Biopsy diagnosis of well-differentiated hepatocellular carcinoma based on new morphologic criteria

Nodular hepatic lesions detected in 123 patients with chronic liver diseases were subjected to ultrasonically guided needle biopsy. Of these, 94 cases were diagnosed as hepatocellular carcinoma of a moderately or poorly differentiated type with classical histologic features of hepatocellular carcinoma. In 14 cases in whom hepatocytes had minimal atypical changes and were mostly of normotrabecular arrangement (one to two cells thick), a diagnosis of well-differentiated hepatocellular carcinoma was made on the basis of the following three histologic criteria: nuclear crowding, increased cytoplasmic basophilia and microacinar formation. The nodules which showed two or more of these findings were diagnosed as well-differentiated HCC. The diagnoses of these 14 cases were subsequently confirmed by clinical course, histology in the resected specimen and/or autopsy findings. The nodules that presented similar but equivocal changes were arbitrarily categorized as borderline lesions (five cases). The nodules showing the findings almost identical with those of pseudolobules were regarded as benign, large regenerative nodules (nine cases). The remaining one case had a hemangioma. Thus, these three histologic criteria proved to be useful in the biopsy diagnosis of nodular hepatic lesions, with certain limitations. Additionally, the majority of large regenerative nodules, borderline lesions and well-differentiated HCCs were found to be smaller than 2 cm.

[The clinical usefulness of portal venous flow ratio by hepatic angiography with 99mTc-Sn colloid in chronic liver diseases: a comparison with histological finding]

The ratio of portal venous to hepatic blood flow was measured in chronic liver diseases by radionuclide angiography with 99mTc-Sn colloid and its clinical value was discussed. The ratio was proportionally decreased to the progression of the diseases (normal 74.5 +/- 7.3%, chronic hepatitis 58.8 +/- 9.2%, compensated liver cirrhosis 29.3 +/- 19.3%). In alcoholic liver diseases, the standard deviation of the ratio was large as 52.7 +/- 23.7%, and the low ratio in the early period of the disease increased within one or two months as the disease recovered. In comparison with the histological findings of the liver, the ratio in the alcoholic liver diseases was well correlated with the severity of liver fibrosis and liver cell swelling. In conclusion, this noninvasive and simple method is valuable in diagnosing the chronic liver disease, especially alcoholic liver diseases, and also in estimating its clinical course.

[Leukemic Burkitt's lymphoma with an initial symptom of ocular motor disturbance]

A 58-year-old male was admitted to Osaka City University Hospital because of diplopia in May, 1987. Hematological examinations revealed abnormal blastoid cells in his peripheral blood and bone marrow. We found many mitochondria and polysomes in the cytoplasm of the blastoid cells by the electron microscopy. Moreover, left axillary lymph node biopsy specimen disclosed the typical "starry sky" pattern. The blastoid cells in the bone marrow had chromosomal abnormality; 47XY, 8q-, 14q+, 22q-, +mar. Therefore, the diagnosis of Burkitt's lymphoma (leukemic change) was performed. He was treated with chemotherapy, but the blastoid cells resisted many anticancer agents and he died in September 30. On admission left ocular motor disturbance was revealed. Generally, it was reported that meningitis with CNS involvement of lymphoma is accompanied by cranial nerves palsy. However in this case lymphoma cells was not found in the cerebrospinal fluid. The cause of ocular motor disturbance was the adhesion to the medial rectus muscle and compression to the ocular motor nerves of the lymphoma mass.

Structural gene and complete amino acid sequence of Pseudomonas aeruginosa IFO 3455 elastase

The DNA encoding the elastase of Pseudomonas aeruginosa IFO 3455 was cloned, and its complete nucleotide sequence was determined. When the cloned gene was ligated to pUC18, the Escherichia coli expression vector, bacteria carrying the gene exhibited high levels of both elastase activity and elastase antigens. The amino acid sequence, deduced from the nucleotide sequence, revealed that the mature elastase consisted of 301 amino acids with a relative molecular mass of 32,926 daltons. The amino acid composition predicted from the DNA sequence was quite similar to the chemically determined composition of purified elastase reported previously. We also observed nucleotide sequence encoding a signal peptide and "pro" sequence consisting of 197 amino acids upstream from the mature elastase protein gene. The amino acid sequence analysis revealed that both the N-terminal sequence of the purified elastase and the N-terminal side sequences of the C-terminal tryptic peptide as well as the internal lysyl peptide fragment were completely identical to the deduced amino acid sequences. The pattern of identity of amino acid sequences was quite evident in the regions that include structurally and functionally important residues of Bacillus subtilis thermolysin.

Introduction of macromolecules into primary cultured neuronal cells by fusion with erythrocyte ghosts

The macromolecules were injected into primary cultured neuronal cells by fusion with human erythrocyte ghosts containing macromolecules. The injection efficiency was about 30% and 80% of the cells extended neurites like normal neuronal cells. In order to succeed in this method, phytohaemagglutinin E and polyethylene glycol 1000 were essential, and monolayer culture cells were used.

Purification and characterization of cytochrome P-450 induced by benz(a)anthracene in mouse skin microsomes

Topical application of benz(a)anthracene to mouse skin elicited a 2-fold increase in cytochrome P-450 content, with accompanying increases in monooxygenase activities such as benzo(a)pyrene hydroxylation, 7-ethoxycoumarin O-deethylation, and acetanilide 4-hydroxylation, in the microsomes. A major form of cytochrome P-450 was purified from skin microsomes of mice treated with polycyclic aromatic hydrocarbon. A specific content of 1.95 nmol/mg of protein, which corresponded to 48-fold purification from the microsomes, was observed. The purified protein produced a single major band on sodium dodecyl sulfate-polyacrylamide gel electrophoresis having a molecular weight of 55,000. Using Western blotting, the band immunochemically cross-reacted with antibody which had been raised against rat liver cytochrome P-450MC-1. The purified preparation efficiently catalyzed benzo(a)pyrene hydroxylation and 7-ethoxycoumarin O-deethylation when reconstituted with NADPH-cytochrome P-450 reductase. These activities were inhibited by 7,8-benzoflavone as well as anti-cytochrome P-450MC-1 antibody, but not by P-450PB-1 antibody. The results indicate that, in mouse skin microsomes, a cytochrome P-450 induced by benz(a)anthracene is enzymatically and immunochemically similar to rat liver cytochrome P-450MC-1. It is suggested that this enzyme plays an important role in the activation of carcinogenic polycyclic aromatic hydrocarbons.

Drug-induced mononucleosis-like hepatic injury in a patient with systemic lupus erythematosus

A case of systemic lupus erythematosus (SLE) with mononucleosis-like hepatic injury was described. An emergent cesarean section was performed in a 25 yr-old house wife at 34 weeks gestation, followed by administration of several antibiotics. After the surgery she complained of high fever, hepatomegaly and dull right hypochondralgia, and mild liver dysfunction was also found. The liver biopsy showed prominent mononuclear cell infiltration in the sinusoids with minimum hepatocellular necrosis and mild triaditis, resembling hepatic lesion in infectious mononucleosis (mononucleosis-like injury). There were no clinical and serological features suggestive of infectious mononucleosis. This hepatic lesion was thought to be a manifestation of allergic reaction to drugs to which the lymphocyte stimulation test was found to be positive. Immunological abnormalities inherent in SLE might be related to occurrence of such allergic drug reaction.

Angiography in the diagnosis of liver disease

Although necessity for angiography has been reduced somewhat because of the development of newer imaging modalities, such as ultrasound and CT, celiac or hepatic arteriography, portography, and hepatic venography often prove useful in the diagnosis of liver disease. They can be utilized for therapeutic purposes as well in certain vascular abnormalities.

Structural analysis of lipopolysaccharides from Eikenella corrodens by use of murine monoclonal antibodies

The structure of lipopolysaccharides (LPSs) of Eikenella corrodens was analyzed with prepared murine monoclonal antibodies. A common core epitope was found in three of seven LPS preparations from E. corrodens strains and Fusobacterium nucleatum ATCC 25586. Four E. corrodens LPSs were found to possess an O-side-chain epitope which cross-reacted with LPSs from Fusobacterium necrophorum ATCC 25286 and Capnocytophaga ochracea M-12. Lipid A of E. corrodens LPS shared an epitope common among LPSs from various gram-negative rods.

[Assessment of laboratory findings in megaloblastic anemia--measurement of serum vitamin B12 and methylmalonic acid]

The laboratory findings of 20 patients with untreated megaloblastic anemia due to vitamin B12 deficiency were analysed. The material consists of 13 patients with pernicious anemia, 6 with postgastrectomy B12 deficiency and one with malabsorption syndrome. Hematological data (RBC, Hgb, Ht, WBC, Plt) were correlated with each other and serum LDH levels. Megaloblastic changes of bone marrow were apparent in cases of which Hgb values were below 9 g/dl, although its change were not clear in cases with mild anemia (above 9 g/dl). However, giant metamyelocytic changes of bone marrow were seen even in cases with mild anemia. Serum B12 levels in 6 out of 19 cases (31.6%) measured by clinical laboratory center were within normal range. In contrast, its level in all cases measured by radiodilution assay using R-protein or intrinsic factor were lower than normal values. Serum B12 levels measured by the latter method were correlated with various hematological data and also related with hematological severity, although its level measured by clinical laboratory did not have any correlation with hematological data. Schilling test seemed to be unreliable, because sample volume which was suggested by kit manual was too small (2 ml) to catch enough radioactivity for accurate measurement. Serum methylmalonic acid levels measured by gas capillary mass spectrophotometry were higher than normal values in all cases and were well correlated with hematological data.

Cobalamin-dependent replication of L1210 leukemia cells and effects of cobalamin analogues

L1210 cell line cells were made deficient in Cbl by propagation in a medium devoid of CNCbl in which fetal calf serum had been replaced by bovine serum albumin. These Cbl-deficient cells gradually ceased to multiply when the medium contained 5-CH3THF, although cell growth was resumed following the addition of CNCbl, OHCbl or folic acid. The results of this study provide experimental proof for the 'methyl trap' hypothesis. In contrast to the above effect of CNCbl, cobinamide and Cbl analogues which were produced by a reaction of OHCbl with ascorbic acid did not have any growth-inducing effect on the cells which had been cultured in a 5-CH3THF-supplemented medium and had ceased to multiply. Nor did these analogues have an inhibitory effect on CNCbl-dependent growth.

Hypergonadotropinemia with estradiol secretion in peri- and postmenopausal period

Plasma gonadotropins and estradiol levels were evaluated in 155 peri- and postmenopausal women. The average menopausal age was 52.5 years in 56 postmenopausal women. Plasma FSH and LH levels showed hypergonadotropinemia in many premenopausal women 45-49 years old, whose plasma estradiol levels, however, sometimes remained higher than 25 pg/ml. It was observed that 19 of 38 women (50%) had an estradiol level exceeding 25 pg/ml, of those 50-59 years old, whose gonadotropin level showed hypergonadotropinemia in 29 cases (76.3%). Ovarian vein levels of estradiol obtained during laparotomy of 21 patients were significantly higher than peripheral vein concentrations. In 3 of 5 climacteric women with irregular menstrual intervals and whose plasma gonadotropin level was within the postmenopausal range, some degree of estradiol secretion in the ovarian vein was detected. Estradiol was still present in the ovarian vein blood of some postmenopausal women. These data show that the basal gonadotropin level may become high several years before the menopause and that some ovarian function may be preserved after the menopause. Furthermore, it is possible that estrogen secretion may be disturbed by consistent hypersecretion of gonadotropins in the climacteric period.

Purification and characterization of 5 beta-cholestane-3 alpha,7 alpha,12 alpha-triol 27-hydroxylase from female rat liver mitochondria

5 beta-Cholestane-3 alpha,7 alpha,12 alpha-triol 27-hydroxylase (5 beta-cholestane-3 alpha,7 alpha,12 alpha-triol, NADPH:oxygen oxidoreductase (26-hydroxylating), EC 1.14.13.15) was purified from female rat liver mitochondria based on its catalytic activity. The final preparation of the enzyme showed a single major band on the sodium dodecyl sulfate-polyacrylamide gel electrophoretogram. The content of purified enzyme was 12 nmol/mg of protein, and the specific activity was 431 nmol/min/mg of protein. The molecular weight of the enzyme was determined from sodium dodecyl sulfate-polyacrylamide gel electrophoresis as 52,500. The absorption spectra of the purified enzyme and that of the dithionite-reduced CO complex showed peaks at 417 and 450 nm, respectively, indicating the enzyme belongs to the cytochrome P-450 family. Upon reconstitution with the electron-transferring system of the adrenal (adrenodoxin and NADPH-adrenodoxin reductase), the enzyme showed high activity hydroxylating 5 beta-cholestane-3 alpha,7 alpha-12-triol at position 27 with a turnover number of 35.5 min-1 and Km of 6.3 microM. The enzyme activity was completely lost when the electron-transferring system was replaced by that of microsomes (NADPH-cytochrome P-450 reductase purified from rat liver microsomes), confirming that the P-450 enzyme was of the mitochondrial type, but not of the microsomal. The omission of cytochrome P-450, adrenodoxin, or NADPH-adrenodoxin reductase resulted in complete loss of enzyme activity. The specific activity toward 5 beta-cholestane-3 alpha, 7 alpha-diol was less than one-half that toward cholestanetriol and that toward cholesterol was about one-fiftieth. The enzyme showed no activity toward xenobiotics such as benzphetamine, 7-ethoxycoumarin, and benzo[a]pyrene. Its activity was not inhibited by metyrapone and slightly inhibited by aminoglutethimide. The enzyme activity was markedly lowered in an atmosphere of CO/O2/N2, 40/20/40.

Effect of LHRH agonist (buserelin) on pulsatile secretion of LHRH and LH

The LHRH agonist buserelin was administered intranasally to eight patients with endometriosis in doses of 300, 600 or 900 micrograms/day for six months. In all patients buserelin clearly suppressed ovulation. In the patients treated with 900 micrograms/day, estradiol levels declined to less than 30pg/ml, and LH release in response to LHRH testing decreased markedly after 2 months of treatment. A mild decrease in LH release was noted in the premarin test at the end of the treatment. At the end of buserelin treatment baseline levels of plasma LHRH, LHRH pulse amplitude and frequency were not lowered. However, baseline levels of plasma LH and LH pulse amplitude decreased. These results indicate that buserelin may act to decrease pituitary response to LHRH.

Light and electron microscopic study of the liver in paraquat poisoning

Intrahepatic cholestasis in paraquat poisoning in man has been thought to be secondary to extensive bile duct injuries, though its exact mechanism remains unsettled. We have examined liver biopsy specimens from two cases of paraquat poisoning. Case 1 (fatal) presented severe intrahepatic jaundice, and liver biopsy showed centrilobular cholestasis with extensive bile duct loss. Ultrastructurally, dilatation of bile canaliculi with decrease of microvilli and thickening of pericanalicular ectoplasm was found in the hepatocytes. Case 2 (alive) showed mild liver dysfunction without jaundice. While liver biopsy showed nonspecific reactive changes with intact bile ducts and ductules, electron microscopy disclosed dilatation of bile canaliculi with decrease of microvilli and thickening of pericanalicular ectoplasm in the hepatocytes, suggesting that damage to the bile secretory apparatus in the hepatocytes develops irrespective of extensive bile duct loss. These findings suggest that bile secretory apparatus in the hepatocytes as well as biliary epithelial cells could be a target of paraquat or its metabolites.

Effects of forskolin and cilostazol on clot retraction

We examined the effects of two inhibitors of aggregation of human platelets the, Forskolin and Cilostazol on clot retraction. Both substances suppressed clot retraction in a dose-dependent way. Both suppress platelet aggregation because of an increase in intercellular cyclic AMP, but there was no close correlations were shown between suppression rate for clot retraction and cyclic-AMP content in platelets in the clot in each substance. Furthermore, although it has been considered that actomyosin in platelets is a major contractile source for clot retraction and that failure of actin polymerization results suppression of clot retraction. As it was difficult to obtain active actin from platelets of the reagents on the polymerization. Cilostazol accelerated actin polymerization, whereas Forskolin did not. From these findings, it was considered that the effects of both substances on clot retraction could not be interpreted directly just by the increasing effect for intracellular cyclic-AMP. Clot retraction is consider to be a in vitro model of hemostasis and its contractile force is supplied from platelets (1,2,3). Experiments used prostaglandin E-1 revealed that elevation of cyclic-AMP (c-AMP) would regulate the clot retraction, and experiments used cytochalasin B demonstrated that actomyosin is responsible to the retraction (4,5). Many date demonstrate that elevation of c-AMP level suppresses platelet aggregation (6,7). c-AMP, therefore, should play a key role on platelet activation. Forskolin and Cilostazol are newly-developed reagents as a suppress for platelet functions. Pharmacological action of these substances have been interpreted to process increase effect for intracellular c-AMP of platelets(8,9). If so, both substances should show some effect on clot retraction. Under this assumption, we examined the effects.

The role of Bacteroides gingivalis in periodontal disease

The microbial flora in adult advanced periodontitis lesions is comprised of Gram-negative rods, with Bacteroides gingivalis as one of the major representatives. This review deals with biological properties of surface antigens, hemagglutinin (attachment factor), and capsular structure of B. gingivalis. Sera containing high IgG antibody levels to B. gingivalis enhanced the complement-mediated bactericidal activity in vitro, although the susceptibility to complement-mediated lysis differed among B. gingivalis strains. The protective effect of immunization against B. gingival is infection was examined in hamsters in which cotton threads had been tied to the gingival margins of the mandibular first molar. Repeated oral topical application of hyper-immune sera against B. gingivalis resulted in effective elimination of the organisms from the periodontal lesions in the experimental animals.

Purification and characterization of vitamin D 25-hydroxylase from rat liver mitochondria

Vitamin D 25-hydroxylase was purified from female rat liver mitochondria based on the catalytic enzyme activity. The final preparation of cytochrome P-450 was homogeneous judging from sodium dodecyl sulfate-polyacrylamide gel electrophoresis (Mr = 52,500). The specific content of the purified enzyme was 12 nmol/mg of protein. The absorption spectrum of the purified enzyme showed a peak at 417 nm and that of the dithionite-reduced CO complex at 450 nm, indicating the enzyme belongs to the cytochrome P-450 family. Upon reconstitution with the electron-transferring system of the adrenal system (adrenodoxin and NADPH-adrenodoxin reductase), the enzyme showed a high activity in hydroxylating 1 alpha-hydroxycholecalciferol at position 25 with a turnover number of 3.8 min-1 and Km of 54 microM. The enzyme activity was completely lost when the electron-transferring system was repLaced by that of microsomes (NADPH-cytochrome P-450 reductase purified from rat liver microsomes), confirming that the P-450 enzyme was of the mitochondrial type, not the microsomal type. The omission of cytochrome P-450, adrenodoxin, or NADPH-adrenodoxin reductase resulted in complete loss of enzyme activity. The liver mitochondrial cytochrome P-450 hydroxylates vitamin D3 and 1 alpha-hydroxyvitamin D3 at position 25, but did not show any activity toward xenobiotics such as benzphetamine, 7-ethoxycoumarin, and benzo[a]pyrene. The enzyme activity was not inhibited by aminoglutethimide but slightly inhibited by metyrapone. The enzyme activity was markedly inhibited in an atmosphere of CO:O2:N2, 40:20:40.