Father-son testicular malignancy. Does genetic anticipation occur?

Testicular malignancy in a father and son is reported. The father had sequential bilateral seminomas while the son had embryonal cell carcinoma and seminoma. Reported cases of father-son testicular malignancy are reviewed and a predominance of seminomas in the fathers is apparent while the sons' tumors are highly malignant teratomas, choriocarcinomas and embryonal cell carcinomas. The possibility of genetic anticipation in father-son testicular malignancy is discussed.

Advanced male non-seminomatous germ-cell tumours. Combination chemotherapy with cis-platinum, vinblastine and bleomycin

Nineteen men with advanced germ-cell tumours were treated with a combination of vinblastine, bleomycin and cis-diamminedichloroplatinum II (cis-platinum). One patient died nine days after starting chemotherapy. Seventeen patients responded to therapy (14 completely and three partially). Toxicity was very high, and three patients died of septicaemia during therapy. Eight patients remain in complete remission 36 to 80 weeks after starting chemotherapy.

Burkitt's lymphoma in Australia

Three patients with Burkitt's lymphoma have been seen at Royal Prince Alfred Hospital during the past 18 months. Following treatment, two patients are in complete clinical remission.

Treatment of small cell bronchogenic carcinoma with VM-26

VM-26 is active in small cell bronchogenic carcinoma even in patients resistant to previous chemotherapy. The overall response rate was 28%, with a response rate of 29% in patients resistant to previous chemotherapy. This response rate is similar to that obtained with other single agents including Adriamycin, vincristine, cyclophosphamide, and procarbazine. The mild subjective and objective toxic effects of the drug make it a potentially useful agent in the treatment of this tumor.

Combination chemotherapy with vincristine, bleomycin, and methotrexate for advanced head and neck cancers

Thirty-three patients with a histologically confirmed diagnosis of advanced squamous cell carcinoma of the head and neck were treated with a combination of vincristine, methotrexate, and bleomycin. The regimen was as follows: Day 1, vincristine (2 mg iv) and methotrexate (200 mg/m2 iv over 24 hours); Day 2, bleomycin (15 mg/day by iv infusion for 48 hours). Folinic acid rescue began 36 hours after the start of methotrexate. The regimen was repeated at intervals of 3 weeks. Toxicity was minimal but the overall response rate was only 24% (three complete responses and five partial responses) and the median duration of remission was only 16 weeks overall. The combination of vincristine, methotrexate, and bleomycin in this dosage schedule has a response rate lower than that reported with single-agent treatment of advanced head and neck cancers.

Thymidine sensitivity of cultured leukaemic lymphocytes

Cultured leukaemic lymphocytes from patients with T, null, or pre-B acute lymphoblastic leukaemia are shown to be highly sensitive to growth inhibition by thymidine. Thymidine sensitivity was correlated with reduced activity of the catabolic enzyme thymidine phosphorylase and sustained elevation of the deoxythymidine triphosphate pool after exposure to thymidine. It is suggested that thymidine may have a role in the management of certain acute lymphoblastic leukaemias of lymphomas.

Undifferentiated carcinoma in young men: the atypical teratoma syndrome

In 5 young men with apparent undifferentiated carcinoma involving lung, mediastinum, and lymph-nodes subsequent response to treatment, tumour-marker analysis, and histology review suggested a diagnosis of embryonal-cell carcinoma. It is suggested that atypical presentation of extragonadal germ-cell tumours may be common. Because such tumours respond to chemotherapy, accurate diagnosis is essential.

Cis-dichlorodiammine platinum (II) in advanced ovarian carcinoma

Twenty-seven patients with advanced ovarian cancer were treated with a total of 80 courses of cis-dichlorodiammine platinum (II) (cisplatin). The doses in three courses were less than 50 mg/m2, in 64 courses they were 50 mg/m2, and in eight courses they were 100 mg/m2. In addition, five courses of low-dose daily treatment (20 mg/m2 for five days) were administered. Twelve patients received cisplatin alone, 12 received cisplatin and cyclophosphamide (750 mg/m2), and three patients received cisplatin with other drugs. There were eight responders (33%) in the 24 evaluable patients. Renal toxicity occurred in four patients, ototoxicity in four, and leucopenia (which was life-threatening in one patient) occurred in 16 patients (white cell count less than 3.0 X 10(9)/L). There were two early drug-related deaths. The median survival of patients who responded to cisplatin treatment was longer than 30 weeks compared with nine weeks for non-responders.

Unknown primary adenocarcinoma: incidence of overinvestigation and natural history

Out of 1300 patients referred to a medical oncology unit, there were 87 with metastatic cancer in whom a primary tumour site was not evident from the history and after physical examination and chest radiography had been carried out. An analysis of the investigations performed in these patients and their results showed that in only eight of the 87 patients did non-surgical investigations at presentation determine the primary site. In two patients it was identified by diagnostic laparotomy, and in a further 13 clinical follow-up led to recognition of the primary tumour site before death. Few investigations should be performed in patients in whom the primary site is known since they have a low yield, and in our population identifying the primary tumour did not improve the outcome or alter management. Treatable tumours should be excluded, and this may be done in most cases by simple blood tests, particularly those measuring acid phosphatase activity and other tumour markers.

Evidence for a new mechanism of cytotoxicity of 1-beta-D arabinofuranosylcytosine

Inhibition of DNA synthesis by a pulse of 1-beta-D-arabinofuranosylcytosine (ara-C) results in reinitiation of DNA replication in DNA segments replicated earlier in that S phase and hence double replication of some DNA segments. Experiments were with tissue culture cell lines of human origin. DNA replicated early in S phase was labeled with a pulse of [3H]deoxycytidine with the cells pulsed later in S phase with ara-C. The DNA replicated after the time of the ara-C pulse was density labeled with 5-bromodeoxyuridine. Reinitiation of DNA replication in the already replicated [3H]DNA segments was demonstrated using CsCl density gradient analysis by an increase in the 3H label present in the light-heavy peak of semiconservatively replicated DNA. Also, in DNA of control cells, all of the 3H was in the same strand of the light-heavy DNA duplex as was the 5-bromodeoxyuridine, as shown by alkaline CsCl density gradient analysis of purified light-heavy DNA. However, after a pulse of ara-C, utilization of [3H]DNA strands as template strands was demonstrated by the presence of 3H label at the density of unsubstituted DNA chains in alkaline CsCl gradients of the purified light-heavy DNA. This double replication phenomenon can explain certain chromosomal abnormalities induced by ara-C.

Malignant haemangiopericytoma: case report and ultrastructural study

A case of a rapidly fatal malignant haemangiopericytoma arising in the deep tissues of the face is recorded. The histology of the tumour was anaplastic but otherwise typical. Ultrastructural study confirmed the diagnosis by revealing tumour cells with delicate interdigitating cytoplasmic processes and basement membrane formation resembling pericytes. A feature of the tumour not previously recorded in haemangiopericytoma was ciliogenesis.

Sequential pure red cell and megakaryocyte aplasia associated with chronic liver disease and ulcerative colitis

The clinical course of a patient with chronic hepatitis and previous ulcerative colitis who subsequently developed pure red cell aplasia (PRCA) is described. The PRCA remitted initially with corticosteroid therapy. A subsequent relapse responded to cyclophosphamide therapy following splenectomy. This was followed by a fatal third episode of red cell aplasia associated with megakaryocyte aplasia.

Incorporation of deoxynucleotides into DNA by diethylaminoethyldextran-treated lymphocytes

In the presence of diethylaminoethyldextran cultured human lymphocytes will utilize deoxynucleotides for the synthesis of DNA, whereas in the absence of diethylaminoethyldextran no incorporation of deoxynucleotides is detected. Labeled deoxynucleoside mono-, di-, and triphosphates are incorporated into DNA at approximately the same rate. Deoxynucleotide incorporation is essentially linear for 10 min but continues at a gradually diminishing rate for an additional 20 to 50 min. The initial rate of DNA synthesis is at least 20 to 40% of the in vivo rate, and in those cells that are in S phase 0.7-1.5% of the DNA is synthesized. By the three properties examined (restriction to S phase, semiconservative mode, and initial product in short chains), DNA synthesis in diethylaminoethyldextran-treated cells resembles DNA synthesis in vivo.

Peripheral vascular disease as a mode of presentation of pseudoxanthoma elasticum

Two men presenting with premature peripheral vascular disease and minimal risk for atherosclerosis were found to have pseudoxanthoma elasticum (PXE). Fluorescein angiography was found to be of potential value in the early recognition of angioid streaks and pseudoxanthoma elasticum. There was evidence of disruption of arterial elastic tissue which may contribute to atherogenesis in PXE. Management is presently limited largely to minimizing risk factors for atherosclerotic vascular disease.

Anemia of azaribine in the treatment of psoriasis

Azaribine is an effective agent in the treatment of psoriasis. In this investigation the extent of clinical dermatologic remission appeared to correlate with the degree of metabolic block induced by 6-azauridylic acid, as quantitated by the urinary excretion of orotic acid and orotidine, and the development of anemia. Following azaribine therapy there was a coordinate rise of the specific activities of erythrocyte orotate phosphoribosyltransferase and orotidine-5'-monophosphate decarboxylase. There was no correlation between the pretreatment activity of these enzymes and the clinical response to azaribine. The anemia of azaribine therapy was mile and of a megaloblastic type. Uridine effectively corrected the azaribine-induced anemia, but led to exacerbation of the patients' psoriasis. Following uridine therapy there was a reduction in the urinary excretion of orotic acid and orotidine, presumable reflecting end-product inhibition or repression of the first steps of a repeated pyrimidine biosynthesis.

Interconversion of different molecular weight forms of human erythrocyte orotidylate decarboxylase

Orotidylate decarboxylase has been purified approximately 300-fold from human erythrocytes. It was shown to exist in three molecular weight forms, a probable monomer of molecular weight 62,000, a dimer, and a tetramer. Conversion of the monomer to higher molecular weight forms was associated with increased stability to thermal inactivation and was promoted by a number of low molecular weight compounds, including orotic acid and competitive inhibitors of the enzyme. Orotic acid phosphoribosyltransferase co-purified with the decarboxylase but was much more susceptible to inactivation. The partially purified orotidylate decarboxylase showed a triphasic Lineweaver-Burk plot when examined over a wide range of substrate concentrations. The separated molecular weight forms gave linear double reciprocal plots with Km values corresponding to the three values obtained with the erythrocyte enzyme preparation. The values obtained were 25, 3, and 0.6 muM for the monomer, dimer, and tetramer forms, respectively.