[A case of systemic lupus erythematosus developed with intestinal perforation].

A case of intestinal perforation associated with SLE is presented. A 54-year-old woman was diagnosed as having SLE twenty-five years ago when she had facial erythema, photosensitivity, oral aphtha, polyarthraliga, leukopenia, positive LE cell and positive antinuclear antibody. She had been treated with prednisolone and admitted to Kushiro City General Hospital because of one month history of fever and anorexia in February 1996. Laboratory findings did not reveal activity of SLE, and a diagnosis of urinary tract infection was made based on the findings of urinalysis. After severe diarrhea, disseminated intravascular coagulation (DIC) developed. A rectal perforation was revealed by endoscopic and radiological examination. An emergency laparotomy revealed necrosis of the rectum and sigmoidostomy was performed. The biopsied specimen of the rectum were diagnosed as gangrene of ischemic colitis histologically. Because of a penetration to the urinary bladder, an ureterocutaneostomy was performed. She died of sepsis and DIC on the 127th day of admission. Only 11 cases of intestinal perforation associated with SLE have been reported in Japan, and the association of vasculitis has been considered. In the present case, the prolonged use of prednisolone might cause the necrotizing ischemic colitis.

The development of personal computer-based medical consultation system for diagnosis of congenital malformation syndromes using MUMPS.

This paper describes a medical consultation system for diagnosis of congenital malformation syndromes. The system consists of a personal computer, NEC PC-98XL (MS-DOS), using SP-MUMPS for the retrieval of knowledge data, and BASIC for the input/output of image data. This system displays pictorial knowledge and is designed so users can build up the knowledge base, as needed, by adding knowledge from medical literature and records of patients actually treated.

A monoclonal antibody to the carbohydrate chain on human hepatocellular carcinoma-associated antigen which suppressed tumor growth in nude mice.

There have been few reports stating that monoclonal antibody alone inhibits human solid tumor growth in vivo. The present study demonstrated that monoclonal antibody S1 (IgG2a), which recognized the antigenic determinant of the carbohydrate moiety, showed antibody-dependent cell (or macrophage)-mediated cytotoxicity (ADCC or ADMC) in conjunction with murine splenocytes of both BALB/c and athymic mice. In vivo experiments demonstrated that the antibody S1 clearly prolonged the survival of athymic mice which had been inoculated with a human liver carcinoma cell line. In addition, the antibody S1 significantly suppressed the human hepatoma line transplanted s.c. into nude mice. 125I-Labeled monoclonal antibody S1 revealed that the antibody accumulated significantly in the tumor mass. Many mononuclear cells were observed surrounding tumor cells when the antibody was given. This model system might be useful for analyzing the ADCC (or ADMC) mechanism in vivo.

Preparation of human monoclonal antibodies of IgG type to gastro-intestinal cancer-associated antigen.

The B lymphocytes from pleural effusion of a gastric cancer patient were fused with murine myeloma cells (X63-Ag8.653). Thirty-four out of 62 clones were found to secrete human monoclonal antibodies (23 IgGs and 11 IgMs) by means of enzyme-linked immunosorbent assay. Fourteen monoclonal antibodies were tested for histological reactivity with cancer and normal tissues by immunoperoxidase staining. Among them, two monoclonal antibodies reacted rather specifically with gastro-intestinal cancerous tissues. The human monoclonal antibody (HMoAb) 3B7 (IgG) reacted strongly with 4 out of 5 gastric carcinoma tissues and 2 out of 5 colonic carcinoma tissues, but did not react with non-cancerous tissues (stomach, colon, liver, pancreas and lung). In addition, HMoAb 3B7 reacted heterogeneously with autologous gastric carcinoma tissue sections. The hybridoma 3B7 has continued producing human monoclonal antibody for 12 months after fusion. By chromosomal analysis, it was shown that hybridoma 3B7 retains both human and mouse chromosomes. HMoAb 3B7 may be useful for research on tumor-associated antigens and therapeutic techniques.