[A case of recurrent colon cancer treated markedly effective with 5'-DFUR]

A 71-year-old male with recurrent colon cancer was admitted to our hospital with obstructive jaundice. Virchow's node metastasis was palpable in his neck. The enlarged intraabdominal lymphnodes due to recurrence and liver metastasis were demonstrated on computed tomography. Bile duct obstruction was treated by expandable metallic biliary endoprosthesis. 5'-DFUR (5'-deoxy-5-fluorouridine) was administered orally at 600 mg daily. Virchow's node metastasis completely disappeared by 46 days after administration of 5'-DFUR. The enlarged intraabdominal lymphnodes and liver metastasis disappeared on computed tomography. No significant side effects from 5'-DFUR were encountered for 18 months. 5'-DFUR appears to be a useful and safe treatment for recurrent colon cancer.

Expression of a novel human homeobox-containing gene that maps to chromosome 7q36.1 in hematopoietic cells

A homeobox is a DNA sequence of 180 base pairs that encodes a DNA-binding domain known as a homeodomain. The polymerase chain reaction (PCR) has been used to prepare probes of homeobox-containing genes. We cloned and sequenced the amplified products of PCR that was performed with human genomic DNA and two primers that correspond to well-conserved regions in homeoboxes. Fifteen kinds of homeobox gene were identified and 13 of them were assigned to HOX genes that have already been reported. Two others represented novel homeobox genes and one of them, GBX1, was mapped to chromosome 7q36.1 by fluorescence in situ hybridization. Northern hybridization of mRNA for various kinds of hematopoietic cell showed that the newly identified GBX1 gene is expressed in K562 cells and Daudi cells.

Cephalosporins having a heterocyclic catechol in the C3 side chain. I. Enhancement of efficacy against gram-negative bacteria

Two groups of cephalosporins substituted with a variety of heterocyclic catechols in the C3 side chain were synthesized. One is a group of 3-(heterocyclic catechol-substituted methyl)cephalosporins and another is 3-[(E)-3-heterocyclic catechol-substituted 1-propen-1-yl]cephalosporins. Cephalosporins in the latter group showed higher in vivo efficacies than those in the former group having the same heterocyclic catechol, especially against Pseudomonas aeruginosa A9843A, although there was no significant difference between their in vitro activity. Among the latter group, the 5,6-dihydroxybenzimidazole derivative (6e) and the 2,6-dihydro-7-hydroxy-6-oxo- isoquinoline derivative (6b) showed much higher activity than ceftazidime (CAZ) and imipenem (IPM) against P. aeruginosa A9843A both in in vitro and in vivo studies.

Ganglions and ganglionic neurons in the cat's larynx

Localization, projections and role of ganglia and ganglionic neurons in the laryngeal framework were demonstrated in cats. Six to 8 large size ganglia containing 50 to 80 ganglionic neurons per ganglion in the paraglottic space, 4 to 6 small ganglia involving 5 to 25 cells in each ganglion dorsal to the posterior cricoarytenoid muscle, and 1 to 3 small ganglia including 15 to 25 perikarya per ganglion around the inferior laryngeal nerve were observed. Each ganglion showed spindle shaped covering fibrous capsule. Ganglionic neurons totaling 600 to 800 were oval shaped with an average diameter of 25 microns. Projections of the ganglionic neurons to the superior cervical ganglion (SCG) and nodose ganglion (NG) through the ipsilateral internal branch of the superior laryngeal nerve and to periphery were detected. From the dorsal motor nucleus of vagus, SCG and NG, the ganglionic cells received projections ipsilaterally. On immunocytochemistry many vasoactive intestinal polypeptide (VIP)-immunoreactive (ir) neurons, some neuropeptide Y (NPY)- and tyrosine hydroxylase (TH)-ir neurons and a few substance P (SP)-ir cells were recognized in ganglions. VIP-, NPY-, TH-, SP-, and calcitonin gene-related peptide (CGRP)-ir fibers were also observed in and around vessels and glands. Following denervation, VIP-, NPY- and TH-ir neurons and fibers did not change. These results prove that laryngeal ganglionic neurons have endogenic autonomic, especially cholinergic nature and innervate vessels and glands.

Ca2+ transients and cell shortening in diabetic rat ventricular myocytes

To investigate the role of abnormal Ca2+ metabolism in the diminished contractile function of diabetic myocardium, we measured the Ca2+ transients and cell contraction of diabetic rat myocytes. Isolated diabetic (8 weeks after 40 mg/kg streptozotocin, i.v.) and normal myocytes were loaded with acetoxymethyl ester of indo-1 (indo-1/AM). Ca2+ transients and cell circumferential shortening were measured simultaneously, using high temporal resolution video image analysis. The diastolic base and systolic peak of Ca2+ transients were significantly lower in diabetic myocytes than in normal myocytes (peak ratios: 0.49 +/- 0.02 vs 0.56 +/- 0.01, p < 0.05; base ratios: 0.43 +/- 0.01 vs 0.48 +/- 0.01, p < 0.01, Mean +/- SE). The cell circumferential shortening of diabetic myocytes was also significantly lower than that of normal myocytes (2.9 +/- 0.3% vs 5.2 +/- 0.9%, p < 0.05). Although isoproterenol (10(-8) and 10(-7) M) increased the peak of Ca2+ transients in both diabetic and normal myocytes, the peak value of Ca2+ transients in the diabetic group was significantly lower than that in the normal group. The decreased Ca2+ transients may be responsible for the decreased contractile function in diabetic myocardium.

Factors contributing to labyrinthine ataxia

Twenty-one normal adults were the subjects of this study. They were instructed to step in the same position with eyes closed for a total of 50 steps under two conditions: i) Immediately after simultaneous irrigation of the right and left auditory canals for 10 s with 30 degrees C water and 44 degrees C water, respectively, and ii) following irrigation of the right auditory canal with 30 degrees C water. The two conditions simulate two different types of imbalance of labyrinthine function: The former physiological and the latter non-physiological. Under the first condition, 33% of the subjects tended to fall to the right side during stepping. Under the second conditions, 86% showed ataxia. The difference was statistically highly significant, p < 0.01. The results indicate that physiological imbalance does not always cause ataxia. A physiological imbalance occurs during active turning. The motion brings about an ampullopetal lymphatic flow in the ipsilateral horizontal semicircular canal and an ampullofugal flow in the contralateral canal, as under the second condition. The former increases the function of the labyrinth, while the latter decreases it. This results in imbalance but no ataxia.

Pradimicins T1 and T2, new antifungal antibiotics produced by an actinomycete. I. Taxonomy, production, isolation, physico-chemical and biological properties

Pradimicins T1 and T2, new members of the pradimicin family of antibiotics, were produced by an actinomycete strain AA3798. Pradimicin T1 exhibited potent activity against a wide spectrum of fungi in vitro and demonstrated efficacy against systemic Candida albicans and Aspergillus fumigatus infections in mice.

Treatment of adult T-cell leukemia/lymphoma with MST-16, a new oral antitumor drug and a derivative of bis(2,6-dioxopiperazine). The MST-16 Study Group

BACKGROUND

MST-16, a new orally administered bis(2,6-dioxopiperazine) analogue and an inhibitor of topoisomerase II, was given to 24 patients with adult T-cell leukemia-lymphoma (ATLL) in a Phase I-II multi-institutional cooperative study.

METHODS

MST-16 was administered orally daily for 7 days, with courses repeated at intervals of 2-3 weeks in 24 patients.

RESULTS

Two complete remissions (CR) and eight partial remissions (PR) were obtained in 23 evaluable patients who received 1200-2800 mg/day of MST-16. Among 13 acute-type ATLL, one CR and five PR were obtained. Among eight lymphoma-type ATLL, two PR were detected. Among two chronic-type ATLL, one CR and one PR occurred. Remissions were obtained at 7-232 days (median, 23 days) and lasted 43-374 days (median, 68 days). The major toxic effects were leukopenia (68%), anemia (52%), thrombocytopenia (35%), and gastrointestinal disorders (22%).

CONCLUSIONS

MST-16 was shown to be effective in ATLL, which has no standard therapy. This drug deserves further clinical trials because it shows little cross resistance to currently available antitumor drugs.

Autologous BMT in high risk patients with CALLA-positive ALL: possible efficacy of ex vivo marrow leukemia cell purging with monoclonal antibodies and complement

Autologous BMT (auto-BMT) has been conducted for 17 high-risk common ALL antigen (CALLA)-positive non-T cell type ALL patients. Ex vivo purging of leukemia cells from infused BM cells was performed using complement and three kinds of mouse monoclonal antibodies reactive to CALLA-positive leukemia cells: NL-1 (IgG2a), NL-22 (IgM), and HL-47 (IgM). Minimal residual leukemia cells in BM were examined by PCR method in Philadelphia chromosome (Ph1)-positive ALL cases. BCR/ABL chimeric transcript, which was positive in BM samples before purging, was shown to be absent after ex vivo purging in all three cases tested. Among four Ph1-positive cases transplanted in first CR, three cases survived in CR remission 77, 29 and 26 months after BMT, and one case died without relapse 4 months after BMT. The other four Ph1-negative cases transplanted in the first CR also remained in CR except one who relapsed. The results of minimal residual leukemia cell studies and clinical data indicate the effectiveness of our ex vivo leukemia cell purging method and auto-BMT in the early stage of CR for patients with high risk ALL.

Nucleotide sequence of the Mn-stabilizing protein gene of the thermophilic cyanobacterium Synechococcus elongatus

The nucleotide sequence of the psbO gene encoding the extrinsic 33 kDa protein (the Mn-stabilizing protein) from the thermophilic cyanobacterium Synechococcus elongatus was determined. The deduced amino acid sequence consisted of 272 residues; 26 for the signal peptide and 246 for the mature protein. The amino acid sequences of nine proteolytic peptides from the isolated protein completely agreed with the deduced amino acid sequence. Several unique variations of amino acids were found in the primary structure, of which some may be related to the high thermostability of the protein.

Phorbol ester-induced monocytic differentiation is associated with G2 delay and down-regulation of cdc25 expression

Treatment of human U-937 myeloid leukemia cells with 12-O-tetradecanoylphorbol-13-acetate (TPA) is associated with growth arrest and induction of monocytic differentiation. The present results demonstrate that exposure of G1- or S phase-enriched U-937 cells to TPA was associated with delayed transition through G2-M and then exit from the cell cycle in the subsequent G0-G1 phase. In contrast, G2-M cells treated with TPA progressed through G1-S, were delayed in the next G2-M phase, and then entered a nonproliferative G0-G1 state. The effects of TPA on expression of cell cycle control genes demonstrated down-regulation of the cdc25 mitotic inducer during S-G2 progression. In order to investigate the role of cdc25 in the control of cell cycle progression, U-937 cells were stably transfected with an antisense cdc25 construct under control of a metallothionein-inducible promoter. Expression of this construct in G1 phase cells was associated with a significant delay in transition through S and G2-M phase. Similar results were obtained when G1 phase cells were incubated with a 14-base pair antisense cdc25 oligomer. Taken together, these results indicate that the cdc25 gene product is functionally associated with S-G2 transition of proliferating myeloid leukemia cells and that down-regulation of this gene by TPA is associated with G2-M delay.

Treatment of myelodysplastic syndromes with all-trans retinoic acid. Leukemia Study Group of the Ministry of Health and Welfare

We treated 23 patients with myelodysplastic syndromes (MDS); 2 refractory anemia (RA) with prior therapy, 11 RA with excess of blasts (RAEB), and 10 RAEB in transformation (RAEB-T), with daily oral 45 mg/m2 all-trans retinoic acid (ATRA) in a multiinstitutional prospective study. In two patients with RAEB and one with RAEB-T, a more than 1,000/microL increase of peripheral neutrophil counts was observed with some reduction of blast percentage in the bone marrow 2 to 9 weeks after the start of ATRA. However, the effect was transient and did not last for more than 5 weeks despite the continuation of ATRA therapy. In one other patient with RA, one patient with RAEB, and one patient with RAEB-T, slight increase of hemoglobin levels or reduction of blast percentage in bone marrow was noted. Toxicities attributable to ATRA were minimal and included cheilitis, xerosis, dermatitis, gastrointestinal disorders, abnormal liver function tests, and high serum triglyceridemia. Although ATRA works remarkably as a differentiation therapy in acute promyelocytic leukemia, its effect in MDS included in this study was modest. Further study of this agent alone or in combination may be warranted in less advanced stages of this disease.

Vocal cord paralysis caused by esophageal cancer surgery

Esophageal cancer surgery was the cause of paralysis in 111 (16.7%) of 664 patients with vocal cord paralysis seen from 1981 to 1990 at Kurume University Hospital. Eighty-six patients had unilateral paralysis, whereas 25 had bilateral lesions. Of the 111, 95 (86%) had hoarseness and 59 (53%) had aspiration. The crude survival rate was 63% for 1-year, 32% for 3-year, and 22% for 5-year follow-up. The average life expectancy was short. The general condition was poor in many patients. Thirty-four of the 136 paralytic vocal cords (25%) recovered mobility. An intracordal silicone injection was done in 30 patients, and a medialization procedure was performed in 1. The vocal function was improved in the majority of cases. In 4 patients, severe aspiration persisted following intracordal injection. Of the 4, 1 had cricopharyngeal myotomy and laryngeal suspension and 2 underwent total laryngectomy. The fourth patient died of aspiration pneumonia. The results of the review of the 111 patients have led us to the following treatment policy for patients with vocal cord paralysis caused by esophageal cancer surgery. When the patient has aspiration, vocal cord medialization should be performed as early as possible. If severe aspiration persists even after the medialization procedure, some additional intervention, including cricopharyngeal myotomy, laryngeal suspension, laryngotracheal separation, or total laryngectomy, should be considered. When hoarseness is the only major problem, the prognosis of vocal cord paralysis should be determined on the basis of the state of the recurrent laryngeal nerve and, if available, electromyography findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Synthesis and antifungal activities of pradimicin A derivatives modification of the alanine moiety

Chemical modifications of the carboxyl group in the alanine moiety of pradimicin A were performed and in vitro and in vivo antifungal activities of the derivatives were examined in comparison with those of pradimicin A. The amide derivatives showed activities comparable to pradimicin A, indicating that the free carboxyl group can be modified without impairing the antifungal activity.

Pradimicins FS and FB, new pradimicin analogs: directed production, structures and biological activities

Exogenous addition of D-serine to Actinomadura spinosa AA0851 resulted in directed production of pradimicin FS, a new D-serine analog of pradimicin S, together with pradimicin FB. Pradimicin FS was produced in higher yields by derivation of ferrous sulfate-resistant strains from strain AA0851. Pradimicin FB, a minor product, was identified as deglucosylpradimicin FL. Pradimicin FS was equivalent to pradimicin S in syncytium formation inhibition activity and in vitro and in vivo antifungal activities.

Small subunits of Photosystem I reaction center complexes from Synechococcus elongatus. I. Is the psaF gene product required for oxidation of cytochrome c-553?

Photosystem I (PS I) reaction center complexes isolated from the thermophilic cyanobacterium Synechococcus elongatus with nonionic detergents, digitonin or sucrose monolaurate, contained eight small subunit polypeptides. Two of the small polypeptides were identified by analysis of their N-terminal amino-acid sequences as the psaF and psaE gene products. Treatment with a cationic detergent, cetyltrimethylammonium bromide, resulted in depletion of five small subunits including the psaF gene product. Five PS I complexes isolated with an anionic detergent, sodium dodecylsulfate, contained zero to four small subunits but were all depleted of the psaF polypeptide. The function of the psaF gene product was examined by measuring reduction kinetics of flash-oxidized P-700 in the presence of different concentrations of cytochrome c-553. Oxidized P-700 was rapidly reduced by the reduced cytochrome in all the PS I complexes that contained, at least, the psaC and psaD polypeptides and the second-order rate constants of electron transfer from cytochrome c-553 to P-700 were essentially the same between PS I complexes that contained the psaF polypeptide and those that lost this polypeptide. Thus, the psaF polypeptide is not required for the bimolecular reaction between P-700 and cytochrome c-553. Mg2+ had a moderate stimulating effect on the rate of P-700 reduction whether PS I complexes were associated with the psaF gene product or not. The function of this subunit polypeptide is discussed.

Laser surgery for epithelial hyperplasia of the vocal fold

A total of 88 patients with epithelial hyperplasia of the vocal fold were treated with endolaryngeal microscopic carbon dioxide laser surgery during the period from 1978 to 1990. The majority of the patients were male smokers. During the follow-up period ranging from 12 to 156 months, 15 patients developed recurrence(s). The recurrent lesion was benign epithelial hyperplasia in 8 patients and invasive carcinoma in 7 patients. The recurrences occurred only in preoperative smokers. Discontinuation of smoking following laser surgery did not affect the incidence of recurrence. The incidence of development of carcinoma did not differ between two histologic types: simple hyperplasia without cellular atypia and dysplasia associated with cellular atypia. The incidence of cancer development for dysplasia cases in the present series (6%) was lower than that in previous reports in which the carbon dioxide laser was not employed for the treatment. Postoperative improvement of vocal function was manifested in an increase of the maximum phonation time, a decrease of the mean airflow rate, and an increase in vibratory amplitude and mucosal wave.

Hepatic arterial and portal venous oxygen content and extraction in liver cirrhosis

We examined the oxygen content in the hepatic arterial, hepatic venous and portal venous blood to evaluate the oxygen supply to the liver and hepatic oxygen extraction in cirrhosis. The arterial-portal venous difference of the oxygen content was within the normal range in cirrhosis patients, although the oxygen content of the hepatic artery and portal vein was lower than in the control patients. The hepatic venous oxygen content was normal in the cirrhosis patients. The oxygen tension and saturation were always higher in the splenic vein than in the other branches of the portal system. Oxygen was supplied chiefly by the hepatic artery, and arterial oxygen extraction was normal in cirrhosis. In addition, there was no change in arterial extraction during oxygen inhalation by cirrhosis patients. Portal venous oxygen extraction was decreased in cirrhosis and was increased by oxygen inhalation. These findings indicate the autoregulation of hepatic oxygen through a mutual relationship between the hepatic arterial and the portovenous oxygen supply.

Enhancement by captopril of bradykinin-induced calcium transients in cultured endothelial cells of the bovine aorta

Using microscopic fluorometry and fura-2-loaded cultured bovine aortic endothelial cells, we determined the effects of captopril, an angiotensin converting enzyme (ACE) inhibitor, on bradykinin-induced Ca2+ transients in endothelial cells. In the presence of extracellular Ca2+, 10(-9) M bradykinin induced an early rise in the transients followed by sustained elevations of cytosolic calcium concentration ([Ca2+]i). Bradykinin concentration-dependently increased [Ca2+]i (EC50 6.7 x 10(-9) M). Captopril, 10(-5) M, enhanced and prolonged the bradykinin-induced Ca2+ transients and shifted the concentration-response curve to the left (EC50 8.5 x 10(-10) M). In porcine coronary aterial strips with intact endothelium, cumulative applications of bradykinin induced an endothelium-dependent relaxation during prostaglandin F2 alpha-induced contraction (EC50 = 2.0 x 10(-9) M). Treatment with 10(-5) M captopril enhanced the bradykinin-induced relaxation and shifted the concentration-response curve to the left (EC50 = 7.6 x 10(-10) M). Thus, captopril enhances the bradykinin-induced relaxation by mechanisms mainly dependent on the endothelium, namely the inhibition of ACE.

Atypical clinical presentations associated with the MELAS mutation at position 3243 of human mitochondrial DNA

Mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) is commonly associated with an A-->G transition at position 3243 of the mitochondrial DNA. To determine the diversity of clinical syndromes associated with this mutation, 91 patients with mitochondrial encephalomyopathies that did not conform to the MELAS phenotype were screened. Twenty one patients with the 3243 mutation, most of whom had progressive external ophthalmoplegia (PEO) were found. Clinical features did not distinguish PEO patients with the 3243 mutation from those with large-scale deletions of mtDNA. However, most cases with single large-scale mtDNA deletions were sporadic, whereas most patients with the 3243 mutation had affected maternal relatives. Histochemical studies of muscle showed that cytochrome c oxidase (COX) deficiency was more severe in patients with PEO than in patients with typical MELAS, even though PEO patients had a lower percentage of mutant genomes in muscle. These data imply that the 3243 mutation is a major cause of familial PEO, and suggests that the threshold number of mtDNAs harboring the 3243 mutation necessary to affect a particular tissue vary in different patients. The proportion of mutant genomes in combination with other, still undefined, tissue-specific modulating factors seem to determine the overall clinical syndrome.

Phase II study of NK313 in malignant lymphomas: an NK313 Malignant Lymphoma Study Group trial

Liblomycin (NK313) is a bleomycin analog that has proved to be associated with less pulmonary toxicity and with more potent antitumor activity than bleomycin in animal tumors. In a phase I study, pulmonary toxicity was not observed, whereas myelosuppression was the dose-limiting factor. The maximum tolerated dose was 140 mg/m2 given once a week for 4 weeks. In the present phase II study, patients with malignant lymphomas received liblomycin at 80 or 100 mg/m2 by intravenous infusion over 15 min once a week for 4 weeks. A total of 39 patients were entered, and 31 [4 with Hodgkin's disease (HD) and 27 with non-Hodgkin's lymphoma (NHL)] were evaluable. The median age of the patients was 52 years (range, 22-74 years), and their performance status ranged from 0 to 3. In all, 28 of the patients had a history of intensive anticancer chemotherapy. Responses were evaluated according to WHO criteria. We obtained 1 complete remission and 9 partial remissions (PRs), for an overall response rate of 37%, in the 27 patients with NHL, whereas 1 PR was achieved in the 4 patients with HD. In all, 9 PRs (32.1%) were obtained in patients who had been exposed to prior chemotherapy, including 4 PRs (33.3%) in 12 patients who had previously been treated with bleomycin. Myelosuppression and nausea and vomiting were the major toxicities, which occurred in about 50% of the patients, and myelosuppression was severe in two patients treated at a dose of 100 mg/m2. We concluded that liblomycin demonstrated significant antitumor activity against malignant lymphomas.

Localization of proliferating cell nuclear antigen in aural cholesteatoma

Middle ear cholesteatoma is not a genuine tumor but has a remarkable proliferative activity which causes serious destruction of the mastoid bone. In the present study, we used immunohistochemistry with antiproliferating cell nuclear antigen (PCNA) antibody on cholesteatomatous tissues to evaluate the localization of PCNA, as it has been said that PCNA is a very available protein for showing cell proliferative activity. Moderately concentrated PCNA was demonstrated within the germinal basal layer cells of the cholesteatomatous epithelium in three of eight surgical specimens. Furthermore, in one case of very active osteolytic cholesteatoma, PCNA activity was demonstrated in the mesenchymal cells, probably fibroblast-like cells, in direct contact to the destroying mastoid bone lesions. Although the etiology and histopathology of the invasive and proliferative activity of middle ear cholesteatomatous tissues are unclear, this observation suggests that immunohistopathological examination using PCNA antibody might be a useful tool for evaluating bone resorption activity and for establishing the prognosis of various types of cholesteatoma.