The heterogeneity of target recognition by lymphokine-activated killer precursor cells

Lymphokine-activated killer (LAK) cells were generated from peripheral blood lymphocytes (PBL) that were depleted of mature cytotoxic natural killer (NK) cells. PBL NK activity was abolished by pretreatment of effector cells with the toxic lysosomotropic agent L-leucine methyl ester (LME) or by depletion of effector cells by K562 monolayer absorption (MA). Both treatments markedly reduced the proportion of cells expressing NK-associated markers such as CD 16 (Leu 11b, B73.1), Leu 7, and NKH-1 (Leu 19), whereas these treatments had minimal effects on cells expressing T cell markers (CD 3, CD 4, and CD 8). LME and MA also drastically decreased the proportion of K562 target-binding lymphocytes. LAK activity against NK-sensitive and NK-resistant targets can be generated from the NK cell-depleted PBL by incubation with interleukin-2. Peak LAK activity generated from MA-treated PBL was later than the peak of LAK activity generated from either untreated or LME-treated PBL. Although MA of PBL on NK-resistant S4 sarcoma targets had little effect on NK activity, LAK activity against both K562 and S4 targets was reduced. These results suggest that there are at least three LAK precursor subpopulations in PBL: mature NK cells that can bind and kill K562 targets (LME-sensitive and MA-sensitive); "pre-NK" cells that can bind but cannot kill (LME-resistant and MA-sensitive); and non-NK cells that cannot bind and cannot kill K562 targets (MA-resistant).

Impairment of CO2 reactivity in severe head injury patients: an investigation using thermal diffusion method

For measurement of the cerebral blood flow (CBF) the thermal diffusion method is quite convenient and allows the chronological measurement of CBF and CO2 reactivity of cerebral vessels. We investigated the CO2 reactivity of fifteen head injury patients. The results showed that in head injury cases, the disturbance of the CO2 reactivity correlates well to poor outcome. Using thermal diffusion method, investigations of CO2 reactivity are useful for further understanding of the physiological state of head injury patients.

Positron emission tomographic studies on cerebral hemodynamics in patients with cerebral contusion

Positron emission tomography is currently one of the most useful methods for measurements of cerebral hemodynamics and oxygen metabolism, because it facilitates accurate analysis of the local cerebral circulation in three-dimensional quantitative images. In this study, we performed positron emission tomography studies to measure cerebral circulation in a total of 11 patients who sustained head injuries with contusion. Several parameters were measured including regional cerebral blood flow, regional cerebral blood volume, permeability, and regional cerebral metabolic rate for oxygen. Data from brains both with and without contusion were analyzed for chronological changes, in the subacute stage from the 8th to 29th day and in the chronic stage until 360 days after the injury and compared with similar data in a group of normal subjects. It was concluded that in the subacute stage, regional cerebral blood flow decreased (26 +/- 7 and 39 +/- 10 ml/100 g/min) and regional cerebral blood volume increased (5.6 +/- 1.8 and 5.4 +/- 0.9 ml/100 g) both in areas of cerebral contusion and in areas remote from cerebral contusion and that permeability increased in areas of contusion but not in remote brain areas. In the chronic stage, these parameters showed a tendency for recovery.

Double intracranial tumours of maldevelopmental origin--teratoma at the pineal region and an epidermoid cyst in the fourth ventricle

A 21-year-old man with double intracranial tumours of maldevelopmental origin, teratoma at the pineal region and an epidermoid cyst in the fourth ventricle, is reported. The tumours were removed totally by multiple operations; the epidermoid cyst was resected by suboccipital craniectomy with the patient in prone position and the teratoma was removed via occipital transtentorial approach with the patient in sitting position. Maldevelopmental tumours located within the cranial cavity with different histological types such as the present case have not sofar been described. Histogenesis of these tumours is confusing because teratoma often contains tissues of epidermoid cyst. Etiological considerations for these tumours are presented and appropriate operative procedures for tumours simultaneously occurring in the pineal and the fourth ventricle are also discussed.

Treatment of multiple intracranial aneurysms in the anterior circulation--case report

A 69-year-old female underwent surgery for subarachnoid hemorrhage due to a ruptured intracranial aneurysm. Nine additional aneurysms were found. Four of the latter nine aneurysms were clipped in a second operation, and two were wrapped.

Intimal fibroelastic thickening--its etiological significance in juvenile cerebral infarction. Case report

Recurrent occlusive stroke of the vertebrobasilar system is reported in a 16-years-old man. Multiple arterial occlusions, segmental stenosis, or irregular dilatation were found in the angiography involving both the intra- and extracranial vertebro-basilar arteries. Surgical specimen of the extracranial vertebral artery with localized irregular lumen disclosed fibroelastic thickening of the intima with mural thrombus, which were thought to be an embolic source. Etiological significance of this intimal lesion in juvenile cerebrosvascular accident is discussed.

Stimulation of rat liver growth by a 1,3-dithiole derivative, KZ-1026

The oral administration of 2-(1,3-dithiol-2-ylidene)-1-phenyl-1,3-butanedione (KZ-1026) to normal rats at doses of 50, 100 and 200 mg/kg/day for 3 days accelerated liver enlargement in association with a dose-dependent increase in the total amounts of protein, RNA and DNA in the liver. The liver weight at 24 hr after the third dose of 200 mg/kg reached 174% of the control. With respect to the effect on liver enlargement, KZ-1026 differed from phenobarbital, since KZ-1026, unlike phenobarbital, increased hepatic DNA content without significant effects on P-450 and aminopyrine-N-demethylase. Incorporation of [3H]thymidine into liver DNA was stimulated by a single dose of KZ-1026 (200 mg/kg), and it peaked at 24 hr post dose (18 times the control), followed by an increase in the number of liver nuclei. Liver growth was also accompanied by an increasing hepatic reserve cell mass, expressed by the capacity of eliminating exogenous galactose from the blood stream. Pretreatment with KZ-1026 (200 mg/kg/day) for 3 days significantly improved the survival rate of subtotally hepatectomized rats from 39% to 78%. These findings indicate that KZ-1026 accelerates hepatocyte proliferation, resulting in an enhancement of liver functional mass in normal rats.

Magnetic resonance imaging of brain contusion

In this study we investigated the time course of brain contusions using magnetic resonance imaging and compared the findings with those of a computed tomography scan. The lesions, which were demonstrated as homogeneous density areas on the computed tomography scan were demonstrated as different intensity areas in the magnetic resonance image. The intensity of the images varied according to the time at which the images were obtained. The findings indicated changes in the nature of the contusions including hematoma hemoglobin, perifocal edema extension, and so on. In conclusion, magnetic resonance imaging is important in the follow-up of chronological change as well as in original diagnosis of brain contusions.

CT demonstration of massive cerebral air embolism from pulmonary barotrauma due to cardiopulmonary resuscitation

A 77-year-old man with loss of consciousness, circulatory collapse, and apnea caused by myocardial infarction underwent cardiopulmonary resuscitation with intratracheal intubation and manual bag ventilation. Computed tomography of the head demonstrated massive air embolism in the entire cerebral circulation. The patient was diagnosed as brain dead the next day. Demonstration of massive cerebral air embolism on head CT is presented.

[Preventive effect of KZ-1026 on acute liver injury induced by CCl4 in rats: histochemical, enzyme-histochemical and ultrastructural studies]

The preventive effect of KZ-1026 on acute liver injury induced by CCl4 in rats was evaluated histochemically, enzyme-histochemically and ultrastructurally. Rats that received 50% CCl4 (2 ml/kg) intraperitoneally were sacrificed at 3, 7 and 24 hr. Remarkable reductions in hepatic glycogen, RNA and G-6-Pase activity were observed in the centrilobular area at 3 hr, and ballooned cells appeared in the mid-zone at 7 hr. At 24 hr, the above histochemical parameters in the hepatocytes of the centrilobular area and mid-zone were extensively reduced, while the number of ballooned cells in the mid-zone was increased. KZ-1026 (200 mg/kg) was given orally at 24 and 4 hr before, simultaneously with or 3 hr after CCl4 treatment, and each rat was sacrificed at 24 hr after CCl4 administration. Pretreatment with KZ-1026 24 hr before CCl4 administration prevented reduction of RNA, glycogen and G-6-Phase activity, as well as disruption of rER and proliferation of sER due to CCL4 toxicity. This preventive effect of KZ-1026 was reduced by posttreatment; however, only the decrease in cytoplasmic RNA was well prevented. These results suggested that KZ-1026 is protective against CCl4-induced acute liver injury.

Extensive spinal necrosis with spinal leptomeningeal dissemination of cerebral astrocytoma. Case report

A 58-year-old male with malignant astrocytoma in the right parietal lobe developed ascending spinal dysfunction 15 months after subtotal resection of the primary lesion. He was treated by postoperative radiation and combined chemotherapy. Autopsy revealed extensive spinal necrosis affecting the level below the lower cervical region. Microscopic examination demonstrated diffuse leptomeningeal metastasis of glioma cells to the whole spine. There was no previous report in the literature of massive myelomalacia attributable to leptomeningeal dissemination an astrocytic supratentorial tumour. Clinical and neuropathological findings suggested that disturbance of venous drainage of the spinal cord might be responsible for myelomalacia in this case.

Immunotherapy of solid tumor by intratumoral infusion of lymphokine-activated killer cells

Fifty million lymphokine-activated killer (LAK) cells were infused into rat T9 gliosarcoma tumors for 1 hr at an infusion rate of 0.1 ml/hr. Cultured normal spleen cells were infused into similar tumors as a control. The LAK cell-treated tumors began to regress at approximately 3 weeks after infusion and disappeared by 6 weeks, while the cultured normal spleen cell-treated tumors grew progressively. Immunohistochemical analysis demonstrated prominent infiltration of cytotoxic/suppressor T cells in the LAK cell-treated tumors, while few lymphocytes were recognized in the control tumors. These data suggested that LAK cells infused intratumorally might be capable of mediating tumor regression by inducing host immunity against the tumor.

Functional analysis of mononuclear cells infiltrating into tumors. III. Soluble factors involved in the regulation of T lymphocyte infiltration into tumors

We have analyzed the mechanisms controlling the accumulation of T lymphocytes in tumor tissues. Spleen cells, left or right popliteal lymph node cells, and tumor-infiltrating cells were obtained from tumor-inoculated rats and were cultured for 24 h. Culture supernatants were obtained and assessed for lymphocyte migration factor (LMF) activity with the use of a modified Boyden chamber. We found that tumor-infiltrating cells derived from T-9-sensitized rats produced LMF. Two waves of LMF production were observed. The first wave of LMF production was detected between 6 and 12 h (LMF-a) and the second wave of LMF production was detected between 4 and 6 days (LMF-4d and -6d) after tumor inoculation. The tumor-infiltrating cells consisted of heterogenous cell populations. We found that only tumor-infiltrating neutrophils of T-9-sensitized rats produced LMF-a. Five peaks of LMF (A through E) were detected upon fractionation of LMF-a using Mono Q anion exchange column chromatography. Peak D exhibited the strongest activity. The action of peak D was chemotactic, but not chemokinetic. The m.w. of peak D was 33,000 and 70,000. Only W3/25 (+) (helper/inducer) T cells were found to be sensitive to peak D. The production of LMF-a by purified tumor-infiltrating neutrophils in vitro is in agreement with the histologic observation that the infiltration of neutrophils precedes the appearance of W3/25 (+) T cells in tumor tissues of T-9-sensitized rats. It is thus likely that peak D of LMF-a is responsible for the infiltration of T lymphocytes into tumor tissues.

Functional analysis of mononuclear cells infiltrating into tumors. III. Soluble factors involved in the regulation of T lymphocyte infiltration into tumors

We have analyzed the mechanisms controlling the accumulation of T lymphocytes in tumor tissues. Spleen cells, left or right popliteal lymph node cells, and tumor-infiltrating cells were obtained from tumor-inoculated rats and were cultured for 24 h. Culture supernatants were obtained and assessed for lymphocyte migration factor (LMF) activity with the use of a modified Boyden chamber. We found that tumor-infiltrating cells derived from T-9-sensitized rats produced LMF. Two waves of LMF production were observed. The first wave of LMF production was detected between 6 and 12 h (LMF-a) and the second wave of LMF production was detected between 4 and 6 days (LMF-4d and -6d) after tumor inoculation. The tumor-infiltrating cells consisted of heterogenous cell populations. We found that only tumor-infiltrating neutrophils of T-9-sensitized rats produced LMF-a. Five peaks of LMF (A through E) were detected upon fractionation of LMF-a using Mono Q anion exchange column chromatography. Peak D exhibited the strongest activity. The action of peak D was chemotactic, but not chemokinetic. The m.w. of peak D was 33,000 and 70,000. Only W3/25 (+) (helper/inducer) T cells were found to be sensitive to peak D. The production of LMF-a by purified tumor-infiltrating neutrophils in vitro is in agreement with the histologic observation that the infiltration of neutrophils precedes the appearance of W3/25 (+) T cells in tumor tissues of T-9-sensitized rats. It is thus likely that peak D of LMF-a is responsible for the infiltration of T lymphocytes into tumor tissues.

Diurnal changes in vasopressin and oxytocin levels in cerebrospinal fluid of post-operative patients with intracranial aneurysms

Diurnal changes in vasopressin and oxytocin levels in cerebrospinal fluid were investigated under normal diurnal conditions. The patients examined had ruptured intracranial aneurysms, and underwent neck-clipping operations and continuous drainage from the basal cistern. All of the patients recovered consciousness without signs of neurological deficit. The investigations were conducted for 2 days starting 5-9 days after the neck-clipping operations were performed. The oxytocin concentration decreased as night fell, remained low during this period and then increased during the day. The vasopressin level demonstrated no definite rhythmic tendency. No correlation was revealed between the changes in the concentrations of either vasopressin or oxytocin in the cerebrospinal fluid and the osmolality.

[Traumatic posterior fossa hematoma]

The traumatic posterior fossa hematoma was regarded as relatively rare thing, but recently, as the result of the prevalence of CT scanners, the number of reported cases is increasing. We report nine cases of traumatic posterior fossa hematoma. We divided into two categories: one was the acute epidural hematoma, the other was the acute subdural hematoma with cerebellar contusion. Five were cases of the acute epidural hematoma, three were cases of the acute subdural hematoma with cerebellar contusion and a case had both an epidural and a subdural hematoma. All the cases had struck the occipital region and had the occipital bone fracture. The prognosis of the five cases of the acute epidural hematoma was excellent, but that of the four cases of the acute subdural hematoma with cerebellar contusion was poor and they all died inspite of the removal of the hematoma executed in three cases. We estimated that the hitting forth was extremely strong in cases of the subdural hematoma with cerebellar contusion, and that the momentary deformity of the occipital bone might injure the cerebellum directly. Once a hematoma was produced in the posterior fossa, it oppresses the brainstem and causes the acute hydrocephalus, so the state of consciousness and respiration deteriorate suddenly. In cases of the acute epidural hematoma, appropriate surgical intervention could save the patients and resulted in good outcome. But in some cases of the fulminant type acute epidural hematoma of the posterior fossa caused by tearing the sinuses, though we have not experienced, patients die before the diagnosis and treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of rat T cell subset antigen by monoclonal antibody

6B2-B8 T cell hybridoma cells were used to immunize mice, and immune spleen cells were fused with NS/1 myeloma cells. One clone, designated RTH-7, reacted with 89.5% of rat thymocytes, 30.2% of rat spleen cells, and 42.3% of rat lymph node cells. The RTH-7 reacted with a subset of rat T cells but not with B cells. Double staining analysis demonstrated that RTH-7 stained a rat T cell subset distinct from R1-10B5-positive cells that were known to be equivalent to mouse Lyt-2. It was revealed that RTH-7 and W3/25 recognize different antigenic epitopes on the same molecule. The RTH-7 as well as W3/25 substantially inhibited the production of interleukin 2 by cells in mixed lymphocyte reaction and the lymphocyte proliferation induced by mixed lymphocyte reaction. The RTH-7 inhibited the lymphocyte proliferation induced by Con A whereas W3/25 failed to do so. The RTH-7 defined antigen has a molecular weight of 53,000 under reducing condition and 47,000 under nonreducing condition. The RTH-7 defined antigen showed a wide range of heterogeneity in pI (6.2-8.8). The associated molecule of approximate molecular weight of 27,000 was occasionally detected with the RTH-7 defined antigen in 6B2-B8 T cell hybridoma cells as well as peripheral T cells but not in thymocytes. Thus, RTH-7 detects a cell surface antigen of a functional T cell subset of rat origin.

[A case of persistent trigeminal artery aneurysm treated by proximal obliteration of feeding vessels in both intra- and extracranial compartments]

The authors described a case with a saccular aneurysm of the persistent trigeminal artery (PTA) treated with intra- and extracranial proximal obliteration of the feeding arteries. PTA aneurysm is a rare disorder found only 14 cases in the literature. There have been only 4 cases treated by surgical procedure; 2 underwent direct surgery and the remaining 2 had carotid ligation. Both of the cases treated by direct obliteration of the aneurysm sustained diplopia and sensory disturbance around the orbit as postoperative neurological deficits. We thought another choice of treatment to reduce the risk of rupture of the aneurysm avoiding postoperative complications. Clinical presentation of the present case was rt-oculomotor palsy, which disappeared before the operation. Cerebral angiography disclosed an intracavernous sinus aneurysm with a broad neck arising from the rt-internal carotid-PTA junction. Bilateral posterior cerebral arteries were perfused by the rt-internal carotid artery was compressed manually, lt-vertebral angiography showed the aneurysm and the internal carotid artery simultaneously via the PTA as retrograde filling. Because the direct surgery might cause damage to the cranial nerves passing through the cavernous sinus, we employed proximal obliteration of the feeding vessels. The operation was done by the following steps: ligation of the cervical portion of the rt-internal carotid artery, rt-superficial temporal artery-middle cerebral artery anastomosis, clipping of the PTA at the basilar side.(ABSTRACT TRUNCATED AT 250 WORDS)

Value of high-resolution computed tomography in diagnosis of petrous bone fracture

High-resolution computed tomography (CT) was performed on 31 patients clinically suspected of having petrous bone fracture. The location of the fracture was demonstrated accurately in 28 patients (90.3%), whereas it could be diagnosed by plain skull film in only 17 patients (54.8%). The anatomic location of fractures demonstrated by high-resolution CT clearly corresponded to the clinical symptoms and signs. We have classified petrous bone fracture into five types according to the anatomic levels demonstrated on CT images. The findings indicate that high-resolution CT is extremely useful for diagnosing petrous bone fracture.

Rapidly growing aneurysm

A rare case of rapidly growing intracranial aneurysm is reported. The enlarged aneurysmal wall was extirpated and studied histologically. The cause of the rapid growth of the aneurysm is discussed.