Distribution of alpha-fetoprotein-producing cells and proliferating cells in human hepatoma cells transplanted into athymic mice

To clarify the relationship between alpha-fetoprotein (AFP) production and cell growth in hepatocellular carcinoma an immunohistochemical method was used to examine the geographical distribution of AFP-producing cells and DNA-synthesizing cells in hepatoma tissue which was formed by subcutaneous transplantation of the human hepatoma cell line, HuH-7, into athymic mice. DNA-synthesizing cells were localized to the perivascular restricted areas where AFP-producing cells were preferentially demonstrated. The fall of the labeling index of bromodeoxyuridine was accompanied by a decrease in AFP production. The results indicate that AFP is produced mainly by the cells participating in tumor growth but not by quiescent cells.

Dehydropipernonaline, an amide possessing coronary vasodilating activity, isolated from Piper longum L

An amide (dehydropipernonaline) that has coronary vasorelaxant activity was isolated from the fruit of Piper longum L. This substance was characterized on the basis of spectroscopic data.

Endoscopic ultrasonography in the diagnosis of esophageal carcinoma, with particular regard to staging it for operability

We report on the usefulness of endoscopic ultrasonography (EUS) for the staging of esophageal carcinoma for operability, including the diagnosis of infiltrating depth and lymph node metastases. The accurate diagnosis of the depth of invasion of a carcinoma by means of EUS was achieved in 75% of all cases. Concerning the evaluation of resectability, it should therefore be concluded that EUS can provide us with accurate information on the invasion of the carcinoma beyond the adventitia and/or its distant metastatic growth to the neighboring organs including lymph nodes. From this investigation it can be concluded that EUS is an excellent method for the staging of esophageal carcinoma with regard to its operability.

Terpenoid biotransformation in mammals. IV Biotransformation of (+)-longifolene, (-)-caryophyllene, (-)-caryophyllene oxide, (-)-cyclocolorenone, (+)-nootkatone, (-)-elemol, (-)-abietic acid and (+)-dehydroabietic acid in rabbits

The metabolism of (+)-longifolene, (-)-caryophyllene, (-)-caryophyllene oxide, (-)-cyclocolorenone, (+)-nootkatone, (-)-elemol, (-)-abietic acid and (+)-dehydroabietic acid was studied in rabbits. Each of these sesquiterpenoids was converted to primary, secondary or tertiary alcohols, among which the primary alcohol was predominant. A vinylic methyl group and an exomethylene group were easily hydroxylated and converted to a glycol via an epoxide in many cases. Eight new metabolites were determined by chemical and spectroscopic methods.

[Therapeutic endoscopy in digestive cancer]

It is obvious that surgical resection is a superior therapy for gastric cancer. In this sense, endoscopic therapy could be regarded as an orphan in this field. However, in the combination of endoscopic therapy and ultrasonic endoscopy, endoscopic therapy for gastric cancer should be acknowledged to be equal to surgical therapy. We have treated early gastric cancer by means of endoscopical photocoagulation using a Nd-YAG laser, particularly in inoperable cases due to other complication or old age. Forty-seven lesions found in 41 patients have so far been photocoagulation and followed up. By this treatment, cancer cells disappeared in 42 out of 47 lesions, although 2 cases died of other diseases and recurrence was experienced in 3 cases. In addition to photocoagulation therapy using a laser, we have recently developed a large-biopsy technique called strip biopsy in order to get sufficient tissue for diagnosis in comparison with bite biopsy. By this method, we are able to resect the full thickness of the mucosa including the submucosal layer up to a size of about 4 cm, without any severe complication such as hemorrhage and perforation. We succeeded in resecting the early gastric cancer in 34 lesion in 31 patients. The combination therapy of endoscopical photocoagulation and strip biopsy seems to be reasonable for the therapy of early gastric cancer.

[Diagnosis of the infiltrating depth of gastric cancer by endoscopic ultrasonography]

In the diagnosis of the infiltrating depth of thirty four cases with gastric cancer, in which twenty two cases were early cancer and fourteen cases advanced cancer, the rate of the diagnostic accuracy by EUS was eighty eight % in the differentiation between early cancer and advanced cancer. While, in distinction of cancer spreading into the mucosa, the submucosa, the muscularis propria and over the subserosa, diagnostic accuracy was sixty four % in early cancer and seventy five % in advanced cancer. There were two reasons mainly in the wrong diagnosis of EUS. One was the existence of fibrosis in cases of the depressed type of early cancer and the other was the dissemination of the cancer cells extending into the deeper tissues, which could be detected only by histological examinations.

Isolation of evodiamine, a powerful cardiotonic principle, from Evodia rutaecarpa Bentham (Rutaceae)

The crude acetone extract of the fruits of Evodia rutaecarpa Bentham (Rutaceae) exhibited a positive inotropic effect on the guinea pig isolated left atria. The extract was subject to bioassay-directed fractionation to yield the powerful cardiotonic agent evodiamine.

What are the signs of recent hemorrhage, and what do they mean? Criteria for massive bleeding

Hematemesis, melena, shock, vague symptoms, anemia, blood examinations and endoscopic findings are reviewed as signs of recent hemorrhage. An assessment of the condition of patients with upper GI bleeding is important for planning treatment. Therefore, in order to be able to evaluate a method of treatment of GI bleeding, reports referring to treatment of GI bleeding must contain a clear record of the severity of the patient's state and of the bleeding source. A common criterion for massive bleeding has been proposed. Specifically, a patient suffering from shock who needs more than 1,000 ml of blood or plasma expander by rapid transfusion within one hour, or more than 2,000 ml within the initial 24 hours, to stabilize his circulation, and whose Hb level is 8.0 g/dl or less, should be graded as having massive bleeding. Gastric ulcers with exposed blood vessels need endoscopic YAG laser hemostasis or ethanol injection therapy as quickly as possible, since 43% of the cases rebleed within 72 hours under conventional drug therapy, and such rebleeding can be prevented by the endoscopic hemostatic methods.

[Endoscopic therapy of digestive cancer]

We have treated early gastric cancer by means of endoscopical photocoagulation using a Nd-YAG laser since December 1980, particularly in inoperable cases due to other complications or old age. Forty-seven lesions found in 41 patients have so far been photocoagulated and followed up. By this treatment, cancer cells disappeared in 42 out of 47 lesions, although 2 cases died of other diseases and recurrence was experienced in 3 cases. In addition to photocoagulation therapy using a laser, we have recently developed a large-biopsy technique called strip biopsy in order to get sufficient tissue for diagnosis in comparison with bite biopsy. By this method, we are able to resect the full thickness of the mucosa including the submucosal layer up to a size of about 4 cm, without any severe complication such as hemorrhage and perforation. We succeeded in resecting the early gastric cancer in 34 lesions in 31 patients. Of course, the combination therapy of endoscopical photocoagulation and strip biopsy seems to be reasonable for the therapy of early gastric cancer. For the purpose of improving endoscopy therapy for early gastric cancer, accurate diagnosis particularly with regard to the depth of invasion of cancer cells must be performed. In this sense, we have attempted to improve the resolution of the ultrasonic endoscope. Ultrasonic endoscopy can yield more accurate information about the depth of invasion and its metastasis to the lymph nodes. Therefore, ultrasonic endoscopy is excellent, not only for making sure of the grade of gastric cancer, but also for the detection of its recurrence, which can not be observed by ordinary endoscopy. It is obvious that surgical resection is a superior therapy for gastric cancer. In this sense, endoscopic therapy could be regarded as an "orphan" in this field. However, in the combination of endoscopic therapy and ultrasonic endoscopy, endoscopic therapy for gastric cancer should be acknowledged to be equal to surgical therapy.

Endoscopic ultrasonography

EUS has many advantages over x-ray and other endoscopic procedures for the detection of lesions located in the wall of the GI tract. In the oesophagus, invasion of cancer and spread to lymph nodes can be visualized by EUS before surgery. In the stomach, the invasion depth of cancer and the therapeutic effect of laser irradiation to early cancer can be studied. EUS may also be useful in the evaluation of chemotherapy in malignant lymphoma. In benign diseases of the GI tract, EUS can provide important information about submucosal tumours. It can improve the differential diagnosis of malignant and benign submucosal tumours. EUS will also contribute to the elucidation of the pathogenesis of giant folds developing in the stomach. In addition, EUS is beneficial in the diagnosis of chronic pancreatitis, pancreatic cyst, pancreatic cancer, cancer of the papilla Vateri and diseases of the biliary tract. In conclusion, we feel that endoscopic ultrasonography may prove to be a useful technique in the diagnosis of intra- and extramural lesions of the GI tract, but comparisons with conventional imaging procedures should be performed.

Inhibitory effects of polyprenoic acid (E5166) on production and secretion of alpha-fetoprotein and on cell kinetics in human hepatoma cells

We investigated the effects of polyprenoic acid, E5166, on the production and secretion of alpha-fetoprotein (AFP) and on cell kinetics in a human hepatoma cell line (HuH-7). The cellular AFP content, measured flow cytometrically for cells stained by an indirect immunofluorescence method, was decreased by treatment with E5166. AFP in the culture medium decreased exponentially during exposure of cells to the drug. These changes were dose-dependent. The growth of HuH-7 cells in vitro was clearly suppressed in the presence of E5166. The inhibition of growth depended on the concentration of the agent. The fraction of S phase cells decreased relatively in the cells treated with a high concentration of the drug, whereas it increased in the cells treated with lower doses.

A fundamental study of normal layer structure of the gastrointestinal wall visualized by endoscopic ultrasonography

The gastrointestinal wall could be separated into five layers or nine layers by means of the ultrasonic endoscope, and the histological structure of these layers was ascertained by comparing endoscopic ultrasonograms of resected specimens of the gastrointestinal tract with their corresponding histology. The results were as follows: With five layers of the gastrointestinal wall, the first and the second layer corresponded to the mucosa, the third layer was the submucosa, and the fourth layer corresponded to the muscularis propria. The first layer was a border echo demonstrated inside the mucosa. The fifth layer consisted of the serosa and a border echo visualized outside the serosa. When a thin layer was visualized at the same time in both the second and the fourth layers, the gastrointestinal wall was separated into nine layers in total. With nine layers of the gastrointestinal wall, the muscularis mucosae was composed of a thin layer in the second layer and a narrow layer between a thin layer in the second layer and the third layer. A thin layer in the second layer was a border echo visualized inside the muscularis mucosae. A thin layer in the fourth layer of the gastrointestinal wall consisted of a border echo and a connective tissue between the inner circular muscle and the outer longitudinal muscle.

Minute lesions of esophageal cancer

Fifty-four cases of minute esophageal cancer (1 cm or less in the greatest dimension) were collected and analyzed. Of these 67% were mucosal cancer and 28% were submucosal cancer. Prognosis was anticipated to be good as there was only one case of lymph node metastasis and three of vascular invasion. A lesion of 1 cm can be regarded as curable regardless of its depth of invasion. The endoscopic approach with use of a dye staining technique is useful for detection of or screening for minute esophageal cancer.

Endoscopic ultrasonography of lymph nodes surrounding the upper GI tract

We investigated the usefulness of endoscopic ultrasonography (EUS) of lymph nodes surrounding the upper GI tract and tried the enhanced EUS by the method of the oral administration of '10% oil-in-water-type emulsion.' The results were as follows: The ultrasonographic visualization rate of lymph nodes surrounding the esophagus was 33.7% in total; however, it was 43.4% for those greater than 5 mm and 58.7% for those greater than 10 mm. The frequency of lymph node metastasis of esophageal cancer was 48.1% for those larger than 10mm with a round shape and 14.3% for the same size with an ellipsoid shape; for those less than 10mm, it was also low. Lymph nodes surrounding the esophagus and the stomach were enhanced by administration of 10% oil-in-water-type emulsion. The visualization rate of lymph nodes can be increased by using this new method. Endoscopic ultrasonography is very useful for the detection of swelling lymph nodes surrounding the upper GI tract before the operation.

Tumorigenicity study of disodium glycyrrhizinate administered orally to mice

Disodium glycyrrhizinate (DG) was administered at concentrations of 0.15 (maximum tolerated dose), 0.08, 0.04 or 0% in the drinking-water to groups of 50, 70, 60 and 60 male B6C3F1 mice, respectively. Female groups, each consisting of 50 mice, were given DG in the drinking-water at concentrations of 0.3 (maximum tolerated dose), 0.15, 0.08 or 0%. Treatment was continued for 96 wk and the experiment was terminated at wk 110. There was no difference between treated and control groups in tumour incidence, in the latent period before tumours appeared or in the distribution of different types of tumour. Thus the long-term oral administration of DG to mice did not yield any evidence of chronic toxicity or tumorigenicity.

Effects of glutamic acid analogues on identifiable giant neurones, sensitive to beta-hydroxy-L-glutamic acid, of an African giant snail (Achatina fulica Férussac)

The effects of the seven glutamic acid analogues, alpha-kainic acid, alpha-allo-kainic acid, domoic acid, erythro-L-tricholomic acid, DL-ibotenic acid, L-quisqualic acid and allo-gamma-hydroxy-L-glutamic acid were examined on six identifiable giant neurones of an African giant snail (Achatina fulica Férussac). The neurones studied were: PON (periodically oscillating neurone), d-RPLN (dorsal-right parietal large neurone), VIN (visceral intermittently firing neurone), RAPN (right anterior pallial neurone), FAN (frequently autoactive neurone) and v-RCDN (ventral-right cerebral distinct neurone). Of these, d-RPLN and RAPN were excited by the two isomers (erythro- and threo-) of beta-hydroxy-L-glutamic acid (L-BHGA), whereas PON, VIN, FAN and v-RCDN were inhibited. L-Glutamic acid (L-Glu) had virtually no effect on these neurones. alpha-Kainic acid and domoic acid showed marked excitatory effects, similar to those of L-BHGA, on d-RPLN and RAPN. Their effective potency quotients (EPQs), relative to the more effective isomer of L-BHGA were: 0.3 for both substances on d-RPLN, and 1 for alpha-kainic acid and 3-1 for domoic acid on RAPN. alpha-Kainic acid also had excitatory effects on FAN and v-RCDN (EPQ for both: 0.3), which were inhibited by L-BHGA but excited by gamma-aminobutyric acid (GABA). Erythro-L-tricholomic acid showed marked effects, similar to those of L-BHGA, on VIN (EPQ: 0.3) and RAPN (EPQ: 3-1), but produced weaker effects on PON and d-RPLN (EPQ: 0.1). DL-Ibotenic acid produced marked effects, similar to those of L-BHGA, on PON, VIN (EPQ for both: 1) and RAPN (EPQ: 1-0.3), but had weak effects on d-RPLN (EPQ: less than 0.1) and FAN (EPQ: 0.1). It had excitatory effects on v-RCDN (EPQ: 0.1). This neurone was inhibited by L-BHGA but excited by GABA. L-Quisqualic acid showed the same effects as L-BHGA on all of the neurones examined (EPQ range 30-0.1). It was the most potent of the compounds tested on RAPN (EPQ: 30-10), FAN (EPQ: 30) and v-RCDN (EPQ: 3). alpha-Allo-kainic acid and allo-gamma-hydroxy-L-glutamic acid had no obvious effect on any of the neurones examined. As described above, the responses of the neurones examined to these substances varied widely. However, L-quisqualic acid generally had effects on the neurones similar to those of L-BHGA; the L-BHGA-excited neurones were also excited by alpha-kainic acid and domoic acid.

Pancreatic sphincterotomy and pancreatic endoprosthesis

Recently, endoscopic sphincterotomy (EST), developed as a treatment of bile duct stone or papillary stenosis, has been used for transpapillary biliary drainage in cases of extrahepatic biliary stenosis. For the nonoperative treatment of chronic pancreatitis, we have developed this procedure into a technique for opening the pancreatic duct orifice. Pancreatic sphincterotomy was performed successfully in 10 out of 13 cases with chronic pancreatitis and improved the clinical symptoms in 9 cases. Moreover, in 3 cases we succeeded in inspecting the intrapancreatic duct by peroral pancreatoscopy, and in removing stones from the main pancreatic duct in 2 cases in this series, using the basket. Also through the opened pancreatic orifice, a pancreatic endoprosthesis was placed endoscopically into the main pancreatic duct in 3 cases to improve pancreatic drainage. This report discusses method, evaluation, and complications of pancreatic sphincterotomy in the endoscopic treatment of chronic pancreatitis, and describes successful cases of the basket removal of pancreatic stones and the placement of pancreatic endoprosthesis through the opening of the pancreatic orifice.

6-Tridecylresorcylic acid, a novel ATPase inhibitor that blocks the contractile apparatus of skeletal muscle proteins

6-Tridecylresorcylic acid (TRA) isolated from a primula Lysimachia japonica Thunb. inhibited contraction of myofibrils, superprecipitation of myosin B, and ATPase activities of myosin and actomyosin prepared from rabbit skeletal muscle in a dose-dependent manner. The IC50 values in molarity of TRA were as follows: myosin (K+,EDTA)-ATPase, 3.5 X 10(-6); myosin Ca2+-ATPase, 3.5 X 10(-5); and actomyosin Mg2+-ATPase, 1.6 X 10(-5). The inhibition of ATPase activity of myofibrils by TRA was virtually reversed by washing with the fresh saline solution. Kinetic analysis of inhibitory effects of TRA suggests that the inhibition of (K+,EDTA)-ATPase activity of myosin or subfragment-1 is parabolic noncompetitive. TRA had no effect on alkaline phosphatase and choline acetyltransferase activities. TRA may provide a useful chemical tool for the study of the molecular mechanisms of actin-myosin contractile systems.

Clinical usefulness of ranitidine in giant gastric ulcer

We define "giant" gastric ulcer as a chronic gastric ulcer, with a diameter greater than or equal to 3 cm. Treatment of inpatients with several conventional antiulcer agents resulted in significantly lower healing rates in giant gastric ulcer than in "large" (greater than 15 and less than 30 mm diameter) or "medium" (greater than 5 and less than or equal to 15 mm diameter) ulcers. In 48 patients with giant gastric ulcers treated with ranitidine, cumulative endoscopic healing rates were: 0% after 2 weeks, 16.7% after 4 weeks, 50.0% after 6 weeks, 77.1% after 8 weeks, 85.4% after 10 weeks, and 87.5% after 12 weeks of treatment. Corresponding healing rates were determined for the control group, which included patients treated with various conventional antiulcer agents. Comparison of these results revealed that from the fourth week of treatment onward, healing rates of the ranitidine group were significantly higher than those of the control group. There was little difference in the cumulative healing rates in the ranitidine group. From these results, ranitidine is considered to be useful in the treatment of giant gastric ulcer.

Curious manifestations in cavernous hemangioma of the liver

We report a cavernous hemangioma of the liver with some curious findings. Angiography showed a hypervascular lesion and the arterioportal shunt which commonly is regarded as a pathognomonic sign of malignancy. Laparoscopy showed a well-defined, reddish-purple elevated lesion with a central umbilication. As the patient was a painter and dealing with vinyl chloride monomer, we suspected the possibility of hemangiosarcoma. The lesion proved to be a cavernous hemangioma with central fibrous replacement probably in consequence of thrombosis of some cavernous spaces.

Effects of alpha-kainic acid, domoic acid and their derivatives on a molluscan giant neuron sensitive to beta-hydroxy-L-glutamic acid

No identifiable giant neuron of an African giant snail (Achatina fulica Férussac) was found to be sensitive to L-glutamic acid (L-Glu). However, some of them, including the RAPN (right anterior pallial neuron), were sensitive to beta-hydroxy-L-glutamic acid (L-BHGA). The effects on RAPN of alpha-kainic acid (alpha-KA), domoic acid (DMA) and their derivatives, which are structurally related to L-Glu and L-BHGA, were examined in order to elucidate the chemical structures necessary to produce the effects under study. Erythro- and threo-L-BHGA showed similar excitatory effects on RAPN (the minimal effective concentration (M.E.C.): 10(-4)M). alpha-KA, alpha-KA methylketone and DMA also showed marked excitatory effects on the same neuron (M.E.C.: 3 X 10(-5)-10(-4)M). The two derivatives of alpha-KA, (2S, 3S, 4S)-2-carboxy-4-(1-methyl-5(R)-hydroxymethyl-l(Z),3(Z)-hexadienyl) pyrrolidine-3-acetic acid and (2S,3S,4S)-2-carboxy-4-(1-methyl-5(R)-hydroxymethyl-1(Z),3(E)-hexadie nyl) pyrrolidine-3-acetic acid, also had excitatory effects (M.E.C.: about 3 X 10(-4)M) which were somewhat less potent than those of L-BHGA, alpha-KA etc. However, alpha-allo-KA, alpha-allo-KA methylketone and dihydro-alpha-KA even at a high concentration of 4.7 X 10(-4)M, had no effect on RAPN. From the results obtained, it appears likely that the seven excitatory compounds mentioned above act on the common receptors of the RAPN neuromembrane, due to similarities in their structures and in the type of excitation caused by these compounds.

[Autofluorescence of gastric cancer--study by flow cytometry]

Autofluorescence from cancer cells and non-cancerous cells of the stomach was measured by flow cytometry. The number of cells with fluorescence and its intensity was higher in cancer than in the surrounding mucosa. Preliminary results suggest that, if fluorescence emission from non-cellular substances is eliminated, measurement of fluorescence excited by laser illumination would permit earlier detection of gastric cancer.

Serotonergic receptor antagonist from Nandina domestica Thunberg

A crude methanolic extract of the fruit of Nandina domestica Thunberg strongly inhibits serotonin-induced contractions of the rabbit aorta. The extract of the fruit has been fractionated to afford nantenine (O- methyldomesticine ) as the active agent.

New development of peroral cholangioscopy--evaluation of double-angle, oblique viewing cholangioscope

Seven years have passed since the first report on peroral cholangioscopy by Takekoshi and Takagi (1) in Japan. Recently, several types of peroral cholangioscope with a forceps channel have been made for this treatment. However, the success rate of insertion of these instruments into the common bile duct was less than 50%. Therefore, in cooperation with Fuji-Photo-Optical Co. Ltd., we have made a new scope with the aim of facilitating insertion into the bile duct. Using this new scope, called a double-angle, oblique viewing cholangioscope, we obtain good orientation in the duodenum in en-face view and close inspection of the duodenal papilla, which makes possible easier insertion into the common bile duct. This new scope proved useful in basket removal of bile duct stone, or differential diagnosis between stones and carcinoma of the biliary tract.