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Reports the identification of chimeric gene in leukemic patients. Translocation between chromosomes; Characteristics of secondary leukemia; Assessment of the peripheral blood count.

It has been reported that acetylcholine hyperpolarizes the maximum diastolic potential of canine Purkinje fibers through a pathway involving a G protein and induces a decrease in their automaticity. It is unclear, however, whether the negative chronotropic action of acetylcholine in the presence of β-adrenergic stimulation is due to the hyperpolarization of the maximum diastolic potential or a decrease in the slope of phase 4 depolarization. We used standard microelectrode techniques to study the negative chronotropic mechanism of acetylcholine in the presence of isoproterenol in adult canine Purkinje fibers. Fibers were incubated for 24 hours in Tyrode's solution alone (n = 10) or plus pertussis toxin (n = 10), and then superfused with acetylcholine (10-9 to 10-4 M) in the presence of isoproterenol (10-7 M). Acetylcholine in the presence of isoproterenol significantly decreased automaticity without hyperpolarization of the maximum diastolic potential, and decreased the slope of phase 4 depolarization. Th effects of acetylcholine on automaticity and the slope of phase 4 depolarization were attenuated by pertussis toxin. The present findings indicate that the negative chronotropic action of acetylcholine in the presence of isoproterenol is due to the decrease in the slope of phase 4 depolarization through a pathway involving a pertussis toxin-sensitive G protein and that it is not the result of hyperpolarization of the maximum diastolic potential. [ABSTRACT FROM AUTHOR]

We report eight cirrhotic patients with liver cancer of less than 2 cm in diameter, and who were successfully treated by surgery. The sensitivities of diagnostic procedures for small lesions showed that alpha-fetoprotein (AFP) was 75 per cent, radionuclide scanning 25 per cent, CT 33 per cent, ultrasonography 40 per cent and angiography 88 per cent. Serial measurement of AFP appears to be the most helpful for detection of hepatocellular carcinoma at the early stage, particularly in cirrhotic patients. Although hepatic imagings are of limited value for small hepatic tumors, those tools are often useful as a back-up for the routine tests but not for initial procedures. It should also be kept in mind that hepatic arteriography performed in the high risk group often leads to detection of small cancers. In cirrhotic patients with small hepatocellular carcinoma, surgical resection should be done, providing the clinical status and hepatocellular reserve are adequate. [ABSTRACT FROM AUTHOR]

Objectives: Recently, it has been recognized that there are increasing incidences of hepatocellular carcinoma (HCC) multicentricity. Thus, intraoperatively detected hepatic lesions that were once thought to he metastatic lesions now need to he carefully reexamined to determine whether they are true metastatic lesions or the multicentric development of HCC. Methods: We investigated the histological characteristics of small nodular lesions detected during intraoperative ultrasonography in 33 consecutive patients with small HCC who underwent laparotomy at our institution. Results: Fourteen nodular lesions were found incidentally in 10 of 33 patients (30.3%), and were classified into the following three groups: 11 nodules in nine patients (27.3%) were HCC, two nodules in two patients (6.1%) were hemangioma, and one nodule in one patient (3.0%) was a large regenerative nodule. HCC therefore comprised 78.6% of the intraoperatively detected nodular lesions. Of the 11 HCCs, six were hyperechoic, four were hypoechoic, and one was isoechoic. Five (83.3%) of six small hyperechoic HCCs and two (50.0%) of four hypoechoic HCCs were well differentiated and retained their preexisting liver structure. These findings closely coincide with the characteristics of early stage HCC. Thus, early stage HCC comprised 63.6% of the intraoperatively detected HCC cases. Conclusions: A certain proportion of small satellite HCCs detected during intraoperative ultrasonography in patients with small HCC, which were previously thought to he metastatic lesions from the main HCC, may instead he early stage HCCs. Such findings would also support the concept of the multicentric development of HCC. Approximately 60% of all small HCC cases detected intraoperatively may he early stage HCC. As a result, it is predicted that the emergence of HCC is either multicentric or unicentric, with early intrahepatic spread, although the former seems to he more common. [ABSTRACT FROM AUTHOR]

Twelve-day-old VX2 carcinoma was inoculated in the hind leg of 24 rabbits and, after 12 days, Doxorubicin (Adriamycin) suspended in Lipiodol Ultra-Fluid (Lipiodol) was then given through the femoral artery. A selective deposit of the contrast material in the tumor for an extended time was evident on the x-rays and the antitumorous effect was remarkable. Lipiodolized antitumor agents warrant further investigation for possible clinical application. [ABSTRACT FROM AUTHOR]

We resected a multiple hepatocellular carcinoma (HCC) which contained portal tracts, showed evidence of an early multistep condition, and a multicentric development of HCC which progressed simultaneously. A preoperative working examination revealed a tumor in S5 of the liver, which was 2.5 cm in diameter. In addition, a "nodule-in-nodule" appearance was seen on the ultrasonographic imaging. At intraoperative ultrasonography, an additional two HCCs were detected. At histologic examination of the resected specimen, the main nodule showed a nodule-in-nodule appearance. In the outer nodule, there was a well-differentiated HCC, while the portal tracts remained. The less-differentiated HCC grew in the inner nodule and was replacing the well-differentiated HCC in the outer nodule. These findings suggests morphological transition in the early stages of the multistep development of HCC. Two additional tumors (1.1 cm and 1.0 cm in diameter) detected at intraoperative ultrasonography proved to be HCC's (grade I) with marked fatty change, and with portal tracts remaining within both the HCCs. Furthermore, both of the HCCs retained their preexisting liver structure. These histologic findings coincided with the characteristics of the early stage HCC, whereas the coexistence of early stage HCCs suggest the multicentric development of HCC. Distortion, compression, and invasion of the portal tracts may appear as the tumor grows, thereby evoking an increasing risk of metastasis via the portal tracts. Therefore, the early diagnosis and treatment of HCC before the portal tracts disappear, when 1.5 cm in size or less, may be very important for surgeons and diagnosticians, as an effective curative resection may be feasible. [ABSTRACT FROM AUTHOR]