of HBsAg contained HBcAg-immunoreactivity. The inclusion body type of HBsAg was characteristic of liver cirrhosis with hepatocellular carcinoma (HCC); the subcellular localization of HBsAg was seen in clusters of the endoplasmic reticulum around the nucleus, and HBsAg-immunoreactivity was observed on many virus-like particles in most of the cisternae in those with HBeAg antigenemia. These findings suggest that the synthesis of HBsAg is active in patients with liver cirrhosis and that the formation of HBV is also active in those with HBeAg antigenemia and that HBV may be retained more in cirrhotic livers with hepatocellular carcinoma after proliferation than in those without it.

Serum 2',5'-oligoadenylate synthetase activity during interferon treatment of chronic hepatitis B

We measured 2',5'-oligoadenylate synthetase activities in serum and peripheral blood mononuclear cells from 10 patients with chronic hepatitis B who were being treated with interferon so as to determine whether 2',5'-oligoadenylate synthetase activity in serum reflected 2',5'-oligoadenylate synthetase activity in peripheral blood mononuclear cells, and whether it could be used to monitor interferon treatment. Pretreatment values of 2',5'-oligoadenylate synthetase activity in patients' serum and peripheral blood mononuclear cells were not statistically different from values from control subjects. When interferon was administered, serum levels of 2',5'-oligoadenylate synthetase began to rise within 3 hr, reached peak values at 12 hr and then declined. The levels of 2',5'-oligoadenylate synthetase activity both in serum and peripheral blood mononuclear cells increased substantially during interferon treatment, ranging 2- to 50-fold greater than initial levels. The levels of 2',5'-oligoadenylate synthetase in serum correlated closely with levels in peripheral blood mononuclear cells. In addition, when the levels of 2',5'-oligoadenylate synthetase rose during interferon administration, serum hepatitis B virus DNA polymerase values fell, and, in some cases, DNA polymerase rose again when 2',5'-oligoadenylate synthetase fell after discontinuation of interferon. These findings suggest that 2',5'-oligoadenylate synthetase activity in serum accurately reflects the antiviral effect of interferon and could be used to monitor interferon treatment.

Development of and clinical experience with a new TV monitoring system in electronic endoscopy. Bi-plane TV monitoring system

We developed a bi-plane TV monitoring system using a TV endoscope (Electronic endoscope manufactured by Toshiba-Machida, Tokyo, Japan) that permits simultaneous display of real-time and prerecorded images. Various findings of the two examinations can be precisely compared using this system, and a detailed evaluation of the progress of peptic ulcers obtained. In addition, the effects of various endoscopic therapies can be accurately evaluated. In endoscopic injection sclerotherapy of esophageal varices, new varices (or recurrent varices) were differentiated. In laser therapy for early gastric cancer, precise delimitation of the lesion for radiation was possible, and the therapeutic effects were more accurately evaluated. These results show the diagnostic as well as therapeutic usefulness of this system. Furthermore, for the examination of the lower digestive tract, X-ray images were incorporated into this system. This is a useful modality for diagnostic and therapeutic procedures in colonic disease.

Cholestatic liver disease in a 20-yr-old woman with histiocytosis X

A 20-yr-old woman with known diabetes insipidus complained of high fever and jaundice. Liver specimens biopsied under peritoneoscopy showed proliferating histiocytic or foamy cells in periportal areas. Immunocytochemical investigation demonstrated the presence of S-100 protein, but the absence of lysozyme in their histiocytic cells, and ultrastructural study revealed Birbeck granules in them. Vinblastine therapy reduced jaundice and high fever, and diabetes insipidus was controlled. Clinical, immunohistological, and cytological features suggested Letter-Siwe disease with jaundice, which responded well to treatment.

Heterogeneous colony forming ability in vitro of the abnormal clone-derived granulocyte-macrophage precursors in myelodysplastic syndromes

The clonal origin of granulocyte-macrophage colony forming cells (CFU-GM) in the myelodysplastic syndrome (MDS) was cytogenetically studied. Chromosome analysis was carried out on single GM-colonies from six patients with MDS, whose bone marrow cells had chromosome abnormalities. Abnormal clone-derived CFU-GM were grown in four patients under the presence of human placental conditioned medium. In the remaining two, all analysed colonies revealed a normal karyotype, although the majority of metaphase cells showed an abnormal karyotype in bone marrow preparations. These results indicate that the abnormal clone-derived CFU-GM in MDS have a clone-by-clone variation in colony forming ability in vitro.

Cytogenetic evidence of clonal proliferation of leukemic progenitor cells from patients with acute promyelocytic leukemia (APL)

We have studied in-vitro growth of leukemic progenitor cells (L-CFU) in ten patients with acute promyelocytic leukemia (APL). All patients showed consistently an extraordinarily high incidence of cluster formation under the stimulation of human placental conditioned medium (HPCM) and/or phytohemagglutinin-stimulated leukocyte conditioned medium (PHA-LCM). Cytogenetic analyses of clusters or colonies disclosed the presence of a 15;17 translocation. These findings may represent the close relationship between specific chromosomal aberration, t(15;17), and the growth pattern of L-CFU of APL in vitro.

Cytogenetic evidence for a clonal involvement of granulocyte-macrophage and erythroid lineages in a patient with refractory anaemia

To investigate the clonal origin of refractory anaemia, we carried out cytogenetic studies on single haematopoietic colonies derived from granulocyte-macrophage precursors (CFU-GM) and erythroid precursors (BFU-E). Marrow cells from a patient with refractory anaemia revealed the coexistence of a normal and an abnormal karyotype; 46,XY/45,XY,-15,-18,+der(15q18q). Cytogenetic studies on CFU-GM- and BFU-E-derived colonies obtained from the bone marrow showed the presence of the same karyotypic abnormality carrying the der(15q18q). Colonies carrying a normal diploid karyotype were also detected in the same culture dish. These results indicate that the clone with the der(15q18q) chromosome abnormality arises in a stem cell which can differentiate to at least both granulocyte-macrophage and erythroid lineages.