Clinical significance of cortisone and cortisone/cortisol ratio in evaluating children with adrenal diseases

Cortisone is derived from the peripheral metabolism of cortisol and lacks biological activity. The rapid interconversion between cortisol and cortisone has been well established. The altered equilibrium between these steroids may regulate glucocorticoid activity in various tissues. We evaluated the serum levels of cortisol and cortisone, and the cortisone/cortisol ratio in ten children with adrenal diseases using reversed-phase high performance liquid chromatography. Children with hypoadrenalism exhibited a greater decrease in cortisol as compared with cortisone. Cortisone levels were higher than cortisol levels, and the cortisone/ cortisol ratio exceeded 1.0. Children with adrenal cancer exhibited normal or high values of cortisol, whereas cortisone levels were decreased and the cortisone/cortisol ratio was decreased to nearly zero. The ratio returned to normal after the excision of adrenal tumors. The simultaneous evaluation of cortisol, cortisone, and cortisone/cortisol ratio provides a clinical clue of adrenal diseases.

Analysis of pesticides in environmental water samples by solid-phase micro-extraction-high-performance liquid chromatography

Solid-phase micro-extraction (SPME) followed by high-performance liquid chromatography (LC) has been applied to analyze pesticides in water samples. A device interfaces SPME to the LC injection process by solvent extracting analytes from the fiber and then introducing the solvent into the LC injector. LC analysis with UV detection was performed first with a conventional column (4.6 mm I.D.). To enhance efficiency of SPME, three extraction conditions, stirring, temperature and salt concentration, were optimized. Subsequently, semi-microcolumn LC (1.5 mm I.D.) was evaluated for this method, giving lower detection limits and less solvent consumption. Detection limits were within Japanese regulatory limits for drinking water. The SPME-LC method was applied to real-world environmental water samples.

[Intrahepatic arterial infusion chemotherapy for the colon cancer patients with liver metastases--a comparison of arterial embolization chemotherapy versus continuous arterial infusion chemotherapy]

To compare the prognostic benefit between arterial embolization chemotherapy (AEC) and continuous arterial infusion chemotherapy (CAIC), we clinicopathologically examined 32 colorectal cancer patients with liver metastases. Seventy patients were treated with AEC, and 15 patients with CAIC. In the AEC regimen, either ADR or CDDP dissolved in Lipiodol was infused by the implanted reservoir every one to two months. Otherwise, for the CAIC regimen, 360 mg/m2/day of 5-FU was continuously infused by the reservoir for 14 days. Subsequently, on day 22 after the initial 5-FU infusion, 180 mg/m2/day of 5-FU was continuously infused for 7 days. After a 7-day interval without infusion, 180 mg/m2/day of 5-FU was infused for 7 days. This 7-day infusion/7-day no-infusion cycle was repeated. The efficacy of the AEC was 6% (1 PR + 7 NC + 9 PD), CAIC (6 PR + 4 NC + 5 PD), suggesting that CAIC provides the better response rate. With regard to prognosis, the 1- and 2-year survival rates of AEC were 63% and 19%, respectively. The median survival time was 415 days. Otherwise, the 1- and 2-year survival with CAIC was 54% and 40%, respectively, and the median survival time was 470 days. No significant difference between the AEC and the CAIC was observed in the colorectal cancer patients with liver metastases.

Analysis of anxiolytic drugs by capillary electrophoresis with bare and coated capillaries

The analysis of anxiolytic drugs, including barbiturates and benzodiazepines, by CE with bare and coated capillaries was investigated. Two types of CE modes, capillary zone electrophoresis (CZE) and micellar electrokinetic chromatography (MEKC) were employed for the separation of the solutes. Charged, structurally similar compounds exemplified by hypnotic drugs such as barbiturates were separated by both CZE and MEKC. Optimal separation conditions were established by varying the pH, the concentration of surfactant, the strength of the electric field, and the addition of the organic solvent. CZE provided different selectivities than those obtained by MEKC. For the separation of uncharged compounds such as benzodiazepines, MEKC was the method of choice because the structural difference conferred differences in hydrophobicity, leading to the different interaction with the micelle. Separations by CZE and MEKC with plain, bare fused-silica capillaries were compared to those with C8 and C18 coated capillaries. Although for these solutes, resolution and analysis time were comparable in the three types of capillaries, successful separation of more than 20 kinds of anxiolytic drugs as the mixture was achieved by using C8 and C18 coated capillaries as the separation medium.

Comparison of cyclodextrin modified micellar electrokinetic capillary chromatography and reversed-phase liquid chromatography for separation of polycyclic aromatic hydrocarbons

The elution mechanism of polycyclic aromatic hydrocarbons (PAHs) in cyclodextrin modified micellar electrokinetic capillary chromatography (CD-MEKC) has been compared to that in reversed-phase liquid chromatography (RPLC). The contribution of the inner surface of the capillary has been discussed mainly pertaining to the migration mechanism of PAHs. As a result, the C18-coated capillary can produce a separation field similar to that which is generally found in RPLC with the C18 alkyl bonded stationary phase, and the main migration mechanism is thought to be facilitated by the hydrophobic interaction between the solutes and the cyclodextrins (CDs). Very high linear relationships were found for log k1 versus log P in both CD-MEKC with the C18-coated capillary and RPLC with the C18 stationary phase using sodium dodecyl sulfate (SDS) as the mobile phase additive.

Detection of circulating intercellular adhesion molecule-1 in hepatocellular carcinoma

Serum levels of circulating intercellular adhesion molecule-1 (cICAM-1) were measured in 23 patients with chronic hepatitis (CH), 22 with liver cirrhosis (LC) and 45 with hepatocellular carcinoma (HCC) using an ELISA. Serum samples from all patients showed significantly higher cICAM-1 levels than serum from 50 normal controls. The cICAM-1 level was significantly increased in LC or HCC when compared with CH, but no differences were noted between LC and HCC. Levels of cICAM-1 correlated well with serum bilirubin, retention rate of indocyanine green, hyaluronic acid, type IV collagen 7-S and type III procollagen peptide levels but not with tumor size or circulating tumor markers (alpha-fetoprotein and des-gamma-carboxyprothrombin). Our findings indicate that the measurement of cICAM-1 is useful for the determination of the severity of liver disease and hepatic fibrosis. HCC tissues obtained from 10 patients were immunohistochemically stained for ICAM-1. Enhanced ICAM-1 expression was found on the tumor cell membranes. Sequential measurements of cICAM-1 levels showed that they changed in a similar manner to those of alpha-fetoprotein during the course of treatment of HCC in a patient with very high pretreatment levels of both markers. These results suggest that HCC cells shed ICAM-1 into the circulation. We conclude that cICAM-1 is not a diagnostic marker for HCC, but may be useful for monitoring the response to treatment.

Effect of long-term calcitonin therapy by injection and nasal spray on the incidence of fractures in osteogenesis imperfecta

The effect of calcitonin therapy by injection or nasal spray on the incidence of bone fractures was studied in patients with osteogenesis imperfecta. In contrast to injection of calcitonin, intranasal administration of calcitonin twice a week for 2 weeks, followed by 2 weeks of no therapy, was simple and seemed beneficial for decreasing bone fractures in patients with osteogenesis imperfecta.

Determination of bis(amidinohydrazones) by micellar electrokinetic capillary chromatography

A micellar electrokinetic capillary chromatography method was developed for the separation and determination of aliphatic congeners of bis(amidinohydrazones) in standard solution. Eight bis(amidinohydrazones) could be determined in less than 15 min at an applied voltage of 22 kV, using 0.05 M sodium phosphate as buffer (pH 7.0) together with 1 mM N-cetyl-N,N,N-trimethylammonium bromide. Hydrostatic sample injection was employed. The method exhibited good repeatability and a linear range of 2.5-100 micrograms ml-1. A detection limit of 1 micrograms ml-1 was achieved. The method also allows the determination of bis(amidinohydrazones) in human serum samples.

Treatment of hepatocellular carcinoma by transcatheter hepatic arterial injection of radioactive iodized oil solution

After 12 days of culture, VX2 carcinoma cells were inoculated into the liver of 16 rabbits; 14 days later, 131I-labeled iodized oil ([131I]-Lp) suspended in lipiodol was injected into the hepatic artery. Selective accumulation of the contrast material in the tumor for an extended time was evident on X-rays and hepatic scintiphotographs. The antitumor effect was remarkable. [131I]-Lp agents warrant further examination for their clinical usefulness. Internal radiation therapy by transcatheter hepatic arterial injection of [131I]-Lp (group A) was evaluated in 9 patients with hepatocellular carcinoma (HCC, tumor stage III or IV) associated with liver cirrhosis (LC) and compared with combination therapy of Lp-TAE (group B) in 18 patients with HCC (tumor stage III or IV) associated with LC. In group A, serum AFP levels dropped rapidly in eight of the nine patients who had an elevated initial level of more than 500 ng/ml. The average reduction in tumor size was 50% in eight cases as determined by computed tomography. Histological examination of one resected liver specimen at 3 months after the third injection of [131I]-Lp revealed microscopic features highly suggestive of a radiation effect in the [131I]-Lp-containing area. The 1-year survival value for patients with HCC was estimated at 49.0% using the Kaplan-Meier method. The survival of patients treated with internal radiation therapy tended to be better than that of those treated with Lp-TAE (P = 0.119).

Clinicopathological study on combination therapy consisting of arterial infusion of lipiodol-dissolved SMANCS and transcatheter arterial embolization for hepatocellular carcinoma

Combination therapy (LpTAE) consisting of arterial infusion of a lipophilic anticancer drug, SMANCS, dissolved in an oily lymphographic agent, lipiodol (LPD), and transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) was studied with special reference to the pathological findings. A total of 32 patients were subjected to surgical resection after LpTAE. The pattern of LPD deposition in the tumor was examined by CT scan (Lipiodol CT, LpCT) at 7 days and/or 1 month after LpTAE. The resected materials were examined radiographically with soft X-rays and histologically. LPD was deposited in tiny daughter nodules with a diameter of less than 5 mm and in tumor thrombi as well as in the main tumors, which showed necrotic change. Part of the LPD flowed out from the main tumor via the drainage vein and was deposited in the capsular invasion, resulting in necrosis. LPD accumulated almost exclusively within the blood spaces of trabecular-type HCC, creating a pattern corresponding to a cast of the tumor vessels, which showed prominent necrosis. On the other hand, LPD was not deposited in scirrhous, compact, or well-differentiated HCC, which showed little or no necrosis. It was demonstrated that LpCT images, which accurately depicted the existence and the extent of LPD deposition and necrosis in the tumor, were useful for precise evaluation of the therapeutic effect. Our findings indicate that LpTAE and LpCT are valuable for the diagnosis and treatment of HCC and should play a central role in systemic therapeutic approaches to this disease.

Separation of large polycyclic aromatic hydrocarbons in particulate matter by liquid chromatography

The level of mutagenic activity of particulate polycyclic aromatic hydrocarbons (PAHs) is highly dependent upon structure, so that similar isomers can range from being very active to totally inactive. The suitability of GC/MS or LC with single wavelength absorbance or fluorescence monitoring, coupled with the availability of standards, has resulted in emphasis being placed on the small PAHs (five or fewer rings).In the work reported here, LC was coupled to a computerized photodiode array detector. The former separated the components in a diesel particulate matter extract and the latter spectrally differentiated the large PAHs (more than 24 ring-carbons). Since each PAH has a characteristic UV/VIS absorbance spectrum, each generated a unique pattern of absorbance maxima and minima. Computerized pattern recognition techniques were then used to investigate quantitative structure-activity relationships of the PAHs as predictors of carcinogenicity.The chemical profile of a series of unsubstituted PAHs, for which carcinogenic data was available, was represented by 17 descriptors of the reactivity and properties of those PAHs. Using this data set, the properties of another series of PAHs were found to be consistent with their reported carcinogenicity.

[The treatment of condyle neck fracture: statistics gathered by multi centric study and the related prognosis]

There are two different treatments for condyle neck fracture. One is non-surgical treatment involving intermaxillary fixation, and the other is radical surgical treatment through various techniques, but it is difficult to discuss the relative merits. The purpose of this report is to decide whether surgical treatment is necessary, by comparing the two types of treatment. In the period between April 1981 to December 1987, we treated 136 cases of condyle neck fracture at the Second Department of Oral and Maxillofacial Surgery School of Dentistry Aichigakuin University, and in 18 nearby hospitals. Of the 136 cases, 58 cases had fracture only at the condyle neck, while 78 cases had some concomittant fracture. As regards treatment, of the 136 cases, 49 (36%) were treated surgically, while 87 (64%) were treated non-surgically for condyle neck fracture. The surgically treated cases were divided into three groups: 24 cases were treated by pinning, 16 cases were treated by inter osseous wiring, and there were 9 other cases. In the treatment of concomittant fracture, 38 cases involved inter osseous wiring, 22 cases involved metal plate fixations, and there were 4 other cases. Non-surgical treatment accounted for 15 cases. The rate of surgical treatment for concomittant fracture was 82.1% of the cases treated. In surgically treated cases of condyle neck fracture, the mouth opening prognosis was generally poor. However, in these cases the deviation of mouth opening was generally better than in non-surgically treated cases. There were no differences in mastication, occlusion and pain in the TMJ region.

Trans-catheter hepatic arterial injection of lipiodol soluble anti-cancer agent SMANCS and ADR suspension in lipiodol combined with arterial embolization and local hyperthermia for treatment of hepatocellular carcinoma

The clinical effect and safety of Lp-TAE alone and combined with radiofrequency (RF) capacitive hyperthermia (HT) were evaluated in 20 patients with hepatocellular carcinoma (HCC) associated with cirrhosis of the liver. After the oily carcinostatic agents were administered by Lp-TAE, HT, at a temperature of greater than 42.5 degrees C, was induced for 40 min, twice a week by an RF of 8 MHz for a total of 10 to 38 times. The response rate was 40% in the 10 cases that were treated with Lp-TAE combined with HT and 20% in the 10 cases that were treated with Lp-TAE. The patients who were treated with Lp-TAE combined with HT had a tendency to have better survival rates than those of the Lp-TAE group (p less than 0.099). The main side-effects of Lp-TAE combined with HT were low-grade fever, localized pain, myelo-suppression and liver dysfunction, but these were transient and eventually disappeared.

[A new method of preparation of doxorubicin-in-oil suspension using ultrasonificator attached with Cuphorn]

The property of selective deposition of oily contrast medium, Lipiodol (LPD), in tumor tissue was utilized for targetting intraarterial infusion chemotherapy for hepatic cancers. For this therapy anti-cancer agents need to be suspended in LPD. In this report the new suspension device using ultrasonificator attached with Cuphorn was studied. Doxorubicin (Dx) was stable to ultrasonification for 1 hour. Ten mg/ml of Dx was mixed with LPD and this mixture was treated 2 times for 5 minutes with the ultrasonification method. This procedure was simple and sterile, as the commercially used Dx vials into which LPD was injected were set in the Cuphorn and ultrasonificated just as sealed. Microscopic examination of the suspension showed uniform dispersion of Dx particles without formation of aggregates. Dx particles were finely and regularly fragmented. In vitro the suspensions showed a gradual release of Dx from LPD to water phase. In one case with hepatocellular carcinoma received intraarterial infusion of this suspension, the size of the tumor and serum level of alpha-fetoprotein was prominently decreased. This ultrasonification method was simple and convenient to prepare Dx-in-oil suspension.

Preparation and evaluation of octadecyl-treated porous glasses. Application to the determination of methotrexate in serum

The retention and selectivity of methotrexate (MTX) in serum were studied by high-performance liquid chromatography on octadecyl-treated porous glasses and silicas. From elemental analysis data for carbon, the maximum number of bonded octadecyl surface groups per gram (mean pore diameter 153 A, specific surface area 193 m2/g, pore volume 0.83 ml/g) in octadecyl-treated glass was calculated to be 0.131 x 10(21). MTX in human serum could be separated on both glasses and silicas with methanol-acetate buffer mixtures as eluents.