1991年 · 第104卷第04期

The bone marrow morphology of fifty patients with leukemia was analyzed before and two weeks after allogeneic bone marrow transplantation and compared to that of ten normal, healthy control subjects. Conditioning of the marrow graft recipients had been carried out with a combination of 16 mg/kg of Busulfan and 120 mg/kg of cyclophosphamide. The bone marrow at two weeks after transplant showed characteristic features that were unique for this clinical setting. Regenerative precursor cells with a distinct morphology commonly formed clusters or islands. Although mixed, multilinear islands were seen; the majority of islands were unilinear with a homogeneous cell content. These hematopoietic colonies were in direct proximity to degenerated cells of presumed host origin. No damage to the microenvironment was seen, the most characteristic finding being large, uniform, unilocular fat cells in close proximity to regenerative precursor cells. These morphologic changes are indicative of a complete and persistent marrow engraftment.

In light of the effects of gastrointestinal (GI) peptides on bile secretion and biliary tract mobility, we studied the effects of GI peptides on gallstone formation in guinea pigs fed on low protein lithogenic diet. The peptides under study included cholecystokinin octapeptide (CCK-8), vasoactive intestinal peptide (VIP), somatostatin (SRIF), secretin (SEC), and neurotensin (NT). Hepatic bile flow, electrolytes, and other bile components were also measured. It was found that CCK-8 and VIP suppressed the formation of gallstones and increased hepatic bile flow and Na+, K+, Cl- output significantly. On the other hand, SRIF significantly promoted gallstone formation. The rates of gallstone formation in CCK-8, VIP, and SRIF treated guinea pigs were 15.4%, 23.5%, and 88.0%, respectively, in contrast to 56.8% in the control group. The inhibitory effect of CCK-8 and promoting effect of SRIF on gallstone formation were dose-dependent.

Clinical behavior of giant cell tumor of bone (GCT) may vary remarkably from latent to very aggressive. Quantitative pathological methods were used to evaluate the aggressiveness of GCT. Fifteen cytometric parameters were measured and computed on routine sections of 40 GCTs which had been treated with curettage. The surgery factor (with or without additional procedures like bone cement packing or freezing after the curettage) was also taken into account and computed. Nineteen of the 40 GCTs were cured and 21 recurred. While no single one from the 15 parameters measured showed significant differences between the cured and recurrent groups according to the Mann-Whitney's U test or Student's t test, a 4-variable function was established with a stepwise discriminant analysis which could correctly identify 70.8% of the predicted cases as cured or recurrent (jackknife procedure). The function also suggested that in addition to the surgery factor, which no doubt had close relation with the prognosis, the most important risk factor in histological parameters was SA40, i.e. the percent of cells with nucleus larger than 40 square microns. Single cells extracted from paraffin-embedded blocks of 38 GCTs were analyzed by DNA-image cytometry. The 2c deviation index (2cDI) showed wide heterogeneity ranging from those consistent with benign tumors to those with apparent malignant ones, which may account for its diversity in clinical behaviour. Sixteen of the 38 cases had been treated with curettage, 8 of them were cured and followed up for at least 3 years and the remaining 8 recurred. The significant difference of 2cDI between the two groups suggested that these DNA parameters are useful in evaluating the aggressiveness of GCT for the selection of an adequate treatment. Quantitative approaches appeared to be more objective and more sensitive in evaluating the aggressiveness and predicting the prognosis of GCT than the subjective grading system used before.

To study the mechanism of plasma endothelin (pET) increment in chronic renal failure (CRF) patients, we investigated 20 CRF cases given hemoultrafiltration for 90 min followed by hemodialysis and 12 given hemodialysis only to examine the effect on ET. The results revealed that 90-min ultrafiltration with 2 500ml fluid extraction significantly decreased plasma ET (1 132±793--753±702 pg/ml, P less than 0.05), while hemodialysis without water extraction for the same period of time resulted in no significant change (1 195±891--1 011±654pg/ml, P greater than 0.05). BUN in the ultrafiltration group showed no marked changes (102±11.4--83.5±119 mg/dl), but the hemodialysis group presented a significant decrease (97±12--63±7 mg/dl, P less than 0.05), showing that the ET fall had no significant relevance to the metabolic products extracted. In 120 min following hemodialysis, ET levels in both groups decreased by different amounts. MAP decreased in both groups throughout the procedure period. Therefore, it is suggested that decreased extracellular volume via ultrafiltration can lead to lowering of ET levels, showing that extracellular volume may influence the ET level.

Allergenicity of three plant abortifacient proteins, trichosanthin (TCS), α-momorcharin (α-MMC) and β-momorcharin (β-MMC) and the kinetics of IgE antibody response against these proteins were studied in C57BL/6N and BALB/cAn mice. These proteins were purified from Chinese medicinal herbs, characterized by biochemical and immunological procedures and found to be homogeneous by PAGE, SDS-PAGE and immunoelectrophoresis. The results obtained were summarized as follows: 1) different levels of IgE antibody responses against TCS, α-MMC and β-MMC were induced when they were injected i.p. as antigen adsorbed onto AI(OH)3 gel into BALB/cAn or C57BL/6N mice on day 0 and day 28; 2) the allergenicity of the proteins was in the order of β-MMC greater than α-MMC greater than TCS; 3) two injections of 10 micrograms or 50 micrograms of TCS or α-MMC given at 4 weeks interval without adjuvant elicited a low or undetectable PCA titer, while the same dose given weekly for 5 weeks resulted in high levels of IgE production; and 4) on the basis of PCA observations, no cross immunological reactivity among these three proteins was found, it seemed to support that TCS, α-MMC and β-MMC may be alternately used for inducing abortion.

A group of monoclonal antibodies against gastric cancer, pooled in equal proportions, was used to investigate their corresponding antigens (MG-Ags) in serum and body fluid of patients with gastrointestinal cancer and benign diseases using microsphere-ELISA method. The mean serum level (plus 3 standard deviations) in 59 normal subjects was arbitrarily set as the positive threshold value. The positive rate was found to be 68.8% (135/196) in sera of patients with gastric cancer, 70% (14/20) in colonic cancer, 72.2% (24/33) in rectal cancer, 43.8% (7/16) in esophageal cancer, 45.5% (5/11) in cholecystic cancer and 34.9% (15/43) in lung cancer, which, however, was not found in primary liver cancer, pancreatic cancer and ovarian cancer. In 214 patients with benign diseases, a false positive rate was 7.48%. In gastric juice and ascitic fluid of patients with gastric cancer, the positive rates were found to be 61.7% (27/44) and 83.3% (20/24) respectively. These antigens were also determined repeatedly in sera of patients with gastric cancer who had undergone gastrectomy. It was found that the level of MG-Ags in sera began to decrease at 8-10 days after operation. These results suggest that the determination of MG-Ags is useful in the diagnosis of gastrointestinal cancer and evaluation of the treatments.

We studied the diagnostic accuracy of magnetic resonance imaging (MRI) and the possibility of its substitution for myelography in 78 patients with lumbar canal stenosis and/or disc herniation, who had myelography and MRI examination. The diagnostic results of the two methods were compared respectively with those of operation, showing no statistical significance (coincidence rate 88.5% vs 92.3%, P greater than 0.05). We conclude that MRI could clearly reveal the pathological changes and anatomical relations of lumbar structures without invasive and radioactive damages, and that with the improvement of operative technique, better understanding of images, and reduction of cost, MRI is likely to replace myelography in the future.

Free radical generating substances, including fulvic acids, mycotoxins, Fe(II), etc attack chondrocytes, causing dedifferentiation. The dedifferentiated cells synthesize and secrete abnormal collagens rich in type I instead of the normal type II. These substances also directly attack collagens in the extracellular matrix. The abnormal collagens make the matrix change from hydroxyapatite crystallization inhibiting to promoting, and give crystals of low crystallinity, high aggregation and small size. This study leads to a new concept of the development of Kaschin-Beck's Disease (KBD).

Patients whose routine MRI were negative but were clinically highly suspected of having intra-cranial or intra-spinal canal space-occupying lesions, and those whose routine MRI were positive but presented difficulties in defining the contour or the nature of the lesion, or difficulty in distinguishing the lesion from the surrounding edema were selected for Gd-DTPA enhancement. Altogether there were 80 cases, in which 51 had intracranial lesions and 29 intraspinal canal lesions. In each patient, Gd-DTPA 0.06-0.1 mmol/kg was injected intravenously 5 minutes before imaging (pituitary microadenoma images were taken immediately and 10 minutes after injection). No patient had contrast media reaction or complications. In cases with hemorrhage, hematoma, edema, cyst and arteriovenous malformation, no marked enhancement was observed after contrast media injection. When difficulty in differential diagnosis between these lesions and tumors occurs, injection of Gd-DTPA is very helpful. Gd-DTPA enhancement is of great benefit in diagnosis of intracranial or intraspinal canal tumors in four ways. 1) It reveals lesions which can not be demonstrated or can not be demonstrated clearly before enhancement, including iso-intensity lesions and small lesions which comprised 13.7% of our cases. 11 cases with equivocal diagnoses before enhancement obtained unequivocal diagnoses after enhancement. 2) It differentiates the tumor from edema more definitely. 3) It helps to distinguish the nature of lesions. 4) It shortens examination time when the T2 weighted image procedure is omitted.

Arachidonic acid metabolism via cyclooxygenase pathway in mouse resident peritoneal macrophages were stimulated by phorbol-12-myristate-13-acetate (PMA), calcimycin and exogenous arachidonic acid, respectively. Racemic, (-) and (+)-gossypol dose-dependently inhibited PMA or calcimycin-induced synthesis of prostacyclin, thromboxane A2 and prostaglandin F2 alpha, but failed to affect arachidonic acid-induced synthesis of prostaglandin. It is suggested that both (-)-gossypol and (+)-gossypol inhibit synthesis of prostaglandin at the level of arachidonic acid release, and the inhibition of prostaglandin synthesis by gossypol might not be the main mode of its antifertility action.

Two cases of genital carcinoma were found after radiotherapy for carcinoma of the cervix. Vulval carcinoma occurred 30 years after radiation with initial symptoms of itching and whitish changes of the skin at the external genitalia. Adenocarcinoma of the endometrium occurred 9 years after radiation and diffused intra-abdominal metastasis was found surgically. The sites of second malignancies following irradiation for cervical carcinoma and the time interval between them were reviewed. The characteristics of the post-radiation vulval carcinoma and the endometrial carcinoma were discussed.