Diagnosis of zygosity by questionnaire and polymarker polymerase chain reaction in young twins

We developed a zygosity questionnaire for use in young twins and assessed its validity using the results of DNA diagnosis. The participants were divided into two groups: 105 pairs of adolescent twins (12-16 years old), 47 pairs of child twins (2-12 years old), and their respective parents. The DNA diagnosis of zygosity was made with polymarker polymerase chain reaction (PCR) amplification of five loci, using the AmpliType PM PCR Amplification and Typing Kit; this method has an accuracy rate of 99.0%. A parsimonious model for each sample was established using stepwise logistic regression analysis of the 20 items of the questionnaire. The total accuracy rate of the model was satisfactory for both parental reports (three items) and self-reports (three items) of adolescent twins (97.4 and 95.6%, respectively), while that for parental reports on child twins (two items) was less satisfactory (92.5%). For adolescent twins, if DNA diagnostic workups were limited to those with discordant reports either from themselves or from their parents, the accuracy rate increased to 100% for parental reports and 98% for self-reports.

Primary oral squamous cell carcinoma: an analysis of 703 cases in southern Taiwan

We retrospectively analyzed the records of 703 cases of oral squamous cell carcinoma (SCC) collected from 1 January 1985 to 31 December 1996 at a teaching hospital in southern Taiwan, to identify the characteristics of patients and factors associated with survival. There was an overwhelming male predominance (male:female = 15:1). The mean age of the patients was 52. The peak age of oral SCC patients declined from 50 to 59 years in the first six years (1985-1990) and 40-49 years in the last six years (1991-1996). The most common site of oral SCC was the buccal mucosa with 263 patients (37.4%). Most patients (346/703 patients; 49.2%) had stage III cancer. The most common site of occurrence of SCC was the buccal mucosa (263/703 patients; 37.4%), both overall and in patients who chewed betel quid alone or in combination with cigarette smoking and/or alcohol consumption; the tongue was the most common site among patients without any oral habits (18/48 patients; 37.5%). Furthermore, the age of occurrence was on average 6-12 years younger among patients who chewed betel quid than in those who did not. Of the 703 patients, 496 received treatment with surgery, chemotherapy, and/or radiation therapy. Of these, 209 (42.1%) died. The cancer stage significantly influenced mortality: the 5-year survival rate in patients treated from 1985 to 1991 was 72% in those with stage I, 38.9% in those with stage II, 26.7% in those with stage III, and 11.8% in those with stage IV cancer. Six variables were found to significantly affect survival: tumor size, lymph node involvement, surgery, betel quid chewing, staging, and histological differentiation (all p < 0.05, Kaplan-Meier analysis with log rank test). Of these, surgery and cancer stage independently affected survival in a proportional hazards model (both p < 0.0001). Therefore, the early surgical intervention, and the withdrawal from oral habits, especially betel quid chewing, will be advantageous to patients' survival.

Difference in the effects of radioprotection between aerial and root parts of Lycium chinense

Radiation protection from bone marrow death by consecutive injections of crude extracts from different parts of Lycium chinense (LC), root (LCR) and aerial part (LCA), before whole body X-irradiation was confirmed by tests with ICR strain mice. Both extracts were effective after intraperitoneal injection of a high dose, once a day, for seven consecutive days before irradiation. Based on the studies of endogenous hematopoietic spleen colony formation (CFUs), and the postirradiation behavior of hematograms and hematocrits, it was demonstrated that the LCR protects mice more effective when given in a dose of 500 mg/kg. Enhanced CFUs was found in the irradiation range of 4-8 Gy by various treatments. Recovery of leukocyte, erythrocyte and thrombocyte counts was significantly stimulated by the extract of LCR with 500 mg/kg administration. Stimulated recovery by the extract from the LCR was also observed in hematocrit. On the contrary, the extracts of both LCA and LCR did not markedly affect recovery of leukocyte, erythrocyte, thrombocyte counts and hematocrits by 250 mg/kg administration. It could be deduced that the uncertainly radioprotective action is induced by a possible process of enhanced regeneration of the hematopoietic stem cells due to either enhanced postirradiation repair or an increased proliferation of the hematopoietic stem cells under the suitable extract administration.

A quantitative model for designing keyboard layout

This study analyzed the quantitative relationship between keytapping times and ergonomic principles in typewriting skills. Keytapping times and key-operating characteristics of a female subject typing on the Qwerty and Dvorak keyboards for six weeks each were collected and analyzed. The results showed that characteristics of the typed material and the movements of hands and fingers were significantly related to keytapping times. The most significant factors affecting keytapping times were association frequency between letters, consecutive use of the same hand or finger, and the finger used. A regression equation for relating keytapping times to ergonomic principles was fitted to the data. Finally, a protocol for design of computerized keyboard layout based on the regression equation was proposed.

Effects of SCH 59228, an orally bioavailable farnesyl protein transferase inhibitor, on the growth of oncogene-transformed fibroblasts and a human colon carcinoma xenograft in nude mice

The products of the Ha-, Ki-, and N-ras proto-oncogenes comprise a family of 21 kDa guanine nucleotide-binding proteins which play a crucial role in growth factor signal transduction and in the control of cellular proliferation and differentiation. Activating mutations in the ras oncogenes occur in a wide variety of human tumors. Ras proteins undergo a series of posttranslational processing events. The first modification is addition of the 15-carbon isoprene, farnesyl, to a Cys residue near the carboxy-terminus of Ras. Prenylation allows the Ras oncoprotein to localize to the plasma membrane where it can initiate downstream signalling events leading to cellular transformation. Inhibitors of the enzyme which catalyzes this step, farnesyl protein transferase (FPT), are a potential class of novel anticancer drugs which interfere with Ras function. SCH 59228 is a tricyclic FPT inhibitor which inhibits the farnesylation of purified Ha-Ras with an IC50 of 95 nM and blocks the processing of Ha-Ras in Cos cells with an IC50 of 0.6 microM. SCH 59228 has favorable pharmacokinetic properties upon oral dosing in nude mice. The in vivo efficacy of SCH 59228 was evaluated using a panel of tumor models grown in nude mice. These included several rodent fibroblast lines expressing mutationally-activated (val12) forms of the Ha-Ras oncogene. In some cases, these proteins contain their native C-terminal sequence (CVLS) which directs farnesylation. In one model, the C-terminal sequence was altered to CVLL, making the expressed protein a substrate for a distinct prenyl transferase, geranylgeranyl protein transferase-1. When dosed orally at 10 and 50 mg/kg (four times a day, 7 days a week) SCH 59228 significantly inhibited tumor growth of cells expressing farnesylated Ha-Ras in a dose-dependent manner; over 90% growth inhibition was observed at the 50 mg/kg dose. Tumor growth of cells expressing the geranylgeranylated form of Ha-Ras was less potently inhibited. Growth of tumors derived from a rodent fibroblast line expressing activated Ki-Ras containing its native C-terminal sequence (CVIM), which preferentially directs farnesylation, was also inhibited by SCH 59228. Inhibition in the Ki-Ras model was less than that observed in the Ha-Ras model. In contrast, tumors derived from cells transformed with the mos oncogene were not significantly inhibited even at the highest dose level. SCH 59228 also significantly and dose-dependently inhibited the growth of human colon adenocarcinoma DLD-1 xenografts (which express activated Ki-ras). These results indicate that SCH 59228 possesses in vivo antitumor activity upon oral dosing in tumor models expressing activated ras oncogenes. This is the first report of oral antitumor activity with an FPT inhibitor. These results are discussed in light of recent observations on alternative prenylation of some Ras isoforms.

Demonstration of the capabilities of a parallel high performance liquid chromatography tandem mass spectrometry system for use in the analysis of drug discovery plasma samples

There is a continuing need for increased throughput in the evaluation of new drug entities in terms of their pharmacokinetic (PK) parameters. This report describes an alternative procedure for increasing the throughput of plasma samples assayed in one overnight analysis: the use of parallel high performance liquid chromatography (HPLC) combined with tandem mass spectrometry (parallel LC/MS/MS). For this work, two HPLC systems were linked so that their combined effluent flowed into one tandem MS system. The parallel HPLC/APCI-MS/MS system consisted of two Waters 2690 Alliance systems (each one included an HPLC pump and an autosampler) and one Finnigan TSQ 7000 triple quadrupole mass spectrometer. Therefore, the simultaneous chromatographic separation of the plasma samples was carried out in parallel on two HPLC systems. The MS data system was able to deconvolute the data to calculate the results for the samples. Using this system, 20 compounds were tested in one overnight assay using the rapid rat PK screening model which includes a total of 10 standards plus samples and two solvent blanks per compound tested. This application provides an additional means of increasing throughput in the drug discovery PK assay arena; using this approach a two-fold increase in throughput can be achieved in the assay part of the drug discovery rat PK screening step.

Epidemiology of obesity in elderly people

Our study used data collected at Chung-Shing-Shin-Tseun community in Taiwan in May 1998 to evaluate the relationship between obesity and the cardiovascular and sociodemographic risk factors in elderly people. Individuals aged 65 and over were recruited as study subjects. A total of 1093 persons, out of 1774 registered residents, were contacted in face-to-face interview. The response rate was 61.6 percent. However only 586 respondents took blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. The chi-square analysis and multivariate logistic regression were used to study the significant correlates of obesity. Our results showed that 66 percent were men and 34 percent were women. The mean age was 73.1 +/- 5.3 years. The overweight proportions were 24.8 percent in elderly men and 29.7 percent in elderly women. The obesity proportions were 12.7 percent in elderly men and 11.5 percent in elderly women. After controlling the other covariates, the multivariate logistic regression analysis showed that overweight and obesity were associated with hypertension, hypertriglyceridemia, and hyperglycemia. In conclusions, the prevalence of overweight and obesity is high in Taiwanese elderly people. Thus, it is necessary to evaluate other metabolic disorders if one metabolic abnormality is observed.

Development of an automated mass spectrometry system for the quantitative analysis of liver microsomal incubation samples: a tool for rapid screening of new compounds for metabolic stability

There is a continuing need for increased throughput in the evaluation of new drug entities in terms of their pharmacokinetic parameters. One useful parameter that can be measured in vitro using liver microsomal preparations is metabolic stability. In this report, we describe an automated system that can be used for unattended quantitative analysis of liver microsomal samples for a series of compounds. This system is based on the Sciex API 150 (single quadrupole) liquid chromatography/mass spectrometry system and utilizes 96-well plate autosampler technology as well as a custom-designed AppleScript which executes the on-line data processing and report generation. It has the capability of analyzing at least 75 compounds per week or 300 compounds per month in an automated fashion.

Hypercholesterolemia and its correlates in Taiwanese elderly people

BACKGROUND

Our study used data collected in Chung-Shing-Shin-Tseun community in Taiwan in May 1998 to evaluate the relationship between hypercholesterolemia and the cardiovascular and sociodemographic risk factors in elderly people.

METHODS

Individuals aged 65 and over were recruited as study subjects. A total of 1,093 persons, out of 1,774 registered residents, were contacted in face-to-face interview. The response rate was 61.6 percent. However, only 586 respondents took blood tests and completed questionnaires. Analysis in this study was based on these 586 subjects. The t-test, chi-square analysis, and multivariate logistic regression were used to study the significant correlates of hypercholesterolemia.

RESULTS

Our results showed that 66 percent were men and 34 percent were women. The mean age was 73.1 +/- 5.3 years. The mean total cholesterol value was 5.1 +/- 1 mmol/l in elderly men and 5.5 +/- 1.3 mmol/l in elderly women. The proportions of hypercholesterolemia were 43.7 percent in elderly men and 59.6 percent in elderly women. After controlling the other covariates, the multivariate logistic regression analysis showed that the significant related factors of hypercholesterolemia were age, hypertriglyceridemia, and hyperuricemia. No significant association was found between hypercholesterolemia and gender, obesity, high systolic pressure, high diastolic pressure, hyperglycemia, educational level, retirement status, or marital status.

CONCLUSION

Hypercholesterolemia is significantly associated with hypertriglyceridemia and hyperuricemia in elderly people. It is important to determine other metabolic disorders if one metabolic disorder is disclosed.

Current concepts of fetal growth restriction: part II. Diagnosis and management

OBJECTIVE

To update diagnostic concepts and management strategies of fetal growth restriction (FGR).

DATA SOURCE

An English literature search was conducted for pertinent articles related to FGR from 1976 to 1997 including original research articles, review articles, and book chapters.

METHODS OF STUDY SELECTION

In part II, clinical studies involving both diagnostic and therapeutic approaches to the management of FGR were included. Throughout the study period, the evolution of concepts is demonstrated.

TABULATION, INTEGRATION, AND RESULTS

Diagnostic methods including two- and three-dimensional ultrasound for diagnosis of fetal structural abnormalities, organ volumetry, and estimating fetal weight are presented. Clinical tools to assess fetal well-being such as nonstress tests, contraction stress tests, biophysical profile scores, and Doppler blood flow velocimetry of fetal circulation and funicentesis are discussed. Correlations between these indirect fetal evaluations and fetal blood biochemical parameters obtained by funicentesis are also reviewed. Finally, various therapeutic approaches, especially timing of delivery of growth-restricted fetuses, are formulated.

CONCLUSION

We suggest that both diagnostic and therapeutic approaches to FGR should be modified. With the current development of technology, newly available three-dimensional ultrasound might offer more precise diagnostic data than conventional two-dimensional ultrasonography in the near future. From current concepts of pathophysiology of FGR, morphometric measurement abnormality alone should not be a basis for intervention. Combined use of morphometric measurements and functional evaluation tests and good clinical judgment using flexibility and individualization are the key elements in successful management of FGR.

Anti-inflammatory effects of Taiwan folk medicine 'Teng-Khia-U' on carrageenan- and adjuvant-induced paw edema in rats

'Teng-Khia-U' is a folk medicine from Taiwan, derived from the entire plants of Elephantopus scaber L., E. mollis H.B.K. and Pseudoelephantopus spicatus (Juss.) Rohr (Compositae). To evaluate the anti-inflammatory activities of these crude drugs, models with carrageenan-induced acute arthritis and complete Freund's adjuvant (CFA)-induced chronic arthritis in rats were conducted. The results indicated that pretreatment with 'Teng-Khia-U' significantly inhibited the carrageenan-induced acute arthritis. Moreover, they also significantly suppressed the development of chronic arthritis induced by CFA.

Global spiral patterns in galaxies: complexity and simplicity

A coherent exposition of the density wave theory of galactic spirals is presented in a recent monograph. It is centered on the working hypothesis of quasi-stationary spiral structure, a possibility first proposed by Bertil Lindblad. This hypothesis has since been found to be widely applicable in a number of physical contexts, including the explanation of the Hubble classification system and other categorical classes. Direct empirical support of this hypothesis has been provided especially by the regularity of the infrared images frequently observed in a number of galaxies (e.g., NGC 309), and by the observed amplitude modulation along the spiral arms (e.g., M51, M81, and NGC 1300). The present paper is a brief review of this theory with further clarification of the fundamentals and of certain specific issues raised in the literature. On the theoretical side, the likelihood for the validity of this hypothesis has been supported by modal studies. Emphasis is placed on the widely observed coexistence of a single regular structure in the Pop II objects and the more complex irregular structures in the Pop I objects, a contrast first discovered by Zwicky many years ago in the main disk of M51. It is pointed out that, in both barred and nonbarred spirals, this basic phenomenon may be understood by noting the fact that the microscale of the collisionless system of Pop II stars--i.e., the diameter of the epicycle--is typically on the same order of magnitude as the observed spacing between the spiral arms. The spiral pattern is thus a very compact structure which is unlikely to respond readily to internal and external disturbances of moderate magnitudes. This apparent robustness in structure is suggested by its observed regularity despite the impact from the coexisting Pop I objects with their strong irregular turbulent motions. This physical picture supports Oort's conjecture of a limited role for tidal interaction in most of the spiral structure of galaxies. It also enables us to place in proper perspective a controversy between two schools of thought, with different emphasis placed on intrinsic mechanisms and on tidal interaction. It is primarily a matter of applicability, or frequency of occurrence of the different scenarios proposed. There is, as yet, little observational evidence presented in the literature that would support the need of an interpretation of the global spiral structure in the galactic disk in terms of a fast evolving structure recently generated from a featureless initial state through tidal interaction. Dynamically, the likelihood for realizing such a scenario is also estimated to be quite low. The above discussions are placed in the context of a general point of view much advocated in current scientific literature; namely, the need to analyze alternative mathematical models for diverse physical contexts in the study of "complex" systems and to judge separately the merits of each model on the basis of its empirical confirmation in an appropriate physical context.

Cementless Roy-Camille femoral component

From 1984 to 1987, a complete, single-layered, porous-coated femoral component (Roy-Camille type) was used for primary cementless total hip replacement in 80 patients. Seventy-two patients (77 hips) with a minimal follow-up of 5 years (mean 7.2 years) were assessed clinically and radiographically. Thigh pain occurred in 4 hips. Osteolysis appeared in 5 hips. Cortical thinning around the femoral component was significant at the proximal and middle levels. In total, 6 femoral components failed, which led to reoperation due to aseptic loosening (4 hips) and septic loosening (2 hips). The hip rating score (modified d'Aubigne and Postel rating system) in the surviving hips progressed from 9.0 (range 6-10) preoperatively to 16.3 (range 12-18) points at the latest follow-up. From this study, we found that the complete, single-layered, porous-coated stem had a low loosening rate after 5 years. Bone ingrowth into the porous coating was found in most of the cases. A lower stress shielding effect in comparison with the complete, multi-layered, porous-coated prosthesis was also noted.

[Self-care behaviors, self-efficacy, and social support effect on the glycemic control of patients newly diagnosed with non-insulin-dependent diabetes mellitus]

The purpose of this study was to explore the glycemic control and influencing factors in outpatients newly diagnosed with non-insulin-dependent diabetes mellitus (NIDDM). By purposeful sampling, data were collected from 130 outpatients with NIDDM at one medical center in Kaohsiung. The results indicated: (1) the mean value for HbA1C was 7.12%; and 63.1% of the patients belonged to moderate to well controlled group; (2) male patient's HbA1C value was significantly lower than female patient's; patients with no religious belief also had a lower HbA1C value than patients with a religious background; (3) there were strongly negative correlations between self-care behaviors, social support, and self-efficacy and HbA1C; (4) using a multiple stepwise regression analysis, religious belief and self-care behaviors were found to explain 10.9% variance of HbA1C level. The results of this study could be used as a reference for diabetes health education program.

Gene transfer via pollen-tube pathway for anti-fusarium wilt in watermelon

In order to obtain transgenic fusarium wilt resistant watermelon plants, squash DNA was introduced into the ovaries of watermelon plants via the pollen-tube pathway. The introduction of foreign genes into ovaries was accomplished using co-transformation with the CaMV35S-GUS as a marker. Transformed watermelon plants contained integrated copies of the GUS activity and the seeds of transformed progeny produced a blue color when stained with 5-bromo-4-chloro-3-indolyl glucuronide, whereas seeds from untransformed control plants did not. Of 200 transformed seedlings, ten were wilt resistant. The presence of the GUS activity in the genome of stable transgenic seedlings was confirmed by Southern blot analysis. Furthermore, the generation of random amplified polymorphic DNA (RAPD) fingerprints using primers with embedded restriction sites showed amplification products unique to these transgenic plants. Primers OPA-1 and OPA-9 gave distinct band patterns of genomic DNA using the polymerase chain reaction.

Comparison of the effects of perceived self-efficacy on coping with chronic cancer pain and coping with chronic low back pain

OBJECTIVE

The purposes of this study were to explore the differences between chronic cancer pain and chronic low back pain with respect to (a) the use of coping strategies to manage pain and (b) the relationship between self-efficacy for attenuating pain and pain outcomes.

DESIGN

Descriptive correlational design.

PATIENTS

Eighty-five patients experiencing chronic low back pain (n = 85) and 88 patients with chronic cancer pain (n = 88) were recruited for this study.

OUTCOME MEASURES

Modified Coping Strategies Questionnaire, self-efficacy expectancies, and the Brief Pain Inventory.

RESULTS AND CONCLUSIONS

The major findings of this study were that (a) patients with chronic cancer pain reported significantly lower pain intensity and pain interference than did patients with chronic low back pain; (b) the most frequently used coping strategies were almost the same between the low back pain group and the cancer pain group; (c) for both chronic cancer pain and chronic low back pain groups, patients' perceived self-efficacy was significantly inversely correlated with pain intensity and pain interference with daily life; and (d) patients' use of coping strategies was positively correlated with pain intensity and pain interference with daily life. These findings were discussed in terms of implications for clinical practice and future research.

Current concepts of fetal growth restriction: part I. Causes, classification, and pathophysiology

OBJECTIVE

To update basic concepts and management strategies of fetal growth restriction (FGR).

DATA SOURCE

An English literature search was conducted for pertinent articles related to FGR from 1976 to 1997. Original research articles, review articles, and book chapters were reviewed.

METHODS OF STUDY SELECTION

This study was divided into two parts. For this article, both human data and animal data pertinent to understanding causative factors, pathogenesis, clinical type, and pathophysiology were included. To perform a meaningful comparison, the concept of investigators and their methods of investigation were critically compared between the two study periods: 1976-1985 and 1986-1997.

TABULATION, INTEGRATION, AND RESULTS

Older concepts involving basic principles of FGR based on animal models during the first study period were integrated with new research findings obtained from human FGR during the second study period. By comparative analysis of older animal data and new human data, current concepts of FGR were synthesized.

CONCLUSION

Fetal growth restriction affects a heterogenous group of infants. Despite development of new technology for investigation, many older basic concepts related to FGR are still fundamentally sound. However, new investigations directly performed on human fetuses are a useful expansion of the older concepts.

Risk factors for substance use disorders among inpatients with major affective disorders in Taiwan Chinese

An assessment of potential risk factors for substance use disorders was performed in 49 patients with major affective disorders in a general hospital acute care unit in Taiwan. The major depression patients were noted to have a higher prevalence of substance use disorder than bipolar disorder patients (p = 0.011). Those patients with substance use disorders were noted to be significantly male-predominated (p = 0.043), to have a later onset age of affective disorder (p = 0.009), and to have more visits to the emergency room in the recent one year (p = 0.009). The sedatives-hypnotics-anxiolytics was the most frequently used forms of drug abuse. The major depression patients had a significantly higher sedative-hypnotics-anxiolytics use disorder rate than the bipolar disorder patients (p = 0.001). All patients with alcohol use disorder were noted to have other substance use disorders as well. Fifty six percent of those patients with substance use disorder were polysubstance users. Eighty three percent of the male patients with substance use disorder had poly-substance use disorder.

Plasma alkaline phosphatase activity in children and adolescents

From February to June in 1996, there were 47,800 students for health examination in Taichung City, Taiwan. The population consisted of the first and fourth graders of primary schools and the first grader of junior high schools. We selected 3,452 healthy students for further study by two stage sampling. In this report, 52.5% of the students were boys, and 47.5% of the students were girls. The mean age of students was 9.9 +/- 2.4 years. Girls at age 7 and age 10 had higher activity of alkaline phosphatase than boys at the same age. The peak of alkaline phosphatase activity in girls occurred at age 10. Alkaline phosphatase activity was significantly related to weight-length index by multiple regression analysis (p < 0.05). Although clinical application as an obesity factor still needs further investigation, in the future it may be well to routinely check this enzyme when assessing childhood obesity.

A method to reduce response times in prehospital care: the motorcycle experience

This study compared the response times of a motorcycle and a standard ambulance in a congested urban emergency medical services (EMS) setting. The study was performed in Taipei, Taiwan, a densely populated urban area. A basic life support (BLS) motorcycle (without defibrillation capability) and an advanced life support (ALS) ambulance were based at three study hospitals and simultaneously dispatched when there was a perceived need for ALS ambulance transport. Over a 3-month period, prehospital personnel evaluated 307 medical and trauma emergencies. Time data were insufficient for analysis in 33 cases, leaving a study population of 274. Response times of the motorcycle and the ambulance were prospectively assessed and compared. During rush hours, the response times of the motorcycle and ambulance were 4.9+/-3.0 minutes and 6.3+/-3.4 minutes (P < .05), respectively, and in non-rush hours, 4.2+/-2.1 minutes and 5.1+/-2.5 minutes (P < .05), respectively. Using motorcycles to transport EMTs to the emergency scene significantly reduced response time compared with a standard ambulance in a congested urban setting. Large prospective studies are required to determine the impact on patient outcome of shorter EMS response times using motorcycles. EMS motorcycles appear feasible and deserve consideration to help expedite prehospital care in other systems in densely populated cities.

Anomalous pancreaticobiliary ductal union--an etiologic association of gallbladder cancer and adenomyomatosis

BACKGROUND/AIMS

Anomalous pancreaticobiliary ductal union (APBDU) has been proposed as a risk factor of gallbladder cancer. To clarify the frequency and the subtype distribution of APBDU in patients with gallbladder cancer and adenomyomatosis, a retrospective study was performed.

METHODOLOGY

The radiograms of endoscopic retrograde cholangiopancreaticography of 680 patients with well-documented biliary and pancreatic ducts from April 1992 to November 1996 were reviewed. The length of the common channel and insertion of the pancreatic duct and the bile duct were identified and recorded.

RESULTS

Gallbladder cancer and adenomyomatosis were identified in 8 and 12 patients, respectively. Patients with gallbladder cancer were significantly older (mean age: 66.5 years, p<0.01) than those with gallbladder adenomyomatosis (mean age: 42.7 years). APBDU was noted in 59 (8.7%) of 680 cases with complete pancreaticobiliary radiograms. Among them, 5 of 8 patients with gallbladder cancer coexisted with APBDU. Four (80%) belonged to the P-B type. Six of 12 patients with gallbladder adenomyomatosis had APBDU. Five (83.3%) belonged to P-B type.

CONCLUSIONS

Patients with gallbladder cancer and adenomyomatosis were frequently associated with APBDU. The close relationship and similar distribution of the P-B type of APBDU in both diseases suggest an etiologic association in various gallbladder diseases.

Antitumor activity of SCH 66336, an orally bioavailable tricyclic inhibitor of farnesyl protein transferase, in human tumor xenograft models and wap-ras transgenic mice

We have been developing a series of nonpeptidic, small molecule farnesyl protein transferase inhibitors that share a common tricyclic nucleus and compete with peptide/protein substrates for binding to farnesyl protein transferase. Here, we report on pharmacological and in vivo studies with SCH 66336, a lead compound in this structural class. SCH 66336 potently inhibits Ha-Ras processing in whole cells and blocks the transformed growth properties of fibroblasts and human tumor cell lines expressing activated Ki-Ras proteins. The anchorage-independent growth of many human tumor lines that lack an activated ras oncogene is also blocked by treatment with SCH 66336. In mouse, rat, and monkey systems, SCH 66336 has excellent oral bioavailability and pharmacokinetic properties. In the nude mouse, SCH 66336 demonstrated potent oral activity in a wide array of human tumor xenograft models including tumors of colon, lung, pancreas, prostate, and urinary bladder origin. Enhanced in vivo efficacy was observed when SCH 66336 was combined with various cytotoxic agents (cyclophosphamide, 5-fluorouracil, and vincristine). In a Ha-Ras transgenic mouse model, prophylactic treatment with SCH 66336 delayed tumor onset, reduced the average number of tumors/mouse, and reduced the average tumor weight/animal. In a therapeutic mode in which gavage treatment was initiated after the transgenic mice had developed palpable tumors, significant tumor regression was induced by SCH 66336 in a dose-dependent fashion. This was associated with increased apoptosis and decreased DNA synthesis in tumors of animals treated with SCH 66336. Enhanced efficacy was also observed in this model when SCH 66336 was combined with cyclophosphamide. SCH 66336 is presently being evaluated in Phase I clinical trials.

Gastric leiomyosarcoma mimicking a cystic tumor at the pancreatic tail--one case report

A 73 year-old female patient suffered from anemia and a palpable abdominal mass. Abdominal ultrasonography and magnetic resonance imaging revealed a lesion with papillary excrescences at the pancreatic tail. Endoscopic retrograde cholangiopancreatography showed a normal pancreatic duct, but a small submucosal tumor was found in the stomach incidentally. Laparotomy disclosed an exophytic tumor arising from the submucosal layer of the stomach. Pathology revealed a gastric leiomyosarcoma with remarkable liquefaction and cystic change. Gastric leiomyosarcoma can be so necrotic as to be mistaken for a cystic tumor. It is critically important to differentiate the peripancreatic cystic lesion because the treatment strategy is totally different.