Malignant fibrous histiocytoma of the right ventricle of the heart.

Right-sided cardiac malignant fibrous histiocytoma (MFH) is extremely rare, and to the authors' knowledge only three cases have been reported. In this study, a case of MFH in the right ventricle, the septum, and the pulmonary valves and artery in a 47 year old male is described. The tumor showed typical pathological features of MFH, such as cellular pleomorphism, storiform pattern and abundant mitoses. Immunohistochemical and electron microscopical findings were compatible with MFH, and excluded the possibility of leiomyosarcoma and angiosarcoma. Whole body examination, including Gallium scintigram, localized the primary site to the heart. The details of this case are presented with a review of the reported cases of cardiac MFH.

Investigation of melena and hematochezia as the chief complaint of gastrointestinal bleeding in pediatric surgical patients.

The causes of melena or hematochezia in 48 pediatric patients were examined. Malrotation with volvulus was an important cause of hemorrhage during the newborn period, and intussusception was very typical in patients aged from 1 month to 1 year. Polyps of the rectum and colon were the most common causes of melena or hematochezia in patients older than 1 year. No cause of melena or hematochezia could be identified in 11 children. Ten patients have remained in good health with no further episodes of melena or hematochezia. Localized multiple polyps of the rectum with focal carcinoma were detected in only one patient. In general, although no further investigation is required after detection of the cause of bleeding and its successful treatment, it should be kept in mind that gastrointestinal malignancy can occur in children.

Partial purification and characterization of dendritic cell differentiation factor.

Previously, we reported that interleukin-2 (IL-2)-stimulated helper T cells produced an unknown soluble factor which induced dendritic cell-like differentiation in primary cultures of monocytic leukemia cells and we referred to this factor as dendritic cell differentiation factor (DCDF). In this study, we attempted to purify and characterize DCDF and investigated its biological effect on normal human monocytes. Gel filtration chromatography indicated that the molecular weight of DCDF is approximately 30-35 kDa. Chromatofocusing indicated that the isoelectric point of DCDF is approximately 5.0. DCDF, partially purified by subsequent gel filtration, chromatofocusing, and hydrophobic chromatography, significantly enhanced the HLA-DR expression of normal human monocytes and a human monocytic leukemia cell line, THP-1. This biological activity was not neutralized by any known antibodies to human cytokines. DCDF significantly amplified the T-cell stimulatory activity of monocytes in the allogeneic mixed leukocyte reaction (MLR). Moreover, DCDF significantly enhanced IL-1 beta and IL-6 production by monocytes in a dose-dependent manner. These results suggest that DCDF is a novel human cytokine which stimulates the accessory cell function of monocytes.

[A case of traumatic hernia of diaphragm showing prolapse of liver with abnormal lobulation into pleural cavity].

A 48-year-old male was admitted to our hospital in 1988 with injury by a traffic accident, resulting in fracture of the right rib, right clavicle, and pelvic. The patient came to us again with a chief complaint of abdominal pain in May, 1991 when digestive tract gas was observed in the right pleural cavity casting a doubt of diaphragmatic hernia. Chest CT scan and liver scintigraphy disclosed prolapse of the colon into the pleural cavity together with a picture on the diaphragm being supposed as parenchyma of the liver. Operation findings showed prolapses of the colon and the omentum through the opening of diaphragm into the pleural cavity and also exhibited prolapse of hepatic parenchyma, supposedly S4, together with gallbladder into the pleural cavity. The case, which had showed no abnormality in the Chest X-ray film before the injury, was conceivably an extremely rate case of traumatic hernia with the right diaphragm showing; abnormality of hepatic lobulation accompanied by diaphragmatic rupture, and prolapse of the liver with abnormal lobulation.

Induction of interdigitating reticulum cell-like differentiation in human monocytic leukemia cells by conditioned medium from IL-2-stimulated helper T-cells.

Monocytic leukemia (MoL) cells were obtained from the peripheral blood of a patient in whom the leukemic cells infiltrating various lymphoreticular organs exhibited features intermediate between interdigitating reticulum cells (IDC) and ordinary phagocytic macrophages, whereas the leukemic cells in the peripheral blood were essentially monocytic and lacked such features. Peripheral blood CD4+ T-cells were established as an interleukin-2-dependent T-cell line. When the MoL cells were exposed for a few days to conditioned medium from the T-cell line, they extended several dendritic cytoplasmic projections and became intensely positive for HLA-DR antigen, cytoplasmic S-100 beta protein, and CD1 antigen. Functionally, the conditioned medium significantly down-regulated Fc-mediated and Fc-independent phagocytic activities, and the levels of lysosomal enzymes such as lysozyme and nonspecific esterase in the MoL cells. Moreover, the conditioned medium significantly up-regulated the accessory cell function of the MoL cells as measured by the primary allogenic mixed leukocyte reaction (MLR). Furthermore, the conditioned medium significantly down-regulated the expression of CD14 antigen. Biochemical analysis indicated that the factor responsible for these changes is a protein which is distinct from known human cytokines and whose molecular weight is approximately 31 kDa. These findings suggest that IDC are closely related the monocytic lineage and that helper T-cells play an important role in constructing the microenvironment of T-lymphoid tissues which is necessary for the differentiation and maturation of IDC.

Natural killer (NK) activity of cultured S100 beta-positive T-leukemia cells.

In order to clarify the function of human S100 beta-positive T-cells, S100 beta-positive T-leukemia cells (S100 beta TLC) were examined in vitro. S100 beta TLC were obtained from the peripheral blood of a patient with S100 beta-positive T-cell leukemia and enriched by an E-rosetting method. Two dimensional flow cytometric analysis indicated that the vast majority of the E-positive fraction were S100 beta TLC expressing CD3 and CD8 antigens. Although S100 beta TLC expressed CD3 antigen, they were negative for the alpha/beta and gamma/delta T-cell antigen receptor (TCR) defined by monoclonal antibodies (mabs) WT-31 and delta TCS-1, respectively. It was speculated that S100 beta TLC initially expressed alpha/beta TCR but lost it during malignant transformation. When S100 beta TLC were cultured for 24 h, they acquired cytotoxic activity towards various NK-sensitive cell lines including K-562, Molt-3 and CEM-CCLF, but did not exhibit lysing activity towards NK-resistant cell lines including Raji, Daudi and MT-1. Despite the NK-activity of cultured S100 beta TLC, they lacked the morphological features of large granular lymphocytes (LGL). S100 beta TLC did not exhibit lymphokine-activated killer (LAK) activity. When S100 beta TLC were cocultivated with NK-sensitive cells or NK-resistant cells, they selectively bound to NK-sensitive cells, indicating that they lysed target cells by cell-to-cell contact. The finding that S100 beta TLC lacked TCR molecules and their NK activity was not inhibited by mabs reactive with the CD3-TCR complex indicated that the CD3-TCR complex was not involved in their target recognition.(ABSTRACT TRUNCATED AT 250 WORDS)