Term delivery choriocarcinoma patient with brain and lung metastases successfully treated by etoposide, methotrexate, actomycin D, cyclophosphamide and vincristine (EMA-CO) chemotherapy.

It is well known that antecedent term delivery and metastasis to sites other than the lungs and vagina are high risk factors for patients with gestational trophoblastic neoplasia. Here we report on a patient with choriocarcinoma who presented with brain and lung metastases after term delivery and was treated by EMA-CO chemotherapy. A 31-year-old woman delivered a healthy infant at term. Frequent episodes of hemoptysis occurred beginning 3 weeks after the delivery. On admission to our hospital, she had lesions in the uterus, lungs and brain as well as motor aphasia and hemiplagia. The pretreatment beta-hCG level was 21,000 ng/ml and the WHO score was 16 (high-risk group). The EMA-CO regimen was administrated as first-line chemotherapy and the patient achieved complete remission after 7 courses. Treatment was terminated after 11 courses and maintained with etoposide (25 mg/day) for 6 months. The patient has remained in complete remission for more than 16 years without other adjuvant therapies. We believe that EMA-CO can currently be considered the regimen of first choice for most high-risk patients with gestational trophoblastic neoplasia in view of its effectiveness and excellent tolerability.</p

Expression of a Chitinase Gene and Lysis of the Host Cell Wall during Chlorella Virus CVK2 Infection

AbstractA chitinase gene (vChti-1) encoded by the Chlorella virus CVK2 was cloned and characterized. The vChti-1 open reading frame consisted of 2508 bp corresponding to 836 amino acid residues. The predicted amino acid sequence contained two sets of a family 18 catalytic domain that is responsible for chitinase activity. Northern blot analysis revealed that the vChti-1 gene was expressed in virus-infected Chlorella cells late in infection, when a single transcript of about 2.5 kb appeared at 120 min postinfection. This result was confirmed by Western blotting with a specific anti-vChti-1 protein antibody; a protein of about 94 kDa was detected specifically beginning at 240 min postinfection and was present until cell lysis. The protein was not incorporated into viral particles but remained in the medium after cell lysis. The vChti-1 protein produced in virus-infected cells showed chitinase activity on zymogram assays

Changes in the molecular sieve of glomerular basement membrane in rats with aminonucleoside nephrosis.

Isolated and purified glomerular basement membranes (GBM) of normal and aminonucleoside (PAN) nephrosis rats were observed by electron microscopy after negative staining. Although GBM of normal rats appeared as a molecular sieve with uniform pores, GBM of nephrotic rats showed enlargement and elongation of the pores. For an average of fifty pores, the long dimension was 40.4+/-10.7 A and the short dimension 13.8+/-3.6 A in nephrosis whereas the long dimension was 12.3+/-2.5 A and the short dimension 8.4+/-1.0 A in normal rats. Changes in the pores in GBM were thought to result in increased permeability of serum protein and hence proteinuria

Bartter's Syndrome — Case Report —

A 26-year-old female with Bartter's syndrome associated with Graves' disease is reported. This patient had a history of Graves' disease from the age of 22 and anti-thyroid drug (Methimazole) had been administered for 2 years. Thyroid function returned to normal but general fatigue and polyuria continued. Hypokalemia was diagnosed at 25 years of age and she was referred to our hospital for evaluation. Blood pressure was normal and laboratory data revealed normal thyroid function, hypokalemic alkalosis, high plasma renin activity and high plasma aldosterone concentration. She showed normal pressor sensitivity to norepinephrine infusion, grossly diminished pressor sensitivity to exogenous angiotensin II infusion compared with the normal. A renal biopsy specimen showed juxtaglomerular cell hyperplasia. Electron microscopy confirmed lacis cell (agranular cell) proliferation.</p

Electron microscopic demonstration of meshwork structure in human and bovine glomerular basement membranes

With the electron microscopic and the negative staining method, the glomerular basement membrane of human and bovine kidneys was shown to have a definite fine meshwork structure. The pores of the meshwork of bovine glomerular basement membrane appeared to be pentagonal or hexagonal in shape. Strands of the meshwork branched three-dimensionally and made up the whole basement membrane. The portion of the sgrand between two neighboring branches was presumed to be a structural unit of the basement membrane. Glomerular basement membrane in man showed a structure similar to that seen in cattle, although the pore size of the meshwork was smaller in man than in cattle.</p

Ultrastructure of rat renal tubular basement membrane--meshwork structure demonstration by negative staining.

The tubular basement membrane (TBM) (i.e. tubular basal lamina) of rat kidney was shown to be a fine meshwork by electron microscopy after negative staining. Strands of the meshwork formed a regular three dimensional lattice work. The pores of the meshwork were polygonal. There were two main pore sizes: one approximately 30 A in diameter, the other 42--60 A. In view of our previous observation that glomerular and alveolar basement membranes were made up fine meshwork, it is quite possible that the basement membranes of other organs are also made up such fine meshwork.</p