Establishment of a human small cell lung carcinoma cell line carrying amplification of c-myc gene and chromosomal translocation of t(3p;6p) and t(12q;17p)

A transplantable tumor and an in vitro culture cell line (GK-T3) were established from metastatic liver tissue of human small cell lung carcinoma (SCLC). Southern blot analysis revealed about 30-fold amplification of c-myc gene in the tumor cells in liver, xenografts, and in vitro cell line. The degree of c-myc amplification was essentially conserved through serial passages in nude mice and cultivation in vitro. The level of c-myc mRNA was significantly increased in these cells. Cytogenetically, numerical and complex structural abnormalities were observed in GK-T3 cells, including t(3p;6p), t(12q;17p), two homogeneously staining regions (hsrs) and several double minutes (dmins). These results suggest that activation of c-myc gene and alteration of gene(s) around these chromosomal breakpoints may play a role in tumorigenesis of GK-T3 SCLC.

Intra-arterial infusion chemotherapy on unresectable hepatocellular carcinoma under occlusion of hepatic arterial flow

Intra-arterial infusion chemotherapy (IAIC) by occluding hepatic arterial flow augments intrahepatic drug concentrations, resulting in response rates higher than those with conventional infusion methods. We recently developed an intra-hepatic artery catheter and device attached with an implantable double-lumen reservoir that can be used for repeated IAIC in outpatient clinics. Eight patients with unresectable hepatocellular carcinoma were treated by infusion of anticancer drugs using this method. The catheter was inserted into the hepatic artery under laparotomy. The occlusion balloon was attached to the common hepatic artery, and catheters were connected to the subcutaneous double-lumen reservoir. Approximately 0.5 ml of distilled water was injected through the one port of the double-lumen reservoir to inflate the balloon, which compressed the artery within the cylinder-like occluder. 4'-O-tetrahydropyranyladriamycin (THP-ADM) was used as the anticancer agent, and two patients received combined administration with carboplatin. Three to seven repeated infusions were possible without any severe side effects. This treatment was also easy to perform in the outpatient clinic. Six of the eight patients survived for more than 2 years, an improvement over the survival rates obtained in a previous conventional IAIC group. We conclude that IAIC with THP-ADM for unresectable hepatocellular carcinoma under occluding blood flow using our device is more convenient and more effective than other available methods.

B-raf oncogene: activation by rearrangements and assignment to human chromosome 7

cDNA clones presumably containing a transforming gene were isolated from transformed NIH3T3 cells, which were obtained by the transfection of DNA from peripheral blood lymphocytes of a familial adenomatous polyposis patient. Sequence analysis of the cDNA clones showed that the gene contained an activated B-raf, the 5' half of which was replaced by the human small nuclear ribonucleoprotein E protein gene and an unknown gene. A partial genomic physical map of the transforming gene was made on the basis of the physical map of the cDNA clones, indicating that rearrangements had occurred during the transfection. The human B-raf gene was shown to be located on chromosome 7 by Southern blotting analysis of rodent-human somatic cell hybrid DNA using the B-raf cDNA as a probe.

Role of lipid peroxidation in acetaminophen-induced hepatotoxicity: comparison with carbon tetrachloride

The effect of acetaminophen on lipid peroxidation in vivo and in vitro was studied in rat liver and the data were compared with those with carbon tetrachloride. Carbon tetrachloride increased diene conjugates in vivo and thiobarbituric acid reactive substance production in vitro in the liver microsomal incubation. These changes were further enhanced by ethanol that has previously been shown to increase carbon tetrachloride-induced hepatotoxicity. On the other hand, acetaminophen did not increase diene conjugates in vivo and inhibited thiobarbituric acid reactive substance production in vitro. These effects were minimally affected by ethanol which has previously been shown to inhibit acetaminophen-induced hepatotoxicity. Thus, lipid peroxidation may play a minimal role in acetaminophen-induced hepatotoxicity in contrast with carbon tetrachloride-induced hepatotoxicity.

Carbamazepine-induced hyponatremia in a patient with partial central diabetes insipidus

A 51-year-old Japanese man was referred for the evaluation of persistent hyponatremia. The serum sodium level remained around 120 mmol/l despite mild water restriction. His past history included chronic alcoholism, myocardial infarction and lumbar disc herniation. Carbamazepine (200 mg, b.i.d.) has been used for more than 8 years for low back pain. Serum sodium returned to normal after carbamazepine was stopped, and rechallenge produced acute symptomatic hyponatremia (117 mmol/l) on day 2 after a total dose of 600 mg. Hepatic, renal and endocrine function were within normal limits, and the response to a water load (20 ml/kg) was also normal. Partial central diabetes insipidus was diagnosed by his response to water restriction and nasal desmopressin administration. Polyuria and hypernatremia were not evident in this case, probably due to a combination of low solute intake and low, but not deficient, levels of plasma ADH. This case demonstrates that carbamazepine may cause acute hyponatremia even in central diabetes insipidus, probably by sensitizing the distal renal tubules.

Application of a simple culture of Plasmodium berghei for assessment of antiparasitic activity

Mouse erythrocytes infected with Plasmodium berghei were incubated for a short period in microplate wells. The parasites changed morphologically from the immature ring form to mature schizonts, and free merozoites were released. However, reinvasion of the erythrocytes appeared not to be possible in this system. This intraerythrocytic one-step growth of the parasite could be determined quantitatively by counting incorporation of 3H-hypoxanthine. The incorporation was markedly decreased by addition of certain antiparasitic agents to the culture. The sensitivity of this growth inhibition test was comparable to or higher than the mouse protection test. The results suggested the practical utility of this simple assay in screening antimalarial activity.

Incorporation of [3H]hypoxanthine by short-term cultured Theileria sergenti and its inhibition by drugs

Red blood cells parasitized with Theileria sergenti were cultured in vitro for a short period in microplate wells. Addition of [3H]hypoxanthine to cultures enabled us to titrate the intraerythrocytic parasite growth because a significant amount of [3H]hypoxanthine was incorporated into the parasitized red blood cells (PRBC) in proportion to the number of PRBC. The incorporation of [3H]hypoxanthine was almost completed in an early phase of incubation. Bovine peripheral blood leukocytes incubated with lysate of PRBC did not incorporate [3H]hypoxanthine, indicating that contaminating leukocytes were not involved in the incorporation in the PRBC culture. The incorporation of [3H]hypoxanthine was decreased markedly by the addition of certain anti-parasitic drugs such as chloroquine, quinine, and pyrimethamine. This inhibition test was performed quantitatively with high sensitivity. Based on these results, this short-term culture seemed to be useful for drug screening or studying the mechanisms of theilerial infection. However, anti-T. sergenti antibodies failed to inhibit the [3H]hypoxanthine incorporation.

[Malignancy of hepatocellular carcinoma evaluated with nuclear DNA ploidy pattern]

Nucleus DNA ploidy analysis was performed by flow cytometry on 81 patients with hepatocellular carcinoma. DNA ploidy patterns were divided into two groups; diploid pattern and aneuploid pattern, which were estimated by the rate of the first peak channel on histograms. DNA aneuploidy significantly correlated with serum AFP level (p < 0.01), TNM stage (p < 0.01), and pathological findings: vp (p < 0.5), im (p < 0.01). The aneuploid cases showed better prognosis than the diploid cases (Generalized-Wilcoxon test, p < 0.01). In the diploid cases, recurrent tumors manifested almost solitary isolated. The disease free period after hepatectomy was longer in diploid cases (mean 24.2 months) than in aneuploid cases (mean 14.4 months). There was a higher frequency of aneuploid cases of recurrence within 2 years compared to diploid cases. Two and half year survival rates after recurrence of diploid cases (69.6%) was significantly better than those of aneuploid cases (38.2%) (p < 0.05). The DNA ploidy pattern of hepatocellular carcinoma plays an important role in predicting the malignant potentials of the disease.

Inhibition of acetaminophen hepatotoxicity by acetaldehyde in the rat

Since we have observed that acetaldehyde, an oxidative metabolite of ethanol, inhibits acetaminophen activation in rat liver microsomes, the in vivo effect of acetaldehyde on acetaminophen hepatotoxicity was tested. In vivo experiments in 3-methylcholanthrene-pretreated male Sprague-Dawley rats showed that administration of cyanamide (20 mg/kg, i.p.) and acetaldehyde (600 mg/kg, s.c.) given 3 and 1 h, respectively, prior to acetaminophen (500 mg/kg, i.p.) but not cyanamide alone prevented acetaminophen hepatotoxicity as assessed by serum transaminases and histology. Acetaldehyde may partly be responsible for the inhibitory effect of ethanol on acetaminophen hepatotoxicity.

[A clinical study of liver resections in patients with small hepatocellular carcinoma less than three centimeter in diameter]

Liver resections for 52 cases with small hepatocellular carcinoma (HCC) less than 3cm in diameter were clinically studied. The 5-year-survival rate was 57.1%, which was better than that of percutaneous ethanol injection (PEI) therapy. Histological study revealed infiltration to the capsule in 48.1%, of which 20% had extra-capsular invasion. This finding seemed to be an important problem in PEI therapy. The group in which resected area was much larger than the extent of tumors had a tendency having good cumulative survival and non-recurrence rates. It is thought that the curative resection should be intended for small HCC if the patient has enough hepatic reserve to undertake a curative operation.

[Problem of the long-term arterial infusion therapy with implantable reservoir for unresectable hepatocellular carcinoma]

Arterial infusion therapy with implantable reservoir was performed for forty-seven cases with unresectable hepatocellular carcinoma since 1986-1991. The one-year survival rate of cases of arterial infusion therapy with implantable reservoir was 50.6% and the 2-year survival rate was 37.8%. The survival rate was 51.4% and 32.2%, respectively, in the TAE cases for the same period. Considering the kinds of reservoirs used for HCC, the survival curve of 23 cases with double lumen reservoir showed a significantly better pattern than that of 24 cases with the usual single lumen reservoir (p less than 0.05). Cumulative usable rate of reservoir was 78.6% at one year, and 42.4% at two years (Kaplan-Meier method). Therapy after the reservoir was unusable, particularly with arterial obstruction by catheter, was restricted because arterial infusion therapy was impossible. It is considered very important to retain the hepatic artery because arterial infusion therapy is mainly for unresectable hepatocellular carcinoma.

Purification and characterization of AspMD1, an isoschizomer of Sau3AI, from a marine bacterium, Alcaligenes sp MD1

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Effects of caffeine on paracetamol activation in rat and mouse liver microsomes

1. The effects of caffeine on the NADPH-dependent production of paracetamol-glutathione conjugate were studied in rat and mouse liver microsomes. 2. In the presence of caffeine, glutathione conjugate production in rat microsomes was enhanced, whereas that in mouse microsomes was not affected significantly, showing an apparent species difference. 3. The data partly explain the species difference in the effects of caffeine on paracetamol hepatotoxicity.

[Intra-arterial infusion chemotherapy for unresectable hepatocellular carcinoma using an implantable reservoir]

Arterial infusion therapy using implantable reservoirs was used in 44 patients with hepatocellular carcinoma which was unresectable for severe liver dysfunction or advanced tumor. The prognosis for patients with whom the double lumen reservoir developed by our department which can occlude the hepatic artery, was compared with that of patients for whom the conventional reservoir was employed. We also evaluated the reduction surgery previous to infusion therapy for tumor-advanced unresectable HCC. The six-month survival rates (Kaplan-Meier method) of the double lumen reservoir cases were significantly higher than for conventional reservoir cases. The survival rates of the cases of reduction surgery and infusion therapy (within only one year) were higher than for infusion therapy cases. Not only the use of the double lumen reservoir but the reduction surgery for unresectable HCC increases the effectiveness of infusion therapy and improves the prognosis.

[Studies on postoperative arterial infusion chemotherapy using implanted reservoir for hepatocellular carcinoma]

The effect of postoperative arterial infusion therapy using implanted reservoir was evaluated in 28 cases of resected hepatocellular carcinoma which showed at least one of those findings as Vp (+), Vv (+), IM (+) and more than 5 cm in tumor diameter. Ten of them underwent arterial infusion therapy with combination ADM and CDDP after hepatic resection (IA group) and the rest underwent no regional chemotherapy (control group). The one-, two- and three-year cumulative disease-free survival rates between control group and IA group were 55.6% against 80.0%, 25.4% against 70.0%, and 16.9% against 37.3%, respectively. The one-, two- and three-year cumulative survival rates between control group and IA group were 71.8% against 90.0%, 51.8% against 70.0% and 41.5% against 56.0%, respectively, a difference that was not statistically significant. We suggest this therapy can prevent intrahepatic recurrence, although it does not improve prognosis. To achieve a better prognosis, a new arterial infusion chemotherapy more effective than this one must be developed.

[Intraportal vein infusion chemotherapy after hepatectomy for hepatocellular carcinoma--preliminary report]

Four cases of advanced hepatocellular carcinoma patients were treated by intra-portal infusion of 5-FU immediately after surgery. 5-FU at 120-250 mg daily was injected continuously via portal catheter from postoperative day 4 to 21. Two cases with short administration period of 4 days died of recurrence on the residual liver at 9 and 7 months after hepatic resection. Another 2 cases with a total amount of 5-FU at 2,165 mg and 2,250 mg, respectively, survived 4 years 3 months and 4 year 8 months each. Mild leukocytopenia and transient liver dysfunction were found as side effects. Intraportal infusion of anticancer drugs is a promising means to prevent intrahepatic micrometastasis after resection of hepatocellular carcinoma.

Effects of Mycoplasma pulmonis infection and exposure to nitrogen dioxide on activities of natural killer cells and macrophages of the mouse

A marked enhancement was seen in activities of mouse splenic natural killer (NK) cells and macrophages one week after infection with Mycoplasma pulmonis (Mp) or exposure to nitrogen dioxide (NO2). Macrophage activity of the Mp-infected mouse showed further augmentation by exposure to NO2 while NK activity of Mp-infected mice was not affected by NO2-exposure.

Ileal atresia with perforation in siblings

Two siblings with ileal atresia are described; one boy presented with ileal perforation and the other with meconium peritonitis, diagnosed by antenatal ultrasonography. The site and type of atresia, complications and associated anomalies of reported cases among siblings also are discussed.

Transformation of bilineal hybrid acute leukemia to acute lymphoid leukemia: a case report with serial analyses of cytogenetics and gene rearrangement

A 17-year-old male with bilineal hybrid acute leukemia is described. Two-color flow cytometric analysis of blast surface phenotype revealed that there were two groups of blasts which showed either CD 10+ CD 19+ CD 13- CD 33- or CD 10- CD 19- CD 13+ CD 33+, but not both. He developed a complete remission by treatment with vincristine, prednisolone, adriamycin, and L-asparaginase. After 8 months, however, leukemia relapsed and lymphoid blasts were dominant. Cytogenetic analysis at presentation showed 46,XY,t(3;9)(p21;p22), and at relapse it showed 46,XY,t(1;3;9)(1pter----1q32::3p25----3pter;3 qter----3p21::9p22----9pter; 9qter----9p22::3p21----3p25::1q32----1q ter),t(2;19)(p21;q13). Analysis of the heavy chain joining region at diagnosis showed three hybridizing bands, all rearranged, but at relapse only one rearranged band. Analysis of the constant region for the beta T-cell receptor gene (TCR beta) both at diagnosis and at relapse showed one rearranged and one germline band, suggesting that rearrangement of one allele of TCR beta of not only lymphoid but also myeloid blasts occurred. It is considered that the target cell of lymphoid leukemia cells and that of myeloid leukemia cells at diagnosis were the same, which differentiated to two lineages, and the clone which evolved from lymphoid lineage proliferated at relapse.

Richter syndrome with two B cell clones possessing different surface immunoglobulins and immunoglobulin gene rearrangements

A patient with two populations of B cell malignancy in the bone marrow is reported. One population consisted of mature small lymphocytes, expressing surface IgM + D, lambda and proliferating very slowly. The other population consisted of abnormal large lymphoid cells, expressing surface IgM, K and proliferating actively. We considered the former as chronic lymphocytic leukemia cells and the latter as malignant lymphoma cells. Therefore, this case was considered as Richter syndrome. The analysis of immunoglobulin heavy chain gene rearrangement showed the different patterns between the two populations. It suggested that the two populations arose from the different origins. We discussed the genetic relationship between the two clones of Richter syndrome referring to other reported cases.