Increases in discontinuous rib cartilage and fused carpal bone in rat fetuses exposed to the teratogens, busulfan, acetazolamide, vitamin A, and ketoconazole

Skeletal changes induced by treatment of pregnant rats with four potent teratogens, busulfan, acetazolamide, vitamin A palmitate, and ketoconazole, were evaluated using Alizarin Red S and Alcian Blue double-staining to investigate the relationship between drug-induced skeletal malformations and cartilaginous changes in the fetuses. Pregnant rats (N = 8/group) were treated once or twice between gestation days (GDs) 10 to 13 with busulfan at doses of 3, 10, or 30 mg/kg; acetazolamide at 200, 400, or 800 mg/kg; vitamin A palmitate at 100,000, 300,000, or 1,000,000 IU/kg; or ketoconazole at doses of 10, 30, or 100 mg/kg. Uterine evaluations and fetal external and skeletal examinations were conducted on GD 20. Marked skeletal abnormalities in ribs and hand/forelimb bones such as absent/ short/bent ribs, fused rib cartilage, absent/fused forepaw phalanx, and misshapen carpal bones were induced at the mid- and high-doses of busulfan and acetazolamide and at the high-dose of vitamin A palmitate and ketoconazole. Increased incidences of discontinuous rib cartilage (DRC) and fused carpal bone (FCB) were observed from the low- or mid-dose in the busulfan and acetazolamide groups, and incidences of FCB were increased from the mid-dose in the vitamin A palmitate and ketoconazole groups. Therefore, DRC and FCB were detected at lower doses than those at which ribs and hand/forelimb malformations were observed in the four potent teratogens.

Study on reaction kinetics and selective precipitation of Cu, Zn, Ni and Sn with H₂S in single-metal and multi-metal systems

Determination of reaction kinetics and selective precipitation of Cu, Zn, Ni and Sn with H(2)S in single-metal and multi-metal systems were studied to develop a process of metal recovery from plating wastewater. As samples, single-metal model wastewaters containing Cu, Sn, Zn or Ni, and multi-metal model wastewater containing Cu-Zn-Ni or Sn-Zn mixtures were used. In both single-metal and multi-metal systems, the pH value was precisely controlled at a value of 1.5 for CuS and SnS precipitation, 4.5 for ZnS precipitation and 6.5-7.0 for NiS precipitation. Subsequently, the sulfidation of Cu, Sn, Zn and Ni was evaluated. It was found that an amount of H(2)S equimolar to a given metal was sufficient to achieve almost complete precipitation of the particular metal. Further, the selectivity of metal precipitation was found to be higher than 95% in the Cu-Zn-Ni multi-metal system and higher than 91% in the Sn-Zn system. It was also found that the sulfidation reaction proceeded in accordance with Higbie's penetration theory and reaction rate constants and mass-transfer coefficients under various experimental conditions were determined. Finally, the reaction rate constants obtained in single-metal and multi-metal systems were found to be almost the same indicating that the precipitation of a particular metal was not significantly affected by the presence of other components.

Sulfidation treatment of molten incineration fly ashes with Na2S for zinc, lead and copper resource recovery

The present study focuses on the conversion of heavy metals involved in molten incineration fly ashes to metal sulfides which could be thereafter separated by flotation. The sulfidation treatment was carried out for five molten incineration fly ashes (Fly ash-A to Fly ash-E) by contacting each fly ash with Na(2)S solution for a period of 10 min to 6h. The initial molar ratio of S(2-) to Me(2+) was adjusted to 1.20. The conversion of heavy metals to metal sulfides was evaluated by measuring the S(2-) residual concentrations using an ion selective electrode. The formation of metal sulfides was studied by XRD and SEM-EDS analyses. In the case of Fly ash-A to Fly ash-D, more than 79% of heavy metals of zinc, lead and copper was converted to metal sulfides within the contacting period of 0.5h owing to a fast conversion of metal chlorides to metal sulfides. By contrast, the conversion of about 35% was achieved for Fly ash-E within the same contacting period, which was attributed to a high content of metal oxides. Further, the S(2-) to Me(2+) molar ratio was reduced to 1.00 to minimize Na(2)S consumption and the conversions obtained within the contacting period of 0.5h varied from 76% for Fly ash-D to 91% for Fly ash-C. Finally, soluble salts such as NaCl and KCl were removed during the sulfidation treatment, which brought about a significant enrichment in metals content by a factor varying from 1.5 for Fly ash-D to 4.9 for Fly ash-A.

Sulfidation treatment of copper-containing plating sludge towards copper resource recovery

The present study is concerned with the sulfidation treatment of copper-containing plating sludge towards copper resource recovery by flotation of copper sulfide from treated sludge. The sulfidation treatment was carried out by contacting simulated or real copper plating sludge with Na(2)S solution for a period of 5 min to 24 h. The initial molar ratio of S(2-) to Cu(2+) (S(2-) to Me(2+) in the case of real sludge) was adjusted to 1.00, 1.25 or 1.50, while the solid to liquid ratio was set at 1:50. As a result, it was found that copper compounds were converted to various copper sulfides within the first 5 min. In the case of simulated copper sludge, CuS was identified as the main sulfidation product at the molar ratio of S(2-) to Cu(2+) of 1.00, while Cu(7)S(4) (Roxbyite) was mainly found at the molar ratios of S(2-) to Cu(2+) of 1.50 and 1.25. Based on the measurements of oxidation-reduction potential, the formation of either CuS or Cu(7)S(4) at different S(2-) to Cu(2+) molar ratios was attributed to the changes in the oxidation-reduction potential. By contrast, in the case of sulfidation treatment of real copper sludge, CuS was predominantly formed, irrespective of S(2-) to Me(2+) molar ratio.

Sulfidation of zinc plating sludge with Na2S for zinc resource recovery

A high amount of zinc disposed in the landfill sites as a mixed-metal plating sludge represents a valuable zinc source. To recover zinc from the plating sludge, a sulfidation treatment is proposed in this study, while it is assumed that ZnS formed could be separated by flotation. The sulfidation treatment was conducted by contacting simulated zinc plating sludge with Na(2)S solution at S(2-) to Zn(2+) molar ratio of 1.5 for a period of 1-48 h, while changing the solid to liquid (S:L) ratio from 0.25:50 to 1.00:50. The conversion of zinc compounds to ZnS was determined based on the consumption of sulfide ions. The reaction products formed by the sulfidation of zinc were identified by X-ray diffraction (XRD). As a result, it was found that the conversion of zinc compounds to ZnS increased with an increase in S:L ratio. A maximum conversion of 0.809 was obtained at an S:L ratio of 1.00:50 after 48 h. However, when the zinc sludge treated at S:L ratio of 1.00:50 for 48 h was subjected to XRD analyses, only ZnS was identified in the treated zinc sludge. The result suggested that the rest of zinc sludge remained unreacted inside the agglomerates of ZnS. The formation behavior of ZnS was predicted by Elovich equation, which was found to describe the system satisfactorily indicating the heterogeneous nature of the sludge.

MR cisternography of the cerebellopontine angle: comparison of three-dimensional fast asymmetrical spin-echo and three-dimensional constructive interference in the steady-state sequences

BACKGROUND AND PURPOSE

MR cisternography has been used as the noninvasive screening tool of the cerebellopontine angle. The purpose of this study was to directly compare two currently dominant types of sequences for heavily T2-weighted MR cisternography.

METHODS

Three-dimensional fast asymmetric spin-echo (3D-FASE) sequences, which are 3D half-Fourier rapid acquisition with relaxation enhancement and 3D constructive interference in the steady-state (3D-CISS) sequences, were compared on a clinical 1.5-T MR unit using the same scan times. In five healthy volunteers, the contrast-to-noise ratio (C/N) between CSF and the cerebellum was measured at three locations. Then, for qualitative analysis, the quality of the labyrinth was scored on the original source multiplanar reformatted images, the virtual endoscopic images, and the maximum intensity projection (MIP) images. In 20 consecutive patients with suspected cerebellopontine angle tumors, visualization of the tumors was evaluated using 3D contrast-enhanced spoiled gradient-echo imaging as the standard of reference.

RESULTS

Both sequences showed comparable mean C/N values; however, in qualitative analysis, the scores for 3D-CISS on the source, virtual endoscopic, and MIP images were significantly lower than those on the images obtained with 3D-FASE, owing to more prominent flow and magnetic susceptibility artifacts on the 3D-CISS sequences. In all subjects, discontinuity of the semicircular canals was seen on the virtual endoscopic and MIP images obtained with 3D-CISS, owing to susceptibility artifacts, but not on those obtained with 3D-FASE. All 12 tumors were detected by both sequences, but 3D-CISS gave one false-positive result.

CONCLUSION

3D-FASE is considered the method of choice because artifacts are reduced and specificity is increased.

Difference in toxicity of beta-amyloid peptide with aging in relation to nerve growth factor content in rat brain

Amyloid beta-peptide (Abeta) is the major constituent of the senile plaques in the brains of patients with Alzheimer's disease. We have demonstrated previously that memory impairment, dysfunction of the cholinergic and dopaminergic neuronal system and morphological degeneration are produced after the continuous infusion of Abeta into the cerebral ventricle in 8-week-old rat. In the present study, we investigated the toxicity of Abeta in infant (10 days old), adult (8 weeks old) and aged (20 months old) rats in relation to nerve growth factor (NGF) content in various regions of the brain. After a 2-week-infusion, choline acetyltransferase (ChAT) activity was significantly decreased in the hippocampus of adult, but not infant or aged rats. NGF levels in the hippocampus were increased only in adult rats. These results suggest that Abeta is toxic only in the matured adult brain, and that the mechanism of toxicity is related to NGF synthesis.

Parotid gland papillary cystadenocarcinoma in a Fischer 344 rat

A spontaneous parotid gland tumor with histomorphologic features characteristic of cystic and papillary growth was found in a 72-week-old F344 rat. The tumor had a prominent cystic appearance and invasive growth into the dermis beyond the muscular layer of the skin. The cyst walls were lined by a single layer of cuboidal to tall columnar epithelium with prominent papillary projections continuous with the cyst lining. The tumor cells had mucoid, pale cytoplasm and medium to large nuclei. The myoepithelium did not appear to be associated with the tumor cysts and the papillae. Atrophic parotid gland tissues were seen between cysts and in the periphery of the cystic lesions. In light of these findings, the tumor was diagnosed as papillary cystadenocarcinoma of parotid gland; this is the first description of a salivary gland papillary cystadenocarcinoma in a rat.

Giant cell tumor of bone in an aged Fischer 344 rat

A giant cell tumor (GCT) was detected on the distal end of the femur in a 98-wk-old male Fischer 344 rat. The yellowish white mass had expanded, compressing adjacent muscle tissues. The tumor had an osteolytic and relatively homogeneous appearance and was composed of multinuclear giant cells scattered in a mass of mononuclear stromal cells. No osteoid tissue formation was observed. The tumor cells were strongly immunoreactive for ED-1 and some were also positive for alpha-smooth muscle actin, suggesting that the tumor originated from the monocyte/macrophage lineage showing myofibroblastic differentiation. This is the first report concerning spontaneous GCT of bone in a rat.

Dissociation of impairment between spatial memory, and motor function and emotional behavior in aged rats

We investigated changes in learning and memory in aged rats, in relation to motor function and emotional behavior. Male Kbl Wistar aged rats (108-weeks-old) were divided into two groups, memory impaired and non-impaired, based on performance during six training trials in the Morris water maze task. Aged rats with a goal latency longer than the mean plus the 99% confidence limit of young rats, were regarded as memory impaired, whereas those with a goal latency within the range of the 99% confidence limit of the mean of young rats, were considered as memory non-impaired. Although the performance of the memory impaired aged rats in the standard test of the Morris water maze improved after six re-training trials to the level of the non-impaired aged rats and young rats, working memory impairment was evident. There were no differences in motor function and emotional behavior between the impaired and non-impaired aged rats. These results suggest that deficits of learning and memory in memory impaired aged rats can be dissociated from changes in motor function and emotional behavior.

Effects of vitamin K2 (menatetrenone) on atherosclerosis and blood coagulation in hypercholesterolemic rabbits

Gamma-Carboxyglutamic acid (Gla)-containing protein, synthesized in the presence of vitamin K, has been found in atherogenic plaques, but the pharmacological effect of vitamin K on atherosclerosis is unclear. We examined whether vitamin K2 (menatetrenone) could affect the progression of both atherosclerosis and hypercoagulability in hypercholesterolemic rabbits. Vitamin K2 in daily doses of 1, 10 and 100 mg/kg was given with a 0.5% cholesterol diet for 10 weeks to 8 rabbits each. The plasma levels of total-cholesterol in the vitamin K2-treated groups were clearly lower than that of the hypercholesterolemic control group. The excessive dose of vitamin K2, even at the high dose of 100 mg/kg/day for 10 weeks, did not accelerate the progression of atherosclerosis and did not promote the coagulative tendency in the rabbits. In contrast, the vitamin K2 treatment (1 to 10 mg/kg/day) suppressed the progression of atherosclerotic plaques, intima-thickening and pulmonary atherosclerosis, the increase of ester-cholesterol deposition in the aorta, and both the elevation in plasma factor X level and increase in Hepaplastin test value in the rabbits. These results indicate that the pharmacological dose of vitamin K2 prevents both the progression of atherosclerosis and the coagulative tendency by reducing the total-cholesterol, lipid peroxidation and factor X activity in plasma, and the ester-cholesterol deposition in the aorta in hypercholesterolemic rabbits.

Continuous infusion of beta-amyloid protein into the rat cerebral ventricle induces learning impairment and neuronal and morphological degeneration

To investigate the toxicity of beta-amyloid protein, a component of the senile plaques in Alzheimer's disease, it was infused into the cerebral ventricle of rats for 14 days by a mini-osmotic pump. Performances in the water maze and passive avoidance tasks in beta-amyloid protein-treated rats were impaired. Choline acetyltransferase activity significantly decreased in the hippocampus both immediately and 2 weeks after the cessation of the infusion. However, the learning impairment was recoverable 2 weeks after cessation of the infusion. Both immediately and 2 weeks after the cessation of the infusion, glial fibrillary acidic protein immunoreactivity increased. Furthermore, beta-amyloid protein altered the staining in the nuclei of hippocampal cells for only 2 weeks after the cessation. These results suggest that beta-amyloid protein produces some damage in the central nervous system in vivo.

Pituitary carcinoma of pars distalis as a common neoplasm in Fischer-344 rats

The incidence of invasive spontaneous pituitary carcinomas in Fischer-344 rats were studied. The pituitaries were examined histopathologically together with surrounding tissues including sphenoid bone. The incidence of carcinoma was higher than that previously reported in Fischer-344 rats. All the carcinomas observed in this study showed evidence of local invasion either ventrally into bone and bone marrow or laterally into peripheral nerves and blood vessels. No dorsal infiltration into the brain was recognized. Pituitary carcinoma with local invasion is a relatively common neoplasm when examined histopathologically together with the surrounding tissues.

Effects of N-methyl-D-aspartate receptor antagonists on carbon monoxide-induced brain damage in mice

The mechanism of neurodegeneration and the possible therapeutic amelioration were investigated in a model induced by successive carbon monoxide (CO) exposures. Successive CO exposures resulted in a consistent pattern of degeneration of hippocampal CA1 pyramidal cells, which was quantified using an image analyzer. Competitive and noncompetitive antagonists of N-methyl-D-aspartate (NMDA) receptors, cyclopentenophenanthrene, (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten,5,10-imine maleate and an antagonist of glycine binding sites, 7-chlorokynurenic acid, significantly reduced the CO-induced neurodegeneration. Ifenprodil (a antagonist of polyamine binding sites) and glycine had no effect. From these results, it is clear that NMDA receptor/ion channel complex is involved in the mechanism of CO-induced neurodegeneration, and that glycine binding site antagonist as well as NMDA competitive and noncompetitive antagonists may have neuroprotective properties in neurological disorders associated with overactivation of NMDA receptors.

Memory impairment and morphological changes in rats after continuous infusion of active fragment of anti-nerve growth factor-antibody

We report here that the specific Fab' fragment of anti-nerve growth factor (NGF)-antibody (anti-NGF, 12, 120 and 400 micrograms/4 weeks, i.c.v.) impairs learning and memory. The goal latency of the control rats in water maze task was rapidly shortened by training compared to those of the anti-NGF-treated rats. The degree of reduction in movement counts of the anti-NGF-treated rats in habituation task was significantly smaller than that of the control rats. However, the step-through latency of the anti-NGF-treated rats was not significantly shorter than that of the control rats. With regard to the choline acetyltransferase activity, no effects were observed in any of the brain regions. Anti-NGF treatment altered nuclear morphology in the hippocampus and parietal cortex. As a result, it seems that the anti-NGF-induced amnesia could be due to an impairment of nuclear morphology.

Effects of successive carbon monoxide exposures on delayed neuronal death in mice under the maintenance of normal body temperature

The 3 time carbon monoxide (CO) exposures potentiated the delayed neuronal death (DND) in comparison with that induced by single CO exposure. Deterioration of DND induced by CO exposures was observed when normal body temperature was maintained during the exposures, since CO exposure fell the body temperature to about 34 degrees C. Pretreatment with noncompetitive NMDA receptor antagonist, MK-801 (30 nmol/mouse), ameliorated DND induced by successive CO exposures under the maintenance of normal body temperature. These results suggest that the mice exposed successively to CO under the maintenance of normal body temperature is a useful hypoxic model.

Aged-related changes in learning and memory, choline acetyltransferase activity and number of neuronal cells in rats

In a water maze task, the goal latency and distance of swimming onto the platform of aged rats (24 months old) were slowly shortened by repeated training compared with those of young rats (8 weeks old). A significant decrease in choline acetyltransferase activity in the frontal cortex, parietal cortex and striatum was observed in aged rats. Moreover, the number of neuronal cells in the hippocampal CA1 subfield and dentate gyrus of aged rats was smaller than that of young rats. The atrophy of striatal cells was observed. These results suggest that age-related delay of acquisition is due to the above-mentioned biochemical and histological changes, and that rates of aging in biochemical and morphological parameters are different in the discrete brain areas.

Memory impairment and morphological changes in rats induced by active fragment of anti-nerve growth factor-antibody

Treatment of rats with a specific Fab' fragment of anti-nerve growth factor (NGF)-antibody (anti-NGF, 12, 120 and 400 micrograms/4 weeks, i.c.v.) impaired their learning ability. The distance of swimming of anti-NGF-treated rats in a water maze was shortened more slowly by training than that of control rats. Anti-NGF treatment altered the staining of nuclei of cells in the hippocampus, parietal cortex and dentate gyrus with hematoxylin. It is suggested that the anti-NGF-induced amnesia could be due to change in nuclear morphology.

Carbon monoxide-induced delayed amnesia, delayed neuronal death and change in acetylcholine concentration in mice

We investigated the interrelationship of delayed amnesia, delayed neuronal death and changes in acetylcholine concentration induced by carbon monoxide (CO)-exposure in mice. In the test for retention of the passive avoidance task, amnesia was observed 5 and 7 days after CO-exposure when the mice were exposed to CO 1 day after training; in the case when the mice were exposed to CO 5 and 7 days before training, amnesia was also observed in a retention test given 1 day after training. The number of pyramidal cells in the hippocampal CA1 subfield was lower than that of the control 3, 5 and 7 days after CO-exposure. But the neurodegeneration in the parietal cortex, area 1, was not observed until 7 days after CO-exposure. The findings indicated that the amnesia and the neuronal death were produced after a delay when the mice were exposed to CO. In addition, the delayed amnesia was closely related to the delayed neuronal death in the hippocampal CA1 subfield. Moreover, [3H]glutamate and [3H]glycine binding sites did not change after CO-exposure but, 7 days after CO-exposure, the concentration of acetylcholine and the binding of [3H]quinuclidinyl benzilate in the frontal cortex and the striatum were found to have significantly changed, but those in the hippocampus did not show significant change. Therefore, we suggest that delayed amnesia induced by CO-exposure may result from delayed neuronal death in the hippocampal CA1 subfield and dysfunction in the acetylcholinergic neurons, in the frontal cortex, the striatum and/or the hippocampus.

Adenoid cystic carcinoma of Bartholin's gland: a clinical, immunohistochemical and ultrastructural study of a case with regard to its histogenesis

Adenoid cystic carcinoma of Bartholin's gland is a rare tumor, of which 45 cases including the present one have been reported in the literature. Although the histogenesis of this tumor is still controversial, the tumor is suspected to be of myoepithelial origin, and most studies have been performed on the salivary glands with few reports concerning Bartholin's gland. We report a case of adenoid cystic carcinoma of Bartholin's gland with regard to its histogenesis. A typical tumor nest had three main components: true luminary structures containing sialomucins, solid monotonous cells of a myoepithelial nature, and numerous pseudocysts containing abundant proteoglycans and basal membrane-like materials. From these results we speculate that reserve cells located in the intercalated small ducts of Bartholin's gland may have the potential to differentiate into two cell types, myoepithelial and luminary cells, the former forming the pseudocysts.

Retroperitoneal giant tumor formed by migrating polyembryoma with numerous embryoid bodies from an ovarian mixed germ cell tumor

We report on a very rare case of retroperitoneal tumor formed by migrating polyembryoma with numerous embryoid bodies from an ovarian mixed germ cell tumor. It was successfully removed combined with artificial replacement of the aorta following chemotherapy. We also discussed the fate of embryoid bodies following metastasis or chemotherapy.

Bilateral gonadoblastoma producing steroid hormones in a patient with 45,X/46,XY gonadal dysgenesis

A case of bilateral gonadoblastoma in a phenotypic female with 45,X/46,XY gonadal dysgenesis is presented. Hormonal investigations revealed that serum testosterone, estradiol and beta-human chorionic gonadotropin decreased following excision of the tumors, but follicle-stimulating hormone and luteinizing homrone levels increased further. Immunohistochemical staining for testosterone and estradiol was positive in both Leydig and lutein-like cells in the tumor. It is suggested that gonadoblastoma is capable of producing testosterone and estradiol, and Leydig or lutein-like cells may be the actual source of these steroid hormones.

Radiosensitivity test for cancer of the uterine cervix

In selecting the method of treating uterine cervical cancer, radiosensitivity is one of the most important factors. To know this factor before treatment, we are trying to estimate radiosensitivity with changes of primary tumors before and after the irradiation. Tumors must be irradiated uniformly with small doses, and based on these considerations, we are attempting external test irradiation for estimation of radiosensitivity. Radiosensitivity was determined histopathologically by comparing the results of histological specimens taken before and seven days after test irradiation. Radiosensitivity is closely related to prognosis: of 183 cases with good sensitivity, 146 cases (79.8%) were surviving at five years after radiotherapy. On the other hand, the five-year survival rate of cases with poor sensitivity was only 37.2%. Comparing radiation with operation in operable cases of stage I and II, the five-year survival rate in cases with good sensitivity was about the same (90%). On the contrary, in cases with poor sensitivity, there was a substantial difference: that is, 66.0% of operated cases had a five-year survival compared with 39.7% of radiated cases.

Uterine body invasion of carcinoma of the uterine cervix as seen from surgical specimens

To estimate the actual states of uterine body invasion of carcinoma of the uterine cervix, 301 radically hysterectomized specimens were reviewed histologically. Incidence of uterine body invasion was 21.6% in all cases (65 cases out of 301), 7.8% in stage Ib, 25.5% in stage IIa, and 38.2% in stage IIb. Most of the positive invasion cases had spread to other surrounding tissues. Vaginal wall was invaded in 58.5% of all positive cases, parametrial infiltration was recognized in 87.7%, and pelvic lymph node metastasis was seen in 52.3%. On the contrary, in negative cases these were 33.9, 19.1, and 15.7%, respectively. There was a higher incidence of the L type of Imai's CPL classification among positive cases of uterine body invasion than among negative cases (81.5% vs 38.1%). When cervical cancer spread into the uterine body, peritoneal carcinomatosis and distant metastasis increased. Thus the outcome of patients with positive invasion was, naturally, poor. Patients with negative invasion had a 5-year survival rate of 92.4%, compared to 53.8% in patients with positive uterine body invasion. These results suggest that uterine body invasion of carcinoma of the uterine cervix is an important prognostic factor and treatment should be modified in such cases.

Pelvic lymph node metastasis of uterine cervical cancer

The state of pelvic lymph node metastasis was observed in 627 cases of Okabayashi's radical hysterectomy performed from 1950 to 1984 of which 589 cases with a known 5-year survival rate were examined according to their relationship to prognosis. The incidence of lymph node metastasis was 29.7%, becoming progressively higher with succeeding clinical stages. The metastasis rates according to site were 6.9% hypogastric nodes, 4.9% obturator nodes, 4.4% iliac nodes, and 25.0% parametrial nodes. Among the factors considered in the postoperative classification, lymph node metastasis demonstrated high values in cervical infiltration cancer, positive parametrial infiltration, positive vaginal invasion, and infiltration into the uterine body and L type of CPL classification. The 5-year survival rate was 83.0% in negative cases of pelvic lymph node metastasis, while in positive cases, it was as poor as 45.8%. Considering the relationship of various factors, it is shown that the presence of lymph node metastasis has a great effect on prognosis.

Case report of malignant primary nerve sheath tumor arising in the female pelvis

This paper reports a malignant primary nerve sheath tumor (MPNST) which originated in the obturator nerve in a 54-year-old woman. That the tumor originated in the nerve sheath is supported by the site of occurrence, which was consistent with the obturator nerve, an arrangement of cells similar to that in schwannoma, and that extracellular basement membrane was noted ultrastructurally. This tumor was classified not as malignant schwannoma but as a nerve sheath fibrosarcoma because the matrix of tumor tissues contained abundant mucinous materials, some tumor cells were fibroblastic, and the clinical change was rapid. In general, with plexiform neurofibroma there is a familial manifestation and it occurs as a complication of von Recklinghausen's disease, associations not demonstrated in this patient. From these findings, this tumor is considered to be an extremely rare nerve sheath fibrosarcoma which originated from a malignant change in a sporadic and solitary plexiform neurofibroma.

A clinicopathologic study on adenomyosis uteri

Clinicopathologic investigations were carried out on 51 cases that had received hysterectomy and had been diagnosed histologically as adenomyosis uteri during a 4-year period since 1977, and the following results were obtained: 1) adenomyosis uteri was found in 51 out of 418 hysterectomized patients, the incidence being 12.2%, 2) 74.5% of the cases with adenomyosis uteri were in the fifth decade, the average being 44.8 years old, 3) 94% of the cases were gravidous, 82% being parous. The incidence of sterility was low in the case of adenomyosis uteri, 4) major symptoms of the adenomyosis uteri were dysmenorrhea and hypermenorrhea, and these symptoms increased in frequency as the degree of adenomyosis uteri progressed, 5) fibroid was a complication of the adenomyosis uteri in 25 cases, while endometrial carcinoma was observed in only 1 case, 6) the ectopic endometrium also showed the same changes in secretory conditions and menstrual changes as the surface endometrium, 7) many cases showed a difference in periodicity between the menstrual cycle and endometrial cycle, and also between the menstrual cycle and the ovarian cycle, and 8) in the ovary, luteinized cysts were observed in 21, 6% of all the cases, corpus luteum persistence in 27.5%, stromal hyperplasia in 33.3%, and follicular cysts in 64.7%. Both the stromal hyperplasia and the follicular cysts were found to increase in frequency as the degree of adenomyosis uteri advanced.

Further evidence of prolactin production from human decidua and its transport across fetal membrane

In this study the human decidua, chorion and amnion were incubated for short term. Only the decidua, secreted much prolactin clearly among them as a function of time. When the amounts of prolactin in the maternal blood, cord blood obtained from umbilical vein, or those released into decidual incubation medium were compared with the amniotic fluid prolactin levels, only the decidual prolactin correlated significantly with the amniotic fluid prolactin. The urine obtained from newborns showed a low concentration of prolactin. These results suggest that the origin of prolactin present in the amniotic fluid is not from the mother or fetus, but from the decidua which has the ability of producing prolactin, and that prolactin secreted from this tissue may be transported into the amniotic fluid through the fetal membrane and accumulated there.

Clinicopathologic study of adenosquamous carcinoma of the uterine cervix

The 22 adenosquamous carcinoma cases were studied clinicopathologically. The tumor provides many difficulties such as: rapid spreading properties, delayed detection as advanced carcinoma because of the presence of endophytic growth, frequent prevalence of vessel permeation, and radioresistance. Adenosquamous carcinoma was categorized histochemically and histomorphologically into two types--adenosquamous carcinoma (AC) and mucoepidermoid carcinoma, with a comparison being given. As a result, adenosquamous carcinoma (AC) was found inferior to mucoepidermoid carcinoma in radiosensitivity and prognosis, so that categorization into the two types has been considered to be clinically meaningful.

[Significance of serum immunosuppressive substance (IS) levels in the field of gyneco-obstetrics]

To investigate the immune responses of patients with cancer, we assayed a newly found immunosuppressive substance (IS) by the single radial immunodiffusion method. This substance is extracted from ascites of colon cancer. The IS average level in 46 healthy women was 555.4 +/- 112.1 micrograms/ml. The normal upper limit should be 800 micrograms/ml. Seventy cases with uterine cervical cancer had a significantly higher IS level (667.0 +/- 189.8 micrograms/ml) than healthy women (t=3.57, p less than 0.001), especially in Stages III & IV. All 28 patients except one with recurrent cancer showed an IS level higher than 800 micrograms/ml. (1431.7 +/- 480. 9 micrograms/ml). Before recurrence was found clinically, the IS level became higher. In ovarian tumors, assay of the IS level yielded an interesting result: In 16 cases with benign tumors the level was 568.8 +/- 109.7 micrograms/ml. On the other hand, nine patients with ovarian cancer had levels over 800 micrograms/ml. These data suggest that the assay of IS substance may be useful for the staging of uterine cervical cancer, early detection of the recurrence, differentiation between benign and malignant ovarian tumors and so on.

The postoperative classification for uterine cervical cancer and its clinical evaluation

A postoperative classification for uterine cervical cancer has been made in consideration of the spatial spreading of cancer, biological malignancy of 120 cases which were treated with radical hysterectomy and pelvic lymphadnectomy. This classification corresponds extremely well to prognosis. The 5-year survival of the cases with prognostic index (P.I.) 9 or less was 96.1%, while those with P.I. above 10 showed 31.8%. In the Shinshu University School of Medicine clinic, this classification has become indispensable for decision of postoperative irradiation, selection of irradiation methods, and chemotherapeutic agents. Using this classification for individualized therapy, the survival rate was elevated in advanced cancer, class III or IV, with lymph node metastasis and P.I. above 10.

Endometrial carcinoma and its precancerous lesions related with glandular cystic hyperplasia

Morphological investigations were carried out on 184 cases with GCH and related diseases, and the following results were obtained: 1. Pure GCH was observed in 112 cases (60.9%), GCH with ADH in 56 cases (30.4%), and GCH with ATH in 11 cases (6.0%). ECA related with GCH was found in 5 cases (2.7%). 2. It was suggested that GCH can serve as a remote precursor of ECA. Namely, GCH in some cases was found to develop into ECA apparently through the change from ADH to ATH. 3. It was morphologically observed that in GCH, both glandular epithelium and stromal cells were proliferated by being stimulated by estrogen, and such a proliferation was interrupted by an estrogen antagonist, progesterone. On the other hand, in the case of ATH, the growth of stroma was generally decreased and the proliferation of glandular epithelium became predominant. Moreover, the action of progesterone was minimum in ADH and ATH. These findings indicate that precancerous lesions such as ADH and ATH are those capable of developing easily into carcinoma.

Adenocarcinoma of the endometrium following prolonged use of an intrauterine device

An Extremely rare case with the endometrial carcinoma induced by the prolonged (for 20 years) use of IUD (Oota Ring) was reported. The patient was a 57-year-old woman who visited our clinic claiming spotting, and the cancer was revealed by a D & C examination. Since no high risk factors for endometrial carcinogenesis were noted in this patient, it was inferred that prolonged use of IUD played an important role as a cocarcinogen. In particular, the mechanical action of the inserted IUD was thought to be responsible for carcinogenesis. The inflammatory reactions observed in the tumor tissues were considered to be the secondary changes induced by carcinoma.

A clinicopathological study on glandular cystic hyperplasia of the endometrium

Biopsy specimens of the endometrium obtained from the 154 cases diagnosed as glandular cystic hyperplasia were classified into 3 types. The results obtained are as follows: 1) The number of cases thus classified was 43 for type I, 78 for type II and 33 for type III. 2) Clinical diagnosis showed that functional uterine bleeding had the highest incidence, followed by myoma of the uterus, endometrial carcinoma and abortion in this order. 3) By age, 69.0% of the cases was concentrated in the fifth decade, the average age being 44.7 years. 4) Major clinical symptoms were 1) irregular cycle of menstruation, 2) prolonged genital bleeding, 3) anemia and 4) recurrence of symptoms. These symptoms were observed most frequently in type I, followed by type II and type III. Similar tendency was observed also in the incidence of complications with some of these symptoms. 5) The degree of endometrial hypertrophy was 3.7 +/- 1.0 mm for type I, 2.8 +/- 0.9 mm for type II and 1.6 +/- 0.9 mm for type III. 6) The incidence of the endometrial glandular epithelium in its active form was 70.7% for type I, 26.7% for type II and 25.9% for type III. 7) Stromal hyperplasia was found in 70.7% of the type I, 50.0% of the type II and 29.6% of the type III respectively.

Bizarre leiomyoblastoma (epithelioid leiomyosarcoma) of the uterus--a case with a malignant clinical course

A case of a bizarre leiomyoblastoma (epithelioid leiomyosarcoma) which developed in the uterus of a 64-year-old woman and showed a malignant clinical course was reported. Histologically, the tumor in the present case had a number of bizarre giant cells, while the portion showing an epithelioid pattern was minor. Since the existence of an intimate inter-relationship between tumor cells and the smooth muscles of the blood vessel wall was a characteristic finding in the present case, a possible role of vascular smooth muscles as a tumorigenic matrix was suggested. Because of the closure of the internal os of the uterus by the tumor, the uterus had a cystomorphous appearance, and contained about 800ml of intrauterine fluid. The highest number of mitosis observed was 7 per 10 HPF. In view of abundant existence of intranuclear cytoplasmic inclusions, the malignancy of the present case was strongly suspected from a histological diagnostic point of view. The patient died 5 months after surgery because of metastases to the lumbar vertebra and to the lung.

Study on the histogenesis of ovarian tumors--with special reference to five clinical cases with common epithelial tumors detected during the preclinical stage

Common epithelial tumors of the ovary, which were found during the preclinical stage in the 5 cases were described, and the histogenesis of ovarian tumors was discussed. 1. All the ovaries in the 5 cases maintained a nearly normal external appearance. As regards the cut surface, 3 cases showed gross-observable tumor mass, and 2 cases had microscopically detectable tumor tissues. All of these tumors were solid, and the cyst formation was not evident to the macroscopical examination. 2. Three cases were serous tumors, and the other 2 cases were of the endometrioid type. Two cases were malignant, and 3 cases were LPM. In two of the cases, the pictures which appeared to correspond to the early stage picture of the unclassified tumor were observed. 3. Non-tumoral inclusion cysts were observed in 4 cases, and the majority of them showed some growth activities. In 2 cases out of these 4, the transient pictures from the active inclusion cyst to the tumor were observed. 4. Tumorgenesis was multicentric based on inclusion cysts, and the tumor proliferated with spreading inside the lymph space in the ovary. The formation of the small cyst and the proliferation in a papillary form were the basic pattern of the tumor.

A study on prognostic factors of uterine cervical cancer

Prognostic factors of cancer of the cervix were studied in 286 cases treated by radiotherapy. The four items stated below relating to morphological characteristics and found to be comparatively easy to determine clinically were selected as prognostic factors. The factors are (1) clinical stage, (2) morphology of the uterine cervix, (3) histological type of cancer and (4) radiosensitivity. Each prognostic factor and prognosis indicated in every case by chi-square test (chi 2 test) a risk rate lower than 0.1%, a significant difference. Furthermore, every prognostic factor was given points according to their grade, and the total points were expressed as a prognostic index. The prognostic index was classified into the mold zone (from 1 to 8 points), the moderate zone (from 9 to 10 points), and the severe zone (from 11 to 18 points), and the five year survival rate of each zone was observed to be 91.5%, 56.1% and 18.9% respectively. Thus, at a risk of less than 0.1%, a significant difference was observed. By setting up the prognostic index, it was possible to estimate the prognosis of every case of cervical carcinoma, which to date had been nearly impossible to estimate by each prognostic factor alone.

[Studies on parametrial infiltration of uterine cervical cancer (author's transl)]

It is clear that the prognosis of uterine cervical cancer depends on the spread of cancer, especially lymphnodes metastases and parametrial infiltration. The correct diagnosis of parametrial infiltration before treatment is, however, difficult and there are many over- and under-diagnosis. In this paper, we discuss the details of parametrial infiltration based on the radically hysterectomized specimens in Shinshu University Hospital from 1964 to 1978. In these period, 284 cases of uterine cervical cancer were operated by Okabayashi's radical hysterectomy and our postoperative classification were carried out. The results were as follows; 1) The incidence of parametrial infiltration were 16.4 in Stage Ib, 36.6% in Stage IIa, 57.5% in Stage IIb and 35.6% in all cases. 2) When divided the parametrial tissue into three parts, we could find carcinomatous infiltration into uterine part in 77.3% of positive cases, middle part in 16.2% and pelvic part in 16.2%. 3) The agreement between clinical diagnosis and histological findings were 72.2% in all cases. 4) The CPL classification had close relation with parametrial infiltration (C type; 0%, P type; 17.9%, L type; 61.8%). 5) The 5-year survival rate of patients with infiltration showed poor outcome (63.0% in 81 cases), but that with no infiltration had good prognosis (98.4% in 128 cases). In conclusion, parametrial infiltration is very important for treating the uterine cervical cancer patients.

A case of ovarian endometrioid carcinoma and malignant transformation of adenomyosis uteri

The perusal of literatures revealed that simultaneous malignant transformation of predisposing ovarian endometrioid tumor and uterine adenomyosis is a rare occurrence. A case report of endometrioid carcinoma in the right ovary and malignant transformation of adenomyosis in the uterus in a 52-year-old female was described. Both foci were histologically classified as mature adenoacanthoma and separately originated from the so-called endometriosis. There is no continuity associated with metastasis between the two carcinoma foci.

A clinicopathological study on glassy cell carcinoma of the cervix

From the present investigation, it was verified that glassy cell carcinoma is a clinicopathologically independent tumor. As a result, the following conclusions are drawn: 1. The frequency of glassy cell carcinoma is 1.3% of all cervical carcinomas. 2. The prognosis of this type of tumor is poor. Death occurred in 13 of 14 cases studied. The survival period was an average of 16.1 months. 3. The following factors contribute to poor prognosis of this type of tumor: rapid growth, readiness for distant metastasis, and resistance to irradiation. 4. Histologically, undifferentiated tumor cells with distinct nucleoli, including many mitotic figures, form a mantle-like layer around small blood vessels. Cells characterized by the presence of cytoplasm with a ground-glass appearance are found outside this layer. 5. The authors have proposed a form of carcinoma possessing the characteristics of both squamous cell carcinoma and adenocarcinoma, and called it an intermediate group. Glassy cell carcinoma seems to be classified into a subtype of this group. Some other subtypes closely related to this carcinoma were noticed. 6. Tumors to be distinguished from glassy cell carcinoma, large cell, non-keratinizing squamous cell carcinoma and lobular type carcinoma were pointed out in this report.

A histological study on immune reaction of advanced uterine cervical carcinoma with regard to the effect of a low-dose irradiation and PS-K

Histopathological studies were carried out to determine whether or not an immunological reaction was involved in the treatment of cervical carcinoma. The following conclusions could be drawn from them. (1) A low-dose irradiation on the primary cancer-nest intensified the interstitial reaction. (2) When PS-K was administered after low-dose irradiation, the interstitial reaction was intensified more remarkably than with irradiation alone. Moreover, it was possible for PS-K administration to restore the responsiveness of lymph nodes which had been inhibited by the irradiation. (3) Some of the observed morphological changes suggested the local occurrence of an immunological reaction. The following findings could be pointed out: (a) In the primary lesion of the uterine cervix, exudative cells consisting mainly of lymphocytes, plasma cells, and macrophages formed a barrier-like layer surrounding the cancer-nest. Granuloma accompanied by foreign-body type giant cells were formed in the interstitial tissue. Moreover, lymphoid tissues with a germinal center were formed. (b) In lymph nodes of the region involved, responsiveness was enhanced in the paracortical area, or a germinal center formed with its responsiveness enhanced. (4) There was a correlation between the degree of interstitial reaction of the primary lesion and the survival results of a follow-up survey. There was also a correlation between the degree of enlargement of lymph nodes and the survival results of this survey.

A study on radiosensitivity and prognostic factors of cervical adenocarcinoma

Investigations were made, with the patient having uterine cervical adenocarcinoma of differentiated type, on the histological damage of tumor cells caused by irradiation, on the time course of the of the diminution of adenocarcinoma cells and on the reason why the prognosis of patients with adenocarcinoma is usually poorer than those with squamous cell carcinoma. The results obtained are as follows: 1. As to the histological picture of good irradiation effect, the damage of the nucleus, desquamation of adenocarcinoma cells from their bases and the decrease of the number of adenocarcinoma cells due to irradiation was markedly slower than that of squamous cell carcinoma. 3. As important factors affecting the prognosis of patients with adenocarcinoma, the method of treatments, clinical stage, the size of cervical tumor and the degree of histological invasion may be implicated. In particular, regardless to the method of treatments good prognosis may not be expected to the case which is at advanced clinical stage, has hypertrophy of the cervix cervix greater than 4.5 cm in diameter or deep ulcer formation or shows histological picture of severe infiltration.