[Pathological and clinical analysis of 102 cases of lip carcinoma]

102 cases (103 tumors) of lip carcinoma treated by surgery are analyzed. There were 37 (35.9%) verrucous carcinoma and 66 (64.1%) squamous cell carcinoma which included grade I 29 cases, grade II 21, grade III 14 and grade IV 2. Of the 66 squamous cell carcinomas, six lesions co-existing with verrucous carcinoma were derived from the latter. This fact demonstrated that anaplastic transformation of verrucous carcinoma could occur in patients without radiotherapy. This study suggests that the enlarged neck lymph nodes need not be dissected prophylactically for patients with squamous cell carcinoma grade I and grade II, and with verrucous carcinoma. The management of the cervical nodes still suffices if they enlarge after the primary lesion has been removed. But radical dissection of neck lymph nodes should be performed promptly for patients with squamous cell carcinoma grade III and grade IV.

Anti-human immunodeficiency virus agent 3'-azido-3'-deoxythymidine inhibits replication of Epstein-Barr virus

We show that the anti-human immunodeficiency virus agent, 3'-azido-3'-deoxythymidine (AZT), which suppresses infectivity and cytopathic effects of human immunodeficiency virus, also effectively inhibits Epstein-Barr virus (EBV) DNA replication. However, AZT has no effect on four other human herpesviruses: cytomegalovirus, varicella-zoster virus, and herpes simplex virus types 1 and 2. The combination of acyclovir and AZT, while it is not synergistic, has an additive effect against EBV replication. AZT may prove to be a useful drug for treatment of coinfections with human immunodeficiency virus and EBV.

Role of calcium in electron-acupuncture analgesia and the developments of analgesic tolerance to electro-acupuncture and morphine

Role of brain Ca2+ in electro-acupuncture analgesia and the development of analgesic tolerance to electro-acupuncture and morphine were studied. At the same time, the inhibition by protein synthesis inhibitors of the development of analgesic tolerance to electro-acupuncture was observed. The results showed that like morphine tolerance, the brain Ca2+ and cAMP levels in mice were enhanced with the development of analgesic tolerance to electro-acupuncture. After treatment with protein synthesis inhibitors anisomycin, actinomycin or cycloheximide the development of analgesic tolerance to electro-acupuncture was inhibited, and concurrently, the brain Ca2+ and cAMP levels in the animals greatly reduced. From the changes of brain Ca2+ and cAMP levels, the analgesic effects by electro-acupuncture, morphine and lanthanides seem to be very similar and share a mutual ion basis and the mechanism of action. So does the development of analgesic tolerance to electro-acupuncture and morphine. These findings also suggest that the inhibition induced by the inhibitors of the analgesic tolerance to electro-acupuncture and morphine may be related to synthesis of new peptides or RNA in brain.

Establishment and characterization of a cell line HR-8348 derived from human poorly differentiated adenocarcinoma of rectum

A human rectal poorly-differentiated adenocarcinoma cell line HR-8348 is established from the surgically removed tumor mass of a male adult patient. The cell doubling time is 36.05 h. The mitotic index is 44.5%. The cells are all of epithelial type and mostly of polygonal shape. Electron microscopic examination shows malignant nuclei with enlarged nucleoli; there are abundant microvilli and some secretory granules. The plating efficiency in soft agar is 12.9%. In PHA (1 microgram/ml), the cells show obvious agglutination. Chromosomal analysis reveals a mode of 70 chromosomes per cell, with a marker chromosome. CEA in cells is detected positively both qualitatively and quantitatively. Hetero-transplantation of the cells to nude mice shows that the tumor mass has the same morphology as the original mass from the patient, with Alcian blue positive material in the cytoplasm. Repeated detection for mycoplasma contamination shows negative.

Stroke in the Lehigh Valley: seasonal variation in incidence rates

We investigated the seasonal pattern of stroke using the Lehigh Valley Stroke Register. This register includes all patients hospitalized with stroke or transient ischemic attack (TIA) from among the 600,000 Lehigh Valley residents. Meterological data were obtained from the National Oceanic and Atmospheric Administration. The study, which uses 18 months of data, included 1,944 cases. Using single harmonic regression analysis, the seasonal pattern of TIA and infarction, but not hemorrhage, fit a sine-cosine wavefunction with a 12-month period (R2 = 41% and 36%, respectively). For infarction, the strongest seasonal pattern was exhibited for women of all ages and for both sexes in the age groups 65-74 and 75-84, but only the sine component was significant. The peak months for TIA were June-August, while the peak months for infarcts were February-April. Correlations between ambient temperature and each type of stroke were computed. A significant positive correlation for TIA was found (r = 0.57, p = 0.01). After adjusting for a 2-month lag between the low for infarction and the peak for temperature, a significant negative correlation was found (r = -0.64, p = 0.01). No significant correlation was found for hemorrhage. Possible reasons for the opposite relations of TIA and infarct are discussed.

[Carcinoma of esophagus treated by 8MV X-ray and checked by simulator]

From January 1, 1978 to December 31, 1983, 570 patients with carcinoma of esophagus were treated by 8 MV X-ray and checked by the Philips simulator. In order to assess their value, a series of 3,798 patients reported previously was used for comparison. To further evaluate the effect of 8 MV X-ray and simulator separately, a series of 154 patients was treatment by non-8 MV X-ray during the same period. The results showed that the 1 and 3 year survival rates of 8 MV X-ray series were better than the 3,798 series (P less than 0.01). It means that after the use of simulator and 8 MV X-ray the survival rates were improved. As compared to the radiation other than 8 MV X-ray, there was no difference between 8 MV X-ray and non-8 MV X-ray series, which means that the improvement may have been due to the better localization by the simulator. Having more importance, no radiation myelitis was found after the use of simulator. The sex, age, length, location, X-ray type, NSD and causes of failure were compared in these groups.

[Superior sulcus cancer of the lung--report on 45 patients]

From 1960 to 1980, 45 patients with superior sulcus cancer of the lung were seen in our hospital. 39 were male and 6 were female. The youngest was 28 years old and the eldest was 75. The presenting symptoms and signs were back and shoulder pain in 32 patients, compression of the brachial plexus in 17, Horner's syndrome in 12, supraclavicular mass in 11, superior cava vena obstruction in 4, shadow in the apex in 45, destruction of the rib in 19 (10 in the second rib), destruction of the adjacent vertebra in 8 (5 in T3) and destruction of the clavicle in 1. In 18 patients proved by pathology and cytology, 8 were adenocarcinoma, 3 squamous cell carcinoma, 3 undifferentiated and 4 unclassified carcinoma. 27 patients were diagnosed by X-ray films. 40 patients were admitted for treatment. 3 recieved chemotherapy alone and all of them died in one year. Of the 6 treated by radiation plus chemotherapy, 3 survived for one year but all died in two years. 2 were treated by radiation plus operation and none survived for more than 3 years. 29 were treated by radiation only. The 1, 3 and 5 year survival rates were 51%, 13.7% and 6.9%. Destruction of the rib or the adjacent vertebral body was irrelative to the prognosis but the presence of supraclavicular mass reduced the survival rate. Cause of death was local recurrence in 48% (13/27) and distant metastasis in 48% (13/27). The authors suggest that radical en bloc resection together with radiation the worth further study.

Multiple sclerosis and childhood infections

Migration from an area where MS is common to an area where it is rare (and vice versa) affects the risk of MS, provided migration occurs in childhood. A childhood infection might explain this effect. Therefore, the age pattern of infectious diseases in different regions was examined. A higher proportion of children showed positive titers to many viral diseases early in life in areas where MS is rare compared with those where MS is common. Also, mortality rates from a variety of infectious diseases correlated negatively with the MS mortality. Thus, infection early in life may "protect" against MS, and conversely, later infection, when the immune system has partially matured, may increase risk. MS may be an age-dependent, host-immune response to childhood infection.

Standardized incidence ratios of stroke: a worldwide review

Comparison of stroke incidence in various parts of the world is difficult because differences in diagnostic criteria, medical facilities and age-sex distributions are often not taken into account. We calculated age-sex standardized incidence ratios (SIR) of stroke in 37 regions based on recent reports. The USA (1976) was taken as the standard population. In western countries SIRs varied from 0.8 to 2.1. In China and Japan, SIRs varied from 0.7 to 3.6. While the lowest and highest SIRs differed by a factor of 5, only 6 of the 37 studies yielded a SIR of more than 2.0 or below 0.75. Of these, 4 were from China and Japan. The highest ratios were based on a very intensive door-to-door survey and probably should not be compared to less intensive studies. We conclude that world-wide variation in age-sex adjusted stroke rates is relatively small.

Induction of sIg-negative B lymphocytes for differentiation by PWM

It has been reported in the literature that PWM-responsive B lymphocytes are sIgM+, sIgD-, lack receptors for mouse erythrocytes, and are larger than PWM-negative lymphocytes. This paper describes the observation of B cells among the thymocytes from a patient with myasthenia gravis. In the thymocytes, actually no sIg+ cell was found, and Staphylococcus aureus Cowen strain I could not induce the mononuclear cells in the thymus to differentiate. It was surprising that 6.9 per cent of the cells were BA-1 positive cells. At the same time, in the presence of PWM, 9680 +/- 555 cells out of 1 X 10(-6) thymocytes could be induced to differentiate to immunoglobulin-secreting cells (ISC) in culture. This result suggests that PWM might be able to induce sIg- B lymphocytes to differentiate as well.

Effect of (E)-5-(2-bromovinyl)-2'-deoxyuridine on the growth and viral capsid antigen expression of Epstein-Barr virus-associated tumor (B-95-8) cells transplanted to nude mice

When persistently Epstein-Barr virus (EBV)-infected lymphoblastoid (B-95-8) cells were transplanted subcutaneously or intracerebrally to nude mice of either BALB/c or NIH background, tumors developed, and the tumor cells spontaneously expressed viral capsid antigen (VCA). This model was used to evaluate the in vivo anti-EBV activity of (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVDU), a highly potent and selective antiherpes agent, which was recently shown to inhibit several parameters of EBV infection in vitro. When administered intraperitoneally at 200 mg/kg/day for 4 weeks, or 500 mg/kg/day for 2 weeks, starting immediately after B-95-8 cell inoculation, BVDU effectively reduced tumor growth and VCA expression of either subcutaneously or intracerebrally inoculated B-95-8 cells.

Radiologic study of 42 cases of Wilson disease

This paper reports 42 cases of bone and joint radiographic changes in hepatolenticular degeneration. The cases were proven clinically by ophthalmologic and laboratory study, and their radiographic and joint changes were divided into five groups: no abnormal findings, osteoporosis, osteomalacia (rickets), distinct changes, and miscellaneous. Distinct changes include marginal bone fragments, angulation of carpal bones, squaring of metacarpal heads, and calcification of the joint capsule or tendon insertion. The mechanism causing the bone changes in hepatolenticular degeneration is also discussed.

Effect of (E)-5-(2-bromovinyl)-2'-deoxyuridine on several parameters of Epstein-Barr virus infection

The selective and potent anti-herpesvirus drug, (E)-5-(2-bromovinyl)-2'-deoxyuridine (BVdU), has been examined for its inhibitory effects on several parameters of Epstein-Barr virus (EBV) infection in the lymphoblastoid cell lines Raji, P3HR-1, B-95-8 and P3 hybrid cells (a human embryo oropharyngeal cell line fused with a nasopharyngeal carcinoma cell line). At a dosage of 0.03 to 0.1 mM, BVdU caused a marked inhibition of (i) spontaneous viral capsid antigen (VCA) expression in B-95-8 and P3 hybrid cells, (ii) VCA expression and DNA synthesis in B-95-8 cells induced with croton oil and n-butyrate, (iii) early antigen (EA) expression and DNA synthesis in Raji cells superinfected with EBV, and (iv) VCA expression and DNA synthesis in B-95-8 cells superinfected with EBV. In its inhibitory effects on these various parameters of EBV infection, BVdU appears to be comparable to acyclovir [9-(2-hydroxyethoxymethyl)guanine], another selective anti-herpesvirus drug which has been previously recognized as an effective inhibitor of EBV replication.

Radiation treatment of carcinoma of the oropharynx. Report on 201 patients

The prognosis for 201 patients with carcinoma of the oropharynx, treated mainly by irradiation, was analyzed. The crude 5, 10, 15 and 20 year survival rates were 50.3 per cent, 36 per cent, 26 per cent, and 17 per cent respectively, and the corresponding cure rates 44, 35, 26 and 17 per cent respectively. Patients under 50 years of age had a better 5 year survival than those over 60 years. The poorly differentiated and the anaplastic carcinomas had a better prognosis than the well differentiated lesions. Early stages had a much better prognosis than advanced lesions. Split course and continuous course irradiation gave similar results. The optimum dose range was 60 to 70 Gy. Early disappearance of the primary tumor during radiation therapy was prognostically favourable.

Treatment of experimental herpes simplex virus encephalitis with (E)-5-(2-bromovinyl)-2'-deoxyuridine in mice

(E)-5-(2-Bromovinyl)-2'-deoxyuridine (BVDU) was examined for its ability to increase the survival rate of mice infected intracerebrally with herpes simplex virus type 1 (strain KOS). BVDU was administered orally (through the drinking water), intraperitoneally, or subcutaneously at doses ranging from 40 to 400 mg/kg per day, starting 0, 2, 4, or 6 days postinfection. Regardless of the route of administration, BVDU effected a significant reduction in the mortality rate of mice infected with herpes simplex virus type 1 if treatment was initiated shortly after virus infection, i.e., day 0 or 2 (or day 4, if BVDU was administered subcutaneously) postinfection, at a dosage of 80 mg/kg per day or higher. Similar beneficial effects were noted with orally administered BVDU in mice inoculated intraperitoneally or intranasally with herpes simplex virus type 1. These findings establish the therapeutic efficacy of BVDU in the systemic treatment of herpes simplex virus type 1 encephalitis in mice.

Inhibitory effect of interferon on the growth of spontaneous mammary tumors in mice

Partially purified mouse interferon type I (Mu IFN-beta), crude mouse interferon type II (Mu IFN-gamma) serum, and the interferon inducer polyinosinic acid-polycytidylic acid (poly I:C) were evaluated for their effects on the growth of spontaneously occurring mammary carcinomas in BALB/c mice. As soon as their tumors had reached a palpable size (diameter: 3-5 mm), the mice received three ip injections of Mu IFN-beta, Mu IFN-gamma, or poly I:C per week for 6 weeks. A significant (fourfold to fivefold) reduction in tumor size was achieved with Mu IFN-beta (at 10(6) U/mouse), Mu IFN-gamma (at 10(3) U/mouse), and poly I:C (at 1 mg/mouse). A similar reduction in tumor size was noted when the mice were treated with cyclophosphamide (2.5 mg/mouse, three ip injections per wk for 6 wk). Treatment with Mu IFN-beta combined with Mu IFN-gamma resulted in a greater tumor growth-inhibitory effect than treatment with either Mu IFN-beta or Mu IFN-gamma alone. In addition to inhibiting the growth of primary tumors, interferon also reduced the incidence of lung metastases. However, complete tumor regression was not observed in any mouse while under interferon therapy.