Demonstration of intracytoplasmic immunoglobulin in non-T-acute lymphocytic leukemia cases of children with immunoelectron microscopic examination

Leukemic cells from 25 cases of non-T-acute lymphocytic leukemia (ALL) in children were investigated for intracellular immunoglobulin by the use of immunoelectron microscopic study (immuno-EM). As a result, 12 cases were negative for both heavy and light chains of the immunoglobulin in the neoplastic cells. Of these, one case that was also negative for common ALL antigen (CALLA) was defined as null cell type. The remaining 11 cases were defined as common ALL type. Six cases were defined as pre-B-cell type because they were positive for cytoplasmic mu chain but negative for cytoplasmic light chains. Seven cases were defined as B-cell type, all of which possessed lambda light chains in the neoplastic cells. Immunohistologic studies using monoclonal antibodies showed that most non-T-ALL cases were positive for CALLA and B4, whereas about 50% of them were positive for B1. Our immuno-EM study suggests that it is one of the effective ways of subclassifying non-T-ALL in children.     

INNUNOCYTOLOGICAL STUDIES ON THE CONSTITUENT CELLS OF THE SECONDARY NODULES IN HUMAN TONSILS

The rate of presence of surface immunoglobulins (sIg) and incidence of the surface receptors (SRBC-receptor, Fc-receptor and C3 receptor) were examined on the constituent cells of secondary nodules enucleated from human tonsils and foated in suspension. As most of the rosette-forming cells for SRBG-receptor were judged to belong to small round cells, the germinal center was considered to be a "non-T-cell region." The coronal B-lymphocytes and small germinal center cells were fairly matured B-cells because both bore sIg (100%), Fc receptor (25%) and C3 receptor (90-80%), while the former cells were thought to be more matured on the basis of their possession of surface δ-chain. As the large germinal center cells bore sig (50%) and carried Fc receptor (25%) and C3 receptor (50%), they seemed to be the major immature cells among the cell constituents of the secondary nodules. Moreover, it is presumed that the majority of the large germinal center cells are able to differentiate into coronal B-lymphocytes, probably memory cells, and a minor population of them into cIg-containing cells.     

Multiple aneurysms of the visceral arteries with migrating vascular bruit on postural change: A case report

Multiple aneurysms of the gastroepiploic artery and the ileocecal branch of the superior mesenteric artery were found in a 68-year-old male patient by angiography. The patient presented with one-hour postprandial epigastric pain of 10 years duration. Abdominal bruit was auscultated at the two different sites, one of which shifted downwards upon upright position. From the freely movable nature of the great omentum, this bruit, migrating upon postural change, was most likely from the gastroepiploic artery aneurysms. The aneurysms were excised and the abdominal bruit disappeared. The etiology of the aneurysms was suggested to be arterial fibrodysplasia histologically. From this experience, it was stressed that postural change should be added to a routine physical examination to rule out an aneurysm from the freely movable great omentum.     

A case of superficial carcinoma of the esophagus on esophageal varices

We report a case of superficial esophageal carcinoma in a patient with esophageal varices. Esophagogram revealed a 2 cm large irregular mucosal elevation during work-up for esophageal varices which was acertained on endoscopical examination to be carcinoma. Biopsy material showed moderately differentiated squamous cell carcinoma. Subtotal esophagectomy was performed followed by reconstruction by cervical esophagogastrostomy through the retrosternal route. Few resected cases of esophageal carcinomas accompanied by esophageal varices have been reported because 1) early radiographic abnormalities of small superficial esophageal carcinomas can be overlooked in the case of large varices and 2) the number of operable cases is limited because of associated liver cirrhosis.     

Clinical evaluation of an isolated fourth ventricle

Since the introduction of the CT scan in 1976, we have experienced 6 cases of the isolated fourth ventricle among 244 hydrocephalic patients (2.5%). Age at diagnosis of the isolated fourth ventricle ranged from 1 year 8 months to 13 years (mean age, 8 years, 6 months). The time interval between the first shunting procedure and the diagnosis of the isolated fourth ventricle varied from 1 year 5 months to 7 years 4 months (mean interval, 4 years 1 months). The prior hydrocephalus were due to intraventricular hemorrhage in two patients, meningomyelocele in a patient and brain tumor in three patients. Two patients had history of cerebrospinal fluid (CSF) infection and five cases underwent multiple shunt revisions. Posterior fossa signs were evident in all cases. It was quite easy to make a diagnosis of the isolated fourth ventricle with CT scan, which demonstrated a large rounded or pear-shaped midline cyst in the posterior fossa. Slit-like lateral ventricles were noted in three cases, while the remaining three had enlarged lateral ventricles. Ventriculography confirmed the isolation of the fourth ventricle in 5 cases. Metrizamide which had been injected into the fourth ventricle was diluted when CT scan was performed 48 hours later, and contrast medium disappeared since then. Magnetic resonance imaging (MRI) well showed the characteristic findings of the isolated fourth ventricle: cystic dilatation of the fourth ventricle, compression and distortion of the brain stem, upward tentorial herniation, occlusion of the aqueduct, downward displacement of the occipital lobe, septum formation of the fourth ventricle and accompanied anomalies such as, Chiari malformation or syringomyelia.(ABSTRACT TRUNCATED AT 250 WORDS)     

Morphine hydrochloride suppositories. II. Bioavailability of morphine hydrochloride suppositories in dogs

Bioavailabilities of morphine after rectal administration of three different morphine.HCl suppositories were evaluated in dogs, whose rectum was lavaged or non-lavaged. The suppositories were prepared with three fatty bases (Witepsol H-15, Witepsol W-35, Suppocire AT) by the fusion method. The release of morphine from the suppositories was examined after stored for two weeks at 30 degrees C. The plasma concentrations of morphine and its metabolites, morphine-3-glucuronide and morphine-6-glucuronide, were determined by high-performance liquid chromatography. The bioavailabilities of morphine after rectal administration were compared with those after intravenous and oral administration of morphine++.HCl solution. In the case of rectal lavaged dogs, the plasma levels of morphine after rectal administration of morphine.HCl solution were higher than those after oral administration of morphine.HCl solution. The release of morphine from Witepsol H-15 suppository was more rapid than those from other suppositories. Morphine after rectal administration of Witepsol H-15 suppository was rapidly absorbed in the rectum, and the inter-animal variation of its plasma levels was smaller than those of other suppositories. In rectal non-lavaged dogs, the bioavailabilities of morphine after rectal administration of morphine.HCl solution and suppositories decreased more than those of rectal lavaged dogs. Although the bioavailability of morphine after rectal administration of morphine.HCl was decreased by the influence of contents in the rectum, morphine from Witepsol H-15 suppository was more rapidly absorbed in the rectum, and the inter-animal variation of its plasma levels was smaller. These results indicate that, among their suppositories, Witepsol H-15 suppository is available for the terminal care of malignant disease.