T-cell subsets analyzed by monoclonal antibodies in patients with primary immunodeficiency diseases

The proportion of T-cell subsets was normal in all patients with X-linked agammaglobulinemia except for an 8-month patient who showed a decrease in OKT8+ T-cell population. In two patients with hypogammaglobulinemia with IgM production, T-cell subsets were normal in distribution and the patients' B cells produced only IgM in culture with autologous T cells. A patient with common variable immunodeficiency showed no imbalance in distribution of T-cell subsets. Imbalance of regulatory T-cell subsets was found in a patient with DiGeorge syndrome and severe combined immunodeficiency.

[Cooperative studies on surgical adjuvant immunochemotherapy for prevention of postoperative recurrence of gastric cancer]

A controlled clinical trial of surgical adjuvant immunochemotherapy of gastric cancer was started in July, 1974 involving twelve institutes (Chairman; T. Kondo) in Japan. Patients with gastric cancer undergone curative resection were eligible. These patients were divided into 3 groups; Group A, mitomycin C (MMC) + 5-fluorouracil (5-FU): Group B, MMC + 5-FU + PSK or MMC + 5-FU + OK-432; and Group C, surgery alone. Of 1412 patients accumulated up to December 1977, 848 cases were evaluable: Group A-264 cases, group B-290 and group C-294. Side effects such as leukopenia, thrombopenia, elevated GOT and GPT, albuminuria and digestive disorders, were observed in 54 cases (20.5%) of group A and in 59 cases (20.3%) of group B. The 3-year survival rates of total cases were 79.2% with group A, 77.0% with group B and 85.2% with group C. The 2-year survival rates of histological stage II cases were 93.4% with group A, 90.5% with group B and 80.7% with group C. The difference in survival rate between A and C (12.7%) was statistically significant (p less than 0.05). The efficacy was not related to the histological type of gastric cancer. Adjuvant immunochemotherapy using OK-432 was significantly effective on a 1-year survival rate of stage IV gastric cancer.

An Ia-like antigen positive null cell leukemia cell line (THP-5) lacking in the stimulating capacity in autologous and allogeneic mixed lymphocyte reaction

A null cell leukemia cell line, THP-5, was established from the peripheral blood of a patient with acute null cell leukemia. THP-5 cells were characterized by the presence of Ia-like antigen and the absence of other cell surface markers examined. Despite the presence of Ia like antigen, THP-5 cells had no stimulating capacity in autologous or allogeneic mixed lymphocyte reaction.

Immunoelectronmicroscopic study on the transport of secretory IgA in the lower respiratory tract and alveoli

To define the immunocytochemical localization of secretory component (SC), IgA and J chain in human bronchioles and alveoli, a direct peroxidase-labeled antibody method was used. SC was found in non-ciliated cells of the bronchioles including respiratory bronchioles and type II alveolar epithelial cells, whereas SC was rarely present in ciliated cells and type I alveolar epithelial cells and was absent from goblet cells. In the positively reacting cells, SC was found in secretory protein synthetic organelles such as perinuclear spaces and endoplasmic reticulum, Golgi complexes, and on the external surfaces of the apical and basolateral plasma membranes. IgA and J chain were localized in the epithelial cells where SC was found. Ultrastructually IgA was present on the apical and basolateral plasma membranes, in pinocytic invaginations of the membranes, and in vesicles distributed through the cytoplasm, especially in the apical cytoplasm of the epithelial cells where SC was found. In addition, IgA and J chain were found to be associated with the endothelial cells of the capillaries, plasma cells and the surrounding interstitium. These observations suggest that SC is synthesized and secreted by epithelial cells, especially non-ciliated cells of the bronchioles including respiratory bronchioles and type II alveolar epithelial cells. They also suggest that secretory IgA (sIgA) is transported into alveolar spaces and the bronchiolar lumen through these cells by SC-mediated transport mechanism. This sIgA may play an important role in defense mechanisms of the lower respiratory tract and alveoli.

[Evaluation of left ventricular asynergy by two-dimensional echocardiography: comparison between fixed external axis system and floating axis system]

Detection and quantitative estimation of segmental asynergy in the infarcted area has been impeded by the rotation and anterior movement of the heart during systole. In the present communication, we compared the two measurements determined by the floating and fixed external axis systems. The former takes into account of the effect of cardiac movement. Furthermore, we assessed which system is superior by the left ventriculographic and coronary arteriographic analyses. The materials consisted of 24 cases of myocardial infarction. There was no significant difference between the two systems in the estimation of the number of asynergic segments or between echocardiographic and ventriculographic findings. The floating axis system had a tendency to underestimate asynergy, so that the number of hypokinetic segment estimated by the floating system was greater than that by the fixed external axis system. Therefore, the fixed external axis system was superior to the floating axis system in determining the causative coronary artery.

An Epstein-Barr virus-negative B lymphoma cell line (THP-2) from a Burkitt's lymphoma of a Japanese patient

An Epstein-Barr virus-negative lymphoma cell line, THP-2, was established from a Burkitt's lymphoma taken from a Japanese patient. THP-2 cells grew in single cell suspension with a doubling time of 24 hr; the cells carried surface-bound mu-lambda immunoglobulins and formed rosettes with IgG antibody-coated ox erythrocytes. THP-2 cells expressed B1, common acute lymphoblastic leukemia (ALL) (J5) and Ia-like antigens of their surface as defined by monoclonal antibodies. Epstein-Barr virus-associated nuclear antigen (EBNA) was not detected. The cell line THP-2 has been maintained for over 5 years. Among the markers examined, only common ALL antigen has been present on the cell surface of THP-2 for these 5 years.

[Clinical evaluation of latamoxef, an oxacephem antibiotic with special reference to transport of latamoxef into the lung tissues and prevention of postoperative infections after thoracotomy]

There are few clinical reports about concentration of latamoxef (LMOX) in lung tissues. At present, clinically, we report a concentration of LMOX in serum and lung tissues on 21 patients of chest disease and a study of the administration schedule of LMOX for prophylaxis of postoperative infections on 31 operated patients with chest disease. Our results are the followings: The peak concentration of LMOX in serum is 77.4 micrograms/ml at 1 hour after starting drip infusion of LMOX 1 g. The concentration of LMOX in lung tissues is from 25% to 50% of serum level. LMOX is more useful to prophylaxis of postoperative infections after thoracotomy than cephalothin, especially in case of administration of LMOX just before operation. No side effects of LMOX are noted in our cases. LMOX has wide antibacterial activity against various clinical isolates and is useful to treatment of postoperative infections.

Two non-T/non-B leukemia cell lines (THP-3-1 and THP-3-2) established from a patient at different stages of the disease

Two leukemia cell lines of different phenotypic expression were established from a single patient with non-T/non-B acute lymphocytic leukemia (ALL); one (THP-3-1) was derived from the peripheral blood taken on admission before chemotherapy and the other THP-3-2) during the terminal stage. Both THP-3-1 and THP-3-2 cells were positive for terminal deoxynucleotidyl transferase (TdT) and Ia-like antigen but negative for surface immunoglobulins (Ig), nuclear antigen of Epstein-Barr virus (EBNA) and receptors for sheep erythrocytes. However, there was a difference in the expression of common ALL antigen (J5) between the two cell lines. J5+ cells were found in only 5% of THP-3-1 and in 96% of THP-3-2.

[Clinical evaluation of cefotiam chloride in the surgical field, with special reference to its intrathoracic distribution and prevention of postoperative infections following thoracic surgery]

There are few report about the concentration of antibiotics in the tissue of intrathoracic organs. At present, it was analized the concentration in serum and tissue of intrathoracic organ and urinary excretion for CTM, and clinical effect against postoperative infection and side effect of CTM were discussed. 1) The peak concentration in serum was 48.7 micrograms/ml and half lives of CTM was about 30 minutes in 1 hour drip infusion of CTM 1g. 2) The concentration of CTM in lung tissue was about 30--50% of serum level. The concentration of CTM to pulmonary lesion was relatively high. 3) The concentration of CTM to the secretion of normal bronchiole was high as well. 4) The concentration of CTM to the bone marrow of rib was less than lung tissue. 5) Urinary excretion of CTM was 50--77% of total dose by 6 hours after injection. 6) CTM has wide spectrum and is useful to prophylaxis of postoperative infection. 7) It may be ineffective for Pseudomonas aeruginosa infection of lung.

Internal carotid occlusion: assessment, by Tc-99m-tagged microspheres, of bypass from superficial temporal to middle cerebral artery

The assessment of regional blood perfusion through the STA-MCA anastomosis was performed by the method of intracarotid injection of Tc-99m-labeled human albumin microspheres (HAM scintigraphy). This study included 11 anastomoses in 10 cases with occlusion of the internal carotid artery, who were treated by bypass surgery. The area of intracranial perfusion through the bypass was well defined in all cases by HAM scintigraphy. This method is excellent for imaging the regional blood perfusion through the anastomotic vessel, and the scintigraphic findings agree well with those of postoperative angiography. HAM scintigraphy will partially replace postoperative angiography because of its simplicity and low invasiveness.

Diurnal variations in monoamine contents in discrete brain regions of the mongolian gerbil (Meriones unguiculatus)

Under controlled conditions of environmental light and darkness of 12:12 h, the concentrations of noradrenaline, dopamine, and serotonin in six brain regions (i.e., cortex, hippocampus, striatum, midbrain including hypothalamus, pons-medulla oblongata, and cerebellum) of the male Mongolian gerbil, an animal widely used in stroke research, were measured fluorometrically at different times of the day. The significant daily fluctuations in these monoamine concentrations were observed in cortex, striatum, hippocampus, midbrain including hypothalamus, and pons-medulla oblongata. Thus, diurnal variations have to be taken into account when studying the effects of ischemia on the change of monoamine concentrations in these brain areas of the gerbil.

Evaluation of cross-circulation through circle of Willis using an ultrasonic Doppler technique. Part I. Comparison between blood flow velocity by ultrasonic Doppler flowmetry and angiogram

In 24 patients with cerebrovascular disease and 6 without organic brain lesions, the increased velocity of blood flow in both the internal carotid and vertebral arteries during a contralateral carotid compression was compared with the angiographic appearance of the circle of Willis. The flow velocity was measured using ultrasonic Doppler flowmetry. It was not possible to investigate fully the relationship between the increase of velocity of blood flow in the internal carotid artery and the anatomical variations of the circle of Willis, specifically the anterior cerebral and communicating arteries. The velocity of flow in the patients with an aplastic proximal portion of the anterior cerebral artery showed no increase. There were no differences in the increase of velocity of flow in the vertebral artery in patients with hypoplastic, normal and fetal posterior communicating arteries. It is considered that although anatomical variations of the circle vessels influence the cross-circulation via the circle of Willis, peripheral vascular factors distal to the circle also play an important role in the quantity of cross-circulation through the circle.

Operative procedure and indications for surgical management of pulmonary metastasis of choriocarcinoma

From 1961 to 1977, thoracotomy was performed on 19 patients with pulmonary metastasis of choriocarcinoma in Nagoya University with regard to the role of thoracotomy in management of pulmonary metastasis of choriocarcinoma. Our surgical indications for the disease are: 1) the patients must be a good risk for surgical intervention. 2) The primary malignancy be controlled. 3) Evidence of pulmonary metastasis be limited to the lung. 4) The urinary human chorionic gonadotropin (hCG) titers should be controlled at low levels below 1000 mIU/ml by preoperative chemotherapy. At levels below 200 mIU/ml, the indication for surgery will be assessed by the cellular response to chemotherapeutic agents. As an operative procedure, in view of a low incidence of lymph nodes metastases, extended pulmonary surgery appears to be unnecessary providing that the gross pulmonary lesion is removed by partial resection of the lung or lobectomy. Postoperative adjuvant chemotherapy is required to induce a complete remission of the choriocarcinoma.

Evaluation of cross-circulation through circle of Willis using an ultrasonic Doppler technique. Part II. Comparison between blood flow velocity by ultrasonic Doppler flowmetry and cerebrovascular resistance

The correlation between the increase in velocity of blood flow in both the internal carotid and vertebral arteries during a carotid compression and the cerebrovascular resistance (CVR) was investigated in 11 patients with chronic ischemic cerebrovascular disease and 4 without organic brain lesions. The velocity of blood flow was measured by an ultrasonic Doppler flowmeter. CVR was calculated from cerebral blood flow and arterial blood pressure. There was no correlation between the increased velocity of blood flow in the internal carotid and vertebral arteries and CVR. The increased velocity of blood flow in patients with low CVR was, however, significantly higher than that of patients with high CVR. The investigation of cross-circulation by ultrasonic Doppler flowmetry is a useful non-invasive method for the detection of changes in cerebral vascular resistance.

Ultrasonic Doppler studies after superficial temporal-middle cerebral artery anastomosis

The ultrasonic Doppler technique was applied to evaluate the effect of STA-MCA anastomosis. Not only the STA itself, but also ophthalmic and major aortocranial arteries were recorded by the Doppler technique in 12 patients who had undergone STA-MCA anastomosis for internal carotid artery occlusion or stenosis. The examination was performed before, and within a month after the operation. The blood flow pattern of the STA, which had had an external carotid flow pattern, was altered to an internal carotid flow pattern by the STA-MCA bypass operation. The findings of Doppler sonograms of the STA were exactly consistent with post-operative angiograms and precisely represented the bypass patency. Among 7 patients with reverse flow direction in the ophthalmic artery before the operation, the reverse flow had decreased in 5 patients post-operatively. But no remarkable change in the ophthalmic artery was detected in the remaining 2 patients. The blood flow velocity patterns of major aortocranial arteries showed no change post-operatively.

Surgical indications for resection in pulmonary metastasis of choriocarcinoma

One hundred and twenty-two patients with choriocarcinoma were treated from 1965-1977. Pulmonary metastasis was noted in 82 of the 122 patients. In 21 cases, open thoracotomy and lobectomy were performed in conjunction with chemotherapy. Fifteen patients achieved complete remission and six patients died. It became evident that the factors with the greatest effect on the outcome of the surgical treatment are the preoperative hCG values and the extent of pulmonary metastasis. The following are the authors established criteria for the operative intervention of pulmonary metastasis of choriocarcinoma (modifying Thomford's principles): (1) The patient must be a good risk for surgical intervention. (2) That the primary malignancy is controlled, (the uterus has already been resected, or no angiographical evidence of tumor in pelvic cavity). (3) There is no evidence of metastatic disease elsewhere in the body. (4) Roentgenologic evidence of pulmonary metastasis is limited to one lung. (5) The urinary hCG value is below 1000 mIU/ml.

Hemodynamic and volume characteristics, and peripheral plasma renin activity in Takayasu's arteritis

Hemodynamic and volume characteristics, and/or peripheral plasma renin activity were investigated in 19 patients with Takayasu's arteritis who included 8 hypertensive patients with renal arterial disease and 11 normotensive patients. In hypertensive patients, mean arterial pressure had an inverse correlation with cardiac index, a direct correlation with total peripheral resistance index and no correlation with blood volume. These hemodynamic and volume characteristics were different from those of hypertension with renal arterial disease previously reported. High plasma renin activity was presented in not only hypertensive patients with renal arterial disease but normotensive patients. The investigation of high plasma renin activity in Takayasu's arteritis must be also directed to the mechanism except renal arterial lesions.

Esophageal cyst, a case report and a review of the literature

The esophageal cyst is a rare disease only 20 cases of which have been reported in the literature in Japan. We recently treated such a patient and at thoracotomy, we found the cyst to be located the submucosal layer of the esophagus. The cyst could be easily extirpated and the patient made an uneventful recovery. Gross findings revealed thick, yellow and mucus-like contents inside the cyst. Microscopically, the cyst was lined with ciliated columnar epithelium and there was no evidence of cartilage. The 21st such occurrence in Japan is reported herein and a discussion is made of related literature.

Thromboxane generation in patients with essential hypertension or cerebrovascular disease and effect of oral aspirin

The ability of platelets to synthesize thromboxane B2 (TxB2) from arachidonic acid (AA) or prostaglandin H2 (PGH2) was studied in 26 control subjects, 40 patients with essential hypertension, 20 patients with cerebrovascular disease (CVD) not taking aspirin and 11 patients with CVD taking aspirin. The activity of platelets to form TxB2 from AA or PGH2 was measured using 1-14C arachidonic acid or 1-14C PGH2 as a substrate. There was no significant difference in TxB2 generation from AA or PGH2 among the platelets collected from the control subjects, hypertensive patients and CVD patients not taking aspirin. In CVD patients taking aspirin, marked suppression was observed in TxB2 synthesis from AA, but no suppression in TxB2 synthesis from PGH2. At least 750 mg aspirin per day were required for nearly complete suppression of TxB2 generation from AA.

Behcet's disease with sinus thrombosis and arteriovenous malformation in brain

A 55-year-old man suffered from Behcet's disease with bilateral sigmoid sinus thrombosis and dural arteriovenous malformation has been studied clinically and pathologically. A possible causal relationship between Behcet's disease and sigmoid sinus thrombosis is discussed.

The effect of intravenous hyperalimentation on cell mediated immunity

The effect of intravenous hyperalimentation (IVH) on cell mediated immunity was examined in 22 patients. Each patient received PHA and PPD skin tests before and after the performance of IVH. In this study both PHA and PPD skin reactivity showed significant increase after IVH, and serum albumin levels had positive correlation with the PPD skin reaction changes. Absence of the established delayed hypersensitivity in the surgical patient, especially those with malignant diseases, is probably secondary to generalized malnutrition, and established cell mediated immunity can be restored by proper nutritional repletion.

Subclavian steal in Takayasu's arteritis. A hemodynamic study by means of ultrasonic Doppler flowmetry

Blood flow in the vertebral artery and the upper extremity was studied in five cases of Takayasu's arteritis with subclavian steal by use of ultrasonic Doppler flowmetry and finger plethysmography. The diagnosis of subclavian steal was made by observation of flow reversal in the vertebral artery on the subclavian steal side during grip exercise and, in addition, the vertebral flow change with brachial artery occlusion. The blood flow increase of both internal cartotid and non-affected (non-subclavian steal side) vertebral arteries during a common carotid compression was almost normal in patients with Takayasu's arteritis in this study. During carotid compression on the side of the subclavian steal, ipsilateral vertebral blood flow greatly decreased, and the amplitude the ipsilateral finger plethysmogram decreased slightly or moderately. It is suggested that there are significantly important factors in suppressing sumptoms of vertebrobasilar ischemia in these patients with Takayasu's arteritis with subclavian steal. These factors are believed to be (1) good function of the circle of Willis, (2) good blood supply to the brain stem, and (3) collateral circulation to the distal subclavian artery not via the vertebral artery.

Predication of the effect of carcinostatic agents on tumor-bearing host by the sensitivity test using acid phosphatase activity in vitro

For the purpose of predicting the effect of carcinostatic agents on tumor-bearing host in vitro, a sensitivity test of a drug in tumor bearers was developed. This test is based on the change in the specific activity of acid phosphatase of individual tumor and liver tissue, and the difference in them was used as an indicator of effectiveness. The value was called the "effective value." The present papar is concerned with the relationship between the effective value and effectiveness of the agents in rodents and man. The results showed that the effective value became higher with increasing concentration of Mitomycin-C incubated with tumor and liver tissues. The survival time of Ehrlich carcinoma-bearing mice, which were given Mitomycin-C intraperitoneally, was longer and increase in the dose of Mitomycin-C. In ascitic or subcutaneous form of Ehrlich carcinoma, AH-130, and Yoshida sarcoma, the effective value was parallel with the survival time of or the inhibition of tumor growth in tumor-bearing animals treated with Mitomycin-C. In 25 patients with gastric carcinoma treated with Mitomycin-C, the postoperative survival time was more closely correlated with the effective value calculated by the titers of both tumor and liver than the value of tumor alone.