Functional activity of protein S determined with use of protein C activated by venom activator

A new screening procedure, an easy and specific assay for determining functional Protein S activity, has been developed, with use of Protein C activated by venom activator (Protac). Purified Protein C (100% amidolytic activity) was activated by venom activator (6 units/mL). To a mixture of 100 microL of Protein S-deficient plasma, 20 microL of sample plasma, 100 microL of cephalin (Actin), and 20 microL of activated Protein C we added 100 microL of 25 mmol/L CaCl2 solution and measured the clotting time with a KC 10 coagulometer. The functional Protein S activity correlated well with the concentrations of Protein S antigen measured by enzyme immunoassay and the Laurell rocket technique (r = 0.810 and 0.850, respectively) in normal subjects, patients with myocardial infarction undergoing warfarin therapy, and patients with liver cirrhosis.

Functional activity of protein S determined with use of protein C activated by venom activator

A new screening procedure, an easy and specific assay for determining functional Protein S activity, has been developed, with use of Protein C activated by venom activator (Protac). Purified Protein C (100% amidolytic activity) was activated by venom activator (6 units/mL). To a mixture of 100 microL of Protein S-deficient plasma, 20 microL of sample plasma, 100 microL of cephalin (Actin), and 20 microL of activated Protein C we added 100 microL of 25 mmol/L CaCl2 solution and measured the clotting time with a KC 10 coagulometer. The functional Protein S activity correlated well with the concentrations of Protein S antigen measured by enzyme immunoassay and the Laurell rocket technique (r = 0.810 and 0.850, respectively) in normal subjects, patients with myocardial infarction undergoing warfarin therapy, and patients with liver cirrhosis.

Characterization of human ovarian and endometrial carcinoma cell lines established on extracellular matrix

Six cell lines were established from four patients with advanced carcinoma of the ovary and from one patient with carcinoma of the endometrium. These lines were established from fresh tumor material maintained initially on culture dishes coated with an extracellular matrix (ECM) produced by bovine corneal endothelial cells. Two of the six lines continue to require ECM as a substrate for optimal growth while the remaining four lines will proliferate on ECM or plastic substrate. Four cell lines transplanted into athymic nude mice were tumorigenic and maintained histologic and karyotypic similarities between the patient's original tumor, the cell line, and the transplantable tumor. Furthermore, in vitro degradation of ECM was grossly apparent by those cell lines which formed nude mice xenografts. Tumor cells were characterized by cytology, transmission electron microscopy, karyology, substrate requirements, steroid binding protein analysis, and morphological appearance in culture.

[Studies on growth of Pasteurella multocida on BTB agar]

It has been reported that the Pasteurella multocida does not grow on the BTB agar. Therefore, this medium has been used as selective and differential medium for Pasteurella multocida. However, we have experienced that some of the Pasteurella multocida from the patient's materials grew on the BTB agar. Here, we will report on the studies of the growth of the Pasteurella multocida strain on the BTB agar. Ten strains of Pasteurella multocida from humans and animals were used as the test strains. Those were adjusted to McFarland No. 5 by the sterilized physiological saline and inoculated on the agars. We compared commercially prepared BTB agars from 3 companies and BTB agars prepared by our-self from dehydrated culture medium. Blood, Chocolate, Nutrient and MacConkey agar were also used in this study. As for the growth of the Pasteurella multocida, we checked the pH of each agar and the temperature during the cultivation. The results are as follows: 1) Pasteurella multocida was confirmed to grow on all of the BTB agar. 2) Pasteurella multocida grew most heavily at 37 degrees C and pH of 7.4 to 8.2. 3) The difference of the growth on each agar was considered to be the difference of the pH and nutritional condition of the agar.

Intracranial vessels with color Doppler echoencephalography in infants

A technique for imaging of the intracranial vessels in infants was described, which used high resolution, commercially available, color Doppler ultrasonography (real-time two-dimensional Doppler). On 12 normal infants, serial scans were obtained in sagittal, coronal, and axial plains. A large number of intracranial arteries and veins could be clearly demonstrated in real-time, including anterior cerebral artery, pericallosal artery, middle cerebral artery, posterior cerebral artery, basilar artery, communicating artery, internal cerebral vein, inferior and superior sagittal sinuses, great cerebral vein, straight sinus, occipital sinus and transverse sinus. In conclusion, color Doppler examination is useful in the detection of vessels in infants and in the measurement of intracranial blood flow velocity.

[Problems in therapy of thoracic esophageal cancer in view of recurrence in the lymph nodes]

The forms of recurrence from the first onset were confirmed in 171 out of 776 patients with thoracic esophageal cancer excised at our Department from 1959 to 1987; 87 patients (50.9%) had recurrence in the lymph nodes. Postoperative radiation in order to prevent recurrence in the lymph nodes was useful for the prevention of recurrence in the cervical lymph nodes, but radiation myelopathy/radiation pneumonitis might be of therapeutic difficulty in patients with recurrence in the areas of radiation. Moreover, patients treated by irradiation were apt to be involved in visceral recurrence. Incidence of recurrence in the lymph nodes was less in patients who had dissection in three areas than that in patients who received dissection in one or two. However, recurrence was observed in the border region between the cervix and the thorax, on the left side of the trachea, in the anterior portion and on the left side of the hilum in the areas of dissection. Useful postoperative chemotherapy is desirable in consideration of the fact that recurrence in the lymph nodes was observed at the posterior region of the pharynx, at the temporal region and in the pelvis and that dissemination and visceral recurrence were increased.

[Effects of pre-operative intrahepatic-arterial infusion in liver cancer with special reference to hepatic resection]

The following conclusions were obtained in terms of the histological response of preoperative TAI and TAE in 27 hepatectomized patients with 15 primary and 12 metastatic liver cancers. 1) TAE was superior to TAI in tumor 100% necrosis rate. 2) TAE showed higher necrosis rate than TAI in tumors with capsule formation smaller than 2 cm. 3) Even TAE reveals no histological response in tumors with intracapsular infiltration.

The three-dimensional architecture of vasa vasorum in the wall of the human aorta. A computer-aided reconstruction study

The three-dimensional architecture of vasa vasorum in the wall of aorta was studied by microcomputer-aided reconstruction from serial sections of wall tissue in two young individuals submitted to autopsy. The outer media was sparsely penetrated by special tunnels containing an arteriole and a venule, which we termed a "vascular cord" due to the broad space between neighboring cords that contained no capillary network whatsoever. A dense venular plexus was found extending along the outer surface of the media, forming a plane of low blood pressure. This characteristic pattern of vasculature appeared to provide an important basis on which to study the way the medial tissues are sustained.

The development of vasa vasorum of the human aorta in various conditions. A morphometric study

The developmental behavior of vasa vasorum under various conditions was studied on the wall tissues of aorta and great arteries from 29 autopsy cases, where the length density (LA) of vasa vasorum in a unit area of wall was determined by morphometry. In a control group, LA was found to increase exponentially, along with increasing wall thickness D, among arteries from various anatomic sites of patients with greatly divergent ages. The regression curve crossed the x-axis at D = 0.6 mm, showing that arteries thicker than this have an auxiliary circulation by vasa vasorum. The LA was markedly high both in neonates and in patients with cyanotic heart anomaly, ie, in conditions where medial cells were sustained under reduced oxygen supply. Thus, vasa vasorum were shown to elongate their intramural segments in response to the changes of microenvironment in which the medial cells are placed, meeting the demand by the cells for increased supply of oxygen and nutrients.

Study on the origin of apical tubules in ileal absorptive cells of suckling rats using concanavalin-A as a membrane-bound tracer

The ileal absorptive cells of suckling rats exhibit high levels of endocytic activity being engaged in nonselective uptake of macromolecules from the intestinal lumen. The apical cytoplasm usually contains an extensive network of small, membrane-limited tubules (apical tubules: AT), in addition to newly formed endocytic vesicles and large endocytic vacuoles. To determine whether the AT are directly involved in the endocytic process by carrying the tracer into the cell, we have analysed movements of the apical cell membrane of the ileal absorptive cells by using a membrane-bound tracer (horseradish peroxidase-labelled concanavalin-A: Con-A HRP). The ileal absorptive cells were exposed in vitro to Con-A HRP for 10 min at 4 degrees C, incubated for different times in Con-A free medium at 37 degrees C, and prepared for electron microscopy. After 1 min incubation at 37 degrees C, invaginations of the apical cell membrane, including coated pits, and endocytic vesicles were labelled with HRP-reaction product, whereas the AT and large endocytic vacuoles were negative. After 2.5 min, almost all the large endocytic vacuoles were labelled with reaction product, which was seen in their vacuolar lumen and along the luminal surface of their limiting membrane. A few AT with reaction product were seen in the apical cytoplasm; they were in frequent connection with the reaction-positive large endocytic vacuoles. With increasing incubation time, the number of the labelled AT increased. Thus, after 15 min at 37 degrees C, the apical cytoplasm was fully occupied by the reaction-positive AT. The ends of these AT were often continuous with small spherical coated vesicles. No reaction product was detected in the Golgi complex at any time after incubation. These observations indicate that the AT located in the apical cytoplasm probably originate by budding off from the large endocytic vacuoles, rather than being involved in the process of endocytosis.

The prognostic significance of resection of primary tumor in gastric and colorectal cancer patients with synchronous liver metastasis

The significance of primary tumor resection in gastric and colorectal cancer patients with liver metastasis (H(+)) was evaluated in terms of operative mortality and survival rate by dividing the materials [293 gastric cancer and 80 colorectal cancer patients (53 colon and 27 rectum) with synchronous liver metastasis] into the following groups: Firstly, with or without peritoneal dissemination (P), secondly, with or without resection of the primary tumor and thirdly, with or without postoperative adjuvant chemotherapy. The following results were obtained: (1) The direct operative death rate of primary tumor resection, excluding death from other causes, showed an absence of statistically significant differences between the P0H(+) and P(+)H(+) gastric and colorectal cancer patients. (2) There was no significance in the prognosis between the primary tumor resection + postoperative chemotherapy group and the non-resectable group in the P(+)H(+) gastric and colorectal cancer patients, revealing no prognostic value of the primary tumor. (3) In the P0H(+) gastric and colorectal cancer patients, the primary tumor resection + postoperative chemotherapy group was significantly more favorable in prognosis than was the primary tumor resection alone group or the non-resectable group, showing the value of primary tumor resection.

Effects of antipyretics in rinderpest virus infection in rabbits

Administration of acetylsalicylic acid or mefenamic acid during experimental infection of rabbits with a rabbit-adapted strain of rinderpest virus did not prevent initiation of the febrile response but significantly reduced the duration of fever. Suppression of fever had a markedly deleterious effect on the course of infection, resulting in an increased content of infectious virus in the mesenteric lymph nodes, increased mortality, and retarded recovery in animals that survived the infection. Histological lesions were mainly lymphocytic depletion in lymphoid organs and lymphoid necrosis in both rabbits treated with antipyretics and those left untreated, but damage was more pronounced in the former than in the latter. More viral antigen was detected by immunofluorescence in lymphoid organs of drug-treated rabbits than in those of untreated rabbits. Antipyretic treatment resulted in higher serum interferon levels in the early phase of infection and an increased antibody response in animals that survived the infection.

Spectrum of double outlet right ventricle induced by electrical shock at the conotruncus of the embryonic chick heart: emphasis on cellular changes and evaluation of hemodynamics using Doppler

Administration of electrical shock to the conotruncal area of embryonic chicks at developmental stage 24-27 induced a complex malformation, namely, double outlet right ventricle (DORV) of varying degrees of severity. The device used to apply electrical current to the heart was constructed using a 9-volt battery, a push-button switch, and a 100-ohm potentiometer with calibrated dial. This allowed a short pulse of known voltage to be applied through the electrodes to a selected area of the heart. Two different methods were chosen to administer electrical shock at the conotruncal area of the heart. One method utilized longitudinal application of electrical shock, and the other used horizontal application of electrical shock directly to the conotruncus. Three distinct types of DORV were found in the longitudinal (L) and the horizontal (H) electrical shock groups: 1) DORV without a ventricular septal defect (VSD), in which the dilated sinus of Valsalva of the aortic valve extends into the right ventricle. 2) DORV with a subaortic VSD, with variable degrees of pulmonary stenosis and a hypoplastic left ventricle. 3) DORV with a subpulmonic VSD, pulmonic stenosis and a hypoplastic right ventricle. Longitudinal stimulation produced a higher incidence of cardiovascular anomalies than horizontal stimulation (p = 0.01). Histological examination showed complete disappearance of myocardial fibers, myocardial degeneration, and the aggregation of protein material or glycogen within myocardial cells. Our Doppler findings demonstrate that relative to control embryos, peak velocity initially increased 3 minutes after electrical stimulation (p less than 0.01), and subsequently decreased significantly within 30 minutes (p less than 0.01). One may hypothesize that the marked initial increase of peak velocity was induced by tissue damage, which led to a narrowing of the conotruncal outflow tract. Evidence for contruncal narrowing was also reflected in percent window data (% W), which indicates the level of turbulence within a vessel. However, the decrease of peak velocity 30 minutes after stimulation might be caused by myocardial damage resulting in a diminished cardiac output. The relationship between cell death processes in the conotruncal area and DORV spectrum induced by electrical shock is discussed.

Formation of apical tubules from large endocytic vacuoles in kidney proximal tubule cells during absorption of horseradish peroxidase

Using horseradish peroxidase (HRP) as a tracer, we have investigated if the so-called apical tubules (AT) in the kidney proximal tubule cells are directly involved in the endocytic process by carrying the tracer into the cells, or if they are derived from the intracellular membrane compartments. Rat kidney was fixed by vascular perfusion at different time intervals after intravenous injection of HRP and prepared for electron microscopy. An analysis revealed that 0.5 min after injection, invaginations of the plasma membrane and small apical endocytic vesicles, including coated vesicles, were labelled with reaction product, whereas almost all large apical endocytic vacuoles and the AT were negative. The endocytic vacuoles and about 18% of the AT were labelled 1 min after injection. The reaction product in the large endocytic vacuoles was usually seen along the luminal surface of the vacuoles. The AT with reaction product appeared as a branched network, and were frequently connected with the labelled endocytic vacuoles. Three min after injection, reaction product was detected in about 38% of the AT, and thereafter, the percentage increased to about 74% after 7 min. No reaction product was detected in the Golgi complex at any time after HRP-injection. These findings indicate that the AT are probably formed by budding off from the large endocytic vacuoles, rather than being directly involved in the endocytic process.

[Combination of radiotherapy with cisplatin in esophageal cancer]

Combination of radiotherapy with Cisplatin was performed in order to improve the results obtained with radiotherapy alone in the treatment of esophageal cancer. The therapeutic effect of this regimen and administration of Cisplatin were analyzed in 7 primary and 8 recurrent esophageal cancer patients from April 1983 to February 1985 in N.I.R.S. Cisplatin 10 mg/m2, without hydration and diuresis, was given daily followed by radiotherapy of 2 Gy daily for five consecutive days. The course was performed for two consecutive weeks and repeated after a one-week withdrawal of Cisplatin alone. Total doses of Cisplatin were 200 mg and the total dosage of radiotherapy including fast neutrons was TDF 110 to 120. Cisplatin 30 to 50 mg/m2 was continued monthly for maintenance every four weeks after the second course. Response rates in primary and recurrent cases were 71.4% and 62.5% respectively. Administration of Cisplatin 10 mg/m2 daily was useful since nausea and vomiting rarely appeared and bone marrow toxicity and renal dysfunction as side effects were mild and reversible. In the combination of radiotherapy with Cisplatin, it seemed most effective to perform radiotherapy immediately after Cisplatin administration, considering the change in serum concentration.

[Cytogenetic studies of X-chromosome replication patterns in cell hybrids between murine embryonal carcinoma cells and female rat thymocytes]

By means of a 5-bromodeoxyuridine incorporation and acridine orange fluorescence staining method together with 3H-thymidine autoradiography, I studied the chronology of X chromosome replication in newly formed cell hybrids between the hypoxanthine phosphoribosyl transferase-deficient OTF9-63 murine embryonal carcinoma cell and the female rat thymocyte. Most near-tetraploid hybrid cells retained all chromosomes from both parents including one mouse X and two rat X chromosomes throughout the period of this study. Data showing changes in the chronology of X chromosome replication obtained here were indicative of reactivation of the inactive X chromosome from the rat thymocyte, and de novo X-inactivation of one or two X chromosomes. The extinction of lymphocyte phenotypes from the hybrids and their subsequent differentiation to the cell type resembling endoderm found in the peri-implantation mouse embryo were apparently in parallel with the above changes. These data thus demonstrated that there is a close causal correlation between the X-inactivation process and the cell differentiation.

[Establishment and characterization of the cell line derived from low differentiated adenocarcinoma of the endometrium]

A new human carcinoma cell line (HEC-1), which was derived from low differentiated adenocarcinoma of the endometrium, has been established. Cells from tumor tissues grown in athymic mice were cultured in minimal essential medium supplemented with 20% fetal calf serum. Contaminated mouse fibroblasts were removed from the culture by the absorption of anti-mouse serum. Continuous cell growth (doubling time: 51.6 hrs) could be observed during 64 passages. The cultured cells appeared monolayer and the cellular arrangement was a pavement-like pattern. The morphology of cells was analogous to the one of adenocarcinoma cells. The modal number of chromosomes of the original tumor cells were 46. The t. dic (1; 16)(p21; q24) marker which had been identified as the clonal abnormality in the original tumor cells, was also observed consistently in cultured cells, though the loss of chromosome 19 was disappeared during the passage. This suggested that the rearrangements of the long arm of chromosome 1 played an important role for the endometrial carcinogenesis.

[Retroperitoneal liposarcoma with various histological figures]

A case of retroperitoneal liposarcoma consisting of three large nodules with three different types of histologic findings is presented. A 69-year-old man was diagnosed as having a malignant tumor in the retroperitoneum and underwent successful tumor extirpation. The resected tumor had three different type of nodules, 18 X 15 X 7.0 cm, 8 X 15 X 4.0 cm, 15 X 10 X 2.5 cm in size, respectively. The histologic examination revealed myxoid, well-differentiated fibrosing and lipoma-like liposarcoma type, respectively. Chemotherapy was undertaken postoperatively, and there is no evidence of recurrence two years after surgery.

Sequential X-chromosome reactivation and inactivation in cell hybrids between murine embryonal carcinoma cells and female rat thymocytes

By means of a 5-bromodeoxyuridine (BrdU) incorporation and an acridine orange fluorescence staining method together with [3H]thymidine ([3H]TdR) autoradiography, we studied the chronology of X-chromosome replication in newly formed cell hybrids between the hypoxanthine phosphoribosyl transferase (HPRT)-deficient OTF9-63 murine embryonal carcinoma (EC) cell with 43 +/- chromosomes and the female rat thymocyte having 42 chromosomes. Most near-tetraploid hybrid cells retained all chromosomes from both parents including one mouse X (XM) and two rat X (XR) chromosomes throughout the period of this study. Data showing changes in the chronology of X-chromosome replication obtained here were indicative of reactivation of the inactive X chromosome from the rat thymocyte, and de novo X-inactivation of one or two chromosomes. The extinction of lymphocyte phenotypes from the hybrids and their subsequent differentiation to the cell type resembling endoderm found in the peri-implantation mouse embryo apparently occurred in parallel with the above changes. These hybrids also showed an interesting possibility of preferential reinactivation of the reactivated XR chromosome in the early stages after cell fusion.

[Abnormalities of chromosome involving 1q in uterine endometrial carcinomas]

Cytogenetic studies were performed on endometrial specimens from four patients with hyperplasia, six with adenocarcinoma and one with mixed mesodermal tumor. Except for one cell, all 65 cells from the hyperplastic specimens had a normal female karyotype. However, a total of 92 cells from the 5 adenocarcinoma specimens had chromosomal abnormalities, though all 20 cells from a specimen of a well differentiated adenocarcinoma showed a normal karyotype. The chromosome number and morphology of the aneuploid cells had minimal changes. The modal number of chromosomes was pseudodiploid in one case and hyperdiploid in four. Three kinds of structural abnormalities involving chromosomes 1q were identified as of clonal origin: del. 1 (p21) in 2 cases, t. dic (1;16) (p21;q24) in one case and i (1q) markers in 2 cases. Since the carcinoma cells had two chromosomes 1 of normal morphology, the presence of the marker chromosome led to a partial trisomy or tetrasomy of the long arm of a chromosome 1. This involvement of the long arm of chromosome 1, therefore, may be assumed to represent a karyotypic change in the characteristics of adenocarcinoma of the endometrium. Complex karyotypes with many rearranged chromosomes were observed in cells from the mixed mesodermal tumor. The karyotypic differences between endometrial carcinoma and the mixed mesodermal tumor suggest that the genesis (and its mechanism) of the former may differ from that of the latter.

Evaluation of treatment for gastric cancer with liver metastasis

In 161 cases of gastric cancer with liver metastasis but without peritoneal dissemination, evaluations were executed to find effective treatment. The most favorable results with best prognosis were obtained in the group receiving gastrectomy + hepatectomy + chemotherapy, followed by gastrectomy + chemotherapy, and gastrectomy alone. The most unfavorable outcome was in nonresected cases. Chief chemotherapy to be used after gastrectomy was FML (5-fluorouracil (5-FU) + mitomycin C [MMC] + lentinan) continuous intra-arterial infusion. Hepatectomy was found to be effective as an active measure for tumor reduction in cases of liver metastasis so far as the metastatic lesions are only a few scattered ones in both lobes.

Recurrence of intrathoracic esophageal cancer

We have investigated the site of recurrence after resection of esophageal cancer in a total of 147 cases, which were examined and classified according to the site as follows: lymph nodes, organs, local sites, remnant of the esophagus, and peritoneum. The highest incidence of recurrence was 40% in both lymph nodes and organs. Recurrence was found frequently in the cervical and upper mediastinal lymph nodes. Careful examination should be made in the abdominal paraaortic lymph nodes. As for recurrence in organs, high rates were observed in lung, liver and bone; 70% of the recurrences in these organs were combined with simultaneous metastasis in other organs. In our examination of autopsied cases with local recurrence, the cancer was revealed as a tumor mass covering extensively each side of the posterior mediastinum. At the same time pleural dissemination was frequently observed. In the cases involving recurrence in the remnant esophagus, the disease-free interval was about 18 months--longer than the interval before recurrence in any other site. Peritoneal recurrence appeared in the patients with middle thoracic esophageal cancer. The prognosis following recurrence was extremely bad, with only a few exceptions: the survival period after recurrence was 8 months if it was in the lymph nodes, and an average of 4 months for other types of recurrence. The survival period was only 2 months after peritoneal recurrence.

Protection against suture insufficiency in ante-thoracic esophagogastrostomy

In attempts to decrease suture insufficiency in case of ante-thoracic esophagogastrostomy, a gastric tube was so specially prepared that the short gastric vessels as well as the splenic vessels were severed very adjacent to the spleen. The anastomosis of the gastric tube thus prepared to the cervical esophagus was made using EEA-autosuture instruments. The suture insufficiency rate was thus markedly improved, with a value of approximately 10 per cent. Even cases of suture insufficiency with minor leakage, control was complete with simple pressure with gauze.

Secondary cystic lesions in the cerebellum in very low birth weight infants

We studied 4 very low birth weight infants with secondary cystic lesions in the cerebellum by serial cranial ultrasound and computed tomography. These infants presented severe respiratory distress, asphyxia at birth and intraventricular hemorrhage. In the neonatal period, cranial ultrasound examination showed significant intraventricular hemorrhage and posthemorrhagic ventricular dilatation with intraparenchymal hemorrhage. However, a cerebellar cyst was not seen in any of the infants. We found evidence of cerebellar hemorrhage by ultrasound in only one patient. Follow-up ultrasound examinations and CT scans showed progressive posthemorrhagic ventriculomegaly in three of the infants and large cystic lesions in the infratentorial area from 3 to 6 months old in all 4 infants. We conclude that the cystic lesions were caused by hemorrhagic and hypoxic-ischemic insults which occurred in very low birth weight infant.

[Cytophotometric DNA analysis of the early and superficial esophageal cancer]

Although it is widely known that early esophageal cancer (n-) patients have a favorable prognosis after surgery and the superficial esophageal cancer (n+) patients have a poor one, the differences between them have not been found out under the microscopic examination of the primary lesion. Cytophotometric DNA analysis of the primary lesion was done to search for the differences between early and superficial esophageal cancer. Significant differences were obtained in the mean DNA value (p less than 0.01), the percentage of nuclei beyond tetraploid (p less than 0.001) and the product of 2 indices above (p less than 0.001). The result suggests that cytophotometric DNA analysis is a useful means for differentiating the early esophageal cancer from the superficial esophageal cancer and that the most suitable perioperative combined therapy can be chosen through the Feulgen-stained biopsy specimen.

Malignant potential of homozygous and heterozygous complete moles

There are two main mechanisms of origin for complete hydatidiform mole: (a) fertilization of an empty egg by a haploid sperm followed by duplication (monospermic mole); and (b) fertilization of such an egg by two haploid spermatozoa (dispermic mole). The former is inevitably homozygous (homozygous mole), whereas the latter may be heterozygous for a given genetic marker (heterozygous mole). A recent cytogenetic study showed that three cases of choriocarcinoma were undoubtedly heterozygous, which prompted us to compare the incidence of postmolar sequelae between patients with homozygous moles and those with heterozygous moles. Making use of chromosomal heteromorphisms and human lymphocyte antigen and phosphoglucuromutase 1 polymorphisms, we established the androgenetic origin of a complete mole in 49 of 56 cases. Homozygosity was confirmed in 21 moles, and heterozygosity was confirmed in five. Three of five patients with heterozygous moles developed postmolar trophoblastic disease, whereas none of the 21 patients with homozygous moles suffered postmolar trophoblastic disease except one who showed signs of degenerating residual trophoblasts. Consistent with this observation is the fact that all of the four destructive moles studied here were of dispermic origin. Thus, heterozygous moles seem to have a higher malignant potential than do homozygous moles.

[The age incidence of spontaneous abortion]

A series of studies on the age incidence of spontaneous abortion was conducted. The results of the studies is summarized as follows: A total of 16,179 deliveries accompanied by 1,537 cases of spontaneous abortion in 5 hospitals was investigated. The ratio (spontaneous abortion/deliveries) was 0.095 (1,537/16,179) in all age groups, 0.197 (15/76) in the under 20 years age group, 0.089 (215/2,422) in 20-24 years age group, 0.083 (705/8,478) in 25-29 years age group, 0.090 (404/4,496) in 30-34 years age group, 0.232 (149/641) in 35-39 years age group, 0.650 (39/60) in 40-44 years age group and 1.169 (7/6) in the over 45 years age group. The ratio in the under 20 years age group was higher than the ratio in 20-34 years age group (P less than 0.05). The ratio in the over 35 years age group was higher than the ratio in 20-24 years age group (P less than 0.001). This results indicated that spontaneous abortions depended on the maternal age. Deliveries in 20-34 years old occupied 95.2% of all 16,179 deliveries and the incidence of spontaneous abortions in 20-34 age group was stable. It is suggested, that the spontaneous abortion is natural selection in the mother's body and nature protects the older mother's body from deliveries and child-rearing.

[Thoracic esophageal cancer in a young adult]

A 34-year-old Japanese male was admitted to the Second Department of Surgery, Chiba University Hospital complaining of swallowing difficulties of three months duration. Radiological examination with barium swallowing revealed thoracic esophageal cancer, classified as EiEa, was 6cm long and of the serrated type. Preoperative combined therapy included Fast Neutron, Pepleomycin, Bestatin and hyperthermia. The operative procedure was total thoracic esophagectomy and ante-thoracic esophago-gastrostomy using the right thoracotomy approach plus laparotomy. Postoperative combined therapy included Linac irradiation and Cisplatin. His postoperative course was uneventful and he was discharged without complications. The tumor was of ill-defined ulcerative type macroscopically; the pathological diagnosis was moderately differentiated squamous cell carcinoma.

[Basic and clinical studies on metastatic cancer--with special reference of multidisciplinary treatment of gastric and colorectal cancer patients with hepatic metastasis]

We studied 161 gastric cancer patients with P0, H(+) and 51 colorectal cancer patients with P0, H(+) from among cancer patients of the digestive organs and obtained the following conclusions. The effective treatment for synchronous hepatic metastasis was regarded as the group with surgical removal of the primary lesion plus hepatic resection plus chemotherapy, demonstrating most favorable prognosis in both gastric and colorectal cancer patients. Prognosis of the group treated with surgical removal of the primary lesion plus hepatic resection plus chemotherapy, was the most excellent and was followed by the group with surgical removal of the primary lesion plus chemotherapy and group with surgical removal of the primary lesions and group surgical removal of the primary lesion in this order. Concerning chemotherapy after surgical removal of the primary lesion, continuous intraarterial infusion therapy with FML regimen combining Lentinan revealed more favorable prognosis also in both gastric and colorectal cancer patients. Hepatic resection with aggressive reduction surgery was of significance in the treatment for the patients with hepatic metastasis of H1 and H2. Long-term survival is also expected for the patients with metachronous hepatic metastasis of H1 by hepatic resection plus chemotherapy.

Randomly controlled study of chemotherapy versus chemoimmunotherapy in postoperative gastric cancer patients

From September 1979 through March 1981, a total of 302 patients with gastric cancer and undergoing gastrectomy at the Department of Surgery at Chiba University Hospital and its 14 affiliated hospitals was studied for clinical effectiveness of immunotherapy with Nocardia rubra cell wall skeleton. The patients were stratified by gross stage of cancer and degree of operative curability. They were then assigned randomly to either chemotherapy group or chemotherapy plus immunotherapy group. Immunotherapy used was intradermal injection of 400 micrograms of N. rubra cell wall skeleton which was given weekly for the first month and monthly thereafter. After the specimen was examined microscopically, the patients were classified by histological stage of cancer and radicality of surgical intervention into curative or noncurative groups. The patients were surveyed for survival period in December 1981. The postoperative survival rate was compared in patients of histologically curative or noncurative resection cases between the two treatment groups. No statistical difference was detected between the groups in age, sex, or operative procedures that might influence the patient's survival. As a result, statistical intergroup difference in survival rates was not seen in patients of the curative group, probably due to a short observation period. However, the intergroup difference in survival rates was statistically significant in patients of the noncurative group (p less than 0.01). These results indicate the adjunctive effect of N. rubra cell wall skeleton as an immunotherapeutic agent in patients undergoing gastrectomy for gastric cancer.

The accumulation of delta-crystallin mRNA in transdetermination and transdifferentiation of neural retina cells into lens

By means of hybridization with DNA complementary to delta-crystallin mRNA (delta-mRNA) sequences (delta-cDNA), the levels of delta-mRNA in three different culture systems of 8-day-old chick embryonic neural retina were determined. After 30 days of culturing in vitro, the level of delta-mRNA in cells cultured under conditions of spreading cultures (SpC) was 50 times higher than in the cells maintained in aggregate cultures (AgC) throughout. When the cells pre-cultivated in SpC for an initial 10 days were transferred into AgC, the delta-mRNA level in 30-day cultures was 40 times higher than that in 3-day SpC. The level of delta-mRNA in neural retina in situ was negligible, but it became detectable in 10-day SpC. The initial appearance of detectable delta-mRNA in 10-day SpC coincides with the timing of 'transdetermination' of neural retina cells into lens cells.