Blood Vessel Invasion in the Primary Site and Involved Lymph Nodes of Breast Cancer: Its Significance to Hematogenous Metastases

One hundred sixty-nine patients who had had radical mastectomywere investigated for blood vessel invasion in the primary tumorsites (TBVI); and 72 of these patients with regional lymph nodemetastasis were examined for blood vessel invasion within andin the vicinity of the involved lymph node (NBVI). Although distant metastases occurred more frequently in thepatients with blood vessel invasion in the tumor than in thosewith no blood vessel invasion, the differences were rather smallwithin respective negative and positive node metastasis subgroups. Analysis of blood vessel invasion in the involved lymph nodeshowed higher incidences of distant metastases in the subgroupswith positive blood vessel invasion in the lymph node than inthe subgroups with no such invasion; 42.1% 5s. 9.5% (negativeTBVI subgroup) and 47.4% 5s. 15.4% (positive TBVI subgroup). ^* This work was supported by a grant-in-aid for cancer researchfrom the Ministry of Health and Welfare.     

INSULIN AND GLUCAGON SECRETION IN HEPATIC GLYCOGENOSES

ABSTRACT. Okada, S., Seino, V., Kodama, H., Yutaka, T., Inui, K., Ishida, M., Yabuuchi, H. and Seino, Y. (Department of Pediatrics, Osaka University Hospital, Fukushima-ku, Osaka and The Third Division, Department of Medicine, University of Kobe, Kobe, Japan). Insulin and glucagon secretion in hepatic glycogenoses. Acta Paediatr Scand 68: 735, 1979.—Insulin and glucagon secretion was investigated in ten patients with hepatic glycogenosis, types I and III, in order to understand the relationship between hypoglycemia and pancreatic function. In all patients, both oral glucose tolerance and intravenous arginine infusion tests revealed hypoinsulinemia. Decreased urinary C-peptide levels with standard food intake also supported hypofunction of pancreatic beta cells. On the contrary, the normal secretion pattern of glucagon in both types indicated in the arginine loading test, intact alpha cells in the pancreas. Persistent hypoinsulinism, which is apparently an adaptation to hypoglycemia, could be an important cause of nutritional dwarfism in both types of glycogenosis. The usefulness of the measurement of urinary C-peptide, which evaluates the pancreatic function and provides management for normal body growth, is discussed.     

Effect of ureteral reimplantation on prevention of urinary tract infection and renal growth in infants with primary vesicoureteral reflux

AIM: We retrospectively reviewed the results of ureteral reimplantation in infants with primary vesicoureteral reflux (VUR) to evaluate the effect on prevention of urinary tract infection (UTI) and renal growth. MATERIALS AND METHODS: From July 1991 to December 2001, a total of 205 infants (180 boys and 25 girls) with primary VUR underwent ureteral reimplantation at the Department of Urology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. Indications for surgery were high-grade reflux (grade IV-V), breakthrough UTI and non-compliance of medical treatment. Age at surgery raged from 1 to 11 months (mean, 6.4 months). Ureteral reimplantation was performed according to Cohen's method. Only two of 336 refluxing ureters required ureteral tailoring. Follow-up ranged from 12 to 110 months (mean, 64 months). Surgical outcome, frequency of UTI and individual renal growth measured by (99m)Tc-dimercaptosuccinic acid (DMSA) scintigraphy was evaluated. RESULTS: Postoperative ultrasound and voiding cystourethrography showed neither residual reflux nor ureterovesical obstruction. Contralateral low grade reflux occurred in six of 74 patients (8.1%) who had unilateral reflux preoperatively. After reimplantation, 10 patients documented 13 febrile UTI. Eleven of the 13 episodes occurred early in the postoperative period (<6 months). Frequency of febrile UTI reduced from 0.23538 before surgery to 0.00894 and 0.00081 per patient per month at 6 and 12 months after surgery, respectively. No development of renal scarring was seen in postoperative DMSA scan. Changes of differential renal function was <0.05 in all patients. CONCLUSION: The present results show ureteral reimplantation in infants is safe and very effective for the prevention of UTI. After surgical treatment in infancy, individual renal growth of children with primary VUR is stable.     

CYCLIC PEPTIDES: X. Bitter Taste and Chymotryptic Hydrolysis of Cyclic Depsidipeptides Containing a Tryptophan Residue*

Four stereoisomers (I-LL, I-LD, I-DL and I-DD) of a cyclic depsidipeptide (I) containing a tryptophan and a 2-hydroxy-4-methylpentanoic acid residue were synthesized, and their taste and chymotryptic susceptibility were examined. Compound I-LL is a depsipeptide analog of a bitter principle BP-II, cyclo(-L-Trp-L-Leu-), obtained from casein hydrolyzate. All of the four stereoisomers of I are strongly bitter to taste. Another depsipeptide analog, L-aspartyl-L-2-hydroxy-3-phenylpropanoic acid methyl ester, of the sweet H-L-Asp-L-Phe- OMe showed bitter taste instead of sweet. Chymotrypsin hydrolyzed I-LL and I-LD in moderate rates, and I-DL and I-DD very slowly.     

ENZYME-CATALYZED FORMATION OF SEMISYNTHETIC STAPHYLOCOCCAL NUCLEASE USING A NEW SYNTHETIC FRAGMENT, [48-GLYCINE] SYNTHETIC-(6–49)

While trypsin can catalyze resynthesis of the peptide bond between fragments in the noncovalent complex of nuclease-T-(6–48) and nuclease-T-(49–149), this reaction leads to excision of Lys 49 and formation of inactive [des Lys 49]-nuclease-(6–149). To provide a method for making active covalent semisynthetic nuclease, we chemically synthesized the fragment of residues 6 to 49 in which lysine 48 was replaced by glycine. This peptide was made using the recently described solid phase support, 4-(oxymethyl)phenylacetamidomethyl-polystyrene. The resultant crude polypeptide exhibited 30–50% of native nuclease-T enzymatic activity when added to native nuclease-T-(50–149). When the noncovalent complex formed by native nuclease-T-(50–149) and a 10-fold molar excess of [Gly 48]synthetic-(6–49) was equilibrated with trypsin in 90% glycerol, an increase in enzymatic activity from 8 to 32% (versus nuclease) was observed. Simultaneously, approximately 20% conversion of nuclease-T-(50–149) to nuclease-molecular weight material was observed by gel electrophoretic analysis. These data indicate that a covalent semisynthetic species is formed with activity about equal to that of native nuclease. The results confirm the importance of loop integrity on catalytic site organization. The Gly 48-containing fragment system defined above can allow preparation of semisynthetic nuclease sequence analogs.     

CASE REPORT: Insulin - like growth factor II expression in hepatocellular carcinoma with alcoholic liver fibrosis accompanied by hypoglycaemia

This case of hepatocellular carcinoma (HCC) with alcoholic liver fibrosis, which was not associated with hepatitis viruses, was accompanied by hypoglycaemia. The immunoreactive insulin level was low and other hormonal examinations were almost normal. Immunohistochemical studies showed a high level of insulin-like growth factor II (IGF2) peptide in the HCC section and the size heterogeneity of serum IGF2 investigated by western blot revealed a large form at approximately 15 kDa. These results suggest that the HCC with alcoholic liver fibrosis produced IGF2 and that the hypoglycaemia was caused by tumour-associated IGF2.     

Evidence for the in Vivo Localization of Heterologous Anti-Leukocyte and Anti-Bone Marrow Antibodies in the Rat Bone Marrow

1. The intravenous injection of I¹³¹-labeled heterologous anti-leukocyte and anti-bone marrow antibodies into rats resulted in a high specific in vivolocalization in the bone marrow, indicating the presence of localizing anti-body.

2. No in vivo localization in lungs was demonstrated, in possible contrastto the earlier concept of pulmonary emboli of clumped leukocytes sensitizedwith antibodies in experimental immunoleukopenia.

3. Heterologous anti-leukocyte and anti-bone marrow antibodies injectedintravenously disappeared from plasma and fixed to peripheral leukocytesand bone marrow cells within 1 hour.

Submitted on June 25, 1962 Accepted on December 24, 1962     

Transient Manifestation of Antegrade Conduction Over a Kent Bundle After Ventricular Pacing

Postventricular Pacing Preexcitation. Antegrade conduction over a Kent bundle was transiently manifested after the cessation of ventricular overdrive pacing in two patients; otherwise, the heart behaved as if it had a concealed accessory pathway. Conventional electrophysiologic study suggested either a longitudinal dissociation of an accessory pathway or closely located double accessory pathways. The mechanism of the transient manifestation of ventricular preexcitation was discussed. (J Cardiovasc Electrophysiol, Vol. 3, pp. 423–430, October 1992)