Japanese cedar pollinosis and HLA-DP5

Japanese cedar pollinosis is a type I allergic disease caused by Japanese cedar (Cryptomeria japonica) pollen. We investigated the association between the disease and HLA class II alleles by HLA-DNA typing using a PCR-SSOP method and found that the frequency of HLA-DP5 (DPA1*02022 and DPB1*0501) was significantly increased in the patients. To investigate whether the HLA-DP5 molecule is directly involved in the pathogenesis of the disease, Japanese cedar pollen antigen (CPAg)-specific T cell lines were established from 3 patients who possessed HLA-DP5 (DPA1*02022/ DPB1*0501). By using these CPAg-specific T cell lines and HLA class II-expressing L-cell transfectants, we found that disease-associated HLA-DP5 restricted T cells specific for CPAg existed in the patients. Furthermore, among 38 synthesized overlapping peptides spanning the entire length of one of the major Japanese cedar pollen allergens, Cry j 1, an immunodominant peptide which induced HLA-DP5 restricted Th2 was identified. These observations suggest that the HLA-DP5 may be involved, at least in part, in the pathogenesis, by helping the IgE antibody production against CPAg.

[Steroid-responsive sensorineural hearing loss with low tone loss]

Five cases of sensorineural hearing loss of sudden onset were reviewed. They were not responsive to administration of ATP and Vit. B12, but very responsive to steroid administration. All the patients were male and showed hearing loss in low frequencies in pure tone audiogram. Administration of steroid recovered hearing impairment immediately. However, cessation of steroid aggravated the recovered hearing. Serological and immunological examinations did not show any abnormal findings on all the patients. It was considered that these five patients had characteristics of both steroid-sensitive and low tone-loss type sensorineural hearing losses.

Voltage-dependent Ca2+ channels in the spiral ganglion cells of guinea pig cochlea

Voltage-dependent Ca2+ channels in spiral ganglion cells (SGCs) isolated from guinea pig cochlea were investigated using the patch-clamp technique in a whole-cell recording mode. The voltage-dependent Na+ and K+ currents were blocked by adding tetrodotoxin, 4-aminopyridine, and tetraethylammonium to the external solution and by using choline or Cs+ in the external and internal solutions instead of Na+ or K+, respectively. The depolarizing voltage steps evoked inward currents with slow current decay. The maximum amplitude of the inward current increased in a hyperbolic manner with increasing extracellular Ca2+ concentration, indicating that the inward current was a voltage-dependent Ca2+ current (ICa). In 5 mM Ca2+ external solution, the ICa activated from a membrane potential around -60 mV and reached full activation at about -10 mV. The ICa inactivated from about -60 mV and became fully inactivated at about O mV, consistent with the high-voltage-activated Ca2+ channel subtype. Ionic selectivities for Ca2+ channels in SGCs were as follows: Ca2+ > Ba2+ > Sr2+. Effects of both inorganic and organic Ca2+ antagonists also were examined. The inhibitory strength was as follows: La3+ > Cd2+ > Ni2+ > or = Co2+ for inorganic Ca2+ antagonists, and flunarizine > nicardipine > methoxyverapamil > diltiazem for organic ones.

Disturbance of regulation of sodium by cis-diamminedichloroplatinum in perilymph of the guinea pig cochlea

We studied the acute effects of cis-diamminedichloroplatinum (CDDP) on the cochlear partition and inner ear fluid in the guinea pig. At 48 hours after the administration of a single intramuscular injection of CDDP, 12.5 mg/kg of body weight, the endocochlear resting potential (EP) was significantly decreased to 32.1 +/- 1.8 mV in the treated animals, versus 80.6 +/- 1.0 mV in the control animals. There was a significant rise in potassium (K+), sodium (Na+), and chlorine (Cl-) in the endolymph of the animals treated with CDDP as compared with the control animals. Only Na+ was found to increase significantly in the perilymph, reaching more than twice the level of the control animals; both K+ and Cl- remained within the normal range. Serum electrolytes also remained within the normal range. Evaluation of modified ionic permeabilities across the endolymph-perilymph barrier showed an apparent increase in Na+ permeability and a normal range of K+ and Cl- permeabilities. Histopathologic examination of the cochlea showed a moderate collapse of the endolymphatic space, with atrophy of the stria vascularis and destruction of the outer hair cells. The findings suggest that the acute changes produced in the cochlea by administration of CDDP were attributable to a breakdown in the regulation of Na+ metabolism in the perilymph.

Coexistence of MALT-type lymphoma and squamous cell carcinoma of the larynx

A 66-year-old Japanese man was diagnosed as having a MALT-type lymphoma by histopathological examination. The lesion involved the vocal folds bilaterally, occupying the larynx and extending beyond it, as shown by computed tomography (CT). A course of radiation therapy with moderate doses was given. Six months later, a squamous cell carcinoma was found in the larynx and total laryngectomy was then performed. The patient remained well, without recurrence, 46 months after the operation. thus, MALT-type lymphoma may coexist with a squamous cell carcinoma of the larynx.

[A prospective randomized trial of adjuvant chemotherapy with UFT for head and neck carcinoma. Head and Neck UFT Study Group]

A prospective randomized trial was performed in 67 institutions for the purpose to evaluate the efficacy of adjuvant chemotherapy after radical treatment of head and neck carcinoma. A comparison was made between the following two groups; one-year oral administration of UFT, 300 mg/day, after radical treatment (UFT group); and a non-treatment group. Patients were classified under the following three categories; 1) stage II-IV, receiving radical surgery; 2) stage II, receiving radical radiotherapy; and 3) nasopharyngeal cancer. The numbers of cases were 424, 111 and 25, respectively, and they were randomized into two groups. The numbers of eligible cases were 398, 105 and 25, respectively. Statistical analysis was performed in the cases receiving radical surgery and in those receiving radical radiotherapy. As the results, in cases receiving radical surgery no significant difference was observed in 3-year survival rates (77.9% for UFT group vs 72.9% for non-treatment group) or 3-year relapse-free rates (73.4% for UFT group vs 66.2% for non-treatment group) between the two groups. However, the distant relapse rate was significantly lower in the UFT group than in the non-treatment group (7.9% vs 14.6%; p = 0.034). In the cases receiving radical radiotherapy, no significant differences was observed in either 3-year survival rates or 3-year relapse-free rates. Thus it was suggested that UFT maintenance therapy might suppress the distant metastasis after radical surgery. We considered a further confirmative trial for patients at high risk of distant metastasis after radical surgery to be advisable.

Single channel recordings of calcium currents in chick cochlear hair cells

Single Ca2+ channel currents were recorded from chick cochlear hair cells by using cell-attached patches. The elementary current was about -2 pA at 70 mV positive to the resting potential (R.P.+ 70 mV); the slope conductance over a 40 mV voltage range was 24 pS. The open time histogram was reasonably well expressed by a single exponential function, while the closed time histogram was expressed by a sum of two exponential functions. The Ca2+ channel was activated around R.P.+ 60 mV and the average ensemble current did not decay during 130 ms depolarization, suggesting that the Ca2+ channel in chick cochlear hair cells is the L-type. The Ca2+ channel has three modes of gating behaviour, expressed as current records with brief openings (mode I), no openings (mode 0), or long-lasting openings and very brief closings (mode 2).

Giant tumor formed by nodular fasciitis of the pharynx: a case report

Nodular fasciitis caused a benign tumor which is composed of fibrous tissue. The most commonly affected site is the upper extremity, which accounts for half of all cases. Ten to 20% of the lesions occur in the head and neck area, most of which are subcutaneous. We report a case of nodular fasciitis, which presented as an unusually large submucosal tumor of the pharynx. The tumor was extended from the retropharyngeal to the parapharyngeal space, and it was measured 8 x 4 x 3 cm in size. Since nodular fasciitis is known for the spontaneous regression, the tumor was transorally debulked by the use of YAG laser.

Cisplatin blocks mechano-electric transducer current in chick cochlear hair cells

The effects of cisplatin (cis-dichlorodiammine platinum II, CDDP) on the mechano-electrical transduction (MET) current were investigated with a whole-cell patch-electrode voltage clamp technique in dissociated cochlear hair cells of chicks. CDDP blocked the MET channel in a dose- and voltage-dependent manner. At -50 mV, CDDP blocked the MET channel with a Hill coefficient of approximately 2 and a dissociation constant (KD) of 1.5 x 10(-3) M. The kinetics of CDDP blockade consist of a voltage-independent and a voltage-dependent component.

A trial of individual dose intensity and relative performance factors in tegafur maintenance chemotherapy for head and neck cancer

Tegafur (Sunfural-S), as masked compound of a 5-fluorouracil derivative, was administered orally as a maintenance chemotherapeutic agent at a dose of 600 mg/day in 98 cases of head and neck epithelial cancer. The effectiveness of the drug was evaluated by a statistical method involving two formulae: individual dose intensity (IDI) and relative performance (RP). When comparing patients rated above a reference IDI value of 1.0 with those rated below 1.0, it was not possible to predict patient survival or tumor-free rates. In contrast, the value of the RP did show such a correlation. These findings support the effectiveness of Tegafur as a maintenance chemotherapeutic treatment for head and neck cancer patients.

Molecular cloning of a human cDNA encoding a novel protein, DAD1, whose defect causes apoptotic cell death in hamster BHK21 cells

The tsBN7 cell line, one of the mutant lines temperature sensitive for growth which have been isolated from the BHK21 cell line, was found to die by apoptosis following a shift to the nonpermissive temperature. The induced apoptosis was inhibited by a protein synthesis inhibitor, cycloheximide, but not by the bcl-2-encoded protein. By DNA-mediated gene transfer, we cloned a cDNA that complements the tsBN7 mutation. It encodes a novel hydrophobic protein, designated DAD1, which is well conserved (100% identical amino acids between humans and hamsters). By comparing the base sequences of the parental BHK21 and tsBN7 DAD1 cDNAs, we found that the DAD1-encoding gene is mutated in tsBN7 cells. The DAD1 protein disappeared in tsBN7 cells following a shift to the nonpermissive temperature, suggesting that loss of the DAD1 protein triggers apoptosis.

Differentially potentiating effects by dipyridamole on cytotoxicity of 5-fluorouracil against three human maxillary cancer cell lines derived from a single tumor

Dipyridamole (DPM), an inhibitor of nucleoside transport, is a unique potentiator of 5-fluorouracil (5-FU). We examined the combined effects of DPM and 5-FU on three cell lines (IMC-2, IMC-3, IMC-4) derived from a single tumor of a patient with maxillary cancer. DPM at 1.0-2.0 microM potentiated the cytocidal action of 5-FU > 20-fold against IMC-2 cells, while DPM at 10-20 microM potentiated the action of 5-FU against IMC-3 cells by 2-fold and against IMC-4 cells by approximately 4-fold. We examined why DPM differentially potentiated 5-FU against the three cell lines. The three maxillary cell lines showed heterogeneous sensitivities to the combination of 5-FU and DPM. We compared intracellular metabolism of 5-FU in IMC-2, IMC-3 and IMC-4 cells by HPLC. Determination of 5-FU metabolites demonstrated that cellular contents of 5-fluorodeoxyuridine monophosphate (FdUMP) were 104.66, 15.35 and 61.5 fmol/10(6) cells in IMC-2, IMC-3 and IMC-4 cells, respectively, in the presence of 10 microM DPM when the three cell lines had similar levels (0.21-0.33 fmol/10(6) cells) of FdUMP in the absence of DPM. By contrast, cellular levels of 5-FU and 5-fluorouridine triphosphate (FUTP) were not appreciably changed by DPM in three cell lines. The cellular level of thymidylate synthase mRNA in IMC-2 cells was found to be about one-fifth of that in IMC-3 and IMC-4 cells. The differential effects of DPM on the potentiation of 5-FU cytotoxicity might be closely related to the cellular levels of FdUMP and its target enzyme, thymidylate synthase in three human maxillary cancer cell lines.

Analysis of vocal abuse: fluctuations in phonation time and intensity in 4 groups of speakers

We have seen many patients with a voice disorder due to vocal abuse. However, there is little information about the speaking behaviour of such patients. The object of this study was to analyze speaking behaviour and to evaluate the relationship between the cause of voice disorders and its effects on speech. We had previously measured phonation time with a speech time accumulator. Recently, we have developed a speech intensity/speech time accumulator. We obtained data by accumulating the phonation time at 4 degrees of vocal intensity, ranging from weak to strong. By using this instrument, we measured the speaking habits of 29 subjects for 131 days and collected data about the criteria for vocal abuse. Our results showed that the office workers exhibited a phonation time (33.6 +/- 13.6 min for 8 h) three times shorter than that of teachers and patients with vocal fold nodules (102.1 +/- 22.9 min for 8 h). For the teachers and patients with a long phonation time, half of the total phonation time was at high intensity.

Heterogeneity in epidermal growth factor responsiveness and tumor growth of human maxillary cancer cell lines

We have established three cell lines (IMC-2, IMC-3, and IMC-4) from a human maxillary tumor, which exhibited different sensitivities to epidermal growth factor (EGF). It was inhibitory to colony-forming abilities of IMC-3 and IMC-4 cells in culture, while it affected that of IMC-2 cells slightly if at all. The differential sensitivities to EGF among the three cell lines were reproducibly observed when several cell sublines were further established from tumors appearing in nude mice. Saturation-binding kinetics with 125I-EGF showed similar levels of EGF-binding activities among the three cell lines. However, IMC-2, IMC-3, and IMC-4 showed almost similar sensitivities to cisplatin. Autophosphorylation of EGF receptor in the presence of EGF proceeded at similar levels among the three cell lines. Tumor growth was followed in nude mice when IMC-2, IMC-3, and IMC-4 at 1 x 10(7) cells were inoculated. The IMC-2 tumors enlarged at much faster rates than the other two cell lines. The IMC-4 tumors showed very slow growth rates, and IMC-3 tumors enlarged at an intermediate rate. These data suggest that the maxillary tumor used comprised cell populations that differed in their growth behaviors in response to EGF.

[An early phase II clinical study of cis-diammine glycolato platinum, 254-S, for head and neck cancers]

An early phase II clinical study of 254-S, a new anticancer platinum complex, for head and neck cancer was conducted by the 254-S Head and Neck Cancer Study Group consisting of 10 institutions. Based on the results obtained in the phase I study, 254-S was administered at 100 mg/m2 by 60 min intravenous drip infusion after being dissolved in 300 ml of 5% xylitol. In principle, the 254-S administration was repeated at least 2 times at 4 week intervals. Hydration was performed, if needed. All 24 cases registered were regarded as complete cases evaluable for tumor response. Complete response (CR) was observed in 4 patients (16.7%), partial response (PR) in 5 (20.8%), no change (NC) in 11 and progressive disease (PD) in 4, for a 37.5% response rate. Three CR and 3 PR (40.0%) were obtained in 15 patients with prior chemotherapy, including 1 CR and 2 PR (33.3%) in 9 patients previously treated with cisplatin. Side effects were observed in 19 patients (79.2%). Major toxic effects were hematotoxicity, including thrombocytopenia (58.3%), leukopenia (58.3%) and anemia (33.3%), and gastrointestinal toxicity, including nausea and vomiting (45.8%) and anorexia (37.5%). Abnormal parameter changes on renal function were found in 2 patients (8.3%). Based on these results, it was concluded that 254-S is potentially a useful anticancer agent for the treatment of head and neck cancer, and should be further investigated in a late phase II clinical study.

[A late phase II clinical study of cis-diammine glycolato platinum, 254-S, for head and neck cancers]

A late phase II clinical study of 254-S, a new anticancer platinum complex, for head and neck cancer was conducted by the 254-S Head and Neck Cancer Study Group consisting of 31 institutions. As in the early phase II study for head and neck cancers, 254-S was administered at 100 mg/m2 by 60 min intravenous drip infusion, repeated at least twice at 4-week intervals. Of 80 cases registered, 66 were regarded as complete cases evaluable for tumor response. Complete response (CR) was observed in 7 patients (10.6%), partial response (PR) in 22 (33.3%), no change (NC) in 24 and progressive disease (PD) in 13, for a 43.9% response rate. Two CR and 11 PR (37.1% response rate) were obtained in 35 patients with prior chemotherapy, including 2 CR and 7 PR (33.3% response rate) in 27 patients previously treated with cisplatin. Of 70 patients evaluable for toxicity, side effects were observed in 60 patients (85.7%). Major toxic effects were hematotoxicity, including leukopenia (62.9%), thrombocytopenia (40.0%) and anemia (45.7%), gastrointestinal toxicity, including nausea and vomiting (64.3%), and anorexia (47.1%); grade 3 or 4 thrombocytopenia was found in 20.0% of the patients, and this toxicity was regarded as the dose limiting factor. Nephrotoxicity observed was mild and infrequent. Based on these results, it was concluded that 254-S is a very useful anticancer agent for the treatment of head and neck cancer.