Prediction of degree of residual stenosis in coronary thrombolysis

In order to predict the residual stenosis in coronary thrombolysis, the factors easily obtained from clinical history--age, gender, history of angina before acute myocardial infarction (AMI), family history, hypertension, diabetes, hypercholesterolemia, smoking, and interval between onset of AMI and recanalization--were observed in 114 patients with successful coronary thrombolysis. In 55 patients with angina before AMI, 29 patients had residual stenosis greater than or equal to 75% and 26 patients had residual stenosis less than 75%. In 59 patients without angina before AMI, 15 patients had residual stenosis greater than or equal to 75%, and 44 patients had residual stenosis less than 75%. The presence or absence of angina before AMI was the main variable that discriminated the groups of residual stenosis of more or less than 75%, which was the only significant independent variable to predict the residual stenosis. These data suggest that the presence of angina pectoris before AMI is likely to be associated with a significant degree of residual stenosis after thrombolysis.

Hepatic encephalopathy due to a large intrahepatic communication between the portal vein and inferior vena cava

A 59 year old man with cirrhosis presented with encephalopathy and hyper-ammonaemia. T1 weighted magnetic resonance imaging demonstrated a large void tubular structure connecting the right posterior portal vein branch and the inferior vena cava through the right hepatic lobe inferiorly, and cine-mode imaging showed a flow within this channel. Clearly in this patient a significant portion of the portal venous blood was being shunted into the inferior vena cava, causing encephalopathy. The exact origin of this channel is not known, but several possibilities are discussed. It is also predicted that similar previously unknown large intrahepatic shunts will be discovered increasingly with the availability of modern imaging techniques.

Induction of resistance to TNF cytotoxicity and mitochondrial superoxide dismutase on U-937 cells by 1,25-dihydroxyvitamin D3

1,25-dihydroxyvitamin D3 (1,25(OH)2D3) dose-dependently inhibited the cytotoxicity of tumor necrosis factor (TNF) in a human monoblastic leukemic cell line, U-937. Combination of TNF and 1,25(OH)2D3 remarkably increased mitochondrial superoxide dismutase (mSOD) of U-937 cells, TNF alone increased it only slightly and 1,25(OH)2D3 alone did not. The cytosolic SOD (cSOD) activity was not changed by TNF or/and 1,25(OH)2D3. The mSOD activity was not inhibited by 2 mM KCN, suggesting that mSOD should be a manganese SOD (MnSOD). These results suggest that 1,25(OH)2D3 may reduce the susceptibility to TNF cytotoxicity of U-937 cells by enhancing the ability of inducing MnSOD by TNF.

Gastric mucosal injury induced by chloral hydrate

Gastric mucosal injury by chloral hydrate (CH) was investigated in the rat. Rats were injected with CH intraperitoneally or subcutaneously. After the CH injection, gastric ulcers appeared in the glandular stomach at 6 h and the ulcer index peaked in 12 h. The minimum dosage of CH to produce ulcers was 400 mg/kg intraperitoneally and 600 mg/kg subcutaneously.

[Possible cytotoxic mechanisms of TNF in vitro]

TNF is a protein originally isolated by its ability to induce hemorrhagic necrosis of some tumors in vivo, and cytotoxic effects against certain tumor cells, but not against normal cells in vitro. Though mechanisms of the cytotoxicity and selectivity of TNF action in vitro are not clear, there is much evidence that free radicals such as superoxide and hydroxyl radicals, mediated by TNF, are correlated with TNF cytotoxicity. Recently, manganous superoxide dismutase (MnSOD) in mitochondria has been demonstrated to be a rescue protein against TNF cytotoxicity and to be induced when the cells are exposed to TNF in the resistant cells. Two steroid hormones, glucocorticoid and 1,25-dihydroxyvitamin D3, block the cytotoxicity of TNF. Glucocorticoid may reduce TNF cytotoxicity by inhibiting phospholipase A2 and 1,25-dihydroxyvitamin D3 by inducing MnSOD in combination with TNF.

Combination effects of interferon-gamma and cholera toxin on induction of differentiation of an insensitive U-937 clone

We examined the combination effect of interferon-gamma (IFN-gamma) and cholera toxin and the role of cAMP in the induction of differentiation of a differentiation-insensitive U-937 clone, in which the reactivity to differentiation-inducers was decreased. IFN-gamma (100 units/ml) or cholera toxin (10(-9) M) alone only marginally induced various differentiation-associated characteristics such as NBT-reducing activity, phagocytic activity, a-naphthyl acetate esterase activity and surface markers. However, when combined with each other, they significantly induced these markers. Other cAMP-inducing agents such as prostaglandin E2, forskolin, epinephrine and isoproterenol did not induce NBT-reducing activity, either alone or in combination with IFN-gamma. However, all these cAMP-inducing agents significantly increased intracellular cAMP levels. Tumor necrosis factor, interleukin 6 or granulocyte/macrophage colony-stimulating factor alone did not induce NBT-reducing activity, but they could induce activity when combined with cholera toxin. These results suggest that enhancement of induction of differentiation by cholera toxin in combination with IFN-gamma or other cytokines may not be merely due to increased cAMP levels. There seems to be a transduction signal other than cAMP coupling with cholera toxin to stimulate induction of differentiation of an insensitive U-937 clone.

Quantitative determination of IgM-rheumatoid factor by enzyme immunoassay--standardization using a serum from a rheumatoid arthritis patient

A method to standardize the quantitation of IgM-rheumatoid factor (RF) by enzymeimmunoassay (EIA) is presented. Serially diluted sera from rheumatoid arthritis patients were added to immobilized human IgG, and bound IgM-RF was detected by addition of horseradish peroxidase labeled anti-human IgM (HRPOaM). The concentration of IgM-RF which produced half of the maximal absorbance at 492 nm given by a saturating concentration of IgM-RF in the EIA plate, was defined as 1 U/ml. The IgM-RF values of test samples were measured as the dilution of the sample which provided half-maximal absorbance. The IgM-RF values determined by this method coincided with those determined by referring to a standard curve made from a serum containing known amounts of IgM-RF. Differences in IgM-RF values, which were caused by varying preparations of horseradish peroxidase anti-IgM (HRPOaM) were corrected for the binding capacity of each preparation to various concentrations of human IgM adherent to the plate. The IgM-RF values determined by this method correlated well with the RF values determined by latex photometric immunoassay (r = 0.956, p less than 0.001). IgM-RF values determined by EIA were converted into WHO-units by an empirical formula described. The data observed suggest that the method here reported can standardize IgM-RF values obtained by EIA.

Mechanism of diethyldithiocarbamate-induced gastric ulcer formation in the rat

Diethyldithiocarbamate (DDC) was injected subcutaneously in the rat and the mechanism of gastric ulcer formation was investigated. DDC induced gastric ulcers in a dose-dependent manner. DDC significantly suppressed gastric mucosal copper-zinc superoxide dismutase (Cu, Zn-SOD) activity at 2 hr. However, manganese-superoxide dismutase (Mn-SOD) activity was not changed. Gastric mucosal blood flow (GMBF) decreased to 52% of the control level at 2 hr after administration of DDC and gradually increased to reach the control level by 7 hr. A Shay rat preparation (4 hr) was used to study gastric secretion. DDC (200, 400 and 800 mg/kg) inhibited acid secretion to about 80% of the control level. Histopathological examination of the gastric mucosa after administration of DDC revealed mucosal congestive findings from 1 hr to 3 hr. These data suggested that the mechanism of DDC-induced gastric ulcer formation may be attributable to a decreased level of GMBF and O2- production owing to decreased SOD activity.

[A case of retroperitoneal neurinoma]

A case of retroperitoneal neurinoma is reported. The patient was a 34-year-old female without symptoms. CT scan showed a large low density mass, a part of which was enhanced. US showed a lobulated cystic mass. Angiography showed avascular mass and portal vein was shown with displacement and stenosis. Pathological diagnosis was benign retroperitoneal neurinoma (Antoni A and Antoni B).

[Angiotensin converting enzyme inhibitory activity of MK-0521 in vivo and antihypertensive effect of its single oral administration on blood pressure and effect on the renin-angiotensin system in 2-kidney Goldblatt hypertensive dogs]

Angiotensin converting enzyme (ACE) inhibitory activity of MK-0521 in dogs and the effects of its single oral administration on blood pressure and the renin-angiotensin system in 2-kidney Goldblatt hypertensive dogs were compared with those of captopril and MK-421. MK-0521 at 0.001-0.1 mg/kg, i.v., or 0.01-1 mg/kg, p.o., attenuated the pressor effect of angiotensin I without affecting that of angiotensin II and augmented the depressor effect of bradykinin. The potency of MK-0521 to reduce the pressor effect of angiotensin I was 9.8 times that of captopril by intravenous administration, and by oral administration, it was 15.9-32.1 times that of captopril and approximately 3 times that of MK-421. When administered orally, the onset of action and the time to peak effectiveness were more rapid than those of MK-421, but slower than those of captopril. Duration of the action of MK-0521 was longer than that of captopril and equal or longer than that of MK-421. The inhibition of ACE was well correlated with serum MK-0521 levels. MK-0521 produced a dose-dependent antihypertensive effect in 2-kidney Goldblatt hypertensive dogs at over 0.3 mg/kg, p.o., without affecting the heart rate. The antihypertensive effect of MK-0521 was persistent and approximately 3 times more potent than that of captopril. MK-0521 inhibited the serum ACE activity and increased the plasma renin activity, while it had a tendency to decrease plasma aldosterone level. These changes were parallel to the time course of the antihypertensive effect. These results suggest that the main mechanism of the antihypertensive effect of MK-0521 is the suppression of angiotensin II production due to the inhibition of the ACE.

Angiography in the diagnosis of liver disease

Although necessity for angiography has been reduced somewhat because of the development of newer imaging modalities, such as ultrasound and CT, celiac or hepatic arteriography, portography, and hepatic venography often prove useful in the diagnosis of liver disease. They can be utilized for therapeutic purposes as well in certain vascular abnormalities.

Induction of cytochrome P-450, cytochrome b-5, NADPH-cytochrome c reductase and change of cytochrome P-450 isozymes with long-term trichloroethylene treatment

Several reports have described the effects of trichloroethylene (TCE) on the microsomal mixed function oxidase system (MFOS). These studies suggest that repeated TCE administration induces MFOS, especially cytochrome P-450 and NADPH-cytochrome c reductase. However, it is uncertain what isozymes are induced by TCE treatment, and it is not clear how microsomal enzymes or cytochrome P-450 isozymes are altered when TCE is administered for a duration longer than 28 days. We investigated the changes of MFOS by long-term TCE treatment. Male Wistar rats were injected with TCE, 1.0 g/kg body weight once a day for 5 continuous days or 2.0 g/kg body weight twice a week for 15 days. The mean body weight of the rats treated with TCE for 15 weeks was slightly, but not significantly, less than that of the control rats. Relative liver weights (liver wt/body wt) of the TCE-treated group were however significantly larger (21%) than those of the control group. The weights of the other organs were not changed by long-term TCE treatment. Trichloroethylene treatments for 5 days and 15 weeks caused significant increases in microsomal protein, cytochrome P-450, cytochrome b-5 and NADPH-cytochrome c reductase. TCE treatments produced an increase in a polypeptide band at 52,000 molecular weight range observed with sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). This increase in similar to, but less pronounced than that induced by phenobarbital (PB) treatment. There were no remarkable changes at 56,000 molecular weight range where a band appeared after the treatment with 3-methylcholanthrene (MC). It is likely that the induction of cytochrome P-450 by TCE is relatively similar to that by PB.

[Clinical comparison of 99mTc-diethylenetriaminepentaacetic acid-human serum albumin (99mTc-HSA-D) and 99mTc-human serum albumin (99mTc-HSA) for cardiac blood pool imaging]

99mTc-HSA-D has been developed as a new blood pool scanning agent. Clinical comparison of 99mTc-HSA-D and 99mTc-HSA was made in 16 cases. The activity concentration of 99mTc in blood was measured during 2 hours after the injection in five cases. 99mTc-HSA-D showed higher concentration compared to 99mTc-HSA with the passage of time. Quantitative analysis of contrast between left ventricle and septum was performed on end diastolic frames of gated images 10 minutes after the injection. There was no obvious difference between 99mTc-HSA-D and 99mTc-HSA. The subjective comparison of detectability of lesions between the two agents was performed on three directional gated images. 99mTc-HSA-D was superior to 99mTc-HSA, because the images of the latter deteriorated with the passage of time. On anterior view images 1 hour after the injection, left ventricle/lung and abdominal aorta/background count ratios were greater for 99mTc-HSA-D in many cases. There was no obvious difference in liver/background and kidney/background count ratios between the two agents. Urinary excretion of 99mTc was considerably lesser for 99mTc-HSA-D. The results indicated that 99mTc-HSA-D was superior to 99mTc-HSA for cardiac blood pool imaging.

Intestinal absorption of chloral hydrate, free trichloroethanol and trichloroacetic acid in dogs

In order to examine the intestinal absorption of chloral hydrate (CH), free trichloroethanol (F-TCE) and trichloroacetic acid (TCA), an intestinal circulation system in dogs was developed using jejunal, ileal and colonic loops, and solutions of CH, F-TCE and TCA were circulated within them. The concentrations of these substances and their metabolites in the serum, urine, bile and circulates were then measured. In all groups, the fraction of water absorbed from the intestine was about 10% of the administered volume two hours after administration. The absorbed fraction of CH was about 50% in the jejunum and ileum, and about 40% in the colon. The absorbed fraction of F-TCE was about 60% in the jejunum, 50-60% in the ileum and about 40% in the colon, while the figures for TCA were about 40-50% in the jejunum and about 30-40% in the ileum and colon. The combined biliary and urinary excretion ratios of the administered substances and their respective metabolites to the total amounts absorbed from the intestine were about 25-30% for F-TCE, 10-15% for CH and 0.1-0.2% for TCA in all parts of the intestine two hours after administration.

A patient with systemic lupus erythematosus presenting both central nervous system lupus and steroid induced psychosis

We describe a patient with systemic lupus erythematosus (SLE) who presented with both steroid induced psychosis and central nervous system (CNS) SLE at different times. The cerebrospinal fluid (CSF) immunoglobulin indices and electroencephalogram were found to be helpful and reliable for the correct diagnosis of both conditions. There have been no reports of patients with SLE who showed both steroid induced psychosis and CNS SLE, and our patient has provided substantial evidence that both conditions can occur in the same individual.

Metabolism of chloral hydrate in the anoxic perfused liver

The metabolism of chloral hydrate (CH) under anoxic conditions was investigated in the non-recirculating, hemoglobin-free liver perfusion system. CH uptake in the anoxic liver decreased to about 80% of that in the oxygen-supplied liver. The reduction of CH to trichloroethanol (TCE) increased and the oxidation of CH to trichloroacetic acid (TCA) decreased. The TCE/TCA ratio increased; however, the total trichloro compounds, that is TCE and TCA, were not significantly altered by anoxia. Though approximate 14% of the CH infused into the oxygen-supplied liver was changed to substances other than TCE or TCA, the unknown part was a very small portion in the anoxic liver. The decrease in CH uptake, by the anoxic liver, is thought to be equivalent to the decrease of the unknown metabolites. The TCE/TCA ratio under anoxia was also altered by pyruvate or lactate infusion.

[A case of colon cancer with pulmonary metastasis treated effectively by uracil futraful]

A 57-year-old female was admitted for advanced ascending colon cancer with a solitary pulmonary metastasis measuring 1.5 cm in diameter. As laparotomy revealed an absolute noncurable tumor of stage V (H0, p2, s2 n1 (+], palliative right hemicolectomy was performed. A pathological diagnosis of well differentiated adenocarcinoma was made postoperatively. A daily dose of 400 mg of UFT was given orally. After 8 months, plain chest film and tomography revealed a reduction in the size of the pulmonary metastasis to 1.0 cm in diameter. The metastatic lung tumor was controlled for a period of 1 year and 9 months. It was suggested that UFT was rather effective for pulmonary metastasis from colon cancer.

The absorption of trichloroethylene and its metabolites from the urinary bladder of anesthetized dogs

In order to examine the absorption of trichloroethylene (TRI) and its metabolites from the urinary bladder of dogs, we injected TRI and its metabolites, i.e., chloral hydrate (CH), free trichloroethanol (F-TCE), trichloroacetic acid (TCA) and conjugated trichloroethanol (Conj-TCE), into the urinary bladder of anesthetized dogs, and measured the agents and their respective metabolites in the blood or serum, urine and bile. The percentage of water absorbed from the urinary bladder was 10-20% 2 h after the administration of all substances. The percentage of agents absorbed was 60-70% for the TRI and TCA groups, and 50-60% for the CH, F-TCE and Conj-TCE groups 2 h after administration. The combined urinary and biliary excretion rates of the absorbed materials from the urinary bladder 2 h after administration were 46% for F-TCE, 30% for CH, 6% for Conj-TCE and 0.5-1.0% for TRI and TCA. Urinary re-excretion rates of the total excreted amounts were 65-70% in TRI, CH and F-TCE groups, about 50% in TCA and 99% in Conj-TCE group. It is possible that all of the substances administered, particularly F-TCE, are metabolized to Conj-TCE in the urinary bladder.

Intestinal absorption of trichloroethylene in dogs

In order to examine the intestinal absorption of trichloroethylene (TRI), we developed the intestinal circulation system of dogs and administered TRI solution at three concentrations (0.1, 0.25 and 0.5%) to the three parts of the intestinal tract (jejunum, ileum, and colon) of the operated dogs. We measured TRI and its metabolites, free-trichloroethanol, trichloroacetic acid, and conjugated trichloroethanol, in serum or blood, urine, bile and circulating solutions. The absorption rates of TRI from the intestine were 50-70% of the administered volume of TRI 2 hr after administration in all groups, and all parts of intestine readily absorbed TRI. Moreover, there were no significant differences in the absorption rates of TRI and water between the jejunum and ileum, and ileum and colon, respectively. The excretion rates of TRI and its metabolites in urine and bile were very low (0.1-0.4%) compared with the volume of absorbed TRI from the intestine 2 hr after administration in all groups. The high degree of absorption of TRI should be considered when threshold limits for TRI in the drinking water, the surface water, and the ground water are established.

[Serum concentration of 5-FU and tegafur (FT-207) after administration of tegafur (FT-207) suppository with the colostomy]

Tegafur (FT-207) suppositories were administered at a rate of 750 mg via the artificial anus (ST Group) following surgery of rectal cancer. Comparative studies were conducted of changes in blood concentrations of 5-FU and tegafur at the time of initial administration and following one week of continuous use for the low-anterior resection cases (LA Group) and the rectal administration cases (RE Group). FT-207 concentration at initial administration was low in the ST group compared to those for both LA and RE groups which received anal administration of the drug, but only little changes were noted. Blood concentration one hour after administration was 11.1 micrograms/ml, elevated to 14.3 micrograms/ml at two hours, and remained at 10 micrograms/ml and above for six hours following administration. The ST group 5-FU concentrations at two, four and six hours after administration were significantly lower than those in the RE group but the changes were little. Blood concentrations were 0.015 microgram/ml at one hour after administration, 0.017 micrograms/ml at two hours and maintained virtually the same level thereafter. An effective concentration of 0.012 microgram/ml was maintained even at ten hours following administration. After one week of administration of the suppositories, the ST group showed the lowest concentration among three groups, but it was approximately double compared to the initial concentration; FT-207 showed nearly the same concentration in the LA group and 5-FU blood concentration was 0.025 microgram/ml at one hour after administration, reached to a maximum of 0.030 microgram/ml at two hours and maintained 0.020 microgram/ml and higher at ten hours. 5-FU concentration in the LA and RE groups after one week of continuous administration showed a dual-peaked pattern. No patient with an abnormal artificial anus was involved in this study. The artificial anus is thought to be an adequate and effective administration route of FT-207 suppositories.

[The subrenal capsule assay modified with three-dimensional measurement (volume method) and its higher predictivity]

Subrenal Capsule Assay (SRCA) developed by Bogden et al. is a new in vivo sensitivity test for anticancer agents. However, the presence of host reaction on about day 6 is largest problem for this method, and now many researchers are scrutinizing or introducing several modifications for this assay chiefly by immunosuppressing procedures. As one of the means to measure the actual change of the tumor volume and minimize the misreading of host reactions, we introduced three dimensional measurements of the grafts (volume method) instead of original mean diameter measurement. Using this method, prospective quantitative study was made. The results of 16 assays with 15 cases of miscellaneous malignancies showed 94% evaluability and in 22 treatments predictive accuracy was 77%. Assay/clinical correlation coefficient was 0.38 and coincidence of ranking order of the effectiveness was 6/6, with good contrast to those of 78%, 56%, 0.00 and 1/3, by original method respectively. Clinical responses more than PR were obtained in 9 of 15 cases. Two cases are still in CR for two years by assay directed single agent treatments. Many other minor modifications were also adopted and evaluated by quantitative observation of assay/clinical correlations. SRCA with our modifications seemed to have utilities than original.

Alteration of chloral hydrate metabolism in rats with carbon tetrachloride-induced liver damage

The metabolism of chloral hydrate (CH) was investigated in the isolated perfused rat liver system. The experiments were performed on rats that were administered carbon tetrachloride (CCl4) subcutaneously for 15 weeks to induce chronic liver damage and on untreated rats. Clearance of CH from the perfusion system was lower in damaged liver than in control liver. In both groups, 50-70% of the added CH was excreted into perfusate as trichloroethanol (TCE) and trichloroacetic acid (TCA) within 120 min. The TCE/TCA ratio was 1:1.3 in the control group compared to 2:1 in the damaged liver group. The findings suggest that CH metabolism in the liver is affected by chronic damage.

Induction of umu gene expression by cross-links and other DNA lesions

The induction of umu gene expression by DNA cross-links was investigated in various strains of E. coli with different DNA-repair capacities. Expression was measured by quantifying enzymatic activity of beta-galactosidase produced under regulation of the umu promoter carried on a plasmid carrying the umuC-lacZ gene fusion. The treatment with MMC induced gene expression more efficiently in a wild-type strain when compared with an excision-repair-deficient strain (uvrA). In contrast, PUVA and cis-Pt treatment induced higher levels of the gene expression in the uvrA strain than in the wild-type strain, as did other DNA-damaging agents including 4NQO, MNNG and MMS. None of these chemicals induced umu expression in either lexA and recA strains. The mechanisms of the induction of umu expression by DNA cross-links in relation to DNA damage and repair are discussed.

Extrahepatic metabolism of chloral hydrate, trichloroethanol and trichloroacetic acid in dogs

To examine the details concerning that part of TRI metabolism which was carried out by the extrahepatic organs, we studied the extrahepatic metabolism of chloral hydrate (CH), free-trichloroethanol (F-TCE) and trichloroacetic acid (TCA) using a method developed in our laboratory. Bypass and non-bypass dogs were given CH, F-TCE and TCA, and we compared the concentrations these substances and their metabolites in the serum and urine of the two groups of animals. In the bypass dogs, F-TCE, TCA and conjugated-trichloroethanol (Conj-TCE) appeared in the blood and urine 30 min. after the CH administration, and TCA and Conj-TCE appeared 30 min. after the F-TCE. All levels of administered substance were higher in bypass dogs than in non-bypass dogs, and the compounds were metabolized in small amounts in the extrahepatic organs compared with the liver. Therefore, administered substances remained at high levels in the serum and were excreted in large amounts in the urine in the form of unchanged substances. The metabolized percentage volumes of CH to TCA in the bypass dogs were 10-20%, and those of F-TCE to TCA were very small, while these percentage values of CH to F-TCE were the same or slightly smaller, respectively. Moreover, trichloroethylene (TRI) acts to decrease the leukocyte count in the blood, but the TRI metabolites described above do not have this function.

The cholecystohepatic circulation of trichloroethylene and its metabolites in dogs

In order to examine the cholecystohepatic circulation of trichloroethylene (TRI) and its metabolites, we injected the gallbladder with TRI and its metabolites, i.e. chloral hydrate (CH), free-trichloroethanol (F-TCE), trichloroacetic acid (TCA) and conjugated-trichloroethanol (Conj-TCE), using anesthetized dogs. The absorption rates of water from the gallbladder were 25-30% 2 h after administration for all substances. The absorption rates of substances were 65-70% in the CH, F-TCE and TRI groups, and 40-50% in the Conj-TCE and TCA groups 2 h after the administration. Conj-TCE in the blood absorbed from the gallbladder has a tendency to be directly transported to the venous system rather than to be taken into hepatocytes in the liver. All of the administered substances, in particular, F-TCE might be metabolized to other substances in the gallbladder.

The metabolite ratio as a function of chloral hydrate dose and intracellular redox state in the perfused rat liver

Chloral hydrate (CH), an intermediate metabolite of trichloroethylene, is reduced to trichloroethanol (TCE) by alcohol dehydrogenase and aldehyde reductase, and is also oxidized to trichloroacetic acid (TCA) by the nicotinamide adenine dinucleotide (NAD)-dependent enzyme, CH dehydrogenase. Alcohol dehydrogenase requires reduced NAD (NADH), aldehyde reductase requires reduced nicotinamide adenine dinucleotide phosphate (NADPH) and CH dehydrogenase requires NAD to complete the reaction. It is unclear which reaction is predominant at the physiological redox level in intact liver cells. To study this question, we perfused the livers of well-fed rats with Krebs-Ringer buffer solution containing 0.1 mM pyruvate/1.0 mM lactate. The levels of TCE and TCA in the effluent were measured by gas chromatography, and the fluorescence of reduced pyridine nucleotides was measured with a surface fluorometer. When a low concentration (below 0.25 mM) of CH was administered, more TCA than TCE was produced. When a high concentration of CH was administered (over 0.5 mM), TCE production was greater. Reduced pyridine nucleotides decreased inversely with the CH concentration. Even at low CH concentrations, pyridine nucleotides were not reduced. When 10 mM lactate was added to the perfusate in order to reduce the pyridine nucleotides in the liver cells, the TCE/TCA ratio increased. On the other hand, the TCE/TCA ratio tended to fall following the addition of 5.0 mM pyruvate. In conclusion, the TCE/TCA ratio was altered according to the concentration of CH, and to the redox level of pyridine nucleotides in the liver.

The metabolism of trichloroethylene and its metabolites in the perfused liver

The metabolism of trichloroethylene (TRI) and its metabolites, chloral hydrate (CH), trichloroethanol (free-TCE) and trichloroacetic acid (TCA), were examined in the isolated perfused rat liver, to clarify the role of the liver in the metabolism of TRI. TRI was rapidly converted to TCE and TCA by the perfused liver. TCA was produced from TRI about 2.5 times greater than was total-TCE. CH was metabolized to TCE and TCA immediately. TCA was also a dominant metabolite of CH over total-TCE. TCE(free type) was speedily conjugated by the liver. A portion of TCE was converted to TCA. Less than 10% of these metabolites produced by the liver were excreted into the bile. Most of them appeared in the perfusate.

Extrahepatic organs metabolism of inhaled trichloroethylene

An extrahepatic circulation system for dogs was developed using a portal vein to right femoral vein bypass procedure. This system maintained nearly normal biochemical and physiological parameters, i.e. arterial blood pressure, heart rate, electrocardiogram, leukocyte and erythrocyte count, hematocrit, alkaline phosphatase, blood urea nitrogen, ammonia and creatinine, for 2 h. Thus, the system appears to be a valid technique for investigating extrahepatic metabolism. Dogs were exposed for 1 h to 500, 700 and 1500 ppm of trichloroethylene. Free-trichloroethanol, trichloroacetic acid and conjugated-trichloroethanol appeared in the blood and urine after 30 min of exposure. The amounts of metabolite formed by dogs with hepatic bypass were less than by similarly exposed dogs without hepatic bypasses, specifically 50-80%, 10% and 10-20% for free-trichloroethanol, trichloroacetic acid and conjugated-trichloroethanol, respectively. In addition, trichloroethylene exposure produced a smaller decrease in leukocyte counts in the hepatic bypass dogs than in the non-bypass dogs. This observation may indicate that the liver itself played some role in the elimination or increment of leukocyte counts in the blood.

Identity of differentiation inducing factor and tumour necrosis factor

Human myelogenous leukaemic cells can be induced to differentiate into the monocyte/macrophage pathway by protein inducers called differentiation inducing factors (DIF) in conditioned media of mitogen-stimulated human peripheral blood leukocytes. However, human DIF has not yet been well characterized. DIF is known to be a T-cell lymphokine, as it can be obtained from the T-cell line HUT-102 and can be partially purified from medium conditioned by phytohaemagglutinin (PHA)-stimulated lymphocytes. We found that monocytes also produce factor(s) that induce differentiation of human myelogenous leukaemia cell lines to cells with macrophage-like characteristics. This factor(s) has activity different from that of colony-stimulating factor(s) or interferons. We have now purified a DIF to homogeneity from medium conditioned by PHA-stimulated leukocytes using a human myeloblastic leukemia cell line, ML-1, as target cells. The purified DIF has a relative molecular mass (Mr) of approximately 17,000, with an NH2-terminal sequence the same as that of human tumour necrosis factor (TNF). Recombinant human TNF (rHuTNF) induces differentiation of ML-1 cells and an anti-pDIF monoclonal antibody can neutralize both differentiation inducing activity and cytotoxic activity of DIF and rHuTNF. The findings indicate that one of the DIF(s) produced by leukocytes is probably TNF.

Biliary excretion of trichloroethylene and its metabolites in dogs

To examine the biliary excretion of trichloroethylene (TRI) and its metabolites, we carried out various experiments with TRI and its metabolites, i.e., chloral hydrate (CH), free-trichloroethanol (F-TCE) and trichloroacetic acid (TCA), using anesthetized dogs. The amount of biliary excretion was significantly increased with the administration of CH and F-TCE, whereas it remained at control levels with the administration of TRI and TCA. The substances excreted into bile were conducted in the form of conjugated-TCE (Conj-TCE) in over 90% of the CH, F-TCE and TRI administration groups. About 95% of these Conj-TCE were conjugated with glucuronic acid. The cumulative excretion ratios of substances and metabolites to dose were 20% for CH and F-TCE, and about 1% for TCA and TRI 2 h after administration.

[Trichloroethylene metabolism in chronic liver disorders induced by carbon tetrachloride]

Numerous reports have been published in the field of industrial health on biological monitoring of trichloroethylene exposure, but these studies have been confined to healthy humans. Trichloroethylene metabolism in individuals with chronic liver diseases has not been clarified. This experiment was therefore performed on rats that were administrated carbon tetrachloride subcutaneously for three months to induce chronic liver damage. The metabolism of trichloroethylene and its metabolites, chloral hydrate and trichloroethanol, were investigated using the isolated liver perfusion method. Comparing the changes of these substances in the chronically damaged liver with those in the intact liver, the following results were observed in the chronically damaged liver: The conversion of trichloroethylene to trichloroethanol and trichloroacetic acid decreased. The reduction of chloral hydrate to trichloroethanol increased. The oxidation of chloral hydrate to trichloroacetic acid decreased. The biliary excretion of trichloroethanol and trichloroacetic acid decreased.

Transcription unit mapping in adenovirus: regions of termination

Using a series of single-stranded clones of adenovirus DNA, we determined the extent of RNA polymerase II transit early in infection for two rightward-reading transcription units. RNA synthesis beginning at the major late promoter (16.5 on the genomic map) continued until approximately 65 to 70 map units so that differential choices of mRNAs within that region were not based primarily on transcriptional decisions but rather on posttranscriptional decisions. Transcription from the major late promoter beginning at 16.5 map units, however, did greatly decrease before approximately 75 map units, ensuring that no mRNAs were formed with sequences beyond approximately 75 map units. Early transcription from E3 then began just past 75 map units (at a higher rate than transcription from the major late promoter); E3 transcripts terminated at least 2 kilobases downstream from a second and final poly(A) site in this transcription unit. The effectiveness of termination in E3 was greater than 95 to 99%.

[Clinical correlation and modification of the subrenal capsule assay]

A prospective study using 10 cases with miscellaneous tumors was performed. Discoid (columnar) tumors were measured three-dimensionally (volume method). Modified criteria for evaluability and for both absolute and relative quantitative sensitivities were employed. The evaluability was 9/10 (90%) and by the volume method true positives (more than PR) were 2/2, true negatives (less than PR) were 9/10 and overall predictive accuracy was 11/12 (92%), and accordance in relative sensitivity ranking (e.g. A drug is better than B drug) was seen in 4/4. However using the original method (mean diameter method) the corresponding figures were 0/0, 9/12, 9/12, (75%) and 2/4, respectively. The utility of this assay in the field of clinical chemotherapy therefore seems very promising.

[Clinical application of local hyperthermia combined with antineoplastic agents]

At present hyperthermia shows great promise when combined with other modalities. Local thermo-chemotherapy may also be a very attractive research field, but the combination of hyperthermia and anti-cancer drugs is still poorly understood. In this review, the background and the clinical reports on heat and chemotherapy which have been reported during the last year were analyzed. Finally, our clinical experiences with local hyperthermia combined with anti-cancer drugs for gastrointestinal cancer were also reported.

Partial splenic embolization as an emergency treatment for uncontrollable variceal bleeding: a case report

Partial splenic artery embolization was carried out in one patient with cirrhosis during acute variceal bleeding when other direct hemostatic procedures could not be applied. It clearly assisted in controlling the acute bleeding, and led to subsequent endoscopic sclerosis. Although its effect is indirect, partial splenic embolization may prove useful in certain clinical situations with acute bleeding where other hemostatic means have failed or are not applicable.

Hepatocellular carcinoma detected by iodized oil

This study assesses the diagnostic value of Lipiodol (iodized oil) and computed tomography (CT) in detecting hepatocellular carcinoma (HCC). Twenty-four patients who were suspected of having HCC received injections of a small amount of Lipiodol, along with an antitumor agent, in the hepatic artery following routine celiac angiography. CT scans obtained 7-10 days after Lipiodol administration demonstrated HCC in distinct contrast to the surrounding noncancerous parenchyma. In particular, the CT-Lipiodol procedure disclosed many small HCC lesions that were not shown by celiac angiography, scintigraphy, CT with and without contrast medium enhancement, and ultrasonography. Although this procedure may miss very small or highly fibrotic lesions, it is recommended for patients suspected of having HCC and for patients for whom hepatic resection is being considered.

Immunological study of heart diseases with special reference to the cytotoxicity of the heterophile antibody against cultured myocardial cells

In our previous study, a high rate of "heterophile antibody" was found in idiopathic cardiomyopathy. In the present investigation the cytotoxic activity of this antibody was examined in cultured myocardial cells. Trypsin treated cells cultured for 3 days were used in the two-step method of the complement dependent cytotoxicity test. The trypan blue dye-exclusion method was utilized to determine the percentage of surviving cells, and the cytotoxic effect was expressed by the cytotoxic index (CI). With fresh rabbit serum as complement, the mean CI value of the heterophile antibody positive sera was 20.7, which was in contrast to the value of anti-heart antibodies negative sera (p less than 0.01). As the cytotoxic effect to the heterophile antibody was absent without the complement, it may be complement dependent. Thus, our results suggest that the heterophile antibody may play a role in the pathogenesis or be an incremental factor of idiopathic cardiomyopathy.

The OP-Rheometer system, a new device for analysis of viscosity and viscoelasticity of blood: description and clinical application

OP-Rheometer is a rotational viscometer of concentric type, which was developed to measure blood viscosity at low shear rate (0.2-40 sec-1) and viscoelasticity at 0.1-3.0 Hz in the context of clinical medicine. This system consists of a mechanical unit, a control unit (console), a data processing unit and a printer. The dynamic or steady state flow data are automatically printed out. An outer cylinder (sample container) is connected to a torsion wire assembly supported by a pair of magnetic bearings. The angular displacement is detected by a pair of variable differential transformers. In clinical application of this rheometer, authours have confirmed that the viscosity and viscoelasticity of blood from diabetic patients are higher than for normal subjects.