Mucosal condition of the oral cavity and sites of origin of squamous cell carcinoma

PURPOSE

This study investigated the clinical appearance of the affected mucosa in patients with squamous cell carcinoma (SCC) in the oral and oropharyngeal region.

PATIENTS AND METHODS

The mucosal conditions of 396 patients was classified into two types. Type A, showing ulcer formation and/or tumor formation, and type B, showing only mucosal enlargement without any other abnormality.

RESULTS

Type A was detected in the oral cavity and oropharynx, and type B was observed only in the upper and lower alveolus and gingiva. Of 14 type B patients histologically evaluated for the relationship between the tumor cells and surface oral epithelium, 10 showed a disconnection between the epithelium and the tumor cells, whereas in two the tumor cells extended into the epithelium.

CONCLUSION

It was concluded that SCC of type B is not of oral epithelial origin, but is of maxillary sinus epithelium or odontogenic cell origin. In the mandible, type B SCC originates from odontogenic epithelium (odontogenic carcinoma).

[Amyloidosis of the small intestine secondary to rheumatoid arthritis and juvenile rheumatoid arthritis: report of two cases]

We herein report two cases of gastrointestinal amyloidosis, secondary to juvenile rheumatoid arthritis (JRA) in one, and rheumatoid arthritis (RA) in the other. A 21-year-old woman, who has been suffering from JRA for the past 12 years, was transferred to our hospital due to intense pain in the epigastrium and back, diarrhea, high fever, and paralytic ileus. Treatment by corticosteroid, antibiotics, protease inhibitor, and total parenteral nutrition was not effective. The laparoscopic surgery was performed because of repeated melena followed by an episode of hypovolemic shock. The resected specimen of the ileum showed histologically marked amyloid deposition in the arteriolar walls. A 83-year-old man with RA for 14 years, was admitted to our hospital with complaints of abdominal pain, nausea, and diarrhea. He underwent an emergency operation for perforation of the ileum. The resected specimen revealed amyloid deposition and non-caseating granulomas. The fragility and impaired blood supply caused by amyloid deposition in the vascular walls may have terminated in the severe intestinal lesion. Further clinicopathological studies along this line are keenly desired in order to establish therapeutic modalities for gastrointestinal amyloidosis.

Indium-111 antimyosin monoclonal antibody Fab imaging in patients with cardiomyopathy

Six patients with cardiomyopathy were imaged following intravenous injection of an indium-111 labeled monoclonal antibody directed against the heavy chain of cardiac myosin. Two patients had hypertrophic non-obstructive cardiomyopathy (HNCM), two patients had dilated cardiomyopathy (DCM), and two patients had specific heart muscle disease. One of 2 patients with HNCM and one of 2 patients with DCM had a positive antimyosin scan. The 2 patients with specific heart muscle disease manifested persistent blood pool activity of the antibody, thereby precluding interpretation of the images. The present report demonstrates that antimyosin antibody imaging may provide evidence of myocardial injury, or necrosis in some patients with cardiomyopathy.

Characteristics of specific 125I-omega-conotoxin GVIA binding and 125I-omega-conotoxin GVIA labeling using bifunctional crosslinkers in crude membranes from chick whole brain

Characteristics of specific 125I-omega-conotoxin GVIA (125I-omega-CgTX) binding and 125I-omega-CgTX labeling using bifunctional crosslinkers were systematically investigated in crude membranes from chick whole brain. Aminoglycosides and dynorphine A (1-13) inhibited the specific binding of 125I-omega-CgTX, but not that of the L-type calcium ion channel antagonist [3H](+)PN200-110. It seems likely that the inhibitory effect of dynorphine A (1-13) does not involve kappa-opiate receptors, based on results with the opiate receptor antagonist naloxone and the kappa-opiate receptor agonist U50488H. Spider venom, Cd2+ and La3+ inhibited the specific binding of 125I-omega-CgTX, as well as that of [3H](+)PN200-110. Various L-type Ca2+ channel antagonists did not affect the specific binding of 125I-omega-CgTX. 125I-omega-CgTX specifically labeled 135 kDa and 215 kDa bands in crude membranes under reduced and non-reduced conditions, respectively. The crosslinker disuccinimidyl suberate (DSS) yielded better 125I-omega-CgTX labeling than the other two crosslinkers tested. We investigated the effect of various Ca2+ channel antagonists on 125I-omega-CgTX labeling with DSS in detail, and found that there is a strong correlation between the effects of Ca2+ channel antagonists on 125I-omega-CgTX labeling of the 135 kDa band and specific 125I-omega-CgTX binding. These results suggest that aminoglycosides and dynorphine A (1-13) are specific inhibitors of specific 125I-omega-CgTX binding, and that labeling of the 135 kDa band with 125I-omega-CgTX using DSS involves the specific binding sites of 125I-omega-CgTX, perhaps including one of the neuronal N-type Ca2+ channel subunits in the crude membranes.

Effect of acoustic overstimulation on the hydropic ear

The effect of acoustic overstimulation (2 kHz pure tone) on the compound action potential (CAP) threshold was investigated at frequencies ranging from 2 to 16 kHz using albino guinea pigs, both normal and with experimentally induced endolymphatic hydrops. The hydropic ears were less susceptible to acoustic overstimulation than the normal ears. As the CAP threshold was raised, the frequency exhibiting the greatest CAP threshold shift increased in both animal groups. The tendency was more noticeable in the hydropic ears than in the normal ears. These results are discussed from the aspect of cochlear hydrodynamics.

[A case report of a 6-year-old boy with intracranial yolk sac tumor treated by VAB-6 regimen]

Several clinical trials have demonstrated that cisplatin-based chemotherapy for primary intracranial germ-cell tumors is effective as a neoadjuvant chemotherapy. In this report, we describe a 6-year-old boy, Down syndrome and Hirschsprung's disease with intracranial pure yolk sac tumor treated by combined chemotherapy with cisplatin, vinblastine, bleomycin and cyclophosphamide (modified VAB-6 regimen). He had been admitted to our hospital because of intractable vomiting, and left facial nerve palsy since 1 month before. An MRI revealed an enlarged mass, 4cm in diameter, in the left cerebello-pontine angle with uniformal enhancement by Gd-DTPA, and bilateral ventricular dilatation. He was found to have increased serum alpha-fetoprotein level (AFP 11, 786ng/ml), but not human chorionic gonadotropin beta-subunit. After a partial resection of the tumor, diagnosed as pure yolk sac tumor, and ventriculo-peritoneal shunt, three courses of combined chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide (modified VAB-6 therapy) were carried out. The serum AFP level returned to normal, and the tumor mass entirely disappeared (a complete response) on MRI after the second course of chemotherapy. However, cisplatin-induced vomiting and mild neutropenia and renal tubular injury developed after the third course of chemotherapy. Irrespective of administration of recombinant human G-CSF and broad spectrum antibiotics, he suffered from pneumonia and died of septic shock and multiple organ failure. Autopsy showed microscopic residual tumors. The combination chemotherapy with cisplatin, bleomycin, vinblastine and cyclophosphamide is effective for initial treatment of childhood intracranial yolk sac tumor. It is necessary, however, to reevaluate the cisplatin dosage and treatment schedule in order to reduce such side effects as bone marrow suppression and renal damage.

Synthesis of oligonucleotide having a bent structure by incorporation of an interresidually cyclized uridylyl (3'-5')uridine unit

The chemical synthesis and conformational properties of interresidually cyclized uridylyl(3'-5')uridine derivatives were studied in order to introduce a stable turn structure into oligonucleotides. These cyclized molecules were analogs of uridylyl(3'-5')5-[methylamino(methyl)]-uridine which is the component of the U turn structure of tRNAarg E. coli. The conformational properties of these cyclic dinucleoside monophosphates were studied using NMR and CD spectroscopy with the aid of molecular mechanics and molecular dynamics simulations. These experiments indicated that the turn conformation could be stabilized by introducing a cyclic structure as expected. On the basis of these results, the chemical synthesis of phosphoramidite units of these cyclic dinucleoside monophosphate derivatives were studied to construct oligonucleotides having a stable bent structure.

Synthesis and properties of oligo-omega-amino acids derivatives containing nucleosides

Nucleic acid analogs, that consist of oligo-omega-amino acids as main chains were synthesized. At first, hydroxyl group of deoxy and ribonucleic acid was converted into amino or carboxylic acid group. Then, amino acid derivatives containing aminonucleoside or nucleoside-5'-carboxylic acid at alpha-position were synthesized. Amino acids used in this paper were L-glutamic acid, L-2-amino adipic acid (L-homo glutamic acid), L-ornithine, and L-lysine. These amino acid derivatives containing nucleoside were oligomerized by activated ester methods and Merrifield's solid phase synthesis. The properties of these analogs were studied and compared with oligo-alpha-amino acid derivatives containing nucleoside at omega-position.

[Tension pneumocephalus in association with ventriculoperitoneal shunt and congenital bony defect in the mastoid tegmen]

The authors report a case of tension pneumocephalus in association with a congenital bony defect at the mastoid tegmen, and a ventriculoperitoneal (V-P) shunt for obstructive hydrocephalus, due to the presence of a posterior fossa meningioma. After multiple diagnosis and surgical procedures, congenital bony defect at the right mastoid tegmen demonstrated by a middle ear cavity computerized tomography (CT) scan, was identified as the source of entry of the air. The air must have penetrated the lateral ventricle through a porencephalic cyst in the right temporal lobe. Reconstruction of the bony defect in the mastoid tegmen successfully prevented further recurrence of tension pneumocephalus. We discussed the possible pathogenic mechanisms involved in this kind of tension pneumocephalus, and suggested that a middle ear cavity CT scan should be performed for tension pneumocephalus that has developed after V-P shunt.

New thermoluminescent BaSO4:Eu sheet for in vivo measurement of spatial dose distribution in radiation therapy

A new highly sensitive thermoluminescent (TL) sheet has been studied as a means of in vivo measurement of spatial dose distribution of radiation therapy. This TL sheet (40 cm x 50 cm x 0.2 mm), which is composed of teflon mixed with BaSO4:Eu doped powder, is very flexible and can be cut to the desired size. The TL sheet was found to have a linear response with a very wide dynamic range of at least 0.002 cGy to 5000 cGy absorbed dose. In addition, this sheet does not need be shielded, because of its insensitivity to room light, and therefore the sheet can detect low-energy electrons decreased by a few millimeter thick air for 3H(maximum beta-ray energy: 18 KeV). The spatial dose distribution was printed out with a newly developed digital readout system. In addition, another high-resolution dosimetry system, which exposes X-ray film with TL photons emitted from the irradiated TL sheet at constant room temperature, is reported. Clinically, the in vivo dose distribution on the surface of the rectal cancer for intracavitary radiation therapy was determined. The applicability of TL sheet for in vivo measurement of dose distribution is discussed.

Tooth loss and mandibular osteopenia

The relationship between mandibular bone mass and tooth loss was studied in 269 patients who had neither metabolic disease nor local lesions affecting the mandibular cortex. In all of the subjects, the outline of the mental foramen was distinctly disclosed on unilateral or bilateral panoramic radiographs. Mandibular bone mass was evaluated by determining the mandibular cortical width in the mental region with the use of panoramic radiographs. The relationships of mandibular cortical width to patient age and sex and the number of teeth present were also investigated. In male subjects, there was no significant correlation between the number of teeth present and the mandibular cortical width. Among women in their seventh decade, those with 15 or more teeth showed significantly greater mandibular cortical width than those with fewer teeth. Decrease of mandibular bone mass was positively correlated with tooth loss in female subjects.

Role of angiotensin II in cerebrovascular and renal damage in deoxycorticosterone acetate-salt hypertensive rats

OBJECTIVE AND DESIGN

To study the effects of blockade of the renin-angiotensin system on the development of hypertension and end-organ damage in hyporeninaemic deoxycorticosterone acetate (DOCA)-salt hypertensive rats, using an angiotensin II (Ang II) receptor antagonist (TCV-116) or an angiotensin converting enzyme (ACE) inhibitor (enalapril).

METHODS

DOCA-salt hypertensive rats were produced by uninephrectomy, implantation with DOCA pellets and 1% NaCl loading. TCV-116 (0.1 or 1 mg/kg) or enalapril (10 mg/kg) was given orally once a day from 3 to 6 weeks after the operation. Body weight, blood pressure, plasma renin and creatinine, urinary protein and blood urea nitrogen were measured. After 3 weeks' treatment, oedema and omega 3-subtype benzodiazepine receptor binding in the brain were measured.

RESULTS

Three weeks after the operation the blood pressure in the DOCA-salt hypertensive rats was approximately 200 mmHg, and the plasma renin concentration was lower than in sham-operated rats. However, after a further 3 weeks the renin concentration was slightly above the normal level, and this increase was accompanied by a decrease in body weight and increases in blood urea nitrogen, plasma creatinine, urinary protein and omega 3-subtype benzodiazepine receptor binding in the cerebral cortex, and by brain oedema. Treatment with TCV-116 or enalapril prevented renal damage and decrease in body weight with little effect on blood pressure. Enalapril prevented brain oedema and the increase in benzodiazepine binding in the brain cortex, and 1 mg/kg TCV-116 prevented them markedly.

CONCLUSIONS

Although the hypertension in DOCA-salt hypertensive rats is independent of the renin-angiotensin system, the degree of cerebral and renal damage is associated with the activity of the renin-angiotensin system and has little relationship with the blood pressure level.

The effect of the sympathetic nervous system upon susceptibility to acoustic trauma

This study was designed to determine whether the sympathetic nervous system exerts a protective or enhancing effect in acoustic overstimulation. The compound action potential of the cochlea (CAP) was recorded in guinea pigs while the cervical sympathetic nervous system (SNS) was electrically stimulated or after it was surgically eliminated. The stimulation or the elimination of the cervical SNS has no effect on the threshold of CAP. The threshold shift in CAP after acoustic overstimulation (110, 115, or 130 dB SPL for 10 min) was measured in the cervical SNS stimulation group, in the cervical SNS elimination group, and in the control group. When the animal was under insufficient sedation, there was no difference among these three groups. However, the CAP threshold shift was significantly smaller in the cervical SNS stimulation group than in the other two groups when the animals were sufficiently sedated. The cervical SNS stimulation had some protective effect on the susceptibility to acoustic trauma when the systemic SNS activity was suppressed.

The effects of Tripterygium wilfordii extract on adjuvant arthritis in rats

The effects of the extract of Tripterygium wilfordii. (TWE) on experimental adjuvant arthritis (AA) in the rat was studied. Lewis rats induced with AA were administered with TWE at 50 mg/kg/day for 10 weeks. The paw volume, its ratio to the body weight (paw ratio) and the radiologic changes in the feet of the rats with AA taking TWE were compared with those in the rats taking indomethacin (0.5 mg/kg/day) and no additional drugs. The rats taking TWE showed a smaller paw volume, a lower paw ratio and milder radiologic changes than the rats taking no drugs, however, the beneficial effects were weaker than those of indomethacin. We concluded that the beneficial effects of TWE on rats with AA was suggested. However, these results still need to be further confirmed by additional experiments.

Increased IL-1 receptor antagonist (IL-1ra) production and decreased IL-1 beta/IL-1ra ratio in mononuclear cells from rheumatoid arthritis patients

In order to investigate the possible role of IL-1 receptor antagonist (IL-1ra) in patients with rheumatoid arthritis (RA), this study was undertaken to measure the amounts of IL-1ra and interleukin-1 beta (IL-1 beta) protein produced by mononuclear cells (MNC) and to investigate the relationship between production of these cytokines and clinical parameters. The MNC were cultured for 24 h and the supernatants were measured for IL-1ra and IL-1 beta by ELISA kits. MNC from peripheral blood (PB) and synovial fluid of RA patients produced significantly higher amounts of IL-1ra than normal PBMNC (P < 0.01 and P < 0.05, respectively). When the IL-1 beta/IL-1ra ratio was calculated, IL-1 beta/IL-1ra ratios of RA PBMNC were significantly lower than those of normal PBMNC (P < 0.001). The IL-1 beta/IL-1ra ratio of RA PBMNC was significantly higher in active RA patients than in RA patients in remission (P < 0.02). The amounts of IL-1ra produced by stimulated RA PBMNC positively correlated with the joint score (P < 0.05), serum CRP levels (P < 0.05) and the amounts of IL-1 beta produced (P < 0.01). The amounts of IL-1ra produced by unstimulated RA PBMNC did not correlate with any of the clinical parameters studied. Gold sodium thiomalate (GST), but not auranofin, increased IL-1ra production in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparative study of eosinophil isolation by different procedures of CD16-negative depletion

Eosinophils were isolated by the three methods of CD16-negative depletion: 1) magnetic beads, 2) fluorescence-activated cell sorter (FACS), and 3) complement reaction. Their purity, yield, and viability were compared. The second procedure produced well purity and viability (94.65 +/- 1.51% and 94.98 +/- 1.40%, respectively) but low yield of eosinophils (65.47 +/- 2.47%). The viability of cells obtained by the third procedure was not efficient (80.83 +/- 2.85%), while the purity and the yield were efficient (96.23 +/- 1.09% and 90.75 +/- 1.72%, respectively). In conclusion, the magnetic beads method (purity: 98.02 +/- 0.45%, yield: 91.05 +/- 2.43%, viability: 97.57 +/- 0.37%) was the most advantageous of these three procedures. Moreover, in the functional assay, radical oxygen products from eosinophils isolated by the procedure with complement reaction were less than with the magnetic beads or FACS procedures.

Restenosis after successful emergency coronary angioplasty for acute myocardial infarction: comparison with elective angioplasty

We investigated the initial and late restenosis rate after successful emergency coronary angioplasty in 64 patients with acute myocardial infarction, and compared these results with those of 100 patients (110 lesions) who had successful angioplasty on an elective basis. The majority of the baseline clinical and angiographic variables were similar in the myocardial infarction and elective groups. The restenosis rate at 1 month was high in patients undergoing emergency angioplasty for acute myocardial infarction (23 vs. 12%). At 3-6 months, the angiographic restenosis rate was low for the infarction group (26 vs. 37%). The overall restenosis rate was similar in the infarction and elective groups (39 vs. 40%). Lesion regression after coronary angioplasty was more frequent in the infarction than in the elective angioplasty group (27 vs. 14%, P < 0.05). These findings suggest that considering the high restenosis rate at 1 month and the lower, but still 20% or more, rate at 3-6 months, a follow-up angiography should be performed both prior to discharge and at 3-6 months after the procedure, in patients with acute myocardial infarction.

[Clinical features and long-term outcome of non-Q wave myocardial infarction in the elderly: comparison with Q wave myocardial infarction]

The clinical features and long-term outcome of non-Q wave myocardial infarction (NQMI) in the elderly were assessed in 24 patients with NQMI and compared with those in 48 patients with Q wave myocardial infarction (QMI). NQMI patients had a significantly lower maximal peak of serum creatine phosphokinase activity and lower incidence of pump failure during the acute phase. In-hospital mortality did not differ significantly between the NQMI and QMI patients. Evaluation of acute-phase coronary angiographic features within 6 hours of onset found a significantly higher incidence of infarct-related vessels in the NQMI patients, but the frequency of multivessel disease and the level of collateral flow did not differ between the two groups. Fifteen of the 24 NQMI patients and 34 of the 48 QMI patients underwent emergency coronary revascularization procedures of percutaneous transluminal coronary angioplasty (PTCA) or intracoronary thrombolysis. Successful recanalization was more frequent and the time to recanalization was shorter in the NQMI patients. The requirement for coronary revascularization (PTCA or coronary artery bypass graft) in the chronic phase for residual stenosis did not differ significantly between the two groups. Left ventricular ejection fractions were significantly better in the NQMI patients. The short- and long-term outcomes in elderly patients with NQMI and QMI were good and did not differ between the two groups, probably reflecting the active performance of revascularization in the acute and chronic phases.

Essential involvement of interleukin-8 (IL-8) in acute inflammation

Neutrophil infiltration into inflammatory sites is one of the hallmarks of acute inflammation. Locally produced chemotactic factors are presumed to mediate the sequence of events leading to the infiltration at inflammatory sites. Interleukin-8 (IL-8), a novel leukocyte chemotactic activating cytokine (chemokine), is produced by various types of cells upon stimulation with inflammatory stimuli and exerts a variety of functions on leukocytes, particularly, neutrophils in vitro. However, no definitive evidence has been presented on its role in recruiting and activating neutrophils in the lesions of various types of inflammatory reactions. We administered a highly specific neutralizing antibody against IL-8 in several types of acute inflammatory reactions, including lipopolysaccharide (LPS)-induced dermatitis, LPS/IL-1-induced arthritis, lung reperfusion injury, and acute immune complex-type glomerulonephritis. Anti-IL-8 treatment prevented neutrophil-dependent tissue damage as well as neutrophil infiltration in these conditions. These results suggest that IL-8 plays a causative role in acute inflammation by recruiting and activating neutrophils.