Combined chemotherapy and radiation therapy in head and neck cancer

A combination chemotherapy (PT treatment) with cisplatin and tetrahydropyranyl-adriamycin (THP-ADM) was performed in 17 patients with head and neck squamous cell carcinoma. Chemotherapy treatment began with an intravenous dose of 50 mg/body cisplatin and an intravenous dose of 20 mg/body THP-ADM. Administration of THP-adriamycin was performed on the first day only, while cisplatin treatment was repeated once a day until the third day. Five of the 17 cases achieved complete response (29.4%) and seven achieved partial response. Response rate was 70.6%. Toxicity was mild and controlled with symptomatic treatment. Leukopenia was observed in 71.4% thrombocytopenia 14.3% (due to myelosuppression), appetite loss 38.1%, general fatigue 28.6% and nausea and vomiting 23.8%. No electrocardiographic abnormality was noted.

Effect of transcranial Doppler intensity on successful recording in Japanese patients

The major limitation of transcranial Doppler sonography (TCD) is the failure to obtain data for all patients. The purpose of this study was to determine in detail the effect of increasing ultrasonic acoustic intensity on the rate of successful recording of intracranial blood velocity signals. The study was performed in 239 Japanese patients using a 2-MHz range-gated, pulsed-wave TCD. The middle cerebral artery flow signals were recorded at 76, 152, 228, 304, 380, 456 and 532 mW/cm2 and the results analyzed by age, gender and intensity. The rate of successful recording showed significant increase with the ultrasonic intensity in both genders (45.7% at 76 mW/cm2 vs. 81.1% at 532 mW/cm2 in males and 29.5% vs. 60.7% in females). However, recording was only successful in 54% of aged (50-89 gamma) female patients at the highest ultrasonic intensity used. It should be possible to significantly increase TCD usefulness in an aging Japanese population by further increasing TCD acoustic intensity within safety limitation.

Influence of vestibular organ stimulation on stomach movement and respiration

Some previous investigators have reported controversial results in the stomach movement in response to labyrinthine stimulation (1). The purpose of the present study was to investigate the influence of vestibular stimulation on the stomach movement and respiration in anesthetized cats, and to investigate the differences between increased and decreased responses of the stomach movement. This study used an electrophysiological technique: a bipolar stainless-steel stimulating electrode with a tip diameter of 20 microns introduced chronically into the anterior and/or lateral semicircular canal (2). The intragastric pressure was recorded by using a balloon-transducer system. Respiration was recorded by measurement of the thorax. When the peripheral labyrinth was stimulated, we found conflicting results in that the pressure in the stomach increased several times and sometimes decreased. Respiration usually became irregular or intensified. It seems that forced respiration may be involved in vestibular vomiting but we were unable to induce vomiting.

Hearing recovery and its process from the time of onset in sudden deafness

A total of 547 patients with idiopathic sudden hearing loss were divided into eight groups according to the days (1-8 days) of their initial visit after onset, and initial hearing thresholds, hearing recovery and its process were investigated. There were no significant differences in initial hearing thresholds and hearing recovery among the eight groups. However, a difference was noticeable in the distribution of the thresholds at the initial visit and that on the 7th day between groups 1, 2 and 7. Many cases showed rapid recovery in groups 1, 2 and 7. We speculate that the treatment influenced the hearing recovery process in patients who showed relatively rapid recovery.

[Comparative studies on the time course of proliferating cell nuclear antigen and bromodeoxyuridine staining pattern in regenerating rat liver cells]

Immunohistochemical staining pattern of proliferating cell nuclear antigen (PCNA) was examined in regenerating rat liver specimens fixed under the various conditions (10% buffered formalin for 6hr, 1% paraformaldehyde for 6hr, 100% methanol for 4hr, 70% ethanol for 6hr). Time course of PCNA staining pattern after hepatectomy in the specimens fixed with 100% methanol or 70% ethanol coincided closely with that of bromodeoxyuridine (BrdU) staining pattern, which is known to be standard marker of cell proliferation. Similar result was obtained in fixation with 10% buffered formalin (10% BF) or 1% paraformaldehyde (1% PFA) when only granular staining pattern of PCNA was evaluated. These findings suggest that granular immunostaining of PCNA in tissue specimens fixed with 100% methanol, 70% ethanol, 10% BF or 1% PFA is useful for evaluating the extent of cell proliferation.

Enhanced engraftment of HTLV-I-infected human T cells in severe combined immunodeficiency mice by anti-asialo GM-1 antibody treatment

The effects of anti-asialo GM-1 antibody (AAGM) treatment on the engraftment of human T-cell leukemia virus type I (HTLV-I)-infected human T cells in severe combined immunodeficiency (SCID) mice were studied. The frequency of tumor formation in an HTLV-I-transformed human T-cell line, MT-2 cells, at the site of inoculation was significantly higher in AAGM-treated than untreated mice (P<0.05): 16/18 (89%) and 16/26 (62%), respectively. The promotive effect of AAGM treatment on tumor development was marked in the early stage (less than 3 weeks), suggesting that the immediate reaction of natural killers to the inoculated cells may be important for the prevention of tumor development. The surface phenotypes and clonality of the tumor cells were the same as the MT-2 cells inoculated. Inoculation of peripheral blood mononuclear cells (PBMC) from one of the 4 adult T-cell leukemia/lymphoma (ATL) patients resulted in the development of tumors in AAGM-treated SCID mice. However, the surface phenotypes of the cells from these tumors were a mixture of B cells and T cells, suggesting that these tumors consisted of Epstein-Barr virus-transformed B cells and HTLV-I-transformed T cells. In addition, HTLV-I was detected by polymerase chain reaction in various organs of the mice inoculated with PBMC from the ATL patient and the asymptomatic carrier examined. These results suggest that elimination of natural killer function by AAGM treatment is important, although such treatment is not always necessary for the engraftment of HTLV-I-infected cells in SCID mice.

Tobacco MAP kinase: a possible mediator in wound signal transduction pathways

A complementary DNA encoding a mitogen-activated protein (MAP) kinase homolog has been isolated from tobacco plants. Transcripts of the corresponding gene were not observed in healthy tobacco leaves but began to accumulate 1 minute after mechanical wounding. In tobacco plants transformed with the cloned complementary DNA, trans inactivation of the endogenous homologous gene occurred, and both production of wound-induced jasmonic acid and accumulation of wound-inducible gene transcripts were inhibited. In contrast, the levels of salicylic acid and transcripts for pathogen-inducible, acidic pathogenesis-related proteins were increased upon wounding. These results indicate that this MAP kinase is part of the initial response of higher plants to mechanical wounding.

Em18 and Em16, new serologic marker epitopes for alveolar echinococcosis in western blot analysis, are the only two epitopes recognized by commercially available weak positive (cut off) sera for Em2plus-ELISA

The assay system for antibody responses against Em2, the most specific antigen for serodiagnosis of alveolar echinococcosis (AE), has been established by enzyme-linked immunosorbent assay (ELISA) but not by Western blot assay, since Em2 antigen is not protein but carbohydrate in nature. Recently we reported that previously undescribed protein epitopes, designated Em18 and Em16 due to their molecular weights, were good serologic markers for AE by Western blot analysis. It has been shown that Em18 and Em16 are the only two epitopes recognized by commercially available weak positive (cut off) sera for the Em2plus-ELISA.

[Changes in hearing features according to days from onset of sudden deafness]

We analyzed 746 patients with idiopathic sudden hearing loss who visited our clinic within 16 days after the onset. Patients were divided into 10 groups according to the number of days between the initial visit and the onset. Initial hearing levels, audiometric types and hearing recoveries were investigated in these groups to estimate the natural history of sudden deafness. The results were as follows: 1) There were no significant differences among the 10 groups regarding the averaged five-frequency hearing levels of initial audiograms. 2) Regarding the audiometric types of the initial audiograms, flat and upward slope types were frequently seen in the groups who visited us within 6 days. In contrast, the population of down slope types gradually increased in the groups presenting after 7 days. In the ultimate audiograms, flat and down slope types were frequently seen in all groups. 3) There were significant differences among the 10 groups regarding the averaged five-frequency improvement (one-way analysis of variance, p < 0.01). After 9 days, hearing recovery became less likely.

Moloney murine leukemia virus infection accelerates lymphomagenesis in E mu-bcl-2 transgenic mice

E mu-bcl-2 transgenic mice bearing the bcl-2 proto-oncogene linked to the immunoglobulin enhancer (E mu) sporadically develop B or T cell lymphomas after a long latent period. To identify genes that play important roles in development of lymphoid malignancies, proviral insertional mutagenesis with Moloney murine leukemia virus (MMuLV) was carried out in two lines of transgenic mice expressing the bcl-2 gene primarily in B or T cells. MMuLV infection of non-transgenic mice induced primarily mature T cell lymphomas. By contrast, infection of newborn E mu-blc-2 mice with the virus accelerated lymphomagenesis, and nearly all of the mice eventually succumbed to clonal pre-B, B, or mainly immature T cell lymphoma, indicating the active contribution of the bcl-2 gene in lymphomagenesis. Southern blot analysis of tumor DNA from MMuLV-infected transgenic mice revealed a proviral insertion at the c-myc gene in 26% (9/35) of tumors, at the pim-1 gene in 6% (2/35) and at the pim-2 (recently renamed tic-1) gene in 23% (8/35). Some tumors carried two activated oncogenes. No insertion was detected at the bmi-1 gene. These data suggest the usefulness of this transgenic system for analysis of lymphomagenesis involving the activated bcl-2 gene.

[A case of food-dependent exercise-induced anaphylaxis induced by shrimp]

The clinical study and in vitro study used with leukocytes were made of a case of food-dependent exercise-induced anaphylaxis induced by shrimp. A 26-year-old man experienced anaphylactic reaction of nasal obstruction, face edema and dyspnea while running 90 minutes after eating shrimp. He experienced similar episodes two years ago in his past history. IgE-RAST was positive for shrimp. Anaphylactic reaction and elevation of plasma histamine levels were verified by exercise challenge test after eating 100 g shrimp. At the same time, we verified the dedine of plasma cAMP levels after eating shrimp. In leukocyte stimulating test used with shrimp antigen, histamine level elevations, which were lower compared with calcium ionophore A23187 (Ca I 10(-6) M) stimulation, were recognized in dose dependent manner in this patient. But in normal subject, histamine level elevations were not recognized. We diagnosed him food-dependent exercise-induced anaphylaxis. It was suggested that there was relation between histamine release and decline of cAMP levels of plasma after eating shrimp in this case.

Mutational and LOH analyses of p53 alleles in colon tumors induced by 1,2-dimethylhydrazine in F1 hybrid mice

To elucidate the role of p53 in colon tumorigenesis in mice, we examined allele loss and mutational alteration of the p53 gene in colon tumors induced by 1,2-dimethylhydrazine (DMH) in F1 hybrid mice. Intragenic polymorphism of the p53 gene among parental strains enabled us to assess allele loss of the p53 gene and also to determine parental origin of mutated and/or lost alleles. Allele loss was detected in two of 163 tumors heterozygous for the p53 gene. Polymerase chain reaction-single-strand conformation polymorphism analysis of p53 exons 5-8 revealed 33 mutations in 20 of 182 colon tumors, the incidence being lower than that in human colon cancers. The majority of these mutations were of transition type: G:A transitions at non-CpG sites were most prevalent, while those at CpG sites were less common. Distribution of the mutations along p53 amino acid sequence revealed a difference in the location of 'hot spots' between mice and humans. Incidence of p53 alterations did not differ among alleles of different parental origins, suggesting that genetic changes in DMH-induced mouse colon tumors had occurred independently of parental origin and DMH susceptibility. Detailed analysis of p53 mutations on each allele revealed intratumoral heterogeneity in mouse colon tumors. The low incidence of p53 mutations and rare allele loss suggest that p53 alteration plays only a minor role in colon tumorigenesis in mice.

[Clinicopathological study of incidental renal cell carcinoma]

BACKGROUND

The objective of this study is to evaluate the clinicopathological features of incidental renal cell carcinoma, compared with non-incidental carcinoma.

METHODS

Between July 1st, 1984 and June 30, 1994, 87 renal cell carcinoma patients were treated at our hospital; 56 had non-incidental renal cell carcinoma and 31 had incidental carcinoma. The clinicopathological features were examined.

RESULTS

The incidence of incidental cancer ranges from 0 to 66%, and the incidence has increased in recent years. The median value of maximal tumor size was 4.0cm (1.5 approximately 8.0cm) for incidental cancer, and 8.0cm (3.0 approximately 16cm) for incidental cancer, and 8.0cm (3.0 approximately 16cm) for non-incidental cancer, i.e., the incidental cancer was significantly smaller than the non-incidental one (p < 0.001). The pathological stage of the resected non-incidental renal cell carcinoma (n = 47) was pT1, pT2, pT3 and pT4 in 0, 23, 21 and 3 patients, respectively. For the resected incidental renal cell carcinoma (n = 31) 3, 26, 2 and 0 patients showed pathological stages pT1, pT2, pT3 and pT4, respectively; the pathological stage of incidental renal cell carcinoma was significantly lower than that of non-incidental carcinoma (p < 0.001). Eighteen and 29 resected non-incidental renal cell carcinoma were grades 1 and 2, respectively, whereas 17 and 14 resected incidental renal cell carcinomas were in grades 1 and 2, respectively. Vascular invasion by tumor cells was shown in 31 (66.0%) and 8 (25.8%) patients with non-incidental and incidental renal cell carcinomas, respectively; the incidence of vascular invasion in incidental cancer being significantly lower than in non-incidental cancer (p < 0.001). The performance status and general condition in patients with incidental renal cell carcinoma were superior to those in patients with the non-incidental cancer. The 1, 3 and 5-year survival rate of all 87 renal cell carcinoma patients was 81, 62 and 57%, respectively. These rates for patients with non-incidental renal cell carcinoma were 72, 48 and 41%, respectively, and those for incidental cancer patients were 100%. The survival of patients with incidental renal cell carcinoma was significantly better than that of non-incidental carcinoma patients (p < 0.005).

CONCLUSION

Our results suggest that the detection of incidental renal cell carcinoma will increase, and that the prognosis for renal cell carcinoma will improve. However, even in incidental renal cell carcinoma, careful long-term follow up may be necessary, since some tumors are comparatively large and exhibit vascular invasion.

[Long-term selective beta 1-blockade therapy for a patient with anthracycline-induced cardiomyopathy]

A 44 year-old woman with acute myeloid leukemia (AML, FAB, M4E) developed heart failure during treatment with anthracyclines for AML. She had not experienced heart disease and her left ventricular ejection fraction (LVEF) was 59% at the end of a successful remission induction therapy. Because her LVEF decreased to 33% after early consolidation therapy, the chemotherapy for AML was discontinued. The cumulative dose of daunorubicin, aclarubicin and mitoxantrone was 486 mg/m2, 135 mg/m2 and 55 mg/m2, respectively. In October 1990, four months after the end of the chemotherapy, heart failure (class III, NYHA) developed and did not improve by treatment consisting of dobutamin, digoxin and diuretics. Anthracycline cardiomyopathy was histologically confirmed by endomyocardial biopsy. Then we administered selective beta 1-antagonist, metoprolol (Seloken), with an initial dose of 5 mg/day which was doubled 3 times every 4 or 8 weeks to 40 mg/day, according to the treatment schedule of dilated cardiomyopathy. She recuperated satisfactorily (Class I, NYHA), and was discharged on February '91. Her LVEF gradually improved and it has been maintained at above 50% on an outpatient basis. The patient has been in complete hematological remission during this period. It seems that low dose selective beta 1-antagonist therapy has a potential to improve myocardial function in some patients with anthracycline cardiomyopathy.

Enhancement of transformation in vitro of a nontumorigenic rat urothelial cell line by interleukin 6

Chronic inflammation of the urinary tract is a significant risk factor for the development of bladder cancer. We have shown that acute and chronic inflammation induced by intravesical instillations of killed Escherichia coli strikingly enhances N-methyl-N-nitrosourea (MNU)-initiated rat bladder carcinogenesis. To test the hypothesis that cytokines released during inflammation may be involved in the enhancement of bladder carcinogenesis, we conducted an in vitro experiment. Using soft agar growth as an index of transformation, we examined the effect of inflammation-associated cytokines on the enhancement of MNU-initiated transformation of MYP3 cells, an anchorage-dependent nontumorigenic rat bladder epithelial cell line. In the first experiment, after 1-h exposure to MNU (50 micrograms/ml), cells (5 x 10(4)) were grown in soft agar in the presence of interleukin (IL)-1 alpha, IL-6, IL-8, or tumor necrosis factor-alpha (10 to 100 ng/ml). Colonies consisting of more than 20 cells were counted 4 weeks later. Among the cytokines tested, IL-6 (100 ng/ml) significantly increased colony counts over those for the untreated controls (P < 0.001). In the second experiment, the cells treated with MNU similarly as in the first experiment were cultured with or without IL-6 (100 ng/ml) for 1 week before the cells (5 x 10(4)) were grown in soft agar in the presence or absence of IL-6. IL-6 pretreatment increased colony counts irrespective of subsequent IL-6 treatment (P < 0.05). Moreover, IL-6-stimulated anchorage-dependent growth of MNU transformants far exceeded that of the parental MYP3. However, among the transformants, there was no parallel relationship in response to IL-6 between anchorage-dependent and -independent growth. Our results suggest that IL-6 may provide a selective growth advantage to MNU-initiated bladder epithelial cells in vitro and that it may be a factor accounting for the marked enhancement of inflammation-associated rat bladder carcinogenesis.

[Invention of a forced-air-ventilated micro-isolation cage and rack system--environment within cages: temperature and ammonia concentration]

There is little information about microenvironments within laboratory animal cages, although several guidelines on the macroenvironment in laboratory animal rooms have been reported. We have developed a forced-air ventilation system (FVMIS) to improve laboratory animal well-being. In this study, we tested the performance of the FVMIS in terms of temperature and ammonia concentration within cages. Continuous measurement of temperature and ammonia concentration was carried out in FVMIS cages housing 5 rats each. The average temperature within the cages was 22 degrees C to 24 degrees C, and the temperature difference among cages was 0.93 degrees C. The air exchange rate used was 65 changes per hour. FVMIS was capable of controlling the temperature within cages uniformly and accurately with a lower air exchange rate than with the conventional system. The ammonia concentration reached 20 ppm within 9 days in a filtercapped conventional cage, but took 13 to 16 days to reach 20 ppm with FVMIS. It appears that FVMIS is capable of suppressing the ammonia concentration increase in cages, thereby reducing the frequency of cage changes and the stress to laboratory animals when cages are changed. In the present study, it was confirmed that FVMIS contributes not only to microenvironmental control in terms of temperature and ammonia concentration with a lower air exchange rate, but also to animal well-being.

Early-onset respiratory syncytial virus pneumonia after allogeneic bone marrow transplantation

A 41-year-old woman with follicular lymphoma developed sporadic respiratory syncytial virus (RSV) pneumonia shortly after allogeneic bone marrow transplantation from an HLA-matched sibling. RSV pneumonia is potentially fatal in immunosuppressed patients, but she improved along with the recovery of bone marrow function without specific treatment. Early recovery of myelosuppression supported by granulocyte colony-stimulating factor may have helped to control RSV pneumonia.

[Pharmacokinetics of SK & F 104864 in experimental animals. I. Plasma level]

A camptothecin derivative, SK & F 104864 (topotecan), was injected for 30 minutes into the rabbit ear vein at a dose of 2 mg/kg or 5 mg/kg, and the plasma concentration was assayed by a HPLC method. The plasma level of SK & F 104864 (lactone form) decreased bi-exponentially with mean alpha and beta half-lives of 0.101 h and 0.849 h at 2 mg/kg, respectively, and 0.518 h and 7.57 h at 5 mg/kg, respectively. The AUCs were 0.846 micrograms.h/ml at 2 mg/kg and 2.14 micrograms.h/ml at 5 mg/kg. The plasma level of total topotecan (SK & F 104864 plus SK & F 105992) decreased bi-exponentially with mean alpha and beta half-lives of 0.696 h and 9.07 h at 2 mg/kg, respectively, and 0.795 h and 8.97 h at 5 mg/kg, respectively. The AUCs were 2.15 micrograms.h/ml at 2 mg/kg and 5.73 micrograms.h/ml at 5 mg/kg. The AUCs of lactone form were 39.3% of total topotecan at the 2 mg/kg dose and 37.3% at the 5 mg/kg dose, respectively. After intravenous bolus injection of SK & F 104864 at 20 mg/kg into Sarcoma 180 bearing mice, the alpha and beta half-lives of SK & F 104864 were 0.401 h and 3.99 h, respectively, and the AUC was 5.49 micrograms.hr/ml. The alpha and beta half-lives of total topotecan were 0.517 h and 4.27 h, respectively, and the AUC was 9.88 micrograms.hr/ml. The ratio of lactone form to total topotecan was 55.6%.

[Pharmacokinetics of SK & F 104864 in experimental animals. II. Tissue distribution]

After intravenous bolus injection of a camptothecin derivative, SK & F 104864 (topotecan), at 20 mg/kg into Sarcoma 180 bearing mice, the tissue concentration of total topotecan (SK & F 104864 plus SK & F 105992) in the mice decreased bi-exponentially, and the beta half-lives in most tissues were longer than those in plasma. The AUCs of total topotecan were extremely large in the kidney, that was followed by the pancreas > intestine > stomach > spleen > liver > thymus > lung > tumor > uterus > plasma. The concentration of total topotecan after 24 hours decreased to less than 2% of the peak level in most tissues except the kidney.

Direct enantiomeric separation of platelet-activating factor receptor antagonist SM-10661 by ligand-exchange high-performance liquid chromatography with a copper (II) N,S-dioctyl-D-penicillamine complex

The enantiomeric separation of SM-10661, a platelet activating factor receptor antagonist, was investigated by HPLC using ligand-exchange chiral stationary phases. The stereoisomers of SM-10661 could all be separated by ligand-exchange HPLC with a Cu(II) N,S-dioctyl-D-penicillamine complex (Sumichiral OA-5000). The mechanism for the resolution includes the involvement of hydrophobic interactions between SM-10661 and Cu(II) D-penicillamine.