[Morphology of 3,4,5,3',4'-pentachlorinated biphenyl-induced change in canine lung]

We investigated the light and electron microscopical changes of the lung in dogs treated with 3,4,5,3',4'-pentachlorinated biphenyl (PenCB). Beagle dogs were orally administered with 0.1 mg/kg of PenCB, and sacrificed 3, 5 and 7 weeks after the PenCB administration. Light microscopically, bronchiolar epithelial cells showed cytoplasmic vacuolization, which was most prominent 5 weeks after the PenCB administration. Electron microscopically, nonciliated bronchiolar epithelial cells (Clara cells) revealed degradation of glycogen particles, swollen, irregularly arranged smooth endoplasmic reticulum, and swollen mitochondria, while no significant change was found in other epithelial cells. The endothelial cells also showed no significant change except for increased number of cytoplasmic vesicles. This is a first report on halogenated hydrocarbon-induced degradation of glycogen particles in Clara cells.

[Fibrin deposition and fibrinolysis in the pathogenesis of pulmonary fibrosis]

Fibrin deposition is prominent in the course of several forms of pulmonary fibrosis. To elucidate the role of fibrin deposition and fibrinolysis in the process of pulmonary fibrosis, we studied bleomycin-induced fibrosis and the effect of urokinase on it. Beagle dogs were injected intramuscularly 20 times with bleomycin in doses of 2 and 6 mg/kg body weight every other day. Intravenous urokinase treatment was subsequently performed with 3,000 units daily for 40 days and 9,000 units twice daily for 70 days. Histopathologic examination of the lungs of dogs receiving bleomycin alone revealed fibrosis. The lungs of bleomycin-treated dogs which received urokinase had less severe fibrosis and this was confirmed by morphometry with planimetry and the point counting method. Urokinase treatment also diminished the increase of hydroxyproline content of the lung of bleomycin-treated dogs. Decrease of lung tissue fibrinolytic activity assayed by fibrin plate method in bleomycin-treated dogs was also prevented by urokinase. Intravenous urokinase, 24,000 units per day in divided doses, was administered daily in cancer patients with bleomycin treatment. Incidence of pulmonary fibrosis was decreased by urokinase. These data indicate that fibrin deposition and fibrinolysis may have an important influence on the fibrotic process in the lung.

Noninvasive superfusion of canine tracheal segment to study prostaglandin release in vivo

To be able to study the release of mediators from the canine trachea noninvasively in vivo, we modified an endotracheal tube to allow superfusion of the lumen of an isolated segment of trachea. We tested this apparatus by measuring prostaglandin E2 (PGE2) output in the presence and absence of a stimulant (bradykinin) and a blocker (indomethacin) and comparing the results with results of in vitro studies. We found that PGE2 output increased with time over the 180 min of the study. Bradykinin (10(-5) M) applied to the luminal surface increased PGE2 output markedly. Indomethacin (10(-5) M) decreased PGE2 and prevented the usual increase in PGE2 caused by bradykinin. These findings are qualitatively similar to those for in vitro experiments. We conclude that this apparatus can be used to measure the release of mediators from the trachea of dogs noninvasively in vivo.

Thrombosis-inducing activity found in plasma from two patients with advanced lung cancer

In 2 patients with lung cancer, the coagulation system was supposed to be activated by the findings of elevation of plasma fibrinogen, fibrinogen degradation product (FDP) and/or peripheral platelet counts. The plasma thromboxane B2 and 6-keto-prostaglandin F1 alpha levels in 1 patient were measured and proved to be 160 and 20 times higher than the control level, respectively. When 0.5 ml of plasma from each patient was given intravenously into Balb/c mice, the mice died within 5 min. The multiple thrombosis mainly composed of aggregated platelets and present in the lungs of these mice probably led to death of these animals. On the contrary, no such activity was found in plasma from healthy subjects or other patients with lung cancer who showed no manifestations of enhancement in the coagulation system.

[Autopsy cases of terminal pulmonary infections]

In order to clarify the present state of terminal pulmonary infections, all autopsy cases from 1976 to 1985 reported in the annual records of autopsy cases in Kyushu University Hospital were reviewed. Of the total of 2,238 autopsy cases, pulmonary infections were present in 1,042 (46.6%) and in 595 (26.6%) pulmonary infections were fatal. Among the primary diseases associated with pulmonary infections, hematologic diseases such as leukemia and malignant lymphoma, lung cancer, esophageal cancer and cerebrovascular disease were most frequent. The pathogens of fatal pulmonary infections occurring in autopsy cases were bacteria (26.6%), Aspergillus (3.2%), Candida (1.8%), cytomegalovirus (1.7%), Pneumocystis carinii (1.1%), Mycobacterium (0.9%), Cryptococcus (0.6%) and phycomycetes (0.1%). The incidence of non-bacterial, especially fungal, pulmonary infections has increased during the recent five-year period. Among the pulmonary infections associated with lung cancer in autopsy cases, mycobacteriosis occurred more frequently than fungal infection. The incidence of fatal mycobacteriosis was more frequent in cases receiving steroids than in those not receiving steroids. Antemortem diagnosis of pulmonary infections was made in only 4.6% and 26.3% of cases of non-bacterial infection and mycobacteriosis, respectively. There was no autopsy case diagnosed before death as aspergillosis, which most frequently occurred among the fungal pulmonary infections in autopsy cases.

Prognostic factors of stage I and II non-Hodgkin's lymphomas of the head and neck: the value of the working formulation and need for chemotherapy

From 1966 through 1984, 142 patients with early stage non-Hodgkin's lymphoma of the head and neck were treated. Histologic slides were reviewed and reclassified according to Rappaport's classification and the Working Formulation. Patients were clinically staged; 82 Stage I, and 60 Stage II. Five-year freedom from relapse was 53% for Stage I and 48% for Stage II patients with no statistically significant difference. No patients with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation relapsed. By univariate analyses, stage, primary site, the Working Formulation, Rappaport's classification, extent of radiation field, radiation dose, tumor bulkiness and addition of multiple-agent chemotherapy seemed to be prognostic factors for predicting relapse. Multivariate regression analyses (MVA) showed primary site and multiple-agent chemotherapy were independent prognostic factors. Tumor bulkiness provided marginal prognostic significance. Waldeyer's ring lymphomas fared better than nodal or extralymphatic lymphomas; it seems necessary to report Waldeyer's ring lymphomas independently from nodal or extralymphatic lymphomas. Patients receiving more than 3 chemotherapeutic agents had better prognosis than those receiving 3 or less agents, or no chemotherapy. Pathologic grade was another prognostic factor when the Working Formulation was used in MVA. When Rappaport's classification was used, division of unfavorable histologies into histiocytic and non-histiocytic groups provided only marginal significance in MVA. We conclude that Stage I-II non-Hodgkin's lymphomas of the head and neck with favorable histologies of Rappaport's classification or low grade malignancy of the Working Formulation be treated with radiation therapy only; and patients with other histologies should be treated with multiple-agent chemotherapy and radiation therapy.

Expression of Fc receptors is suppressed in alveolar macrophages from patients with sarcoidosis

To study the expression of Fc receptors in human alveolar macrophages (AM), the cells were collected from 12 healthy controls and 22 patients with sarcoidosis and the activity involved in binding to 125I-soluble immune complexes (IC) was investigated. The binding of 125I-IC was significantly suppressed in cells from the patients. A Scatchard plot analysis revealed that this suppression was due to a reduction in the number of Fc receptors on the surface membrane and not the result of a decrease in the binding affinity of the receptors. Rosette formation was observed by incubating AM with antibody-coated ox red blood cells. The presence of rosette forming cells was about 70% in the AM from healthy controls, while, a rate of only 50% was seen in those with sarcoidosis. These results indicate that the decrease of the 125I-IC binding in the AM from patients with sarcoidosis is to some extent the result of an increase in the population of the Fc receptor negative macrophages.

Physiological analysis of bicozamycin high-producing Streptomyces griseoflavus used at industrial level

Streptomyces griseoflavus, a bicozamycin-producing wild type strain and its high-producing one derived from it by multiple (greater than 15) mutagenic treatments, were analyzed physiologically and biochemically. The high-producing strain was characterized by: (1) An increased pool size of amino acids including leucine and isoleucine, precursors for bicozamycin synthesis, (2) an earlier and greater accumulation of intracellular ppGpp, (3) a more accentuated decrease in GTP pool size, (4) a higher specific activity of ornithine transcarbamylase which produces citrulline, (5) an increased ability to form aerial mycelium, and (6) an increased resistance to its own antibiotic. We propose that (1), (2) and (4) may be responsible for the high yields of bicozamycin and, possibly, of some other antibiotics produced by Streptomyces sp.

A possible role of airway epithelium in modulating hyperresponsiveness

1. In order to examine the role of airway epithelium in the responsiveness of smooth muscle in man, we measured the contractile responses to acetylcholine (ACh), histamine, and prostaglandin F2 alpha (PGF2 alpha) and the relaxation response to isoprenaline (Isop), in 48 bronchi obtained from 10 patients who received surgery. Responses were measured in the presence and absence of the epithelium. 2. Removal of epithelium (by rubbing the mucosa gently with forceps) significantly increased the contractile responses evoked by ACh, histamine and PGF2 alpha. 3. In contrast, removal of epithelium did not alter the relaxation response to Isop. 4. To clarify the mechanism underlying this epithelial inhibitory effect on smooth muscle contraction, we measured the contractile responses of dog trachea with the epithelium removed to increasing concentrations of ACh. After measuring the control response, we added about 0.1 g of the chopped epithelium in the organ chamber, and measured the response again. 5. After adding airway epithelium and incubating with tracheal strips, the contractile response of tracheal strips decreased significantly as compared to the control response. 6. These results show that airway epithelium possesses the ability to decrease the smooth muscle contraction to ACh, histamine and PGF2 alpha in man and dogs. 7. The mechanism of this inhibitory effect of the airway epithelium is not explained by a change in mechanical property of the airway nor the change in diffusion of these drugs to the smooth muscle across the epithelium. Thus, these results suggest that airway epithelium may have an important role in modulating smooth muscle tone, possibly by inactivation of these mediators, or by releasing an epithelium-derived relaxing factor.

Small airways disease in patients without chronic air-flow limitation

We measured airway diameter and quantitated airway pathology scores in respiratory bronchioles (RB) and membranous bronchioles (MB) in 37 patients undergoing resection for solitary pulmonary nodules. The patients had FEV1 greater than 75% of the predicted. Measurements of FEV1, nitrogen washout curve (delta N2/L), closing volume as a percentage of vital capacity (CV/VC%), and maximal flow at 50% of VC (V50) were made prior to surgery. There were 22 smokers and 15 nonsmokers. There were more MB per cm2 of tissue than RB (0.74 versus 1.02). The mean internal diameter for MB was 0.55 +/- 0.27 mm; for RB it was 0.47 +/- 0.15 mm. There were more MB greater than 1.0 mm in internal diameter than RB greater than 1.0 mm, and the mean diameter of MB was less than that noted in autopsy specimens. The total pathology scores for all airways were less than those found in Caucasian populations. Pathology scores were higher for MB than for RB, except for pigment deposition. Inflammation scores were higher in patients with FEV1 less than 100% predicted both for RB (p less than 0.05) and for MB (p less than 0.05). FEV1 values correlated with goblet cell metaplasia scores (p less than 0.05) for MB and with fibrosis (p less than 0.05), pigment deposition (p less than 0.05), and intraluminal macrophages (p less than 0.05) for RB. Tests specific for small airways (delta N2/L, V50, CV/VC%) did not correlate with the pathology scores.

[Increased anti-tumor activity of chemotherapeutic agents combined with direct current against murine transplanted tumors]

The antitumor activity of direct current was studied in mice which were transplanted fibrosarcoma (FSa) into the right thigh. Mice were inserted electrodes into tumor and normal tissue surrounding the tumor, and treated with constant current. The direct current therapy (D.C.T.) (0.6 mA, 120 min) alone was effective to regress tumor, but tumor was not eradicated by D.C.T. alone. Cyclophosphamide (CPA, 100 mg/kg) could markedly reduce the FSa tumor size, but all tumor regrew finally. When D.C.T. was combined with CPA (100 mg/kg), the therapeutic response of FSa tumor was enhanced in mice which were inserted cathode into tumor. For example, in mice receiving direct current (0.6 mA, 120 minutes), the cure rate was 70% compared with 30% by the anode in tumor. Using cure rate assay, D.C.T. and about half dose of CPA could give the similar treatment results as the full dose of CPA alone. That is, D.C.T. will be able to reduce the dose of chemotherapeutic agents. Combination of D.C.T. and doxorubicin was not so effective as CPA, but showed the similar results. The experimental results suggest that D.C.T. alters the drug distribution in the tumor and makes the drugs more effective.

Restoration of Fc receptor-mediated desensitization of superoxide generation in human PMN by PMA

The superoxide (O2-) generating activity of human polymorphonuclear leukocytes (PMN) was suppressed more than 50% compared with control cells by preincubation of the cells with soluble immune complexes (Fc receptor-mediated desensitization). The suppression was observed when wheat germ agglutinin (WGA) or N-formyl-L-methionyl-L-leucyl-phenylalanine (fMLP) was used as stimuli for O2- generation. However, the desensitized cells could produce as much O2- as control cells when they were stimulated with phorbol myristate acetate (PMA). The desensitized cells were pre-exposed to a small dose of PMA for a short period (2-3 min). By this procedure, the activity of the cells for WGA or fMLP induced O2- generation was almost completely restored. Similarly, the inhibitory effect of 3'-deazaadenosing on WGA, fMLP or immune complexes (IC) induced O2- generation was abolished by the short-term pre-exposure of the cells to a small dose of PMA.

Superoxide (O2-) assay monocyte adherence test for the detection of cell-mediated immunity in cancer patients

The reactivity of mononuclear cells from patients with breast cancer to the 3 M KCl extract of breast tumor was tested using the superoxide (O2-) assay monocyte adherence test. The mononuclear cells were incubated with the 3 M KCl extract of breast tumor or normal breast tissues in a microcell for spectrophotometer analysis. After 2 h incubation, the nonadherent cells were removed, and the O2- generated from the monocytes adherent to the intersurface of the microcell was assayed. Thirty of 36 patients with breast cancer before treatment reacted to the extract of breast tumor. Sixteen patients showed adherence inhibition and 14 adherence stimulation. None of 8 patients with breast cancer reacted to the extract of lung tumor. Of 31 control donors (19 healthy volunteers and 12 patients with cancer of other organs), only 3 reacted to the extract of breast tumor.

Value of gallium scans and lymphangiography in non-Hodgkin's lymphoma of the Waldeyer's ring

In 37 patients with seemingly localized non-Hodgkin's lymphoma of the Waldeyer's ring (WR-NHL), lymphangiography (LAG) and/or gallium-67 scans (Ga-67 scans) were done. Before these procedures, 20 patients were diagnosed as Stage I, and 17 as Stage II. LAG was done for 30, and Ga-67 scans for 32, 25 of whom had both. Five patients (16%) were upstaged to Stage III or IV by Ga-67 scans. Only one (3%) had abnormal LAG findings, in whom Ga-67 scans also showed abnormal accumulation in the para-aortic region. Because of this low positive rate, LAG is not recommended for staging of WR-NHL.

Acute and chronic polyarthritis induced by an aqueous form of 6-O-acyl and N-acyl derivatives of N-acetylmuramyl-L-alanyl-D-isoglutamine in euthymic rats and athymic nude rats

The analogs of N-acetylmuramyl-L-alanyl-D-isoglutamine (MDP), 6-O-stearoyl-MDP (L18-MDP), and N-(N-acetylmuramyl-L-alanyl-D-isoglutaminyl)-N-stearoyl-L-lysine (MDP-Lys-L18) and N-(2-tetradecylhexadecanoyl)-MDP (B30-MDP) induced acute polyarthritis in both euthymic rats and in athymic nude rats after a single or multiple systemic administrations of their aqueous forms; water-in-oil emulsions did not induce acute polyarthritis. MDP and the adjuvant-active analogs MDP-O-nBu (MDP butyl ester), N-(3-hydroxy-2-docosylhexacosanoyl)-MDP (BH48-MDP) and the adjuvant-inactive analogs [L18-MDP (L)] or MDP-Lys-L18 (L), which is 6-O-stearoyl-N-acetylmuramyl-L-alanyl-L-isoglutamine, or N-(N-acetylmuramyl-L-alanyl-L-isoglutaminyl)-N-stearoyl-L-lysine, did not induce disease, at the dosages used. Histological examination of the acute exudative inflammatory reactions around joints revealed hypertrophy of both synovial villi and tendon sheath, infiltration of polymorphonuclear leukocytes (PMN) and fibrin deposition of the affected joint spaces. Most of these lesions rapidly subsided after cessation of the adjuvant injections. During multiple systemic injections of acyl-MDPs, this acute arthritis became chronic in euthymic rats but not in athymic nude rats; the chronic polyarthritis consisted of mononuclear cell infiltration and proliferation of the connective tissue growth and severe new bone formation of the shaft of the bone. It remains uncertain whether chronic polyarthritis results from the repeated flare of acute inflammatory reactions to the continuing stimulation of the adjuvants or whether it may require some immunologic process to such exogenous substances as bacterial fragments or autoantigens modified by exogenous substances such as type II collagen.