[An autopsy case of rest stomach cancer accompanied by tongue cancer]

A case of rest stomach cancer, accompanied by tongue cancer, in a 57-year-old man is reported. The patient underwent a stomach resection 11 years earlier because of a discovered cancer. Most cases of rest stomach cancer appear after 10 years in cases of a stomach resection because of a stomach cancer. A double cancer, accompanied by tongue cancer, mostly occurs in people over 60 years old, and more than half such cases involve a cancer in the alimentary tract as well.

Stage (Ia) cervical cancer recurring 13 years after hysterectomy and causing small intestinal perforation. A case report with a review of the literature

A rare case of recurrent cervical cancer presenting multiple metastases to the small intestine is reported. A 69-year-old Japanese woman with a past history of early-stage (Ia) cervical cancer 13 years previously suffered sudden onset of panperitonitis caused by perforation of the small intestine. In the perforated lesion, squamous cell carcinoma, which was histologically similar to that of the primary lesion, was observed, and was diagnosed as a late recurrence of the cervical cancer. Perforation of the small intestine caused by tumor metastasis, especially metastasis from cervical cancer, rerely occurs. Furthermore, recurrence of an early cervical cancer presenting 13 years after hysterectomy is extremely rare. The present case draws attention to the possibility of late recurrence of cervical cancer, even in cases treated at the early-stage.

[Influence of a fosfomycin combination on the anti-tumor effect of CDDP]

To elucidate the influence of fosfomycin (FOM) on the anti-cancer effect of cisplatin (CDDP), experimental chemotherapy of CDDP with or without FOM was performed. A human lung cancer cell line, HLC-1 serially transplanted into nude mice was treated with CDDP 10 mg/kg (i.p.). Tumor doubling time in CDDP group and CDDP + FOM group are 26.78 +/- 6.3 days and 33.90 +/- 11.82 days respectively, and they are significantly elongated compared to control group. Serum NAG level in CDDP + FOM group was significantly lowered. Therefore, we concluded that anti-tumor effect of CDDP was not diminished by FOM combination.

Electrophysiologic study of patients with ventricular dysrhythmias during long-term follow-up after repair of tetralogy of Fallot

We performed an electrophysiologic study (EPS) in 8 patients who had received corrective surgery for tetralogy of Fallot. The mean age was 30 years. An average of 15 years had elapsed after corrective surgery. Two patients had episodes of syncope. ECG showed normal sinus rhythm in 7 patients and atrial fibrillation in 1, and all had complete right bundle branch block. All patients had ventricular premature beats of grade 3 or higher of Lown's classification. Overdrive suppression test was performed in 6 patients. Corrected sinus node recovery time (CSNRT) ranged from 230 msec to 510 msec. Wenckebach block of atrioventricular nodal conduction occurred at rates of 130 to 170 bpm during atrial pacing. The H-V interval was prolonged to 60 msec in 1 patient, but was below 55 msec in the others. Programmed stimulation induced ventricular tachycardia (VT) in 3 patients, nonsustained VT in 2 and sustained VT in 1. In 2 of 3 patients, delayed potential or fragmentations were recorded in the outflow tract of the right ventricle. During the follow-up period of 20 months, 2 patients died suddenly. Their CSNRTs and H-V intervals were normal. Ventricular tachyarrhythmia seems to be important as a cause of late sudden death after repair of tetralogy of Fallot.

Genetic control of the immune responsiveness to Streptococcus mutans by the major histocompatibility complex of the rat (RT1)

The lymph node cells from 11 strains of rats, differing in the genotype of the major histocompatibility complex of the rat (RT1), were examined on the basis of their proliferative response to the cell wall antigen of Streptococcus mutans. The 11 rat strains fell into three groups: high, intermediate, and low responders. To demonstrate the influence of the major histocompatibility complex on immune responsiveness to S. mutans, further experiments were performed using the RT1-congenic rat strains WKAH.1L(LEW), WKAH. 1AV1(ACI), and WKAH.1J(LEJ), which differ only in the genotype of the RT1 region. Although the background genes of each strain were of WKAH origin, WKAH.1L(LEW) and WKAH.1AV1(ACI) rats showed a low response whereas WKAH.1J(LEJ) rats showed a moderate response to the S. mutans cell wall antigen. The results indicate that the immune response is controlled by the class II gene(s) in RT1. Furthermore, the RT1.D locus products were shown to play an important role in the restriction molecule, since a monoclonal antibody, HOK7, directed to the RT1.Dk locus products reduced the proliferative response of lymph node cells.

Potency and receptors involved in coronary vasoconstriction caused by neuropeptide Y(NPY)

Using anesthetized dogs, the coronary vascular effects of neuropeptide Y (NPY) were studied and the action of alpha- or serotonergic receptor blockade on the action of NPY was evaluated. To demonstrate the biological significance of the action of NPY, the vasoconstrictor potencies of NPY and norepinephrine were compared. One to 5 nmol of intracoronary NPY reduced coronary flow in a dose-dependent manner. The action started rather gradually and lasted for 10 min or more. Since perfusion pressure and central venous pressure were unchanged, the decrease in coronary flow should be a result of coronary vasoconstriction. Intracoronary norepinephrine infusion caused vasodilatation but when dogs were pretreated with 0.5 to 1.0 mg/kg of systemic propranolol, a vasoconstrictor effect was observed at a 5 times higher dose than with NPY. Furthermore, the action of NE was only transient, lasting for 30 sec or less. The vasoconstrictor action of NPY was not antagonized by phentolamine or by ketanserin. Since NPY is an endogenous polypeptide found in the sympathetic nerve terminals around coronary arteries, it may participate in the regulation of coronary flow.

New Dw8 associated class II specificities defined by cytotoxic T lymphocyte clones

Two Leu2(-), Leu3(+), Leu4(+) human cytotoxic T lymphocyte (CTL) clones, BE-11 and AF-3, were generated against Epstein-Barr virus (EBV)-transformed cell line GI (Dw8/DRw8/DQWa homozygous). Blocking experiments with various monoclonal antibodies (MoAbs) revealed that the former recognized the DR molecule and the latter recognized the DQ molecule, respectively. Panel studies showed that CTL clone BE-11 lysed not only DRw8-positive cells but also DR1-positive ones. CTL clone AF-3 exhibited cytotoxicity against only Dw8/DRw8/DQWa typed cells. Until now, such specificities have not been defined serologically or biochemically. These results demonstrated that the previously unknown DR and DQ specificities could be defined by CTL clones, suggesting that CTL clones might be especially valuable tools for investigating the structural polymorphism of HLA antigens.

Early experiences of endocardial catheter mapping of the left ventricle in patients with sustained ventricular tachycardia--efficacy, safety and complications

In 23 patients with recurrent sustained ventricular tachycardia (VT) which originated from the left ventricle, endocardial catheter mapping has performed. In an additional 14 patients we also stimulated their left ventricle for non-sustained VT. Multiple sites could be mapped for the recording of local electrical activity, for pacing and for the induction of VT. These procedures could be done without complication. A careful, reasonable, and safe method of endocardial mapping will facilitate clinical electrophysiologic study.

A clinical pathological studies on the human pituitary adenomas by using immuno-histological method

In total 21 cases of pituitary adenomas were analyzed immunohistologically and electron microscopically. Disturbances of sight and visual field were recognized in almost all cases. Prolactinoma was the most frequent from the immunohistological point of view. Double and triple producers were also found. S100 protein was positive only in 3 cases. S100 positive cells are GFAP negative. This is irrelevant with the characteristics of folliculo-stellate cells ever reported.

Immunosensors

The current trends and future aspects of the research and development of immunosensors are overviewed. A non-labelled immunosensor, whose selectivity depends on immunochemical affinity of an antigen for its corresponding antibody, has been developed as the basis for the potentiometric determination of an antigen, with an antibody-bound membrane or electrode. Non-labelled immunosensors for syphilis antibody, blood typing, human chorionic gonadotropin (HCG), and human serum albumin have been investigated. In contrast with non-labelled immunosensors, labelled immunosensors may be characterized by marked enhancement of sensitivity. Of these labelled immunosensors, enzyme immunosensors that use the chemical amplification of a labelling enzyme for sensitivity are promising. Enzyme immunosensors with an oxygen electrode have been developed to determine AFP, HCG, IgG and toxin. Bioaffinity sensors with a preformed metastable ligand-receptor complex, which are similar to the enzyme immunosensor have been found effective for the determination of thyroxine (T4), biotin, and insulin.

Differential expression of HLA-class II antigens in the human thymus. Relative paucity of HLA-DQ antigens in the thymic medulla

By using well-characterized monoclonal antibodies, HU-20, HOK7(1E4) and HU-18, which specifically recognize either common epitopes of HLA-DR molecules (HU-20, HOK7) or HLA-DQw3 molecules (HU-18), it was demonstrated that there were different distributions of these antigens in human thymus. In the cortex, both DR and DQ antigens were strongly expressed on thymic epithelial cells (TEC). The double stainings revealed simultaneous expression of both antigens on TEC. On the other hand, in the medulla, DQ antigens had more limited expression than DR antigens, the latter antigens being demonstrated in the confluent pattern. The double staining method could show small numbers of dual-positive cells in the medulla, which looked like TEC, indicating that at least some medullary TEC were also DR+,DQ+, although the presence of small numbers of DR-,DQ-, as well as DR+,DQ- TEC in the medulla cannot be excluded. The preponderance of DR over DQ antigen in the medulla was consistently found--from a ten week embryo to a two-year-old child--and could be attributed to very weak or no expression of DQ antigens on dendritic cells/macrophages. The distribution pattern of these antigens within the thymus may have correlations with the intrathymic development of T cells through the unique functions of each antigen.

Functioning oxyphil cell adenoma in a patient with secondary hyperparathyroidism

A 45-year-old Japanese woman who has been receiving haemodialysis for 13 years suffered from an ectopic calcifying nodule and deformity of the thorax. She was diagnosed as hyperparathyroidism secondary to chronic renal failure. Total parathyroidectomy was performed, and the excised parathyroid glands showed hyperplasia in four and an adenoma in the left upper gland. On the electron microscopic study, the adenoma was composed of oxyphil cells and transitional oxyphil cells, the latter predominating in number. It was revealed from immunohistochemical study that the oxyphil cells in adenoma were strongly stained for parathyroid hormone (PTH). Continuous stimuli to secrete PTH seemed to generate the functioning oxyphil cell adenoma with an ability of PTH production, as well as hyperplasia of parathyroid chief cells. It seems to be the first case of tertiary hyperparathyroidism caused by an oxyphil cell adenoma. Functions of oxyphil cells and transitional oxyphil cells are briefly discussed.

Factors associated with clinical reactions to rubella vaccination in women

Two types of rubella vaccine were given to 272 seronegative healthy Japanese adult women. Clinical and laboratory studies on clinical reaction after vaccination were carried out on HI antibody response, HLA types, basal body temperature (BBT), menstrual cycles and serum progesterone levels of vaccinees. Clinical reactions were not associated with HLA types of vaccinees, but arthropathy occurred significantly more often in women vaccinated at the progestational stage than in women vaccinated at the estrogenic stage.

[An autopsy case of severe miliary tuberculosis in a patient with acute lymphatic leukemia (ALL)]

A 58-year-old Japanese man being diagnosed as having ALL suffered from continuous fever and dysfunction of the liver and kidneys despite being in a state of haematological remission. Further clinical investigations, however had not been able to find the causes of his condition before his death. The autopsy revealed severe miliary tuberculosis affecting many organs including the heart, lungs, liver, spleen, kidneys, thyroid gland, pancreas, bone marrow, and central nervous system, which is compatible with multiple organ failures. Recent pharmacological advances have increased the usage of many kinds of antineoplastic drugs, and this has resulted in increased chances of opportunistic infections by various microorganisms in the course of treatment. The present case implies the significance of the reactivation of tuberculosis in the secondary immunodeficient syndrome (SIDS).

Leukocyte subsets infiltrating into fully allogeneic, long-surviving rat liver allografts

Leukocyte subsets that infiltrated into unmodified LEJ(RT1j)2 liver grafts from WKAH(RT1k) hosts were studied. This strain combination is fully allogeneic and yields acute rejections in skin and kidney transplantations. On days 3, 7, and 14, cellular infiltrates gradually increased, and many hepatocytes were degenerative and lost cellular glycogen. Blastoid lymphocytes were frequently seen, and mitotic features of hepatocytes were prominent (on day 14, 3 to 4/10 high-power fields). Later, on days 30, 50, and 300, the cellular infiltrates gradually subsided, and blastoid lymphocytes were rarely seen. Throughout the course, Ia+ cells (RT1.Dk+ and/or RT1.B+ cells) were the major cell populations infiltrating into the grafts. Most of the host RT1.D+ cells were histiocytoid in appearance on immunoelectron microscopy. Histiocytoid cells were the most numerous infiltrating cells, constituting 30-50% of the total infiltrating cells. There were different distributions of T cell subsets between the portal and sinusoidal areas, as we previously observed in acutely rejected rat renal allografts. Both RLyt-1+,2-(Th) and RLyt-1+,2+(Tc/s) cells were found almost equally in the portal area, while RLyt-1+,2+(Tc/s) cells predominated over RLyt-1+,2-(Th) cells in the sinusoidal area. However, a gradual replacement of RLyt-1+,2-(Th) cells by RLyt-1+,2+(Tc/s) cells, as seen in the perivascular area of renal grafts, was not found in the portal areas of the liver grafts. Except for the latter finding, the pattern of cellular infiltrates was similar to that of acute renal rejection, and the significance of these cellular infiltrates is discussed.

Chondroid syringoma (mixed tumor of the skin). A clinicopathological study of 13 cases

The clinicopathology of 13 cases of chondroid syringoma were examined. The ages of the patients ranged from 26 to 86 years, with an average of 48 years. There were eight males and five females. Ten tumors out of the thirteen appeared on the face. Only one patient out of ten was suspected of recurrence in follow-up information. Histologically, all tumors consisted of epithelial cells, chondroid or myxoid matrix, and other strumal elements. The tumors were histologically classified into two types; twelve tumors had tubular and cystic lumina lined by two layers of epithelial cells, and only one case had small lumina lined by only a single layer. By an immunohistochemical study with a PAP method, positive stainings of keratin were observed in all cases, and S-100 protein in all but one. Ultrastructurally, the tumor cells showed features of an epithelial cell. Some ultrastructural differences were noted between two types of chondroid syringoma. Type I tumor cells had many tonofilaments in cytoplasm, but cytoplasmic filaments in type II were of the intermediate-type.

Ir gene for bovine insulin in the rat maps to RT1.B beta

The genetic control of the immune response to bovine insulin (BI) in the rat was investigated. As a result of experiments utilizing two intra-MHC recombinant rats and of blocking experiments with monoclonal antibodies against MHC class II antigens, an immune response gene for BI in the rat could be mapped to the RT1.B beta locus.

Role of HLA-DR antigens in Japanese patients with sarcoidosis

Fifty-three Japanese patients with sarcoidosis were tested for HLA-A,B,C, DR, and DQ antigens in order to investigate immunogenetic mechanisms in the pathogenesis of sarcoidosis. All of the patients had abnormal shadows on their chest radiographs, and all had histologically confirmed sarcoidosis. Groups of 60 and 57 unrelated Japanese served as control subjects for HLA-A,B,C and HLA-D region antigens, respectively. The frequency of HLA-DRw52 was 79.2% (42 of 53) in the patient group compared with 50.9% (29 of 57) in the control group, and the difference was significant (chi 2 = 9.66, p less than 0.005, pc less than 0.05, relative risk = 3.69). On the other hand, no significant association was found with HLA-A,B,C antigens. When various clinical features of the patients were taken into account, there was a tendency for the frequency of DRw52 to be lower in the patients who were in an advanced stage or who had resisted treatment with steroids. Furthermore, 31 of the 32 patients without ophthalmic involvement were DRw52-positive, which was highly significant (96.9% as compared with 50.9% of the control group; chi 2 = 19.74, p less than 0.001, pc less than 0.01, relative risk = 29.93), whereas the frequency of DRw52 in the patients with ophthalmic involvement was almost the same as in the control group. These results suggest that HLA-DR antigens play a significant role in the pathogenesis of sarcoidosis, and there may be a heterogeneity in the clinical entity of sarcoidosis.