[Immunohistochemical study on X antigen of HBV (HBxAg) in primary hepatic carcinoma]

Specimens of 110 cases of primary hepatic carcinoma were obtained from the pathological Laboratory of the First Teaching Hospital of the 4th Military Medical University, Xi'an. P. R. China. Sections from formalin-fixed and paraffin-embedded material were stained for HBxAg by ABC method and for HBsAg and HBcAg by PAP method. Among the 110 cases of primary hepatic carcinoma, 64 (58.2%) showed HBxAg-positive reaction in tumor tissue, and 63 (78.8%) of 80 cases of noncancerous surrounding hepatic tissue displayed HBxAg positivity. Among 64 HBxAg-positive cases in tumor tissue, 15 (23.4%) were associated with HBsAg and/or HBcAg and among 63 HBxAg-positive cases in non-tumor tissue, 45 (71.4%) were associated with HBsAg and/or HBcAg. These findings suggested a close relationship between primary hepatic carcinoma and HBV infection. The high detection rate of HBxAg indicates very active expression of the integrated HBV-DNA genome in the host cells. However, how does HBxAg act in pathogenesis of hepatocellular carcinoma remains to be further investigated.

[Expression and significance of Pre-S1 and Pre-S2 in human primary hepatic carcinoma (PHC)]

135 specimens of primary hepatic carcinoma (PHC) were formalin fixed and paraffin embedded and stained for Pre-S1, Pre-S2 and HBxAg by ABC method, for HBsAg and HBcAg by PAP method. The detection rates of Pre-S1 and Pre-S2 positive cases in cancerous tissues were 22.2% and 20.0%. The detection rates of Pre-S1 and Pre-S2 in non-cancerous liver tissues were 60.0% and 59.6%. The positive ratio of Pre-S1 and Pre-S2 in the same hepatoma was 16.3% and that in the same non-cancerous liver tissue was 55.6%. Among 135 cases of PHC, HBsAg, HBxAg and HBcAg positives in tumor tissues were 16.3%, 55.6% and 8.9%, respectively. Those in non-cancerous tissues were 59.6%, 78.8% and 24.2%. This study suggested that the detection rates of Pre-S1 and Pre-S2 positivity in hepatoma tissues were higher than those of HBsAg and HBcAg but lower than that of HBxAg. The frequency of positive Pre-S1 and Pre-S2 in non-cancerous liver tissues was similar to HBsAg, and slightly lower than that of HBxAg. S1 and S2 are considered new markers for HBV infection. Their antigens could play an important role in the pathogenesis of PHC.

Comprehensive assessment of long-term postoperative continence in pediatric imperforate anus. Clinical, manometric and contrast studies

109 patients with imperforate anus were followed up postoperatively for 5 to 28 years. Postoperative continence was evaluated by anorectal manometry, barium enema and clinical symptoms. A comprehensive assessment system, combining the clinical and objective systems was designed which can reflect postoperative anal continence function completely and objectively. It is useful for determining the causes of incontinence and its treatment.

Hepatitis B x antigen in hepatitis B virus carrier patients with liver cancer

Formalin-fixed, paraffin-embedded specimens from 110 cases of primary hepatocellular carcinoma were stained for hepatitis B x antigen (HBxAg), hepatitis B surface antigen (HBsAg), and hepatitis B core antigen (HBcAg). Eighty-four % of these patients were HBxAg positive in their tumor cells. Among the 110 cases studied, 80 had adjacent nontumorous tissue in the same block, and 65 of these nontumorous liver tissues stained positive for HBxAg (81%). HBsAg was positive in 19% of cases within tumor tissue and 61% in surrounding nontumorous tissue. HBcAg was positive in 11% of cases within tumor tissue and 26% in surrounding nontumorous tissue. These findings show that HBxAg is a common marker in the liver of patients with hepatitis B virus (HBV)-associated primary hepatocellular carcinoma and that it is closely associated with tumor cells in these individuals. In addition, the finding of HBxAg in the absence of detectable HBsAg and HBcAg in the liver tissues of many HBsAg carriers suggests that HBxAg could be expressed independent of HBV replication and implies that the synthesis of this antigen may be directed from integrated HBV DNA templates. The finding of HBxAg in the nucleus of hepatocytes from primary hepatocellular carcinoma patients with dysplasia, combined with the known trans-activating properties of HBxAg, implies that HBxAg plays one or more important roles in hepatocarcinogenesis. The finding of HBxAg in bile duct epithelium and cholangiocarcinoma tissues is compatible with the hypothesis that HBV may contribute to this other primary tumor type in the liver. Together, these results further implicate HBxAg in the pathogenesis of primary liver cancers.

HBxAg in the liver from carrier patients with chronic hepatitis and cirrhosis

Formalin-fixed, paraffin-embedded specimens from 110 cases of chronic hepatitis and 108 cases of cirrhosis were stained for HBxAg by the avidin-biotin complex technique using specific antisera made against full-length HBxAg polypeptide or derived synthetic peptides. These tissues were also stained for the HBsAg and HBcAg by the peroxidase-anti-peroxidase method. Among patients with chronic hepatitis, 86% were HBsAg positive in liver cells, 60% were surface antigen positive and 32% were core antigen positive. Among patients with cirrhosis, 97% were HBsAg positive in liver cells, 72% were surface antigen positive and 17% were positive for core antigen. Staining specificity was demonstrated, in part, by using preimmune sera in the place of primary antibody, by blocking of the primary antibody with the appropriate antigen before assay and by testing uninfected liver controls. The persistence and high frequency of HBxAg in liver cells from patients with chronic liver disease suggest that it may play one or more important roles in the pathogenesis of chronic infection. It is possible that detection of HBxAg in the liver could be an additional new diagnostic marker for hepatitis B virus infection. However, the function(s) of HBxAg in the pathogenesis of the chronic liver disease, if any, remains to be explained.

Ferritin in astrocytomas

Ferritin in 119 astrocytoma cases was studied by immunocytochemical PAP and immunogold silver staining (IGSS) methods. In 57% of the cases, ferritin was found in the cytoplasm of the tumor cells. The higher the differentiation of the tumor cells, the less ferritin they contained. Contrary to the reaction of glial fibrillary acidic protein (GFAP), the positive rate of ferritin in various types and grades of astrocytomas was inversely proportional to their degree of differentiation. Electron microscopic observation in 30 cases showed ferritin in the cell sap, cytocavity network, endoplasmic reticulum, Golgi apparatus and also in lysosomes. Some of the cases had extraordinary high level of ferritin in their blood serum.

[Significance of assaying serum bone GLA protein level in patients with hyperthyroidism]

The serum BGP level was assayed in patients with hyperthyroidism (untreated and remittent cases). The mean serum BGP concentration was 8.7 +/- 2.5 ng/ml in 54 patients with untreated hyperthyroidism, which was significantly higher than normal range (4.8 +/- 1.3 ng/ml P less than 0.01). Serum BGP had a significant positive correlation with the concentration of T3 and T4, while serum AKP had no correlation with circulating thyroid hormone levels. In the patients with hyperthyroidism, serum T3 and T4 decreased significantly after the first month of methimazole treatment, and fluctuated within the normal range since then. Serum BGP did not show significant change during the first six months of treatment, although they were eventually reduced significantly at the end of six months. These results suggest that serum BGP measurement is a valuable marker of bone metabolism alteration during hyperthyroidism.

Serum high-density lipoproteins in the crab, Cancer antennarius--III. Density-gradient profiles and lipid composition of subclasses

1. Prestaining the serum total lipoprotein (LP) fraction and density-gradient ultracentrifugation revealed up to five LPs, all in the high-density class (HDL; 1.187 greater than d greater than 1.080 g/ml). These are group-designated as HDL1, HDL2 and HDL3, lowest to highest buoyant density, respectively. The number and precise density of the LPs varied with individual crab and were not gender specific. 2. The percentage of total mass due to triacylglycerides was progressively higher from HDL1 and HDL3, whereas that of phospholipids, cholesterol and combined fat was progressively lower. The percentage mass of combined fat was higher in females than males. 3. As in hemolymph, the LP of eggs was entirely HDL; instances of each HDL subclass were seen, but HDL3 was predominant. Compared with serum HDL, egg HDL was strikingly low in triacyglyceride mass and relatively high in protein. 4. Hemolymph HDL titers of individual females varied independently with egg size through most of the year, but was positively correlated with the egg size in October to December when 2-3-fold increases in HDL titer occur in the female population.

Staining bacterial flagella easily

A wet-mount technique for staining bacterial flagella is highly successful when a stable stain and regular slides and cover slips are used. Although not producing a permanent mount, the technique is simple for routine use when the number and arrangement of flagella are critical in identifying species of motile bacteria.

Evidence that Y-organs of the crab Cancer antennarius secrete 3-dehydroecdysone

Y-organs are paired glands in crustaceans that secrete a class of steroid hormones (ecdysteroids) that regulate growth, molting and development. The glandular secretion has been assumed to be solely the ecdysteroid, ecdysone, a polyhydroxylated derivative of cholesterol. We previously reported that Y-organs of a crab (Cancer antennarius) additionally secreted an ecdysteroid that is less polar than ecdysone. Evidence is presented here that the other secretion product is 3-dehydroecdysone (3-dhE). The compound co-chromatographed with authentic 3-dhE in both normal-phase, and reversed-phase, high-performance liquid chromatography. Mass spectrometry of the ecdysteroid gave results consistent with its identity as 3-dhE. The putative 3-dhE was radiolabeled by injecting crabs with [3H]cholesterol and then incubating the Y-organs. The putative [3H]3-dhE secretion was then subjected to chemical reduction. The reaction yielded labeled products that co-chromatographed with authentic ecdysone and 3-epiecdysone. Results of other experiments gave the following results: (1) Putative 3-dhE was not altered (chromatographic criteria) by incubations with snail hydrolases. (2) Putative [3H]3-dhE, added to incubations of Y-organ halves or homogenates, was not significantly converted to ecdysone; also, no conversion was evident after incubation in medium alone in which the hemolymph serum supplement was raised to 50% of the volume. (3) [3H]Ecdysone was not converted to putative 3-dhE in vitro by Y-organ halves or homogenates.(ABSTRACT TRUNCATED AT 250 WORDS)

[Surface charged liposomes as drug carriers and in vivo tests of mice infected with toxoplasma]

The surface charge is one of the most important properties of liposomes. In this paper surface potential of liposomes was measured by fluorimetry using 1.8-ANS as a probe and by microelectrophoresis. The encapsulation efficiency and leakage rate of ionic drugs were influenced by the surface charge of liposomes. Higher encapsulation efficiency and lower leakage rate were resulted if the surface charge of liposomes was opposite to the ionic charge of encapsulated drug. Mice infected with toxoplasma were used as a model. In in vivo test, liposome-drug was compared with the free drug. The average survival days of groups of liposome-drugs were much longer than that of the group of free drugs. Mouse infected with toxoplasma is a simple, convenient and accurate model for measuring the biological activation of liposome-drugs.

Persistent Campylobacter jejuni infections in patients infected with the human immunodeficiency virus (HIV)

We identified Campylobacter jejuni infections in four patients infected with the human immunodeficiency virus (HIV); three had persistent and severe C. jejuni infections. Multiple isolates obtained from each patient had the same biochemical and serotypic characteristics, indicating recurrent infection rather than reinfection with unrelated strains. Serum antibody responses to C. jejuni group antigens by enzyme-linked immunosorbent assay were markedly impaired in the three patients with persistent infection compared with forty-two immunocompetent C. jejuni-infected controls and with the HIV-infected patient who readily cleared the organism. One patient was bacteremic; his blood isolate was killed by normal serum but was resistant to his own serum, whereas a simultaneous stool isolate of a different serotype was sensitive. Failure of two patients to eradicate the organism and long-term administration of erythromycin therapy led to the in-vivo development of resistance to this antibiotic, which is most frequently used to treat C. jejuni infections.

Controlled evaluation of trypticase soy broth with and without gelatin and yeast extract in the detection of bacteremia and fungemia

The addition of gelatin to blood culture media has been suggested to prevent the inhibition of Neisseria meningitidis, Neisseria gonorrhoeae, Gardnerella vaginalis, and Peptostreptococcus anaerobius that is caused by sodium polyanetholsulfonate. To determine the effect of such supplementation on the overall yield of microorganisms, we compared the yield and speed of detection of clinically important microorganisms from 5422 paired 10-ml samples of blood cultured in Trypticase soy broth (TSB) containing 0.03% sodium polyanetholesulfonate (SPS) and TSB/SPS containing 1.2% gelatin and 1.0% yeast extract (mTSB). The atmosphere of incubation (open venting unit) and ratio of blood to broth (1:5) were the same for both samples. Only cultures with adequate blood sample (greater than or equal to 80% of stated volume) were compared statistically. Addition of gelatin and yeast extract resulted in inhibited growth of Enterobacteriaceae (p less than 0.001), Pseudomonas aeruginosa (p less than 0.01), fungi (p less than 0.05), and the overall set of microorganisms encountered (p less than 0.001). It delayed growth of Enterobacteriaceae (p less than 0.001) but reduced the time to recover staphylococci (p less than 0.02). Of 12 isolates of species usually inhibited by SPS, seven grew only with the addition of gelatin and yeast extract, none grew only without supplementation, and five grew in both media. Although gelatin and yeast extract may improve the yield of some specific bacteria, the routine use of these additives cannot be recommended for all blood culture media.

Controlled evaluation of modified radiometric blood culture medium supplemented with gelatin for detection of bacteremia and fungemia

Although the addition of 1.2% gelatin to broth blood culture media containing sodium polyanetholesulfonate has been shown to enhance detection of certain bacteria, including Neisseria meningitidis, N. gonorrhoeae, Peptostreptococcus anaerobius, and Gardnerella vaginalis, the effect of such supplementation on the detection of other microorganisms causing bacteremia and fungemia is not known. Therefore, we studied BACTEC 6B medium with and without gelatin in 6,833 paired comparisons to examine the effects of supplementation on both the yield and the speed of detection of sepsis. More aerobic and facultative bacteria grew in the 6B than in the 6B-gelatin medium (P less than 0.001), especially staphylococci (P less than 0.01), Escherichia coli (P less than 0.01), other members of the family Enterobacteriaceae (P less than 0.05), and Acinetobacter spp. (P less than 0.05). When microorganisms grew in both bottles, they did so earlier in 6B than in 6B-gelatin (P less than 0.001). We conclude that the 6B medium in its present formulation is superior to 6B medium supplemented with 1.2% gelatin.

Pathogenesis of Campylobacter fetus infections: serum resistance associated with high-molecular-weight surface proteins

Campylobacter fetus subspecies fetus causes both systemic and diarrheal illnesses. We studied 38 strains of C. fetus isolated from 34 patients; underlying illness was present in eight (89%) of nine patients with only systemic isolates compared with three (20%) of 15 patients with only fecal isolates (P = .002). In a standardized assay of susceptibility to normal human serum, 27 (71%) strains were resistant, six (16%) had intermediate susceptibility, and five (13%) were serum sensitive. Major protein bands migrating at 100 kDa or 125 kDa on polyacrylamide gels were present in all of the 25 serum-resistant strains tested but in only four of seven serum-sensitive isolates of C. fetus from humans and animals (P = .007). The presence of these bands was associated with type A lipopolysaccharide. A low-passaged strain, 82-40, was serum resistant and contained the 100-kDa protein; however, a spontaneous mutant of this strain lacked this band and was serum sensitive. The 100-kDa and 125-kDa proteins of three strains of C. fetus were antigenically cross reactive or identical and were exposed on the surface of the C. fetus cell. Serum resistance is inherent to most C. fetus isolates from humans and is associated with the presence of cross-reactive surface proteins.

Erythromycin-resistant Campylobacter infections in Thailand

Erythromycin therapy was compared with no treatment in a prospective trial of acute diarrheal disease among 100 infants in an orphanage in Bangkok. Within 24 h of the onset of diarrhea, 50 children received erythromycin ethylsuccinate (40 mg/kg per day) in four divided doses for 5 days. Campylobacter jejuni isolated from 31, Campylobacter coli isolated from 21, and Shigella spp. isolated from 21 of 100 children were the most commonly recognized pathogens; use of a sensitive, nonselective method substantially increased Campylobacter isolation. Treatment with erythromycin had no effect on the duration of diarrhea caused by Campylobacter spp., Shigella spp., or other agents; 37% of the treatment group and 35% of the control group had diarrhea for 1 week. Of 23 Campylobacter strains isolated from the treatment group before treatment, 15 (65%) were resistant (MIC, greater than or equal to 8 micrograms/ml) to erythromycin. Among orphanage-acquired strains, 53% of 43 C. jejuni strains and 91% of 23 C. coli strains were resistant to erythromycin compared with 11% of 114 C. jejuni strains and 46% of 35 C. coli strains that were community acquired. Erythromycin resistance is common among Campylobacter strains in Bangkok, especially in an institutional setting, which may account for the lack of efficacy of erythromycin for treatment of acute diarrheal illnesses.

[Ultrastructure of primary clear cell carcinoma of the liver]

Surgical specimens of 175 cases of primary hepatocellular carcinoma were prepared by routine paraffin section and HE stain. The clear cell cancer specimens were stained with PAS. All the specimens were observed by light microscope. Ultrathin sections were made for 50 samples and studied by electron microscope. Under the light microscope, 79 (45.1%) showed varying amounts of clear cells. According to the proportion and distribution of these cells, clear cell carcinoma of the liver was divided into three types: scattered type (16 cases, 20.3%), localized (43, 54.4%) and diffuse types (20, 25.3%). The clear cancer cells could be found in hepatoma with various degrees of differentiation. Of these 79 cases, 4 (5.1%) were grade I, 53 (67%) and 22 (27.9%) were grades II and III. Positive PAS stain gives an evidence of glycogen in the clear cell cytoplasm. 7 diffuse type clear cell hepatomas were observed with electron microscope. The cytoplasm had only fewer organelles, leading to a void appearance. The amount of the rough endoplasmic reticulum, free ribosome and polyribosome was markedly decreased. So was mitochondria, usually showing swelling and abnormality. The residual rough endoplasmic reticulum and mitochondria were out of normal arrangement. They often aggregated on one side of the nucleus or near the cell membrane. Glycogen particles were increased in some cell cytoplasms. Some particles were even and fine, some were aggregated into masses or scattered. Nuclei showed abnormalities mild to moderate. The nature of the clear cells in liver cancer is the variance of glycogen or lipid in the cytoplasm.(ABSTRACT TRUNCATED AT 250 WORDS)

Detection of pathogenic Campylobacter species in blood culture systems

Because differences in recognition of Campylobacter fetus and Campylobacter jejuni in systemic infections may be due partially to differences in the ability to cultivate these organisms, we studied their growth characteristics in two widely used blood culture systems. In the Roche Septi-Chek system (Hoffman-La Roche, Inc., Nutley, N.J.), over a broad range of inocula all strains were detected in broth within 2 days and on paddles within 3 days. In the BACTEC 6B aerobic bottles (Johnston Laboratories, Inc., Towson, Md.), C. jejuni and C. fetus took a median of 5 and 3 days, respectively, to reach the growth index threshold. However, in the BACTEC 7D anaerobic bottles, C. fetus required a median of 2 days to reach the growth index threshold, whereas for C. jejuni the median was greater than 10 days. The poor performance of C. jejuni in both BACTEC systems may have been due to unfavorable incubation atmospheres and may partially explain why C. jejuni bacteremia is so infrequently detected. Overall, the Roche Septi-Chek system was excellent for detecting Campylobacter strains in blood cultures.

Controlled evaluation of the agar-slide and radiometric blood culture systems for the detection of bacteremia and fungemia

A commercially available agar-slide blood culture bottle (Septi-Chek; Roche Diagnostics, Div. Hoffman-La Roche, Inc., Nutley, N.J.) was compared with the radiometric blood culture system (BACTEC; Johnston Laboratories, Inc., Towson, Md.) in 8,544 paired blood cultures from adult patients. The systems were inoculated with equal volumes (10 ml) of blood. Overall, there was no statistically significant difference between the two systems in the recovery of clinically important microorganisms, but significantly more members of the family Enterobacteriaceae other than Escherichia coli were detected by the agar-slide system (P less than 0.005). The agar-slide system detected more fungi, and the BACTEC detected more anaerobic bacteria; however, small numbers of recovered organisms precluded statistical significance. When microorganisms grew in both systems, their presence was detected one or more days earlier in the BACTEC (P less than 0.001). More contaminants grew in the agar-slide system (P less than 0.001). Both systems performed well, and either system should provide high yield and prompt detection of positive blood cultures in patients with bacteremia and fungemia if used in an optimal way as recommended by the respective manufacturers.

Inactivation of Campylobacter jejuni by chlorine and monochloramine

Campylobacter jejuni and closely related organisms are important bacterial causes of acute diarrheal illness in the United States. Both endemic and epidemic infections have been associated with consuming untreated or improperly treated surface water. We compared susceptibility of three C. jejuni strains and Escherichia coli ATCC 11229 with standard procedures used to disinfect water. Inactivation of bacterial preparations with 0.1 mg of chlorine and 1.0 mg of monochloramine per liter was determined at pH 6 and 8 and at 4 and 25 degrees C. Under virtually every condition tested, each of the three C. jejuni strains was more susceptible than the E. coli control strain, with greater than 99% inactivation after 15 min of contact with 1.0 mg of monochloramine per liter or 5 min of contact with 0.1 mg of free chlorine per liter. Results of experiments in which an antibiotic-containing medium was used suggest that a high proportion of the remaining cells were injured. An animal-passaged C. jejuni strain was as susceptible to chlorine disinfection as were laboratory-passaged strains. These results suggest that disinfection procedures commonly used for treatment of drinking water to remove coliform bacteria are adequate to eliminate C. jejuni and further correlate with the absence of outbreaks associated with properly treated water.