Microheterogeneity of serum transferrin in the diagnosis of hepatocellular carcinoma

Heterogeneous reactivity of human serum transferrin (Tf) with lectins was analysed using patient sera to determine whether it can be used to distinguish patients with hepatocellular carcinoma (HCC) from those with liver cirrhosis (LC). Microheterogeneity of Tf was analysed by crossed immunoaffinity electrophoresis (CIAE) with concanavalin A (Con A) and Lens culinaris agglutinin (LCA). Sample sera from 58 patients with HCC, 43 patients with LC and 10 normal controls were used in this study and the results were evaluated statistically. The increments of Con A-non-reactive (C1) and -weakly reactive (C2) species of Tf were observed in HCC compared with those of LC and Norm. Significant increase in the combined percentage of Con A- C1 + C2 species was also revealed in HCC (35.5 ± 8.5%, mean ± s.d.) compared with those of LC (29.1 ± 6.8%; P < 0.001) and normal controls (17.1 ± 2.3%; P < 0.001). The elevation of LCA-reactive (L2) species of Tf was recognized in HCC (8.2 ± 3.8%) in comparison with those of LC (4.8 ± 3.1%; P<0.001) and normal controls (1.3 ± 1.7%; P < 0.001). The increment of C1+C2 species and/or L2 species of Tf was observed in 78% (sensitivity) of patients with HCC. The specificity, the positive predictive value and the overall accuracy were 81, 88 and 72%, respectively. Positive ratio of C1+C2 and/or L2 species was 77 and 70% in alpha-fetoprotein low and -high producing HCC patients, respectively. These results indicate that the microheterogeneity analysis of human serum Tf is useful for distinguishing patients with HCC from those with LC and normal controls.     

Measurement of anticardiolipin antibodies by ELISA using β2-glycoprotein I (β2-GPI) in systemic sclerosis

In order to determine the prevalence and clinical significance of β₂-GPI-dependent anticardiolipin antibodies (β₂-GPI/aCL) in patients with systemic sclerosis (SSc), serum samples from 80 patients with SSc, 20 patients with systemic lupus erythematosus (SLE), and 120 healthy control subjects were examined by ELISA using purified β₂-GPI. IgG isotype β₂-GPI/aCL was present in eight of 80 patients with SSc (10%), and the presence of β₂-GPI/aCL IgG was significantly correlated with the presence of isolated pulmonary hypertension (PH). Furthermore, levels of β₂-GPI/aCL IgG were significantly correlated with levels of mean pulmonary arterial pressure. These data suggest that IgG isotype β₂-GPI/aCL might be a serological indicator of the severity of PH in patients with SSc.     

Characteristics of histamine release from cultured human mast cells

Background The mtist cell is one of the important cells In the pathogenesis of allergic disorders. However, isolating human mast cells is a laborious procedure. Recently, cultured human mast cells raised from umbilical cord blood cells have become available. It is necessary to examine whether these cells are useful in investigating the role of mast cells in human diseases. Objective The phenotype of mast cells depends on their anatomical sites. To examine which phetiotype of mast cells these cultured mast cells most closely resemble, their ability to release was investigated. Methods The mast cells were raised from human umbilical cord blood cells in the presence of stem cell factor and interIeukin-6. To determine the mast cell subtypes, the mast cells were immunocytochemically stained for tryptase and chymase. The cultured mast cells were then stimulated with various secretagogues, and histamine release was measured by a fluorometric technique using high-performance liquid chromatography. Results The immunocytochemical staining for mast cell proteases revealed that virtually all cells contained tryptase, the definitive marker of mast cells, and that about a quarter of the cells contained chymase. Anti-TgE effectively stimulated these mast cells to release histamine in a dose-dependent, lime-dependent manner. The release was completed in about 30 min. One of the non-specific stimuli, calcium ionophore A23I87. also induced histamine release in a dose-dependent, time-dependent manner. In contrast, compound 48/80 and substance P failed to induce histamine release from these cells. Conclusion Cultured human mast cells resemble lung mast cells in their ability to release histamine. They will help in studying the functional properties of human mast cells and may contribute to clarifying the pathophysiology of human allergic diseases.     

Percutaneous Microwave Coagulation Therapy Using Cholangioscopy for Recanalizing Self-expanding Metallic Stents Occluded by Tumor Ingrowth: Preliminary Results

Current ablative techniques for recanalizing self-expanding metallic stents occluded by tumor ingrowth are limited by the risk of perforation or destruction of the stent filament. A previous experimental study revealed that microwave coagulation therapy for recanalizing occluded metal stents would be safe and effective, and we investigated the clinical application of this procedure. In this in vivo study, microwave coagulation therapy was performed for occluded metallic stents in 5 patients with pancreatic cancer and one patient with gallbladder cancer. This procedure was performed under percutaneous cholangioscopy and fluoroscopic control. Cumulative stent patency before and after microwave coagulation was estimated using the Kaplan-Meier method supplemented with the log-rank test. Tumor growing through the stent mesh was successfully removed without any complications using this technique. Analysis of stent patency did not reveal any significant difference between one session of coagulation therapy (115.0±18.4 days) and initial stent (102.3±.22.3 days). In contrast, none of the group after two sessions of this intervention was obstructed until their death. The results indicated that microwave coagulation therapy for recanalizing occluded metallic stent is effective and safe even in vivo. This procedure may be an alternative to placement of another stent through the occluded metallic stent. (Dig Endosc 1999; 11: 209–214)     

Granulocyte functions and changes in ability with age in newborns; Report no. 1: Flow cytometric analysis of granulocyte functions in whole blood

BACKGROUND: Serious bacterial infections occur with higher frequency in the first weeks of life than in other age groups and this may be, in part, related to functional impairment of neonatal granulocytes. The purpose of the present study was to estimate the characteristics of granulocyte function during the neonatal period. METHODS: The expression of adhesive molecules on the surface of granulocytes present in umbilical cord blood and peripheral blood obtained at 5 days and 1 month after birth, H(2)O(2) production and protease activity in granulocytes were studied by comparison with adult blood. RESULTS: Although there were no significant differences observed with respect to the expression of CD11b on the surface of granulocytes between each age group and adults, l-selectin was significantly lower in cord blood as compared with adult blood. Production of H(2)O(2) by granulocytes was significantly lower for cord blood than peripheral blood from 1 month old infants or that from adults in the presence of either phorbol myristate acetate or N-formyl-methionyl-leucyl-phenylalanine stimulation. The intracellular activity of elastase and collagenase within granulocytes exhibited a higher tendency for cord blood as compared with adult blood. CONCLUSIONS: Decreased functions of part of the phagocyte system during early infancy were clearly observed.     

Erythropoietin-producing renal cell carcinoma in chronic hemodialysis patients: A report of two cases

Erythropoietin (EPO)-producing renal cell carcinomas in two hemodialysis patients are reported. Despite deteriorated kidney function, these patients did not manifest anemia at diagnosis and their elevated serum EPO levels rapidly returned to within the normal range after nephrectomy. Immunohistochemical staining of the resected specimens showed production of erythropoietin in the tumor cells in one case and in the lining cells of the cyst wall in the other case. Renal cell carcinoma could cause an increase of blood hematocrit level in dialysis patients.