Abstract P1-12-07: Prospective 36-month follow-up to determine changes in body mass index and weight among Chinese breast cancer survivors

Background:Anticancer treatment for breast cancer has been associated with weight gain but such observation has mainly been reported in western patients. More recent data in Asian patients have inconsistent findings. Factors including socio-demographic, clinical and lifestyle may be associated with post-diagnosis weight gain. In this prospective cohort study of women with breast cancer, the objectives were to determine the body mass index (BMI) and weight changes over 36 months after initial diagnosis and the factors associated with such changes.

Methods: Chinese women with newly diagnosed early-stage breast cancer were recruited. Individual woman had her weight measured at breast cancer diagnosis (W0), at study entry (W1) and at 36-month follow-up (W2). Body height was measured at W0. We evaluated change in weight and body mass index (BMI) before and after breast cancer diagnosis.Socio-demographic, clinical and lifestyle factors were assessed to identify potential associated factors with weight changes.

Results: A total of 1133 women with breast cancer had detailed weight measurements at the 3 time-points of assessment. The mean age at diagnosis was 52 years. Fifty-four percent were premenopausal at W1. The proportion of patients with stage 0-I, II and III diseases were 35%, 46% and 19%, respectively.

The proportions of patients who were overweight and obese at the three assessment time-points were 21.2% and 28.5% at W0, 19.7% and 26.6% at W1, and 21.7% and 30.9% at W2 assessment, respectively. When compared to W0, the proportions of women who gained weight within 2-5kg at W1 and W2 were 2.4% and 20.6% respectively, that with weight gain of >5kg at W1 and W2 were 0.5% and 10.0% respectively; 6.1% and 19.6% of women had weight loss >2kg at W1 and W2 respectively.

Compared to W0, the median value of weight change was -0.5 kg (range: -11.4, 18.3) at W1 and 0.6 kg (range: -19.6, 20.5) at W2. On multivariate analysis, only BMI at diagnosis were significantly associated with weight change betweenassessments at diagnosis and W2; the median (range) for weight changes for women who were underweight, normal, overweight and obese were respectively 0.9 (-4.8, 7.6), 0.6 (-13.2, 20.5), 0.5 (-11.5, 13.0) and 0.5 (-19.6, 12.6) kg, p <0.001.

Conclusions: In this prospective study of Chinese women with a history of breast cancer who were followed-up over a 36-months' period, the proportions of women with overweight and obese statuses were relatively stable; weight gain was uncommon among Hong Kong women with breast cancer during the same period. These findings are in contrast with studies conducted in the West, where weight gains were more commonly reported.

Funding: World Cancer Research Fund International (Grant Number WCRF 2010/249 and WCRF 2014/1197)

Citation Format: Yeo W, Lei YY, Cheng AC, Kwok CC, Cheung KL, Lee R, Lee IC, He YQ, Ho S. Prospective 36-month follow-up to determine changes in body mass index and weight among Chinese breast cancer survivors [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-07.

Osteoglycin, a novel coordinator of bone and glucose homeostasis

Objective

The skeleton, which is strongly controlled by endocrine factors, has recently been shown to also play an active endocrine role itself, specifically influencing energy metabolism. However, much less is known about this role. Therefore, we sought to identify novel endocrine factors involved in the regulation of both bone mass and whole-body glucose homeostasis.

Methods

We used transcriptomic and proteomic analysis of Y1 receptor deficient osteoblasts combined with the generation of a novel osteoglycin deficient mouse model and performed comprehensive in vivo phenotype profiling, combined with osteoglycin administration in wildtype mice and human studies.

Results

Here we identify a novel role for osteoglycin, a secreted proteoglycan, in coordinating bone accretion with changes in energy balance. Using an osteoglycin knockout mouse model, we show that at a whole body level, osteoglycin acts to suppress bone formation and modulate whole body energy supplies by altering glucose uptake through changes in insulin secretion and sensitivity, as well as by altering food intake through central signaling. Examining humans following gastric surgery as a model of negative energy balance, we show that osteoglycin is associated with BMI and lean mass as well as changes in weight, BMI, and glucose levels.

Conclusions

Thus, we identify osteoglycin as a novel factor involved in the regulation of energy homeostasis and identify a role for it in facilitating the matching of bone acquisition to alterations in energy status.

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Osteoglycin regulates insulin action, bone mass and food intake in mice.

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Osteoglycin is associated with changes in weight, BMI and glucose in obese humans.

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Osteoglycin is a downstream mediator of NPY signaling via osteoblastic Y1 receptors.

Genital Tuberculosis Presenting as Acute Scrotum Mimicking Fournier's Gangrene

Genital tuberculosis usually presents as local symptoms such as lower abdominal pain and a sensation of scrotal bloating. We report a rare case of genital tuberculosis in a 46-year-old man presenting with symptoms that mimic Fournier's gangrene. He had a progressive local symptoms of scrotal tenderness, redness, swelling, and local rise in temperature. The patient underwent emergency open debridement, and pathology confirmed tuberculosis infection. Recovery was uneventful after 6 months of anti-tuberculosis drug treatment. Literature of genital tuberculosis is also reviewed.

Study on generation of oxygen-depleted water based on stochastically changing solar radiation intensity

To examine the generation probability of oxygen-depleted sea water in Hakata Bay, possible 20 time-series of different hourly-solar-radiation intensities were generated stochastically, and a numerical simulation on dissolved oxygen was carried out for each time series. The results of the model calibration followed the seasonal variation of observed water quality well, and generated cumulative-frequency-distribution curves of daily solar radiation agreed well with the observed ones. The simulation results indicated that the exchange of sea water would have a great influence on the DO concentration, and that the concentration could change more than 1 mg/L in a day. This prediction method seems to be an effective way to examine a solution to minimize fishery damages when DO is depleted.

Seasonal variations in growth rate of phytoplankton in Hakata Bay, Japan

Recently, water pollution with high concentrations of organic matter has occurred frequently in Hakata Bay. It is said that a high level of primary production provides much organic matter and affects water quality of the bay, and it is proved by the appearance of phytoplankton throughout the year. In this study, we simulated variations of phytoplankton population with a box-type model using monthly data in a long-term measurement and we analyzed the final growth rate changes of phytoplanktons that explain the conditions for its appearance. Consequently, we found that the final growth rate varies with pattern of half-year periodicity and water temperature and/or ambient nutrient controls the final growth rate to be low every January and July.

Clinical Features of Neuroendocrine Lung Cancer

PURPOSE

This study was performed to investigate the clinical features of neuroendocrine lung cancer.

MATERIALS AND METHODS

We performed a retrospective review of the histopathology and clinical information of 21 patients diagnosed as having neuroendocrine lung cancer between 1995 and 1999.

RESULTS

Nineteen cases were male and 2 were female. The median age was 64 years (range: 45~80). Pathologic classification were atypical carcinoid (AC) in 2 cases, large cell neuroendocrine carcinoma (LCNEC) in 7 cases, and intermediate cell neuroendocrine carcinoma (ICNC) in 12 cases. Nine patients received tumor resection as first line therapy; adjuvant chemotherapy was given to 3 patients. Concurrent chemoradiotherapy was given to 1 patient. Six patients received palliative chemotherapy. The chemotherapy regimen included etoposide cisplatin in 5 cases and vinorelbine+cisplatin in 1 case. The median survival times were 11, 16 and 59 weeks for AC, LCNEC and ICNC, respectively. The estimated 2-year survival rates were AC 0%, LCNEC 22% and ICNC 31%.

CONCLUSION

Surgery may have a positive effect on survival in patients with early stage cansers. Further investigation is required to improve survival in cases of advanced stage cancer.

A prospective correlation of Laurén's histological classification of stomach cancer with clinicopathological findings including DNA flow cytometry

Between November 1990 and December 1992, 217 patients with stomach cancer were enrolled in a prospective study evaluating the prognostic value of DNA flow cytometry. Laurén's histological type was evaluated in 216 cases, of which 102 (47%) were of the diffuse type, 74 (34%) were of the intestinal type, and 40 (19%) were mixed type tumors. Laurén's histological type showed a significant correlation with age (p = 0.028), sex (p = 0.004), tumor size (p = 0.002), T stage (p = 0.006), overall TNM stage (p = 0.008), histological grade (p < 0.001), and tumor ploidy (p < 0.001). Intestinal type stomach cancer showed a significantly higher proportion of aneuploidy [diffuse vs. intestinal type; 41/102 (40%) vs. 52/74 (70%)]. After a median follow-up of 66.1 months (range, 29.6-78.1), 110 of 216 patients (51%) survived. Patients with intestinal type stomach cancer had a significantly better survival than did those with diffuse type stomach cancer (64% vs. 42% of patients surviving, p = 0.020). Our study suggests that there are biological differences between the two subtypes of Laurén's classification of stomach cancer in addition to the morphological differences. Laurén's classification should remain valid in future studies investigating the pathogenetic and clinical aspects of stomach cancer.

Pathogenic role of endothelin 1 in hemodynamic dysfunction in experimental acute pulmonary thromboembolism

The plasma endothelin-1 (ET-1) level is elevated in patients with acute pulmonary thromboembolism (APE). Whether ET-1 is a pathogenic mediator or a simple marker of APE is not known. We investigated the role of ET-1 in hemodynamic dysfunction in APE through evaluating the effects of ET(A) receptor antagonist in an experimental APE model. We also examined ET-1 expression in embolized lungs. In a canine autologous blood clot pulmonary embolism model, ET(A) receptor antagonist ZD2574 (10 mg/kg, intravenous; ZD2574 group; n = 6) or vehicle (control group; n = 5) was administered. Hemodynamic and gas exchange parameters and plasma levels of ET-1 were serially measured. Prepro-ET-1 mRNA expression and the distribution of ET-1 peptide in lung tissues were also examined. With ZD2574 pulmonary arterial pressure and pulmonary vascular resistance significantly decreased, and were lower compared with the control group. The decrease in cardiac output was also less in the ZD2574 group. Plasma ET-1 levels increased after embolization. Prepro-ET-1 mRNA expression increased in embolized lungs and ET-1 peptide expression also increased in embolized lungs, particularly in the muscular pulmonary arteries, compared with normal lungs. These findings suggest that ET-1 partially contributes to hemodynamic derangements of APE, and that ET(A) receptor antagonists might constitute a useful therapeutic tool for APE.

Characteristics of primary production in a eutrophicated bay

The primary production of phytoplanktons provides organic matter in high concentration in eutrophicated Hakata bay in Japan, even during the winter season in spite of low water temperature. Phytoplanktons may have the biological capabilities to maintain activities of photosynthesis under unfavorable conditions, and these capabilities affect water quality in the bays. In this study, characteristics of primary production were analyzed with a simple box-type ecosystem model. We introduced a concept of efficiency for absorption of sunlight energy to our simulation model of water quality to explain rather high growth rates of phytoplanktons in low sunlight intensity. Through simulation with a box model, we found that the efficiency of primary production in winter is higher than that in summer. It was suggested that the organic pollution comes from dissolved organic carbon (DOC) throughout the year and that the DOC is originated from the primary production of phytoplanktons in biological response of the seasonal change of ambient conditions.

Gene expression profile and identification of differentially expressed transcripts during human intrathymic T-cell development by cDNA sequencing analysis

The development of immature thymocytes to mature T-lymphocytes is a central process for establishing a functional immune system. The gene regulatory events involved in this process are of outstanding interest in understanding the generation of the T-cell repertoire as well as the differentiation of lineage-specific cells, such as CD4(+) helper T-cells or CD8(+) cytotoxic T-lymphocytes. While some essential genes involved in lineage decision and thymocyte differentiation have been already identified, the exact regulatory mechanisms and differential gene expressions are still unknown. The present study was performed to analyze the gene expression profile during T-cell development, in particular, during the differentiation of immature thymocytes into CD4(+) mature T-cells by analyses of expressed sequence tags (ESTs), and to elucidate novel human genes involved in this process. Based on distinct developmental stages, three PCR-based cDNA libraries from immature CD3(-),4(-),8(-) triple-negative, CD4(+),8(+) double-positive, and mature CD4(+),8(-) single-positive thymocytes were constructed. A total of 1477 randomly selected clones were analyzed by automated single-pass sequencing, and the assembly of ESTs resulted in 1027 different species of contig sequences. Among them, 392 contig sequences were matched to known genes, and several novel transcripts were discovered. The matched clones were classified into seven categories according to their functional aspects, and the gene expression profiles of the three thymocyte subsets were compared. The information obtained in current study will serve as a valuable resource for elucidating the molecular mechanism of intrathymic T-cell development.

Hepatic and small bowel mucormycosis after chemotherapy in a patient with acute lymphocytic leukemia

Mucormycosis is a rare but invasive opportunistic fungal infection with increased frequency during chemotherapy-induced neutropenia. The clinical infections due to Mucor include rhinocerebral, pulmonary, cutaneous, gastrointestinal and disseminated diseases. The first two are the most common diseases and all entities are associated with a high mortality rate. Still hepatic involvement of Mucor is rarely reported. We experienced a case of hepatic and small bowel mucormycosis in a 56-year-old woman after induction chemotherapy for B-cell acute lymphocytic leukemia. Initial symptoms were a high fever unresponsive to broad spectrum antibiotics and pain in the left lower abdominal quadrant. It was followed by septic shock, deterioration of icterus and progressively elevated transaminase. An abdominal CT demonstrated multiple hypodense lesions with distinct margins in both lobes of liver and pericolic infiltration at small bowel and ascending colon. Diagnosis was confirmed by biopsy of the liver. The histopathology of the liver showed hyphae with the right-angle branching, typical of mucormycosis. The patient was managed with amphotericin B and operative correction of the perforated part of the small bowel was performed. However, the patient expired due to progressive hepatic failure despite corrective surgery and long-term amphotericin B therapy.

The prevalence and influence of significant psychiatric abnormalities in men undergoing comprehensive management of organic erectile dysfunction

Psychiatric factors are etiologically important in a proportion of patients with erectile dysfunction. We determined the prevalence of psychopathology and the impact it has on current erectile dysfunction (ED) assessment and management. A group of 120 consecutive men with ED presenting to the Human Sexuality Clinic for the first time was prospectively investigated. All patients participated in a standardized evaluative protocol, including history, physical exam, assessment by a psychiatrist (using DSM-IV criteria), selective hormonal screen, and diagnostic intracavernosal injection. Follow-up appointments were to discuss diagnostic findings and, eventually, treatment choices. The prevalence of significant psychiatric pathology, excluding interview stress, was 33%. Only 16 of 40 cases were recognized and highlighted in the initial assessments by urological staff. There was no significant difference in the modalities of treatment choices between patients with psychiatric problems and those without. 10% of the patients had multiple organic risk factors, normal ICI, and significant psychiatric pathology. Psychopathology or emotional factors play a significant role in the etiology of ED and they are difficult to identify in a non-directed assessment. Even in the face of significant vascular risk factors, psychological abnormalities may be the primary etiology. Treating the 'phallodynamically challenged' individual without adequately addressing the possible presence of psychopathology, will account for treatment failures and have the potential for leaving untreated serious emotional problems.

Farmworker exposure to organophosphorus pesticide residues during apple thinning in central Washington State

The purpose of this study was to characterize worker exposure to azinphos-methyl (Guthion) over an entire 4-6 week apple-thinning season. Twenty workers from three work sites in the Chelan-Douglas County region of Washington state were recruited for the study. Exposure potential was estimated by dislodgeable foliar residue measurements, and individual exposures were estimated by biological monitoring through urinary metabolites. Measureable azinphos-methyl residues were found on apple foliage at all sites throughout the six-week sampling period, indicating continuous exposure potential (median residue level of 0.5 microgram/cm2). Measurable levels of the urinary dialkylphosphate metabolite, DMTP, were found in virtually all urine samples (limit of detection = 0.04 microgram/mL). Mean DMTP concentrations differed significantly across sites (0.53, 0.29, and 0.90 microgram/mL for Sites 1-3, respectively; analysis of variance, p < .002), and intraindividual variability was much greater than interindividual differences. Group mean DMTP concentrations at each site fluctuated according to foliar residue levels. Measurable DMTP concentrations were found in 9% of reference workers, ranging from 0.04-0.18 microgram/mL. Cholinesterase activity levels monitored with a field test kit were not considered reliable due to temperature changes of the instrument.

Valacyclovir for the prevention of cytomegalovirus disease after renal transplantation. International Valacyclovir Cytomegalovirus Prophylaxis Transplantation Study Group

BACKGROUND

Cytomegalovirus (CMV) disease is a major complication of organ transplantation. We hypothesized that prophylactic treatment with valacyclovir would reduce the risk of CMV disease.

METHODS

A total of 208 CMV-negative recipients of a kidney from a seropositive donor and 408 CMV-positive recipients were randomly assigned to receive either 2 g of valacyclovir or placebo orally four times daily for 90 days after transplantation, with the dose adjusted according to renal function. The primary end point was laboratory-confirmed CMV disease in the first six months after transplantation.

RESULTS

Treatment with valacyclovir reduced the incidence or delayed the onset of CMV disease in both the seronegative patients (P<0.001) and the seropositive patients (P=0.03). Among the seronegative patients, the incidence of CMV disease 90 days after transplantation was 45 percent among placebo recipients and 3 percent among valacyclovir recipients. Among the seropositive patients, the respective values were 6 percent and 0 percent. At six months, the incidence of CMV disease was 45 percent among seronegative recipients of placebo and 16 percent among seronegative recipients of valacyclovir; it was 6 percent among seropositive placebo recipients and 1 percent among seropositive valacyclovir recipients. At six months, the rate of biopsy-confirmed acute graft rejection in the seronegative group was 52 percent among placebo recipients and 26 percent among valacyclovir recipients (P=0.001). Treatment with valacyclovir also decreased the rates of CMV viremia and viruria, herpes simplex virus disease, and the use of inpatient medical resources. Hallucinations and confusion were more common with valacyclovir treatment, but these events were not severe or treatment-limiting. The rates of other adverse events were similar among the groups.

CONCLUSIONS

Prophylactic treatment with valacyclovir is a safe and effective way to prevent CMV disease after renal transplantation.

Color Doppler flow imaging of hepatocellular carcinomas. Comparison with metastatic tumors and hemangiomas by three-step grading for color hues

The role of color Doppler imaging was evaluated in differentiating hepatocellular carcinomas (HCCs) from metastases and hemangiomas by the amount of tumoral color signals. Intratumoral and peritumoral color signals were analyzed by a three-step grading system (grade 1 to 3) in 51 patients (32 HCCs, seven metastases, and 12 hemangiomas). Correlation of grading scores for intratumoral and peritumoral color signals was evaluated with the size of the tumors as well. HCCs demonstrated a higher grade of intratumoral color signals than did metastases or hemangiomas in all (p < 0.05) and biopsy-proved lesions (p = 0.0084); there was no significant difference in the degree of peritumoral color signals in all (p > 0.05) or 17 biopsy-proved HCCs (p = 0.2078) from the other tumor groups. In addition, the grade of both intratumoral and peritumoral color signals was not related with the tumor size in all groups (p > 0.05). In conclusion, color Doppler imaging provided a valuable role in the diagnosis of HCCs based on the qualitative analysis of the intratumoral color signals.

Nesidioblastosis in an adult with hyperinsulinemic hypoglycemia

A 50-year-old Korean man with repeated episodes of temporary loss of consciousness was diagnosed as having hyperinsulinemic hypoglycemia. Under the tentative diagnosis of insulinoma, localization procedures were carried out but no tumor was found. By percutaneous transhepatic portal venous sampling, no definite gradient in insulin concentration was found. During exploratory laparotomy no tumor was palpable in the pancreas, and intraoperative ultrasonography showed low echogenicity in the pancreatic head. Whipple's operation was performed and 70% of the proximal pancreas was removed. Histomorphometric examination of the resected specimen revealed graded hyperplasia of the islet cells. The most profuse hyperplasia was noted in the head with progressive decrease in the degree of hyperplasia to the body and tail. The patient remains euglycemic and tolerates 24 h fasting without any medication until 15 months after operation.

Pesticides in household dust and soil: exposure pathways for children of agricultural families

Child of agriculture families are likely to be exposed to agricultural chemicals, even if they are not involved in farm activities. This study was designed to determine whether such children are exposed to higher levels of pesticides than children whose parents are not involved in agriculture and whose homes are not close to farms. Household dust and soil samples were collected in children's play areas from 59 residences in eastern Washington State (26 farming, 22 farmworker, and 11 nonfarming families). The majority of the farm families lived within 200 feet of an operating apple or pear orchard, whereas all reference homes were located at least a quarter of a mile from an orchard. Four organophosphorous (OP) insecticides commonly used on tree fruit were targeted for analysis: azinphosmethyl, chlorpyrifos, parathion, and phosmet. Samples were extracted and analyzed by gas chromatography/mass selective detection. Pesticide concentrations in household dust were significantly higher than in soil for all groups. OP levels for farmer/farm-worker families ranged from nondetectable to 930 ng/g in soil (0.93 ppm) and from nondetectable to 17,000 ng/g in dust (17 ppm); all four OP compounds were found in 62% of household dust samples, and two-thirds of the farm homes contained at least one OP above 1000 ng/g. Residues were found less frequently in reference homes and all levels were below 1000 ng/g. Household dust concentrations for all four target compounds were significantly lower in reference homes when compared to farmer/farmworker homes (Mann Whitney, U test; p < 0.05). These results demonstrate that children of agricultural families have a higher potential for exposure to OP pesticides than children of nonfarm families in this region. Measurable residues of a toxicity, I compound registered exclusively for agricultural use, azcnphosmettyl were found in household dust samples from all study homes, suggesting that low level exposure to such chemicals occurs throughout the region. Children's total and cumulative exposure to this pesticide class from household dust, soil, and other sources warrants further investigation.

Pesticides in household dust and soil: exposure pathways for children of agricultural families

Child of agriculture families are likely to be exposed to agricultural chemicals, even if they are not involved in farm activities. This study was designed to determine whether such children are exposed to higher levels of pesticides than children whose parents are not involved in agriculture and whose homes are not close to farms. Household dust and soil samples were collected in children's play areas from 59 residences in eastern Washington State (26 farming, 22 farmworker, and 11 nonfarming families). The majority of the farm families lived within 200 feet of an operating apple or pear orchard, whereas all reference homes were located at least a quarter of a mile from an orchard. Four organophosphorous (OP) insecticides commonly used on tree fruit were targeted for analysis: azinphosmethyl, chlorpyrifos, parathion, and phosmet. Samples were extracted and analyzed by gas chromatography/mass selective detection. Pesticide concentrations in household dust were significantly higher than in soil for all groups. OP levels for farmer/farm-worker families ranged from nondetectable to 930 ng/g in soil (0.93 ppm) and from nondetectable to 17,000 ng/g in dust (17 ppm); all four OP compounds were found in 62% of household dust samples, and two-thirds of the farm homes contained at least one OP above 1000 ng/g. Residues were found less frequently in reference homes and all levels were below 1000 ng/g. Household dust concentrations for all four target compounds were significantly lower in reference homes when compared to farmer/farmworker homes (Mann Whitney, U test; p < 0.05). These results demonstrate that children of agricultural families have a higher potential for exposure to OP pesticides than children of nonfarm families in this region. Measurable residues of a toxicity, I compound registered exclusively for agricultural use, azcnphosmettyl were found in household dust samples from all study homes, suggesting that low level exposure to such chemicals occurs throughout the region. Children's total and cumulative exposure to this pesticide class from household dust, soil, and other sources warrants further investigation.

Extensive colonic stricture due to pelvic actinomycosis

A 36-year-old woman presented with a palpable tender mass at the left lower quadrant of the abdomen. She had suffered from constipation for five years and had a previous history of intrauterine device-use for one year. Preoperative barium enema and abdominopelvic CT showed a compatible finding of rectosigmoid colon cancer or left ovary cancer. She underwent segmental resection of the sigmoid colon along with the removal of left distal ureter, left ovary and salpinx. Pathologic examination revealed actinomycotic abscesses containing sulfur granules. Thereafter, she took parenteral ampicillin (50mg/kg/day) for one month and oral amoxicillin (250mg, tid) for 2 months consecutively. The patient has no specific problems for 6 months after surgical resection and long-term antibiotic therapy. This report may be the first of intrauterine device-associated pelvic actinomycosis involving both sigmoid colon and rectum extensively.

Radiologic assessment in pulmonary lobar transplantation

Pulmonary lobar transplantation provides a clue to the acute donor shortage. To examine the experimental and clinical applicability of lobar transplantation, the authors observed the extent of lung expansion and infiltrate in the allografted lobe through the sequential analysis of the early chest roentgenograms.

MATERIALS AND METHODS

Twenty two mongrel dogs weighting 17 kg on average were used. Donor lung bloc was taken and flushed with Euro-Collins solution. The left lower lobar bloc was procured and implanted in the pneumonectomized recipient dog. The anastomosis was performed in the order of the pulmonary vein, artery, and bronchus. To assess the radiological pattern in the lobar allograft, a grading system was designed according to the extent of lung expansion and infiltrate.

RESULTS

A) Expansion pattern: Good to excellent lung expansion was seen on postoperative day 0 in 6 out of 10 dogs; on day 1, 4/7; day 2, 3/12; day 3, 1/1; and day 4, 1/3, respectively. Radiographs on day 6, 7, and 12 also showed good expansion in one dog. B) Lung opacity pattern: Clear to minimal infiltrates were seen on day 0 in 8 out of 10 dogs; day 1, 7/17; day 2, 2/12; and day 4, 1/3. The same appearances were detected in a single dog on day 6, 7, and 12. C) Expansion-opacity correlation pattern: Radiographs on postoperative day 0 showed good expansion with mild infiltrates, and excellent expansion with minimal infiltrates were observed on day 1 in 3 out of 17 dogs, day 2, 1/12; and day 4, 1/3, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

CT of carcinoma of the pancreas: different mode of spread according to lesion site

Thirty-seven patients were evaluated on computed tomography concerning the different modes of spread (peripancreatic vascular invasion and peritoneal implanting) in the pancreatic carcinoma arising in the four anatomic segments. Each was graded from 0 to 3. The median diameter of the adenocarcinomas was 4.5 cm. It was found that high propensity for vascular invasion occurred in the carcinomas of the body and neck, probably due to the anatomical proximity of the these structures, and the high incidence of intraperitoneal seeding in the carcinomas of the tail was found probably because of its intraperitoneal location.

DNA flow cytometry of stomach cancer. Prospective correlation with clinicopathologic findings

BACKGROUND

DNA ploidy and S-phase fraction measured by DNA flow cytometry were shown to correlate with several clinicopathologic characteristics in several types of tumors.

METHODS

DNA flow cytometry was performed on 329 samples (164 normal mucosa, 165 tumors) obtained from 165 patients (112 men) with stomach cancer, and the findings were correlated with various clinicopathologic characteristics of the patients in a prospective manner.

RESULTS

Seventy-nine of 165 samples (48%) from the tumors gave an aneuploid histogram. None of 164 samples from the normal mucosa showed aneuploidy. There was no significant difference in the frequency of DNA aneuploidy in terms of age, sex, symptom duration, bleeding history, gastric outlet obstruction, weight loss, performance status, serum hemoglobin level, albumin level, creatinine level, tumor size, tumor location in the stomach, and TNM stage. Moderately well differentiated tumors had a significantly higher frequency of aneuploidy compared to well differentiated or undifferentiated tumors. S-phase fraction was obtained in 162 of 164 samples from the normal mucosa, and 123 of 165 samples from the tumors. The overall mean of the S-phase fraction was 4.01% (range, 0.5-23.6%) for the normal mucosa and 13.8% (range, 0-51.9%) for the tumors. Higher S-phase fraction of tumors was correlated with history of weight loss, poorer performance status, and histologically less differentiated tumors.

CONCLUSIONS

The overall frequency of aneuploidy was 48% in stomach cancer. DNA aneuploidy showed significant correlation with histologic differentiation of tumors. S-phase fraction of the tumors showed significant correlation with history of weight loss, performance status of the patients, and histologic differentiation of tumors.

Requirement for the simian virus 40 small tumor antigen in tumorigenesis in transgenic mice

To examine the role of simian virus 40 (SV40) large T and small t antigens in tumorigenesis in animals, we generated transgenic mice which expressed either both the SV40 large T and small t antigens or the SV40 large T antigen alone under the control of the mouse mammary tumor virus long terminal repeat. The mouse mammary tumor virus long terminal repeat directs the expression of transgenes in ductal epithelial cells of several organs, including the mammary gland, lung, and kidney, and in lymphoid cells. The mice which expressed both the T and t tumor antigens developed lung and kidney adenocarcinomas, while those which expressed large T alone did not. Both types of mice developed malignant lymphomas with similar frequencies and latency periods. Our results show that the SV40 small t antigen cooperates with the large T antigen in inducing tumors in slowly dividing epithelial cells in the lung and kidney.

Stimulation of rat bladder epithelial DNA synthesis by intravesical instillation of distilled water

Two commonly used cystoscopic infusion fluids were examined to determine whether their infusion stimulates DNA synthesis of the bladder epithelium. Following a single intravesical dose of 0.5 ml of distilled water or 1.5% L-glycine solution, rats were killed periodically up to 1 week. A transient but significant increase in epithelial cell [3H]thymidine labeling was observed at 48 hr after distilled water instillation. Glycine solution did not stimulate DNA synthesis.

Cryptococcal capsular polysaccharide-induced modulation of murine immune responses

Cryptococcus neoformans, an opportunistic fungal pathogen, often causes serious and life-threatening infections in immunocompromised hosts as well as in normal individuals. In the present study, purified cryptococcal capsular polysaccharide antigen was examined for its effect on several parameters of immune response and its ability to induce immune response to itself. Injection of the antigen into mice resulted in a dose-related specific antibody response which was detected at the individual antibody plaque-forming-cell level by a hemolytic assay in gel. Relatively low doses of cryptococci induced a maximal response, whereas higher doses resulted in a markedly depressed response. The antibody response to the cryptococcal capsular polysaccharide antigen appeared to be T cell independent and regulated by suppressor T cells, since mice injected with antilymphocyte serum or antithymocyte serum showed specific antibody responses to the antigen that were higher than those of untreated mice. It also markedly affected the in vitro mixed-lymphocyte reaction when added to cultures of mouse spleen cells being challenged in vitro with mitomycin C-treated allogeneic cells. The lower doses stimulated the response, whereas higher doses suppressed it. The macrophage response to yeast cells but not opsonized sheep erythrocytes was also modulated by the cryptococcal antigen.

Growth and Enterotoxin Production by Staphylococci in Genoa Salami 1

Staphylococcus aureus strains 265 and 243 which produce enterotoxins A and B, respectively, were inoculated into meat being made into Genoa salami in the amount of 10³, 10⁵, and 10⁷, cells/g. No lactic starter culture was added. Samples were taken at different stages of processing to determine the microbial populations, percentage moisture, total acidity, pH, and enterotoxin content. Staphylococcal populations varying from about 10⁷ to 5 × 10⁸/g were detected during tempering of the salami. Enterotoxin A was detected in surface but not in core samples of salami inoculated with 10⁵ and 10⁷ S. aureus 265 cells/g. However, no enterotoxin B was detected in the salami inoculated with S. aureus 243, which requires a relatively high a_w for enterotoxin production. Staphylococcal counts were higher in surface samples than in core samples, attributable to the difference in oxygen, but there was no significant difference in microaerophilic lactic Kid bacteria in different portions of the salami.

Effect of beef broth protein on the thermal inactivation of staphylococcal enterotoxin B1

Enterotoxin B produced by Staphylococus aureus 243 in brain heart infusion broth was concentrated by dialysis against 40% polyethylene glycol (20 M), partially purified on a Sephadex G-100 column and heated at 110 degrees C in thermal death time cans. Various heating menstrua included 0.04 M Veronal buffer (pH 7.4), beef broth, and fractions of beef broth obtained by ultrafiltration or precipitation with ammonium sulfate. The toxin was assayed serologically using the microslide gel double-diffusion method. The time requiring for 90% inactivation at 110 degrees C (D110 value) obtained in buffer and in beef broth was 18 and 60 min, respectively. When the concentration of beef broth was increased fivefold, the D110 increased to 78 min. The apparent protective effect or protein was further investigated using beef broth protein obtained by precipitation with (NH4)2SO4. The D110 values were 51 and 70 min when the protein concentration in the heating menstruum was 3.8 and 7.7 mg/ml, respectively. However, when the beef broth protein was dialyzed against buffer before use as a heating menstrum, the D110 was only 39 or 41 min at comparable protein concentrations. Results indicated a dialyzable factor, whose protective effect was partially destroyed by trypsin and chymotrypsin but did not by disodium ethylenediaminetetraacetate, was involved in the protection of enterotoxin B during heating.