Immunohistochemistry of carcinoembryonic antigen, secretory component and lysozyme in benign and malignant common bile duct tissues

An immunoperoxidase technique has been utilized for the localization of carcinoembryonic antigen (CEA), secretory component (SC) and lysozyme ( LZ ) in normal and cancerous common bile duct tissues. Little or no CEA was found in the non-cancerous common bile duct tissues. SC was found in the surface epithelium and accessory gland epithelium and LZ was demonstrated only in the accessory glands. Some inflammatory cells were also positively stained for LZ . In adenocarcinoma, CEA was always present on the luminar border of the carcinoma cells, occasionally with intercellular and intracellular localization. LZ was absent, or only faintly detected in carcinoma. SC was generally distributed in well-differentiated adenocarcinoma cells, but showed a reduced intensity of staining with progressive dedifferentiation. These findings suggest that CEA, SC and LZ could be useful markers providing valuable information in the pathological diagnosis of bile duct carcinoma.

Abnormal alveolar cells in monocrotaline induced pulmonary hypertension

Monocrotaline given to rats causes lung injury which is followed by pulmonary hypertension. A large, abnormal intraalveolar cell has been repeatedly observed. The purpose of the present study was to define the nature of the cell and to determine how it related to the lung injury. As observed by electron microscopy, the intraalveolar cell contained numerous large, dense granules, as well as lipid whorls, extensive Golgi complexes, and many small vesicles. These cells appeared to be macrophages, possibly altered by ingestion of lipid-like material which was free in the alveolar space. Enlarged type II pneumonocytes and mast cells were seen in the alveolar walls but their appearance differed from that of the free alveolar cells. The electron microscopic findings plus the presence of Fc and C3b receptors on the cells indicated they were alveolar macrophages. When the severity of pulmonary hypertension was varied by a) giving monocrotaline to rats of varying age, b) by varying the dose of monocrotaline, or c) by varying the time interval after monocrotaline administration, the number of abnormal alveolar macrophages related to the severity of the pulmonary hypertension. When we reduced the number of circulating leukocytes by whole body radiation, monocrotaline administration was followed both by accelerated pulmonary hypertension and increased numbers of abnormal alveolar macrophages. The abnormal macrophage appeared to be a marker of the monocrotaline induced pulmonary hypertension. However, neither the abnormal macrophage nor the monocrotaline injury appeared to depend on circulating leukocytes.

Observation of "tear-drop" fracture-dislocation of the cervical spine by computerized tomography

Five cases of "tear-drop" fracture-dislocation of the cervical spine was examined radiologically. Examination by CT scan showed a transverse fracture line in the compressed vertebral body in all cases. In three of five cases, a mid-sagittal fracture line was accompanied by this transverse fracture. Comparing these two types of fracture with neurological complications, severe complications were found among the cases having both fracture lines. On the other hand, the conventional radiographs could not show the relationship between the degree of narrowing of the spinal canal and the severity of complication.

[High-dose combination chemotherapy with autologous bone marrow transplantation in breast carcinoma]

Twelve patients with breast carcinoma were treated with high-dose combination chemotherapy supported by autologous bone marrow transplantation (ABMT). Seven of them had advanced metastatic disease and received 12 cours of A treatment, response rate (CR +PR) was 71.5% (CR: 1, PR: 4, NC: 2 and PD: 0) and it should be noted that all 4 patients who had received adriamycin 150 mg+5-fluorouracil 1,500 mg divided in two consecutive days or equivalent high-dose of other chemotherapeutic regimen responded (CR: 1 and PR: 3). To the therapy Five other patients received ABMT-supported adjuvant chemotherapy because of high risk of recurrence. One of them died of unrelated cause and other 4 are free of disease at 11, 14, 17 and 17 months following this treatment. A major toxicity was of myelosuppression and nadirs of neutrophils were 100-1,800 on days 9-19 (median: 400 on day 12), neutrophils recovered rather rapidly to levels of greater than or equal to 1,000, greater than or equal to 1,500 and greater than or equal to 2,000 by day 15, 16 and 17, respectively. High-dose combination chemotherapy with ABMT seemed quite effective in advanced breast carcinoma and a similar approach in adjuvant setting has also been suggested.

Lung vessel leak precedes right ventricular hypertrophy in monocrotaline-treated rats

Monocrotaline induces microvascular leak and pulmonary hypertension in rats. We have hypothesized that the leak is related in some way to the pulmonary hypertension and precedes it. In rats given 40 mg monocrotaline/kg body wt subcutaneously, lung wet weight-to-dry weight ratios and lung albumin content began to increase within the first 3 days and became maximal at 1 wk. Alveolar lavage fluid showed little or no increase in protein. Right ventricular hypertrophy increased progressively from 2 through 3 wk. An increase in lung dry weight paralleled the right ventricular hypertrophy. The amount of blood retained in the lung did not account for the increased lung water, albumin, or weight. We considered that microvascular leak without leak into the alveolar space preceded pulmonary hypertension, right ventricular hypertrophy, and increased lung dry weight. In rats not given monocrotaline but exposed for 3 wk to hypobaric hypoxia, lung albumin, lung dry weight, and right ventricular weight increased. Increased lung dry weight probably reflects hyperplasia of lung cells. If so, an association of microvascular leak, lung cell hyperplasia, and right ventricular hypertrophy may occur in both monocrotaline- and hypoxia-induced pulmonary hypertension.

High-dose chemotherapy supported by autologous bone marrow transplantation in solid tumors

High-dose chemotherapy supported by autologous bone marrow transplantation (ABMT) was given 34 times on twenty six patients with solid tumor. Excluding 6 patients with adjuvant use and 2 patients with non-evaluable lesion, the response rate (CR + PR) of 44.4% was observed among 18 evaluable patients with advanced solid tumor. The results seem to be quite significant since many of the patients had become refractory to conventional treatments and intensity of chemotherapy was still moderate in some of the patients. ABMT following a course of chemotherapy is a promising approach of overcoming the toxic limitations of intensive chemotherapy since a dose-response relationship exists in many situations of cancer chemotherapy and ABMT appears to prevent fatal myelosuppression.

A case report of congenital hypomyelination

A 3 year, 11 month-old Japanese male with congenital hypomyelination is described. Clinical features are delay of motor development, generalized muscle hypotonia and weakness, absent tendon reflexes due to peripheral neuropathy, and normal mental development. Electrophysiologically, nerve conduction velocities could not be measured. Histological examination of the right sural nerve revealed total of absence myelin of most of the myelinated fibers. Electronmicroscopically, there was a concentric network of lamellae formed by double-layered sheets of basement membranes with fragments of Schwann cell cytoplasm around the myelinated fibers, so called "onion-bulbs". These peculiar features were similar to those in the cases reported by Lyon, (1969); Kennedy et al., (1977); Karch et al., (1975); and Anderson et al. (1973).

Antiepileptic effects of clobazam in children

Many benzodiazepines used as anticonvulsants have nitrogen radicals in positions 1 and 4. Clobazam has nitrogen radicals in positions 1 and 5. We studied the antiepileptic effect of clobazam in 36 patients with intractable epilepsies in childhood. Their ages were 1 year 1 month to 16 years 5 months (mean 8 years). The mean initial dose was 0.33 mg/kg of daily doses and increased up to 0.71 mg/kg. Nine cases (primary generalized epilepsy 2/2, secondary generalized epilepsy 7/29) were completely free from seizures, and another 9 (secondary generalized epilepsy 8/29, partial epilepsy 1/5) experienced a decrease of 50% or more in seizure frequency. Seizure frequency did not change in 16, and increased in the other 2 (secondary generalized epilepsy 2/29). The antiepileptic effects were observed on the first day to 10th day after clobazam treatment. There were recurrences of seizures in 4 out of 9 patients with complete control of seizures, 1 month alter in 3 and 10 months later in one. Mean serum clobazam level of 7 improved cases was 73 ng/ml and that of 3 cases with no response was 94 ng/ml. Although mild clinical side effects such as drowsiness were observed transiently in 17 cases, no abnormality was found in laboratory investigations performed.

Cerebral blood flow changes in orthostatic dysregulation fainters

The changes in blood flow of both the internal carotid and the vertebral artery during orthostatic test with or without fainting attack were studied in 25 healthy children and 30 patients with orthostatic dysregulation (OD). In healthy children and non-fainted OD patients, no change in blood flow occurred in either the internal carotid artery or the vertebral artery during orthostatic test. On the other hand, a significant decrease in blood flow of the internal carotid artery and/or the vertebral artery occurred during fainting of OD patients. These data suggest that three mechanisms might be involved in fainting of OD patients; a decrease in blood flow of the internal carotid artery, the vertebral artery and a decrease in blood flow of both these arteries.

Endonasal findings using a fiberoptic telescope in postoperative cases of chronic sinusitis

It is the purpose of this study to investigate the healing process in chronic sinusitis by means of a fiberoptic telescope. The patients were divided into 3 groups, in which various combinations of operative techniques were used. Group 1:53 patients with moderate chronic sinusitis. In this group endonasal ethmoidectomy and endonasal exposure of the sphenoidal sinus were performed. Group 2:73 patients with moderate or severe sinusitis. In this group a Caldwell-Luc operation was added to the operations which were used in group I. Group 3:8 patients, in which only endonasal ethmoidectomy was performed. In most cases, the maxillary sinus was cured, but in some of the cases the drainage opening was closed at an early stage. The epithelization of the ethmoidal sinus is mostly completed in about one month after the surgical operation. Adhesions between middle turbinate and lateral wall were seen regularly. Hypertrophic scars were observed in the posterior ethmoid, the ethmoidal roof and the lamina papyracea. We classified the healing process into 4 types. All postoperative infections were treated by antibiotics. Adhesions and scar tissue formations were treated endoscopically.

The PFD test for pancreatic disease patients

The PFD test was performed on various pancreatic disease patients. The urinary PABA excretion rate was significantly lower in chronic pancreatitis patients and in pancreatic carcinoma patients than in the controls, but no difference was observed between PABA excretion in the two diseases. After surgery, PABA excretion values of pancreatic carcinoma patients were significantly lower than those of non-pancreatitis non-pancreatic carcinoma patients. This was thought to be caused by the difference in residual anastomosed pancreatic tissues. Mild to severe pancreatitis, fibrosis and/or fat necrosis were seen in the pancreatic tissues of carcinoma patients, but these changes were minimal in non-pancreatitis non-pancreatic carcinoma patients. The PFD test is useful in detecting decreases in pancreatic exocrine functions or measuring the grade of pancreatic disorders in various pancreatic diseases, although it can not be used to differentiate pancreatic diseases.

The diagnosis of the gastric cancer by radionuclides and their labels, using catheter-type semiconductor radiation detector (CASRAD)

New method of differential diagnosis of gastric cancer was reported. After intravenous 32P administration, lesion was counted by small catheter-type readiation detector system under gastrofiberscopic direct vision control. Optimum counting time was examined in man and it was found to be between 20 to 50 hours after intravenous administration of 32P. Under the currently available technology of miniature detector, still beta-emitting carcinopohilic agent was found to be the agent of choice to this end, since gamma-emitting carcinophilic agents can not provide data originated only from the gastric mucosa in question.

Neuronal depletion of cerebellum in late infantile metachromatic leukodystrophy

The cerebellums of two children with late infantile metachromatic leukodystrophy were investigated by light and electron microscopy. These observations showed that the morphological abnormalities were comprised not only of severe demyelination and presence of metachromatic granules but also marked loss of Purkinje cells and granule cells. The depletion of Purkinje cells is considered to have resulted from demyelination of their myelinated axons. On the other hand, the reduction of granule cells is considered to be caused by the loss of Purkinje cells and presynaptic elements such as mossy fibers and glomerular collaterals of climbing fibers. The depletion of these neurons induced destruction of synaptic connection in the cerebellum.

A case report of leiomyosarcoma originating in the ligamentum teres of the liver

A case of leiomyosarcoma that appeared to have originated in the ligamentum teres hepatis of a 66-year-old female has been presented. The case was suspected of leiomyosarcoma originating in the ligamentum teres of the liver from the findings by preoperative examinations, and definitely diagnosed as such in a laparotomy and by histological examination of the resected tissue specimen.

New technique for measuring dynamic axonal transport and its application to temperature effects

A new technique was devised for the dynamic detection of the axoplasmic transport of beta-radioactively labeled materials in which a semiconductor radiation detector was used as the beta-ray counter. The detector element is a silicon p-n junction diode and has a diameter of 2.0 mm. With this detector, the beta-radioactive distribution of axoplasmic transport could be measured in a axon maintained physiologically without cutting nerves. This method makes possible determination of the transport rate using one bundle of peripheral nerves. The rate in the bullfrog was 6.4 mm per hour at 24.0 degrees D. Temperature effects on the bullfrog axoplasmic transport were also observed at different temperatures, ranging from 5.0 to 24.0 degrees C. At these temperatures the rate increased as an exponential function of temperature from 1.1 to 6.4 mm per hour. Within this temperature range, the Q10 is 2.5 and an Arrhenius plot of the natural logarithm of velocity versus the reciprocal of absolute temperature yielded an apparent activation energy of 14.8 Kcal. this technique offers great advantages in permitting direct study of the axoplasmic flow of the axon in a physiological condition.

Effect of anticonvulsant therapy on serum 25-hydroxyvitamin D level

Serum 25-hydroxyvitamin D levels in young patients receiving anticonvulsants were assayed. They had neither retardation of physical and psychomotor development nor malnutrition. The patients treated with phenobarbital alone revealed rather high levels of serum 25-hydroxyvitamin D during 2 months after institution of the therapy, then they gradually returned to the normal level by the end of 3 to 5 months and thereafter decreased further, while a marked decrease of serum 25-hydroxyvitamin D levels was observed in patients receiving combined anticonvulsant (phenobarbital, diphenylhydantoin and others) therapy even during 1 to 2 months after initiation of the treatment. Our results suggest that the patients who have combined anticonvulsant therapy will have more tendency to suffer from osteomalacia than those who have phenobarbital alone.

Enzymatic study of GM-1 gangliosidosis

Two types of GM-1 gangliosidosis were studied biochemically. Type 1 liver accumulated non-lipid hexosamine in addition to GM-1 ganglioside, but there was no increase of hexosamine and GM-1 in type 2 liver. The optimum pH of liver beta-galactosidase of type 1 and type 2 was 5--6 while that of the normal control was 4.5. Type 1 brain beta-galactosidase showed a slightly acidic optimum pH, i.e. 4.0 in comparison with that of the normal control. The optimum pH of type 2 brain beta-galactosidase was 5.5, like the liver enzyme. The thermostability of liver beta-galactosidase was the same in type 1 and type 2, while that of brain was different. Beta-galactosidase of type 1 and type 2 liver is more stable at 42 degrees C than the normal control, but a different thermostability was observed in type 1 and type 2 brain. Liver beta-galactosidase of type 1 showed one peak each at acid and neutral pH, and type 2 liver had only one peak at neutral pH.