Short communication: adverse chronic effects of high-dose irradiation on proximal bronchus in patients treated for bronchogenic carcinoma

Of five patients with epidermoid carcinoma of the lung who were treated with small fields of 80 Gy in 40 fractions/8-11 weeks (TDF123-129) to the hilar region, four patients developed marked stenosis of the proximal bronchi without tumour progression and died of pulmonary insufficiency 1-3 years after radiotherapy. These results should serve as a warning against escalation of the radiation dose, and the upper optimal dose might prove to be less than 80 Gy for the treatment of pulmonary hilar lesions.

Biocytin-specific 110-kDa biotinidase from human serum

Biotinidase purification from human serum was performed under new protocol. With HPLC biotinidase assay instead of colorimetric method and using non-ionic surfactant, 110-kDa biotinidase was discovered and co-purified in addition to the previously identified 76-kDa biotinidase. This newly identified enzyme accounted for 5% of the total biotinidase activity. Protein core of 110 kDa was estimated as 72 kDa by use of N-glycanase and SDS-PAGE analysis, while that of the 76-kDa enzyme was estimated as 59 kDa. Total amino acid analysis indicated 30% higher absolute amounts of amino acids in 110-kDa enzyme. The following differences were observed from kinetic study: the 110-kDa enzyme showed a 10-fold lower Km value and a 9-fold higher kcat/Km value for biocytin than those of 76-kDa enzyme. Thus, 110-kDa enzyme is more likely to be the physiological biocytin hydrolase (biocytinase), since the biocytin concentration in human serum is extremely low. The pathogenesis of an inborn error of the metabolism such as a variant form of biotinidase deficiency, which presented an atypical clinical course, might be related to these isoenzymes in terms of their different roles in the body.

Lipoamidase activity in normal and mutagenized pancreatic cholesterol esterase (bile salt-stimulated lipase)

Purified human milk lipoamidase was digested with endoproteinase Lys-C and the digested peptides were subjected to gasphase microsequence analysis. The sequencing of three isolated peptides of human milk lipoamidase revealed the identity of this protein with human milk bile salt-stimulated lipase (pancreatic cholesterol esterase). The identity of the cholesterol esterase with lipoamidase was confirmed by expressing a recombinant form of rat pancreatic cholesterol esterase and testing for lipoamidase activity of the recombinant protein. The results showed that the recombinant cholesterol esterase displayed both lipolytic and lipoamidase activities and was capable of hydrolysing triacetin and lipoyl-4-aminobenzoate (LPAB). The mechanisms of the esterase and amidase activities of the enzyme were further tested by determining enzyme activity in a mutagenized cholesterol esterase with a His435-->Gln435 substitution. This mutation has been shown previously to abolish enzyme activity against esterase substrates [DiPersio, Fontaine and Hui (1991) J. Biol. Chem. 266, 4033-4036]. We showed that the mutagenized protein was effective in hydrolysing the amidase substrate LPAB and displayed similar enzyme kinetics to those of the native enzyme. These data indicate that the mechanism for the cholesterol esterase hydrolysis of lipoamides is different from that of the hydrolysis of substrates with an ester linkage. The presence of an enzyme in the gastrointestinal tract capable of both ester and amide hydrolysis suggests an important role for this protein in the digestion and absorption processes.

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.

Radioimmunodetection of lung cancer with IMACIS-1, I-131 labeled monoclonal antibodies to CEA and CA19-9. Comparison of accumulations in irradiated and non-irradiated site

IMACIS-1 is a radiopharmaceutical containing a mixture of Iodine-131 labeled monoclonal antibodies to CEA and CA19-9. IMACIS-1 immunoscintigraphy was evaluated for tumor detection in 7 primary lung cancer and 2 metastatic lung cancer patients who received radiotherapy. No adverse side effects due to IMACIS-1 were observed in this study. Positive detection was achieved in 5 of 9 patients (55.6%). It was less, but nearly the same as the detection rate obtained with Gallium-67 citrate (67Ga-citrate) in these patients. There was no clear correlation between IMACIS-1 accumulation and the CEA or CA19-9 serum levels. The IMACIS-1 positive detection rate decreased in many of the irradiated lesions. We considered that the decreased number of tumor cells and changes in blood perfusion are some of the factors controlling accumulation in tumors.

Biocytin synthetase activity in human milk as assessed by high-performance liquid chromatography

A reversed-phase liquid chromatographic assay for biocytin synthetase activity has been developed. By this method, biocytin synthetase, isolated to homogeneity from human milk, was found to synthetize biocytin from biotin and L-lysine in the presence of ATP and magnesium ion(s). Both ATP and magnesium ion(s) were required for the synthesis of biocytin. Equal molar amounts of ADP and ATP were produced and consumed, respectively, in the course of the production of the same molar amount of biocytin; however, production of AMP was not observed. Biocytin synthetase Michaelis constants were 2.5, 1.8, and 0.11 mM for biotin, L-lysine, and ATP, respectively. Biocytin synthetase from milk was shown to synthesize biocytin in a stoichiometric amount.

Cerebrospinal fluid flow void in children

We studied the frequency and clinical value of cerebrospinal fluid flow void in 49 normal children who underwent MRI on a 0.35 T unit. T2-weighted axial SE images were retrospectively analysed to determine relative signal intensities of the fourth, third and lateral ventricles and the cerebral aqueduct, rated as high intensity, low intensity, and no signal (flow void). Flow void was seen in the fourth ventricle in 20% of children up to 3 months of age, 67% from 4 to 6 months of age, in all children aged between 7 months and 2 years and in about half of those aged more than 3 years. In cerebral aqueduct the figures were 40% up to 1 month, age, 80% at 2-3 months and 100% above 4-6 months of age, and in the third ventricle 0% up to 1 month, 60% at 2-3 months, 67% at 4-6 months, and almost 100% in above 7 months. Flow void was much more frequent at 1-6 years of age than in adults and less frequent in neonates, which may reflect the different compliance of the growing brain.

[Long-term neurological outcome in children with convulsions during exanthema subitum]

We examined long-term neurological outcome of 12 patients, whose first febrile seizures had occurred during exanthema subitum (ES) and who had been treated with continuous daily administration of anticonvulsant drugs. Six of 12 children had a family history of febrile or afebrile convulsions and in a sister of one patient, athetoid palsy followed the status of afebrile convulsion (AC) during ES. Twelve cases were clinically classified into four groups; (A) 2 patients in whom ACs were repeated as soon as the fever of ES had dropped, (B) 6 patients in whom frequent recurrences of febrile convulsion followed ES, showing epileptic EEG abnormalities, (C) 1 patient who had suffered from later epilepsy, (D) 3 patients who showed complex type of febrile convulsion only during ES without any EEG abnormalities. Except one patient in group (A), who showed residual hemiparesis on the left, 11 cases demonstrated normal psychomotor development, and in 5 of all 12 cases, the treatment with anti-convulsant drugs could be discontinued. Unless severe neurological sequelae are complicated, long-term prognosis is not so poor in children whose first febrile convulsion occurred during ES.

A morphometric study of the blood-brain barrier in Alzheimer's disease

BACKGROUND

Abnormalities in the human blood-brain barrier may contribute to the pathogenesis of Alzheimer disease (AD).

EXPERIMENTAL DESIGN

Morphometric parameters relevant to integrity of the blood-brain barrier (cerebral capillary endothelium) were assessed in brain biopsies from patients with AD and compared with values from age-matched nondemented controls.

RESULTS

Alzheimer patients showed diminished mitochondrial density and area within cerebral capillary endothelium, an increased number of capillary profiles containing pericytes (a possible second line of defense when the capillary endothelium fails), and features of inter-endothelial junctions that suggest 'leakiness' of the blood-brain barrier.

CONCLUSIONS

The data indicate subtle but definite abnormalities suggesting compromise of the blood-brain barrier in AD that may contribute to its pathogenesis, and support neuropharmacologic and morphologic studies that suggest that a form of denervation microangiopathy may occur in AD brain, possibly secondary to loss of neurons from the pontine locus ceruleus. The changes may also play a role in the deposition of A4 Alzheimer amyloid within cerebral microvessel walls.

[Health conditions of caregivers of elderly living at home and the influence of factors present in the home care environment]

Health conditions of primary caregivers for elderly aged 65 and over living at home were surveyed. Subjects were 167 caregivers in Osaka prefecture. Results obtained were as follows. 1) The primary caregivers were largely associated with and varied with the sex of the cared elderly. The caregivers for the female elderly were almost daughters-in-law or daughters. The caregivers for the male elderly were mostly their elderly wives. 2) Seventy-five percent of the caregivers had health complaints, such as anxiety for health, physical fatigue, lower back pain, sleeplessness, or emotional fatigue. 3) Logistic regression analysis was used to statistically analyze factors in the home care environment. Health conditions of the caregivers showed significant correlation with age of caregivers, sex of the elderly, degree of dementia, and number of family members.

Release of anchored membrane enzymes by lipoamidase

Lipoamidase is found to be able to release various membrane-anchored enzymes from the membrane compartment of pig brain. Released enzymes revealed their intact enzyme activities in the soluble fraction. Lipoamidase could release at least two types of anchored enzymes, i.e. glycosyl-phosphatidylinositol-bonded and myristoylated enzymes, but not integral membrane bound enzymes. The reaction was competitively inhibited by lipoyllysine. This releasing mechanism found in the membranes may play important roles in the secretory mechanism of extracellular enzymes and also in the cellular signal-transduction system through topological changes in cellular enzymes.

An enzyme releasing lacto-N-biose from oligosaccharides

alpha-L-Fucosidase (alpha-L-fucoside fucohydrolase; EC 3.2.1.51) preparations from Streptomyces sp. 142 were found to contain an enzyme specific for lacto-N-biosidic (Gal beta 1-3GlcNAc beta 1-) linkages (type 1 structure) in oligosaccharides. The enzyme preparation, which was eluted after alpha-fucosidase from a CM-Sepharose column, contained some alpha-fucosidase activity but was free from other glycosidases and proteases. Substrate specificity studies with oligosaccharides labeled with 2-aminopyridine showed that the enzyme specifically hydrolyzed lacto-N-tetraose (Gal beta 1-3GlcNAc beta 1-3Gal beta 1-4Glc) but did not hydrolyze lacto-N-neotetraose (Gal beta 1-4GlcNAc beta 1-3Gal beta 1-4Glc), lacto-N-triose, sialyl lacto-N-tetraose, lacto-N-fucopentaose I, II, or III, asialo-GM1 tetrasaccharide, or poly-N-acetyllactosamine. Structural analysis of the enzyme digest of the N-acetyllactosamine type of triantennary sugar chain with type 1 structure showed that lacto-N-biose (Gal beta 1-3GlcNAc) and the N-acetyllactosamine type of biantennary sugar chain were produced. Thus this enzyme was tentatively named lacto-N-biosidase, because it hydrolyzes oligosaccharides containing a type 1 structure at the nonreducing terminus and produces lacto-N-biose.

Electrolyte disturbances caused by intravenous contrast media

The changes in serum electrolytes (sodium, potassium, ionized calcium, and total calcium) produced by high-dose (3 ml/kg) intravenous contrast media were investigated in Japanese white rabbits. The test solutions included sodium/meglumine diatrizoate (370 mgI/ml), sodium/meglumine ioxaglate (320 mgI/ml), iohexol (350 mgI/ml), iopamidol (370 mgI/ml), 20% mannitol, and isotonic saline. The alterations in serum ionized calcium were relatively small and transient, and correlated with changes in the hematocrit. Diatrizoate caused a significant decrease in ionized calcium in comparison with other contrast media and mannitol. The ratio of ionized calcium to total calcium showed no significant decrease in any group. The changes in potassium did not correlate with those in hematocrit. Diatrizoate caused a smaller decrease in potassium than low-osmolality contrast media, which may suggest that diatrizoate caused a shift in potassium from extravascular space to intravascular space. In conclusion, intravenous infusion of high doses of low-osmolality contrast media did not cause clinically significant alterations in serum electrolytes.

Evaluation of high-resolution CT after tympanoplasty

The temporal bones of 28 patients who underwent tympanoplasty were evaluated with high-resolution CT (HRCT). Seventeen patients had undergone tympanoplasty with a columella, used to form an ossicular reconstruction. The incus body was used as the columella in 4 patients and a prosthesis was used in 13 patients. No columella was used in the other 11 patients. After tympanoplasty, CT demonstrated normal appearance in 8 patients. Of the other 20 patients, 16 were diagnosed with chronic otitis media, and 4 were diagnosed with recurrent cholesteatoma on the basis of follow-up CT examinations. Seven underwent reoperation. In all 4 patients with recurrent cholesteatoma, the diagnosis was pathologically confirmed at reoperation. In 1 patient diagnosed with chronic otitis media, the pathological diagnosis was recurrent cholesteatoma. The columellae in 8 of the 17 patients could not be identified on CT because of surrounding soft tissue mass, but in the other 9 patients the condition of the ossicular reconstruction was well demonstrated. Prosthesis dislocation was apparent in 2 patients. We recommend HRCT examination in the follow-up of tympanoplasty patients.

Radiation therapy for stage I and II laryngeal cancer using 10 MV X-rays or cobalt-60 gamma-rays

From 1970 to 1985, 117 patients with stage I and stage II carcinoma of the larynx (98 with glottic, 15 with supraglottic, and 4 with subglottic cancer) received radiation therapy. The patients were treated with (1) a 60Co machine equipped with 45-degree wedge filters, at a total dose of 6,000-7,000 cGy, 300 cGy per fraction, 3 days a week in the period from 1970-1974; (2) 10 MeV linear accelerator X-rays from 1975-1980, and (3) 10 MeV linear accelerator X-rays and/or the 60Co machine in the period from 1981-1985, at a total dose of 6,000-7,000 cGy, 5 days a week by parallel opposing portals without wedge filters. The 5-year local control rates by radiotherapy alone were 66%, 78%, and 83%, respectively, in the three periods, and the 5-year survival rates were 77%, 97%, and 96% following salvage surgery for recurrent disease. In the 1970-1974 period, four patients developed severe laryngeal edema, and two patients had total laryngectomy without local residual tumor. In the 1975-1985 period, 16 patients had local recurrence in five years, and in five of them the tumor exhibited verrucous-like histopathological findings. In the 1975-1980 period, local recurrence was considered to result from underdosing of lesions with 10 MV X-ray beams and split-course irradiation. In the last five years of the period, the 5-year local control rate for stage I and II carcinoma of the glottis, excluding verrucous-like carcinoma, reached 90% with 10 MV X-rays combined with 60Co gamma-rays.

Phase I trial of murine monoclonal antibody L6 in combination with subcutaneous interleukin-2 in patients with advanced carcinoma of the breast, colorectum, and lung

PURPOSE

A phase I trial was undertaken to determine the toxicity and biologic effects of a combination of murine monoclonal antibody L6 (MoAb L6) plus subcutaneous (SC) interleukin-2 (IL-2).

PATIENTS AND METHODS

Fifteen patients with refractory adenocarcinoma (five breast, five lung, five colorectal), received L6 at 200 mg/m2 intravenously (IV) daily on days 1 to 7, followed by a 1-week rest period. IL-2 was given at either 2, 3, or 4.5 x 10(6) U/m2 daily doses times 4 days for a total duration of 3 weeks.

RESULTS

Side effects of L6 consisted of mild fever and chills along with a rash and serum sickness in one patient. One patient developed dyspnea and urticaria, that resolved with antihistamines. Maximum-tolerated dose (MTD) of SC IL-2 was 3 x 10(6) U/m2, with dose-limiting toxicities that consisted of grade 4 fatigue and dyspnea. Significant decreases in complement levels along with increases in absolute lymphocyte count and eosinophil count were observed. Mean antibody-dependent cellular cytotoxicity from mononuclear cells taken from patients who received IL-2 was elevated significantly compared with baseline in all patients independent of IL-2 dose (P less than .05). Serum IL-2 levels were elevated in 13 of 14 patients (range, 0.9 to 100 U/mL). Human antimouse antibody (HAMA) titers were elevated in nine of 14 (64%) patients who were tested between 3 and 8 weeks after L6 infusion. One patient with breast cancer had a transient mixed response, and one patient with colorectal cancer had a partial response.

CONCLUSIONS

L6 and SC IL-2 were well tolerated in the majority of patients when given in the outpatient setting. In view of the clinical efficacy of this combination, more phase II trials are warranted.

Murine thymic CD4+ T cell subsets: a subset (Thy0) that secretes diverse cytokines and overexpresses the V beta 8 T cell receptor gene family

We demonstrate here the presence of a distinct mature CD4+8- T cell subset in mouse thymus. This subset, termed "Thy0," is delineated by the absence of 3G11 expression from about half of the 6C10-/HSAlow/- fraction of CD4+8- thymic cells. Thy0 is detectable from the neonatal period and largely contributes the Th0-type diverse cytokine production previously reported for the HSAlow/-CD4+ thymic population. Further, cells expressing the T cell receptor V beta 8 gene family are found at increasing frequency in Thy0 with age, comprising 40-60% of Thy0 in adult BALB/c mice. This alteration of V beta 8+ cell frequency is unique to Thy0, since no other CD4+ subset in thymus or spleen shows such V beta 8 overusage. All functional CD4+ T cell subsets, including Thy0, show appropriate V beta clonal deletion associated with endogenous superantigens. Thus, it appears that Thy0 is an intrathymically generated secondary cell subset produced after CD4+ T cell selection.

Expression and function of adhesion molecules on human hematopoietic stem cells: CD34+ LFA-1- cells are more primitive than CD34+ LFA-1+ cells

Advances in fluorescence-activated cell sorter technology have brought about multicolor analysis of cell phenotypes. To clarify the phenotypes of human hematopoietic stem cells (HSCs), we initially prepared novel antibodies against CD34 and labeled one of them (4A1) with allophycocyanin (APC). With this, we analyzed the phenotypes of CD34+ HSCs and showed that primitive HSCs or CD34+CD33- cells expressed adhesion molecules such as CD43, CD44, CD11a, CD11c, CD18, and leukocyte adhesion molecule (LAM-1). The more primitive hematopoietic cells or CD34+CD38- cells also expressed CD11a and CD18 with an incidence of 20% to 30%. To clarify the role of adhesion molecules in HSCs, we examined the colony forming capacity after long-term culture with allogeneic irradiated stromal layers. Among CD34+CD33- cells, CD18+ cells gave rise to colony-forming cells (CFCs) on stromal layers, but reached a maximum at week 2, after which the number of generated CFCs decreased. On the other hand, CD18- cells generated less CFCs than CD18+ cells at 2 to 3 weeks, but increased after 4 weeks of culture. When CD18 or CD11a antibody was added to a coculture system of CD34+CD33- cells with stromal layers, the number of generated CFCs decreased significantly compared with the no antibody control. Leukocyte function-associated antigen-1 (LFA-1) (CD11a/CD18) was expressed on some populations of hematopoietic cells and contributed to the proliferation by interacting with stromal cells. However, more primitive cells capable of reconstituting hematopoiesis did not express LFA-1. These data provide a rationale for the administration of anti-LFA-1 antibody after bone marrow transplantation for reducing the graft failure.

Risk factors for cognitive aging in adult twins

Monozygotic (MZ) and dizygotic (DZ) twins in later adulthood were studied in order to examine genetic and environmental contributions to the decline of cognitive performance. In this study, 118 twin pairs took a comprehensive medical examination at a university hospital. Cognitive function was measured by the Wechsler Adult Intelligence Scale (WAIS). The intraclass correlation coefficients on Digit Span (D) and Digit Symbol (DS) subtests of the WAIS did not show any significant difference between MZ and DZ twins although Block Design (BD) showed a significant difference. The values of the intraclass correlation coefficients were mostly around 0.5 and showed significant within-pair similarity of test scores. The mean score of D, DS and BD declined with advancing age. The intraclass correlation coefficients for D, DS and BD were around 0.2 in the MZ twins reared apart, and around 0.6 in the MZ twins reared together. These results indicated a significant environmental influence on cognitive aging in later adulthood.

Intrapair differences of physical aging and longevity in identical twins

The genetic and environmental contributions to physical aging (hair graying, balding, presbyopia) and longevity (age at death) were examined by within-pair comparison in monozygotic (MZ) and dizygotic (DZ) twins in later adulthood. Physical aging was investigated on 135 pairs of adult twins aged over 50. Hair graying and hair loss (baldness) showed significantly higher rates of concordance in the MZ twins than in the DZ twins. The intrapair difference of the degree of hair graying was negligible in 79%, slight in 15% and striking in 5% among the MZ pairs; while negligible in 40%, slight in 50% and striking in 10% among the DZ pairs. The intrapair difference of the degree of hair loss was negligible in 92%, slight in 8% (and striking in none) among the MZ pairs; while negligible in 69%, slight in 25% and striking in 6% among the DZ pairs. The age at onset of presbyopia showed a slightly higher rate of concordance in the MZ than in the DZ pairs. Longevity (age at death) was surveyed on 184 pairs of twins who died at over 40 years of age. The intrapair difference of longevity was 6.65 +/- 5.6 years (maximum 18.0; minimum 0.04) in the MZ pairs, and 8.66 +/- 7.2 years (maximum 18.6; minimum 2.9) in the DZ pairs. The MZ pairs showed a slightly smaller within-pair difference of longevity than the DZ pairs.

T cell functions of IL-2-activated tumor-infiltrating lymphocytes from renal cell carcinoma

Renal cell carcinoma (RCC) is one of the few cancers partially sensitive to biotherapy. However, involvement of T cell immunity in host-defense against autologous tumor cells remains unclear. This manuscript investigated T cell functions of interleukin-2 (IL-2)-activated tumor-infiltrating lymphocytes (TILs) from human RCCs by studying their oligoclonality, cytotoxicity, and cytokine production. IL-2-activated RCC-TILs from 17 of 33 cases (52%) (p < 0.01 vs. IL-2-activated patients' peripheral blood mononuclear cells, PBMC) displayed oligoclonal expansion as determined by seven different monoclonal antibodies (mAbs) to T cell receptor (TCR) V alpha or beta regions after 2 to 5 weeks in culture. By comparison, IL-2-activated PBMC from only 1 of 15 healthy donors (7%), 3 of 23 patients (13%), and IL-2-activated lymphocytes from nontumorous kidney from 1 of 8 (12.5%) cases (V beta 5.1) did. Specifically, IL-2-activated RCC-TILs showed oligoclonal expansion of V alpha 2+ cells (8/33 cases, p < 0.05 vs. IL-2-activated patient's PBMC), V beta 5.1+ cells (6/33), V beta 8+ cells (4/33), V beta 12+ cells (4/33), and V beta 6.7+ cells (2/33). Oligoclonal expansion of plural TCR V regions was observed in 6 of 33 cases. IL-2-activated RCC-TILs from 4 of 16 cases produced higher levels of interferon-gamma (IFN-gamma) in culture with autologous tumor cells than with allogeneic tumor cells. Those from 11 of 16 cases did not produce IFN-gamma in response to autologous tumor cells, and the remaining case produced it in a major histocompatibility complex (MHC)-nonrestricted manner. IL-2-activated RCC-TILs with oligoclonal expansion in 4 of 5 cases showed IFN-gamma production in response to the corresponding anti-TCR V region mAb as well as anti-CD3 mAb. IL-2 and IL-4 were not detected in any cases tested. IL-2-activated RCC-TILs displayed cytotoxicity relatively restricted to autologous tumor cells in only 1 of the 16 cases evaluated, MHC-nonrestricted cytotoxicity in 12 cases, NK activity in one case and no cytotoxicity in two cases. In summary, IL-2-activated RCC-TILs demonstrated the oligoclonality in approximately half of the cases (17 of 33, 52%), but rarely displayed either autologous tumor-specific-IFN-gamma production (4 of 16 cases) or -cytotoxicity (1 of 16 cases).