[Percutaneous transhepatic intraportal administration of amphotericin B to a patient with multiple liver abscesses due to Candida albicans: with monitoring by fungal index as a parameter of Candida volume]

A 59-year-old female with acute promyelocytic leukemia in remission was admitted to our center because of an episode of incidental high fever with general fatigue. She was found to have hepatomegaly. Abdominal CT revealed multiple liver abscesses and a positive culture was obtained for candida albicans from an aspirated abscess. She was treated with percutaneous transhepatic intraportal administration of amphotericin B in addition to oral and intravenous administration. We confirmed the remission of these abscesses by means of the fungal index which is the difference between the values of the limulus test and endotoxin specific test. The fungal index appears to be useful for early diagnosis and treatment of fungal infection.

Spontaneous remission in pure red cell aplasia associated with thymoma

A 57-year-old woman with thymoma-associated pure red cell aplasia (PRCA) manifested spontaneous recovery of erythropoiesis. Anemia recurred before the surgical removal of her thymoma, however, and the second anemic remission following surgery did not occur promptly. In this report, we describe a rare occurrence of spontaneous remission in PRCA.

[A remarkable effect of alpha-interferon in a case of angioimmunoblastic lymphadenopathy with dysproteinaemia (AILD) refractory to steroids and combination chemotherapies]

We experienced a remarkable effect of recombinant interferon alpha 2a (alpha-IFN) in a case of angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) which was refractory to steroids and combination chemotherapies. A 62 year-old woman was admitted because of high grade fever and extreme swelling of cervical lymph nodes. Poly-clonal hypergammaglobulinemia and plasma cell-like atypical lymphocytosis in the peripheral blood were demonstrated. Cervical lymph node biopsy disclosed histology of AILD. She initially responded well to prednisolone. Three months later, AILD relapsed in spite of prednisolone treatment. She received combination chemotherapies and responded well again. Seven months later, she became refractory to these combination chemotherapies. Consequently, we tried alpha-IFN (3 million units/day given intramuscularly). She became afebrile on the next day, and lymph nodes swelling gradually disappeared. She has been free from the disease for more than three months.

[Complete remission in erythroleukemia: induced with low dose Ara-C, consolidated with high dose Ara-C]

A 20-year-old man was admitted because of general fatigue. Peripheral blood examination revealed pancytopenia (WBC 1,700/microliters, RBC 210 x 10(4)/microliters, Plt 3.2 x 10(4)/microliters) with remarkable erythroblastosis. Bone marrow examination revealed erythroid hyperplasia and an increase of abnormal myeloblasts with Auer bodies (37% of non erythroid cells). A diagnosis of erythroleukemia (AML M6) was made. He received two courses of combination chemotherapy (BHAC-DMP and VAMA (VP-16, Ara-C, 6-MP, and doxorubicin (ADR)) but complete remission (CR) could not be achieved. Consequently, he was treated with LDAC. After two courses of LDAC. CR was obtained. Subsequently, he received two courses of HDAC as consolidation, and therapy has been off thereafter. He remains in CR state for more than 12 months.

[Administration of haptoglobin in ABO incompatible bone marrow transplantation]

Haptoglobin was administered i.v. in 2 cases of ABO incompatible bone marrow transplantation for the prevention of hemoglobinuria due to acute hemolysis. The first case was a 25-year-old woman with severe aplastic anemia. The transplantation was both major and minor mismatch, where the donor was type A and the recipient was type B. The second case was a 31-year-old man with chronic phase of chronic myelogenous leukemia. The transplantation was major mismatch, where the donor was type B and the recipient was type O. After the administrations of haptoglobin 8,000 units we transfused bone marrow infusates from which incompatible erythrocytes were removed. Though prominent hemoglobinemia was observed in both cases, the serum haptoglobin values were not saturated and hemoglobinuria was not detectable. Haptoglobin appears to be useful for the prevention of acute renal failure associated with acute hemolysis in ABO incompatible bone marrow transplantation. Intravenous haptoglobin supplement therapy makes transplantation safer and may contribute to improve the recovery rate of total nucleated bone marrow cells after the erythrocyte depletion without worrying much about their contamination.

[Complete remission in multiple myeloma with natural interferon-alpha (HLBI) and melphalan/prednisolone intermittent therapy]

A 46-year-old man was admitted because of lumbago and numbness of the left leg. Pelvic X-ray showed a large defect in the left sacrum and CT revealed multiple punched-out lesions. Serum IgA was 1,740 mg/dl with a monoclonal component of IgA kappa by serum electroimmunofixation. Bence Jones protein of kappa type was detected in urine. Diagnosis of myeloma was made on the basis of histology of the biopsied sacral tumor. Repeated melphalan/prednisolone intermittent therapy (MP) was done with concomitant administration of natural interferon-alpha (IFN-alpha) 3 X 10(6) U intramuscularly for 67 days. Performance status including gait markedly improved. Normal bone marrow morphology and disappearance of M-protein by electroimmunofixation were achieved after 13 cycles of MP, when pelvic X-ray revealed prominent recalcification. No further treatment was instituted for subsequent 6 months, without any demonstrable M-protein. Complete remission of myeloma is rare with conventional therapies and thus new therapeutic modalities have been waited for. IFN-alpha may promise better responses if appropriately combined with other chemotherapies.

[Study of non specific reactive phenomena in EIA method of CA 125]

We studied the false positive phenomena in immunoassay of CA 125 using mouse monoclonal antibody, and studied the natures of interfering substances. The serum CA 125 level in 405 patients was determined simultaneously by using the EIA and RIA methods. The overall correlation was good between CA 125 levels of the EIA and RIA methods. However, CA 125 levels in 41 cases were remarkably higher in the EIA method as compared with the RIA method. None of these patients had any disease that was known to result in elevation of the serum CA 125 level. The CA 125 activity of sera from five patients with remarkably discrepant values was contained in the column fractions corresponding to a molecular weight of human IgM in gel chromatography of TSK gel G 4000 SWXL that was smaller than the molecular weight of CA 125. To further determine whether IgM was involved in the CA 125 activity, we investigated the effect of adding anti-human IgM serum to discrepant sera. CA 125 activity was markedly reduced by the antiserum, whereas CA 125 activity in non-discrepant sera were not effected by this antiserum. Thus, data obtained from this group of experiments indicate that the interfering material in discrepant serum is IgM.

[Successful treatment by a drainage of subdural hematoma in a case of intracranial hemorrhage due to DIC complicated with acute promyelocytic leukemia]

A 24 year-old female was admitted because of hypermenorrhea and petechiae. The peripheral blood tests on admission were consistent with acute promyelocytic leukemia complicated with DIC. BHAC-DMP therapy was started along with platelet transfusions and heparin administration. On the day 9 of admission, on the contrary to the improvement of hematological data, the patient suffered from severe headache and nausea. The neurological examination revealed anisocoria. Right side chronic subdural hematoma was a diagnosis made by emergency CT scan and was treated with drainage of the hematoma. Post-operatively, the patient did well, and achieved complete remission on the day 43 of admission. Since intracranial hemorrhages due to DIC complicated with leukemia are often fatal, those patients are usually treated conservatively. However, as shown in this case report, some cases might have an indication for the neurosurgical operation. It is important to check conditions carefully whether the patient has an indication for the operation.

[A case of metastatic liver cell carcinoma in the abdominal wall corresponding to the location of a buried arterial catheter]

The authors encountered a case of primary liver cell carcinoma which metastasized to the abdominal wall at a site corresponding to the location of an indwelling catheter for intra-arterial injections. The patient was a 54-year-old male with primary liver cell carcinoma in the posterior inferior segment. Because of a subsegmentectomy of the liver on September 25, 1986 and postoperative chemotherapy, a catheter for intra-arterial injections was inserted from the right gastroepiploic artery. After anticancer agents were administered postoperatively via this catheter, the same catheter was implanted subcutaneously before discharge. From the latter part of June 1987 after discharge, there was an increase in alpha FP and a subcutaneous tumor, which gradually increased in size, was found at a site in the right hypochondrium corresponding to the location of the arterial catheter. Angiography revealed a tumor nourished by the right 10th intercostal artery, and an operation was performed to remove this tumor. From a pathological examination, this case was diagnosed as metastatic liver cell carcinoma (metastasis to the abdominal wall). The tumor was not connected with the liver and matched the site in the abdominal wall where the arterial catheter was embedded. Therefore, implantation of a catheter cannot be ruled out as a mode of metastasis other than the blood stream.

Elicitation of diacetylenic compounds in suspension cultured cells of eggplant

Induction of stress metabolites in the suspension cultured cells of eggplant (Solanum melongena L.) was examined. When autoclaved RNase A or nigeran, both of which are nonspecific phytoalexin elicitors in bean cells, were added to the cell culture of eggplant, greatly enhanced levels of three compounds were observed. One of them was cis-pentadeca-6-ene-1,3-diyne-5,15-diol, a novel diacetylenic compound. This compound has considerable fungitoxic activity. Also identified was falcarindiol, another fungitoxic diacetylenic compound previously reported as one of the phytoalexins in infected tomato fruits and leaves. Elicited compounds preferentially accumulated in the culture medium rather than in the cells and decreased to original levels during prolonged culturing. The elicitation of these compounds was closely correlated with cellular damage in terms of the decrease of growth rate and was inhibited by 10 micromolar cycloheximide.

[Chronic oral toxicity study of proglumetacin maleate in beagle dogs]

A chronic oral toxicity test of proglumetacin maleate (PGM), an anti-inflammatory agent, was studied at dose-levels of 0, 0.6, 2.5 and 10.0 mg/kg/day using male and female beagle dogs. They were treated for 12 months, followed by 1 month recovery period. Excretion soft and mucous feces was observed in females of 2.5 mg/kg/day group. In addition, excretion of diarrheal and blood-tinged feces was also found in females of 10.0 mg/kg/day group. One female animal given 10.0 mg/kg/day of PGM was found dead on day 178 of administration. For about a month before death, diarrheal and blood-tinged feces, decreases in body weight and food consumption, and anemia had been noticed. At the autopsy, brown-cloudy ascitic fluid, adhesion of visceral organs, hyperemia or hemorrhage in the mucosa and serosa of the digestive tract, and an ulcer in the duodenum were found. No significant influences of PGM were noted on the changes of body weights, food and water consumptions, excluding the dead animal. A fecal occult blood test showed an increase in no. of animals with blood-positive reaction in 2.5 and 10.0 mg/kg/day groups of both sexes, especially marked in females of 10.0 mg/kg/day group. In urinary tests, no significant changes were found in any of the PGM-treated groups of both sexes; the dead one, however, showed decreases in urine volume and electrolyte excretion on month 6 of administration. No significant hematological changes associated with the administration of PGM were found in any of the animals excluding the dead one, in which anemia and inflammation-related findings were found on month 6 of administration. Serum-biochemical tests showed no significant changes in any of the PGM-treated groups of both sexes. No significant influences of PGM were found on ICG and PSP clearances, ocular fundus and ECG. At the autopsy performed at the end of administration, no significant changes were found in any of the PGM-treated groups of both sexes. Histopathologically, a duodenal ulcer and peritonitis-related findings were observed in the female dead animal of 10.0 mg/kg/day group. No influences of PGM were found in any of the tests performed at the end of the recovery phase. From these results, the non-effective dose of PGM was estimated to be 0.6 mg/kg/day, and the toxic doses of PGM to be more than 10.0 mg/kg/day for males and 10.0 mg/kg/day for females, respectively, in beagle dogs treated orally with PGM for 12 months.

[Teratological test of 10% nitroglycerin (NT-1 ointment) in rabbits]

A teratological test of 10% nitroglycerin (NT-1 ointment) was carried out in New Zealand White rabbits. Pregnant rabbits were treated percutaneously with NT-1 ointment from day 6 to 18 of gestation at dose levels of 15, 60 and 240 mg/kg/day as nitroglycerin itself. All pregnant rabbits were killed on day 29 of gestation, and the influences of NT-1 ointment upon the performances of dams and fetuses were examined. During the treatment period, erythema was observed on the treated dorsal skin in all groups excluding the nontreatment control group. However, it disappeared soon after the cessation of NT-1 ointment administration. Influences of NT-1 ointment administration were not found at any dose levels on the food consumption and body weight changes of pregnant rabbits. In addition, influences of NT-1 ointment on the reproductive performance of dams and the development of fetuses were not observed at any dose levels. Therefore, the non-effect dose of NT-1 ointment on reproductive performance of dams and fetal development in rabbits was estimated to be 240 mg/kg/day and more as nitroglycerin itself.

[Percutaneous chronic toxicity study of 10% nitroglycerin (NT-1 ointment) in rabbits]

A chronic toxicity test of 10% nitroglycerin (NT-1 ointment) was carried out in male NZW rabbits. NT-1 ointment was applied to the back skin for 26 weeks at daily doses of 15, 60 and 240 mg/kg as nitroglycerin itself, and 5-week withdrawal period was followed. Topical dermal responses to NT-1: Macroscopically, erythema, edema, scales, papules and dermal thickening were observed in response to NT-1 ointment. In the withdrawal period, however, all of them disappeared. Histopathologically, thickening of epidermis and cell infiltration were observed in response to NT-1 ointment. In addition, elongation of rete ridges and Touton giant cells were found only in 60 and 240 mg/kg groups, and hyperkeratosis only in 240 mg/kg group. At the end of withdrawal period, Touton giant cells were still found in 60 and 240 mg/kg groups, although the other dermal reactions disappeared. Systemic responses to NT-1 ointment: A slight increase in the excretion of loose or mucous feces was observed in 240 mg/kg group. The weights of right and left kidneys were increased by the administration of 240 mg/kg NT-1 ointment, and a similar trend was seen also in the weight of heart, although there found no such among-group differences at the end of withdrawal period. White blood cells, especially neutrophils, and gamma-globulin fraction were increased in response to 240 mg/kg NT-1 ointment. In conclusion, a no-toxic effect dose of NT-1 ointment as nitroglycerin itself was considered to be 15 mg/kg/day for the skin and 60 mg/kg/day for the general somatic system.

Ferredoxin from a liverwort, Marchantia polymorpha. Purification and amino acid sequence

Marchantia polymorpha ferredoxin was purified by DE-52 and Sephadex G-75 column chromatographies to homogeneity. The complete amino acid sequence of the carboxymethylated (Cm) ferredoxin was determined by conventional methods to be as follows. Thr-Phe-Lys- Val-Thr-Leu-Asn-Thr-Pro-Thr-Gly-Gln-Ser-Val-Ile-Asp-Val-Glu-Asp- Asp-Glu-Tyr-Ile-Leu-Asp-Ala-Ala-Glu-Glu-Ala-Gly-Leu-Ser-Leu-Pro- Tyr-Ser-Cys-Arg-Ala-Gly-Ala-Cys-Ser-Ser-Cys-Ala-Gly-Lys-Val-Thr- Ala-Gly-Glu-Val-Asp-Gln-Ser-Asp-Glu-Ser-Phe-Leu-Asp-Asp-Asp-Gln- Met-Asp-Glu-Gly-Tyr-Val-Leu-Thr-Cys-Ile-Ala-Tyr-Pro-Thr-Ser-Asp- Leu-Thr-Ile-Asp-Thr-His-Gln-Glu-Glu-Ala-Leu-Ile. The total number of amino acid residues was 95 and the molecular weight was calculated to be 10,174, excluding iron and sulfur atoms. The distribution of the four cysteine residues chelating the two iron atoms was identical to those of other [2Fe-2S] ferredoxins. The relationship between M. polymorpha and other plants was discussed in terms of plant phylogeny.

[Peri- and postnatal study on halopredone acetate in rats]

A peri- and postnatal study of halopredone acetate (THS-201), a synthetic corticosteroid, was carried out using Jcl: Wistar rats. Pregnant rats were treated subcutaneously in doses of 0.05, 0.4, 3.2 and 25.6 mg/kg/day, from day 17 of gestation to day 21 after delivery. All pregnant rats were allowed to litter naturally, and the postnatal development of offsprings was observed. The results obtained from the present study were as follows. No influences of THS-201 administration were observed on gestation, delivery and lactation of dams. THS-201 administration did not have any influences on viability and development, various functions such as reflex response, learning and reproductive performance of F1 generation, and further on development of F2 generation. Therefore, it was concluded that the non-effect dose of THS-201 for the reproduction of dams and development of F1 generation was 25.6 mg/kg/day.

[Fertility study on halopredone acetate in rats]

A fertility study of halopredone acetate (THS-201), a synthetic corticosteroid, was carried out using Jcl: Wistar rats. Male rats were treated subcutaneously for 63 days before mating and throughout mating, and female rats were treated subcutaneously for 14 days before mating and until day 7 of gestation, in doses of 0.04, 0.2, 1.0 and 5.0 mg/kg/day. Male and female rats in the same dose were mated. All of the pregnant rats were killed on day 20 of gestation and their fetuses were examined morphologically. The results obtained from the present study were as follows. A decrease in body weight gain was observed in male rats of 1.0 and 5.0 mg/kg groups, compared to the vehicle control group. In female rats of 5.0 mg/kg group, a decrease in body weight gain during gestation period was observed. However, no influences attributable to THS 201 administration were observed on the fertility and fetal development. These results indicated that the non-effect dose of THS-201 for the fertility of rats and fetal development was 5.0 mg/kg/day.

[Teratogenicity study on halopredone acetate in rats]

A teratogenicity study of halopredone acetate (THS-201), a synthetic corticosteroid, was carried out using Jcl: Wistar rats. Pregnant rats were treated subcutaneously in doses of 0.1, 0.5, 2.5 and 12.5 mg/kg/day, from day 7 to day 17 of gestation. Two-thirds of pregnant rats were killed on day 20 of gestation to examine the development of fetuses, and remaining rats were allowed to litter naturally in order to investigate the postnatal development of offspring. The results obtained from the present study were as follows. During the gestation and lactation periods, there occurred a decrease in the maternal body weight gain in 2.5 and 12.5 mg/kg groups. No influences of THS-201 administration were observed on gestation, delivery and lactation of dams. No external, visceral and skeletal anomalies attributable to THS-201 were observed in the fetuses. THS-201 administration did not have any influences on viability and development, various functions such as reflex response, learning and reproductive performance of F1 generation, and further on development of F2 generation. Therefore, it was concluded that the non-effect dose of THS-201 for the reproduction of dams and development of F1 generation was 12.5 mg/kg/day.

Nutritive value of acetate in growing pigs

Twelve crossbred barrows from four litters (average initial body weight of 21 kg) were used to examine the nutritive value of acetate in growing pigs. The treatments were the addition of acetate in the form of triacetin to the basal diet at 0, 5 and 10% of the metabolizable energy (ME) intake. Metabolism tests were conducted during wk 1 and 4 on acetate. The responses of weight gain and N retention to increasing levels of acetate were linear (P less than .001). Efficiency of acetate utilization for body weight gain was .90 g/g acetate, and the mean N-sparing effect of acetate was 32.9 mg N/g acetate. In the liver, heart and femoral muscle examined from d 36 to 47 on acetate, there was a linear increase in RNA content (P less than .05) and in protein content (P less than .01), as the level of acetate intake was increased. Digestible energy and N-corrected ME (MEn) of acetate found in the first week on acetate were not different from its heat of combustion. Those found in the fourth week on acetate, however, were larger (P less than .05) than the heat of combustion. It was considered that a nutritional adaptation to acetate utilization, or a synergistic action of acetate with other energy sources, occurred. The energetic efficiency of acetate utilization for growth was estimated to be 56 to 59%.

Acetate-glucose relationship in growing pigs

Twelve crossbred barrows from four litters (average initial body weight of 21 kg) were used to examine the relationship between acetate and glucose metabolism in pigs. The treatments were the addition of acetate in the form of triacetin to the basal diet at 0, 5 and 10% of the metabolizable energy intake. In the immediate postprandial period, the administered acetate decreased the venous plasma glucose concentration linearly (P less than .05) and increased linearly the venous plasma concentrations of lactate (P less than .01) and ketone bodies (P less than .001). There was a linear increase in the glycogen content of the liver (P less than .001), heart (P less than .001) and femoral muscle (P less than .01), as the level of acetate intake was increased. In the remote postprandial period (12 h after the last meal), glucose, which was considered to have been derived from hepatic glycogen storage, became the dominant blood metabolite in place of the acetate administered with the diet. This led to the reduction in hepatic production of endogenous acetate, arterial acetate concentration and in acetate utilization in the hind limb. Hepatic urea production was also decreased. Thus, there was a reciprocal change in acetate and glucose metabolism.