Oral administration of a recombinant cholera toxin B subunit promotes mucosal healing in the colon

Cholera toxin B subunit (CTB) is a component of a licensed oral cholera vaccine. However, CTB has pleiotropic immunomodulatory effects whose impacts on the gut are not fully understood. Here, we found that oral administration in mice of a plant-made recombinant CTB (CTBp) significantly increased several immune cell populations in the colon lamina propria. Global gene expression analysis revealed that CTBp had more pronounced impacts on the colon than the small intestine, with significant activation of TGFβ-mediated pathways in the colon epithelium. The clinical relevance of CTBp-induced impacts on colonic mucosa was examined. In a human colon epithelial model using Caco2 cells, CTBp, but not the non-GM1-binding mutant G33D-CTBp, induced TGFβ-mediated wound healing. In a dextran sodium sulfate (DSS) acute colitis mouse model, oral administration of CTBp protected against colon mucosal damage as manifested by mitigated body weight loss, decreased histopathological scores, and blunted escalation of inflammatory cytokine levels while inducing wound healing-related genes. Furthermore, biweekly oral administration of CTBp significantly reduced disease severity and tumorigenesis in the azoxymethane/DSS model of ulcerative colitis and colon cancer. Altogether, these results demonstrate CTBp's ability to enhance mucosal healing in the colon, highlighting its potential application in ulcerative colitis therapy besides cholera vaccination.

Exome sequencing for bipolar disorder points to roles of de novo loss-of-function and protein-altering mutations

Although numerous genetic studies have been conducted for bipolar disorder (BD), its genetic architecture remains elusive. Here we perform, to the best of our knowledge, the first trio-based exome sequencing study for BD to investigate potential roles of de novo mutations in the disease etiology. We identified 71 de novo point mutations and one de novo copy-number mutation in 79 BD probands. Among the genes hit by de novo loss-of-function (LOF; nonsense, splice site or frameshift) or protein-altering (LOF, missense and inframe indel) mutations, we found significant enrichment of genes highly intolerant (first percentile of intolerant genes assessed by Residual Variation Intolerance Score) to protein-altering variants in general population, an observation that is also reported in autism and schizophrenia. When we performed a joint analysis using the data of schizoaffective disorder in published studies, we found global enrichment of de novo LOF and protein-altering mutations in the combined group of bipolar I and schizoaffective disorders. Considering relationship between de novo mutations and clinical phenotypes, we observed significantly earlier disease onset among the BD probands with de novo protein-altering mutations when compared with non-carriers. Gene ontology enrichment analysis of genes hit by de novo protein-altering mutations in bipolar I and schizoaffective disorders did not identify any significant enrichment. These results of exploratory analyses collectively point to the roles of de novo LOF and protein-altering mutations in the etiology of bipolar disorder and warrant further large-scale studies.

Design and production of genetically modified soybean protein with anti-hypertensive activity by incorporating potent analogue of ovokinin(2-7)

The potent anti-hypertensive peptide, RPLKPW, has been designed based on the structure of ovokinin(2-7). The sequence encoding this peptide was introduced into three homologous sites in the gene for soybean beta-conglycinin alpha' subunit. The native alpha' subunit as well as the modified, RPLKPW-containing alpha' subunit were expressed in Escherichia coli, recovered from the soluble fraction and then purified by ion-exchange chromatography. The RPLKPW peptide was released from recombinant RPLKPW-containing alpha' subunit after in vitro digestion by trypsin and chymotrypsin. Moreover, the undigested RPLKPW-containing alpha' subunit given orally at a dose of 10 mg/kg exerted an anti-hypertensive effect in spontaneously hypertensive rats, unlike the native alpha' subunit. These results provide evidence for the first time that a physiologically active peptide introduced into a food protein by site-directed mutagenesis could practically function in vivo even at a low dose.

Designing potent derivatives of ovokinin(2-7), an anti-hypertensive peptide derived from ovalbumin

We obtained a potent anti-hypertensive peptide, RPFHPF, by replacing the amino acid residues of ovokinin(2-7) (RADHPF), an orally active anti-hypertensive peptide derived from ovalbumin. After intravenous administration in anesthetized Wistar rats, the designed peptide [Pro2, Phe3]-ovokinin(2-7) had a long-lasting hypotensive activity at a dose of 10 mg/kg, while that of ovokinin(2-7) was only transient even at a dose of 100 mg/kg. After oral administration in conscious spontaneously hypertensive rats (SHRs), [Pro2, Phe3]-ovokinin(2-7) significantly lowered the systolic blood pressure in a dose-dependent manner. It is noteworthy that the minimum effective dose of [Pro2, Phe3]-ovokinin(2-7) was 0.3 mg/kg, about one-thirtieth of that of ovokinin(2-7). On the other hand, orally administered [Pro2, Phe3]-ovokinin(2-7) did not show any significant hypotensive effect in normotensive Wistar-Kyoto rats (WKYs) even at a dose of 3 mg/kg. Taken together, [Pro2, Phe3]-ovokinin(2-7) proved to be an ideal, potent anti-hypertensive peptide with little effect on normal blood pressure when given orally.

Bioactive peptides derived from food proteins preventing lifestyle-related diseases

Many kinds of bioactive peptides which might prevent lifestyle-related diseases are released from food proteins after enzymatic digestion. Inhibitory peptides for angiotensin I-converting enzyme (ACE) having anti-hypertensive effect have been isolated from enzymatic digests of various food proteins. LKPNM, which was isolated from the thermolysin digest of dried bonito was activated 8-fold by ACE itself and showed a prolonged effect after oral administration. Two vasorelaxing peptides, ovokinin and ovokinin(2-7), showing antihypertensive effect after oral administration were obtained from ovalbumin digests. We found that low molecular weight peptides derived from food proteins lowered serum cholesterol without increasing excretion of cholesterol and bile acids. An immunostimulating peptide isolated from an enzymatic digest of soybean protein prevented alopecia induced by cancer chemotherapy.

A novel anti-hypertensive peptide derived from ovalbumin induces nitric oxide-mediated vasorelaxation in an isolated SHR mesenteric artery

In this report, we deal with the isolation of a novel vasorelaxing peptide from a chymotryptic digest of ovalbumin and its vasorelaxing activities. This peptide is composed of Arg-Ala-Asp-His-Pro-Phe (RADHPF) in its sequence, corresponding to residues 359-364 of ovalbumin. This peptide (30-300 microM) exerted a dose-dependent vasodilation in an isolated mesenteric artery from a spontaneously hypertensive rat which was pre-constricted by phenylephrine, besides the relaxation being endothelium-dependent. It is noteworthy that the nitric oxide synthase inhibitor N(G)-nitro-L-arginine methyl ester inhibited this relaxation, implying involvement of nitric oxide in its mechanism of action. Following oral administration of RADHPF at a dose of 10 mg/kg, the systolic blood pressure in a spontaneously hypertensive rat was significantly lowered.

Gastroduodenal intussusception secondary to a gastric carcinoma

A case of gastroduodenal intussusception secondary to transpyloric prolapse of a primary gastric carcinoma is reported. Both the condition itself and the leading tumor, gastric carcinoma, are extremely exceptional. A diagnosis of this rare entity was established pre-operatively by endoscopy that demonstrated spontaneous reduction of the intussusception. This may be the first documentation of spontaneous reduction of the gastroduodenal intussusception during endoscopy.

Malignant mesenchymoma arising in an incisional scar of the abdominal wall

A case of malignant mesenchymoma of the anterior abdominal wall, composed of leiomyosarcoma, chondrosarcoma and osteosarcoma is described. The tumour, arising in the old scar of a previous operation, was completely removed surgically. Eleven months after the operation the patient is well with no evidence of recurrence. There have been no previous reports of malignant mesenchymoma developing in operation scars. We believe that this traumatic factor played a significant role in the aetiology of this rare soft-tissue neoplasm.

[A case of advanced gastric cancer with liver metastasis disappeared by oral administration of 5'-deoxy-5-fluorouridine after absolute non-curative operation]

A 64-year-old male was found to have a gastric cancer (Borrmann type 3) on the posterior wall of the stomach. Histological diagnosis was poorly differentiated adenocarcinoma. Ultrasonography revealed a hypoechoic lesion (18 x 14 mm) in the anteroinferior segment (S5) of the liver. The biopsy specimens from those lesions proved to be poorly differentiated adenocarcinoma. Total gastrectomy and distal pancreatosplenectomy were performed. During the operation, other liver metastases were found in the anterosuperior segment (S8) and inferolateral segment (S3). 5'-deoxy-5-fluorouridine (800 mg/day) was administered per os from the 33 rd postoperative day. The hypoechoic lesion of S5 in liver disappeared in the 17th postoperative month. The man is healthy with no evidence of recurrence 47 months after the operation. This case is very important because of the long-term CR.

[Peritoneal dissemination of cecal cancer disappearing in a patient taking 5'-DFUR for 3 years]

A 51-year-old woman presenting with a left ovarian tumor underwent left oophorectomy and hysterectomy with intraperitoneal administration of cisplatin, cyclophosphamide, and 5-fluorouracil on December 13, 1989. Microscopically the tumor was well-differentiated adenocarcinoma. Postoperatively cecal cancer was detected. Laparotomy revealed multiple peritoneal dissemination on March 23, 1990, when palliative ileocecal resection was performed. Microscopy revealed several of the nodules to be adenocarcinoma and the cecal lesion well differentiated adenocarcinoma. The patient was then placed on 5'-deoxy-5-fluorouridine (800 subsequently 600 mg/day). In November, 1991, bright red blood per rectum led to the discovery of rectal cancer. On January 26, 1993, laparotomy revealed rectal tumor invading the bladder but the metastatic nodules on the peritoneum had disappeared. Thus pelvic exenteration was performed. The tumor was well-differentiated adenocarcinoma. The ovarian lesion may have been a metastasis from the cecal cancer, a so-called Krukenberg tumor. The rectal cancer was most likely to be asynchronous cancer. 5'-DFUR seemed effective in remitting the peritoneal dissemination.

SPECT images of technetium-99m-ethyl cysteinate dimer in cerebrovascular diseases: comparison with other cerebral perfusion tracers and PET

To assess the clinical role of 99mTc-ethyl cysteinate dimer (ECD) as a cerebral perfusion tracer, 10 patients with unilateral cerebral infarction were studied.

METHODS

ECD SPECT images were compared with IMP and/or HMPAO SPECT in nine patients, seven in chronic phases and two in subacute phases. Five of these patients and one additional patient with chronic infarction received PET imaging in order to compare ECD distribution with quantitative regional cerebral blood flow (rCBF) and oxygen metabolism (rCMRO2) images.

RESULTS

In patients with chronic cerebral infarction, regression analysis showed excellent correlation between ECD and IMP in the uptake ratio of lesions-to-nonaffected cortices (r = 0.91). In two cases of subacute infarction, decreased uptake of ECD was observed in the area of "luxury perfusion," which showed elevated or preserved rCBF with diminished rCMRO2. On visual analysis, ECD image contrast was less prominent compared to that of IMP, but contrast was better than that of HMPAO.

CONCLUSIONS

ECD uptake showed a curvilinear relationship against rCBF, suggesting flow-limited uptake in a high flow range. ECD is a clinically useful cerebral perfusion tracer with distinct characteristics when compared with other available agents.

PET and the autoradiographic method with continuous inhalation of oxygen-15-gas: theoretical analysis and comparison with conventional steady-state methods

The steady-state method using 15O gas inhalation and positron emission tomography (PET) is a simple and practical way of imaging cerebral blood flow (CBF) and oxygen metabolism. Several disadvantages do exist, however, including prolonged examination time, requirement of steady-state and a large tissue heterogeneity effect. To avoid the drawbacks of the steady-state method but to preserve its simplicity, we applied the PET/autoradiographic method to the build-up phase during the continuous inhalation of 15O-gas with intermittent arterial sampling. A simulation study was performed to determine the optimal scanning period, evaluate the delay and dispersion effect of the input function and estimate the tissue heterogeneity effect. To assess the clinical feasibility of the proposed technique for the study of oxygen metabolism, sequential measurements with this method and the conventional steady-state method were performed in eight patients. The simulation study showed that a 5-min scan started 3 min after the commencement of 15O-gas inhalation was optimal. With this method, the delay and dispersion effect on CBF was the same as that of the conventional steady-state method, but the tissue heterogeneity effect was reduced. In eight patients, CBF values calculated by this method showed time dependency and were slightly higher than those obtained by the steady-state method. The oxygen extraction fraction showed no significant time dependency and was well correlated with that obtained by the steady-state method. We conclude that the proposed method is a simple and acceptable alternative to the conventional steady-state method.

Induction of discriminant function concerning postoperative local recurrence or distant metastasis in 589 patients with differentiated thyroid cancer

For the purpose of predicting postoperative local recurrence and/or distant metastasis in differentiated thyroid cancer, a discriminant analysis was done. To assess the reliability of this method and the induced function, simulation was done by using random samples under various conditions. Simulation revealed that the results obtained by this method were relatively stable. The discriminant functions Z1 and Z2 were induced, which are required at many hospitals. If the ratio of recurrence is less than 1:8 in a hospital, function Z1 should be applied. If the ratio is 1:10, function Z2 should be applied. Z1 = -(sex x 2.104) + (age x 0.032) - (diameter of tumor x 0.033)-(site of tumor x 0.871) - (histology x 0.393) + 0.249 (discriminant boundary 0.451) Z2 = -(sex x 1.967) + (age x 0.018) + (diameter of tumor x 0.025) - (site of tumor x 0.646) + (histology x 0.014) - (local invasion x 0.840) - (lymph node metastasis x 0.009) + (operation x 0.364) - (lymph node dissection x 0.235) + 1.058 (discriminant boundary 0.400). In an internal check, sensitivity was 78%, specificity 64%; and false-negative rate 5%. In an external check, sensitivity was 68%, specificity 93%, and false-negative rate 9%. In the actual application to hospitals, sensitivity was 58% to 100%, specificity 47% to 63%, and false-negative rate 0% to 16%. In clinical usage, a high sensitivity and low false-negative rate are required. These results fulfilled this condition.

Improved detection rate of early breast cancer in mass screening combined with mammography

A cohort study to compare mass screening with and without mammography was conducted in Miyagi Prefecture, Japan in order to establish whether the effectiveness of breast cancer screening would be improved when mammography was combined with physical examination. A trial of mass screening combined with mammography was carried out in 9634 women aged over 50. Lateral imaging of the breast using single-view film mammography was performed at the first stage of mass screening in addition to physical examination of the breast. Results in the trial were compared with those obtained in 35511 age-matched subjects without mammography. Thirty breast cancers were found in the trial with a detection rate of 0.31%, which was much higher than that (0.08%) obtained by physical examination without mammography. In 15 of the 30 patients the breast tumor was not palpated at the first screening, but abnormal findings were detected in the mammography. A higher rate (73%) of early breast cancer was obtained in the screening trial with mammography than that (39%) obtained in the screening with physical examination alone. Mass screening combined with mammography is superior to that without mammography for breast cancer screening, especially for the detection of non-palpable, early breast cancer.

Lumbar artery pseudoaneurysm: an unusual cause of a retroperitoneal hematoma: report of a case

Pseudoaneurysm of the lumbar artery is a rare complication of penetrating trauma. We present herein a case thought to have been caused by a blow to the left flank without any evidence of a stab wound. In this patient, the diagnosis of a first lumbar artery pseudoaneurysm with a retroperitoneal hematoma was confirmed by computed tomography (CT) findings, after which transcatheter embolization was successfully performed.

[99mTc-HMPAO SPECT in the brain death--a case report]

Brain single photon emission computed tomography (SPECT) with 99mTc-d,l-hexamethyl-propyleneamine oxime (HMPAO) was performed twice in a 78-year-old man clinically diagnosed as brain death according to the standard criteria of the Japanese Ministry of Welfare. The first brain SPECT demonstrated the tracer accumulation in the brain, indicating preserved cerebral blood flow. The second brain SPECT performed 3 days later revealed cessation of the blood flow. In patients with preserved cerebral blood flow, the diagnosis of brain death cannot be made, even if they meet the existing criteria, because previous report noted the recovery in some of those patients. Brain perfusion SPECT plays an important role as a confirmatory test for the diagnosis of the brain death.

Noninvasive measurement of regional cerebral blood flow change with H(2)(15)O and positron emission tomography using a mechanical injector and a standard arterial input function

To estimate changes in regional cerebral blood flow (rCBF) without arterial sampling in the study of functional-anatomical correlations in the human brain, using (15)O-labeled water and PET, a standard arterial input function was generated from the input function in 10 normal volunteers with dose calibration and peak time normalization. The speed and volume of injection were precisely controlled with a mechanical injector. After global normalization of each tissue activity image, the standard arterial input function was applied to obtain estimated CBF images. Relative changes in estimated rCBF to whole brain mean CBF(DeltaFest) and those in regional tissue activity (DeltaC) were compared with true relative rCBF changes (DeltaF) in 40 pairs of images obtained from 6 normal volunteers. DeltaFest correlated well with DeltaF, whereas DeltaC consistently underestimated DeltaF. This noninvasive method simplifies the activation studies and provides the accurate estimation of relative flow changes.

Analysis of thyroid carcinoma based on material registered in Japan during 1977-1986 with special reference to predominance of papillary type

BACKGROUND

As geographic differences have been observed in the characteristics of thyroid carcinoma, an analysis was made on thyroid carcinoma in the iodine rich country of Japan.

METHODS

A total of 10,973 patients with histologically confirmed thyroid carcinoma registered in Japan from 1977-1986 were analyzed. Cases detected incidentally at autopsy and cases of nonepithelial tumor were excluded. This series included approximately 27% of all thyroid carcinoma cases in Japan.

RESULTS AND CONCLUSIONS

Histologic distribution showed that papillary carcinoma accounted for 78.4% of cases, follicular carcinoma accounted for 17.2%, medullary carcinoma for 1.4%, squamous cell carcinoma for 0.3%, and anaplastic carcinoma for 2.7%. There is a tendency in Japan to diagnose papillary carcinoma as follicular carcinoma and to diagnose malignant lymphoma as anaplastic carcinoma. It was considered that the percentage of papillary carcinoma was higher and the percentage of follicular carcinoma and anaplastic carcinoma was lower than foregoing values. The characteristics of thyroid carcinoma in Japan were described, and the low incidence of nonpapillary carcinoma compared with papillary carcinoma was discussed in relation to iodine excess as an etiologic factor.

Clinical course and thyroid stimulating hormone (TSH) receptor antibodies during surgical treatment of Graves' disease

This study assessed the results of surgical treatment for Graves' disease in our hospital and examined the relationship between the values of thyroid stimulating hormone (TSH) receptor antibodies and postoperative thyroid function. From 1983 to 1988, subtotal thyroidectomy was performed in 313 patients with Graves' disease. The follow-up rate was 89.1% (278 of 313 patients). Thirteen (4.2%) patients required methimazole postoperatively for hyperthyroidism and 23 (7.3%) patients required L-thyroxine postoperatively for hypothyroidism. The relationship between the postoperative thyroid function and TSH receptor antibodies was examined. The pre-operative thyrotropin binding inhibitory immunoglobulin (TBII) value had no relationship to postoperative thyroid function. Only in the patients who were hyperthyroid postoperatively did the TBII value remain elevated, but the value decreased gradually in patients who were not hyperthyroid postoperatively. In 43 of 94 patients whose pre-operative TBII values were high, the postoperative TBII value normalized. The higher the preoperative TBII value, the longer time was required for it to normalize postoperatively. The postoperative thyroid stimulating antibody (TSAb) values were higher in patients who remained hyperthyroid than in the patients who were not hyperthyroid. In the patients who remained hyperthyroid postoperatively, there was a significant correlation between the postoperative TBII value and the TSAB value. In the patients who were hypothyroid postoperatively, the TSBAb values were negative. In patients undergoing surgical treatment of Graves' disease, the postoperative TBII and TSAb values were related to postoperative hyperthyroidism. The TSBAb value had no relationship to postoperative hypothyroidism.

Replacement of cholesterol gallstones by murideoxycholyl taurine gallstones in prairie dogs fed murideoxycholic acid

The effect of two hydrophilic bile acids, murideoxycholic acid (3 alpha,6 beta-dihydroxy-5 beta-cholanoic acid) and ursodeoxycholic acid, on cholesterol and bile acid metabolism and hepatic pathology and gallstone composition was studied in the prairie dog. Cholesterol gallstones were induced by feeding a diet containing 1.2% cholesterol for 75 days. The animals were divided into six groups, and gallstone regression was studied as follows: groups 2 and 5, chow plus 0.2% cholesterol; groups 3 and 6, chow plus 0.2% cholesterol plus 0.15% ursodeoxycholic acid; groups 4 and 7, chow plus 0.2% cholesterol plus 0.15% murideoxycholic acid. Animals in groups 2 to 4 were killed after an additional 6 wk; animals in groups 5 to 7 were killed after an additional 12 wk. Gallstone dissolution did not occur in any group. The gallstones in groups 2, 3, 5 and 6 were typical cholesterol aggregates, as determined by polarized light microscopy and Fourier transform infrared spectrometry. The gallstones of the murideoxycholic acid group were large, solitary, dark stones that appeared radiopaque under 22 kVp x-ray examination. Scanning electron microscopy showed that in these stones the cholesterol crystals had been replaced by an amorphous material, both within the stone and on the stone surface. Chemical analysis indicated that at the end of 12 wk the calcium/sodium salt of the taurine conjugate of murideoxycholic acid (murideoxycholyl taurine) comprised 70% of the stones; protein, cholesterol and small amounts of other bile salts were also present. In vitro studies confirmed the insolubility of the sodium and calcium salts of murideoxycholyl taurine. These studies indicate that the hydrophilic bile acids, murideoxycholic acid and ursodeoxycholic acid, did not achieve gallstone dissolution under the conditions used. In the animals fed murideoxycholic acid, an insoluble calcium salt of murideoxycholyl taurine replaced cholesterol as the major constituent of gallbladder stones. This is the first example of an insoluble dihydroxy taurine-conjugated bile acid; administration of the unconjugated bile acid induced precipitation of a kind of gallstone not previously reported. The final result was transformation of cholesterol stones to bile salt stones.

The correlation between the immunohistochemical expression of DF3 antigen and serum CA15-3 in breast cancer patients

The immunohistochemical expression of DF3 antigen and serum concentrations of CA15-3, a breast carcinoma-associated antigen recognized by the monoclonal antibodies (MAbs) 115D8 and DF3, was investigated in breast cancer patients. The levels of serum CA15-3 in 23 primary breast cancer patients did not correlate to the percentage cytoplasmic reactivity of MAb DF3 with the carcinoma cells in tissue specimens from each respective patient. In 17 patients who subsequently developed metastatic breast cancer, however, the serum CA15-3 concentrations generally correlated well to the cytoplasmic reactivity of MAb DF3 with the carcinoma cells in specimens obtained at initial biopsy or mastectomy. Elevated levels of serum CA15-3 were seen in metastatic breast cancer patients when the carcinoma cells in their primary specimens expressed enhanced levels of cytoplasmic DF3 antigen. The results of this study suggest that the immunohistochemical demonstration of DF3 antigen in tissue specimens, together with the periodical measurement of circulating CA15-3 antigen, may be important for monitoring the clinical course of breast cancer patients.

[Simple quantification of brain perfusion SPECT with IMP using a large field gamma camera]

We have developed a simple method to quantitate brain perfusion SPECT with N-isopropyl-p-[123I]iodoamphetamine (IMP). After an intravenous bolus injection of IMP, serial dynamic images of the brain and the lung were obtained every 5 sec for 2 min, followed by a SPECT scan at 20 min. Based on the assumption of IMP as chemical microspheres, fractional uptake (FU) of IMP in the brain was calculated from the time-activity curves of the total brain and the total lungs. FU showed a strong positive correlation with inverse of the body surface area which was calculated from the height and weight of the individual subject, suggesting that FU is influenced by cardiac output. Quantification of IMP brain perfusion SPECT was attempted with FU and estimated cardiac output in each subject, providing an index of regional cerebral blood flow. Compared with PET measurement of regional cerebral blood flow, the present method tended to overestimate the flow values. This method has a great advantage that it can be applied in many institutions having large field gamma cameras. However, the accuracy of the measurement may be limited in the tall subjects and in the cases with cardiopulmonary diseases, and further investigation is required to clarify the usefulness and limitation of this approach.

The effect of alfalfa-corn diets on cholesterol metabolism and gallstones in prairie dogs

Cholesterol gallstones were present in prairie dogs fed alfalfa plus corn with and without exogenous cholesterol (0.4%). The diets fed to the animals for eight weeks contained alfalfa plus corn in fixed proportions of 50:50, 85:15 and 15:85 (w/w). At sacrifice, all animals were healthy but had not gained weight; no deaths occurred during the experiment. Cholesterol gallstones were present in all groups. In the absence of exogenous cholesterol, the highest stone incidence was found in the animals which received the lowest fiber (highest corn) diets (alfalfa plus corn, 50:50, 67%; alfalfa plus corn, 15:85, 83%). Cholesterol gallstone incidence was 100% when exogenous cholesterol was added to the alfalfa plus corn diets (50:50 and 15:85). No pigment gallstones were detected in any animal. Liver and plasma cholesterol concentrations were highest in the animals receiving alfalfa plus corn (15:85) plus 0.4% cholesterol (4.29 mg/g, and 356 mg/dl, respectively). These values were lowest in animals receiving 85% alfalfa plus 15% corn without cholesterol (2.19 mg/g and 88 mg/dl, respectively). Lithogenic indices were below 1.00 in all groups. Biliary bile acids were mainly amidates of cholic acid and chenodeoxycholic acid, with the former predominating. Thus, gallstones can be formed in prairie dogs in the absence of exogenous cholesterol; gallstone incidence is reduced by dietary fiber.

Bile acids substituted in the 6 position prevent cholesterol gallstone formation in the hamster

The aim of the present study is to examine the efficacy of 6-hydroxy substituted bile acids on the prevention of cholesterol gallstones in a new hamster model of cholesterol cholelithiasis. Male golden Syrian hamsters were fed a nutritionally adequate semipurified lithogenic diet consisting of casein, cornstarch, soluble starch, butterfat, corn oil, and cellulose plus 0.3% cholesterol. Six different bile acids were added to this diet at the 0.05% level: chenodeoxycholic acid, ursodeoxycholic acid, hyodeoxycholic acid, murideoxycholic acid, 6 beta-methyl-hyodeoxycholic acid, and 6 alpha-methyl-murideoxycholic acid. At the end of the 6-wk feeding period, the control group receiving the lithogenic diet had a 55% incidence of gallstones. It was found that all bile acids had inhibited the formation of cholesterol gallstones; complete prevention of gallstones was observed with all 4 3,6-dihydroxy bile acids, whereas chenodeoxycholic acid and ursodeoxycholic acid were somewhat less effective (80% and 75% prevention, respectively). The accumulation of cholesterol in serum and liver induced by the lithogenic diet was inhibited to some extent by all of the bile acids; hyodeoxycholic acid, murideoxycholic acid, and 6 beta-methyl hyodeoxycholic acid were most effective in this respect. The administered bile acids tended to predominate in bile in the case of chenodeoxycholic acid, hyodeoxycholic acid, and 6 beta-methyl-hyodeoxycholic acid. In contrast, ursodeoxycholic acid seemed to be converted to chenodeoxycholic acid and murideoxycholic acid to hyodeoxycholic acid. Only 4% of the 6-methyl analogue of murideoxycholic acid, 6 alpha-methyl-murideoxycholic acid, was recovered in gallbladder bile. These experiments show that the new hamster model of cholesterol cholelithiasis is suitable for gallstone-prevention studies. It was not possible to draw definite conclusions concerning the mechanism of action of the administered bile acids on the basis of cholesterol saturation or the presence of liquid crystals. The detailed mechanism of gallstone prevention by hydrophilic bile acids in this model remains to be elucidated.

Effects of calcium and bile acid feeding on colon tumors in the rat

The hypothesis that dietary calcium alters the incidence of colorectal neoplasms was examined in an established model of carcinogenesis. Male Fischer 344 rats (28 days old) were quarantined for 2 weeks. All animals were fed the basal diet (AIN-76) supplemented with cholic acid (0.2%) and/or calcium (1.6%, corresponding to a 3-fold increase above that of the basal diet). N-Methyl-N-nitrosourea (MNU) (2 mg/dose) or saline (control) was given intrarectally to all animals on days 1 and 4 of the experiment. Groups 1-8 were fed the experimental diets concurrently with the first dose of MNU, while groups 9 and 10 were fed the diets 2 weeks prior to MNU (or saline). All animals were sacrificed after 28 weeks. No tumors were observed in the groups given saline (groups 1, 3, 5, 7, and 9). In groups receiving MNU, the addition of cholic acid to the diet (group 4) caused a significant increase in tumors (80% versus 55%), tumors/animal ratio (2.24 versus 0.75), and tumors/tumor-bearing animal ratio (2.80 versus 1.36), group 4 versus group 2, respectively. Increased dietary calcium did not inhibit tumor formation; 68% of animals in groups 6 and 10 had tumors. The combination of dietary cholic acid and calcium (group 8) gave a tumor incidence similar to cholic acid (group 4) alone (72% versus 80%, 2.00 versus 2.24 tumors/animal; 2.77 versus 2.80 tumors/tumor-bearing animal). Most tumors were adenomatous polyps but carcinomas in situ and invasive carcinomas were also present; dietary calcium reduced the number of invasive carcinomas (group 6 versus group 2, P less than 0.04).

Comparison of serum assays for TAG-72, CA19-9 and CEA in gastrointestinal carcinoma patients

Tumor-associated glycoprotein (TAG-72) has been shown to be expressed in a wide variety of epithelial malignant tissues. We have investigated serum levels of TAG-72 antigen in patients with gastrointestinal cancer with a solid phase radioimmunometric assay (RIA), CA72-4, utilizing murine monoclonal antibodies CC49 and B72.3 which recognize the TAG-72 antigen. Elevated levels of serum TAG-72 antigen were found in 48% of 56 gastric carcinoma patients and 67% of 45 colorectal carcinoma patients. The serum concentrations of TAG-72 were compared to those of CA19-9 and CEA. The positive rates of CA19-9 in gastric carcinoma and colorectal carcinoma patients were 29% and 54%, and those of CEA were 52% and 60%, respectively. Elevated serum levels of TAG-72, CA19-9 and CEA were observed in 7%, 14% and 24%, respectively, of patients with benign disease, thus indicating a preferential expression of TAG-72, compared to CA19-9 and CEA, in gastrointestinal carcinoma patients versus in patients with benign disorder. A cocktail of CA72-4, CA19-9 and CEA RIAs increased positive rates to 68% in sera of gastric cancer patients and 84% in sera of colorectal cancer patients. Combination assays using CA72-4, CEA and CA19-9 RIAs for patients with benign gastrointestinal disorder, however, also increased the positive rate to 31%. These results indicate that CA72-4, CA19-9 and CEA RIAs may be complementary in detecting circulating tumor-associated antigens. It must be emphasized, however, that interpretation of the data provided by the combination serum assays requires careful consideration.

Synthesis of new bile acid analogues and their metabolism in the hamster: 3 alpha, 6 alpha-dihydroxy-6 beta-methyl-5 beta-cholanoic acid and 3 alpha, 6 beta-dihydroxy-6 alpha-methyl-5 beta-cholanoic acid

This paper reports the chemical synthesis of two new bile acid analogues, namely, 3 alpha, 6 beta-dihydroxy-6 alpha-methyl-5 beta-cholanoic acid from 3 alpha-hydroxy-6-oxo-5 beta-cholanoic acid and describes their metabolism in the hamster. A Grignard reaction of the oxo acid with methyl magnesium iodide in tetrahydrofuran gave two epimeric dihydroxy-6-methyl-cholanoic acids which were separated as the methyl esters by silica gel column chromatography. The configuration of the 6-methyl groups was assigned by proton nuclear magnetic resonance spectroscopy and was supported by the chromatographic properties of the new compounds. The metabolism of the two new bile acid analogues was studied in the hamster. After intraduodenal administration of the 14C-labeled analogues into bile fistula hamsters, both compounds were absorbed rapidly from the intestine and secreted into bile. Intravenous infusion studies revealed that these compounds were efficiently extracted by the liver; the administered analogues became major biliary bile acids, present as either the glycine or taurine conjugates. These compounds are useful to study the effect of methyl-substituted bile acids on cholesterol and bile acid metabolism and may possibly possess cholelitholytic properties.

Cholelithiasis in hamsters: effects of cholic acid and calcium on gallstone formation

Dietary cholic acid (0.1%) and/or calcium (2.6% as calcium carbonate) were added to a semipurified diet containing cholesterol and ethynyl estradiol to determine whether the incidence of pigment and/or cholesterol gallstones would be changed. Male golden Syrian hamsters were fed the experimental diets for 96 days (Group 1, control; Group 3, cholic acid plus calcium) or only an average of 60 days (Group 2, 0.1% cholic acid). Animals in Group 2 became ill (weight loss, low food intake, diarrhea) possibly due to cholic acid (or deoxycholic acid) toxicity. Cholesterol gallstones and crystals were absent in all experimental groups. The incidence of pigment gallstones was: control, Group 1, 12/16; 0.1% cholic acid, Group 2, 3/13; and 0.1% cholic acid plus calcium, Group 3, 11/22. Cholic acid with or without calcium produced an elevation of both liver and plasma cholesterol: Group 2, 80.1 mg/g and 501 mg/dl; Group 3, 103.7 mg/g and 475 mg/dl vs Group 1, 65 mg/g and 209 mg/dl, respectively. The lithogenic indices of the bile were lower in Groups 2 and 3 compared to Group 1, controls, 0.45 and 0.58 vs 1.16, respectively. The extent of the portal tract pathology could not be correlated with the presence or absence of pigment gallstones or with the levels of lithocholic acid in the hamster bile. In summary, when semipurified diets were supplemented with ethynyl estradiol and cholic acid, with and without calcium supplementation, no cholesterol gallstones formed and the incidence of pigment gallstones was not altered.

Dietary induction of cholesterol gallstones in hamsters from three different sources

Cholesterol gallstones were produced in young male, golden Syrian hamsters, obtained from three different suppliers, by administering a nutritionally adequate, semipurified diet for periods of either 5 or 10 weeks. The major components of the lithogenic diet were casein, cornstarch, butterfat, corn oil and 0.3% cholesterol. The hamsters were obtained from Sesco, Harlan Sprague-Dawley (Engle hamster) and Charles River (Lakeview hamster). There were profound differences among the three groups with respect to gallstone formation and cholesterol metabolism: The highest incidence of gallstones occurred in Sesco hamsters, 44.4% and 63.6% after 5 and 10 weeks on the lithogenic diet, respectively. In the Engle hamster, after a 5-week feeding, cholesterol crystals and gallstones were absent. When the feeding period was extended to 10 weeks, cholesterol gallstones were present in 45.5% of the animals. In the Lakeview hamsters, neither gallstones nor cholesterol crystals were found in the gallbladder after a 5-week period. After 10 weeks, cholesterol gallstones were found in only a single hamster. In all groups, the lithogenic diet produced large increases of liver, serum and biliary cholesterol concentrations and increased liver weights. When the animals were fed for 5 weeks, only the bile of Sesco hamsters became supersaturated. Supersaturated bile was induced in all groups after a 10-week feeding of the lithogenic diet with cholesterol saturation ranging from 1.47 to 1.97. These data indicate that it is possible to induce cholesterol gallstones in hamsters by means of a nutritionally adequate, semipurified diet of moderate cholesterol content.(ABSTRACT TRUNCATED AT 250 WORDS)

7-Methyl bile acids: effects of chenodeoxycholic acid, cholic acid, and their 7 beta-methyl analogues on the formation of cholesterol gallstones in the prairie dog

The purpose of this study was to compare the effects of the naturally occurring bile acids (chenodeoxycholic acid and cholic acid) with their 7-methyl analogues (3 alpha,7 alpha-dihydroxy-7 beta-methyl-5 beta-cholanoic acid and 3 alpha,7 alpha,12 alpha-trihydroxy-7 beta-methyl-5 beta-cholanoic acid) on gallstone formation and prevention and cholesterol metabolism in the prairie dog. Sixty animals were fed a semipurified diet, containing 0.4% cholesterol, with one of the following acids (0.1%): chenodeoxycholic, cholic, 3 alpha,7 alpha-dihydroxy-7 beta-methyl-5 beta-cholanoic, or 3 alpha,7 alpha,12 alpha-trihydroxy-7 beta-methyl-5 beta-cholanoic acid. This concentration of dietary bile acids amounts to a dose of 27-30 mg/kg.day. After 8 wk, 89% of control animals had gallstones and 94% had cholesterol crystals. Chenodeoxycholic and 3 alpha,7 alpha-dihydroxy-7 beta-methyl-5 beta-cholanoic acids decreased the incidence of gallstones to 50%. Cholic acid and 3 alpha,7 alpha,12 alpha-tri-hydroxy-7 beta-methyl-5 beta-cholanoic acid did not prevent gallstone formation. The liver cholesterol level was decreased by chenodeoxycholic acid, whereas cholic and 3 alpha,7 alpha,12 alpha-trihydroxy-7 beta-methyl-5 beta-cholanoic acids increased serum and liver cholesterol. Each administered bile acid became the predominant biliary bile acid and 7-methyl analogues did not increase secondary bile acids. Fecal analysis of radioactive metabolites using 14C-labeled 7-methyl analogues showed that these compounds are resistant to bacterial 7-dehydroxylation. It was concluded that 3 alpha,7 alpha-dihydroxy-7 beta-methyl-5 beta-cholanoic acid inhibited gallstone formation as effectively as chenodeoxycholic acid, whereas both cholic and 3 alpha,7 alpha,12 alpha-trihydroxy-7 beta-methyl-5 beta-cholanoic acids were not effective. The effects of 7-methyl analogues on the parameters of cholesterol metabolism that we studied were similar to those of their parent compounds, chenodeoxycholic and cholic acids. Thus, 3 alpha,7 alpha-dihydroxy-7 beta-methyl-5 beta-cholanoic acid but not 3 alpha,7 alpha,12 alpha-trihydroxy-7 beta-methyl-5 beta-cholanoic acid offers promise in cholelitholytic therapy for the prevention and possibly dissolution of cholesterol gallstones.

[A radioimmunometric assay for circulating tumor-associated glycoprotein (TAG-72) using the antigen determinant CA 72-4]

Tumor-associated glycoprotein (TAG-72) is an antigen recognized by monoclonal antibody (MAb) B 72.3 which was generated against a membrane enriched fraction of human mammary carcinoma cells. CA 72-4 is a novel antigen determinant on TAG-72 and is a quantitative radioimmunometric assay system utilizing two MAbs (CC-49, B 72.3) which react with circulating TAG-72 expressed by human carcinomas. We have employed the CA 72-4 RIA system to measure the antigen in sera. The optimum condition for this assay was found to be a 4 hour incubation at 37 degrees C for the first reaction and a 20 hour incubation at 4 degrees C for the second reaction. Under these conditions, intra-assay variation of the control sera was C.V. 3.0-5.2% and inter-assay variation was 5.6-8.3%. The mean +2 SD of CA 72-4 concentration in 468 healthy persons was 3.9 U/ml. Therefore, less than 4.0 U/ml was taken as the cut off level for the CA 72-4 serum assay. The largest population in healthy persons was at the range of 1.5-2.0 U/ml. Only 15 of 468 persons (3.2%) demonstrated serum CA 72-4 levels more than 4.0 U/ml. These data thus indicate the efficacy of CA 72-4 RIA system for the serum assay as a novel tumor marker. The clinical evaluation of CA 72-4 in patients with epithelial malignancies is now underway.

[Levels of circulating tumor-associated glycoprotein (TAG-72) in patients with carcinoma using a novel tumor marker, CA 72-4]

CA72-4 is a novel quantitative immunoradiometric assay system utilizing two monoclonal antibodies CC-49 and B72.3, which recognize a tumor-associated glycoprotein (TAG-72). We have utilized the CA72-4 RIA kit to measure serum levels of TAG-72 in 205 patients with carcinoma and 192 patients without carcinoma. The cut-off value (4.0 U/ml) was obtained according to the levels and the distribution of CA72-4 in 468 healthy individuals. The positive rates in 82 patients with gastric cancer, 55 with colorectal cancer, 24 with pancreatico-choledochal cancer, 36 with breast cancer, and 3 with ovarian cancer were 52%, 55%, 46%, 39%, and 67%, respectively. Fifty percent of the sera from 205 patients with carcinoma demonstrated increased levels of CA72-4, whereas only 10% of the sera from 192 patients without evidence of malignancy showed levels more than 4.0 U/ml. The average level of serum CA72-4 in the patients with carcinoma was 38.6 U/ml, much higher than that (2.7 U/ml) in patients without malignancy. The patients with gastrointestinal cancer at advanced stages or at recurrence showed higher levels of serum CA72-4 than the patients with cancer at early stages. These results thus indicate that CA72-4 is clinically useful as a novel tumor marker, especially for monitoring serum levels of TAG-72 in patients with gastrointestinal cancer, breast cancer, ovarian cancer and other epithelial malignancies.

Effect of 7-methylated bile acids and bile alcohols on cholesterol metabolism in hamsters

The effect of 7-methyl substituted bile acid and bile alcohol analogues on cholesterol metabolism was studied in the hamster. Animals were fed chow plus 0.1% cholesterol supplemented with 0.1% of one of the following steroids: chenodeoxycholic acid, 7-methyl-chenodeoxycholic acid, 7 beta-methyl-24-nor-5 beta-cholestane-3 alpha, 7 alpha, 25-triol, cholic acid, 7-methyl-cholic acid, or 7 beta-methyl-24-nor-5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,25-tetrol. Cholesterol absorption was determined from fecal analysis after feeding of radiolabeled cholesterol and beta-sitosterol. Of the six compounds studied, chenodeoxycholic acid and 7-methyl-chenodeoxycholic acid decreased intestinal cholesterol absorption (17% and 31% decrease, respectively). Only 7-methyl-chenodeoxycholic acid decreased serum cholesterol concentration (29% decrease), but there were no analogous changes of liver and biliary cholesterol concentration and cholesterol saturation of bile. Total fecal neutral sterol excretion was increased in the groups fed chenodeoxycholic acid and 7-methyl-chenodeoxycholic acid. In addition, the production of coprostanol was increased in both groups. These data suggest that 7-methyl-chenodeoxycholic acid resembles chenodeoxycholic acid in its effect on cholesterol metabolism and may be a potential candidate for further studies of its gallstone-dissolving properties.

Bile salts of the West Indian manatee, Trichechus manatus latirostris: novel bile alcohol sulfates and absence of bile acids

The bile salts present in gallbladder bile of the West Indian manatee, Trichechus manatus latirostris, an herbivorous marine mammal of the tropical and subtropical margins of the Atlantic Ocean, were found to consist of a mixture of bile alcohol sulfates. Bile acids, previously believed to be present in all mammals, were not detected. Using chromatography, mass spectrometry, and 1H- and 13C-nuclear magnetic resonance spectroscopy, the major bile alcohol was identified as 5 beta-cholestane-3 alpha,6 beta,7 alpha-25,26-pentol; that is, it had the nuclear structure of alpha-muricholic acid and the side chain structure of bufol. This compound has not been described previously and the trivial name "alpha-trichechol" is proposed. The second most abundant compound was 5 beta-cholestane-3 alpha,7 alpha,25,26-tetrol. Other bile alcohols were tentatively identified as 5 beta-cholestane-3 alpha,6 beta,7 beta,25,26-pentol (named beta-trichechol), 3 alpha,6 alpha,7 beta, 25-26-pentol (named omega-trichechol) and 5 beta-cholestane-3 alpha,6 beta,7 alpha,26-tetrol. The 1H and 13C NMR spectra of the four 6,7 epimers of 3,6,7 trihydroxy bile acids are described and discussed. All bile alcohols were present as ester sulfates, the sulfate group being tentatively assigned to the 26-hydroxy group. 12-Hydroxy compounds were not detected. The manatee is the first mammal found to lack bile acids, presumably because it lacks the enzymes required for oxidation of the 26-hydroxy group to a carboxylic acid. Trichechols, like other bile salts, are water-soluble end products of cholesterol metabolism; whether they also function as biological surfactants in promoting biliary cholesterol secretion or lipid digestion is unknown.

Mobile unit for use in mass screening for breast cancer

Since 1977, mass screening for breast cancer has been carried out in Miyagi prefecture, Japan. The main activities involve itinerant screening in the communities and group screening at the workplaces. The first step in this screening is the physical examination; the second step, for women with suspicious findings, is examination by mammography and ultrasonography, in a specially equipped mobile unit. The number of subjects screened over a seven-year period ending in March, 1984, was 94,953. Mammography was performed on 4,485 subjects (4.7 per cent) Breast cancer was detected in 116 subjects (0.12 per cent). Since 1980, 2,292 high risk subjects have undergone mammography as the first step screening. The detection rate (0.35 per cent) for this group was higher than for the general subjects examined. Therefore, mammography performed in a mobile unit is a suitable approach for the detecting and diagnosing of breast cancer.

Identification of new bile alcohols, 5 beta-cholestane-3 alpha,7 alpha,24,26-tetrol, 5 beta-cholestane-3 alpha,7 alpha,25,26-tetrol, and 5 beta-cholestane-3 alpha,7 alpha,26,27-tetrol in human gallbladder bile

The nature of cholestanetetrols present as the glucurono-conjugates in human gallbladder bile was studied. Glucurono-conjugated bile alcohols were isolated by ion exchange chromatography and, after enzymatic hydrolysis, were fractionated by reversed phase partition chromatography to give a fraction containing tetrahydroxy bile alcohols which was analyzed by gas-liquid chromatography and mass spectrometry. Along with the three previously identified bile alcohols, 5 alpha- and 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,24-tetrols, and 5 beta-cholestane-3 alpha, 7 alpha, 12 alpha,26-tetrol, three new cholestanetetrols, possessing two hydroxyl groups in the ring system and two in the side chain, were detected in the tetrahydroxy bile alcohol fraction. These new bile alcohols were identified as 5 beta-cholestane-3 alpha, 7 alpha,24,26-tetrol, 5 beta-cholestane-3 alpha, 7 alpha,25,26-tetrol, and 5 beta-cholestane-3 alpha, 7 alpha,26,27-tetrol by direct comparison of their gas-liquid chromatographic behaviors and mass spectral data with those of authentic standards prepared from chenodeoxycholic acid by partial synthesis.

Identification of unconjugated bile acids in human bile

Unconjugated bile acids in the bile of healthy and diseased humans were determined qualitatively and quantitatively by means of gas-liquid chromatography and gas-liquid chromatography-mass spectrometry, after their isolation by ion-exchange chromatography. In a healthy person and three patients with cholelithiasis, unconjugated bile acids comprised 0.1-0.4% of total biliary bile acids. The bile acid composition of the unconjugated fraction was quite different from that of the glycine- or taurine-conjugate fraction, in that it contained a relatively large proportion of unusual bile acids including C23 and C27 bile acids. In two patients with cerebrotendinous xanthomatosis, C22 and C23 bile acids were the major constituents of the biliary unconjugated bile acids, and comprised about 0.8% of total bile acids; no detectable amounts of C27 bile acids were found in their bile. The analysis of biliary unconjugated bile acids may be useful for the diagnosis of metabolic diseases concerning bile acids, particularly the accumulation or disappearance of unusual bile acids.

Skull metastasis of thyroid carcinoma. Study of 12 cases

Over the past 33 years the authors have treated 12 cases of skull metastasis from thyroid carcinoma, accounting for 2.5% of a total of 473 cases of thyroid cancer. A study of these 12 cases revealed the following characteristics. The mean age of the patients was 60.4 years and the predominant incidence was in the seventh decade of life. The incidence of skull metastasis from thyroid cancer was higher among women than among men. The primary sign was a soft hemispheric tumor resting on the skull. The tumors were rich in vascularity with osteolytic changes in the skull. The average period from diagnosis of the thyroid tumor until thyroidectomy was 14.3 years, and until discovery of the skull metastasis was 23.3 years. The clinical course was thus very long. The most frequent histopathological presentation was follicular adenocarcinoma. Such lesions were morphologically well differentiated, with little pleomorphism and atypism, but detailed examination showed infiltration into the vascular lumen or capsule. The mean survival time in these patients was 4.5 years from the time of diagnosis. The prognosis in this lesion was relatively poor, considering its long clinical course.

Trial of early detection of breast cancer by mass screening

Since 1977, mass screening for breast cancer has been conducted in Miyagi Prefecture, Japan. The main activities consist of itinerant screening in the communities and group screening at the workplace. In addition, examinations were also carried out at a detection center. The total number of subjects examined was 90,076 in mass screening, with 4172 (4.6%) of them requiring a second examination. The overall breast cancer detection rate was 0.12% in the mass screening. In contrast, it was 3.1% at the center examination. Cytologic studies of nipple discharge were performed on 31,833 subjects. Positive findings were seen in 4 (0.004%). The incidence of smaller tumors was higher and that of nodal metastasis was lower in subsequent examinations than in the initial screening. In the high-risk group, who also underwent mammography at first screening, the detection rate was higher than that among general subjects examined.

[Trial of early detection of breast cancer by mass screening in Miyagi Prefecture]

Mass screening for breast cancer which was commenced by Miyagi Cancer Society in 1977 has been carried out on 94953 examinees. The main activities comprise itinerant screening in the communities and group screening at the workplaces. In addition to two types of mass screening, examination was also performed at the detection center. The overall breast cancer detection rate was 0.12% in mass screening. In contrast it was 3.1% at the center. Early breast cancer, however, was more frequently found in mass screening than at the center examination. The cytologic studies of nipple discharge were performed on 14314 subjects as first screening. Positive finding was seen in 5 (0.005%). In high risk group, which also underwent mammography at first screening, the detection rate was higher than that among general examinees. Method for effective procedures for detecting early breast cancer are now under study.

Follicular reconstruction and hormone production by human adenomatous goiter cells in culture

Morphological and functional properties of dispersed cells of human adenomatous goiter and those of the thyroid tissue adjacent to and distant from the nodular lesion (normal control) were investigated. In the presence of TSH, reconstructive arrangement of adenomatous goiter cells into a three-dimensional follicular structure occurred in a similar manner to that of normal controls. An addition of thyrotropin (TSH) to culture resulted in the secretion of thyroid hormones in control cells, but adenomatous goiter cells showed no response to TSH. It was found that the ratio of rT3, T3, the ratio of an inactive to an active form, was about three times higher in adenomatous goiter than in normal control. These findings suggested that conversion from T4 to rT3 is increased in adenomatous goiter.