Cytotoxic activity of CD4+ T cells against autologous tumor cells

The 51Cr-release assay is mostly applied to detecting the cytotoxic activity of CD8+ T cells, and little is known about the activity of CD4+ T cells. Therefore, the correlation between the cytotoxic activity of CD4+ or CD8+ T cells and the incubation period with autologous tumor cells was analyzed by two methods. The incubation periods were 4 and 20 h (4 h and 20 h assay) for the 51Cr-release assay. Eight pairs of tumor cells and T cells were assayed. T cells were fractionated into CD4+ and CD8+ T cells by using magnetic beads and panning methods, and those cells were activated by culture with recombinant interleukin-2 and immobilized anti-CD3 monoclonal antibody. In 6 out of 8 cases, no cytotoxic activity of CD4+ T cells was detected by the 4 h assay, whereas cytotoxic activity was detected in all cases in the 20 h assay. The cytotoxic activities in 20 h assay of CD4+ T cells were increased 67-fold in comparison with the activities in 4 h assay (range: 5-197). In the case of CD8+ T cells, cytotoxic activities were detected in 6 out of 8 cases in the 4 h assay. The lytic unit ratio of CD4+ and CD8+ T cells was calculated as 1.5 in the 20 h assay (range: 0.2- > 7.2) versus 0.4 in the 4 h assay (range: < 0.1-1.3). Cytotoxic activities in colorimetric assay using Crystal Violet with a 24 h incubation were similar to those in the 20 h 51Cr-release assay in all eight cases. These results indicate that CD4+ T cells have cytotoxic activity as strong as that of CD8+ T cells towards autologous tumor cells.

Colonic and peritoneal tuberculosis associated with coloduodenal fistula

We report a very rare case of tuberculous colitis that showed relatively long-segment involvement of the colon near the hepatic flexure with coloduodenal fistula that caused severe malnutrition. The formation of fistula in abdominal tuberculosis is very rare. This is the eighth reported case of abdominal tuberculosis with fistula and the first reported case with a coloduodenal fistula.

Demethylation of a repetitive DNA sequence in human cancers

To detect DNA alterations in unknown regions in human cancers, we have performed restriction landmark genomic scanning (RLGS) analysis of DNA isolated from cancer and normal cells. One spot with a highly intensified signal was detected in DNA from all six malignant melanoma cell lines, two of five colon cancer cell lines and one of six pancreatic cancer cell lines analyzed. In DNA from normal cells, two placentas and seven cultured lymphocytes, the signal of this spot was not intense. The DNA fragment corresponding to the spot was cloned. By nucleotide sequence analysis, the DNA fragment was revealed to be a part of a repeating unit of a 13 kbp nucleotide sequence of which 200 copies were located in chromosome 8q21. Southern blotting analysis using the cloned fragment as a probe demonstrated that the intensified signal for the DNA fragment observed in cancer cells was due to demethylation in the recognition sequence of the NotI restriction enzyme. The results suggest that marked demethylation in the repeating units might be associated with the genesis or progression of some types of cancers.

Monoclonal-antibodies 5g8 and 2h6 are complementary immunohistochemical markers of lung carcinomas

Two murine monoclonal antibodies (MAbs) 5G8 and 2H6 were generated by fusing spleen cells obtained from mice immunized with human fetal tissue extract (14 weeks, Nonidet P-40 membrane fraction) from the early first trimester, followed by a booster injection of a lung cancer cell line. The MAb 5G8 recognized antigens with a molecular weight of 90, 50, 20 kDa, was neuraminidase-resistant and showed cross-reactivity with both carcinoembryonic antigen and non-specific cross-reacting antigen. The MAb 2H6 reacted with a sialomucin whose molecular weight was more than 1000 kDa and was different from previously known tumor associated-marker antigens. The distribution of the MAb-recognizing antigens in various tissues was investigated immunohistochemically. In malignant epithelial tumors of the lung, acinar adenocarcinoma and bronchioloalveolar carcinoma were positive for both MAbs; papillary adenocarcinoma, squamous cell carcinoma, and adenoid cystic carcinoma were positive only for MAb 5G8; solid carcinoma with mucin formation, small cell carcinoma, and large cell carcinoma were positive only for MAb 2H6. The combination of the two MAbs covered almost all histological types of lung carcinomas (23 of 24 cases) except carcinoid tumors. MAbs 5G8 and 2H6 reacted also with a restricted number of adenocarcinomas of the other organs. MAb 5G8 did not react with normal fetal or adult tissues, except for metaplastic gastric mucosa, acinar cells of the breast and leucocytes, whereas MAb 2H6 reacted with the surface epithelium of the stomach and colon, the Brunner gland of the duodenum and uterine cervix as well as the epithelium of the fetal digestive tract. Thus, MAb 2H6 which recognized oncofetal sialomucin, played a complementary role to MAb 5G8 as a CEA-related MAb in the immunohistochemical diagnosis of lung carcinomas.

Successful continuous treatment with all-trans retinoic acid for acute promyelocytic leukemia; secondary malignancy after the treatment of osteosarcoma

We report a rare case of complete remission for 32 months with continuous treatment with all-trans retinoic acid (ATRA) alone in a patient with acute promyelocytic leukemia which developed as a second malignancy after the treatment of osteosarcoma after failure of conventional chemotherapy. The adverse effects of ATRA were apparently tolerable.

[Prevention of cancer recurrence by infusion of activated autologous lymphocytes]

Activated and expanded autologous peripheral blood lymphocytes by cultivation with immobilized anti-CD3 antibody and IL-2 have been infused to the patients with hepatocellular carcinoma after culative operation as a randomized clinical trial. This study is on-going and primary efficacy endpoints of this study were disease-free survival and overall survival, and the sample size for the study was designed as a minimum of 146 patients. From interim analysis at the second year from start of the study, Eligible cases were 101, 49 cases in treated group and 52 cases in control. Recurrences were confirmed 13 cases from treated group and 22 cases from control group. Minor adverse reaction were observed in 28 cases (57%).

[Randomized controlled trial of MMC + UFT and MMC + 5-FU therapy in advanced gastric cancer]

To compare the effects of MMC + UFT (A) with MMC + 5-FU (B) therapy on the response rate, survival time and changes with time in quality of life (QOL) in unresectable or recurrent gastric cancer, we carried out a study by a multicenter, randomized controlled trial from June 1990 to August 1992. 39 patients were randomly divided into A group and B group, including 6 incompletely evaluated cases and 3 in eligible cases. Responses were recognized in 3 out of 13 evaluable cases (23.1%) treated with regimen A and in one out of 15 evaluable cases (6.7%) treated with regimen B. Mean survival time was 150 days (A) and 116 days (B), respectively. These results suggested that MMC + UFT therapy is one of the effective regimens for advanced gastric cancer and as useful as MMC + 5-FU therapy. Moreover, it showed that regimen A was superior to B on QOL.

Stabilization of L-asparaginase modified with comb-shaped poly(ethylene glycol) derivatives, in vivo and in vitro

L-Asparaginase from Escherichia coli was coupled with two types of comb-shaped copolymer of poly-(ethylene glycol) derivative and maleic anhydride (activated PM), having molecular weights of 13,000 and 100,000 (activated PM13 and PM100, respectively) with multivalent reaction sites. After single intravenous injections of PM100-asparaginase and nonmodified asparaginase into rats, the enzymic activity of PM100-asparaginase in serum was well retained for at least 11 days, and the serum L-asparagine concentration remained undetectable for 27 days. The half-lives of PM100-asparaginase and nonmodified asparaginase were 50 and 1.5 h, respectively. Stabilization of L-asparaginase toward heat, urea, and acidity was caused by modifying the enzyme with activated PM13 and PM100. Especially, PM100-asparaginase retained high enzymic activity toward heat and urea, compared with PM13-asparaginase. It was suggested that these modifiers with a comb-shaped form and with multivalent reactive sites cover the whole surface of the asparaginase molecule and stabilize its conformation possibly through multiple covalent bindings and through various noncovalent interactions.

Alpha-fetoprotein-producing rectal cancer: calculated tumor marker doubling time

alpha-fetoprotein (AFP) production by rectal cancer is very rare. In the English literature there are only a few reported cases in which serum AFP level was > 1,000 ng/ml. A 43-year-old Japanese man with rectal cancer and liver metastases had a high serum AFP level (941 ng/ml) when first evaluated. Three weeks later, the serum AFP level was extremely elevated (7,060 ng/ml). He underwent abdominoperineal excision of the rectum and biopsy of liver metastases. The placement of an intrahepatic-arterial infusion catheter into the proper hepatic artery via the right gastroepiploic artery was also performed. Immunohistochemically, AFP-positive cells were identified in both the rectal and liver tumors. Nine days postoperatively, the serum AFP level was 2,000 ng/ml. In spite of intensive chemoimmunotherapy, serum AFP level was increased and 14 weeks after surgery was extremely elevated (267,300 ng/ml). The patient succumbed to cancer 3 months after surgery. To our knowledge, this is the first case of an AFP-producing rectal cancer in which AFP doubling time could be calculated as 12.8 days.

Fully mechanized latex immunoassay for serum lipoprotein(a)

We have developed a fully automated system to quantify lipoprotein(a) (Lp(a)) in human serum, based on the latex-enhanced turbidimetric immunoassay by application of the Immuno Chemistry Analyzer 501X. This assay was carried out with undiluted serum and was able to detect at Lp(a) levels higher than 4.0 mg/l. When judged to be out of range of the calibration (> 600 mg/l), the sample was automatically re-tested after automatic 10-fold dilution. Within-run C.V.s ranged from 1.9 to 2.1% and between-run C.V.s from 2.7 to 3.9%. Results by the present method were in good agreement with those by the in-house ELISA (r = 0.978) and the commercial ELISA (r = 0.990). The distribution of Lp(a) levels in sera from 508 healthy donors was highly skewed; the mean and median were 158 mg/l and 105 mg/l, respectively.

[A prospective study of septic episodes due to Staphylococcus aureus and the background of the patients]

From January 1983 to December 1991, 94 cases of Staphylococcus aureus septicemia were identified at Matsue Red Cross Hospital and were evaluated. Methicillin-resistant Staphylococci aureus counted 49%. Seventy two percent of the patients were 60 years or over in age. Intravascular catheters were the most common foci (33%), respiratory infections in 25% and so on. Administration of antibiotics before isolation of Staphylococcus aureus were thought to be the most significant factor in producing the methicillin-resistant septicemia, used in 41% of MSSA and 91.3% of MRSA cases. Especially, the trend of unproper usage of the 3rd generation cephems derivative antibiotics had a major role in producing multi-drug resistant bacteria. No significance was seen in the clinical background, underlying diseases, primary site of infection in between the two groups of methicillin resistant and sensitive cases. Mortality due to septicemia was 47.9% in the MSSA group of patients, while it was much higher in cases of MRSA (73.9%). In conclusion, as the administration of antibiotics even in non-infectious episodes is common in daily clinical activities in some out-patient clinics, the indications should be restricted, in order to prevent the further MRSA infections.

Identification of a new serine kinase that activates NF kappa B by direct phosphorylation

A novel serine kinase, named nuclear factor kappa B (NF kappa B) kinase, has been shown to be associated with the NF kappa B.I kappa B complex in the cytosol of human primary T lymphocytes. It activates the DNA binding activity of NF kappa B by directly phosphorylating its p65 and p50 subunits. There is no evidence that it phosphorylates I kappa B. Experiments with inhibitors and antisera showed that it is distinct from other known serine kinases such as mitogen-activated protein kinase or Mos. It has an apparent molecular size of 43 kDa determined by the substrate binding assay. This kinase might have a central role in mediating various signals to NF kappa B.

CD7, CD4 and myeloid antigen-positive acute lymphoblastic leukemia

We report a case of acute lymphoblastic leukemia (ALL, FAB-L2) with unique cellular characteristics. Leukemic cells were negative for various cytochemical stainings except acid phosphatase. Immunophenotypic studies revealed CD7+, CD4+, CD8-, CD2+, CD3-, CD13+, CD25+, CD33+ and CD34+. The immunoglobulin heavy chain and T-cell receptor beta, gamma and delta chain genes were germline configurations. This patient had a karyotype of complex abnormalities involving Nos. 5 and 7. Leukemic cells showed a prominent response to interleukin-3, granulocyte macrophage colony stimulating factor (GM-CSF) and G-CSF with partial granulocytic differentiation in a colony assay. A binding assay confirmed the presence of both high and low affinity receptors for GM-CSF. These findings suggest that CD7+CD4+CD8-CD3- putative T-cell precursors may retain the capacity to differentiate to myeloid lineage.

[A case of intercostal neuropathy (Th 2-9) due to sarcoidosis]

Neurosarcoidosis is a disorder which presents in 5 percent of cases of general sarcoidosis, in only 10% of which the peripheral nerves are involved. A patient who complained of numbness of the abdomen and back associated with paralytic motion of intestines was admitted. The patient was diagnosed as having neurosarcoidosis of the intercostal nerves (Th2-9) on the basis of abnormality of somatosensory evoked potentials (SEP) and reduced conduction velocity, and evident disease of intrathoracic lesions confirmed by biopsy. Corticosteroid was administered, with relief of symptoms and active response on SEP. Somatosensory evoked potentials and VC were of great value in the diagnosis and follow up of peripheral neuropathy due to sarcoidosis.

Three-dimensional cytoarchitecture of complex branched fibers in soleus muscle from mdx mutant mice

Three-dimensional cytoarchitecture and types and features of muscle fibers were examined in soleus muscles from mdx mutant mice at different stages of development. In the 2-week-old mice, no abnormal muscle fibers were observed light microscopically, whereas in the 4-week-old animals, disrupted fibers were frequent in light microscopy and scanning electron microscopy. Muscle fibers fused with several short fiber branches appeared at the sixth week after birth and increased in number until the tenth week. In the 1-year-old mice, approximately ten or more muscle fibers were seen fused together. They had many complex branches forming an "anastomosing syncytial reticulum." Muscle fibers with irregular diameters and aggregations of the same type fibers were also observed. Our results demonstrated that these complex branched fibers might be formed by long term repetition of the degeneration and regeneration cycle during the development of soleus muscles, indicating that the characteristic features of muscle fibers with irregular diameters and aggregations of the same type fibers are certainly dependent on the existence of the complex branched fibers.

A case-control study of colorectal cancer and its relation to diet, cigarettes, and alcohol consumption in Saitama Prefecture, Japan

A case-control study of colorectal cancer in relation to dietary, smoking, and drinking habits was undertaken in Saitama Prefecture, Japan. The study was based on 181 newly diagnosed cases of adenocarcinoma of the colorectum at a single institution and 653 general population controls. Dietary habits were investigated on the basis of the intake of 12 foods and 12 food groups in a food intake frequency questionnaire, together with individual food preferences. Preference for salty foods was positively related to the risk of both colon and rectal cancer, and the consumption of seaweed was inversely related to these cancers, both with a dose-response relation. Cigarette smoking was inversely related to colon cancer risk, but not to rectal cancer risk. Alcohol intake tended to be associated inversely with colon cancer, but not with rectal cancer. In the multiple logistic regression, preference for salty foods (positively) and the consumption of seaweed (inversely) were independently related to both colon and rectal cancer risks.

Chromosome 3p deletion in a renal cell carcinoma cell line established from a patient with von Hippel-Lindau disease

von Hippel-Lindau disease (VHL) is an autosomal dominant inherited disease, frequently accompanied by occurrences of renal cell carcinoma (RCC). Both the VHL gene and tumor suppressor genes for RCC have been mapped to the short arm of chromosome 3, although the genes have not yet been identified. An RCC cell line, KC12, was established from a VHL patient. Molecular genetic analyses in conjunction with cytogenetic studies revealed that the short arm of chromosome 3 distal to the D3S4 locus at 3p11 was lost in the RCC cell line as a result of an unbalanced translocation between chromosomes 3p and 5q. Structural and numerical aberrations, including those on chromosome 3p, were not detected in T-lymphocytes from the patient, suggesting that the inherited mutation of the VHL gene at 3p25-26 in this patient was too subtle to be detected by either Southern blot or karyotype analysis. Since no permanent RCC cell line has been established from a VHL patient, this cell line will be a useful source for analyzing the VHL gene at 3p25-26 and tumor suppressor gene(s) at 3p13-21.