Ecdysteroid hormones and metabolites of the stone crab, Menippe mercenaria

The Y-organs of the xanthid crab Menippe mercenaria secrete the ecdysteroids, 3-dehydroecdysone (3DE) and lesser amounts of 3-dehydro (or 2-dehydro)-25-deoxyecdysone (3D25dE) in vitro. These ecdysteroids were identified by elution-time comparisons with authentic standards, mass spectrography, and, for 3D25dE, infrared spectrometry. Tissues were incubated 18 hr with [(3)H]3DE. Activities representing 3beta-reductase and 20-hydroxylase generally were present, evidenced by finding in the tissue/medium extract labeled ecdysone (E) and 20-hydroxyecdysone (20E). Labeled 3-dehydro-20-hydroxyecdysone (3D20E) also appeared to be present. Tissue blanks and hemolymph were devoid of activity. Muscle was low, hypodermis was intermediate, and hindgut and gonads were high in activity of the enzymes. Consistent with the presence of these enzymes in peripheral tissues, ecdysteroid products identified in the hemolymph were 20E, 3D20E, and 25-deoxy-20-hydroxyecdysone (25d20E; ponasterone A). Structures of 20E and 3D20E were confirmed by co-elution with authentic standards in high-performance liquid chromatography (HPLC), co-elution of derivatives in gas chromatography, and mass spectroscopy. Ponasterone A (identified by HPLC co-elution with the standard), like 20E is present in the hemolymph in prominent amounts. These data indicate that Menippe, among crustaceans thus far studied, secretes a unique combination of ecdysteroid hormones, namely, a 3- (or 2-) oxo compound and a 25-deoxy compound. This represents a different kind of branch point from 5beta-diketol in ecdysteroid biosynthesis, in which the intermediate, 5beta-ketodiol is bypassed. A result is the joint appearance in the circulation of the hormones, 20E and ponasterone A, which in other species are singly prominent.

Intracerebral hemorrhage after liver transplantation

We report 5 patients with intracerebral hemorrhage after orthotopic liver transplantation (OLT) and identify the possible risk factors. Between November 1991 and April 1999, 75 adult patients received 77 orthotopic liver transplants at Queen Mary Hospital, Hong Kong. Five patients (6.5%) developed intracerebral hemorrhage postoperatively. Clinical and laboratory data were reviewed, and potential risk factors were analyzed. The 5 patients developed intracerebral hemorrhage within 40 days (range, 1 to 37 days; median, 4 days) after OLT. The mortality rate was 80% (4 of 5 patients). The intraoperative blood transfusion volume (median, 17,200 mL; range, 15,750 to 30,360 mL) administered to patients who developed intracerebral hemorrhage postoperatively was significantly greater than that (median, 6,990 mL; range, 1,840 to 22,680 mL) for patients without the complication (P =.0008). Massive intraoperative transfusion (>15,000 mL) was required in all 5 patients (100%) with intracerebral hemorrhage but only 9 of 72 patients (12.5%) in the other group (P =.0001). Four of 5 patients (80%) with intracerebral hemorrhage had intraoperative hypotension compared with 7 of 72 patients (9.7%) in the other group (P =.001). No significant difference was found in age, prothrombin time (PT), activated partial thromboplastin time (APTT), incidence of hypertension, bleeding at extracerebral sites, cyclosporine A neurotoxicity, thrombocytopenia, hemodialysis, and sepsis between the patients with and without intracerebral bleeding. However, the median cumulative score of coagulation parameters (PT, APTT, platelet count) was significantly greater in the group with than without intracerebral bleeding (median score, 3 v 1; P =.023). Intracerebral hemorrhage is 1 of the most disastrous complications after OLT. Intraoperative hypotension, massive intraoperative transfusion, and coagulopathy may be correlated with this complication.

Expression of gap junction genes connexin 32, connexin 43 and their proteins in hepatocellular carcinoma and normal liver tissues

AIM: To investigate the significance and mechanism of cx-32 mRNA, cx-43 mRNA and their proteins in hepatocarcinogenesis.

METHODS: Sixty-one cases of HCC and 14 cases of normal liver tissues were detected by immunohistochemical and in situ hybridization (ISH) methods.

RESULTS: In HCC grades I, II, III and normal liver tissues, the positive rates of Cx32 protein were 55.6%, 42.1%, 18.2% and 92.9%, respectively. The detection rates of Cx43 protein were 44%, 26.3%, 12.1% and 78.6%, respectively. There was significant difference in Cx32 and Cx43 protein between HCC and normal liver tissues (P < 0.01). ISH the positive rates of cx 32 mRNA shown by ISH in HCC grades I, II, III and normal liver tissues were 88.9%, 84.2%, 87.9% and 92.9%, respectively. Those of cx43 mRNA were 77.8%, 78.6%, 78. 8% and 85.7%, respectively. There was no statistical difference in the positive rates of cx32 mRNA and cx43 mRNA between HCC and normal liver tissue (P > 0.05).

CONCLUSION: The aberrant location of Cx32 and Cx43 proteins could be responsible for progression of hepatocarcinogenesis, and the defect of cx genes in post-translational processing might be the possible mechanism.

Expression of gap junction genes connexin 32, connexin 43 and their proteins in hepatocellular carcinoma and normal liver tissues

AIM:To investigate the significance and mechanism of cx32 mRNA,cx43 mRNA and their proteins in hepatocarcinogenesis.METHODS:Sixty-one cases of HCC and 14 cases of normal liver tissues were detected by immunohistochemical and in situ hybridization (ISH) methods.RESULTS:In HCC grades I, II, III and normal liver tissues, the positive rates of cx32 protein were 55.6%, 42.1%, 18.2% and 92.9%, respectively. The detection rates of cx43 protein were 44.4%, 26.3%, 12.1% and 78.6%,respectively. There was significant difference in cx32 and cx43 protein between HCC and normal liver tissues (P < 0.01). ISH the positive rates of cx 32 mRNA shown by ISH in HCC grades I, II, III and normal liver tissues were 88.9%, 84.2%, 87.9% and 92.9%, respectively.Those of cx43 mRNA were 77.8%, 78.6%, 78.8% and 85.7%,respectively.There was no statistical difference in the positive rates of cx32 mRNA and cx43 mRNA between HCC and normal liver tissue (P > 0.05).CONCLUSION:The aberrant location of cx32 and cx43 proteins could be responsible for progression of hepatocar-cinogenesis, and the defect of cx genes in post-translational processing might be the possible mechanism.

Expression and significance of HBV genes and their antigens in human primary intrahepatic cholangiocarcinoma

AIM: To explore the etiology and pathogenesis of human primary intrahepatic cholangiocarcinoma, the expression of HBV genes and HBV-antigens was detected in the cancerous tissue and its surrounding hepatic tissues.

METHODS: HBV-antigens were detected by immunohistochemical technique and HBV genes were examined with in situ hybridization.

RESULTS: In 20 cases of cholangiocarcinoma, the positive detection rate of HBxAg, pre-S1, pre-S2, HBsAg and HBcAg was 75%, 40%, 40%, 10% and 0%, respectively, and in the surrounding hepatic tissues of 19 cases the positive rates were 84.2%, 47.9%, 47.9%, 31.6% and 31.6%. Among 40 cases of cholangiocarcinoma, the positive rate of HBVDNA, x-gene, pre-s gene, s gene and s gene fell on 77.5%, 70.0%, 47.5%, 40% and 42.5%, respectively, and of the surrounding hepatic tissues in 33 cases, 87.9%, 84.8%, 63.6%, 69.7% and 66.7%.

CONCLUSION: The development of human primary intrahepatic cholangiocarcinoma bears a close relationship with chronic persistent HBV infection. Particularly, the x gene of HBV and its protein (HBxAg) might play an important role in pathogenesis of hepatic carcinoma.

Increased ventricular repolarization inhomogeneity during postural changes in patients with syndrome X

The interlead variation in QT interval (QT dispersion) can be used to assess regional inhomogeneity of ventricular repolarization under a variety of conditions, including stress. Patients with syndrome X may have increased sympathetic activity that could change QT interval regionally and give rise to an increase in QT dispersion under exercise testing. To test the hypothesis, 26 consecutive patients with syndrome X (group 1) were studied. Two additional groups matched in terms of age, sex, and left ventricular mass index consisting of 26 nonconsecutive patients with coronary artery disease (group 2) and 20 normal subjects (group 3) were studied for comparison. Standing induced a significantly higher increase of heart rate in group 1 than in groups 2 and 3 (7.5+/-6.0 vs 4.0+/-6.3 and 1.1+/-3.6 beats/min; p = 0.05 and 0.003, respectively). There were significant differences in QT dispersion between groups 1 and 2 on upright standing (48+/-12 vs 34+/-14 ms, p = 0.0003), but not at baseline (33+/-14 vs 38+/-11 ms, p = NS) or at peak exercise (38+/-9 vs 38+/-9 ms, p = NS). Results did not change when QTc dispersion was substituted for QT dispersion. From a conditional multivariate logistic regression analysis, the only independent predictor of occurrence of syndrome X on upright standing was QTc dispersion (odds ratio = 1.255, p = 0.01). Electrocardiographic QTc dispersion provides important clinical information. Patients with syndrome X had a higher increase of heart rate and QTc dispersion in response to standing from the supine position compared with patients with coronary artery disease and normal subjects.

Cytosine deaminase adenoviral vector and 5-fluorocytosine selectively reduce breast cancer cells 1 million-fold when they contaminate hematopoietic cells: a potential purging method for autologous transplantation

Ad.CMV-CD is a replication incompetent adenoviral vector carrying a cytomegalovirus (CMV)-driven transcription unit of the cytosine deaminase (CD) gene. The CD transcription unit in this vector catalyzes the deamination of the nontoxic pro-drug, 5-fluorocytosine (5-FC), thus converting it to the cytotoxic drug 5-fluorouracil (5-FU). This adenoviral vector prodrug activation system has been proposed for use in selectively sensitizing breast cancer cells, which may contaminate collections of autologous stem cells products from breast cancer patients, to the toxic effects of 5-FC, without damaging the reconstitutive capability of the normal hematopoietic cells. This system could conceivably kill even the nondividing breast cancer cells, because the levels of 5-FU generated by this system are 10 to 30 times that associated with systemic administration of 5-FU. The incorporation of 5-FU into mRNA at these high levels is sufficient to disrupt mRNA processing and protein synthesis so that even nondividing cells die of protein starvation. To test if the CD adenoviral vector sensitizes breast cancer cells to 5-FC, we exposed primary explants of normal human mammary epithelial cells (HMECs) and the established breast cancer cell (BCC) lines MCF-7 and MDA-MB-453 to the Ad.CMV-CD for 90 minutes. This produced a 100-fold sensitization of these epithelial cells to the effects of 48 hours of exposure to 5-FC. We next tested the selectivity of this system for BCC. When peripheral blood mononuclear cells (PBMCs), collected from cancer patients during the recovery phase from conventional dose chemotherapy-induced myelosuppression, were exposed to the Ad.CMV-CD for 90 minutes in serum-free conditions, little or no detectable conversion of 5-FC into 5-FU was seen even after 48 hours of exposure to high doses of 5-FC. In contrast, 70% of 5-FC was converted into the cytotoxic agent 5-FU when MCF-7 breast cancer cells (BCCs) were exposed to the same Ad.CMV-CD vector followed by 5-FC for 48 hours. All of the BCC lines tested were shown to be sensitive to infection by adenoviral vectors when exposed to a recombinant adenoviral vector containing the reporter gene betagalactosidase (Ad.CMV-betagal). In contrast, less than 1% of the CD34-selected cells and their more immature subsets, such as the CD34+CD38- or CD34(+)CD33- subpopulations, were positive for infection by the Ad.CMV-betagal vector, as judged by fluorescence-activated cell sorting (FACS) analysis, when exposed to the adenoviral vector under conditions that did not commit the early hematopoietic precursor cells to maturation. When artificial mixtures of hematopoietic cells and BCCs were exposed for 90 minutes to the Ad.CMV-CD vector and to 5-FC for 10 days or more, a greater than 1 million fold reduction in the number of BCCs, as measured by colony-limiting dilution assays, was observed. To test if the conditions were damaging for the hematopoietic reconstituting cells, marrow cells collected from 5-FU-treated male donor mice were incubated with the cytosine deaminase adenoviral vector and then exposed to 5-FC either for 4 days in vitro before transplantation or for 14 days immediately after transplantation in vivo. There was no significant decrease in the reconstituting capability of the male marrow cells, as measured by their persistence in female irradiated recipients for up to 6 months after transplantation. These observations suggest that adenovirus-mediated gene transfer of the Escherichia coli cytosine deaminase gene followed by exposure to the nontoxic pro-drug 5-FC may be a potential strategy to selectively reduce the level of contaminating BCCs in collections of hematopoietic cells used for autografts in breast cancer patients.

Mechanism of inhibition of MDA-MB-468 breast cancer cell growth by 2,3,7,8-tetrachlorodibenzo-p-dioxin

Treatment of estrogen receptor (ER)-negative MDA-MB-468 human breast cancer cells with 10 nM 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) induced formation of a nuclear aryl hydrocarbon (Ah) receptor complex as determined by ligand-binding and gel electrophoretic mobility shift assays. TCDD also induced CYP1A1-dependent activity in MDA-MB-468 cells, which represents the first ER-negative Ah receptor-positive human breast cancer cell line that has been identified. Treatment of this cell line with TCDD and related compounds also caused a 50% inhibition of cell growth, which resembled the growth inhibitory effects previously reported for epidermal growth factor (EGF). However, EGF expression is minimal in this cell line and is not induced by TCDD; moreover, EGF and TCDD induced a different pattern of oncogene expression and apoptosis in MDA-MB-468 cells. In contrast, TCDD caused a rapid and sustained induction of transforming growth factor alpha (TGF alpha) gene expression and secreted protein (nearly 2-fold); moreover, the growth-inhibitory effects of TCDD could be blocked by antibodies to the EGF receptor. In a separate experiment, it was shown that TGF alpha also inhibited growth of MDA-MB-468 cells. The results of this study indicate that the mechanism of growth inhibition of MDA-MB-468 cells by TCDD is due to induction of TGF alpha, which is a potent antimitogen in this cell breast cancer line.

Simultaneous team approach of a crown-lengthening procedure and an operative restoration: technique and long-term effect

Traditionally, crown-lengthening procedures to expose subgingival caries for operative restorative work are carried out in a two-stage approach. A disadvantage of this procedure is that the gingival margin associated with the treated tooth moves apically; this may create an esthetic problem. Resin-modified glass-ionomer cement has been demonstrated to have good biocompatibility with dental hard and soft tissues. Surgical and restorative procedures were combined at the same appointment in an effort to achieve a restoration with minimal change in the gingival margin. Four patients have been treated with this one-stage team approach and followed for 8 to 13 months. The clinical results demonstrated this team approach procedure is excellent for the dentition when esthetics is a consideration.

Effect of pretreatment counseling on discontinuation rates in Chinese women given depo-medroxyprogesterone acetate for contraception

The study examined the effect of pretreatment counseling upon discontinuation of 150 mg depo-medroxyprogesterone acetate (Depo-Provera (DMPA)), given for contraception. A total of 421 Chinese women participated, 204 receiving detailed structured pretreatment and ongoing counseling on the hormonal effects and probable side effects of DMPA and 217 receiving only routine counseling. The primary study endpoint was termination rate; secondary endpoints were frequency of medical events and reasons for termination. Study termination rates were significantly lower in the intensive structured counseling group than in the routine counseling group. At one year, the total cumulative termination rates were 11% (23/204) and 42% (92/217), respectively (p < 0.0001). The most common reasons for terminating DMPA were menstrual changes. No pregnancy, serious or unexpected medical events were reported, nor were statistically or clinically significant changes in vital signs observed. We conclude that pretreatment counseling on expected side effects increases the acceptability of DMPA.

Apoptosis and expression of Bcl-2 after compression trauma to rat spinal cord

We have evaluated by in situ nick-end labeling the presence of apoptotic cells in the spinal cord of rats with compression injury at the level of Th8-9 of mild, moderate, and severe degrees resulting in no neurologic deficit, reversible paraparesis, and paraplegia, respectively. Rats with compression injury surviving 4 or 9 days showed apoptotic glial cells in the longitudinal tracts of the Th8-9, the cranial Th7, and the caudal Th10 segments. The apoptotic cells were most frequently observed in Th7. They did not express glial fibrillar acidic protein (GFAP) and their morphology was compatible with that of oligodendrocytes. Neurons of the gray matter did not present signs of apoptosis. In addition, we studied the immunohistochemical expression of Bcl-2, an endogenous inhibitor of apoptosis. Compression induced Bcl-2 immunoreactivity in axons of the long tracts, particularly after moderate and severe compression and 1-day survival. Neurons of dorsal root ganglia were immunoreactive but the neurons of the spinal cord were unstained. The accumulation, presumably caused by arrested axonal transport in sensory pathways, was absent in rats surviving 9 days. In conclusion, compression trauma to rat spinal cord induces signs of apoptosis in glial cells, presumably oligodendrocytes of the long tracts. This may induce delayed myelin degeneration after trauma to the spinal cord. Bcl-2 does not seem to be upregulated in oligodendrocytes.

Effect of transient expression of the oestrogen receptor on constitutive and inducible CYP1A1 in Hs578T human breast cancer cells

Hs578T human breast cancer cells are an oestrogen receptor (ER)-negative cell line. Treatment of these cells with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) resulted in formation of a 6.9 S nuclear aryl hydrocarbon (Ah) receptor complex, which bound to a [32P]dioxin-responsive element in a gel electrophoretic mobility shift assay. However, TCDD does not induce CYP1A1 gene expression or chloramphenicol acetyl transferase (CAT) activity in cells transiently transfected with pRNH11c or pMCAT5.12, which are Ah-responsive plasmids derived from the 5'-flanking region of the human and murine CYP1A1 genes respectively. Restoration of Ah responsiveness was investigated by co-transfecting Hs578T cells with pRNH11c or pMCAT5.12 and plasmids that express the ER (hER), Ah receptor (AhR) and AhR nuclear translocator (Arnt) proteins. ER expression resulted in significantly increased basal CAT activity; however, TCDD did not induce CAT activity in the transiently transfected cells. Expression of the AhR or Arnt proteins did not alter basal or inducible CAT activity. Expression of N- or C-terminal truncated ER in Hs578T resulted in differential regulation of Ah responsiveness. In Hs578T cells transiently expressing the ER, which contains C-terminal deletions (amino acids 282-595), basal CAT activity was also increased; however, Ah responsiveness was not restored. In contrast, transient expression of N-terminal-deleted (amino acids 1-178) ER resulted in a marked decrease in basal CAT activity but a restoration of Ah responsiveness. These results suggest that basal and inducible CAT activity in Hs578T cells transiently transfected with pRNH11c is modulated differentially by ER domains that are present in the N- and C-terminal regions of the ER.

Home healthcare nurses' knowledge and attitudes towards suicide

This study identified home healthcare nurses' knowledge of and attitudes toward suicide in the elderly. Three questionnaires and a demographic data sheet were distributed to nurses who work in three community health agencies. Findings showed that subjects knew some of the signs of potential suicide. Most subjects had a middle to high degree of sympathy and empathy toward elderly persons who attempted suicide, but disagreed wit. h their suicidal actions. There was no significant relationship between knowledge of the signs of potential suicide and attitudes toward suicide in the elderly.

Testing human hair for drugs of abuse. IV. Environmental cocaine contamination and washing effects

Active cocaine use results in sequestration of parent drug in hair. In addition, hair has unique physicochemical properties that permit absorption of cocaine from the environment. When hair is tested for evidence of cocaine, it is important to consider whether the positive test resulted from active drug use or environmental contamination. In a series of laboratory experiments, it was found that exposure of 'cut' hair to cocaine vapor ('crack' smoke) and to aqueous solutions of cocaine hydrochloride resulted in significant contamination of hair samples. Similar results were obtained with two subjects who were exposed to cocaine vapor in an unventilated room. The amount of contamination adsorbed by hair depended upon both time and extent of exposure. Washing the hair samples with methanol removed > 70% of the cocaine contaminant after cocaine vapor exposure, but was less effective (< 50%) following contamination with aqueous cocaine. Shampoo treatment cycles (overnight soaking) progressively removed increasing amounts of cocaine from the contaminated hair, but residual cocaine remained after 10 cycles. Studies were also performed to determine the usefulness of benzoylecgonine as a marker of active cocaine administration. Small amounts of benzoylecgonine (ca. 1 ng/mg) were formed in hair as a result of environmental contamination with cocaine. Also, it was found that benzoylecgonine could be adsorbed from illicit cocaine contaminated with benzoylecgonine. It was concluded that positive hair test results should be interpreted cautiously due to the possibility of environmental contamination from cocaine and related constituents.

Simultaneous assay of cocaine, heroin and metabolites in hair, plasma, saliva and urine by gas chromatography-mass spectrometry

As part of an ongoing research program on the development of drug detection methodology, we developed an assay for the simultaneous measurement of cocaine, heroin and metabolites in plasma, saliva, urine and hair by solid-phase extraction (SPE) and gas chromatography-mass spectrometry (GC-MS). The analytes that could be measured by this assay were the following: anhydroecgonine methyl ester; ecgonine methyl ester;. ecgonine ethyl ester; cocaine; cocaethylene; benzoylecgonine; cocaethylene; norcocaethylene; benzoylnorecgonine; codeine; morphine; norcodeine; 6-acetylmorphine; normorphine; and heroin. Liquid specimens were diluted, filtered and then extracted by SPE. Additional handling steps were necessary for the analysis of hair samples. An initial wash procedure was utilized to remove surface contaminants. Washed hair samples were extracted with methanol overnight at 40 degrees C. Both wash and extract fractions were collected, evaporated and purified by SPE. All extracts were evaporated, derivatized with N,O-bis(trimethylsilyl)trifluoroacetamide (BSTFA) with 1% trimethylchlorosilane (TMCS) and analyzed by GC-MS. The limit of detection (LOD) for cocaine, heroin and metabolites in biological specimens was approximately 1 ng/ml with the exception of norcodeine, normorphine and benzoylnorecgonine (LOD = 5 ng/ml). The LOD for cocaine, heroin and metabolites in hair was approximately 0.1 ng/mg of hair with the exception of norcodeine (LOD = 0.3 ng/mg) and normorphine and benzoylnorecgonine (LOD = 0.5 ng/mg). Coefficients of variation ranged from 3 to 26.5% in the hair assay. This assay has been successfully utilized in research on the disposition of cocaine, heroin and metabolites in hair, plasma, saliva and urine and in treatment studies.

[Localization of apoptosis-antagonizing bcl-2 translated product in Hodgkin's disease]

We applied more sensitive immunohistochemical method, i.e. multilayered PAP, to investigate the expression and distribution of apoptosis-antagonizing gene bcl-2 in Hodgkin's disease (HD), bcl-2-positive Reed-Sternberg (RS) cells were found in 7 of 21 (33%) of HD, and 2 of 7 (mixed cellularity) accompanied by a lot of reactive lymphoid follicles, the germinal centers of which were also positive for bcl-2. In contrast, in 4 cases of inflammatory lymphoid follicular hyperplasia as positive controls, the mantle zones rich in long-lived B cells were strongly positive stained with bcl-2 antibody, whereas germinal centers were negative. Thus, our data indicate that overexpressed bcl-2 gene-mediated apoptosis impairment is strongly associated with pathogenesis of HD.

Immunohistochemical demonstration of CCAAT/enhancer binding protein (C/EBP) in human liver tissues of various origin

C/EBP is a sequence-specific DNA-binding protein. In order to identify its distribution and localization, immunohistochemical technique (ABC method) was done using anti-C/EBP polypeptide antibodies 1103#, 425# in liver specimens from 20 normal adults, 5 neonates, 6 patients with hepatitis, 25 with liver cirrhosis, 80 with hepatocellular carcinoma (40 cases were associated with surrounding nontumorous tissues) and 26 patients with cholangiocarcinoma (15 cases were associated with surrounding nontumorous tissues). The results showed that C/EBP was diffusely distributed in nuclei and cytoplasm of differentiated liver cells and very low or undetectable in liver cancer cells. The manifestation of C/EBP correlated with degree of differentiation of tumour cells, and was obviously weaker than that in surrounding nontumorous tissues. C/EBP positive staining has also been found in regenerating epithelial cells of bile ductules. The results suggested that C/EBP should play an important role in establishing and maintaining the differentiation of liver cells.

[In situ PCR-gene hybridization method for detecting mycobacterium tuberculosis in tissue specimens]

The authors combined the technique of polymerase chain reaction (PCR) with hybridization in situ, and find the method is better, quicker and more sensitive for detecting a trace of bacterial DNA, especially for observing the relation between the lesion and the peripheral tissue, the method is more simple and no radioactive pollution. It seems to be suitable for detection on samples from autopsy, biopsy and smears. We suppose the method might have a prospect for clinical diagnosis.

[Surgical treatment of atherosclerotic occlusion of lower extremities]

27 patients with atherosclerotic occlusion of lower extremities were admitted from January 1988 to December 1992. Those patients underwent various kinds of bypass operations, with an effective rate of 86.8%. Some factors influencing the operative effect are discussed.

The occurrence of cocaine, heroin and metabolites in hair of drug abusers

The analysis of hair for drugs of abuse reveals information regarding past drug exposure. We developed methods for washing, extraction and analysis of hair samples for cocaine, heroin and metabolites. Twenty paired head- and arm-hair samples, collected from known heroin/cocaine abusers, were analyzed with a new comprehensive GC/MS assay for cocaine, heroin and metabolites. Cocaine and 6-acetylmorphine (6-AM) were the major analytes present in both head- and arm-hair samples. Cocaine was detected in all head- and 17 arm-hair samples. The concentration of cocaine found was 4-760 ng/10 mg in head hair and 0-1090 ng/10 mg in arm hair. Less benzoylecgonine was present in a concentration range of 0-158 ng/10 mg of head hair and 0-125 ng/10 mg of arm hair. Heroin was found in only 2 head-hair samples, whereas 6-AM was present in 14 head and 6 arm-hair samples. The concentration of 6-AM was 0-8 ng/10 mg in head hair and 0-31 ng/10 mg in arm hair. Morphine was present in 3 head-hair samples in a range of 2-9 ng/10 mg and was not detected in arm-hair samples. When results were compared by groups (head hair versus arm hair, Caucasoid versus Africoid), only two significant differences were found. Cocaine concentrations in both head and arm hair were significantly (P < 0.05) higher in the Africoid group than in the Caucasoid group. The reasons for these differences were not readily apparent, but could have been due to differences in the level of cocaine use or to ethnic differences in the deposition of drug in hair.

Biosynthesis of ecdysteroid hormones by crustacean Y-organs: conversion of cholesterol to 7-dehydrocholesterol is suppressed by a steroid 5 alpha-reductase inhibitor

A pair of glands (Y-organs) in crustaceans synthesize and secrete ecdysteroid hormones; the obligate precursor for synthesis is circulating cholesterol. Ecdysteroid output by the Y-organs is regulated negatively by an eyestalk neurosecretory peptide, molt-inhibiting hormone (MIH). The question was addressed, does MIH suppress ecdysteroid synthesis by decreasing cholesterol supply (uptake) or its utilization or both? Experiments were conducted with Y-organs in vitro from the crab, Menippe mercenaria, in the presence of labeled cholesterol, with or without the steroid 5 alpha-reductase inhibitor, L-645390 (Merck). Other experiments superimposed the presence or absence of eyestalk extract containing MIH activity. L-645390 greatly depressed incorporation of cholesterol into an early intermediate, 7-dehydrocholesterol and into secreted ecdysteroids. At the same time, cholesterol accumulated in the Y-organs, to levels significantly higher than in untreated controls. MIH alone depressed both cholesterol uptake and incorporation. MIH together with L-645390 produced the greatest depression of cholesterol incorporation while also preventing the cholesterol accumulation seen with L-645390 alone. These results indicate that cholesterol uptake and its metabolic utilization in Y-organs are separable events representing separate sites of regulation by MIH.

Immunoassay evidence for fentanyl in hair of surgery patients

Head hair samples obtained from surgery patients who received fentanyl during anesthesia were analyzed by immunoassay for the presence of fentanyl. Thirteen hair samples were collected from patients following intravenous administration of 1-6 mg of fentanyl. Additional hair samples were collected following the administration of 0.18 and 0.38 mg of sufentanil to 2 patients. The elapsed time after drug administration for all patients ranged from 7 to 273 days. Twenty control hair samples also were collected from staff members who reported no surgery or anesthesia during the previous year. All samples were initially washed with methanol, followed by extraction with methanol and reconstitution in citrate buffer. Analysis of wash and extract fractions was performed by radioimmunoassay (Coat-A-Count Fentanyl assay). Segmental analysis was performed on the surgery patients' hair samples. Eight of the fentanyl patients' hair samples contained fentanyl concentrations (equivalents) of 0.13-0.48 ng/10 mg of hair in the 'root' end. Fentanyl concentrations in the 'tip' segment were lower than those found in the 'root' segment with the exception of 1 subject whose hair sample had been collected only 7 days after surgery. The remaining 5 patients had fentanyl concentrations similar to those determined for the control subjects hair samples (0-0.08 ng/10 mg, n = 19). No correlation between hair fentanyl concentration and administered dose was found for the 13 fentanyl subjects. Both sufentanil subjects' hair samples tested negative. One control subject who had experienced environmental exposure to fentanyl had a fentanyl concentration of 0.29 ng/10 mg in the extract and 0.63 ng/10 mg in the wash fraction.(ABSTRACT TRUNCATED AT 250 WORDS)

[Expression of five different antigens of HBV in human intrahepatic cholangiocarcinoma and cholangiohepatocarcinoma]

Surgical specimens of 20 cases of human intrahepatic cholangiocarcinoma (n = 12) and cholangiohepatocarcinoma (n = 8) were studied immunohistochemically by ABC technique for HBxAg, pre-S1 and pre-S2 and by PAP method for HBsAg and HBcAg. The neighboring liver tissues with chronic hepatitis or cirrhosis surrounding the tumor were also examined in 19 cases. Of the cancerous tissues, 15 were positive for HBxAg (75%), 8 positive for pre-S1 and pre-S2 (40%), respectively and 2 for HBsAg (10%). Sixteen of 19 liver tissues surrounding the tumor were also positive for HBxAg (84.2%), 9 for pre-S1 and pre-S2 each (47.4%), 6 for HBsAg and HBcAg each (31.6%). The results suggest that a close relationship exists between cholangiocarcinoma and cholangiohepatocarcinoma and hepatitis B virus infection. The HBxAg might play an important role in the pathogenesis of cholangiocarcinoma.

Formation of ecdysteroids by Y-organs of the crab, Menippe mercenaria. I. Biosynthesis of 7-dehydrocholesterol in vivo

Y-organs of the xanthid crab, Menippe mercenaria, secrete ecdysteroid hormones in vitro, apparently both 3-dehydroecdysone and 25-deoxyecdysone. Studies were initiated on the biosynthetic path(s), in which cholesterol is converted to these ecdysteroids. Crabs were injected with [3H]cholesterol. Y-organs and hemolymph were removed 12 hr later and extracted directly and the extracts were analyzed by HPLC. Both polar and nonpolar sterols were surveyed. The only metabolite of cholesterol detectable in Y-organs was 7-dehydrocholesterol (identified by mass spectrometry). The total amount of 7-dehydrocholesterol and the amount that was labeled were generally greater than for cholesterol and were higher in Y-organs from de-eyestalked crabs than in those from intact crabs. Subcellular fractionation of the Y-organs showed that over 70% of total radioactivity was in cholesterol and 7-dehydrocholesterol of mitochondria and microsomes, distributed about equally between the two organellar fractions. In hemolymph, the only nonpolar sterols present were cholesterol and 7-dehydrocholesterol; the concentration ratio was 20:1. However, 7-dehydrocholesterol was not significantly labeled. Analyses of polar compounds revealed two prominent, uv-absorbing ecdysteroids which coeluted with the authentic standards, 3-dehydro-20-hydroxyecdysone and 25-deoxy-20-hydroxyecdysone (ponasterone A). The radioactivity profile showed, in addition, a third prominent peak that corresponded in retention time with 3-dehydroecdysone. These results indicate that the Y-organs in vivo form 7-dehydrocholesterol from cholesterol and convert the latter to secretion products without accumulation of other intermediates. At least two ecdysteroids are secreted and appear to be converted peripherally in this crab to their respective 20-hydroxy derivatives.

[Immunohistochemical study on X antigen of HBV (HBxAg) in primary hepatic carcinoma]

Specimens of 110 cases of primary hepatic carcinoma were obtained from the pathological Laboratory of the First Teaching Hospital of the 4th Military Medical University, Xi'an. P. R. China. Sections from formalin-fixed and paraffin-embedded material were stained for HBxAg by ABC method and for HBsAg and HBcAg by PAP method. Among the 110 cases of primary hepatic carcinoma, 64 (58.2%) showed HBxAg-positive reaction in tumor tissue, and 63 (78.8%) of 80 cases of noncancerous surrounding hepatic tissue displayed HBxAg positivity. Among 64 HBxAg-positive cases in tumor tissue, 15 (23.4%) were associated with HBsAg and/or HBcAg and among 63 HBxAg-positive cases in non-tumor tissue, 45 (71.4%) were associated with HBsAg and/or HBcAg. These findings suggested a close relationship between primary hepatic carcinoma and HBV infection. The high detection rate of HBxAg indicates very active expression of the integrated HBV-DNA genome in the host cells. However, how does HBxAg act in pathogenesis of hepatocellular carcinoma remains to be further investigated.

[Expression and significance of Pre-S1 and Pre-S2 in human primary hepatic carcinoma (PHC)]

135 specimens of primary hepatic carcinoma (PHC) were formalin fixed and paraffin embedded and stained for Pre-S1, Pre-S2 and HBxAg by ABC method, for HBsAg and HBcAg by PAP method. The detection rates of Pre-S1 and Pre-S2 positive cases in cancerous tissues were 22.2% and 20.0%. The detection rates of Pre-S1 and Pre-S2 in non-cancerous liver tissues were 60.0% and 59.6%. The positive ratio of Pre-S1 and Pre-S2 in the same hepatoma was 16.3% and that in the same non-cancerous liver tissue was 55.6%. Among 135 cases of PHC, HBsAg, HBxAg and HBcAg positives in tumor tissues were 16.3%, 55.6% and 8.9%, respectively. Those in non-cancerous tissues were 59.6%, 78.8% and 24.2%. This study suggested that the detection rates of Pre-S1 and Pre-S2 positivity in hepatoma tissues were higher than those of HBsAg and HBcAg but lower than that of HBxAg. The frequency of positive Pre-S1 and Pre-S2 in non-cancerous liver tissues was similar to HBsAg, and slightly lower than that of HBxAg. S1 and S2 are considered new markers for HBV infection. Their antigens could play an important role in the pathogenesis of PHC.

Comprehensive assessment of long-term postoperative continence in pediatric imperforate anus. Clinical, manometric and contrast studies

109 patients with imperforate anus were followed up postoperatively for 5 to 28 years. Postoperative continence was evaluated by anorectal manometry, barium enema and clinical symptoms. A comprehensive assessment system, combining the clinical and objective systems was designed which can reflect postoperative anal continence function completely and objectively. It is useful for determining the causes of incontinence and its treatment.

Hepatitis B x antigen in hepatitis B virus carrier patients with liver cancer

Formalin-fixed, paraffin-embedded specimens from 110 cases of primary hepatocellular carcinoma were stained for hepatitis B x antigen (HBxAg), hepatitis B surface antigen (HBsAg), and hepatitis B core antigen (HBcAg). Eighty-four % of these patients were HBxAg positive in their tumor cells. Among the 110 cases studied, 80 had adjacent nontumorous tissue in the same block, and 65 of these nontumorous liver tissues stained positive for HBxAg (81%). HBsAg was positive in 19% of cases within tumor tissue and 61% in surrounding nontumorous tissue. HBcAg was positive in 11% of cases within tumor tissue and 26% in surrounding nontumorous tissue. These findings show that HBxAg is a common marker in the liver of patients with hepatitis B virus (HBV)-associated primary hepatocellular carcinoma and that it is closely associated with tumor cells in these individuals. In addition, the finding of HBxAg in the absence of detectable HBsAg and HBcAg in the liver tissues of many HBsAg carriers suggests that HBxAg could be expressed independent of HBV replication and implies that the synthesis of this antigen may be directed from integrated HBV DNA templates. The finding of HBxAg in the nucleus of hepatocytes from primary hepatocellular carcinoma patients with dysplasia, combined with the known trans-activating properties of HBxAg, implies that HBxAg plays one or more important roles in hepatocarcinogenesis. The finding of HBxAg in bile duct epithelium and cholangiocarcinoma tissues is compatible with the hypothesis that HBV may contribute to this other primary tumor type in the liver. Together, these results further implicate HBxAg in the pathogenesis of primary liver cancers.

HBxAg in the liver from carrier patients with chronic hepatitis and cirrhosis

Formalin-fixed, paraffin-embedded specimens from 110 cases of chronic hepatitis and 108 cases of cirrhosis were stained for HBxAg by the avidin-biotin complex technique using specific antisera made against full-length HBxAg polypeptide or derived synthetic peptides. These tissues were also stained for the HBsAg and HBcAg by the peroxidase-anti-peroxidase method. Among patients with chronic hepatitis, 86% were HBsAg positive in liver cells, 60% were surface antigen positive and 32% were core antigen positive. Among patients with cirrhosis, 97% were HBsAg positive in liver cells, 72% were surface antigen positive and 17% were positive for core antigen. Staining specificity was demonstrated, in part, by using preimmune sera in the place of primary antibody, by blocking of the primary antibody with the appropriate antigen before assay and by testing uninfected liver controls. The persistence and high frequency of HBxAg in liver cells from patients with chronic liver disease suggest that it may play one or more important roles in the pathogenesis of chronic infection. It is possible that detection of HBxAg in the liver could be an additional new diagnostic marker for hepatitis B virus infection. However, the function(s) of HBxAg in the pathogenesis of the chronic liver disease, if any, remains to be explained.

Ferritin in astrocytomas

Ferritin in 119 astrocytoma cases was studied by immunocytochemical PAP and immunogold silver staining (IGSS) methods. In 57% of the cases, ferritin was found in the cytoplasm of the tumor cells. The higher the differentiation of the tumor cells, the less ferritin they contained. Contrary to the reaction of glial fibrillary acidic protein (GFAP), the positive rate of ferritin in various types and grades of astrocytomas was inversely proportional to their degree of differentiation. Electron microscopic observation in 30 cases showed ferritin in the cell sap, cytocavity network, endoplasmic reticulum, Golgi apparatus and also in lysosomes. Some of the cases had extraordinary high level of ferritin in their blood serum.

[Significance of assaying serum bone GLA protein level in patients with hyperthyroidism]

The serum BGP level was assayed in patients with hyperthyroidism (untreated and remittent cases). The mean serum BGP concentration was 8.7 +/- 2.5 ng/ml in 54 patients with untreated hyperthyroidism, which was significantly higher than normal range (4.8 +/- 1.3 ng/ml P less than 0.01). Serum BGP had a significant positive correlation with the concentration of T3 and T4, while serum AKP had no correlation with circulating thyroid hormone levels. In the patients with hyperthyroidism, serum T3 and T4 decreased significantly after the first month of methimazole treatment, and fluctuated within the normal range since then. Serum BGP did not show significant change during the first six months of treatment, although they were eventually reduced significantly at the end of six months. These results suggest that serum BGP measurement is a valuable marker of bone metabolism alteration during hyperthyroidism.

Serum high-density lipoproteins in the crab, Cancer antennarius--III. Density-gradient profiles and lipid composition of subclasses

1. Prestaining the serum total lipoprotein (LP) fraction and density-gradient ultracentrifugation revealed up to five LPs, all in the high-density class (HDL; 1.187 greater than d greater than 1.080 g/ml). These are group-designated as HDL1, HDL2 and HDL3, lowest to highest buoyant density, respectively. The number and precise density of the LPs varied with individual crab and were not gender specific. 2. The percentage of total mass due to triacylglycerides was progressively higher from HDL1 and HDL3, whereas that of phospholipids, cholesterol and combined fat was progressively lower. The percentage mass of combined fat was higher in females than males. 3. As in hemolymph, the LP of eggs was entirely HDL; instances of each HDL subclass were seen, but HDL3 was predominant. Compared with serum HDL, egg HDL was strikingly low in triacyglyceride mass and relatively high in protein. 4. Hemolymph HDL titers of individual females varied independently with egg size through most of the year, but was positively correlated with the egg size in October to December when 2-3-fold increases in HDL titer occur in the female population.

Staining bacterial flagella easily

A wet-mount technique for staining bacterial flagella is highly successful when a stable stain and regular slides and cover slips are used. Although not producing a permanent mount, the technique is simple for routine use when the number and arrangement of flagella are critical in identifying species of motile bacteria.

Evidence that Y-organs of the crab Cancer antennarius secrete 3-dehydroecdysone

Y-organs are paired glands in crustaceans that secrete a class of steroid hormones (ecdysteroids) that regulate growth, molting and development. The glandular secretion has been assumed to be solely the ecdysteroid, ecdysone, a polyhydroxylated derivative of cholesterol. We previously reported that Y-organs of a crab (Cancer antennarius) additionally secreted an ecdysteroid that is less polar than ecdysone. Evidence is presented here that the other secretion product is 3-dehydroecdysone (3-dhE). The compound co-chromatographed with authentic 3-dhE in both normal-phase, and reversed-phase, high-performance liquid chromatography. Mass spectrometry of the ecdysteroid gave results consistent with its identity as 3-dhE. The putative 3-dhE was radiolabeled by injecting crabs with [3H]cholesterol and then incubating the Y-organs. The putative [3H]3-dhE secretion was then subjected to chemical reduction. The reaction yielded labeled products that co-chromatographed with authentic ecdysone and 3-epiecdysone. Results of other experiments gave the following results: (1) Putative 3-dhE was not altered (chromatographic criteria) by incubations with snail hydrolases. (2) Putative [3H]3-dhE, added to incubations of Y-organ halves or homogenates, was not significantly converted to ecdysone; also, no conversion was evident after incubation in medium alone in which the hemolymph serum supplement was raised to 50% of the volume. (3) [3H]Ecdysone was not converted to putative 3-dhE in vitro by Y-organ halves or homogenates.(ABSTRACT TRUNCATED AT 250 WORDS)

[Surface charged liposomes as drug carriers and in vivo tests of mice infected with toxoplasma]

The surface charge is one of the most important properties of liposomes. In this paper surface potential of liposomes was measured by fluorimetry using 1.8-ANS as a probe and by microelectrophoresis. The encapsulation efficiency and leakage rate of ionic drugs were influenced by the surface charge of liposomes. Higher encapsulation efficiency and lower leakage rate were resulted if the surface charge of liposomes was opposite to the ionic charge of encapsulated drug. Mice infected with toxoplasma were used as a model. In in vivo test, liposome-drug was compared with the free drug. The average survival days of groups of liposome-drugs were much longer than that of the group of free drugs. Mouse infected with toxoplasma is a simple, convenient and accurate model for measuring the biological activation of liposome-drugs.

Persistent Campylobacter jejuni infections in patients infected with the human immunodeficiency virus (HIV)

We identified Campylobacter jejuni infections in four patients infected with the human immunodeficiency virus (HIV); three had persistent and severe C. jejuni infections. Multiple isolates obtained from each patient had the same biochemical and serotypic characteristics, indicating recurrent infection rather than reinfection with unrelated strains. Serum antibody responses to C. jejuni group antigens by enzyme-linked immunosorbent assay were markedly impaired in the three patients with persistent infection compared with forty-two immunocompetent C. jejuni-infected controls and with the HIV-infected patient who readily cleared the organism. One patient was bacteremic; his blood isolate was killed by normal serum but was resistant to his own serum, whereas a simultaneous stool isolate of a different serotype was sensitive. Failure of two patients to eradicate the organism and long-term administration of erythromycin therapy led to the in-vivo development of resistance to this antibiotic, which is most frequently used to treat C. jejuni infections.

Controlled evaluation of trypticase soy broth with and without gelatin and yeast extract in the detection of bacteremia and fungemia

The addition of gelatin to blood culture media has been suggested to prevent the inhibition of Neisseria meningitidis, Neisseria gonorrhoeae, Gardnerella vaginalis, and Peptostreptococcus anaerobius that is caused by sodium polyanetholsulfonate. To determine the effect of such supplementation on the overall yield of microorganisms, we compared the yield and speed of detection of clinically important microorganisms from 5422 paired 10-ml samples of blood cultured in Trypticase soy broth (TSB) containing 0.03% sodium polyanetholesulfonate (SPS) and TSB/SPS containing 1.2% gelatin and 1.0% yeast extract (mTSB). The atmosphere of incubation (open venting unit) and ratio of blood to broth (1:5) were the same for both samples. Only cultures with adequate blood sample (greater than or equal to 80% of stated volume) were compared statistically. Addition of gelatin and yeast extract resulted in inhibited growth of Enterobacteriaceae (p less than 0.001), Pseudomonas aeruginosa (p less than 0.01), fungi (p less than 0.05), and the overall set of microorganisms encountered (p less than 0.001). It delayed growth of Enterobacteriaceae (p less than 0.001) but reduced the time to recover staphylococci (p less than 0.02). Of 12 isolates of species usually inhibited by SPS, seven grew only with the addition of gelatin and yeast extract, none grew only without supplementation, and five grew in both media. Although gelatin and yeast extract may improve the yield of some specific bacteria, the routine use of these additives cannot be recommended for all blood culture media.

Controlled evaluation of modified radiometric blood culture medium supplemented with gelatin for detection of bacteremia and fungemia

Although the addition of 1.2% gelatin to broth blood culture media containing sodium polyanetholesulfonate has been shown to enhance detection of certain bacteria, including Neisseria meningitidis, N. gonorrhoeae, Peptostreptococcus anaerobius, and Gardnerella vaginalis, the effect of such supplementation on the detection of other microorganisms causing bacteremia and fungemia is not known. Therefore, we studied BACTEC 6B medium with and without gelatin in 6,833 paired comparisons to examine the effects of supplementation on both the yield and the speed of detection of sepsis. More aerobic and facultative bacteria grew in the 6B than in the 6B-gelatin medium (P less than 0.001), especially staphylococci (P less than 0.01), Escherichia coli (P less than 0.01), other members of the family Enterobacteriaceae (P less than 0.05), and Acinetobacter spp. (P less than 0.05). When microorganisms grew in both bottles, they did so earlier in 6B than in 6B-gelatin (P less than 0.001). We conclude that the 6B medium in its present formulation is superior to 6B medium supplemented with 1.2% gelatin.

Pathogenesis of Campylobacter fetus infections: serum resistance associated with high-molecular-weight surface proteins

Campylobacter fetus subspecies fetus causes both systemic and diarrheal illnesses. We studied 38 strains of C. fetus isolated from 34 patients; underlying illness was present in eight (89%) of nine patients with only systemic isolates compared with three (20%) of 15 patients with only fecal isolates (P = .002). In a standardized assay of susceptibility to normal human serum, 27 (71%) strains were resistant, six (16%) had intermediate susceptibility, and five (13%) were serum sensitive. Major protein bands migrating at 100 kDa or 125 kDa on polyacrylamide gels were present in all of the 25 serum-resistant strains tested but in only four of seven serum-sensitive isolates of C. fetus from humans and animals (P = .007). The presence of these bands was associated with type A lipopolysaccharide. A low-passaged strain, 82-40, was serum resistant and contained the 100-kDa protein; however, a spontaneous mutant of this strain lacked this band and was serum sensitive. The 100-kDa and 125-kDa proteins of three strains of C. fetus were antigenically cross reactive or identical and were exposed on the surface of the C. fetus cell. Serum resistance is inherent to most C. fetus isolates from humans and is associated with the presence of cross-reactive surface proteins.

Erythromycin-resistant Campylobacter infections in Thailand

Erythromycin therapy was compared with no treatment in a prospective trial of acute diarrheal disease among 100 infants in an orphanage in Bangkok. Within 24 h of the onset of diarrhea, 50 children received erythromycin ethylsuccinate (40 mg/kg per day) in four divided doses for 5 days. Campylobacter jejuni isolated from 31, Campylobacter coli isolated from 21, and Shigella spp. isolated from 21 of 100 children were the most commonly recognized pathogens; use of a sensitive, nonselective method substantially increased Campylobacter isolation. Treatment with erythromycin had no effect on the duration of diarrhea caused by Campylobacter spp., Shigella spp., or other agents; 37% of the treatment group and 35% of the control group had diarrhea for 1 week. Of 23 Campylobacter strains isolated from the treatment group before treatment, 15 (65%) were resistant (MIC, greater than or equal to 8 micrograms/ml) to erythromycin. Among orphanage-acquired strains, 53% of 43 C. jejuni strains and 91% of 23 C. coli strains were resistant to erythromycin compared with 11% of 114 C. jejuni strains and 46% of 35 C. coli strains that were community acquired. Erythromycin resistance is common among Campylobacter strains in Bangkok, especially in an institutional setting, which may account for the lack of efficacy of erythromycin for treatment of acute diarrheal illnesses.

[Ultrastructure of primary clear cell carcinoma of the liver]

Surgical specimens of 175 cases of primary hepatocellular carcinoma were prepared by routine paraffin section and HE stain. The clear cell cancer specimens were stained with PAS. All the specimens were observed by light microscope. Ultrathin sections were made for 50 samples and studied by electron microscope. Under the light microscope, 79 (45.1%) showed varying amounts of clear cells. According to the proportion and distribution of these cells, clear cell carcinoma of the liver was divided into three types: scattered type (16 cases, 20.3%), localized (43, 54.4%) and diffuse types (20, 25.3%). The clear cancer cells could be found in hepatoma with various degrees of differentiation. Of these 79 cases, 4 (5.1%) were grade I, 53 (67%) and 22 (27.9%) were grades II and III. Positive PAS stain gives an evidence of glycogen in the clear cell cytoplasm. 7 diffuse type clear cell hepatomas were observed with electron microscope. The cytoplasm had only fewer organelles, leading to a void appearance. The amount of the rough endoplasmic reticulum, free ribosome and polyribosome was markedly decreased. So was mitochondria, usually showing swelling and abnormality. The residual rough endoplasmic reticulum and mitochondria were out of normal arrangement. They often aggregated on one side of the nucleus or near the cell membrane. Glycogen particles were increased in some cell cytoplasms. Some particles were even and fine, some were aggregated into masses or scattered. Nuclei showed abnormalities mild to moderate. The nature of the clear cells in liver cancer is the variance of glycogen or lipid in the cytoplasm.(ABSTRACT TRUNCATED AT 250 WORDS)