Microvessel count predicts metastasis and prognosis in patients with gastric cancer

BACKGROUND AND OBJECTIVES

In order to evaluate the clinical relevance of angiogenesis in patients with gastric cancer, we investigated the microvessel count in gastric cancer tissues and compared the results with several clinicopathologic factors and prognosis.

METHODS

A total of 55 patients with gastric cancer were included in this study. Microvessel count was determined by immunohistochemical staining using antifactor VIII-related antigen antibody. Histologically recognizable blood vessels within tissue sections served as internal control for immunostaining. Normal mouse IgG diluted to an equivalent protein concentration was used as a negative control in place of the primary antibody in each experiment.

RESULT

The microvessel count ranged from 4.4 to 39.8 and the median count was 15.6. Microvessel count was significantly higher in patients with hepatic metastasis, lymph node metastasis, adjacent organ invasion, and lymphatic invasion. In patients who had undergone a curative operation, survival time in the hypervascular group was significantly shorter than that in the hypovascular group.

CONCLUSIONS

Microvessel count correlated well with tumor progression and may serve as a useful prognostic factor in patients with gastric cancer.

[Pharmacokinetic analysis of intra-peritoneal administration of cisplatin]

Pharmacokinetic parameters after intra-peritoneal administration of cis-platinum (CDDP) were evaluated and compared with those after intravenous administration. CDDP at a dose of 70 mg/m2 were administered intra-peritoneally in 5 patients with advanced gastric cancer (IP group). Pharmacokinetic parameters and toxicities were evaluated in these patients and compared with those in 4 esophageal cancer patients administered the same dose of CDDP intravenously (IV group). In IP group, Cmax of total- and free-Pt were 3.41 +/- 0.89 micrograms/ml and 1.10 +/- 0.30 micrograms/ml, and AUC of total- and free-Pt were 59.6 +/- 14.3 micrograms.hr/ml, 3.12 +/- 0.89 micrograms.hr/ml, respectively. On the other hand, Cmax and AUC of total- and free-Pt in IV group were 3.31 +/- 0.59 micrograms/ml. 1.13 +/- 0.21 micrograms/ml and 45.89 +/- 9.24 micrograms.hr/ml, 1.22 +/- 0.8 micrograms.hr/ml, respectively. AUC of free-Pt in IP group was significantly higher than in IV group. This result suggests that a more promising antitumor effect will be obtained systemically by intraperitoneal administration of CDDP. The incidence and grade of toxicities were similar in these two groups.

Microvessel count predicts metastasis and prognosis in patients with gastric cancer

BACKGROUND AND OBJECTIVES

In order to evaluate the clinical relevance of angiogenesis in patients with gastric cancer, we investigated the microvessel count in gastric cancer tissues and compared the results with several clinicopathologic factors and prognosis.

METHODS

A total of 55 patients with gastric cancer were included in this study. Microvessel count was determined by immunohistochemical staining using antifactor VIII-related antigen antibody. Histologically recognizable blood vessels within tissue sections served as internal control for immunostaining. Normal mouse IgG diluted to an equivalent protein concentration was used as a negative control in place of the primary antibody in each experiment.

RESULT

The microvessel count ranged from 4.4 to 39.8 and the median count was 15.6. Microvessel count was significantly higher in patients with hepatic metastasis, lymph node metastasis, adjacent organ invasion, and lymphatic invasion. In patients who had undergone a curative operation, survival time in the hypervascular group was significantly shorter than that in the hypovascular group.

CONCLUSIONS

Microvessel count correlated well with tumor progression and may serve as a useful prognostic factor in patients with gastric cancer.

Eggshells are shaped by a precise spatio-temporal arrangement of sequentially deposited macromolecules

The avian eggshell is a composite bioceramic which is formed by a controlled interaction of an organic and an inorganic phase. The organic phase contains, among other constituents, type X collagen and proteoglycans, mainly keratan and dermatan sulfate. Understanding the principles governing the synthesis and temporo-spatial distribution of such macromolecules, and their influence on the organization of the crystalline phase, is an essential aspect of establishing the biological basis of the quality of eggshell, both as an embryonic chamber and as a natural food package. In the present study, we have examined the process of eggshell formation by immunohistochemistry, scanning electron microscopy and energy dispersive X-ray microanalysis. Precise sites and timing of secretion were established for the deposition of particular macromolecules. Type X collagen is detected at the very first moment of shell membrane formation. The appearance of keratan sulfate coincides with the appearance of mammillae, while dermatan sulfate is deposited later, coincident with shell matrix deposition. We propose that keratan sulfate, due to its precise localization, temporal appearance and calcium-binding affinity, relates to the maintenance of calcium reserve bodies, the primary source of calcium for the embryo. On the other hand, dermatan sulfate may control crystal growth, resulting in a preferential orientation of calcite crystals within the palisade layer.

Altered maternal psychological profile as health risk factor in poor urban infants

To test the hypothesis that the increased health risk of children selected by a previously calculated and validated predictive model is associated with some maternal psychological characteristics, the universe of 107 mothers of children selected by this model was evaluated by means of Goldberg's General Health Questionnaire (GHQ-30), Raven (Ra) and Rorschach (Ro) tests; 37.4% were cases according to GHQ-30, 80.9% were < 50th percentile in Ra and 85% exhibited deviant responses in Ro tests. Children whose mother's IQ was < 50th percentile suffered more episodes of total morbidity (Tm) and of diarrhoea (p = 0.0364). Children whose mothers were normal in Ro had less Tm (p = 0.0364) and fewer respiratory symptoms (p = 0.0300) and tended to have less diarrhoea (p = 0.0690). In poor urban families in Santiago psychological maternal characteristics are associated with an increased health risk for the infants. Supportive programmes should consider both biological characteristics of the infants and maternal psychological needs.

[Pharmacokinetic analyses of intra-arterial and intra-portal chemotherapeutic agent infusion]

In order to determine the optimal drug administration route in patients with metastatic liver tumor, we studied the pharmacokinetic parameters after intra-arterial or intra-portal adriamycin (ADM) administration. Four patients with metastatic liver tumors were included in this investigation. One catheter was inserted into the gastroduodenal artery for arterial infusion and the other catheter was inserted into the portal vein via mesenteric vein for portal infusion under laparotomy. ADM 30 mg was infused and blood samples were collected from peripheral and hepatic veins. The concentration of ADM was determined with HPLC technique and the pharmacokinetic parameters were analyzed with a three-compartment open model. The parameters analyzed were blood concentration at t0, half-life, rate of elimination, total body clearance, volume of distribution and area under the blood concentration versus time curve. There were no significant differences of the pharmacokinetic parameters between intra-arterial infusion and intra-portal infusion. Also, no differences were observed between the data from peripheral venous blood and those from hepatic venous blood. These data suggest that the drug distributions were almost similar between intra-arterial and intra-portal drug administration in patients with metastatic liver tumor.

Maternal neurotic symptoms and infants' risk of developing persistent diarrhoea

A previously calculated predictive model for health risk selects infants who suffer 4-5 times more morbidity than their unselected peers. Preliminary results suggested that this risk is related to maternal neurotic symptomatology. To evaluate this hypothesis, 52 consecutive mothers whose infants had a positive predictive score (Group 1) and 52 in whom this was negative (Group 2) were evaluated by means of Goldberg's General Health Questionnaire (GHQ-30). A total of 41.9% and 20.5% of the mothers in Groups 1 and 2, respectively, scored above 11 points in GHQ-30, established as the cut off point. It is concluded that among poor urban families in Santiago mothers of infants with high risk of persistent diarrhoea have increased frequency of detectable neurotic symptoms. New programs aimed at this type of infant should include psychological support for their mothers.

Host Status of Crotalaria juncea, Sesamum indicum, Dolichos lablab, and Elymus glaucus to Meloidogyne javanica

Reproduction of Meloidogyne javanica on Crotalaria juncea PI 207657 and cv. Tropic Sun, Sesamum indicum, Dolichos lablab, and Elymus glaucus was assessed using a root-gall index, a reproductive index obtained by dividing the final population of juveniles (J2) in soil by the initial J2 population (Pf/Pi), and the number of J2 per gram of root recovered from roots by mist chamber extraction. Lycopersicon esculentum (cv. UC 204 C) was included as a susceptible host. The root-gall index and soil reproductive index were poor indicators of the host status of our test plants as compared with mist chamber extraction of J2 from roots. Lycopersicon esculentum had a mean root-gall index of 7.8. Some plants of S. indicum and E. glaucus had a few galls and other plants had none, with mean root-gall indices of 1.6 and 0.8, respectively. No galls were observed in C. juncea and D. lablab. Lycopersicon esculentum had the highest mean soil Pf/Pi value (mean = 1.93), while in C. juncea and some replicates of S. indicum no soil J2 were found. Even though some replicates had no galls, all replicates supported nematode reproduction. The mean numbers of J2 per gram root after 5 days of mist extraction were 447.7, 223.3, 165.5, 96.9, 42.3, and 41.9 for D. lablab, L. esculentum, E. glaucus, S. indicum, and C. juncea PI 207657 and cv. Tropic Sun, respectively. Accurate assessment of nematode resistance was influenced by sampling time and the nematode extraction technique used. Individual plants of both C. juncea and S. indicum supported nematode reproduction to some extent; however, both C. juncea and S. indicum have potential as cover crops to reduce M. javanica numbers.

[Application of a predictive model for morbidity among middle socioeconomic class infants]

A predictive model which identifies infants who suffer 4 to 5 times more morbidity than their unselected peers was calculated in previous studies, in population of the low socio-economic stratum (SES) (Rev Med Chile 1992; 120: 342-8): Some families of the middle SES also seek care at the Primary Health Care System. Therefore, since our aim is to propose an instrument to be used at this level, the predictive model was applied in families of this stratum. Children identified by means of the model suffered as many episodes of diarrhea but not of other illnesses, as their peers of the low SES (4.8 vs 4.3 respectively). Families in whom the instrument was positive were fewer in the middle SES (6.8 vs 15.7%). Because during the study a campaign to prevent cholera was carried out in Santiago, and this may modify the predictor's performance, at the end of the follow up the model was validated again in families of the low-SES; results confirmed that children with a positive predictor suffered more diarrhea than those of the non-selected population (6.5 vs 3.4 episodes/children/year).

Effect of health education and primary care on diarrhoeal disease morbidity in children: evaluation of a predictive intervention model

Two groups of infants (intervention group n = 66, and control group n = 45) at risk of persistent diarrhoea (PD) as identified by a predictive model were followed for 12 months. Families were visited at home weekly; mothers in the intervention group received information about prevention and treatment of diarrhoea and were encouraged to seek help in the field station when their children became ill. These children suffered fewer days with any illness, diarrhoea, or respiratory episodes (p < 0.00001 each). Also, in this group, the incidence of PD decreased to the levels of nonselected population only in children whose mothers consulted for the episode of diarrhoea (2.8%). Results show that the intervention decreased the time children suffered diarrhoea and also respiratory and other illnesses. This suggests that the predictive model identified children with high risk but is not disease-specific. Risk appears to be related to maternal behaviours. The model may be useful in the community for detecting groups vulnerable to common paediatric illnesses, including diarrhoeal disease.

Penetration of Crotalaria juncea, Dolichos lablab, and Sesamum indicum Roots by Meloidogyne javanica

Penetration of Crotalaria juncea (PI 207657 and cv. Tropic Sun) Dolichos lablab cv. Highworth, and Sesamum indicum by juveniles (J2) of Meloidogyne javanica was assessed to investigate the mechanism by which these plants may reduce nematode numbers in the field. Growth chamber experiments were conducted at 25 C, with vials containing 90 g sand infested with 450 J2; tomato (UC 204 C) was included as a susceptible host. Fifteen days after inoculation, roots were stained and the nematodes within stained roots were counted. Both C. juncea lines were highly resistant to penetration, as they contained significantly fewer nematodes per cm of root and per root system than the other plants. Although containing more nematodes per cm of root than C. juncea, S. indicum and D. lablab had significantly fewer nematodes per root system and per cm of root than tomato. Roots were significantly longer in the plants with the lowest nematode penetration. Although C. juncea, D. lablab, and S. indicum may have potential utility as cover or rotation crops in soil infested with M. javanica, further quantitative information on the reproduction of M. javanica and other nematodes in these plants is needed.

Evidence that both Ca(2+)-ATPase and (Ca2+ + Mg2+)-ATPase activities in the plasma membrane-rich fraction from bovine parotid gland reside on the same enzyme molecule

1. Evidence was obtained that activities of both low-affinity Ca(2+)-ATPase and high-affinity (Ca2+ + Mg2+)-ATPase in the plasma membrane-rich fraction from bovine parotid gland reside on the same enzyme. 2. Two solubilized ATPases were purified by four steps of HPLC; and both activities eluted at the same fractions from each column, and the specific activity ratio of the two enzymes at each step was constant. 3. By non-denaturing PAGE, the final preparation gave a single band for both protein staining and activity staining for the two ATPases; and the Ca(2+)-ATPase activity comigrated with that of (Ca2+ + Mg2+)-ATPase. 4. In SDS-PAGE, each activity staining for the ATPases also gave a single band, and both activities comigrated. 5. These findings suggest that Ca(2+)-ATPase and (Ca2+ + Mg2+)-ATPase are a single enzyme.

Effect of dietary nucleotide supplementation on diarrhoeal disease in infants

The effects of a nucleotide-supplemented formula on diarrhoeal disease was studied in 141 infants (group 1) who belonged to the low socioeconomic stratum; 148 controls (group 2) received the same formula but unsupplemented. Group 1 experienced less episodes of diarrhoea (109 versus 140), including less first episodes (74 versus 102; chi-square = 8.19, p < 0.004; odds ratio 2.01) and for a lesser number of days (807 versus 996 days); 45.0% and 31.1% of infants in groups 1 and 2, respectively, never developed episodes of diarrhoea. There were no differences in the clinical characteristics of the episodes or in the enteropathogens isolated from symptomatic or asymptomatic infants. The mechanisms through which nucleotides decrease the incidence of diarrhoeal disease in infants remain unclear.

Enzymatic Digestion of Roots for Recovery of Root-knot Nematode Developmental Stages

Developmental stages of Meloidogyne javanica were successfully released from roots by treatment with commercially available cellulase and pectinase. The average percentage recovery of nematode developmental stages from Dolichos lablab, Elymus glaucus, and Lycopersicon esculentum were as follows: eggs = 526%, J2 = 272%, J3 = 783%, J4 = 549%, adult females = 285%, and total = 425%, expressed as percentages of the counts obtained from stained roots spread on glass plates. Root digestion was more accurate and sensitive in detecting low numbers of nematodes in roots than was the glass plate method. No simple linear, quadratic, or cubic relationship was found between the two methods that would allow a conversion factor to be developed.

Chronic iron intake and diarrhoeal disease in infants. A field study in a less-developed country

The effect of chronic iron intake on diarrhoeal disease was evaluated in children in a community of low socio-economic stratum in Santiago, Chile. Children were incorporated into each of two consecutive cohorts; each cohort was divided into two groups, one receiving iron-enriched milk (12 mg/l) (monthly average = 70 children) and the other a control milk (1 mg/l) (monthly average = 83 children), and each cohort was followed up for 6 months. The incidence of diarrhoea was higher among the iron-supplemented children (30.4 vs 25.5 episodes/100 children/month, P < 0.025). This was mainly due to results obtained in infants 3-8 months of age during the summer months. Supplemented infants had more bowel movements on day 1 (P < 0.03) and liquid or semi-liquid stools were passed for more than 15 days more frequently (P < 0.05). While no differences were detected in aetiology, Shigella-associated episodes were less common among iron-supplemented infants (P < 0.008). Asymptomatic shedding of enteropathogens significantly increased in infants 12-18 months of age receiving iron-supplemented milk. In areas with inadequate environmental sanitation, chronic iron supplementation may have negative effects on diarrhoeal morbidity, despite improving iron nutritional status.

Field trial of an infant formula containing anti-rotavirus and anti-Escherichia coli milk antibodies from hyperimmunized cows

Two groups of 124 and 108 children, respectively, living in urban Santiago, Chile in low socioeconomic conditions were prospectively followed for 6 months for their incidence of diarrhea. Each cohort was divided into two subgroups receiving either a commercial milk formula or the same formula containing 1% (wt/wt) bovine milk immunoglobulin concentrate from cows hyperimmunized with human rotaviruses and the major enteropathogenic Escherichia coli (EPEC) serogroups. Neither group differed with respect to incidence of diarrhea (98 episodes in 117 treated children versus 95 episodes in 115 control children), duration and clinical symptoms of diarrhea, and weight gain. Furthermore, neither group differed with respect to isolation of rotavirus (14 and 13 isolates in treatment and control groups, respectively) and isolation of enteropathogenic E. coli (14 and 15 isolates in treatment and control groups, respectively). The treatment but not the control formula contained neutralizing antibody against all human rotavirus serotypes. Titers were comparable to human breast milk samples. All isolated EPEC serogroups were included in the vaccine used for the immunization of the cows. The treatment, but not the control formula, protected mice against a lethal challenge with an EPEC strain. In conclusion, feeding an antibody-supplemented formula had no positive effect on diarrheal diseases under the conditions of a fairly well-controlled small-scale field trial.

Hygiene habits and carriers in families with a child who has had typhoid fever

The relationship between asymptomatic shedding of bacterial enteropathogens and the hygiene habits of families who have had a child with typhoid fever (TF) are investigated. The sample was made up of 80 families: 40 families in which one child had had TF (Group A) and 40 in which no children or either of the parents had had a history of TF (Group B). In each group 20 families belonged to a low socioeconomic status (SES) and 20 to a high SES. A structured interview was used to evaluate the SES and the hygiene habits of the child; observations were made to measure the hygiene habits of the family (toilet, kitchen and food preparation) and bacteriological studies (fecal samples and hand markers). Results show that carriers were more frequent in Group A than in Group B. The bacterial species found were significantly more numerous in Group A than in Group B (fecal samples: E. coli, the classic serotypes, Shigella ssp, and hand markers: E. coli). Families of Group A had higher carriage rates than those of Group B. Finally there exists a significantly higher association between inadequate hygiene habits and carrier families. These results show the need to teach specific habits of proper hygiene to the entire population, because the fact of belonging to the high SES does not in itself preclude inadequate hygiene habits.

Liquid and protein dynamics using a new minimally invasive pleural catheter in rabbits

To obtain continuous access to the pleural space without causing injury, we tested a new transdiaphragmatic pleural catheter for its ability 1) to drain the pleural space without injury and 2) to drain liquid at a rate equal to normal pleural liquid production. In 13 anesthetized rabbits, we opened the abdomen and dissected through the diaphragm to insert a flared-tip catheter into the ventral pleural space on one side and then turned the rabbit prone. In 10 of the rabbits (8 for 6 h, 2 for 24 h), we continuously collected draining pleural liquid, and in 3 rabbits (6 h), we did not open the catheter. We injected radiolabeled albumin intravenously as a protein marker. Terminally, we collected pleural liquid from both pleural spaces and lavaged for total radioactivity. In 14 awake control rabbits without catheters, we measured normal pleural liquid production by the rate of equilibration of radiolabeled albumin from plasma to pleural liquid. We found that, although the percentage of neutrophils was increased on the side with the catheter (54 vs. 1% in control rabbits), the pleural liquid volume, protein concentration, specific activity of albumin, and total radioactivity in the pleural space were the same on the side with the catheter as on the opposite side and in the control rabbits. The liquid flow rate through the catheter over 6 h was 53 +/- 23 microliters/h [0.017 +/- 0.008 (SD) ml.kg-1.h-1], which was not significantly different from the computed rate of normal pleural liquid production in the control rabbits, 49 +/- 14 microliters/h (0.016 +/- 0.004 ml.kg-1.h-1).(ABSTRACT TRUNCATED AT 250 WORDS)

[Application of a model for predicting morbidity in children from a low socioeconomic level]

An instrument to be used at a primary health care level was built on the basis of a predictive model for diarrhea obtained during a previous study. The instrument was applied to 720 mothers or caregivers of infants living in the Southeastern area of Santiago. 83 infants who fulfilled the requisites of the instrument were surveyed during July-August 1989 and compared to age, nutritional and socioeconomic status matched children not fulfilling the same requisites. Infants selected by the predictive instrument suffered 4 times more morbid episodes and respiratory infections and 5 times more diarrheal episodes than controls. Symptoms were present in them during 50% of the survey period as opposed to 14% in controls. Mothers of children at risk had inadequate behaviors in respect to health care of their children and did not follow many of the National Health programs available for their families. The predictive instrument tested may be useful to identify children at high risk of morbidity, creating the possibility for special interventions in them.

Persistent diarrhoea in the community. Characteristics and risk factors

In 58 previously well-nourished patients who were fed cow's milk and who later developed persistent diarrhoea (greater than or equal to 15 days), data obtained during the first 8 days of acute diarrhoea were compared with those of patients whose episodes lasted less than or equal to 8 days. Children with persistent diarrhoea weighted less at birth, passed greater than or equal to 6 stools/day during the first 48 hours, received early treatment with antibiotics. Their milk feedings were stopped during the first 48 hours, they had a past history of digestive diseases and hospitalizations, they were brought in for consultation after 5 days of symptoms and their nutritional status deteriorated more (p less than 0.003, p less than 0.03, p less than 0.0001, p less than 0.0001, p less than 0.0001, p less than 0.002, p less than 0.0001, and p less than 0.03, respectively). Their mothers were significantly younger (p less than 0.0013), had better schooling (p less than 0.037), and fewer children (p less than 0.044), and were separated from the index child during the day more often (p less than 0.056). After persistent diarrhoea was diagnosed, enteropathogens in stools or lactose intolerance or both were demonstrated in 75.9%. Treatment induced remission in all cases. Using logistic regression a predictive model was established which enables us to identify, among patients with acute diarrhoea, those at risk of prolonging their illness.