[A randomized controlled study of PSK combined immuno-chemotherapy for adenocarcinoma of the lung. The Advanced Lung Cancer Immuno-chemotherapy Study Group]

In a randomized controlled study of chemotherapy (CDDP 100 mg/m2 day 1, VDS 3 mg/m2 day 1, 8, 15) vs. immuno-chemotherapy combined with PSK 3 g/day for adenocarcinoma of the lung (stage III, IV, p. s. 0, 1, 2), response rate for 169 cases with completed extramural review was 14.2%. As for the response rates for 138 complete cases, the chemotherapy group showed 17.9%, and the immuno-chemotherapy group was 16.9%. MST were 330 days and 331 days, respectively. In stage III cases, the response rates were 11.1% in the chemotherapy group and 37.5% in the immuno-chemotherapy group (p = 0.046). MST were 457 days (65.3 weeks) and 576 days (82.3 weeks), respectively. In terms of survival curve, it was suggested that the immuno-chemotherapy group was superior to the chemotherapy group (logrank test p = 0.075), but in stage IV cases, there was nothing outstanding in the immunochemotherapy group.

Modulation of porcine granulosa cell functions by interleukin-1

Increasing evidence suggests that functions of the immune system and gonads are closely related with each other. In cultures of granulosa and luteal cells, macrophages have been shown to modulate steroidogenic functions. In this paper we present the modulatory effects of interleukin-1, a cytokine produced predominantly by activated macrophages, on gonadotropin-induced differentiation, as well as growth of cultured porcine granulosa cells.

Correlation between the DNA damage in urinary bladder epithelium and the urinary 2-phenyl-1,4-benzoquinone levels from F344 rats fed sodium o-phenylphenate in the diet

The relationship between urinary metabolites and DNA damage in the urinary bladder epithelium of male and female rats was tested by alkaline elution assay after an intravesical injection of OPP or its urinary metabolites. 2-Phenyl-1,4-benzoquinone (PBQ) revealed a weak DNA-damaging activity in both sexes at 0.05-0.1%. OPP and phenylhydroquinone (PHQ) had no effects at the same level. Histopathologically, a single intravesical injection of 0.1% PBQ induced epithelial hyperplasia of the bladder epithelium on day 5, but PHQ and OPP did not induce it. Feeding studies with OPP-Na were also performed to examine the correlation between urinary PBQ levels and DNA damage in bladder epithelium. Slight DNA damage was observed in males given 1.0 and 2.0% OPP-Na in the diet for 3-5 months. The damage was dependent upon the dietary levels of OPP-Na. The amounts of OPP, PHQ and PBQ in urine were well correlated with the dietary levels of OPP-Na for male rats. The amounts of OPP, PHQ and PBQ were greater in male rats than in females given 2.0% OPP-Na diet for 5 months. The urinary pH of males was slightly higher than that of females. Since 0.4% sodium bicarbonate did not cause DNA damage in the in-situ study, the urinary alkalinity may not affect the initiation steps of urinary carcinogenesis by OPP-Na. The present results indicate that the metabolite PBQ is the reactive species for the initiation steps of bladder tumors induced by OPP-Na and OPP.

In vivo and in vitro effects of the antifungal agent miconazole on estrogen biosynthesis in human breast cancer

This study was undertaken to investigate whether miconazole (MCZ), an antifungal agent, inhibits aromatase activity in human breast cancer tissue preparations (n = 6). Aromatase activity in breast cancer tissue was significantly suppressed by an addition of MCZ (1 microM). The aromatase inhibition rate of MCZ was in the range 15-58%. The change of androgen and estrogen levels was also examined in peripheral blood after administering MCZ (200 mg) intravenously to four patients both with breast cancer and two with systemic fungal infection. Serum androstenedione and testosterone levels fluctuated only little. However, serum estrone and estradiol levels tended to decrease after administration of MCZ. These results suggest that MCZ may be useful in the treatment of breast cancer.

Interleukin-2 receptor/p55(Tac)-inducing activity in porcine follicular fluids

Very recently, it has been reported that interleukin-1 (IL-1) has an inhibitory effect on progesterone production by porcine granulosa cells in vitro. In the present study we investigated the presence of IL-1 or IL-1-like activity in porcine ovarian follicular fluids (FF) as the first step in elucidating the physiological role of IL-1 in follicular growth and maturation. Since IL-1 and IL-1-like substances have interleukin-2 receptor (IL-2R)/p55(Tac)-inducing activity (TIA), we determined the TIA in the FF by means of a highly sensitive TIA assay using flow cytometry. TIA was significantly higher (P less than 0.01) in the FF of small follicles than in those of medium-sized and large follicles. A significant negative correlation (P less than 0.05) was apparent between TIA and 17 beta-estradiol concentration in the FF. The conditioned media of porcine granulosa cells also showed TIA. Of these conditioned media, those from small follicles exhibited higher TIA than those from medium-sized and large follicles. TIA in the conditioned media decreased rapidly as the culture period was extended. Sex steroids such as 17 beta-estradiol, progesterone, testosterone, and androstenedione had no effect on IL-2R/p55(Tac) induction. These results indicate that porcine granulosa cells produce the IL-2R/p55(Tac)-inducing factor, the activity of which decreases in association with the maturation of the follicles. Because of the heterogeneity of IL-2R-inducing factors, the relationship between TIA in the FF and IL-1 should be elucidated. We discuss the possibility that this factor may play a role in follicular maturation and that enhancement of IL-2R/p55(Tac) expression by this factor may contribute to the local defense mechanism in ovarian follicles.

Mechanism of testicular atrophy induced by di-n-butyl phthalate in rats. Part 1

Repeated oral doses of di-n-butyl phthalate (DBP) to male rats caused a decrease in testicular fructose and glucose and a sloughing of the germ cells on the first day of treatment. On day 2, more severe sloughing was seen and was accompanied by decreases in testicular iron and zinc levels and increases in the level of inositol and cholesterols. The sloughing was followed by atrophy, accompanied by dissociation of the germ cells from the Sertoli cells and reduction of triglycerides, cholesterols and phospholipids containing choline and ethanolamine residues in the testis.

Inhibitory effects of interleukin-1 on luteinizing hormone-stimulated adenosine 3',5'-monophosphate accumulation by cultured porcine granulosa cells

To elucidate the mechanisms of the inhibitory effect of interleukin-1 (IL-1) on LH-stimulated progesterone secretion by cultured porcine granulosa cells, we examined which steps of the LH-stimulated, cAMP-mediated, progesterone biosynthetic pathway were affected by IL-1. Pretreatment of the cells for 48 h with IL-1 reduced intra- and extracellular cAMP accumulation in response to LH by 73% and 83%, respectively. The inhibitory effects of IL-1 were time and concentration dependent. Significant inhibition was observed at as low as 50-250 pg/ml, and the effect was maximal at 100 ng/ml (ID50; 2 ng/ml). The lowest concentration of IL-1 used (0.5 pg/ml), in contrast, showed a tendency to stimulate LH-induced cAMP accumulation. Effect of IL-1 on the specific binding of [125I]LH to granulosa cells was then examined, which showed that IL-1 (100 ng/ml) significantly reduced the specific binding by 36%. IL-1 also significantly reduced intra- and extracellular cAMP accumulation by the cells in response to forskolin (50, 150 microM) by 28-46%, indicating that IL-1 can directly inhibit adenylate cyclase activity. Contrary to these inhibitory actions of IL-1 on LH-stimulated cAMP generation, IL-1 did not significantly reduce progesterone secretion induced by (Bu)2cAMP. These results indicate that the inhibitory effect of IL-1 on LH-stimulated progesterone secretion is due to its actions at at least two different sites along the LH-stimulated, cAMP-mediated, progesterone biosynthetic pathway, the LH receptor level and adenylate cyclase systems. The post-cAMP steps of progesterone production, in contrast, did not seem to be affected by IL-1.

Synthesis of alpha-deuterium-labelled cyclohexylamine and its deamination by rabbit liver microsomes

In order to investigate the isotope effect on the microsomal oxidative deamination of cyclohexylamine, alpha-deuterium(D)-labelled cyclohexylamine was synthesized. The deuterium labelling was found exclusively at the alpha-position with a purity of greater than 99 atom percent. Metabolic studies in vitro indicate that a significant deuterium isotope effect operates in the oxidative deamination of alpha-D-labelled cyclohexylamine. On incubation with rabbit liver microsomes in the presence of reduced nicotinamide adenine dinucleotide phosphate (NADPH) and oxygen, the ratio of apparent deamination rate constants (kH/kD) was 2.0 +/- 0.2 (mean +/- S.D.).

Interleukin-1 stimulates growth and inhibits progesterone secretion in cultures of porcine granulosa cells

Interleukin-1 (IL-1) significantly inhibited basal progesterone secretion and influenced the cell number in high density cultures of porcine granulosa cells harvested from small (1-2 mm) or medium (3-5 mm) follicles. These two effects of IL-1 showed similar but inverse dose-response relationships: Significant effects were observed at concentrations higher than 50 pg/ml, and the maximal effective concentration was 5 ng/ml, which reduced progesterone secretion by 53.5 +/- 2.1%. In contrast, IL-1 neither inhibited progesterone secretion nor did it influence cell number in cultures of fully mature granulosa cells harvested from the largest (8-11 mm) follicles. The growth-promoting effect of IL-1 on granulosa cells was further examined in the low density cultures, which revealed that IL-1 significantly stimulated proliferation of the less mature granulosa cells at concentrations higher than 50 pg/ml, and that at a maximal stimulatory concentration (25 ng/ml) it increased cell number to 206 +/- 11% of control. Although IL-1 increased cell number and reduced progesterone secretion of fully mature granulosa cells after 5 days in low density cultures, it seemed that the proliferating population were not the cells with luteinized morphology and positive 3 beta-hydroxysteroid dehydrogenase staining. The proliferating population of cells appeared to have less mature morphology and were negative for 3 beta-hydroxysteroid dehydrogenase staining.

Three-year disease-free survivors of small cell lung cancer treated with combination chemotherapy with or without chest irradiation

One hundred and seventy-four patients with small cell lung cancer (SCLC) treated with combination chemotherapy, with or without chest radiation, were analyzed. Fourteen patients (8%) survived for 3 years or more. Three-year disease-free survival continued for 12 of the 101 patients (12%) with limited disease, and one of 75 (1%) with extensive disease (P less than 0.05). Patients' sex and performance status were not important in achieving long-term survival. All disease-free survivors, except two who could not be evaluated, achieved a complete response. Although the treatment programs had some influence on the long-term survival rates (P less than 0.05), thoracic radiation did not have significant impact on long-term survival. Three of the 13 patients (23%) developed second malignancies and died, and one of these patients also suffered from a progressive neurologic deterioration with dementia. Two other patients died free of SCLC. Consequently, eight have remained alive and free of disease. The last relapse was observed at 1.5 years from beginning of treatment. The disease-free survival may offer the hope of cure of SCLC. However, the survivors are at an increased risk of developing late complications including second malignancies and neurologic abnormalities. Therefore, careful follow-up will be necessary.

[Treatment of malignant pleural effusion]

A malignant pleural effusion in the patients with cancer is one of the common complications that make the patients critically ill condition without the adequate treatment. The present paper reviewed the literature concerning the clinical results of all techniques designed to treat this problem. We would like to recommend intrapleural administration of several sclerosing agents with tube thoracostomy as the technique of choice. We also showed the results obtained in our hospital using intra pleural IL-2 instillation.

Significance of exercise and bed rest in pregnancy--pregnancy and walking (1)

Prior to evaluating the significance of bed rest in managing obstetric diseases, characteristics of physiology of pregnant women were examined on the basis of 24 hours heart rate changes in eight pregnant women at the third trimester and also distances covered in walking by a total of 53 multiparas and of 87 primiparas during free-living daily activities were measured by means of a pedometer. A significantly higher mean heart rate was observed in those pregnant women even during sleep than in non-pregnant control. The primiparas showed significant decreases in the pedometer readings in all stages except for 15-27 weeks of gestation, while the multiparas of less than 28 weeks exhibited no decrease as compared with non-pregnant control. The decrease in the pedometer readings were marked in both primiparas and multiparas, the value being much lower than that of any other week of gestation. However, the equation of weight x distance covered in walking remains rather constant throughout gestation.

Restorative effect of muroctasin on leukopenia caused by anticancer chemotherapy in lung cancer. Comparative study by envelope method

N2-[(N-Acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a derivative of muramyl dipeptide, is known to have the activity to augment the number of white blood cells (WBC) via colony-stimulating factor. Muroctasin has been expected to be applied to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by the combination regimens of chemotherapy, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on Days 4, 7 and 15 after commencement of the study. WBCs in H and L groups were recovered greater than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin treated groups. The portion of immature neutrophil in the bone marrow was also increased by muroctasin treatment. A restorative effect on WBC and neutrophil counts was also confirmed only in the second course of H group. On the other hand, fever and pain in the injected site as side effects were common in the H group and L group in both of courses. In this study, the usefulness of muroctasin in leukopenia was suggested when administered at dosages of 200 micrograms for 6 days.

Tris (2,3-dibromopropyl) phosphate nephrotoxicity in the rat: histological and biochemical changes in renal components by 13C-NMR spectra

Rats receiving a single oral dose of 286.8 mumol/kg tris(2,3-dibromopropyl)phosphate (Tris-BP) showed pyknosis of the renal tubular epithelial cells on Day 1, necrosis on Day 2, regeneration from Day 3 and large nuclei formation from Day 4. 13C-NMR spectra were applied to clarify changes of the renal low-molecular-weight components in the kidney injured by Tris-BP, and sialic acid and inositol were found as the desired marker components. The lesions produced by Tris-BP were characterized by changes in the renal components and enzyme activities. Increases in sialic acid content of the kidney were observed both on Day 1, suggesting destruction of the epithelial cell membrane, and on Day 5, suggesting regeneration accompanied by an increase of inositol content on Days 7 and 10. Renal activity of cytoplasmic enzyme, alanine aminopeptidase, was decreased on Days 1 and 5 and elevated on Days 7 and 10. Lactate dehydrogenase activity showed a tendency to decrease in the kidneys on Day 1 and to increase significantly on Days 2, 5, 6 and 7.

[Studies on an appropriate intra thoracic administration of cisplatin and sodium thiosulfate in malignant pleural effusion]

Twenty-eight patients with malignant pleural effusion received instillation of cisplatin (CDDP) into the pleural cavity to examine the pharmacokinetics and side effects of CDDP Thirteen patients received high-dose CDDP (120 mg/m2-160 mg/m2) in combination with sodium thiosulfate (STS), while 15 others received CDDP alone (80 mg/m2). Total Pt and non-protein-bound Pt (free Pt) concentrations in the pleural effusion and plasma were determined by flameless atomic absorption spectrometry. In one patient, Pt concentrations of intact CDDP and STS-bound CDDP were determined using high performance liquid chromatography and flameless atomic absorption spectrometry. Instillation of CDDP at 160 mg/m2 into the pleural cavity was achieved by concurrent use of STS in the large dose (STS 20 g/m2 1 hr later, totalling 625-fold molar ratio to CDDP). When CDDP was combined with STS, there was alleviation in hematological, renal and auditory toxicity but not in nausea, vomiting or anorexia. When CDDP was instillated into the pleural cavity at 150 mg/m2 (in combination with STS equivalent to 200-fold molar ratio to CDDP), a high Pt concentration of intact CDDP could be maintained in the pleural effusion over a prolonged period of time, recording 8.80 micrograms/ml even as late as 12 hr after instillation. On the other hand nearly all of the free Pt concentration for the first 2 hr was considered to be due to intact CDDP. Once systemically administered, STS quickly moved into the pleural effusion, binding with CDDP in the pleural cavity and thus probably reducing its anti-tumor effect. STS did not greatly affect the plasma concentration of total Pt when it was administered at a 100-fold molar ratio to CDDP, yielding only p poor effect. Our findings suggest that malignant pleural effusion could be effectively treated by the instillation of CDDP 80 mg/m2 into the pleural cavity.

[Restorative effect of muroctasin, MDP-Lys (L 18), on leukopenia caused by anticancer chemotherapy in lung cancer--comparative study by envelope method]

Muroctasin, a derivative of MDP, is known to augment the number of WBC via colony-stimulating factor. Muroctasin has been expected to be promising for application to leukopenia caused by anticancer chemotherapy. When WBC decreased to less than or equal to 3,000/mm3 after the 1st course of chemotherapy, 131 patients with lung cancer, who were previously classified by chemotherapy combination, were enrolled in the study and randomized into 3 groups, 200 micrograms (H), 100 micrograms (L) and untreated control (C) groups. The patients were then subcutaneously treated once daily for 6 consecutive days. WBC and its differential count were measured on days 4, 7 and 15 after commencement of the study. WBCs in H and L groups showed greater recovery than in C group. In WBC differential count, the recovery of neutrophil was prominent in muroctasin-treated groups. A portion of immature neutrophil in bone marrow was also increased by muroctasin treatment. In the present study, the usefulness of muroctasin in leukopenia was indicated when administered at dosages of 200 micrograms for 6 days.

Restorative activity of muroctasin on leukopenia associated with anticancer treatment

The restorative effect of N2-[(N-acetylmuramoyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-lysine (MDP-Lys(L18), muroctasin), a muramyl dipeptide derivative, was studied in patients with leukopenia associated with anticancer chemotherapy and radiation therapy. The drug was subcutaneously administered to 102 cancer patients in a single doses of 200 or 400 micrograms, and each dosage was given either every day for 6 days or every other day over a 5-day period. White blood cell (WBC) counts were made before, during and after treatment. MDP-Lys(L18) was most effective in patients receiving the drug every day and the 400 micrograms dose was somewhat superior to the 200 micrograms dose in augmenting the WBC population. Overall, the response to MDP-Lys(L18), in terms of the increase in number of WBCs, was good to excellent in 41.6% of patients. MDP-Lys(L18) was considerably more effective in patients with solid tumors than in those with hematological malignancies. The most common side effect was fever, which was dose-dependent, more pronounced with alternate-day dosing, and generally well controlled with antipyretics. The results of this study indicate that MDP-Lys(L18) is useful in improving the WBC count in leukopenic cancer patients treated with anticancer therapy. Considering the efficacy and side effect profiles together, it is suggested that 200 micrograms/day for 6 consecutive days is the optimal treatment regimen.

Effects of rose bengal on serum levels of thyroid hormones and thyroid peroxidase activity in male mice

The thyrotoxic effect of Rose bengal (RB) (4,5,6,7-tetrachloro-2',4',5',7'-tetraiodofluorescein disodium salt; Food Red No. 105) was examined in male (C57BL/6N X C3H/N) F1 mice. They were given drinking-water containing RB at levels of 0 (control), 0.125 and 0.250% for 2 weeks. The effect resulted in decreases in serum levels of 3,5,3'-triiodothyronine (T3) and thyroxine (T4), and slight increases in serum 3,3',5'-triiodothyronine (rT3) levels and thyroid weight, but no difference in the values for the body-weight gain, serum thyroid stimulating hormone (TSH) levels and thyroid peroxidase (TPO) activities. However, the in vitro inhibitory effect of RB on TPO activity was observed by addition of RB to the TPO-catalyzed guaiacol oxidation. These results suggest that RB might have weak goitrogenic properties, inhibiting the peripheral conversion of T4 to T3 and/or inhibiting TPO to lead a decrease of T4 and T3 formation.

[Chemotherapy of small cell lung cancer]

The recent results of chemotherapy for SCLC were reviewed in this paper. The combination chemotherapy with some highly active drugs can be summarized as follows: response rate 74-94% in limited disease (LD) and 63-90% in extensive disease (ED), complete response 39-57% in LD and 20-48% in ED, median survival 10-21 months in LD and 7-12 months in ED. To overcome drug resistance in the treatment of SCLC, non-cross resistant alternating chemotherapy has been explored. In our institute, a randomized study of continuous vs alternating regimen for SCLC was carried out from August 1982 to March 1985. This resulted in the acknowledged superiority of the alternating regimen in CR rate and the overall response rate, but no differences in survival. A current study comparing the standard chemotherapy with cyclophosphamide, adriamycin and vincristine (CAV) to alternating CAV with etoposide (E) and cisplatin (P) has suggested an advantage for alternating chemotherapy, with a statistically superior response rate and survival. The high-dose (HD) chemotherapy for SCLC is also a new strategy to improve the current treatment results. We are now studying the efficacy of HD-E (1.0-1.5 g/m2) with or without P (80-120 mg/m2) for relapsed SCLC. The result suggested that HD-E and P is an effective treatment modality as a salvage therapy. The search for new active drugs is another important way to improve the treatment results. Since 1986, a phase II study of Carboplatin has been performed in Japan. The ongoing data suggest that Carboplatin is a highly active agent against SCLC. Finally, further research will be necessary to investigate novel modalities in order to achieve a breakthrough in the current status.

[Phase II studies of a single agent and a cis-platinum-based two-drug combination in patients with non-small cell lung cancer]

Phase II studies of single agent and CDDP-based two drug combination were performed in 189 patients with inoperable non-small cell lung cancer. Six drug regimens were performed: CDDP alone, VDS alone, Epi-ADM alone, CDDP + VDS, CDDP + CPA, CDDP + ADM. The response rates were 15.4% (6/39) with CDDP alone, 8.0% (2/25) with VDS alone, 6.1% (2/33) with Epi-ADM alone, 26.7% (8/30) with CDDP + VDS, 14.3% (4/28) with CDDP + CPA, 17.6% (6/34) with CDDP + ADM and one CR was performed with CDDP + ADM. In patients with no prior chemotherapy, the response rates were 20.0% (6/30), 11.8% (2/17), 12.5% (2/16), 26.7% (8/30), 16.0% (4/25) and 25.0% (3/12), respectively. The median survival times were 25, 27, 23, 33, 25, and 45 weeks, respectively. The efficacy of CDDP in non-small cell lung cancer patients was re-confirmed, and that of CDDP + VDS, CDDP + ADM was suggested. No death due to toxicity occurred and toxicity was generally tolerable.

Comparative studies on nephrotoxic effects of tris (2,3-dibromopropyl) phosphate and bis (2,3-dibromopropyl) phosphate on rat urinary metabolites

The mechanism of Tris-BP or Bis-BP (a metabolite of Tris-BP) induced nephrotoxicity was investigated by determining urinary excretion of enzymes and selected metabolites. Rats received single oral doses of 0, 71.7, 143.4 and 286.8 mumol/kg tris (2,3-dibromopropyl) phosphate (Tris-BP) or bis (2,3-dibromopropyl) phosphate (Bis-BP). Urine was collected over a 24 h period and subjected to biochemical examinations. Comparative studies on Tris-BP- and Bis-BP-induced nephrotoxicities were carried out for abnormal patterns of urinary excretion. The urinary excretion of glucose was higher in Bis-BP than Tris-BP at a dose of 143.4 mumol/kg, but this pattern reversed at a dose of 286.8 mumol/kg. Peak lactate excretion occurred later than peak glucose excretion with 143.4 and 286.8 mumol/kg Tris BP and 143.4 mumol/kg Bis-BP. Bis-BP 286.8 mumol/kg caused a transient urinary elevation of lactate on Day 2. Uric acid was excreted at higher levels for Bis-BP than Tris-BP on day 2 of urine collection. Activities of urinary enzymes including alkaline phosphatase, aspartate aminotransferase and gamma-glutamyltransferase, were different on the first day of post-treatment for Tris-BP and Bis-BP. Leucine aminopeptidase and lactate dehydrogenase levels differed on the second day. Activities of the former enzymes on the day 2 urine suggested a transformation of Tris-BP to Bis-BP. Urinary patterns of lactate dehydrogenase isoenzymes (LDH-1-LDH-5) were different between Tris-BP and Bis-BP when rats were treated with the dose of 286.8 mumol/kg: Tris-BP caused a higher excretion of LDH-4 and LDH-5 in urine on day 1 and all five isoenzymes into the day 2 urine. Bis-BP caused slightly higher excretion of LDH-5 and LDH-4 into the day 1 and 3 urine, respectively. Bis-BP but not Tris-BP caused abnormally urinary excretion of sodium ion. Histopathologically, the nephrotoxic effect of Tris-BP appeared one day later and was more obvious than that of Bis-BP in rats after single oral administration.

Deuterium and tritium labeling of (3-xenyl)cyclohexane by Clemmensen and Wolff-Kishner reduction

Tritium-labeling of (3-xenyl)cyclohexane was investigated by deuterium-labeling on Clemmensen and Wolff-Kishner reduction of 2-(3-xenyl)cyclohexane. Deuterium-labeling by the Clemmensen reduction was proved to be accompanied by isotope exchange via acid-catalyzed enolyzation of the carbonyl group. Thus, the labeled (3-xenyl)cyclohexane was a mixture of compounds with various numbers of deuterium atoms. Labeling by the modified Wolff-Kishner reduction gave a mixture of compounds labeled predominantly at position 2.

Interleukin-1 inhibits luteinization of porcine granulosa cells in culture

Interleukin-1(IL-1), a cytokine predominantly produced by activated macrophages, has been shown to possess a wide range of biological functions as well as to play a role as an immune mediator. As it has been reported that homogenates of peritoneal macrophages contained substances which stimulated progesterone production by luteinized granulosa cells of mice, we examined whether IL-1 could modulate the steroidogenic functions of granulosa cells. Porcine granulosa cells obtained from medium-sized follicles were cultured with IL-1 in the presence or absence of LH, and the effects of IL-1 on LH-stimulated as well as basal progesterone production by these cells were examined. Contrary to our expectation, IL-1 markedly inhibited the LH-stimulated progesterone production in a dose-dependent manner. The morphological luteinization of the granulosa cells induced by LH was also inhibited by IL-1. In addition to effects on LH-induced differentiation, IL-1 exhibited an inhibitory effect on basal (unstimulated) progesterone production as well. The ovarian granulosa cell was identified as one of the possible targets for IL-1, and it was shown for the first time that IL-1 can modulate steroidogenic functions of mammalian cells in culture.

The confirmation of norethindrone aromatization in primary human hepatocytes by the Vitafiber-II cell culture system

A portion of norethindrone (17 alpha-ethynyl-19-nortestosterone) was confirmed to be aromatized to ethynyl estradiol (17 alpha-ethynyl estradiol) in primary human hepatocytes cultured using the Vitafiber-II cell culture system.

The metabolic origin of the sulfur atom in the sulfhydryl group of 2-thiobenzothiazole metabolites derived from benzothiazyl sulfenamide in the rat

After administration of benzothiazyl sulfenamide to rats, over 90% of the S atom in the sulfhydryl group was retained in 2-thiobenzothiazole metabolites. The S atom in 2-benzothiazyl mercapturic acid, a major metabolite, was mostly replaced by the endogenous S from the L-cysteine pool.

Mathematical evaluation of 24-hour blood-pressure variability in young, middle-aged and elderly hypertensive patients

The characteristics of 24-hour blood pressure variation in hypertensive patients were assessed using new indices of variability. Blood pressure of 43 inpatients with essential hypertension was measured using a portable device without disturbing daily behaviors. Variances in systolic and diastolic pressure values obtained for a day (SDd2), and short-term (SDh2) and long-term (SD24(2) variances were calculated; their relationship was expressed as SDd2 = SDh2 + SD24(2). SDh and SD24 were expedient in assessing the relatively fast and slow blood-pressure variations, respectively. The results showed that the ratio SDh2/SDd2 (percentile of the short-term variance in a whole-day variance) increased and therefore SD24(2)/SDd2 decreased as age increased for both systolic and diastolic pressures. It was found, moreover, that systolic SDh was significantly related to age and baroreflex sensitivity, and systolic SD24 to the heart rate during waking hours. The physiological and clinical significance of SDh and SD24 is discussed, briefly, including arterial wall stiffness.

DNA damage in urinary bladder epithelium of male F344 rats treated with 2-phenyl-1,4-benzoquinone, one of the non-conjugated urinary metabolites of sodium o-phenylphenate

DNA damage in the urinary bladder epithelium of male F344 rat was tested by alkaline elution assay after an intravesical injection of o-phenylphenol (OPP) or its non-conjugated urinary metabolites. DNA damage, as represented by an increase of the elution rate constant, was induced by the injection of 2-phenyl-1,4-benzoquinone (PBQ) at the concentration of 0.05-0.1%, but was not observed after the injection of either OPP or 2,5-dihydroxyphenyl at 0.05%. Histopathologically, a single intravesical injection of 0.05% or 0.1% PBQ was shown to induce epithelial hyperplasia of the bladder epithelium on day 5 after the treatment.

Nitrobacter winogradskyi cytochrome a1c1 is an iron-sulfur molybdoenzyme having hemes a and c

Cytochrome a1c1 (nitrite-cytochrome c oxidoreductase) purified from Nitrobacter winogradskyi (formerly N. agilis) contained molybdenum, non-heme iron, and acid-labile sulfur in addition to hemes a and c; it contained 1 mol of heme a, 4-5 g atoms of non-heme iron, 2-5 g atoms of acid-labile sulfur, and 1-2 g atoms of molybdenum per mol of heme c, but did not contain copper. The fluorescence spectra of the molybdenum cofactor derivative prepared from cytochrome a1c1 were very similar to those of the cofactor derivative from xanthine oxidase, and the aponitrate reductase of nit-1 mutant of Neurospora crassa was complemented by addition of the molybdenum cofactor derived from the cytochrome. Further, the ESR spectrum of cytochrome a1c1 was similar to that of liver sulfite oxidase. The content of cytochrome a1 in the cells cultivated with the medium in which tungsten was substituted for molybdenum markedly decreased as compared with that in the cells cultivated in the molybdenum-supplemented medium. These results indicate that cytochrome a1c1 is an iron-sulfur molybdoenzyme which contains hemes a and c.

Fibro-osteochondroma of the uterus

A very rare case of fibro-osteochondroma arising in uterine musculature was studied histologically. The tumor exhibited three types of cellular proliferation--fibroblastic, cartilaginous, and osseous--all within an abundant collagenous matrix. The three components were intermingled, and varied in the degree of differentiation of cartilaginous and osseous tissue. The more differentiated tissues were usually circumscribed by fibrocellular bands of spindle-shaped cells that seemed to have transformed into rounded cartilaginous cells. Presumably this tumor arose from undifferentiated mesenchymal cells in the myometrium, which proliferated to form fibroblasts, chondrocytes, and osteoblasts. The tumor may be designated fibrio-osteochondroma. It is histologically benign and exceedingly rare.

[Studies on the appropriate administration of cisplatin based on pharmacokinetics and toxicity]

Ninety-six patients with non-small cell lung cancer were treated with cisplatin (80-150 mg/m2). The pharmacokinetics of cisplatin were studied in 27 of these patients. Cisplatin was administered intravenously for 30-120 min. Plasma concentrations of total platinum and ultrafilterable (non-protein-bound) platinum were monitored by flameless atomic absorption spectrophotometry. Maximum total platinum levels in plasma were attained at the end of infusion, and thereafter decayed in a biphasic fashion, with an initial phase half-life (t1/2 alpha) of 10.2 to 14.6 min and a secondary phase half-life (t1/2 beta) of 41.7 to 81.3 h. The half-life was prolonged as the dosage was increased. Non-protein-bound platinum was rapidly cleared to below the measurable level within 4 hours at 80 mg/m2 and 120 mg/m2 of cisplatin, but declined in a biphasic manner, with t1/2 alpha of 31.2 min and t1/2 beta of 20.1 h at 150 mg/m2 of cisplatin. Toxicities were increased according to dosage, and decreased with a 50 mg/m2 X 3 days regime. Nephrotoxicity and ototoxicity were the dose-limiting factors in the single-dose escalation scheme used. In conclusion, the optimal dosage of cisplatin appeared to be 120 mg/m2 considering its toxicity.

Twenty-four hour monitoring of deep body temperature with a novel flexible probe

A portable thermomemory unit with a light, thin and flexible probe has been developed for the measurement of whole-day variations in deep body temperature. The probe consists of a thermistor, a heat-flow sensor and a heater. The probe detects heat flow from the skin; the heater then compensates for the heat lost and consequently the skin is effectively insulated from the ambient microenvironment. Skin temperature beneath the probe is therefore determined by the deep body temperature. The probe is 46 mm in diameter and 3 mm thick, its weight is 5 g. The probe is light and flexible and makes close contact with the skin. A 2 kbyte RAM in the unit enables up to 34 h of data to be collected with a sampling rate of once per minute. The device was applied to the chest and abdominal walls, and to the calf; the chest and abdominal deep body temperatures showed a significant dual phase diurnal variation, usually being low during sleep. In contrast, the calf showed a dynamic deep body temperature variation which depended on the amount of leg exercise. The device was found to be effective for analysing daily variations; measurements on the limbs suggested that it could be used for monitoring peripheral circulatory disorders.

T-lymphocyte subsets in primary lung cancer

T-cell subsets in the peripheral blood of 63 primary lung cancer patients (23 with adenocarcinoma, 23 with squamous cell carcinoma and 17 with small cell carcinoma) and 24 normal healthy controls were determined by indirect immunofluorescence, using the monoclonal antibody reagents OKT3, OKT4 and OKT8. Correlations between T-lymphocyte subset values and stages or cell types of disease were sought. Total lymphocytes in the patient group were decreased. However, no significant difference from controls was seen in the percentage of OKT3-positive cells (Pan T-cells) in the cancer patients. The percentage of OKT8-positive cells (cytotoxic/suppressor) was increased in the early stage of disease whereas the percentage of OKT4 positive cells (inducer/helper) remained at the control level throughout all stages. The ratio of OKT4-positive to OKT8-positive T-cells (OKT4/OKT8), reflecting the balance of immunoregulatory T-cells, was, therefore, significantly decreased in patients with stage I-II lung cancer (P less than 0.05), especially in squamous cell lung cancer (P less than 0.05), whereas in stages III or IV, this T4/T8 ratio returned to the control level. In small cell carcinoma, the T4/T8 ratio was significantly decreased in stage III (P less than 0.01) and returned to the control level in stage IV.

[Serial measurements of serum carcinoembryonic antigen (CEA) and neuron-specific enolase (NSE) during chemotherapy of patients with inoperable lung cancer]

Serial measurements of serum CEA levels were analyzed in 226 patients with inoperable lung cancer (115 small cell carcinomas, 64 adenocarcinomas, 37 squamous cell carcinomas and 10 large cell carcinomas) during chemotherapy. Of all patients, 29.1% had pretreatment CEA levels greater than or equal to 5 ng/ml. In all of the patients with complete response, and 15 (68.2%) of 22 patients with partial response whose pretreatment CEA levels were 5 ng/ml or higher, CEA levels fell to below 5 ng/ml. All of 17 patients who showed a decrease greater than 50% in serum CEA levels during chemotherapy showed a shrinkage of more than 50% in the tumor burden. Serial serum CEA level measurements were useful as an indicator of response to chemotherapy in advanced lung cancer. Serial serum NSE levels were measured in 36 patients with small cell lung cancer. Pretreatment NSE levels were elevated to more than 10 ng/ml in 83.1% of all patients. A transient rise in serum NSE levels occurred in 22 out of 33 patients measured on the third day during initial chemotherapy. Serum NSE levels greater than or equal to 10 ng/ml declined to within the normal range in all patients responding to the chemotherapy. The survival in patients whose NSE levels (greater than or equal to 10 ng/ml) fell to within the normal range for more than four weeks was longer than that in other patients. Serial measurements of serum NSE levels were thus useful for monitoring the response to chemotherapy in cases of small cell lung cancer.

Nephrotoxic effect of tris(2,3-dibromopropyl)phosphate on rat urinary metabolites: assessment from 13C-NMR spectra of urines and biochemical and histopathological examinations

Rats received either single oral doses of 0, 25, 50, 100 and 200 mg/kg tris(2,3-dibromopropyl)phosphate (Tris-BP) or repeated doses of 50, 100 and 200 mg/kg/day Tris-BP for 7 days. Urine was collected over a 24-hr period and subjected to 13C-NMR and biochemical examinations. Tris-BP produced significant increases of urinary glucose and lactate. Urinary gamma-glutamyltransferase, lactate dehydrogenase and alkaline phosphatase levels were significantly elevated on the first 2 days of post-treatment. Histopathologically, the kidney exhibited proximal tubular damage at a dose of 200 mg/kg. There was a good correlation among the histopathological, biochemical results, and the 13C-NMR urinary metabolite fingerprints in the assessment of Tris-BP-induced renal damage. The abnormal patterns of metabolite excretion suggested that the lesions produced by Tris-BP were caused by changes in the metabolic function of tubular epithelial cells. The urinary excretion of lactate, enzymes and inhibition of glucose reabsorption from the tubular lumina may be attributed to necrosis and desquamation of the tubular cell.

Evaluation of a new non-invasive semiautomatic blood pressure monitoring device

The accuracy of a new device for indirect blood pressure measurement was evaluated by comparison with the intra-arterial pressure measurement. The device is based on the Korotkoff's method using a cuff and a microphone, but is characterized by a two-channel recorder to monitor the cuff pressure and the events picked up by the microphone. The blood pressure is determined automatically by a computer program which analyzes the microphone signal during a cuff deflation, and manually by the same criteria to confirm the result. The comparison was carried out on 29 subjects undergoing catheterization of the brachial artery for clinical examination. The difference between the direct and indirect reading ranged from -14 to +9 mmHg (-0.55 +/- 0.91, mean +/- SE) for the systolic pressure and from -5 to +14 mmHg (3.78 +/- 0.95) for the diastolic pressure. It was found advantageous that blood-pressure reading can be confirmed repeatedly on the recorded chart after the measurement.

[A randomized control study of the antiemetic efficacy of betamethasone versus methylprednisolone]

A randomized control study of the antiemetic activity of betamethasone (B) vs. methylprednisolone (MP) was carried out. Fifty-six patients receiving CDDP (60 mg/m2-80 mg/m2) were entered. B (8 mg/body on day 1, 4 mg/body on days 2 and 3) was administered intravenously in 18 patients, and MP (1,000 mg/body on day 1, 500 mg/body on days 2 and 3) was administered intravenously in 19 patients. Severe vomiting occurred in 5 of the 19 (26.3%) with MP, 10 of the 18 (55.6%) with B, and 11 of 19 (57.9%) controls. Severe nausea occurred in 3 of the 19 (15.8%) with MP, 6 of the 18 (33.3%) with B, and 5 of the 19 (26.3%) controls. Methylprednisolone was thus considered effective (P less than 0.05) for CDDP-induced emesis.

Alternating non-cross resistant chemotherapy for small cell lung cancer

After stratification for the extent of disease, previously untreated patients with small cell lung cancer randomized to receive therapy with the four-drug combination of cyclophosphamide, oncovin, nimustine hydrochloride (ACNU), and procarbazine (CONP) every four weeks (continuous regimen) or to receive CONP alternating with the three-drug combination of etoposide (VP-16), adriamycin and cisplatin (VAD) at four-week intervals (alternating regimen). Sixty-nine patients were entered in the study. Of 34 evaluable patients receiving the continuous regimen, six (17.6%) achieved complete response (CR) and 16 (47.1%) achieved partial response (PR). Of 31 evaluable patients receiving the alternating regimen, 10 (32.3%) achieved CR, and 16 (51.6%) achieved PR. There was a tendency in favor of the alternating regimen in CR and over-all response rates (0.05 less than p less than 0.1). There were no significant differences between the regimens in response duration or survival. The projected median survival times were 9.2 months and 9.4 months for the continuous and alternating regimens, respectively. One patient receiving the continuous regimen and three receiving the alternating regimen have been living for more than two years. The major toxicity was myelosuppression in both regimens. One patient died of hemorrhage due to thrombocytopenia during induction with CONP, and one patient died of cisplatin-induced renal failure. We conclude that alternating non-cross resistant chemotherapy leads to improved CR and response rates, but does not improve survival.

[A phase II study of epirubicin in advanced lung cancer]

A phase II study of epirubicin (EPI) was performed on 65 eligible lung cancer patients. EPI was administered intravenously at the dosage of 60 mg/m2 for non-small cell lung cancer (NSCLC) and 75 mg/m2 for small cell lung cancer (SCLC) at the interval of three to four weeks. The response rate of 57 measurable patients was 7.0% (predicted true response rate was 1.9-17.0%). In SCLC, the overall response rate was as low as 8.3% (2/24), but a better response rate, 20% (2/10), was observed in patients given no prior therapy. In NSCLC, the response rate was 6.1% (2/33) as a whole and 12.5% (2/16) in patients given no prior therapy. We were able to conclude that EPI was a moderately active agent in SCLC and marginally effective in NSCLC. Although the dose limiting factor was leukopenia, its incidence and degree seemed low as compared with adriamycin (ADM). As for alopecia or GI tract side effects, those associated with EPI appeared less acute than those produced by ADM. No cardiac toxicities were observed, partly because of the low cumulative maximum dose of 311 mg/m2 used in our study.

Increased circulating activated T-cells in lung cancer

T-cell activation (Tac) antigens, which are closely associated with the receptors for interleukin 2 (IL 2) and expressed on activated human T-lymphocytes, are found on a small percentage of normal peripheral T-cells. Elevated levels of Tac antigen-positive (Tac+) cells were observed in a high proportion of patients with untreated primary lung cancer assessed by using monoclonal anti-Tac antibody. The mean percentage of Tac+ cells in peripheral blood lymphocytes was 13.1 +/- 6.4 percent in patients with primary lung cancer (n = 67), as compared with 4.3 +/- 1.9 percent in normal controls (n = 30) (p less than 0.001). No significant differences were observed among the cell types of lung cancer examined (adenocarcinoma and squamous and small cell carcinoma). The stages of the disease also showed no significant differences in the development of Tac+ cells. Our results suggest that T-cell-mediated active immune mechanisms against malignant cancer cells are operative in patients with lung cancer, resulting in an increase in activated T-cells in the peripheral blood, although it remains to be elucidated whether these activated T-cells exert a favorable or unfavorable effect on their host.

[Response and pharmacokinetics of cisplatin instilled into the pleural cavity]

The response and pharmacokinetics of cisplatin instilled into the pleural cavity were studied in 11 patients with malignant pleural effusion; 10 patients had primary lung cancer and one had breast cancer. All of them were adenocarcinoma histologically. In five of the 11 patients effusion disappeared and its cytology became negative for malignancy after four weeks. In the other six patients effusion was reduced and its cytology became negative for malignancy after four weeks. Toxicity was almost similar to that in systemic administration of cisplatin but a few patients had chest pain and fever possibly due to local irritation. The pharmacokinetics showed that a high concentration of cisplatin (free-form, 48.9 micrograms/ml) was maintained over a long period (free from (t 1/2) beta = 33.6 hours) in the pleural cavity. This was regarded as the reason for the high response to this therapy. The intrapleural instillation of cisplatin into the pleural cavity therefore seems to be an effective modality for malignant pleural effusion.

[Phase II study of cis-dichlorodiammineplatinum (II) for non-small cell lung cancer]

A phase II study of cis-dichlorodiammineplatinum (II) (CDDP) was performed in 83 patients with inoperable non-small cell lung cancer (21 squamous cell carcinomas, 57 adenocarcinomas and 5 large cell carcinomas). CDDP was given by i.v. infusion at a dosage of 50 mg/m2 (low-dose regimen) or 80-100 mg/m2 (high-dose regimen) every 3 to 4 weeks. Seventy-nine out of 83 patients were evaluable for tumor response. Sixteen of these evaluable patients achieved complete or partial response, and the overall response rate was 20.3%. The response rates were 27.8% in patients with squamous cell carcinoma and 19.6% in those with adenocarcinoma. None of the patients with large cell carcinoma responded. The high-dose regimen was superior to the low-dose regimen in response rate (25.6% versus 5.8%). The responders survived significantly longer than patients with NC (p = 0.02) or PD (p = 0.003). Leukopenia of less than 3000/mm3 occurred in 12.1% of cases, and thrombocytopenia of less than 7 X 10(4)/mm3 occurred in 7.6%. A transient elevation of serum creatinine value was observed in 9 patients (10.8%). Moderate to severe nausea and/or vomiting occurred in almost all patients. It was therefore considered that CDDP was one of the most effective agents for non-small cell lung cancer with tolerable toxic effects.

Carcinoembryonic antigen (CEA) levels in pleural effusions and sera of lung cancer patients

For determining the value of carcinoembryonic antigen (CEA) levels in diagnosis of malignant tumors of the lung, the CEA levels in 187 specimens of pleural fluid and sera obtained simultaneously from patients with pleural fluid were measured. In all 70 patients with benign diseases, the CEA levels in the effusions were less than the cut-off value of 5 ng/ml (mean +/- SD: 1.44 +/- 1.01 ng/ml). In contrast, in 88 of 117 patients (75.2%) with malignant diseases, the CEA levels in the effusions were over 5 ng/ml (25.3 +/- 24.5 ng/ml) and in 58 of the 117 patients (50.4%), the CEA levels in the serum were values of 5 ng/ml or more (11.9 +/- 18.4 ng/ml). There was a significant correlation between the CEA levels in the effusions and in the sera. The CEA levels in effusions in patients with malignant lung tumors were usually much higher than those in their sera. The incidence of CEA levels of 5 ng/ml or more in both the serum and effusion was highest in the patients with adenocarcinoma. These data indicate that determination of the CEA level in effusions, when done in combination with cytological examinations, may have additional value in diagnosis of lung cancer.