[Problem of the long-term arterial infusion therapy with implantable reservoir for unresectable hepatocellular carcinoma]

Arterial infusion therapy with implantable reservoir was performed for forty-seven cases with unresectable hepatocellular carcinoma since 1986-1991. The one-year survival rate of cases of arterial infusion therapy with implantable reservoir was 50.6% and the 2-year survival rate was 37.8%. The survival rate was 51.4% and 32.2%, respectively, in the TAE cases for the same period. Considering the kinds of reservoirs used for HCC, the survival curve of 23 cases with double lumen reservoir showed a significantly better pattern than that of 24 cases with the usual single lumen reservoir (p less than 0.05). Cumulative usable rate of reservoir was 78.6% at one year, and 42.4% at two years (Kaplan-Meier method). Therapy after the reservoir was unusable, particularly with arterial obstruction by catheter, was restricted because arterial infusion therapy was impossible. It is considered very important to retain the hepatic artery because arterial infusion therapy is mainly for unresectable hepatocellular carcinoma.

Characterization of antibodies to advanced glycosylation end products on protein

Antibodies directed against advanced glycosylation end products (AGEs) formed during a Maillard reaction have been generated and characterized. Since protein-bound AGEs recognized by the antibodies were labile to acid hydrolysis, the antibodies were further characterized by using the AGE-alpha-acetyl-L-lysine methyl ester (AGE-ALME) with a brown and fluorescent property as well as the AGE-proteins. The antibodies reacted with fluorescent compounds, rather than brown pigment compounds, in the AGE-ALME. The fluorescent compounds in the AGE-ALME were separated into four fluorescent compounds by reversed-phase thin layer chromatography (TLC). Of the fluorescent compounds tested, compound 3 (Rf = 0.63), as designated on a TLC plate, showed the highest affinity for the antibodies. In addition, the antibody recognition to the cross-linked oligomers with fluorescence in the AGE-protein was investigated by using bovine pancreatic ribonuclease A (RNase), which is known as a model protein for studying AGE-induced cross-linking. Fluorescence in the AGE-RNase existed in both of the oligomers and the monomer. The cross-linked oligomers exhibited higher affinity to the antibodies than did the monomer, which has a similar degree of fluorescent intensity. These results indicate that our antibodies against cross-linked protein-bound AGEs may serve as a useful tool to elucidate pathophysiological roles of advanced Maillard reaction in diabetic complications and aging processes.

The critical role of blood from HLA-homozygous donors in fatal transfusion-associated graft-versus-host disease in immunocompetent patients

Fatal transfusion-associated graft-versus-host disease developed in a 69-year-old woman with colon cancer who underwent elective hemicolectomy. During the perioperative period, she was transfused with 4 units of nonirradiated fresh whole blood less than 6 hours after the blood was donated by family members. She was immunocompetent and was not treated with any immunosuppressive agents such as corticosteroids, chemotherapy, or irradiation therapy. The implicated donor was thought to be her daughter, who was homozygous for an HLA haplotype that was shared with the recipient: A24, Bw52, CBL, DR2. This is the most common haplotype in the Japanese population. This case and others in the Japanese literature indicate that the transfusion of fresh, nonirradiated blood that contains immunocompetent lymphocytes and peripheral hematopoietic precursor cells from HLA-homozygous donors can be lethal to the recipient.

Radioimmunoassay for the determination of glycated haemoglobin

A competitive radioimmunoassay for the quantitative determination of glycated haemoglobin was developed. The antiserum, obtained by immunizing guinea pigs with reduced glycated human albumin, was capable of identifying and quantitating the glucitollysine residues of glycated Hb after reduction with sodium borohydride. To simplify the sample preparation we introduced trichloroacetic acid precipitation to remove unreacted sodium borohydride instead of using dialysis or gel filtration. Using this procedure, our radioimmunoassay became relatively simple and provided satisfactory within- and between-run (1.3-2.8% and 1.9-5.4% coefficient of variation, respectively). The radioimmunoassay method was compared to the measurement of HbAlc by high performance liquid chromatography which is the most widely used method for quantitating glycated Hb. For this purpose glycated Hb was measured in normal glucose tolerance, impaired glucose tolerance, and diabetes mellitus groups based on WHO criteria. Both assays were able to discriminate between the normal and diabetic groups. In addition, while the determination of glycated Hb by the radioimmunoassay method was able to clearly discriminate between the normal and impaired glucose tolerance groups, the determination of HbAlc by the high performance liquid chromatography method failed to discriminate between these two groups. Moreover, 15 of the 20 impaired glucose tolerance patients exceeded the upper normal range (mean normal values + 2 SD) in radioimmunoassay. But all 20 patients with impaired glucose tolerance were within the upper normal range in HbAlc values. These results demonstrate that the measurement of glycated Hb by radioimmunoassay is more sensitive than the measurement of HbAlc by high performance liquid chromatography since it can discriminate between the normal and impaired glucose tolerance groups.

Guanine levels in house dust as a means of estimating the mite population

House dust has recently been incriminated as an important causative allergen in bronchial asthma and allergic rhinitis. In particular attention is being focused on the mites contained in house dust. Previously, the number of mites contained in house dust was determined by counting under a microscope. This method is not appropriate, however, for epidemiological investigations which require large numbers of specimens, as it is time-consuming and labor intensive. Guanine makes up about 0.3% of the body weight of mites and is present in large amounts in mite excrement, and by using an improved method for quantifying guanine in house dust we obtained a correlation coefficient of 0.776 between the number of mites and amount of guanine. In addition, because virtually no guanine is contained in human nails and hair, thus eliminating possible sources of error, it became clear that the amount of guanine in house dust can be used to estimate the total amount of mite allergen resulting from the bodies and excrement of the acarids.

The effect of abstinence from smoking on urinary excretion of hydroxyproline

The effect of abstinence from smoking on the urinary hydroxyproline to creatinine ratio (HOP ratio) was assessed in 49 smokers who participated in an anti-smoking course. Urine samples were collected at the beginning of the course and weekly during the subsequent 14 weeks in 1985. The subjects were divided into five groups depending on the number of cigarettes smoked daily before abstinence: 1-10, 11-20, 21-30, 31-40 and greater than 40 cigarettes. The urinary HOP ratio immediately after abstinence from smoking was proportional to the mean daily number of cigarettes smoked in the past. All groups showed decreasing HOP ratios with a longer period of abstinence. Half of the total decrease observed in the HOP ratios after 14 weeks was reached within 5 or 6 weeks. When using the Brinkman index to adjust for the number of smoking years, half of the maximum decrease in all groups was reached within 4 weeks. In an exponential decay model fitted to the data, the half-life time taken to reach the non-smokers' level was 9-10 weeks for all groups. The HOP level of smokers who smoked less than 41 cigarettes before cessation approached the HOP level of the control group after 61-74 weeks. The results suggested that the urinary HOP ratio was useful as a biochemical marker for short-term breakdown of lung collagen and lung elastin.

[Studies on the absorption kinetics of subcutaneously administered insulin]

This study was designed to evaluate, using compartmental model analysis, the effects of jet injection, changes in injected dosage, and mixture of short- and intermediate-acting insulin preparations on the absorption kinetics of human insulin (HI) mainly in rabbits. The following results were obtained. (1) It was found that a split-pool model was adequate for the evaluation of the absorption kinetics of insulin. (2) Jet injection resulted in more rapid absorption of insulin than needle injection. Since parameter K12 (inter-pool rate constant) of jet injection was three times as large as that of needle injection, the accelerated absorption by jet injector could result from the rapid movement of insulin from the injection site to the absorption site. (3) A negative correlation between insulin dosage and Kd (degradation rate constant) was observed, suggesting that the process of subcutaneous absorption of insulin includes a nonlinear component. (4) The prompt injection of Actrapid HI mixed with Monotard HI in a single syringe caused a delayed absorption of Actrapid HI. In contrast, there was no prolonged absorption after the injection of regular HI mixed with NPH-HI in a single syringe. There was a significant positive correlation between the percent change of K12 (in separate injection and mixed injection) in vivo and the recovery rate of short-acting insulin when mixed with intermediate-acting insulin in vitro. In clinical studies of diabetic subjects, higher serum free insulin levels before noon and higher K12 values were observed after the mixed injection of regular HI and NPH-HI, compared with that of Actrapid HI and Monotard HI. These results suggest that the application of compartmental model analysis is useful to studying the absorption kinetics of subcutaneously injected insulin.

[Study on the pharmacokinetics of UFT in patients with hepatocellular carcinoma associated with cirrhosis]

UFT was administered preoperatively in 20 cases of primary hepatocellular carcinoma, and tegafur, 5-fluorouracil (5-FU), uracil, total thymidylate synthase (TS) and free TS in blood and liver tissue were determined. The results were as follows. 1. Tegafur level was significantly high in blood, while the levels of 5-FU and uracil were high in the liver tissue. The 5-FU level in the cancerous area was 0.099 micrograms/g, higher than the effective level regardless of the presence or not of complication with liver cirrhosis. 2. Total TS, FdUMP (computed as total TS-free TS) and TS inhibition rate [(computed as (TS-free TS)/TS x 100 (%)] were significantly higher in the cancerous liver tissue than in the non-cancerous area. In the cases where determination was made simultaneously for the cancerous liver and non-cancerous liver tissues, the FdUMP level and TS inhibition rate in the cancerous liver tissue were high in 14 out of 17 cases (82.4%) and 13 out of 17 cases (76.5%) respectively. Therefore, UFT seems to have selective toxicity. 3. No correlation was found between 5-FU level, total TS, FdUMP in the liver tissue on the one hand and TS inhibition rate on the other. 4. UFT yielded sufficient 5-FU levels in the cancerous area regardless of the presence or not of complication with cirrhosis and therefore is expected to inhibit DNA synthesis selectively in the cancerous tissue.

[An epidemiological study on the relationships among HDL-cholesterol, smoking and obesity]

The relationships among high-density lipoprotein cholesterol (HDL-C) and other serum lipid items, and active smoking, passive smoking, obesity, alcohol drinking and working status were investigated. This study was performed both in healthy adults and in schoolchildren. The adult group was sampled at random from those who were diagnosed to be healthy by medical examination at the Automated Multiphasic Health Testing and Services Center in Tokai University Hospital, and the schoolchildren group was selected with regular health examinations in a primary school in Tokyo. In the case of adults, it was found that the greater the value of triglyceride (TG), the greater the number of cigarettes smoked. On the other hand, HDL-C decreased with increasing cigarette smoking. Obesity level increased with increasing values of TG, total cholesterol (TC) and low density lipoprotein (LDL-C) but in the case of HDL-C, the value decreased. Alcohol drinking made the HDL-C level increase. Although the HDL-C level increased slightly with obesity, the relationship between HDL-C and passive smoking was not clear in the case of schoolchildren.

[Reservoir implanted arterial infusion therapy in liver cancer with replaced right hepatic artery]

Seven cases of liver cancer with replaced right hepatic artery were treated with arterial infusion therapy using implanted reservoir. The reservoir was surgically implanted in all cases. In 5 cases, right hepatic artery ligation was done simultaneously. TAE via right hepatic artery and ligation of middle and left hepatic artery was done in 2 other cases. ADM, CDDP, MMC, 5-FU and Lentinan were used. As the result, decrease in tumor size or necrosis of tumor was found in 3 cases of hepatomas, necrosis of tumor was found in 1 of three cases of metastatic liver cancer and remarkable decrease in tumor size and normalization of CEA level were found in another case. Arterial infusion therapy using implanted reservoir for the cases with variation would be effective with the combination of hepatic ligation or TAE.

Production and characterization of antibodies to advanced glycation products on proteins

Antibodies directed against advanced glycation products formed during Maillard reaction have been generated and characterized. These antibodies reacted specifically with advanced glycation products in common among proteins incubated with glucose, but not early-stage compounds such as a Schiff base adduct and Amadori rearrangement products. Incubation of bovine serum albumin with glucose caused a time-related increase in immunoreactivity and a concomitant increase in fluorescence intensity. These antibodies may serve as a useful tool to elucidate pathophysiological roles of advanced Maillard reaction in diabetic complications and aging processes.

Measurement of dephasing time using incoherent light in the Kerr shutter configuration

We propose a convenient signal-selective method to measure the dephasing time using incoherent light performed in the Kerr shutter configuration. The advantage of this method is easy alignment, which allows one to obtain a better signal-to-noise ratio than with ordinary forward two-beam degenerate four-wave mixing. The dephasing time of Cresyl Violet doped in a polymethyl methacrylate film obtained by this method is compared with the result from ordinary two-beam degenerate four-wave mixing.

Radioimmunoassay for non-enzymatically glycated serum proteins

We have developed a radioimmunoassay (RIA) for nonenzymatically glycated serum proteins. The polyclonal antibodies prepared against reduced glycated human albumin were specific for the glucitollysine residues of serum proteins. Serum proteins from diabetic patients (n = 25) contained 5.3 +/- 2.8 nmoles of glucitollysine/mg protein, compared to 2.0 +/- 0.2 in controls (n = 20). The intra- and inter-assay variables were 3.2-6.2% and 4.4-8.6%, respectively. Results from this assay procedure correlated well with those from the boronate affinity chromatography procedure (r = 0.94; P less than 0.001). The data suggested that diabetic serum proteins contained at least 2.5 times as much immunochemically detectable glucitollysine residures as normal serum proteins after reduction of the proteins with sodium borohydride.

A radioimmunoassay for an advanced glycosylation endproduct

A competitive radioimmunoassay for an advanced glycosylation endproduct, 2-(2-furoyl)-4(5)-(2-furanyl)-1H-imidazole (FFI) was developed. The immunogen was prepared by coupling of 4-furanyl-2-furoyl-1H-imidazole-1-hexanoic acid to keyhole limpet hemocyanin. The antiserum obtained by immunizing guinea pigs with the immunogen exhibited high affinity binding to FFI, but no cross-reactivity was observed for structurally related compounds containing an imidazole ring or furan ring(s). By using the radioimmunoassay, the levels of FFI in bovine serum albumin incubated with glucose for varying lengths of time were measured. A time-dependent increase was obtained in the amount of acid-liberated FFI and fluorescence. The radioimmunoassay described here had satisfactory reproducibility as judged by the intra-assay precision of 3.4-6.4% and the interassay precision of 7.3-8.9%. The method allows to quantitate FFI on the modified proteins that have been implicated in the complications of diabetes and in normal aging as well.

[Fabrication and clinical application of intrahepatic arterial catheter facilitating repeated infusion therapy and experience]

Balloon occluded arterial infusion (BOAI) is an ideal and widely accepted method for augmentation of the intrahepatic tissue level of anticancer drugs. But this method nakes repeated infusion very difficult because the Seldinger method is needed to cannulate into the hepatic artery. Recently, we made an intrahepatic artery catheter attached with an implantable reservoir, consisting of an intra-arterial catheter, reservoir and cylinder-like device which has a small balloon on its inner part. The cannulation is done at laparotomy. With this method, five cases of nonresectable hepatocellular carcinoma, one metastatic liver cancer and one noncurative hepatocellular carcinoma were treated. Intrahepatic vessels were quite visible by DSA using CO2 gas. Serum concentration level of adriamycin was lower and undetectable at 120 minutes after infusion. No side effects nor catheter complications were observed. Intra-arterial infusion therapy using this device will be a most useful routine method for cancer control in the outpatient clinic.

Determinants of indoor NO2-concentration and the personal exposures of children and their mothers in Japanese homes

In February and in July 1986 the personal exposures to NO2 of 60 children and their mothers were measured and NO2-concentrations in their homes were measured. In the summer also the NO2-concentration in the kitchen was determined during the time that the mother was in the kitchen. The mothers were asked to keep a diary of the activities of her and her child during that day and of the time that the heating appliances, cooking range, etc. were used. In the winter indoor NO2-concentrations and personal exposures of mother and child were much higher than in the summer. In the winter in many cases the Japanese Ambient Air Quality Standard is exceeded. The elevated levels in the winter can be related to the use of NO2-producing heating appliances especially the gas- or oilstove without a flue. Appliance of a flue still causes the indoor NO2-concentrations to be elevated. The division of a study population into two exposure categories on the basis of presence of a non-vented gasstove is therefore inappropriate. An instantaneous gas fired water heater may also contribute to elevated indoor NO2-concentrations and personal exposures, although the present survey could not provide detailed information about the use of a flue and the location of the geyser. The time that a gasrange is being used may influence the indoor NO2-concentrations, but the results from this survey were not clear. Ventilation in the kitchen reduces the indoor NO2-concentrations, although this seems especially true in case the gas range is being used for a long time. In houses with smokers higher NO2-concentrations were found than in houses with non smokers. In the winter the non-vented gas stove is the most important indoor NO2-source. The present study was not able to demonstrate the effect of outdoor NO2-concentrations on the indoor air concentrations. A longer time span would be necessary. The housestructure, i.e. the construction of the house and the number of rooms influence the indoor NO2-concentrations and personal exposure. In the winter all indoor NO2-concentrations are highly intercorrelated and also highly correlated with the personal exposures of mother and child. Multiple regression models based on either measured or time-weighted NO2-concentrations explain about 85 percent of the variance in the personal exposures of child and mother in the winter. The exposures calculated from the time-weighted NO2-concentrations correlate very well with the measured personal exposures. This was not the case in the summer.(ABSTRACT TRUNCATED AT 400 WORDS)

Impact of smoking on the concentration and activity of alpha-1-antitrypsin in serum in relation to the urinary excretion of hydroxyproline

The impact of active and passive smoking on the serum levels of alpha 1-AT, the trypsin inhibitory capacity (TIC), the trypsin inhibitory activity (TIA) and the urinary hydroxyproline to creatinine ratio (HOP-ratio) was studied. The subjects used in the study on active smoking were 167 healthy adult men and in the study on passive smoking 189 healthy primary school children. Serum levels of alpha 1-AT in active smokers were significantly higher than those in non-smokers. The TIC as well as the TIA in active smokers decreased with increasing number of cigarettes smoked. The urinary HOP-ratio increased significantly with increasing number of cigarettes smoked. On the other hand, in the case of passive smokers a significant difference was obtained only for the HOP-ratio. The correlations between all markers in active smokers were significant. Less significant correlations were found in the case of passive smokers. These results suggest that the urinary excretion of hydroxyproline can be considered as a marker for the imbalance between proteases and anti-proteases as a result of smoking.

[A case of leiomyosarcoma of the prostate]

A 50-year-old man with the symptom of anal pain was treated by pelvic exenteration, ileal conduit diversion and artificial anus. The pathologic diagnosis was leiomyosarcoma of the prostate. At 5 months post-operatively, the patient had no evidence of metastasis or recurrence.

Antibodies to nonenzymatically glucosylated albumin in the human serum

The existence of antibodies to nonenzymatically glucosylated albumin was investigated in nondiabetic and diabetic subjects. The sera from both the nondiabetic and the diabetic subjects were shown to contain the proteins which bound to reductively glucosylated albumin. An enzyme-linked immunosorbent assay demonstrated that the antibodies specific for reductively glucosylated albumin existed in the sera containing the binding proteins. For binding the antibodies glucitollysine as the glucose adduct in reductively glucosylated albumin was an effective competitor. The hexose alcohol epimers glucitol and mannitol were also effective competitors compatible with glucitollysine. Our results suggest that the antibodies to reductively glucosylated albumin are widely present not only in the diabetic subjects but also in the nondiabetic subjects and cross-react with the hexose alcohol.

Mechanism of hepatic megamitochondria formation by ammonia derivatives. Correlation between structure of chemicals and their ability to induce the formation of megamitochondria

Correlation between the chemical structure and the ability to induce hepatic megamitochondria formation was studied by feeding mice and rats diets containing a wide spectrum of ammonia derivatives. Ammonia derivatives with electron-releasing groups, such as hydrazine, phenylhydrazine, hydroxylamine and aniline were effective in inducing megamitochondria. Ammonia derivatives with electron-withdrawing groups, such as formamide, sulfamic acid, acetamide were ineffective in inducing megamitochondria. Inducibility of ammonia derivatives with electron-releasing groups plus electron-withdrawing groups for the megamitochondria formation was dependent upon nucleophilicity of the chemical: 2,4-dinitrophenylhydrazine induced megamitochondria, while acetanilide did not induce megamitochondria. The megamitochondria formation induced by ammonia derivatives was a reversible process. Freeze-fracture studies on megamitochondria indicated that megamitochondria were formed by the fusion of adjacent mitochondria. Phosphorylating capacity of megamitochondria (hydrazine-induced megamitochondria, for example) were normal despite morphological changes. These data might suggest that the nucleophilicity of chemicals plays a key role in the induction of hepatic megamitochondria. These data might also suggest that the phenomenon is an adaptive process to changes of intracellular milieu.

Induction of megamitochondria in the mouse and rat livers by hydrazine

The correlation between structures of chemicals and their inducibility for megamitochondrial formation was investigated. Since the chemical structure universal to the inducers of megamitochondria previously reported (cuprizone and isonicotinic acid derivatives) is the carbazoyl group (-CONHNH2), semicarbazide (NH2NHCONH2) was tested first. Then, hydrazine (NH2NH2) was tested, replacing the carbazoyl group of semicarbazide by an amino group (-NH2). The present study demonstrates that (1) megamitochondria were induced in mouse and rat hepatocytes by feeding the animals with a diet containing semicarbazide or hydrazine, suggesting that the carbazoyl group was not essential for megamitochondrial formation; (2) hydrazine-induced megamitochondrial formation was a reversible process. Coupling efficiencies and activities of ATPase and cytochrome oxidase of megamitochondria induced by hydrazine were slightly decreased, while the activity of monoamine oxidase was moderately decreased. Freeze-fracture electron microscopy revealed particle-free regions in the outer membranes of megamitochondria fixed with glutaraldehyde at 22 degrees C; the regions disappeared at 25 degrees C, indicating that the temperature of the liquid crystalline to gel state lipid phase transition in the megamitochondrial outer membrane was elevated. It is speculated that chemical structure of inducer of megamitochondria could be simplified to NH2-G (G, substituting group).

A study on the exchange rate of magnesium with ATP

The exchange process of Mg2+ with ATP was found to be, in many cases, dominated by Mg2+ exchange between ATP and ATP-Mg (a bimolecular reaction) rather than the Mg2+ off-process from ATP-Mg to solution (a unimolecular reaction). The Mg2+ off-rate from ATP-Mg and the rate constant of the bimolecular reaction were determined at 10 and 25 degrees C at pH 7.3, using 31P-NMR at 145.7 MHz. At this resonance frequency intermediate to slow exchange phenomena with respect to the NMR time scale of 2.5 . 10(3) s-1 were observed in ATP resonances. Various implications of these results to studies of biological systems have been pointed out.

Successive approximation for determining the hydroxyl rotational temperature

A successive approximation is presented for determining the hydroxyl rotational temperature from a comparison of successively approximated intensities of the rotational lines, which are, in the state of raw data, resolved as the [P(1) (4) +P(2) (4)I, [P(1) (3) + P2 (3)1, and [P1 (2) + P(2) (2)l lines. It is found that the determination of rotational temperatures using this successive approximation is far less time-consuming and more convenient than the usual synthetic spectra method, especially in treating numerous spectra from OH bands. As an example, the nighttime variations of the rotational temperature obtained every 6 min with this successive approximation are presented.