[A 50-year-old man with metamorphopsia and optic nerve swelling]

We report a 50-year-old male having metamorphopsia associated with retinal edema. He was well until one month prior to the present admission when he developed occipital headache and backache. Three weeks later, he noted a sudden onset of twisting of visual images. On admission, he was in no acute distress with well preserved general conditions. Only neurological abnormalities were bilateral papilledema, retinal edema and horizontal nystagmus with a rotatory component. Routine blood chemistries were unremarkable. The CSF contained 28 cells/cmm with 60% consisting of large atypical cells. Cranial CT scans revealed no mass, however, the magnified orbital CT showed bilateral swelling of the optic nerve. He was treated with ventriculoperitoneal shunt and Ommaya tube placement through which methotrexate, cytarabine and prednisolone were administered. He was also treated with systemic cisplatin, mitomycin-C and 5-fluorouracil. With these therapy, his headache, metamorphopsia and papilledema improved. He was discharged for out-patient follow-up, however, he had to admitted again because of progressive difficulty of gait and loss of appetite. On admission, he complained of severe backache, and his gait disturbance appeared to be in part due to his backache. A slight weakness was noted in all four limbs with loss of deep reflexes. Mentally he was alert and cranial nerves appeared intact without papilledema. But nuchal rigidity was noted. Cranial CT scan revealed attenuation of all the cortical sulci and marked diffuse low density changes in the cerebral white matter, and his chest film revealed a ring-shape shadow in his left lung field. He deteriorated progressively with terminal gastrointestinal hemorrhage. He expired three weeks after his second admission.(ABSTRACT TRUNCATED AT 250 WORDS)

[A 93-year-old woman presenting consciousness disturbance, left hemiplegia, and respiratory distress]

We present a 93-year old female who abruptly developed left hemiplegia on the way to the wash room. She was admitted to another hospital where her consciousness deteriorated and artificial respiration was necessary. She was transferred to our hospital 20 days after the onset of her stroke. On admission, her BP was 60/40 mmHg, and wheezing râle was heard in both lung fields. No heart murmur was present. She was in comatose state, but a small amount of spontaneous movements were present in her eyelids and the jaw. Neurologic examination revealed no papilledema, small non-reactive pupils with the right side being slightly larger than the left, absence of ocular movements, and loss of oculocephalic response and corneal reflex. An intratracheal tube was in situ, and the observation of the pharynx was impossible. No stiff neck was present. No spontaneous movement was observed in her limbs which were flaccid, and all the deep reflexes were lost except for jaw jerk which was weakly positive. Cranial CT scans revealed low density areas in the right anterior and middle cerebral artery territories with patchy areas of high density being consistent with a hemorrhagic infarction. In addition, a small high density mass lesion was noted in the left frontal lobe adjacent to the falx, which was thought to be a small meningioma. Her clinical course was complicated by pneumonia, hypotension and cardiac failure. She expired 2 months after the onset of her stroke. Postmortem examination revealed an extensive hemorrhagic infarction involving the territory of the right internal carotid artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Enhanced susceptibility of cis-diamminedichloroplatinum-treated K562 cells to lysis by peripheral blood lymphocytes and lymphokine activated killer cells

BACKGROUND

Previous studies have reported that cis-diamminedichloroplatinum (II) (CDDP) exhibits various immunomodulating activities. The current study investigates the effect of CDDP on the susceptibility of K562 cells to lysis by peripheral blood lymphocytes (PBL), natural killer (NK) cells, and lymphokine activated killer (LAK) cells.

METHODS

Cytotoxicity was determined by the 51Cr release assay.

RESULTS

Treatment of K562 cells with CDDP at 10 micrograms/ml or more for 3 hours or more enhanced their susceptibility to lysis by PBL. This CDDP-mediated enhancement of lysis was observed by PBL derived from healthy donors and from patients with urinary bladder tumor or with other malignant and nonmalignant urologic diseases. The CDDP-induced enhancement of K562 cell susceptibility to lysis by PBL also was observed when purified NK cells and LAK cells were used as effector cells. The CDDP analog, carboplatin, enhanced the susceptibility of K562 cells to lysis by PBL, but treatment with transdiamminedichloroplatinum (II) had no effect. Several experiments were done to investigate the mechanism of the enhanced susceptibility of CDDP-treated K562 cells to lysis by PBL. Treatment of K562 cells with CDDP had no effect on the expression of major histocompatibility complex (MHC) Class I, MHC Class II, neural cellular adhesion molecule, and leukocyte function antigen-1 on the tumor cells. The frequency of target cell conjugates to PBL was not changed by CDDP-treated K562 cells. Pretreatment of K562 cells with CDDP and lysosomotrophic agents (L-leucine-methyl-ester or chloroquine) abrogated their enhanced susceptibility to lysis by PBL. CDDP treatment of K562 cells did not augment their sensitivity to alpha-interferon, gamma-interferon, tumor necrosis factor alpha, or natural killer cytotoxic factor (NKCF). Treatment of effector cells with CDDP had no effect on their cytotoxic function.

CONCLUSIONS

These results demonstrate that CDDP has a direct effect on the K562 target cells, rendering them more susceptible to lysis by PBL, NK cells, and LAK cells. In addition, the result suggest that CDDP-mediated enhancement of target cell lysis is not attributable to changes of surface membrane antigen expression or recruitment of precursor cells but to processing of CDDP by the cells. The possible mechanisms of the effect of CDDP on K562 cells and clinical implications are discussed.

Further study on 1/f fluctuations observed in central single neurons during REM sleep

Recently, 1/f fluctuations have been discovered in the single-unit activity of mesencephalic reticular formation (MRF) neurons during REM sleep. In a previous paper, such behavior could satisfyingly be interpreted on the basis of the clustering Poisson process. The question of applicability of this model to other MRF neurons remained unanswered. The present paper reports on 1/f fluctuations in 12 MRF neurons all of which can satisfyingly be modeled by the clustering Poisson process.

Fine genetic mapping of the proximal part of mouse chromosome 2 excludes Pax-8 as a candidate gene for Danforth's short tail (Sd)

Danforth's short tail (Sd) is a semidominant mutation of the mouse with effects on the skeleton and the urogenital system. In view of its phenotype and its position in the proximal part of Chromosome (Chr) 2, three genes qualified as possible candidates: Pax-8, a paired box-containing gene; Midkine (Mdk), a retinoic acid-responsive gene; and a new locus (Etl-4) identified by enhancer trapping with a lacZ reporter gene which showed expression in the notochord, the mesonephric mesenchyme, and the apical ectodermal ridge. Three different backcrosses involving all three genes in different combinations were set up and analyzed. From our results we conclude that Sd, Etl-4, Pax-8, and Mdk are independent loci, with Etl-4 being the closest genetic marker (1.1 +/- 1.4 cM) to the Danforth's short tail (Sd) gene.

An early cytoplasmic change before Lewy body maturation: an ultrastructural study of the substantia nigra from an autopsy case of juvenile parkinsonism

Neurons containing a central pale area which may possibly represent an early cytoplasmic change before Lewy body maturation were observed in the substantia nigra from a rare autopsy case of juvenile parkinsonism. Ultrastructurally, such neurons exhibited cytoplasmic swelling along with disappearance of the rough endoplasmic reticulum from the central part of the perikaryon. The pale central cytoplasm was replaced by numerous-cored vesicles, mitochondria, ribosome-like granules and a few Lewy body filaments. The relation of this central pale area to the pale body is discussed.

A new Pax gene, Pax-9, maps to mouse chromosome 12

Members of the Pax gene family have recently been shown to play important roles in mouse embryogenesis. Of eight so far characterized Pax genes, three have been associated with mouse developmental mutants. Here we report the cloning of a new Pax gene, Pax-9. Most of the DNA sequence encoding the highly conserved paired domain has been determined and compared with previously known paired domains. This comparison classifies Pax-9 as a member of the same subgroup as Pax-1/undulated. By analysis of the segregation of a Pax-9 restriction fragment length polymorphism and a large number of simple sequence length polymorphisms in an interspecific C57BL/6 x Mus musculus mollosinus backcross, Pax-9 was mapped close to the D12Nds1 locus on the proximal part of Chromosome (Chr) 12.

Effect of PSK and its subfractions on peripheral blood lymphocytes mediated cytotoxicity against urinary bladder tumor cells

Our previous studies have indicated that the protein-bound polysaccharide Kreha (PSK) enhances the cytotoxic activity of peripheral blood lymphocytes (PBL) against the T24 human urinary bladder tumor cell line in patients with bladder tumor. Since PSK consists of a mixture of various kinds of protein-bound polysaccharides, the present study was designed to examine which subfractions of PSK mediated the enhancement of cytotoxicity. When PSK was separated according to size, treatment of PBL with the 50 kilodalton (kd) or less fraction killed T24 cells more efficiently than unfractionated PSK-treated PBL. The higher molecular weight fractions did not enhance killing above the control level. PSK was fractionated on a diethylaminoethyl (DEAE)-cellulose column to obtain a protein rich fraction that absorbed onto the column and a polysaccharide rich fraction that did not. PBL treated with the polysaccharide rich fraction were able to kill T24 cells more effectively than unfractionated PSK-treated PBL. The protein rich fraction had no effect on the killing. Further fractionation of the polysaccharide rich fraction was performed by differential precipitation with ammonium sulfate. PBL treated with the precipitated fraction at 70-80% saturation (PSK Fraction D) enhanced cytotoxicity equal to that of the polysaccharide rich fraction. Treatment of PBL with the other fractions did not augment the cytotoxicity. These enhancement by PSK fractions were observed in healthy donors and also in patients with bladder tumor. An increase of the proliferative response of PBL to PSK Fraction D as well as unfractionated PSK was observed. Treatment of PBL with PSK Fraction D had no effect on the proportion of PBL binding to T24 cells, thus suggesting a post-binding effect. The structure of PSK Fraction D as inferred from the results of methylation analysis was mainly an alpha-glucan. These results demonstrate that PSK mediated enhancement of cytotoxicity and proliferation of PBL may be largely due to an alpha-glucan of less than 50 kd.

The streptococcal preparation OK-432 specifically augments the susceptibility of human urinary bladder tumor cells to autologous peripheral blood lymphocytes

The streptococcal preparation OK-432 was tested for its ability to enhance the susceptibility of fresh urinary bladder tumor (UBT) cells to autologous peripheral blood lymphocytes (PBL) in patients with UBT. PBL treated with OK-432 at 0.1 Klinishe Einheit (KE)/ml for 18 hours killed the human T24-lined UBT cells and freshly separated autologous UBT cells more efficiently than untreated PBL. Treatment of K562 erythroleukemia cells with OK-432 at 0.1 KE/ml for 18 hours had no effect on their susceptibility to lysis by fresh PBL. In contrast, treatment of T24 and fresh autologous UBT cells with OK-432 resulted in an enhancement of their susceptibility to PBL. The susceptibility of autologous UBT cells to both large granular lymphocytes (LGL) and T-lymphocytes was also enhanced by treatment of tumor cells with OK-432. Binding of PBL to T24 and fresh autologous UBT cells was also augmented by treatment of the tumor cells with OK-432. The frequency of binding of OK-432 to fresh UBT cells was positively correlated with the increased target sensitivity to autologous PBL. The inhibition of RNA synthesis in fresh UBT cells by OK-432 was also associated with the elevated susceptibility to autologous PBL. These results indicate that OK-432 activates the autologous tumor killing system through stimulation of effector cells and elevation of target susceptibility to effector cells in patients with UBT, and suggest that the OK-432-augmented target sensitivity to PBL may be oriented specifically to UBT cells and local immunotherapy with OK-432 may be remarkably beneficial in the treatment of UBT.

[Tryptophan and its metabolite concentrations in human plasma during the perinatal period]

The concentration of tryptophan (free and protein bound) and its metabolites in the plasma of the maternal vein and in the umbilical vein, umbilical artery and neonatal vein were determined by high performance liquid chromatography. The plasma levels of tryptophan and most of its metabolites in the umbilical vein and artery were significantly higher than those in the maternal vein. Especially the 3-OHAA level in umbilical blood was approximately 50 times as high as that in maternal blood. The concentration of total tryptophan in the plasma of the neonatal vein showed a marked decrease at one day after birth in comparison with that at birth, but the total kynurenine concentration was not decreased in the plasma of the neonatal vein. In the blood, ratios of free to total tryptophan and kynurenine were kept at a constant level throughout the perinatal period. In conclusion, the present study suggests that tryptophan metabolism may play an important role in fetal development.

Expansion of murine T cells bearing a unique T cell receptor beta-chain in Friend virus-induced tumor in situ

Heterogeneity of V alpha 1+ and V beta 10+ TCR alpha beta-chains, which are predominantly used in anti-FBL-3 CTL clones established in vitro, was investigated at a nucleotide level in FBL-3 tumor-infiltrating lymphocytes (TIL) in vivo. The majority (90%) of V beta 10+ beta-chains dominated in TIL used homogeneous V beta 10D beta 2.1 sequences identical to that used in the T cell clones with cytotoxic functions. The homogeneous TCR beta-chain expression was dominant and found to be about 10% of the total TCR beta-chains in the TIL population, which was a greater than 300-to 900-fold increase than in the regional lymph nodes. This is in good agreement with the in vitro data showing that about 11% CTL clones used the homogeneous V beta 10D beta 2.1+ beta-chain. However, the J beta segment does not seem to contribute greatly to the recognition and selection of this TCR because some of homogeneous VD+ beta-chains were associated with J beta segments other than J beta 2.7 of the CTL clones. The frequency of the V alpha 1J alpha 112-2+ alpha-chain expression of the CTL type was much less (3- to 80-fold increase compared to that of lymph node) and also varied in sample materials, indicating the lower contribution of the alpha-chain for the oligoclonality of the TCR. The results were also confirmed by quantitative PCR and RNase protection assays. This suggests that the dominant expression of the homogeneous TCR beta-chain is due to the expansion of the particular anti-FBL-3 CTL in the tumor in situ. Also, the TCR beta-chain, especially the V beta D beta region, rather than alpha-chain is more important for the recognition and selection of the anti-FBL-3 TIL with cytotoxic functions.

Expansion of murine T cells bearing a unique T cell receptor beta-chain in Friend virus-induced tumor in situ

Heterogeneity of V alpha 1+ and V beta 10+ TCR alpha beta-chains, which are predominantly used in anti-FBL-3 CTL clones established in vitro, was investigated at a nucleotide level in FBL-3 tumor-infiltrating lymphocytes (TIL) in vivo. The majority (90%) of V beta 10+ beta-chains dominated in TIL used homogeneous V beta 10D beta 2.1 sequences identical to that used in the T cell clones with cytotoxic functions. The homogeneous TCR beta-chain expression was dominant and found to be about 10% of the total TCR beta-chains in the TIL population, which was a greater than 300-to 900-fold increase than in the regional lymph nodes. This is in good agreement with the in vitro data showing that about 11% CTL clones used the homogeneous V beta 10D beta 2.1+ beta-chain. However, the J beta segment does not seem to contribute greatly to the recognition and selection of this TCR because some of homogeneous VD+ beta-chains were associated with J beta segments other than J beta 2.7 of the CTL clones. The frequency of the V alpha 1J alpha 112-2+ alpha-chain expression of the CTL type was much less (3- to 80-fold increase compared to that of lymph node) and also varied in sample materials, indicating the lower contribution of the alpha-chain for the oligoclonality of the TCR. The results were also confirmed by quantitative PCR and RNase protection assays. This suggests that the dominant expression of the homogeneous TCR beta-chain is due to the expansion of the particular anti-FBL-3 CTL in the tumor in situ. Also, the TCR beta-chain, especially the V beta D beta region, rather than alpha-chain is more important for the recognition and selection of the anti-FBL-3 TIL with cytotoxic functions.

[A case of pulmonary sarcoidosis with B lymphocytosis in peripheral blood]

A 24-year-old man was admitted on October 14, 1988, with bilateral cotton-like shadows on chest X-ray film. Chest CT demonstrated multiple nodular shadows in bilateral lung fields. Laboratory data on admission showed peripheral blood lymphocytosis and slight decrease of serum IgG and IgA. ACE was within normal limits, and BALF findings showed no increase of lymphocytes. Surface marker analysis of peripheral blood lymphocytes showed an increase of B lymphocytes of antibody independent stage (B1, B4, J5, OKB7, sIgM, and sIgD positive cells were increased). Southern blot analysis of peripheral blood showed no rearrangement of immunoglobulin chains (H chain and L chain). In order to differentiate sarcoidosis from lymphoproliferative disorder, open lung biopsy was performed. Pathologic study revealed multiple epithelial granulomas without caseation. Immunohistochemical study demonstrated no accumulation of B cells of the lung. This patient was pathologically diagnosed as having pulmonary sarcoidosis. The abnormal chest shadows gradually improved without therapy; however, B cell lymphocytosis and slight decrease of serum IgG and IgA persisted. In general, lymphocytopenia of peripheral blood is usual in sarcoidosis. We report a rare case of pulmonary sarcoidosis with polyclonal B lymphocytosis of antibody independent stage in peripheral blood.

Ticlopidine treatment in idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia accompanied by nephrotic syndrome

A 36-year-old woman was admitted for idiopathic plasmacytic lymphadenopathy with polyclonal hyperimmunoglobulinemia (IPL) associated with nephrotic syndrome. She was expected to lapse into renal failure because renal biopsy showed focal glomerulosclerosis. VEMP chemotherapy and bolus methyl prednisolone were not effective against excessive urine protein of over 10 g/day. We thus began administration of ticlopidine (6 mg/kg/day), prednisolone (0.4 mg/kg/day) and cyclophosphamide (1 mg/kg/day). After 3 months of this regimen, the urine protein level decreased to less than 0.5 g/day, and renal function was maintained for more than 3 years. It is suggested that ticlopidine is effective for nephropathy complications associated with IPL.

[Percutaneous transluminal angioplasty of dialysis access shunts]

Sixteen balloon angioplasties were performed in 10 patients with upper-extremity dialysis access shunts. The initial success rate was 80% (12/15). Of the initial successes, 58% (7/12) were patent at six months and 13% (1/8) at one year. In nine cases, repeat PTA was necessary. The mean interval of patency was about four months. The longest interval was two and a half years. The complication of thrombosis of the loop shunt during PTA was successfully treated by fibrinolytic therapy.

Ectopic aberrant adrenals with epididymal abnormality

We report a rare case of ectopic aberrant adrenals associated with epididymal abnormality found during exploration for a left undescended testis. Two ectopic adrenals were found, one on the epididymis and the other adjacent to the spermatic cord. We believe the simultaneous occurrence of epididymal abnormality and ectopic aberrant adrenals has not been reported before.

[A case of malignant pleural mesothelioma with osseous and cartilaginous formation]

A 85-year-old man was admitted to our unit on November 17, 1989 with bloody sputum and abnormal shadow on chest X-ray film. Chest X-ray and CT on admission showed a large tumor mass approximately 9 cm in diameter in the right middle and lower lung field. Microscopic examination of the needle biopsy specimen from the tumor revealed biphasic malignant pleural mesothelioma. After admission, thoracentesis was performed, because of rapidly increasing right-sided pleural effusion. One of the two trochar catheter was inadvertently inserted in the tumor. Tumor tissue obtained through the catheter showed malignant mesothelioma with osseous and cartilaginous formation. Only isolated reports by Goldstein and Yousem have reported osseous and catilaginous differentiation in malignant mesothelioma. To our knowledge, this is the first reported case in Japan.

Modulation by cis-diamminedichloroplatinum (II) of the susceptibilities of human T24 lined and freshly separated autologous urinary bladder transitional carcinoma cells to peripheral blood lymphocytes and lymphokine activated killer cells

The effects of cis-diamminedichloroplatinum (II) on the susceptibilities of human T24 lined and freshly separated autologous urinary bladder transitional carcinoma cells to lysis by peripheral blood lymphocytes of patients with urinary bladder cancer was analysed in a 12-hour 51Cr release assay. Treatment of T24 cells with cis-diamminedichloroplatinum (II) at 10 micrograms./ml. for three hours enhanced their susceptibility to peripheral blood lymphocytes and lymphokine activated killer cells. Kinetics studies demonstrated that the enhancement of their susceptibility became noticeable by three hours and continued until 12 hours. The susceptibilities of autologous tumor cells to both large granular lymphocytes and T lymphocytes were also enhanced by treatment of them with cis-diamminedichloroplatinum (II). There was no significant difference in the number of peripheral blood lymphocytes binding to cis-diamminedichloroplatinum (II)-treated T24 cells as compared with untreated T24 cells. Treatment of T24 cells with mitomycin C did not change their natural killer sensitivity. Pretreatment of T24 cells with cis-diamminedichloroplatinum (II) and lysosomotrophic agents (L-leucin-methyl-ester or chloroquine) reduced the enhancement of their susceptibility to natural killer cells by cis-diamminedichloroplatinum (II) alone. On the other hand, pretreatment of peripheral blood lymphocytes with cis-diamminedichloroplatinum (II) had no influence on the cytotoxicity against T24 cells. These results indicate that cis-diamminedichloroplatinum (II) may have an augmenting effect on the susceptibility of tumor cells to the cell-mediated cytotoxicity partly through a modification of cell membrane independently of its antimetabolic activity and this modification may be one of the possible mechanisms responsible for tumor regression after chemotherapy with cis-diamminedichloroplatinum (II).

Effects of bacillus Calmette-Guerin on cytotoxic activities of peripheral blood lymphocytes against human T24 lined and freshly isolated autologous urinary bladder transitional carcinoma cells in patients with urinary bladder cancer

The effects of bacillus Calmette-Guerin (BCG) on the cytotoxic activities of peripheral blood lymphocytes against human T24 lined and freshly separated autologous urinary bladder transitional carcinoma cells in patients with urinary bladder cancer were analyzed in a 12-hour chromium 51 (51Cr) release assay. The results of this study indicate that BCG activates the tumor killing system through stimulation of effector cells and elevation of target cell susceptibility in patients with urinary bladder cancer, suggesting that BCG-augmented cytotoxicity may be oriented specifically to urinary bladder cancer cells. This could explain the remarkable clinical benefits of intravesical instillation of BCG against urinary bladder cancer.

Production and characterization of mouse monoclonal antibodies against the transmembrane protein of a human immunodeficiency virus type 2

We established seven hybridoma clones producing monoclonal antibodies (MAbs) against the envelope transmembrane protein (TMP) of a Ghanian isolate of human immunodeficiency virus type 2 (HIV-2[GH-1]) from mice immunized with the detergent-disrupted purified whole virus. The MAbs were found to react with 35 kilodalton (kD) TMP of the HIV-2[GH-1] virus in a Western blot assay (WB). Two of these MAbs recognized 135 kD proteins in addition to TMP in the lysate of HIV-2[GH-1]-infected cells. Two other MAbs cross-reacted with viral components corresponding to TMPs of HIV-2ROD and SIVMAC isolates in a Western blot. Results of competitive binding assay suggest that there are at least three epitopes on a TMP molecule of the HIV-2[GH-1] isolate. The MAbs did not inhibit syncytium formation between HIV-2[GH-1]-infected MOLT-4 cells and MOLT-4 clone 8 cells, nor virus infection to MOLT-4 clone 8 cells.

[Fracture of percutaneously inserted IVC filters--two cases of Günther's filter]

During the period from 1988 to 1990, percutaneous insertion of Günther vena caval filters were performed in ten patients in our institution. In two of them, fracture and partial migration of anchoring limbs were observed. Günthter's filter is an attractive device for interventional radiologist because of its technical ease of percutaneous placement and relative stability within the vein. However, our experience suggests that this device is not entirely safe and reliable. The patients should be carefully followed up with a possibility of distal migration in mind. Further structural improvement seems necessary.

Resonance Raman study on intact pea phytochrome and its model compounds: evidence for proton migration during the phototransformation

Resonance Raman (RR) scattering from intact pea phytochrome was observed in resonance with the blue band at ambient temperature. The relative populations of the red-light-absorbing form (Pr) and far-red-light-absorbing form (Pfr) under laser illumination were estimated from the absorption spectra. The most prominent RR band of Pr obtained by 364-nm excitation under 740-nm pumping exhibited a frequency shift between H2O and D2O solutions, but that of Pfr obtained by 407-nm excitation under 633-nm pumping did not, indicating a distinct difference in a protonation state of their chromophores. Since the protonation level of a whole molecule of intact phytochrome remains unchanged between Pr and Pfr, this observation indicates migration of a proton from the chromophore of Pr to the protein moiety of Pfr. As model compounds, octaethylbiliverdin (OEBV-h3), its deuterated and 15N derivatives, and their protonated forms were also studied with both RR and 1H and 15N NMR spectroscopies. The RR spectrum of the protonated form, for which the protonation site was determined to be C-ring pyrrole nitrogen by NMR, displayed a deuteration shift corresponding to that of Pr, suggesting a similar protonated structure for the pyrrolic rings of Pr. The RR spectral difference between OEBV-h3 and OEBV-d3 and that between H2O and D2O solutions of Pfr suggested that the N-H protons of the A-, B-, and D-rings of intact phytochrome are replaced with deuterons in D2O. A role of the 7-kDa segment of phytochrome is discussed on the basis of RR spectral differences between the intact and large phytochromes.

Dominant expression of a distinctive V14+ T-cell antigen receptor alpha chain in mice

A distinctive variable region 14-positive (V14+) alpha chain (V alpha 14+) of the T-cell antigen receptor is predominantly expressed in multiple mouse subspecies. The V alpha 14 family has two members, V alpha 14.1 and V alpha 14.2, which differ by only three amino acids at positions 50-52. Based on the EcoRI restriction fragment length polymorphism of the gene encoding V alpha 14, mice can be divided into three groups: type I with an 11.2-kilobase (kb) fragment, type II with a 2.0-kb fragment, and type III with the 2.0-kb and 11.2-kb fragments. Usage of V alpha 14-J alpha 281, where J alpha 281 is an alpha-chain joining segment, with a one-base N region dominates at the level of 0.02-1.5% of alpha chains in all laboratory strains, Mus musculus castaneus, and Mus musculus domesticus but not in Mus musculus molossinus, Mus musculus musculus, and Mus spicilegus samples. The preferential V alpha 14-J alpha 281 expression seems to be due to positive selection because the V-J junctional region is always glycine, despite the ability of the V alpha 14 gene to associate with J alpha other than J alpha 281. As V alpha 14-J alpha 281 expression is independent of known major histocompatibility complex antigens, including H-2, TLA, Qa, and HMT, the selecting ligand must be a monomorphic molecule of the mouse, expressed in a subspecies-specific manner. Additional observations, such as the expression of homogeneous V alpha 14-J alpha 281 in athymic mice, suggest that the positive selection of V alpha 14+ T cells occurs extrathymically.

[Study on argyrophilic inclusions of multisystem atrophy (Oppenheimer)]

Non-hereditary olivo-ponto-cerebellar atrophy (OPCA) and striato-nigral degeneration (SND) have been looked upon as a single disease entity called multisystem atrophy (MSA) by Oppenheimer. This study revealed that both intracytoplasmic argyrophilic inclusions (AI) in pontine neurons and glial (argyrophilic) cytoplasmic inclusions (GCIs) widely distributed in the CNS are characteristics of MSA.

MATERIALS

a) 12 cases with MSA, b) 16 cases with autosomal dominant (AD) form of spinocerebellar degeneration (SCD): AD form of OPCA 5 cases, Joseph disease 4 cases, AD-dentatorubropallidoluysian atrophy (Naitoh & Oyanagi's form) 6 cases, AD-spastic ataxia (Brown) 1 case, c) 4 cases with autosomal recessive (AR) form of SCD: AR form of OPCA 1 case, myoclonic epilepsy with ragged-red fibers (MERRF) 1 case, complicated form of spastic paraplegia 2 cases, d) 6 cases with non-hereditary SCD including intoxications: late cortical cerebellar atrophy 1 case, alcoholic cerebellar degeneration 2 cases, phenytoin-induced cerebellar degeneration 1 case, neuroleptic malignant syndrome 1 case, and e) 27 cases with other neuropsychiatric diseases: Alzheimer disease 20 cases, progressive supranuclear palsy 5 cases, schizophrenia 2 cases.

METHOD

We examined 10 mu-thick paraffin sections stained with HE, Klüver-Barrera, Bodian, Holzer, Gallyas, and Bielschowski methods.

RESULTS

AI in pontine neurons were found only in two cases of MSA. Interestingly no AI could be detected even in cases with AD form of OPCA showing mild degeneration in the pontocerebellar system. On the other hand, GCIs were found in all cases with MSA irrespective of the degree of degeneration in the olivo-ponto-cerebellar or striato-nigral system. However, there was no GCIs in cases with other form of SCD and other neuropsychiatric diseases. Gallyas stain was the best method for detecting GCIs. GCIs were widely distributed in the CNS except for superficial layers of the cerebral cortex, the cerebellar cortex, and the dorsal column of the spinal cord. There were also many GCIs in the putamen, pontine base, and cerebellar white matter, even though these sites were well preserved.

Activation by the protein-bound polysaccharide PSK (krestin) of cytotoxic lymphocytes that act on fresh autologous tumor cells and T24 human urinary bladder transitional carcinoma cell line in patients with urinary bladder cancer

PSK, a protein-bound polysaccharide Kureha, was tested for its ability to modulate the cytotoxicity of lymphocytes that act on autologous tumor cells and T24 human urinary bladder tumor cells in urinary bladder cancer patients in a 6-h 51Cr release assay. In vitro treatment of peripheral blood lymphocytes (PBL) with PSK for 18 hours resulted in an augmentation or induction of cytotoxicity against relatively resistant T24 cells in previously reactive and nonreactive cases, respectively. The PSK-treated PBL were able to kill more effectively tumor cells that were freshly isolated from the same cancer patients than non-treated PBL. The effects of PSK were noted with PBL as well as tumor infiltrating lymphocytes (TIL) and with PSK at concentrations of 10 to 100 micrograms./ml., while PSK at higher doses reduced their lytic activities. The addition of PSK to the assay at the same concentrations also enhanced the cytotoxicities. Autologous tumor killing (ATK) activities of both large granular lymphocytes (LGL) and T lymphocytes were enhanced by PSK. Treatment of PBL with PSK did not effect on the proportion of PBL binding to the tumor cells, while it augmented the cytotoxic activity. Cell-free supernatant of PSK-stimulated lymphocyte culture did not contain any detectable amounts of interferon-alpha (IFN-alpha), interferon-gamma (IFN-gamma) and interleukin-2 (IL-2). In addition, anti-IFN-alpha monoclonal antibody (MAb), anti-IFN-gamma MAb and anti-IL-2 MAb did not inhibit PSK-induced augmentation of cytotoxicity against T24. Oral administration of PSK (three gm./day) to patients with urinary bladder cancer daily for seven days before operation resulted in an augmentation of the cytotoxicity against T24 cells in five out of 10 patients and no change of the cytotoxicity in the other five patients. ATK activity was also enhanced by oral administration of PSK in three out of five patients. These results indicate that the antitumor activity of PSK may be in part mediated through activation of tumor killing system independent of IFN-alpha, IFN-gamma and IL-2.

[Clotting and fibrinolytic activities in acute alcoholic golden hamsters with or without ether anaesthesia]

Fluid cadaveric blood is generally known as a characteristic of sudden death. However, it has been reported that soft blood clots have been observed in a number of cases of sudden death after alcohol drinking. Such a tendency was also recognized on autopsy cases in our laboratory. This study was carried out to reveal the effects on clotting and fibrinolytic system in golden hamsters under acute alcohol intoxication. Furthermore, the influences of ether anaesthesia were also observed. Activities of clotting and fibrinolytic factors were measured with fluorogenic peptide substrate. Prothrombin and factor X activities began to decrease 1 hr after administration of alcohol. But thrombin-like and factor Xa-like activities significantly increased after 1 hr and then returned to the initial value 4 hr after administration. Plasminogen activity began to decrease 1 hr after administration, whereas plasmin-like and t-PA-like activities increased after 1 hr and returned to the initial values or decreased after 4 hr. These results show that under acute alcohol intoxication clotting and fibrinolytic factors (prothrombin, factor X and plasminogen) in golden hamsters were converted temporarily to their active forms (thrombin, factor Xa and plasmin). No influence of only ether anaesthesia on clotting and fibrinolytic activities was observed. At 1 hr after administration of alcohol some effects of ether anaesthesia on prothrombin, prekallikrein and kallikrein were observed and then were not observed after 4 hr. But it seems that the influence of ether anaesthesia on clotting and fibrinolytic activities was negligible in the process after alcohol consumption.

Juvenile parkinsonism: a case with first clinical manifestation at the age of six years and with neuropathological findings suggesting a new pathogenesis

A clinico-pathological study of a 39-year-old female with Juvenile parkinsonism was carried out. Although the clinical manifestations were consistent with parkinsonism, the pathological findings were significantly different. Pathological examination showed the lesion to be localized to the substantia nigra, the number of neurons to be abnormally low, the proportion of melanin-containing cells to be reduced, and a large number of immature cells to be present. No neuronal degeneration associated with gliosis or release of melanin granules, such as seen in Parkinson's disease, was observed. Neuropathological studies, including cytometry and comparison against normal controls in the distribution of melanin granules, suggested hypoplasia and poor neuronal maturation of the substantia nigra. Since neuromelanin is thought to be the result of normal dopamine metabolism, reduction of melanin-containing cells in this case suggests inadequate or abnormal dopamine metabolism. Thus, the clinical manifestation of parkinsonism in this case seems to be related to the small number of melanin-containing cells which implies the dopamine deficiency state.

Post-irradiation treatment with OK432 can prevent radiation-induced bone marrow death

The radioprotective effect of OK432, a Streptococcus haemolyticus preparation, on bone marrow death was examined in mice. The LD50 value was increased from 7.55 Gy in controls to 8.45 Gy in mice treated once with OK432 immediately after irradiation. Multiple administrations of the agent further elevated the LD50 value to 9.56 Gy. The radioprotective effect was also apparent when multiple treatments were commenced as late as 72 h after irradiation.

[A case of idiopathic chronic scrotal hematocele]

A case of chronic scrotal hematocele is reported. A 63-year-old male first noticed the painless swelling of his left scrotal contents about 30 years before he visited our clinic on September 16, 1987. Examination revealed a hard mass, 10 x 8 cm in diameter, in the left scrotum. The scrotum did not transmit light. Since it was impossible to exclude testicular tumor completely, we performed left high orchiectomy. The extracted mass contained old brownish black clotted blood and a normal testis. Histopathological examination revealed that the hematocele showed a dense, fibrous wall with hyalinization. Six cases of chronic scrotal hematocele including our case have been reported in the Japanese literature.

Quantitative analysis of serum IL-6 and its correlation with increased levels of serum IL-2R in HIV-induced diseases

We have devised a luminescence sandwich ELISA for the quantification of IL-6 in both sera and cell culture supernatants, which had a detection limit of 100 fg/ml of test sample. By using the luminescence sandwich-ELISA, low but measurable levels of IL-6 (9.5 pg/ml on average) were found in the sera from normal individuals. The serum levels of IL-6 were elevated in HIV-seropositive asymptomatic carriers (55.5 pg/ml on average), and the IL-6 levels were correlated with the degree of HIV-induced disease progression (AIDS-related complex 106.8 pg/ml on average and (AIDS 283 pg/ml). IL-6 immunoreactivity in the sera of AIDS patients eluted at a 25,000 m.w. major peak, which was biologically active and heat-stable, and a 500,000 m.w. minor peak in size-exclusion HPLC. Interestingly, a significant correlation was observed between the serum IL-6 levels and soluble IL-2R levels. In vitro, HIV infection of PHA-activated PBMC led to enhanced release of IL-6 into the culture supernatants. Moreover, soluble IL-2R release was markedly increased by adding exogenous IL-6, whereas it was decreased by adding the neutralizing anti-IL-6 mAb to the cultures. These results demonstrate that increased IL-6 levels are significantly associated with sIL-2R levels, and suggest a cause of the increased levels of this receptor in patients with HIV infection. Furthermore, both serum IL-6 and serum IL-2R levels in HIV infection reflect the stage of the HIV-induced disease.

Quantitative analysis of serum IL-6 and its correlation with increased levels of serum IL-2R in HIV-induced diseases

We have devised a luminescence sandwich ELISA for the quantification of IL-6 in both sera and cell culture supernatants, which had a detection limit of 100 fg/ml of test sample. By using the luminescence sandwich-ELISA, low but measurable levels of IL-6 (9.5 pg/ml on average) were found in the sera from normal individuals. The serum levels of IL-6 were elevated in HIV-seropositive asymptomatic carriers (55.5 pg/ml on average), and the IL-6 levels were correlated with the degree of HIV-induced disease progression (AIDS-related complex 106.8 pg/ml on average and (AIDS 283 pg/ml). IL-6 immunoreactivity in the sera of AIDS patients eluted at a 25,000 m.w. major peak, which was biologically active and heat-stable, and a 500,000 m.w. minor peak in size-exclusion HPLC. Interestingly, a significant correlation was observed between the serum IL-6 levels and soluble IL-2R levels. In vitro, HIV infection of PHA-activated PBMC led to enhanced release of IL-6 into the culture supernatants. Moreover, soluble IL-2R release was markedly increased by adding exogenous IL-6, whereas it was decreased by adding the neutralizing anti-IL-6 mAb to the cultures. These results demonstrate that increased IL-6 levels are significantly associated with sIL-2R levels, and suggest a cause of the increased levels of this receptor in patients with HIV infection. Furthermore, both serum IL-6 and serum IL-2R levels in HIV infection reflect the stage of the HIV-induced disease.

[The forming phase and various properties of Au, Ag, Cu and Ga mixture in metal fired crowns]

A new time-saving method has been developed to produce artificial crowns without using the casting process. Plastic mixtures of gallium and other metal particles are kneaded into desired shape and then heated for hardening. By this method, the time required for hardening and producing restorative materials has been shortened greatly. In the present experiment, gallium was triturated with powdered gold, silver and copper to make binary alloy samples. The dimensional change was measured between heat treatment. After heat treatment, the test piece was examined for compressive strength, compressive shrinkage, hardness, tarnishing and difference in phase. Non-heated and heated alloy specimens (Au-Ga, Ag-Ga, Cu-Ga) expanded to form the new phase. The ability of Au-Ga samples to bear compressive strength, when heated at 300 degrees C or more (AuGa2----AuGa), became 2.6 times greater than that of non-heat-treated specimens. The compressive strength of Ag-Ga samples dropped briefly at 350 degrees C (Ag0.72Ga0.28----Ag3Ga) but increased at 450 degrees C (Ag3Ga----AgGa). The strength of Cu-Ga pieces fell by half at 475 degrees C and upward (CuGa2----unknown phase). A compression test showed that the contraction percentage of Au and Ag specimens became large as a result of heat treatment, while that of Cu alloys remained almost unchanged. The results of a hardness test (HV) were comparable to those of the compressive strength test. The Au-Ga alloys increased in hardness after high-temperature treatment. In the Ag-Ga alloys, hardness declined at 350 degrees C and increased at 450 degrees C. There was no difference in hardness between Cu specimens after heat treatment and those allowed to stand at room temperature. A tarnishing test revealed that Au-Ga samples turned slightly yellowish. In the case of Ag-Ga samples, the reflectivity Y (%) dipped slightly but discoloration was not recognizable. However, the Cu-Ga samples which were heated at temperatures of up to 280 degrees C showed a slight drop in reflectivity, but those heated at temperatures higher than 280 degrees C decreased to 50-66% in reflectivity and turned black.

Non-missile head injury: report of a patient surviving for 6 years

A female patient with non-missile head injury is described. She showed slight improvement in her level of consciousness, and survived for 6 1/2 years after injury. At autopsy, the white matter lesions were localized rather than diffuse in distribution. In addition to lesions in the corpus callosum, anterior commissure and dorsolateral quadrant of the rostral brain stem, those in the parasagittal cerebral white matter, and in the hilus of the dentate nucleus and superior cerebellar peduncle were considered to be due to primary axonal injury. A cavity in the frontal white matter was remarkable in that there was no evidence to indicate expansion of the lesion due to haemorrhage. These features suggested that the injurious physical forces had acted parallel to the direction of the axons.

[A case of secondary bladder tumor the origin (gastric cancer) of which could not be identified before autopsy]

Primary bladder tumor is the most frequent malignant tumor in the field of urology, whereas the incidence of secondary bladder tumor from a distant organ is quite rare. We report here a 21-year-old female patient with metastatic bladder tumor from gastric cancer. She came to our hospital with a complaint of only bladder irritability. Cystoscopical and cytological examinations revealed rhabdomyosarcoma of the bladder. She did not respond to radiation therapy and combined chemotherapy, consisting of actinomycin D, vincristine and cyclophosphamide, and died 91 days after admission. Autopsy revealed a primary tumor of poorly differentiated scirrhus carcinoma of the stomach. Thus this was a quite rare case of metastatic bladder carcinoma characterized by bladder irritability without gastrointestinal symptoms.

[A case of primary localized amyloidosis of the urinary bladder]

A case of primary localized amyloidosis is reported. The patient was a 73-year-old female who suffered from miction pain and consulted our department. There was a 1.5 x 1.5 cm slightly red, nonpapillary tumor around the right ureteral orifice in cystoscopy. The diagnosis was amyloidosis with cystitis hemorrhagica histopathologically. After the treatment with antibiotics for about one month there were no symptoms and no tumors in the urinary bladder cystoscopically. The clinical course was relatively good. The treatment varies from transurethral resection to total cystectomy with urinary diversion. This case was cured by non-operative treatment, but close follow-up of the patient is necessary because of the frequency of multiple recurrence.

[A case of renal subcapsular hematoma caused by paravertebral muscular injection of local anesthetics]

We report a case of left renal subcapsular hematoma caused by paravertebral muscular injection of acetylcholine chloride for the treatment of lumbago in a 42-year-old man. Since the patient suffered from left lumbago after paravertebral muscular injection, he consulted us. Excretory pyelography showed a left poor visualizing kidney and computed tomography demonstrated left renal subcapsular hematoma. Conservative treatment was done. After two weeks, drip intravenous pyelogram was normal and after four months computerized tomographic scan demonstrated no renal subcapsular hematoma. The main causes of renal subcapsular hematoma are renal injury, nephritis, renal tumor and renal biopsy. Renal subcapsular hematoma caused by paravertebral muscular injection is rare and three cases of hematoma including this case have been reported in the Japanese literature.

Lysing of fresh human tumor by a cytotoxic factor derived from autologous large granular lymphocytes independently of other known cytokines

During interaction with autologous tumor cells large granular lymphocytes (LGL) of cancer patients released a soluble cytotoxic factor, termed LGL-derived cytotoxic factor, which mediated lysing of autologous fresh tumor cells. The cytotoxic factor was compared with purified human recombinant cytotoxic cytokines, including tumor necrosis factor (TNF), lymphotoxin (LT), interferon (IFN) alpha, IFN gamma, interleukin-1 alpha (IL-1 alpha) and IL-2. The LGL cytotoxic factor exhibited cytotoxicity against autologous and allogeneic fresh human tumor cells in an 18-h 51Cr-release assay, while these target cells were resistant to lysing by any of the recombinant cytokines. Mixtures of recombinant(r) TNF, rLT, rIFN alpha, rIFN gamma, rIL-1 alpha and rIL-2 were still unable to produce cytotoxic effects on fresh human tumor cells. Treatment with monoclonal and polyclonal antibodies directed against rTNF, rLT, rIFN alpha, rIFN gamma, or rIL-1 alpha did not inhibit the cytotoxic activity of LGL-derived cytotoxic factor against fresh human tumor cells. Even a mixture of all the antibodies was incapable of blocking the cytolytic activity of the factor to fresh human tumor cells. Furthermore, intact LGL-mediated lysing of autologous tumor cells was not inhibited by any of the antibodies. These results may indicate that a cytotoxic factor produced by LGL in response to autologous tumor cells mediates lysing of fresh human tumor cells independently of TNF, LT, IFN, IL-1 and IL-2.

Multicentric astrocytomas of the optic chiasm, brain stem and spinal cord

Autopsy was performed on a 52-year-old man with a 20-year history of neurological symptoms. At autopsy, both a brain stem tumor and a spinal cord tumor were found. These showed the features of pilocytic astrocytoma histologically. A pilocytic astrocytoma was also found in the optic chiasm upon microscopical examination. These three tumors were thought to be multicentric astrocytomas, because there was no continuity among them and no evidence of dissemination or metastasis by any pathway. From a review of the literature, the present case is considered to be an exceedingly rare one because of the multicentric sites of occurrence.

Enhancement by X-ray irradiation of target cell susceptibility to natural killer cells

The in vitro effect of X-ray irradiation on tumor cell susceptibility to lysis by natural killer (NK) cells was studied in human systems. When relatively NK-resistant T24 bladder transitional carcinoma cells were irradiated with X-rays and cultured for 18 h, they showed increased sensitivity to lysis by blood lymphocytes in a 4-h 51Cr release assay. No enhancement was seen when irradiated target cells were tested immediately after exposure to X-rays. The X-ray-induced augmentation was observed with as little as 1 Gy of irradiation, the level of which was comparable to that observed at higher doses. The doses of X-rays did not influence the viability and spontaneous release of the target cells. Treatment with mitomycin C of target cells did not change their NK sensitivity. On the other hand, irradiation with X-rays of blood lymphocytes resulted in a transient increase in NK activity at 3 h, and then the activity declined and was completely lost by 24 h. However, when irradiated lymphocytes were stimulated with interferon (IFN), they maintained the high activity against untreated T24 cells. These results suggest the possible use of relatively low doses of X-ray irradiation in combination with IFN for treatment of human cancer.

Fatal erythroderma (suspected graft-versus-host disease) after cholecystectomy. Retrospective analysis

Fatal postoperative erythroderma (POE) developed in a 52-year-old woman with gallstones who underwent elective cholecystectomy. During surgery, she was transfused with 3 units of unirradiated packed red cells stored in the liquid state for at least 4 days after collection. The POE is believed to have been the result of transfusion-associated graft-versus-host disease (TA-GVHD). The diagnosis of GVHD was based upon the characteristic clinical picture and retrospective HLA typing. The implicated donor was homozygous for an HLA haplotype that appeared to be shared with the recipient: A24-CBL-Bw52-DR2-DRw52-DQw1, the most common haplotype in the Japanese population. This case raises the possibility that a transfusion of relatively fresh blood from a donor who has no HLA antigens incompatible with the recipient may result in GVHD in patients with no apparent immunoincompetence who are undergoing relatively minor surgery with no chemotherapy or radiation therapy.

Production of interleukin 6 by human spleen cells stimulated with streptococcal preparation OK-432

The streptococcal preparation OK-432 was tested for the ability to stimulate human spleen leukocytes (SPL) for generation of interleukin 6 (IL-6). When SPL were cultured with OK-432 for 24 h in serum-free T medium, the cell-free supernatant induced production of IgM in the SKW6.CL-4 and IgG in the CESS human B cell line, while no such activity was detected in unstimulated SPL culture. The activity was neutralized by treatment with antiserum directed against B cell stimulatory factor 2 (BSF-2). An optimum production of BSF-2 was observed when SPL were stimulated with 10 micrograms/ml of OK-432. The culture supernatant also induced proliferation of IL-6-dependent murine hybridoma MH-60.BSF2 (hybridoma growth factor; HGF). It is thus evident that the molecule produced by OK-432-activated human SPL is BSF-2/HGF/IL-6. These results indicate that the antitumor agent OK-432 stimulates human spleen cells to produce IL-6.

Effects of X-ray irradiation on natural killer (NK) cell system. II. Increased sensitivity to natural killer cytotoxic factor (NKCF)

Irradiation with low-doses of X-rays of tumor cells elevated their susceptibility to lysis by natural killer (NK) cells in an accompanying paper. Cytotoxicity assays conducted at the single cell level revealed that X-ray irradiation of K562 cells did not affect the number of effector-target conjugates but increased the frequency of dead conjugated target cells. During interaction with K562 cells large granular lymphocytes released a soluble cytotoxic factor (NKCF) that killed the target cells. X-ray irradiation did not affect the NKCF stimulatory ability of K562 cells, while it elevated their sensitivity to the lytic effect of NKCF. In contrast to X-rays, exposure to ultraviolet (UV) radiation of K562 cells did not elevate their NK sensitivity but rather reduced it. Treatment with mitomycin C produced no effect on NK sensitivity. These results indicate that X-ray irradiation elevates the target sensitivity to NKCF, which may be involved in the increased NK sensitivity, and that the X-ray effect may be different from that of UV radiation or DNA synthesis inhibition.

Effects of X-ray irradiation on natural killer (NK) cell system. I. Elevation of sensitivity of tumor cells and lytic function of NK cells

The in vitro effect of X-ray irradiation on the human natural killer (NK) system was studied. When K562 cells were irradiated with X-rays and cultured for 18 hours, they showed increased sensitivity to lysis by blood lymphocytes and purified large granular lymphocytes (LGL). The X-ray-induced augmentation was observed as little as 2 Gy irradiation, reaching maximum at 5 to 20 Gy. The doses of X-rays did not influence the viability and spontaneous release of the target cells. On the other hand, irradiation with X-rays of NK cells at 5 to 15 Gy resulted in a transient increase in NK activity at 1 hour, and then the activity declined and was completely lost after 24 hours. However, when LGL were cultured with interferon immediately after irradiation, they maintained elevated NK activity. These results suggest the possible use of low doses of X-ray irradiation in combination with biological response modifiers for treatment of cancer.

Solitary mast cell tumor of the lung

An extremely rare solitary mast cell tumor of the lung was studied histologically, immunohistochemically, and ultrastructurally. The histologic features of the tumor included nodular growth of well-differentiated mast cells and clear cells with no granules. The current case is the third case of a solitary mast cell tumor (granuloma) of the lung in the literature. Clinicopathologic features of this tumor are compared with the other two cases reported previously in the international literature, and the nature of the clear cells is discussed.

Immunohistochemical localization of pulmonary surfactant apoproteins in various lung tumors. Special reference to nonmucus producing lung adenocarcinomas

Eighty-nine primary lung carcinomas and 23 metastatic lung tumors were immunohistochemically studied for the expression of pulmonary surfactant apoproteins, by using monoclonal (PE-10) and polyclonal antibodies. Surfactant apoprotein was demonstrated in the cytoplasm and/or nuclear inclusion bodies of only primary lung adenocarcinomas (36 of 75 cases), not in any other histologic type of primary lung carcinoma or in metastatic lung tumors. In primary lung adenocarcinoma, although typical type II pneumocyte type adenocarcinoma was not included in the current series, the majority of surfactant apoprotein-positive single cell type tumors were of the Clara cell type, with a single bronchial surface epithelial cell type, according to the light microscopic subclassification of adenocarcinoma cells. The Clara cell type adenocarcinomas could at times be distinguished only with difficulty from adenocarcinoma of type II pneumocyte type. Normal and hyperplastic type II pneumocytes were of course positive for surfactant apoprotein in the cytoplasm. However, none of the positive cells could definitely be identified as Clara cells in non-neoplastic lungs. The findings obtained in this study indicate that surfactant apoprotein is a good marker to distinguish adenocarcinoma of the lung from other histologic types of lung cancer and from neoplasms metastatic to the lung, and that type II pneumocytes and Clara cells, non-neoplastic and neoplastic, are morphologically and functionally closely related and might belong to the same cell lineage.

A case of paternity testing influenced by the silent allele of Rh erythrocyte groups

A paternity test is presented in which a father and his two children possessed an extremely rare amorphic gene R-29 (r,---). One of the children was determined to be illegitimate at the first trial as her Rh phenotype was R2R2(ccDEE) and the father's phenotype was R1R1(CCDee). At the Court of Appeal, however, the rare Rh gene r(---) was shown to be inherited from the father to the appellant child through extended tests including her brother whose phenotype was also R2R2(ccDEE). She was acknowledged to be legitimate.