[Effect of porcine calcitonin on pain caused by cancer-induced bone destruction]

The analgesic effect of porcine calcitonin (PCT) was studied in 32 patients with cancer-induced bone destruction. Twenty patients (62.5%) showed some response among them 10 of 13 patients who had suffered from uncontrollable pain despite other treatment methods such as radiotherapy, and or the administration of other analgesics. The effect was observed about 10 days after the administration of the drug. Combined therapy with PCT and other modalities such as radiotherapy, chemotherapy and hormone therapy had a marked effect in controlling the pain.

The Guillain-Barré syndrome: clinical and electroneuromyographic studies

Clinical and electrophysiological studies were carried out on 39 patients with the Guillain-Barré syndrome to evaluate which elements were of prognostic value during the acute phase. Residual clinical signs such as motor weakness and absent patellar tendon reflexes were found in 16 (52%) of those patients who had had a preceding illness. Persistence of deficit was significantly correlated to age at onset, the degree of quadriparesis and loss of deep sensation in the acute phase. Of the 10 patients who showed a reduction in motor nerve conduction velocity (MCV) in the early stage, 8 (80%) revealed significantly residual clinical symptoms at follow-up. There was a tendency for the incidence of residual signs to be more common in the patients with slowing of mixed nerve conduction velocity, and prolonged latency of H-wave and the residual latency. Nerve conduction studies, especially measurement of MCV, were of value as a reliable prognostic indicator in this syndrome.

[A case of extramedullary plasmacytoma of the stomach]

A 51-year-old man with extramedullary plasmacytoma of the stomach is presented. He complained of epigastralgia. Barium meal revealed 2 submucosal tumors in the gastric body. Laboratory investigations showed neither hypergammaglobulinemia nor proteinuria. Bone X-ray examinations were not remarkable. There was tumor invasion to the pancreas and metastasis to the perigastric lymph nodes. Proximal gastrectomy was performed, and the patient died 5.5 years after the operation. Histologically, the proliferation of atypical plasma cells with eccentric nuclei was seen. Those cells invaded all layers of the stomach. The tumor cells were pyroninophilic and contained Russel bodies. Immunohistochemical study using the immunoperoxidase technique demonstrated IgG and lambda-light chains in the tumor cells.

The fine structure of pancreatic stones as shown by scanning electron microscopy and X-ray probe microanalyser

To delineate the process of pancreatic stone formation, stones from four patients were studied with a scanning electron microscope and X-ray probe microanalyser. The stones consisted of a central core and surrounding shell. Two kinds of stones were demonstrated: one had a core composed of a calcium-rich amorphous substance and interlacing fibrils; the other had a core consisting of multiple cavities with smooth walls composed of a calcium-deficient amorphous substance. The shells showed a common structure: zones of layers or bands of a calcium-rich amorphous substance, network fibrils filled with a calcium-rich amorphous substance, and laminated parallelogrammic or polygonal plates of calcite parallel to the surface in one layer and oblique or perpendicular in the next layer. Calcium was in the crypto-crystalline state as well as crystalline state of calcite. Crystalline calcite showed spiral and epitaxial growth along with findings of dissolution, resembling cholesterol crystals of gall stones. Pancreatic stones are probably formed through central core formation and layered growth of a shell. Comparison of stones and protein plugs suggests that protein plugs can grow to stones with calcite deposition accompanied by precipitation of network fibrils and an amorphous substance.

The inhibitory effect of lipid peroxide on the activity of the membrane-bound and the solubilized lipoprotein lipase

The effects of lipid peroxide (15-hydroperoxy arachidonic acid) on the activity of lipoprotein lipase was investigated. The activities were examined in 2 enzyme species: the lipoprotein lipase bound to the coronary vessels of the rat heart and that solubilized in the human post-heparin plasma. As a substrate, 3H-labelled human chylomicron was used. Lipid peroxide decreased the maximal velocity of the reaction between the chylomicron and lipoprotein lipase on the vascular surface. In the post-heparin plasma, the lipid peroxide decreased the maximal hydrolysis rate, but did not change the half life time in the unsaturated reaction. It is suggested that lipid peroxide directly damages a part of the membrane-bound lipoprotein lipase, and that the degeneration of cell membranes and the vasoconstriction caused by lipid peroxide will additionally disturb the hydrolysis of the plasma triglyceride on the vascular surface.

[6-week intravenous toxicity test of cefpiramide in rhesus monkeys]

A subchronic toxicity of cefpiramide (CPM) was studied in rhesus monkeys. The drug was administered intravenously to 4 groups of 2 males and 2 females each at a daily dose of 0, 100, 300 mg/kg and 1,000 mg/kg, respectively, for 6 weeks. Vomiting and diarrhea were observed at every dose of CPM, more frequently at the beginning of the treatment period. In addition, salivation was observed at 300 mg/kg or more and a transient subdued mood and inappetence at 1,000 mg/kg. A slight decrease of body weight was noted in a female given 1,000 mg/kg. There were no treatment-related changes in fecal occult blood test and electrocardiograms. Ophthalmological examinations showed no abnormalities being attributable to the treatment. A transient or slight anemia was observed in 2 monkeys receiving 1,000 mg/kg. Examination of bone marrow revealed no abnormalities. There were no effects on plasma biochemical parameters. In urinalysis, a female in the 1,000 mg/kg group showed a glycosuria. Kidneys of 3 animals given 1,000 mg/kg were pale at necropsy. Liver and kidneys were heavier in some animals at 300 mg/kg or more and at 1,000 mg/kg, respectively. Histological examination revealed a multifocal degeneration and regeneration of the proximal renal tubular epithelium in all animals receiving 1,000 mg/kg. No treatment-related changes were encountered in other organs and tissues. From these results, the maximum non-effective dose level of CPM was considered to be 300 mg/kg.

[26-week intravenous toxicity test of cefpiramide in cynomolgus monkeys]

A chronic toxicity of cefpiramide (CPM) was studied in Cynomolgus monkeys. Groups of 4 males and 4 females were given daily doses of 100, 300 mg/kg or 600 mg/kg by intravenous administration for 26 weeks. Another group of 4 males and 4 females was given physiological saline and served as the control. In CPM groups, diarrhea or soft feces was observed after the commencement of administration at every doses. The frequency of these signs decreased as the study progressed and animals at lower doses returned to normal earlier. There were no treatment-related changes in body weights, fecal occult blood and electrocardiograms. A female in the 600 mg/kg group died after 13 weeks of treatment. The cause of death was assumed to be an acute myocardial necrosis resulting from thromboarteritis. It was not considered to be treatment-related. Ophthalmological examination revealed no abnormalities attributable to the treatment. Erythrocyte counts, hemoglobin and hematocrit values decreased in 3 animals receiving 600 mg/kg of the drug. The changes, however, were transient at least in 2 of these animals. There were no effects on plasma biochemical and urinalysis parameters. Small yellow spotes were noted in the renal cortex of 2 monkeys in the 600 mg/kg group at necropsy. Liver and kidneys were slightly heavier in animals receiving 600 mg/kg. Histopathological examinations revealed focal nonsuppurative interstitial nephritis in 1 animal given 300 mg/kg and 5 animals given 600 mg/kg. No treatment-related changes were observed in other organs and tissues. From these results, the maximum non-effective dose level of CPM was considered to be 100 mg/kg.

Histochemical studies on enzyme-digested protein plugs of patients with chronic pancreatitis: a preliminary report

Sulfated acidic mucopolysaccharides have been found to be significant components of "protein plugs" in patients with chronic pancreatitis. The precise identification of the mucopolysaccharides and their distribution within the protein plugs may clarify the pathogenesis of the plugs. Pure pancreatic juice from five patients with chronic pancreatitis was obtained by endoscopic retrograde catheterization of the papilla of Vater. Enzymes for digestion of the plugs included hyaluronidase of the bovine testes and streptomyces hyalurolyticus, chondroitinase ABC and AC, and sialidase (neuraminidase). Our study indicated that: I) Sialic acid is distributed throughout the plugs and may be a major component, followed by a lesser amount of chondroitin sulfate B. 2) Chondroitin sulfate A, C, D and E and chondroitin may be minor components. 3) Hyaluronic acid is negligible in the plugs.

Accumulation of hydrocarbon in a patient with adrenoleukodystrophy

The lipid composition of tissues from a patient with adrenoleukodystrophy was examined. Cholesterol esters of both brain and adrenal tissues contained increased proportions of fatty acids longer than C22 in agreement with previous reports. During this study, thin-layer chromatographic analysis of the neutral lipid fraction from the cerebral white matter and the adrenal gland revealed an unknown spot, which was identified as hydrocarbon of n-alkanes (CnH2n + 2, n = 16-33) by means of gas-liquid chromatography and gas chromatography/mass spectrometry. There may be a relationship between the accumulation of hydrocarbons and the change in fatty acid metabolism that is the fundamental disorder of ALD, as: (1) the fatty acids abnormally accumulated in cerebral white matter and adrenal gland coincided in chain length (i.e. C24-C26) with the main peaks of n-alkane in the same tissues, and (2) an abnormal accumulation of n-alkanes occurred in the diseased tissues where cholesterol esters with very long chain fatty acids were markedly increased.

Characteristics of gait ataxia in spinocerebellar degeneration assessed by means of simple quantitative method

Cerebellar ataxic gait was compared with normals by a simple quantitative method. Strain gauges attached to the heel, the first and the fifth metatarsal areas of a shoe, were used and the gait was telemetrically recorded. A natural and one per second click sound-synchronized gait was analyzed. A contact sequence of the three areas of the sole, the stride time, the stance-phase time and the foot contact pattern were compared between patients and normals. All of these items disclosed different results in the two groups.

Role of endoscopic elimination of protein plugs in the treatment of chronic pancreatitis

The purpose of this report is to evaluate the role of endoscopic elimination of protein plugs in the treatment of chronic pancreatitis (CP) and suspected CP. Endoscopic aspiration of pure pancreatic juice (PPJ) was performed on 69 patients with CP or suspected CP. PPJ was collected from within the main pancreatic duct by endoscopic retrograde catheterization of the papilla after a rapid intravenous injection of secretin and CCK-PZ. Following results were obtained. (1) Various numbers of protein plugs were obtained along with PPJ in 26 of the 69 patients. (2) Endoscopic elimination of protein plugs provided 17 of the 26 patients with dramatic relief from abdominal pain and back pain, indicting that the procedure was often useful, at least, for relieving pain in patients with protein plugs in the pancreatic duct system. (3) Follow-up studies suggested that the procedure could be an effective therapeutic tool in selected cases of CP or suspected CP in which no prominent stenotic lesions were noted in the major pancreatic duct system and abstinence from alcohol beverage was strictly observed. (4) In 43 patients with no protein plugs in the pancreatic juice, in contrast, transient or partial relief from abdominal pain was provided in only one patient, respectively.

Effect of clinofibrate, a new hypolipidemic agent, on biliary and serum lipids in patients with hyperlipidemia

Clinofibrate was given to 15 patients with hyperlipidemia, for 6-8 weeks at the daily dose of 600 mg, and its effect on 3 biliary lipid components (cholesterol, bile acids and phospholipids) and on the lithogenic index was investigated. After clinofibrate treatment, 6 of the patients were given 1.5 g/day clofibrate for 6-8 weeks to compare the effect of clofibrate with that of clinofibrate. The molar percentages of biliary cholesterol and phospholipids to the total mol number of the 3 biliary lipid components decreased, and that of bile acids increased during clinofibrate administration. In this way, the molar ratio of bile acids to cholesterol increased during the treatment. Neither the lithogenic index calculated by the formula of Admirand and Small nor that of Hegardt, Dam and Holzbach was altered significantly by the treatment. There was no apparent relationship between the effect of the drug on the lithogenic index and any of the factors initial lithogenic index, rate of decrease of serum lipids, or type of hyperlipidemia. Although clofibrate had no significant effect on the maximum solubility of cholesterol in the bile, the molar percentage of biliary cholesterol was elevated and the lithogenic index increased as compared with the control and clinofibrate period. No significant influence on bile acid composition in the bile was observed, with either clinofibrate or clofibrate.

The crystal and molecular structure of 2'-deoxy-2'-fluoroinosine monohydrate

The structure of the hydrate of 2'-deoxy-2'-fluoroinosine has been determined by single-crystal x-ray diffraction. The nucleoside crystallizes in space group P2(1)2(1)2(1) with unit cell dimensions, a = 33.291, b = 10. 871, c = 6.897A. There are two nucleosides and two water molecules in the asymmetric unit. The structure was solved by direct methods and refined to a residual R = 0.095. The two independent nucleosides in the asymmetric unit show different conformations about the glycosidic bond, while other structural details are similar. The base orientation to the sugar is syn in molecule A, whereas anti in molecule B. The exocyclic C(4')-C(5') bond conformation defined with respect to C(3')-C(4')-C(5')-O(5') is gauche+ in both molecules A and B. The sugar ring pucker defined by the pseudorotation phase angle P is a twisted conformation in both, C(3')-endo-C(4')-exo with P = 29 degrees in molecule A and C(4')-exo-C(3')-endo with P = 41 degrees in molecule B. It is shown by comparison with x-ray results of other 2'-fluoronucleosides and unmodified nucleosides including inosines that, in addition to a strong preference of the C(3')-endo type pucker, twisted conformations involving C(4')-exo puckering may be one of characteristic features of 2'-fluoronucleosides.

Determination of barbiturates in mouse tissues by high-performance liquid chromatography

Procedures for determining barbiturates in mouse tissues were investigated. High-performance liquid chromatography (HPLC) with mixtures of water and methanol as the mobile phase and muBondapak C18 as the stationary phase is superior to gas and thin-layer chromatography with respect to ease of sample preparation, accuracy, sensitivity and time required for analysis. The first step in the analysis, the extraction of barbiturates from tissues, was also investigated and good recoveries were achieved. The time courses of barbiturate concentrations in mouse brain, kidneys and liver after oral administration of barbiturate-beta-cyclodextrin complex to mice were determined by HPLC using UV detection at 210 nm.

[Quarantine and health control of the squirrel monkey (Saimiri sciureus) (author's transl)]

A total of two hundreds and seventy squirrel monkeys (Saimiri sciureus) of both sexes were imported from South America through an animal dealer of the U. S. A. in eight lots from May, 1973 to July, 1974. They were investigated for the presence of the parasites for a maximum of fifteen months including nine weeks of quarantine period from the time of import. The mortality rate before or immediately after arrival at our laboratory reached 56.7% in the first two lots. This, however, could be reduced later to 4.8% by improving some conditions of transportation. Bacteriological surveys revealed no shigella or salmonella infections during the quarantine period. No tuberculin positive reactors were also detected. Filarial infestations seemed to be common in this species; about 45.5% had adult worms in the peritoneal cavity and about 65% harbored microfilaria in the peripheral blood. Acanthocephla was also found in a high rate in the lower alimentary tracts. It has been suggested that the worms disappear in fifteen months by keeping animals in the intermediate host-free circumstances. The sarcocyst was found in the femoral muscle of 7 (18.9%) of 37 animals examined histologically.

Lack of toxicity of chenodeoxycholic acid in the squirrel monkey

The toxicity of chenodeoxycholic acid was studied in squirrel monkeys of both sexes. The drug was orally administered to five groups of 26 animals each at a daily dose of 0, 10, 20, 40, and 80 mg per kg, respectively, for a maximum of 52 weeks. No clinical symptoms that could suggest drug toxicity were observed. All laboratory studies, including liver function tests, were within normal limits. The proportion of lithocholic acid in biliary acids remained unchanged, whereas that of chenodeoxycholic acid was dose-dependently increased. No histopathological changes considered to be attributable to drug administration were observed.

Specializations of the retinochoroidal juncture

The occurrence of attachment sites between the basal plasma membrane of the retinal pigment epithelium and its basement lamina have been observed in a variety of animal species, including man. Similar structures connect adjacent basal infoldings of the retinal pigment epithelium. The topographic distribution of such attachment sites and basal infoldings in rat eyes show small differences between the peripapillary, posterior, and peripheral retina. Such attachment sites may help to provide a firm connection between the retinal pigment epithelium and choroid.

Optic nerve glioma in an 18-month-old child

An optic nerve glioma in an 18-month-old child was examined by both light and electron microscopy. The tumor revealed the characteristic features of uniform benign and fibrillary astrocytoma. Rosenthal fibers and calcium depostis were found within numerous intracellular glial processes. The above features indicated a slow-growing tumor of long duration, confirming the generally supported assumption of the congenital nature of optic nerve glioma. One unsuspected feature was the presence of fenestrated blood vessels.

Osteogenic sarcoma. A study of one hundred and thirty cases

One hundred and thirty patients with osteogenic sarcoma were studied clinically, roentgenographically, and pathologically. Prognosis by each of ten factors was analyzed with the Wilcoxon test. The test yielded p smaller than 0.05 in a comparison between the survival curves of patients fifteen years old or younger and that of patients over fifteen, but other comparisons did not yield p smaller than 0.05. The actual five-year survival rate was 25.5 per cent (twenty-six of 102 patients who had radical surgery). Our therapeutic regimen for osteogenic sarcoma at the present time consists of regional perfusion, amputation, bronchial artery infusion, and systemic administration of anticancer agents.