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Using glycerol density gradient centrifugation technique, single saturation dose assay, and Scatchard plot, the effect of dextran-coated charcoal (DCC) treatment of homogenate or crude cytosol on estradiol binding protein in human benign prostatic hyperplasia was investigated. Receptor binding is increased after thirty minutes DCC treatment of homogenate or cytosol. Increase in estradiol binding is accompanied by loss in cytosolic protein. A 75 per cent increase in binding of estradiol to its receptor was observed after two hours incubation of DCC with homogenate. The concomitant increase in estradiol binding and decrease in protein concentration in both homogenate or cytosol after DCC treatment indicate the possible removal of some protein(s) which inactivate(s) the estradiol receptor. Removal of cofactors required for activation of proteases and removal of endogenous steroids which could be occupying the estradiol sites also are possible. This simple experimental procedure has improved significantly the methodology for the measurement and characterization of estrogen receptor in human BPH.

Cultured prostate carcinoma cells incubated in the presence of a novel hybrid immunotoxin and ricin A chain exhibited synergy with the chemotherapeutic drugs vinblastine, methotrexate, and bleomycin. No cooperative effect was noted with adriamycin. Under conditions where individual components of immunotoxin or chemotherapeutic drug mixtures were nontoxic or minimally toxic the immunotoxin-drug mixture exhibited marked impact on 14C amino acid incorporation into prostate carcinoma cells. Analysis of drug-treated cells by flow cytometry indicated that cells exposed to vinblastine and bleomycin bound hybrid immunotoxin antibody to a greater extent than cells not exposed to these drugs. Adriamycin did not exhibit synergistic cytotoxicity with hybrid immunotoxin. Also, adriamycin did not enhance antibody binding as evaluated by flow cytometry. The fact that hybrid monoclonal antibody-ricin A chain (HIT-RAC) conjugates inhibited uptake of 14C amino acids 3 to 10-fold within 48 h of incubation with target cells and that this inhibition was further increased 2 to 3-fold in conjunction with three out of four chemotherapeutic drugs tested may be attributed to the unique cytotoxicity imposed by the hybrid immunotoxins. The RAC moiety is not chemically coupled to antibody but instead occupies one of the antigen-combining sites of the molecule. In this manner, RAC is closely juxtaposed to the cell membrane of the target cell and is anchored in this position via binding of the remaining antigen-combining site to p40 prostate restricted antigen.

There is a great demand for more specific methods for assaying individual components of coagulation and fibrinolysis, with the chief aim being to use them as biochemical markers of the Adult Respiratory Distress Syndrome (ARDS) induced by severe trauma. This prospective study was undertaken on 18 severely traumatized patients in various stages of shock admitted to the Intensive Care Unit of the University Hospital in Uppsala, Sweden. After haemodynamic restitution, during which surgery was often required as an intervening procedure, the patients were carefully studied regarding pulmonary function, coagulation and fibrinolysis. Eight patients developed ARDS according to our criteria, and one patient died from this condition. It was found that patients who developed ARDS had significantly lower levels of antithrombin-III, higher levels of von Willebrand factor levels, higher levels of tissue plasminogen activator inhibitors and lower levels of plasminogen as compared with those who did not develop this condition. We believe that these coagulation and fibrinolysis variables can be used along with appropriate pulmonary function tests as specific biochemical markers to disclose the development of traumatic-induced ARDS.

The present study performed on a total of 567 cases of human female breast cancer compares the results of the biochemical assay (dextran-coated charcoal assay = DCC) for oestrogen receptor (ER) with those of several morphological methods developed for the detection of the ER or for the prediction of prognosis by use of other systems (FSA = fluorescent ligand binding assay, ER-ICA = monoclonal antibody assay for ER, LRA = lectin receptor assay using peanut agglutinin, and Barr body estimation). Whereas no correlation at all was observed among the results of the DCC and those of the FSA and Barr body estimation, the ER-ICA and the LRA showed an unanimous tendency towards higher values of ER with increasing intensity of the staining product. The results of the ER-ICA may be expressed by an immuno-reactive score (IRS) calculated from the staining intensity (SI) and the percentage of positive cells (PP). The morphological methods are evaluated with special regard to their correlation with the DCC, their theoretical basis, and their practical application. In summary, the ER-ICA appears to be the sole method directly visualizing the ER protein and--in contrast to the DCC--is therefore completely independent of the content of endogenous or exogenous oestrogens in the tumor tissue. The LRA provides valuable additional information concerning tumour differentiation and possible response to endocrine therapy, whereas the FSA and Barr body estimation should be considered as obsolete and should therefore be abandoned.

Specimens of pooled prostatic fluid, collected by rectal massage from men under 50 years of age with no apparent prostatic disorders, were subjected to two-dimensional gel electrophoresis to study the composition of its proteins. In a preliminary study, a total of 57 major protein groups were detected. In the present study, we attempted to identify, in the two-dimensional gels, those that are related to prostate-associated proteins, i.e., prostatic acid phosphatase (PAP), prostatic specific antigen (PSA), and prostate binding protein (PBP). Individual proteins were recognized by the procedure of Western Blot using specific antisera with peroxidase-antiperoxidase as the staining reagent. Each protein spot in the two-dimensional gel was expressed, along the abscissa, by its isoelectric point (pI) and, along the ordinate, by the molecular weight (MW). PAP consisted of a train of more than ten protein spots that occupied an area in the gel from pI 7.0, MW 45,000 to pI 6.0, MW 50,000. Four protein spots with a MW of 34,000 and a pI range of 8.2-8.8 were identified as PSA. PBP was observed as having three protein spots that were located at pI 5.6-6.6 with a single MW of 15,000. For PAP and PSA, additional protein spots with lower MWs also stained positively with the specific antisera, suggestive of the presence of degradative products of these proteins. Following the removal of the serum-related proteins by an extensive absorption with anti-human serum antibody by affinity chromatography, the prostatic fluid contained 27 major groups of non-serum proteins. These non-serum proteins in the prostatic fluid included PAP, PSA, PBP, and their related smaller molecular species. These results indicate that the prostatic fluid contains PAP, PSA, PBP and that their presence and the patterns of their distribution in the two-dimensional gels should be considered as the characteristic property of the prostatic secretions.

The average level of kallikrein assayed as acetone-activated plasminogen activator (PGA) in plasma specimens from 10 reactors to clinical dextran or to radiographic contrast media did not differ from the level in 16 controls. This result was obtained in plasminogen-free citrated plasma stabilized with benzamidine. In the absence of benzamidine a significant reduction of PGA activity was registered in the reactor plasma, but not of activity against the tripeptide substrate S-2302 or the ester substrate BAEe. After storage of the plasma specimens for 12 to 18 months at -70 degrees, the PGA activity obtainable in reactor plasma had increased to the level registered in control plasma. Known inhibitors of plasma kallikrein and of histidine-rich glycoprotein (HRG) were assayed by radial immunodiffusion. The levels of alpha 2-macroglobulin, antithrombin-III and HRG were within the normal range in plasma from reactors, the level of C1-esterase inhibitor was slightly increased (116%), and the level of alpha 1-antitrypsin was higher than normal (124%). Evidence is provided that the loss of PGA activity taking place during acetone activation of fresh reactor plasma could not be due to a transition of native alpha-kallikrein to 3-chain beta-kallikrein. It is concluded that a plasma constituent unstable during storage is responsible for the selective and partial loss of PGA activity registered in reactor plasma.

The occurrence of hepatocellular carcinoma in a 22-year-old man with thalassemia major is reported. As a result of transfusional hemochromatosis, this patient had already developed diabetes, hypogonadism, heart failure, and the sicca syndrome; he was serum and tissue HBsAg negative. Liver iron concentration measured postmortem was found to be 50 times normal. Multiply transfused patients are at risk of developing hepatocellular carcinoma. Serial measurements of serum alpha-fetoprotein should permit early detection of the tumor and reduce mortality. Preventive measures include early immunisation against hepatitis B virus and prevention of iron accumulation by intensive use of desferrioxamine. Treatment of hemochromatosis-associated hypogonadism with androgens should be considered with caution.

This study concerns the association between the hemochromatosis susceptibility gene and a 10 kb Pvu II HLA-class I specific restriction fragment. Forty Pvu II fragments are detected after hybridization with A3 or B7 probes, and 20 among them are polymorphic. The 10 kb polymorphic Pvu II fragment correlates absolutely with the A3 serological allele and patients with hemochromatosis, heterozygous or homozygous for A3, have the 10 kb Pvu II band.

316 cases of proved hepatic cirrhosis (HC) which underwent Laparoscopy (L) were analysed. In 94 cases, hepatic biopsy by needle (HBN) was also practised under laparoscopic view, 96 cases were controlled until death, with a follow-up of almost 90 months. In 54 of these, there is a complete necropsy study. The performance in diagnosis of cirrhosis, L and HBN are compared separately. L gave the exact result of 96.6% and HBN 74.7%. HBN commonly practised with a Menghini needle (1.2 or 1.4 mm) as it is one that produces less complications, gives and insufficient sample, which determines that in 25.3% of the cases under biopsy, the HC diagnosis could not be proved, while L only fails in this aspect, in 3.38%. To this disadvantage of HBN, we must add another negative factor, the frequency which HBN can not be practised due to prothrombin under 50%, which nevertheless is not an obstacle for practising an L. In this series we have not reported any deaths with this two techniques. L has the additional advantage to contribute other useful data which can not be obtained with HBN alone. as revealing signs of portal hypertension, and hepatobiliary or peritoneal pathology which can coexist with HC. Due to this reasons, in the study of HC, we preferred as the first method of diagnosis, L, instead of HBN. When through this endoscopy we obtain the typical aspect, we omit adding HBN, which we only practised in doubtful cases of not very nodular livers (glabra cirrhosis) or when a probable post-hepatis, Wilson disease or hemochromatosis is being investigated. In the present conditions, we believe that the new methods of diagnosis "of non invasive images" can not substitute L or HBN in precising the diagnosis of HC.

The antithrombin-III-independent effect of heparin was studied in the following thrombin-catalyzed reactions: activation of purified plasma factor V and partially purified plasma factor VIII:C, generation of factor Va from the platelets and, in the presence of collagen, of the platelet procoagulant activity. Five heparin fractions and a heparinoid were compared to crude heparin. Crude heparin was a more potent inhibitor of these reactions than the fractions or the heparinoid. The inhibitory action of heparin (fractions) appeared to be the result of the formation of a complex between heparin and thrombin that alters the specificity of thrombin towards high molecular weight substrates. The inhibition of these thrombin-dependent feedback reactions in blood coagulation might be of importance in the mechanisms for the dissociation between the antithrombotic and hemorrhagic properties of low molecular weight heparins.

alpha 1-Antitrypsin (AAT) deficiency of phenotype PiZ and idiopathic hemochromatosis (IH) predispose to the development of cirrhosis and liver cell carcinoma. Several reports have suggested an association between these two inborn errors. To elucidate this question we used a monoclonal antibody against the PiZ gentic variant of AAT to analyze and compare the PiZ gene frequency in an area (county of Jämtland in Central Sweden) with a high, and another area (the city of Malmö in Southern Sweden) with a low IH prevalence. The PiZ gene frequencies did not differ between the areas. We also analyzed sera from 27 unrelated adult males with hemochromatosis diagnosed in the high IH area for the presence of the PiZ gene product but none was a carrier of the PiZ allele. These findings strongly refute any association between. AAT deficiency and IH.

No abstract available.

Alteration in antithrombin III (ATIII) biological activity, despite its normal plasma concentration, in diabetic subjects is shown in this report. This alteration is glycemia level-dependent, there existing an inverse correlation between fluctuations of daily blood glucose level, labile glycosylated hemoglobin and ATIII activity. The subcutaneous and endovenous heparin administration restores ATIII activity, but does not modify its plasma concentration in diabetics. Moreover, heparin treatment preserves ATIII activity from glycemia-induced alterations. These data suggest a role for glucose, probably through a labile nonenzymatic glycation process, in determining the alteration of ATIII biological activity. Moreover, showing the possibility by heparin administration to restore ATIII activity and preserve its biological function from effects of glycemia variations, stress the hypothesis that glucose and heparin compete in vivo, both against the same catalytic residue of ATIII.

Chicken oviduct progesterone receptor in cytosol was found to be transformed from the 8S to 4S form by incubation at 25 degrees C as well as by 0.3 M KCl in the absence of hormone. Heat transformation of ligand-free receptor took place at a much slower rate than that of ligand-bound receptor. The eventual percentage of transformation, however, was almost the same. The 4S form of the receptor transformed by KCl in the absence of hormone could bind to DNA-cellulose, but not to nuclei. However, upon exposure it acquired the ability to bind to nuclei. It was shown that the transformed ligand-free receptor could bind to progesterone to form the normal activated steroid-receptor complex. Conversely, when activated 4S progesterone-receptor complex was treated with DCC to peel off the hormone, a resulting ligand-free receptor was formed which behaved just like the KCl-transformed receptor in the absence of hormone.

A cDNA clone corresponding to an mRNA regulated by the progestin R5020, has been isolated by differential screening of a cDNA library from the MCF7 breast cancer cell line, which contains estrogen and progesterone receptors. This probe hybridized with a single species of poly A + RNA of 8-kb molecular weight as shown by Northern blot analysis and could also be used to total RNA preparation. This recombinant clone hybridized specifically to an mRNA coding for a 250,000 daltons protein when translated in vitro. This protein was identical to the 250 kDa progestin-regulated protein that we previously described (Biochem. Biophys. Res. Commun. 121, 421-427, 1984) as shown by immunoprecipitation with specific rabbit polyclonal antibodies. Dose-response curve and specificity studies show that the accumulation of the Pg8 mRNA and that of the 250-kDa protein was increased by 5 to 30-fold following progestin treatment and that this effect was mediated by the progesterone receptor. Time course of induction indicated that the accumulation of mRNA was rapid and preceded that of the protein. This is the first report on a cloned cDNA probe of progestin-regulated mRNA in human cell lines.

To detect an early colon carcinoma in its stage of carcinoma in situ, colonoscopic examinations with removal of all adenomas of the left colon (particularly of the sigmoid tract and rectum), followed by histological and biochemical evaluations, have been performed on 30 patients. Two-thirds of the adenomas examined presented histological patterns of tubular, tubulovillous, and villous adenomas; those with moderate or severe dysplasia were at high risk of neoplastic transformation. Measurement of estradiol (ER) and progesterone (PR) receptors was performed in the cytosol and in the nuclei of solitary and multiple adenomas and in those with synchronous carcinomas using the dextran-coated-charcoal (DCC) method. Steroid receptors were usually found in the cytosol of the large polyps of male rather than female patients (46% vs 11%) and in the cytosol of the adenomas with moderate or severe dysplasia in male patients. Malignant lesions usually possessed both ER and PR in the cytosol and nuclear fraction. These findings led to hypothesize that patients with adenomas of the colorectal tract with moderate or severe dysplasia and nuclear steroid receptors should be considered at high risk for colon carcinoma and therefore need a special follow-up program.

We have used purified protease nexin-I (PN-I) from human fibroblasts to develop a polyclonal antibody that specifically blocks the PN-I-mediated cellular binding of thrombin and urokinase. Anti-PN-I IgG did not inhibit the binding of 125I-epidermal growth factor-binding protein to fibroblasts, which is mediated by protease nexin-II, another cell-secreted, serine protease inhibitor that is distinct from PN-I. This furthers the belief that the protease nexins are distinct from one another. In addition, while anti-PN-I IgG immunoprecipitated PN-I X thrombin complexes, it did not do so with antithrombin-III X thrombin. Metabolically labeled PN-I was also immunoprecipitated by IgG, indicating that the protein can be labeled in vivo. The antibody also recognized primarily one band on Western transfers of conditioned medium from fibroblast cultures. These results suggest that anti-PN-I will be useful in probing the physiological role of PN-I as well as its biosynthesis.

In an attempt to detect early evidence of hemochromatosis-induced diabetes mellitus, hemoglobin Alc (Hgb Alc) levels were determined in four patients treated with chronic transfusions. All four were found to have significantly elevated Hgb Alc levels on several occasions. On further investigation, it was discovered that elevated levels of glycosylated hemoglobin were present in donor blood stored in dextrose solutions, thus leading to a higher level in the recipients. Hemoglobin Alc levels appear to be unreliable in patients receiving large amounts of transfused blood.

The accidental finding of raised levels of serum aminotransferase levels may lead to extensive investigations of the liver in apparently healthy people. To identify diagnostic groups and their need for investigations, we have evaluated the results of all investigative procedures carried out in 149 asymptomatic patients with persistently raised serum levels of aminotransferases. Fatty liver was found in 64%. These patients often had a high body weight. A high alcohol intake and diabetes mellitus were also noted. Chronic active or persistent hepatitis was found in 20% of the patients. Six per cent had cirrhosis, 4% had alpha 1-antitrypsin deficiency, and 3.5% had hemochromatosis. Apart from ferritin, alpha 1-antitrypsin, and markers for hepatitis B, blood tests were of little value for distinguishing among different diagnostic groups. This was the case also for the imaging procedures, and neither liver scintigraphy nor ultrasonography was a reliable source of diagnostic information. The results of our study indicate that diagnosis in this group of patients cannot be made without liver biopsy.

Iron overload is relatively common and is now detected more frequently because of inclusion of serum iron measurement in automated clinical chemistry panels. Secondary hemosiderosis and hemochromatosis result from increased iron absorption associated with increased erythropoiesis compensating for hemolysis, increased dietary iron, inappropriate prolonged oral iron therapy or chronic multiple transfusions. Primary hemochromatosis is a genetic metabolic disorder associated with the HLA locus on chromosome 6 resulting in increased iron absorption, though erythropoiesis and dietary iron are normal, and abnormal diversion of iron from reticuloendothelial (RE) to parenchymal cells. A genetic increase of intracellular iron carrier is a proposed basic mechanism. Only in the cirrhotic stage of primary hemochromatosis do RE iron and serum ferritin increase. Since both serum iron and serum ferritin may remain normal in the precirrhotic stage and may be falsely positive in the absence of iron overload, direct measurement of body iron stores is often useful. Measurement of tissue iron in liver biopsy specimens is widely used. However, quantitation of total mobilizable body iron by measurement of a 6-hour urine collection after intravenous injection of 59Fe-DTPA is noninvasive, sensitive, relatively accurate, and together with other laboratory and clinical data provides a practical means of establishing the correct diagnosis and therapy early enough to minimize organ damage.