Phorbol ester receptors and the induction of differentiation in the human T lymphoblastic cell line MOLT-3

To examine the mechanism of induction of differentiation in the human malignant T-lymphoblastic cell line, MOLT-3, by 12-O-tetradecanoylphorbol-13-acetate (TPA), the role of receptors for phorbol esters was investigated. Binding of [20-3H]-phorbol-12,13-dibutyrate to TPA-resistant subclones derived from MOLT-3 was less than 50% of that of the parental MOLT-3. Scatchard analysis showed that the concentration of phorbol ester receptors in a TPA-resistant subclone was about 50% of that in the parental MOLT-3, but affinities of binding were similar, indicating that more than a certain number of phorbol ester receptors is required to induce differentiation by TPA in this human T cell line.

The mode of hepatitis B virus DNA integration in chromosomes of human hepatocellular carcinoma

Nineteen DNA samples that carry integrated hepatitis B virus (HBV) DNA were isolated from seven independent human hepatomas by molecular cloning, and their structures were determined. The results, combined with reported data, were analyzed so that one can obtain insights into the mechanisms of integration of this virus DNA and possible rearrangements that occur subsequently. The distribution of DNA junctions along the virus genome suggests that there are recombination-proficient regions. Thus, about half of the integrants were the Coh type, viz., one of their virus-cell DNA junctions fell within the so-called cohesive end region that lies between two 11-bp direct repeats (DR1 and DR2) in the virus genome where transcription and replication of the genome are initiated. All the integrated virus genomes were defective at least in one site around the cohesive end region, particularly within the X gene. The recombination-proficient regions are used not only for formation of virus-cell but also of virus-virus junctions. Neither virus nor cell DNA show unique sequences at the junctions, and targets for integration lie on many different chromosomes.

Involvement of inflammatory leukocytes in hepatic induction of T-kininogen in rat

Hepatic synthesis as well as plasma levels of T-kininogen, a protein precursor of T-kinin (Ile-Ser-bradykinin), increase in rats following the induction of acute inflammation. Studies have been undertaken to elucidate an involvement of inflammatory leukocytes in the acute-phase response of T-kininogen. Peritoneal exudate cells (PEC) were prepared from rats six days after the intraperitoneal injection of Freund's complete adjuvant. By transfer of these leukocytes into the peritoneal cavity of normal rats, plasma kininogen levels of these recipients increased about threefold after one day. Secretion of kininogen from rat hepatocytes in primary culture was enhanced about twofold by coculturing with PEC. A similar effect was also obtained by adding culture supernatant of these leukocytes into hepatocytes, and the increased levels of kininogen in culture medium of hepatocytes was due to the increased levels of T-kininogen. From these results, it was concluded that leukocytes in the inflammatory site, probably macrophages, release some substance(s) which stimulate(s) the hepatic synthesis of T-kininogen.

[A case of a perforation indicative of early gastric cancer with various macroscopic findings and a collective review of the relevant Japanese literature]

A case of perforated early gastric cancer and a collective review of the relevant Japanese literature is reported. A 83-year-old woman with free air discovered by an abdominal X-ray, was referred to our hospital. On operating, a perforated ulcer was found within and lesions, indicative of a IIc + III type early gastric cancer. Macroscopically, there was an elevated lesion at the antrum of the stomach as well. Histologically, these lesions were connected and moderately differentiated adenocarcinoma. Another lesion was also found at the anterior wall and diagnosed as IIb type gastric cancer.

[Smoldering adult T-cell leukemia complicating severe respiratory failure--an autopsy case report]

An autopsy case of smoldering adult T-cell leukemia (ATL) is presented. 67 year-old woman was admitted to our hospital with complaints of fever, cough and increasing dyspnea on October 2, 1985. Laboratory findings revealed high LDH, azothermia and slightly leukocytosis with low percentage of flower cells. CRP was strongly positive. Gas disturbance was markedly. Anti-ATLA antibody using indirect immunofluorescence method was X40 positive. Subsets of peripheral lymphocytes showed OKT 4 dominant. (OKT 3; 67.5%, OKT4; 60.6%, OKT8; 8.8%). A chest X-ray film revealed cardiomegaly and fine granular shadows in bilateral lower pulmonary fields. Diagnosis of interstitial pneumonitis was defined in transbronchial lung biopsy (TBLB) specimen. O2 therapy, steroid therapy added antibiotics were ineffective, respiratory failure and renal failure were progressive, she died by septic shock in 39th hospital days. In autopsy, no characteristic histological changes of ATL were found in lymph node, bone marrow, spleen, liver, kidney and lung. Sepsis was the cause was of death. Finally this case diagnosed smoldering ATL and pulmonary fibrosis due to bronchial ectasia with repeated pulmonary bacterial infections. The pulmonary complications of patients with ATL were discussed.

Cardiovascular effects of ketamine in humans with cervical or lumbar epidural blockade

To examine the effect of sympathectomy induced by epidural blockade on the cardiovascular effects of ketamine anesthesia, the authors compared the changes in arterial blood pressure (AP) and heart rate (HR) following intravenous administration of ketamine in patients who had cervical epidural anesthesia (n = 18), lumbar epidural anesthesia (n = 16), or light general anesthesia alone (n = 16). Ketamine, 2 mg/kg, iv, produced statistically significant increases in both AP and HR in all patients studied. However, the per cent increases in systolic AP in the cervical group were statistically less than those in the lumbar epidural group and control groups (P less than 0.05), which did not significantly differ from each other. The changes in HR following ketamine in the cervical group were significantly less than those in the other two groups (at 3-10 min following ketamine) (P less than 0.05). These results indicate that the cardiovascular stimulatory effects of ketamine are suppressed partially by a high level of epidural anesthesia but not by a low level of epidural blockade. Since patients with cervical epidural anesthesia had an analgesic level extending between C4 and Th8, the above attenuative effects of epidural blockade may be considered to be attributable to cardiac sympathectomy induced by a high level of epidural anesthesia.

Suppressor T lymphocyte induction by a factor released from cultured blastocysts

For the analysis of immunologic escape mechanisms of embryos during the implantation period in mice, the effects of culture supernatant of blastocysts on in vitro responsiveness to alloantigen of mice was investigated. Blastocyst-cultured conditioned medium was prepared by culturing late blastocysts of outbred ICR mice for 5 days. The addition of culture supernatant containing four or eight blastocysts to allogeneic mixed lymphocyte culture inhibited both the MLR responses and the generation of cytotoxic T lymphocytes (CTL). Preincubation of the culture supernatant with lymphocytes syngeneic to the responder cells of MLR induced potent suppressor cell activity in the MLR. The supernatant did not inhibit the activity of CTL at the effector phase, but preinduced suppressor cells obtained by incubation of splenocytes with the supernatant showed almost complete suppression of CTL activity at the effector phase. Both of the suppressor cells, active on MLR and at the generation phase of CTL as well as active at the effector phase, had a surface phenotype of Thy-1+ and Ig-. The suppressive material could be extracted from the eight-cell stage of fertilized ova or blastocysts but not from unfertilized ova, indicating that the production of the factor(s) is dependent on the stages of early embryogenesis. These results suggest that the active induction of suppressor T lymphocytes by the factor(s) released from implanted embryos is one of the protective mechanisms from maternal immunologic attack.

Suppressor T lymphocyte induction by a factor released from cultured blastocysts

For the analysis of immunologic escape mechanisms of embryos during the implantation period in mice, the effects of culture supernatant of blastocysts on in vitro responsiveness to alloantigen of mice was investigated. Blastocyst-cultured conditioned medium was prepared by culturing late blastocysts of outbred ICR mice for 5 days. The addition of culture supernatant containing four or eight blastocysts to allogeneic mixed lymphocyte culture inhibited both the MLR responses and the generation of cytotoxic T lymphocytes (CTL). Preincubation of the culture supernatant with lymphocytes syngeneic to the responder cells of MLR induced potent suppressor cell activity in the MLR. The supernatant did not inhibit the activity of CTL at the effector phase, but preinduced suppressor cells obtained by incubation of splenocytes with the supernatant showed almost complete suppression of CTL activity at the effector phase. Both of the suppressor cells, active on MLR and at the generation phase of CTL as well as active at the effector phase, had a surface phenotype of Thy-1+ and Ig-. The suppressive material could be extracted from the eight-cell stage of fertilized ova or blastocysts but not from unfertilized ova, indicating that the production of the factor(s) is dependent on the stages of early embryogenesis. These results suggest that the active induction of suppressor T lymphocytes by the factor(s) released from implanted embryos is one of the protective mechanisms from maternal immunologic attack.

Baroreflex control of heart rate during cardiac sympathectomy by epidural anesthesia in lightly anesthetized humans

To evaluate the effects of acute sympathetic denervation on the baroreflex control of heart rate, baroreflex sensitivities were compared in lightly anesthetized humans who had either cervical (N = 20) or lumbar epidural anesthesia (N = 18), or neither (N = 18). Levels of anesthesia during cervical block using 10 ml of 2% mepivacaine without epinephrine were C3-T7 and T7-S1 during lumbar epidural block. Baroreflex sensitivity was assessed with a pressor test using phenylephrine infusion to increase systolic blood pressure by 60 mm Hg within 2 min. There were no statistically significant differences in the baroreflex sensitivities in the absence of epidural block and during lumbar epidural block, the slopes of the regression line (in msec of RR interval change per mm Hg increase in systolic blood pressure, i.e., msec/mm Hg) relating systolic pressure and the succeeding pulse interval being 3.8 +/- 1.4 (mean +/- SD) and 3.7 +/- 1.7, respectively. The mean slope during cervical block, 1.1 +/- 1.2 msec/mm Hg, was significantly different from the slopes observed in the absence of epidural block and during lumbar epidural block (P less than 0.01). The results suggest that cardiac sympathectomy induced by epidural anesthesia can suppress partially baroreceptor function by interrupting sympathetic efferent fibers innervating the heart during high levels of epidural anesthesia, but that lumbar sympathectomy during epidural anesthesia is unlikely to affect baroreceptor activity.

Plasma concentrations of lidocaine associated with cervical, thoracic, and lumbar epidural anesthesia

We measured arterial plasma concentrations of lidocaine by enzyme immunoassay when 10 ml of 2% lidocaine without epinephrine was injected into the cervical, thoracic, or lumbar epidural spaces in 30 patients. There was no difference in the time courses of plasma levels of lidocaine. Peak concentrations were achieved 10 min after injection and were similar regardless of the site of injection. These results indicate the absence of significant differences in the rate of vascular absorption of lidocaine from different parts of the epidural space.

Circulatory responses to airway stimulation and cervical epidural blockade

In order to investigate the effects of acute cardiac sympathectomy, the circulatory responses due to tracheal intubation and broncho-carinal stimulation were compared in lightly anesthetized, paralyzed patients who had either cervical (n = 18) or lumbar epidural blockade (n = 18), or neither (n = 12). The mean analgesic levels obtained using 2% mepivacaine with epinephrine were C4-T8 in the cervical group, and T7-S1 in the lumbar group. Increases in arterial blood pressure (AP) and heart rate (HR) due to laryngoscopy were significant (P less than 0.01) but similar in the three groups of patients. Broncho-carinal stimulation by a suction catheter did not produce noticeable changes in AP and HR in the cervical group; significant increases were observed in the other two groups (P less than 0.01). It was concluded from this study that acute sympathectomy induced in part by cervical or lumbar epidural block does not attentuate circulatory responses due to laryngoscopy and tracheal intubation. The cervical blockade, however, can prevent such responses due to broncho-carinal stimulation without predominant vagotonic reflexes; this may be attributed to the interruption of sympathetic afferents to the spinal cord at the epidural level.