Effect of left ventricular contractile performance on passive left atrial filling--clinical study using radionuclide angiography

Many invasive and noninvasive methods have been used to study the cardiac atria; however, few allow quantitative measurement of atrial function. To determine the interaction between left ventricular (LV) contraction and left atrial (LA) filling, gated radionuclide angiography was conducted in 30 normal subjects (24 men and 6 women, mean age 58 +/- 10 years, range 26-68). LV and LA time-activity curves and their first-derivative curves were obtained simultaneously by using the method of Bough et al. The LV ejection fraction (64 +/- 18%) and LV peak ejection rate (LVPER; 3.42 +/- 0.27 EDV/s) were computed from these curves. As indices of LA filling, LA fractional emptying (38 +/- 12%) and LA peak filling rate (LAPFR; 2.86 +/- 0.17 LAVmax/s)--the latter being defined as the peak rate of LA filling during the LA filling phase--were also computed from these curves. In all subjects, the timing of the LVPER coincided with the occurrence of LAPFR, and there was a significant positive correlation between the LVPER and LAPFR (r = 0.81, p < 0.001), indicating that the LAPFR was strongly affected by the degree of LVPER. Thus, these results indicate that LV contractile performance plays an important role in determining LA passive filling during ventricular systole.

Slow relaxation process in the main transition of phosphatidylcholines studied with heat capacity spectroscopy. I. Multilamellar vesicles

Extremely slow relaxation processes have been examined near the main transition of multilamellar vesicle samples of dimyristoylphosphatidylcholine (DMPC) and dipalmitoylphosphatidylcholine (DPPC) with a heat capacity spectroscopic technique. The dynamic heat capacity showed a significant frequency dependence in the studied frequency region of 0.5 mHz to 50 mHz. The relaxation observed here has been analyzed with the Cole-Cole equation. The mean relaxation times were 120 s in DMPC, and 260 s in DPPC. The relaxation showed a polydispersive character. The parameter beta was around 0.5 in both DMPC and DPPC.

Morphological changes during survival, cellular transformation, and calcification of the embryonic mouse: Meckel's cartilage transplanted into heterotopic sites

Meckel's cartilages obtained from 18-day-old embryonic mice were transplanted into heterotopic sites to examine their site-specific effects on cellular modification, calcification, and long-term survival. The explants were isografted into the liver, subcutaneous tissue, anterior chamber of the eye, kidney, peritoneal cavity, and intrafemoral muscle of mouse for up to 2 weeks. In addition, Meckel's cartilages were wrapped in a Nucleopore filter and transplanted into the spleen. Grafted Meckel's cartilages were observed by light and electron microscopy, including application of von Kossa's reaction and osmium-potassium ferrocyanide fixation. It was demonstrated by von Kossa's reaction that when Meckel's cartilage was grafted in liver parenchyma, initial calcification appeared on the territorial matrix as spotted deposits. The chondrocytes gradually transformed into small ovoidal cells and showed a morphology closely resembling that of osteocytes. Transplants in the kidney subcapsular site contained active surviving chondrocytes, and subcutaneously grafted Meckel's cartilage revealed three types of chondrocytes: nonhypertrophic and calcification-inducing hypertrophic chondrocytes, as well as cells showing osteocytelike phenotypes. Intraocular and Nucleopore filter-wrapped explants showed degenerative changes, and peritoneal-cavity transplants showed cellular hypertrophy, but calcified precipites were not observed. The present investigation demonstrated that in blood-rich tissues Meckel's cartilage showed long-term survival and could modulate calcified precipitation. Thus, this adaptation of Meckel's cartilage to the environment of various heterotopic sites suggests that it has the ability to induce calcification.

Hilar lobar vascular occlusion for hepatic resection

Limited resection can be a therapeutic approach in patients with cirrhosis with very low remnant hepatic function after resection. In this study, two hilar vascular clamping methods (hilar selective clamping [n = 13] and hilar lobar clamping method [n = 8]), which were used for resection of hepatocellular carcinoma in patients with cirrhosis, were compared based on cardiovascular stability during clamping, intraoperative bleeding, operative time and postoperative course. In the past, the Pringle method had been used (n = 19) and those instances were included for comparison. The mean operation time of the lobar clamping group was 209 +/- 41 minutes, which was significantly less than that of the selective clamping group (259 +/- 44 minutes, p < 0.05). Furthermore, the mean intraoperative blood loss of the lobar clamping group was 920 +/- 400 milliliters, which was significantly less than that of the selective clamping group (1,640 +/- 590 milliliters, p < 0.01). The postoperative total bilirubin and glutamine-oxaloacetic transaminase levels tended to be high in the Pringle group, but there was no significant difference between the groups. Although the blood pressure during clamping significantly decreased in all groups, the decrease was profound in the Pringle group as compared with those in the other two groups. Thus, as a method for controlling afferent blood flow during hepatic resection in patients with cirrhosis, we recommend the lobar clamping method as a simple, safe and effective way to minimize bleeding and maintain cardiovascular stability.

Induction of unresponsiveness in rats after either intraportal injection of donor antigen or intravenous injection combined with splenectomy

Recently, we reported that hepatic allografts are permanently accepted when transplanted after intraportal injection (IP) of donor spleen cells (SPCs). The mechanism of this effect was investigated using various protocols for antigen injection. ACI (RT1a) and Buffalo (RT1b) rats were used as donors and recipients, respectively. Experimental groups were divided into the following groups depending on treatment: IP, intravenous injection (IV), splenectomy (Spx), and intravenous injection after splenectomy (IV+Spx). Accumulation of donor antigen in the various organs was examined by injecting 51Cr-labeled SPCs. Cellular and humoral responses after SPC injection was assessed by delayed-type hypersensitivity response and complement-dependent cytotoxicity (CDC) assay. Heterotopic cardiac transplantation and orthotopic hepatic transplantation were performed 10 days after each treatment. The accumulation ratio in the liver was significantly higher in the IP and IV+Spx groups than in the IV group. Delayed-type hypersensitivity responses were lower in the IP and IV+Spx groups than in the IV or Spx groups. The CDC titer 7 days after inoculation was significantly lower in the IP and IV+Spx groups than in the IV group. In order to examine whether the treatment actively suppressed the immune response, the animals were rechallenged with SPCs given intravenously 10 days after the initial injection. Elevation of CDC titer was suppressed in the IP and IV+Spx groups, but not in the IV and Spx groups. Significant prolongation of cardiac allograft survival was not observed in the IV and Spx groups. Prolongation was observed in the IP and IV+Spx groups. The survival of hepatic allografts in the IV group was decreased. No significant prolongation of graft survival was observed in the Spx group. In contrast, all hepatic allotransplants in the IP and IV+Spx groups survived over 45 days. These findings suggest that the accumulation of donor SPCs in the liver may play an important role in inducing unresponsiveness after intraportal injection of donor SPCs.

[Pharmacological studies on human urinary kallidinogenase (SK-827): cerebral protective effects]

We investigated the cerebral protective effects of human urinary kallidinogenase (SK-827) in rabbits. The following results were obtained: 1) At a dose of 5.0 x 10(-3) to 1.25 x 10(-2) PNA U/kg, SK-827 significantly inhibited the decrease of focal cerebral blood flow and the impairment of electrocorticogram (ECoG) activity in infarcted rabbits. 2) SK-827 at a dose of 2.5 x 10(-3) PNA U/kg inhibited the development of infarction area induced by internal carotid arterial injection of glass beads. 3) SK-827 at a dose of 2.5 x 10(-3) to 5.0 x 10(-3) PNA U/kg inhibited the decrease of cerebral cortical pO2 induced by 5% oxygen inhalation. 4) On subacute phase 7 days after the destruction of internal capsule, SK-827 at a dose of 1.25 x 10(-2) PNA U/kg improved the abnormality of spontaneous ECoG. These findings suggest that SK-827 minimizes the reduction of cerebral function induced by ischemia.

[Pharmacological studies on human urinary kallidinogenase (SK-827): effects on cerebral metabolism]

We investigated the effects of human urinary kallidinogenase (SK-827) on cerebral metabolism in normal and infarcted rabbits. SK-827 did not influence cerebral glucose and oxygen uptake in normal rabbits. In infarcted rabbits, cerebral glucose and oxygen uptake significantly decreased. SK-827 tended to inhibit the decrease of cerebral blood flow, and significantly inhibited the decrease of cerebral glucose and oxygen uptake in infarcted rabbits. Thus, SK-827 improved cerebral glucose metabolism in infarcted rabbits.

Reduced phototoxicity of a fluoroquinolone antibacterial agent with a methoxy group at the 8 position in mice irradiated with long-wavelength UV light

A newly developed fluoroquinoline, Q-35 (8-OCH3), in which a methoxy group was substituted at the 8 position of the quinoline nucleus, was very stable under irradiation with long-wave UV light (UVA). Derivatives, a fluoroquinolone with no substitution (the 8-H analog) and one in which a fluorine was substituted (the 8-F analog), were degraded in their solutions by the UVA irradiation. The phototoxic inducibility by these derivatives was further studied in a murine model. When mice were dosed orally with 800 mg of Q-35 (8-OCH3) per kg of body weight, the maximum dose given, and exposed to the UVA light, no inflammatory lesions were observed in their ears. Ear redness was marked in mice given more than 12.5 mg of the 8-F analog or 200 mg of the 8-H analog per kg. Histopathological changes, edema, and infiltration of neutrophils were also observed microscopically in groups receiving the 8-H or 8-F analog but not in groups receiving Q-35 (8-OCH3). Similar inflammatory reactions were observed to occur in a dose-dependent manner with other available fluoroquinolone antibacterial agents such as lomefloxacin, enoxacin, norfloxacin, ciprofloxacin and ofloxacin. These results suggest that the introduction of a methoxy group at the 8 position of the quinolone nucleus is important for the reduction of phototoxicity.

Dot-blot hybridization using digoxigenin-labeled cDNA probe complementary to the S1 gene of avian infectious bronchitis virus permits discrimination between virus strains

Digoxigenin-dUTP-labeled DNA probe was prepared from a cDNA clone complementary to the gene encoding S1 region of the spike protein of infectious bronchitis coronavirus (IBV) strain M41. The probe exclusively reacted with four strains at 56 degrees C which were grouped to the same serotype as the strain used for the probe. In contrast, at 68 degrees C, the probe reacted only with the homologous strain and did not react even with the strains belonging to the same serotype. The dot-blot hybridization thus appeared serotype-specific at 56 degrees C and strain-specific at 68 degrees C. In addition, it was revealed that the S1 gene has some nucleotide sequence variation even among strains in the same serotype. This technique should be applied to determining serotypes of the virus isolates and to differentiating field isolates from the vaccine strain.

Effects of a human urinary kininogenase (SK-827) on cerebral and cutaneous microcirculation in rabbits

Pharmacological effects of a human urinary kininogenase (SK-827) on the cerebral and cutaneous microcirculation were studied in anesthetized normal rabbits. Intravenous administration of SK-827 had no effect on the diameter of pial arterioles or the hemoglobin content (IHb) of the brain. On the other hand, SK-827 increased IHb of the skin, dose-dependently and dilated cutaneous arterioles transiently with increased capillary red blood cell velocity. These findings suggest that the pharmacological effects of SK-827 on the microcirculation of the brain and the skin differ from each other due to the activity of the autoregulatory mechanism.

Effects of a human urinary kininogenase (SK-827) on cerebral microcirculation after glass bead-induced cerebral embolism in rabbits

The pharmacological effects of a human urinary kininogenase (SK-827) on the cerebral microcirculation were studied intravital-microscopically in a rabbit with cerebral microvessel injury induced by glass bead injection into an internal carotid artery. Intravenous administration of SK-827 dilated pial arteries of the brain and increased cerebral hemoglobin content (IHb). SK-827 tended to dilate smaller arterioles more markedly than larger arterioles, and larger arterioles than small arteries. SK-827 appeared to have a vasodilating effects qualitatively different from those of nicardipine and CDP-choline. Findings obtained by concurrent hematological and biochemical examinations also suggested its beneficial effects on the function of platelets and erythrocytes.

Photostability and biological activity of fluoroquinolones substituted at the 8 position after UV irradiation

Q-35 [1-cyclopropyl-6-fluoro-1,4-dihydro-8-methoxy-7-(3-methylaminopiperid ine-1-yl)-4-oxoquinoline-3-carboxylic acid], a fluoroquinolone, has absorbance peaks at 333 and 286 nm. No spectral change was observed even when this aqueous solution was irradiated with 3 J of long-wavelength UV light (UVA) per cm2. On the other hand, its derivatives, which are unsubstituted (8-H analog) or which are substituted with fluorine at the 8 position (8-F analog), were found to have decreased antibacterial activities with a simultaneous increase in their cytotoxicities when they were degraded in a dose-dependent manner with respect to UVA irradiation. Similar results were observed with the other available fluoroquinolones. Enoxacin and lomefloxacin exposed to 0.3 J of irradiation per cm2 and norfloxacin, ofloxacin, and ciprofloxacin exposed to 1 J of irradiation per cm2 underwent absorption spectrum changes, an accompanying decrease in antibacterial activity, and an increase in cytotoxic activity. These results suggest that the introduction of a methoxy group into the 8 position of quinolones plays an important role in the stability of fluoroquinolones against irradiation by UV light.

Cerebral microcirculatory changes after cerebral embolization induced by glass bead injection in rabbits

The authors investigated microcirculatory changes in cerebral embolization induced by an injection of glass beads (mesh size 20/400, 15 mg/body) using intravital microscopy and reflectance spectrophotometry in normal rabbits. Cerebral embolization with the glass bead injection reduced the inner diameter of cerebral arterioles, the index of cerebral hemoglobin concentration (IHb), and the index of oxygen saturation (ISO2). Moreover, platelet aggregation rates and plasma levels of thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha) appreciably increased. During observation of the pial vasculature, "white bodies" became visible at the entrance of arteriolar branchings two to three minutes after the glass bead injection. After indomethacin administration (3 mg/kg, IV), they could not observe white bodies, and platelet aggregation rates were significantly reduced. The plasma levels of TXB2 and 6-keto-PGF1 alpha were also significantly reduced. These findings suggest that glass beads do injury to the microvascular endothelial cells leading to development of white bodies, ie, "flying thrombi." Therefore, the cerebral microvascular embolization induced by the glass bead injection appears to be an experimental model for evaluating efficacy of remedies for the cerebral microcirculatory disorders.

Morphological modifications during long-term survival of Meckel's cartilage hypertrophic chondrocytes transplanted in the mouse spleen

To examine the ultimate fate of hypertrophic chondrocytes, Meckel's cartilage bars from 18-day-old mouse embryos were transplanted into isogenic mouse spleen for 3, 7, 14 and 21 days and observed at the light and electron microscopic levels. The midportions of these Meckel's cartilage bars were used as explants; they were characterized by many hypertrophic chondrocytes containing euchromatic round nuclei, a large amount of glycogen particles, and some vacuoles. Grafted cartilage adapted well to the splenic tissue, showing intense metachromasia around the territorial matrix. Ultrastructural observations indicated that the number of large vacuoles and glycogen aggregates in the hypertrophic cells became markedly reduced with grafting time, whereas the Golgi apparatus and rough endoplasmic reticulum were well-developed. Needle-like crystals showing initial apatite deposition appeared in association with matrix vesicles; these proliferated as time elapsed after transplantation. On day 14 after transplantation, cells displaying such various structural features as pyknotic nuclei, large vacuoles, and cytoplasmic shrinkage were noted in addition to intact hypertrophic chondrocytes. Following resorption of the calcified cartilage by multinucleated giant cells, many osteoblasts appeared along the border of the calcified matrix. Some remaining hypertrophic cells in the calcified matrix had transformed into osteocyte-like cells. On day 21, the resorbed area of the calcified cartilage was invaded by many blood vessels. Hypertrophic chondrocytes, now exposed from cellular lacunae, and the osteocyte-like cells in the calcified matrix displayed involutional changes. The present study showed that, although the hypertrophic chondrocytes in Meckel's cartilage essentially underwent regressive changes, they retained the ability to stimulate endochondral ossification within the microenvironment of the spleen. In addition, some of these cells were transformed into osteocyte-like cells.

Cyclic appearance of cytoplasmic NOR-silver-stained particles in sea urchin embryos

When sea urchin embryos were subjected to nucleolar organizer region (NOR)-silver staining, densely stained particles were observed in the cytoplasm. The appearance of these cytoplasmic particles (CPs) was cell-cycle dependent. During early development, the CPs were detected at interphase, but not during mitosis; they disappeared at metaphase and reappeared at telophase. The CPs appeared periodically even when embryos were treated with cytochalasin B or aphidicolin, which inhibits the progression of cytokinesis and nuclear division, respectively. By contrast, CPs were not detected in the colchicine-treated embryos in which both cytokinesis and nuclear divisions were prevented. The CPs were observed only in the embryos whose stage was early blastula (about 6th to 7th cleavage) or earlier; no CPs were detected even at interphase in the embryos at late blastula (about 8th to 9th cleavage) or later. Electron microscopic evaluation showed CPs to be granular structures, similar to heavy bodies. Also, sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis (PAGE) showed that 95-kDa and 38-kDa proteins were the NOR-silver-staining proteins in sea urchin embryos. These proteins existed during the course of the cell cycles. These results suggest that (1) the cyclic appearance of the CPs or heavy bodies is closely related to the cell cycle as well as the programming of the embryogenesis, but independent of the cycle of cytokinesis and nuclear division; (2) 95-kDa and 38-kDa proteins are the major NOR-silver-staining proteins in sea urchin embryos.

Successful surgical management of pulmonary and adrenal metastases from hepatocellular carcinoma

This article reports a rare case of successful surgery for both lung and adrenal metastases after hepatic resection of hepatocellular carcinoma (HCC). A 55-year-old Japanese man with a 5-year history of chronic liver disease was admitted with an elevated serum alpha-fetoprotein (AFP) value and a liver tumour detected by ultrasonography. Hepatic angiogram showed a tumour stain with the right hepatic vein as a venous drain from the tumour. He underwent posterior-inferior subsegmentectomy of the right hepatic lobe following preoperative chemoembolization. Sixteen months after the first operation, he received pulmonary resection for a solitary metastasis in the right lung. A further 10 months later, a metastatic tumour was detected in the left adrenal gland without any recurrent or metastatic foci, and he underwent left adrenalectomy as his third operation. He is still alive, 8 months after his last operation, and 34 months after hepatic resection, with a normal value of AFP and without any recurrent or metastatic foci. This may be the first report of a patient who underwent successful surgery for pulmonary and adrenal metastases of HCC.

[Postoperative change of serum protease inhibitor and C-reactive protein level--with special reference to surgical resection of liver cirrhosis]

Changes in the activities of blood protease inhibitors and acute-phase reactive substances during surgical resection of liver cirrhosis were investigated by measuring the pre- and postoperative blood concentrations of alpha 1-antitrypsin (alpha 1AT), alpha 2-macroglobulin (alpha 2MG), pancreatic secretory trypsin inhibitor (PSTI), urinary trypsin inhibitor (UTI) and C-reactive protein (CRP), in patients with liver cirrhosis who underwent hepatectomy (Group A, n = 19), those without liver cirrhosis who underwent hepatectomy (Group B, n = 6) and those without liver cirrhosis who underwent surgeries other than hepatectomy (Group C, n = 5). On examining the preoperative blood levels of protease inhibitors, Group A had an increased level of alpha 2MG and a decreased level of UTI compared to Groups B and C. alpha 1AT and CRP began to increase on the first day following hepatectomy and formed peaks on the third postoperative day. The increases were significantly higher in Group B than Group A (p less than 0.01). To investigate factors causative of these differences, alpha 1AT and CRP on the third postoperative day were compared in relation to the time of operation, amount of intraoperative bleeding, weight of the resected liver and preoperative ICGR15. alpha 1AT and CRP were significantly correlated to only preoperative ICGR15. PSTI was increased postoperatively but showed no difference between Groups A and B.

Mature cystic teratoma of the uterine cervix

A rare case of extragonadal teratoma which occurred primarily in the uterus is described. The tumor developed in the uterine cervix to form a polypoid appearance, and consisted of ectodermal, mesodermal and endodermal derivatives. This is the 14th such tumor to be recorded in world literature. A review of the literature and its possible histogenesis are briefly described.

Features of the aperiodic microfibrils associated with mouse dental basement membrane demonstrated by ultrastructural histochemistry

Histochemical features of aperiodic microfibrils (AMF) in mouse tooth germs were examined at the electron microscopic level. Intact and EDTA-isolated materials obtained from one day old first molars were used for ruthenium red (RR) staining, ferritin permeability, periodic acid-silver methenamine (PAM) impregnation, fibronectin localisation, negative staining on cryo-sections and tannic acid fixation. Electron microscopy and negative staining demonstrated that AMF traverse the basal lamina and penetrate below the inner enamel epithelium. In addition to RR staining, PAM impregnation and tannic acid fixation showed deposition on the AMF which was associated with basal laminae. RR staining and tannic acid fixation also indicated the presence of glycoprotein-rich materials in the lamina lucida. The AMF were derived from the lamina lucida which was closely associated with tannic acid-positive granular materials. The precipitation of silver particles by PAM impregnation was seen on banded collagen fibrils, basal lamina and AMF, but the staining features of AMF differed distinctly from those of collagen fibrils. The distribution of ferritin particles revealed that the basal lamina covering EDTA-isolated papilla tissue is a continuous structure. Immuno-reactions for fibronectin were detected on the basal lamina and AMF. Our results suggest that AMF are derived from the glycoprotein-rich lamina lucida and that their histochemical characteristics resemble those of basal lamina.

[Hypoxemia of liver cirrhosis--an autopsy case study]

41 year-old male with liver cirrhosis accompanying severe hypoxemia was presented. Shortly after the diagnosis of liver cirrhosis, he suffered from exertional dyspnea and cyanosis. Though home oxygen therapy had been prescribed for 2 years, hypoxemia gradually progressed accompanied by persistent cough, mucous sputa and intermittent fever. The chest X-ray revealed bilateral interstitial shadow particularly localized in lower lung fields. The arteriovenous shunt ratio was shown to be 24% by oxygen method. Perfusion lung scan using 99mTc-labeled MAA revealed perfusion defects in bilateral lung fields and radionuclide uptake was strongly demonstrated in the kidneys. These clinical data suggested that severe hypoxemia was probably due to multiple arteriovenous shunt. With further progression of hypoxemia for 4 months, he died of hepatic failure and pulmonary infection. Autopsy showed Miyake's type B cirrhosis. Multiple pleural and subpleural arteriolar nevi were demonstrated grossly and microscopically. There were no arteriovenous malformations demonstrated after injection of barium-gelatin solution into the pulmonary artery. Histologically, irregularly dilated vessels were found in the lung parenchyma beneath the pleura and filled with blood and injection material. These clinical and pathological findings provided evidence that the mechanism of arterial desaturation was pulmonary arteriovenous shunting due to liver cirrhosis.

[Pharmacokinetics and prophylactic effect of intraperitoneal administration of mitomycin C resulting in IC50 of gastric cancer]

In order to prevent peritoneal metastasis after gastrectomy for gastric cancer, we conducted a study to find a clinical dose of MMC which would result in IC50, the drug concentration which inhibits the growth of colonies of cells by 50%. After closure of the abdomen, MMC dissolved in 1,000 ml of physiological saline was administered. In the 40 mg group, the mean intraperitoneal MMC concentration after 60 min was 8.2 micrograms/ml, which exceeded IC50 of 7.6 micrograms/ml. In the group, peak serum concentration of MMC was 0.29 micrograms/ml. Seventy to 80% of intraperitoneally administered MMC was transferred in blood. Serious adverse effects were not observed. One-year survival rate of absolute noncurative resection with peritoneal metastasis was 33% in the control group and 78% in the treated group. Two-year survival rate of curative resection with free cancer cells in the peritoneal cavity was 11% in the control group and 60% in the treated group.

[Intraarterial and intraportal chemotherapy combined with decollateralization for cholangiocellular carcinoma and metastatic liver cancer]

Two patients with cholangiocarcinoma and one patient with liver metastasis from inflammatory breast cancer underwent catheterization into both hepatic artery and portal vein following decollateralization using silicone rubber sheeting. They received arterial chemoembolization and chemotherapy and portal chemotherapy through the catheters repeatedly. Two patients with cholangiocarcinoma are still alive more than one year after the beginning of the treatments without regrowth of the tumors. The patient with metastatic liver cancer died of lung metastasis, although the liver foci were controlled by procedure. Thus, both intraarterial and intraportal chemotherapy combined with decollateralization by silicone rubber sheeting seems to be effective for advanced cholangiocarcinoma and metastatic carcinoma.

[Chemoembolization for liver metastasis from colorectal cancer]

Chemoembolization using Lipiodol, cisplatin, angiotensin II and Gelfoam (modified sandwich therapy) was carried out for the patients with liver metastasis from colorectal cancer. 1. Ten of 30 patients who underwent hepatic resection received TAE before operation, and the remaining 20 underwent surgery without preoperative TAE. Three-year survival of the former was 66%, and that of the latter was 44% (not significant). 2. Twenty-two patients who were assessed as non-resectable were surgically catheterized into the hepatic artery. Thirteen patients received TAE (totally 38 times) and intra-arterial infusion chemotherapy, and the remaining 9 underwent intra-arterial chemotherapy alone. The 50% survival of the former and the latter was 545 and 285 days, respectively. One year survival of the former was significantly better than that of the latter. 3. Fourteen patients had intrahepatic recurrences after hepatic resections. Eight patients received TAE and the remaining 6 did not. The 50% survival of the former was 615 days and that of the latter was 190 days. For one-year survival, the former was significantly better than the latter. These results suggested that TAE is an effective modality for liver metastasis from colorectal cancer.

Injection of isolated centriolar complex to induce mitosis in starfish eggs

When centriolar complex isolated from starfish spermatozoa was injected into starfish immature oocytes (fully grown, germinal vesicle stage) followed by treating the latter with 1-methyladenine, mitotic events such as condensation and division of chromosomes of the female pronucleus and cytokinesis following completion of meiosis were observed. No cortical reaction detected in the oocytes. Essentially the same was noted for mature oocytes (pronuclear stage) into which the centriolar complex had been injected. The oocytes that had received sperm tail fraction or buffer alone did not initiate cleavage. It would thus appear that sperm centriolar complex is significantly essential to the initiation of cleavage.

[Evaluation of preoperative chemoembolization using ethiodized oil, cisplatin and gelatin sponge (sandwich therapy) for hepatocellular carcinoma]

The significance of preoperative chemoembolization using ethiodized oil, cisplatin and gelatin sponge (Sandwich therapy) for resectable hepatocellular carcinoma (HCC) was evaluated. One hundred and thirteen patients with solitary and less than 10 cm sized HCC who underwent radical hepatic resection were chosen for this study. Fifty-three patients received Sandwich therapy before surgery (Group A), and the remaining 60 patients under-went surgery without any preoperative treatments (Group B). Any background factors between two groups were not significantly different. The anticancer effects of this therapy were evaluated by histologic examination in 31 patients who had preoperative Sandwich therapy. In 22 of 31 patients (71%), the main nodules were completely necrotic. The ratios of patients with complete necrosis in daughter nodules were 7/12 (58%), in portal vein tumor emboli, 7/10 (70%), in intracapsular invasions, 11/21 (52%), in extracapsular invasions, 4/11 (36%). The 4-year disease-free survival rates in Group A and Group B were 56% and 27% respectively, and the rate of the former was significantly higher than that of the latter (p less than 0.05). The 4-year survival rates in Group A and Group B were 83% and 53% respectively. The rate of Group A was also significantly higher than that of Group B (p less than 0.01). We concluded that preoperative Sandwich therapy was very significant to obtain successful long-term disease-free survival and survival in regard to relatively early stage HCC.

An outbreak of bovine ephemeral fever in Nagasaki Prefecture in 1988

In October, 1988, bovine ephemeral fever (BEF) occurred in Nagasaki Prefecture and throughout Kyushu island, with the exception Miyazaki Prefecture. The first outbreak occurred in Hirado-shi on October 17. The total number of diseased cattle was 24 in 24 farms in Nagasaki Prefecture. The clinical findings were mainly sudden fever, anorexia, and instability in standing. The serum neutralizing antibodies against BEF virus (BEFV) rose in all infected cattle. Twelve strains of the virus were isolated in HmLu-1 cell cultures made directly from the heparinized blood of 17 infected cattle. The buffy coat was mainly collected from the samples and washed three times with phosphate buffered saline. These isolates were all neutralized by an antiserum against BEFV (Yamaguchi strain). With the aid of an electron microscope, a representative of isolates named Hirado-9 with a length of 150 nm was seen in the sample of infected HmLu-1 cell cultures. Both Hirado-9 and Yamaguchi strains reacted with antisera. The outbreak of BEF in 1988 was the first since 1971 in Nagasaki Prefecture. The result proved that BEFV can be easily isolated in HmLu-1 cell culture from the washed blood cells of infected cattle.

[Long-term postoperative courses of hepatocellular carcinoma with and without cirrhosis]

Until the end of August 1988, 158 patients with hepatocellular carcinoma underwent curative hepatic resection in our department. One-hundred and twenty-one patients (77%) had liver cirrhosis (Group A), and the remaining 37 (23%) did not (Group B). Background factors and postoperative courses were compared between Group A and Group B. With regard to clinical stage and curability, there were no significant differences between the two groups. On postoperative follow-up on 1- to 5-year survival, no differences were recognized between the two groups, but on and after 6-year survival, the former were significantly worse than the latter. The main cause of death was cancer in both groups. In group B, all intrahepatic recurrences happened within 3 years after surgery. On the other hand, intrahepatic recurrences of Group A were also found on postoperative 4- and 5-year to be as numerous as the recurrences found at 1-, 2- and 3-year after surgery. Moreover, with recurrent cases on and after 4 years in Group A, the frequency of solitary focus was high. The differences of postoperative courses between these two groups might be caused by metachronous carcinogenesis of cirrhotic liver.

Purification of infectious bronchitis coronavirus by Sephacryl S-1000 gel chromatography

A procedure was developed to purify infectious bronchitis virus (IBV) by gel chromatography (GC) with a Sephacryl S-1000 column. Virus samples concentrated by centrifugation were applied to a Sephacryl S-1000 column and eluted by 0.02 M phosphate buffer (pH 7.2) containing 0.15 M NaCl. Virus particles were recovered mainly in the first peak. Purity of the samples was evaluated by both sodium dodecyl sulfate-polyacrylamide gel electrophoresis and electron microscopy. Using electron microscopy, it was found that there were more spike-rich particles in the virus samples purified by GC than in those purified by sucrose density gradient centrifugation (SDGC). In addition, the hemagglutination unit [log10 (infectivity titer/hemagglutination titer)] of GC-purified virus samples was approximately 10 times lower than that of SDGC-purified virus samples. These results indicate that Sephacryl S-1000 gel chromatography is useful for purification of IBV.

[Blood concentration of granulocytic elastase, surgical invasion and postoperative complications--with special reference to surgical resection of liver cirrhosis]

The blood concentrations of granulocytic elastase (PMN-E), alpha 1-antitrypsin and alpha 2-macroglobulin were examined to evaluate their clinical significance in patients who underwent hepatectomy due to liver cancer with liver cirrhosis (n = 31, Group A), due to liver cancer with chronic hepatitis (n = 5, Group B) and without hepatic complications (n = 6, Group C) and other major surgeries (n = 10, Group D). In all groups, on the first postoperative day, blood PMN-E increased rapidly more than three times of the preoperative levels. Despite a decreasing tendency from postoperative Day 3, the value in Group A reincreased on Day 5. The peak PMN-E values within 24 postoperative hours showed significant positive correlations (p less than 0.01) with the amounts of hemorrhage and blood transfusion during operation in all groups. Even in 18 cases without blood transfusion, peak PMN-E was positively correlated (p less than 0.05) with the operative time and the amount of blood loss during operation. In Group A, patients in whom blood PMN-E increased after postoperative Day 3 developed infection and adult respiratory distress syndrome. After temporary reduction after operation except for Group C, blood alpha 1-antitrypsin increased from postoperative Day 3. However, alpha 1-antitrypsin in Group A was significantly low (p less than 0.01), compared to the increased levels in Group C and D. Blood alpha 2-macroglobulin showed no tendency of postoperative increase in all groups.

[A long-survival case of hepatocellular carcinoma treated by intra-arterial chemotherapy and immunotherapy]

Hepatic resection is generally considered to be superior to any other therapeutic procedures for hepatocellular carcinoma (H.C.C.). However, the resectability of the patients who have HCC. with liver cirrhosis is still low, and surgery is appropriate in only a minority of patients. Although some successful reports of intra-arterial chemotherapy for HCC. have been documented, most of the therapeutic effects are transient and the survival rate is not satisfactory. This report is of a rare case, that of a long-term survivor with HCC treated by intra-arterial chemotherapy and immunotherapy. A 66-year-old man, with a 10-year history of liver cirrhosis was admitted to The Center for Adult Diseases, Osaka, after detection of a tumor in the right lobe on US. On admission, serum AFP was within normal range, HBs-Ag was negative, and ICG-R 15 was 20.8%. On hepatic angiogram, a hypervascular tumor (6 cm in size) was recognized in the middle of the right lobe. He was assessed as unresectable because of insufficient reserve capacity, and the catheterization of the hepatic artery for intra-arterial chemotherapy and the injection 35 KE of OK-432 into the tumor were carried out under laparotomy. After the procedure, the patient was treated by intra-arterial infusion of doxorubicin (ADR) at a total dose of 150 mg and 5-FU in total dose of 25 g, with a hypodermic injection of OK-432 at a total dose of 161 KE. Hepatic angiography, carried out one year after the procedure, disclosed no foci in the liver. The duration of complete remission continued more than 5 years. The patient eventually died of intrahepatic recurrence, but he lived for 7 years and 3 months after the catheterization.

[Intra-arterial and intraportal therapy combined with decollateralization in unresectable cholangiocellular carcinoma--a case report]

A 45-year-old man was referred to our hospital due to obstructive jaundice by intrahepatic cholangiocellular carcinoma. At laparotomy, he was assessed as unresectable because of multiple foci in both lobes. Therefore, two catheters connected to implantable access devices were placed in both the hepatic artery and the portal vein following decollateralization using silicone rubber sheeting, in addition to choledochectomy and choledocho-jejunostomy. After the surgical procedure, he underwent chemoembolization twice using Lipiodol, cisplatin, and Gelfoam, and two intraportal infusions of cisplatin at a dose of 50 mg. Moreover, a total dose of 4 g of 5-FU and 20 mg of MMC was administered through the arterial and portal catheters, respectively. Administration of G-CSF was remarkably effective for severe thrombocytopenia, and leukopenia resulted from this active chemotherapy. He is still alive 7 months after the surgical procedure with the regression of the lesions.

[Adjuvant surgery to enhance therapeutic effects of chemo-embolization in advanced hepatocellular carcinoma]

Different kinds of adjuvant surgery were carried out in three patients with advanced hepatocellular carcinoma (HCC) to enhance the therapeutic effects of chemo-embolization (TAE). The first patient, who had multiple foci localized in the right lobe, underwent ligation of the right portal vein in order to eliminate the small intrahepatic spreads and to protect against transportal metastasis to the left lobe. Afterward, TAEs were repeated a total of 5 times. The patient is still alive 24 months after the surgery with partial remission of the lesions. The second patient with severe cirrhosis had received TAE twice. Since one of the tumors, which existed in the hepatic hilus, did not respond to TAE, only the non-respondent tumor was removed surgically. This patient remains alive 28 months after the surgery with complete remission of the lesions. In the third patient, repeated TAEs resulted in collateral feeding arteries. Permanent decollateralization using silicone rubber sheeting was carried out following ligation of collaterals. Thus adjuvant surgery to enhance the therapeutic effects of TAE may be a significant palliative treatment for HCC.

[Selective anticancer effects of intra-arterial infusion of 3',5'-dioctanoyl-5-fluoro-2'-deoxyuridine (TT82) in hepatocellular carcinoma]

3'-5'-Dioctanoyl-5-fluoro-2'-deoxyuridine (TT 82), one of the lipophilic prodrugs of 5-fluoro-2'-deoxyuridine mixed with Lipiodol (LPD), was injected into the hepatic artery before hepatic resection in 4 patients with hepatocellular carcinoma. Later, the anti-cancer effects of the drug were evaluated mainly by the examination of resected specimens. The serum alpha-fetoprotein levels of three patients in whom the values were over normal range fell to less than 50% of pretreatment values from 7 to 14 days after the injections. In pathological observation of the specimens, the necrosis rates of main tumors were 100%, 70%, 30% and 0%, respectively. In three patients whose main tumors showed complete or partial necrosis, selective depositions of LPD in the tumors were observed on soft X-ray photographs. The concentrations of TT 82 and its metabolites in the tissues of LPD-depositing areas were markedly higher than those in tissue of the regions without LPD deposits. These findings suggested that TT82-Lipiodol mixture remained selectively in the cancerous tissues and exhibited anticancer effects following injection into the hepatic artery.

Detection of antibodies against Akabane virus in bovine sera by enzyme-linked immunosorbent assay

An enzyme-linked immunonosorbent assay was established for detection of antibodies to Akabane virus in bovine sera. The assay was shown to be a useful serological tool for studies on Akabane virus infection.

Ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (B) combination chemotherapy in patients with recurrent cancer of the uterine cervix

A combination chemotherapy of ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (IAP plus B) was used to treat nine patients with recurrent cervical cancer of the uterus. All patients had received conventional radiation therapy with or without hydroxyurea as a potential radiation sensitizer, and seven of them had measurable disease in a previous irradiated field (4 cases) or distant area (3 cases). The tumors included 5 squamous cell carcinomas (non keratinizing: 2, keratinizing: 3), two adenosquamous (including one glassy cell carcinoma), one adenocarcinoma (endometrioid type) and one argyrophil cell carcinoma. All histologic type cancers except argyrophil cell carcinoma responded to IAP plus B treatment. In seven evaluable cases, three complete responses (CR) and 3 partial responses (PR) were recorded (response rate was 85.7%), including 3 responded tumors within previously irradiated pelvic tissue. The median duration of CR was over 7 months and that of PR was 3.5 months. Side effects of IAP plus B were severe in hematologic toxicity (100% of grade 4 leucopenia) but acceptable, permitting five courses of treatments at four week intervals. The results obtained were encouraging, although therapeutic benefits of IAP plus B were not evident in a patient with argyrophil cell carcinoma and the intractable nature of this histologic type cancer in the uterine cervix was again emphasized.

[The effects of dexamethasone and expansion stress on the osteoblasts in mouse calvarial suture in vitro, with special reference to incorporation of 3H-thymidine and 3H-proline]

Behavior of sutures in response to expansion stress are thought to be in parallel with the response of bone to orthodontic tooth movement. To investigate this relation between psychologic stress and osteoblasts during orthodontic tooth movement, the effects of expansion stress and 10(-7) M dexamethasone on sutural osteoblasts of mouse calvaria were examined in vitro. The model consists of a tensile force applied to the mouse sagittal suture. Expansion stress induced the formation of osteoid in the sutural areas, and incorporation of 3H-thymidine and 3H-proline in sutural osteoblasts were found to be stimulated by expansion stress. Furthermore, labelling index of 3H-thymidine in the osteoblasts was also found to be stimulated. On the other hand, dexamethasone inhibited the incorporation, labelling index and matrix formation. Moreover, these induced stimulations in expansion stress were inhibited by 10(-7) M dexamethasone treatment. As described above, dexamethasone, which is a synthetic glucocorticoid, inhibited the incorporation of 3H-thymidine and 3H-proline, the labelling index of 3H-thymidine, and the matrix formation in sutural osteoblasts that were stimulated by expansion stress. Therefore, also during orthodontic tooth movement, increased secretion of glucocorticoid that is stimulated by psychologic stress may inhibit the proliferation, cell differentiation, and matrix formation of osteoblasts in periodontal ligaments.

Isolation and characterization of mutant strains of Bordetella bronchiseptica lacking dermonecrotic toxin-producing ability

Mutant strains of Bordetella bronchiseptica, named B-42, B-76, B-84, and B-119, were obtained after serial passages of a parent strain, L3, on Bordet-Gengou agar plates containing 20% horse blood and 200 micrograms of nalidixic acid per ml (BGN-20 agar plates) at 42 degrees C. Mutant strains completely lacked dermonecrotic toxin-producing ability, and lethal activity of the strains for mice was apparently reduced compared with that of strain L3. Mutant strains were able to grow at 42 degrees C, and the strains were nalidixic acid resistant. The mutant strains showed domed (Dom+) colony morphology with smooth texture (Scs+) and no production of zone of hemolysis (Hly-), but the agglutinability of these strains to antiserum prepared with Dom+ Scs+ Hly+ organisms of strain L3 was the same as that of strain L3. When strain B-42 was inoculated intramuscularly or intranasally into guinea pigs, all the animals survived without manifesting clinical signs and produced a high-level of serum agglutination antibodies against strain L3. These inoculated animals were protected against intranasal challenge with strain L3. These properties of mutant strains are hereditarily stable after 50 subcultures on BGN-20 agar plates or 20 passages in mice. These data suggest that the mutant strains lacking dermonecrotic toxin-producing ability can be used as a live attenuated vaccine against swine atrophic rhinitis.

Induction of achromosomal cleavage by hydroxyurea in starfish embryo and the reversal by a combination of deoxyadenosine and deoxycytidine: possible involvement of salvage pathway for deoxynucleoside triphosphate biosynthesis in the presence of hydroxyurea

Effects of hydroxyurea, an inhibitor of ribonucleotide reductase, on cleavage of starfish embryos were studied. In the presence of 1 mM hydroxyurea, fertilized eggs of the starfish, Asterina pectinifera, cleaved up to the 256-cell stage and decomposed before blastulation. Before the 16-cell stage, each blastomere contained a normal nucleus or chromosomes with mitotic apparatus. The cleavage after the 16-cell stage was slow compared to the control embryos, and not all blastomeres contained a nucleus or normal chromosomes. During the fifth cell division (between 16-cell- and 32-cell-stage embryos), chromatin mass unassociated with the mitotic apparatus remained near the cleavage furrow. When hydroxyurea was removed before the 16-cell stage, the embryos developed to normal bipinnalia larvae via normal blastulae. However, the embryos were disintegrated before blastulation when hydroxyurea was removed after the 32-cell stage. DNA synthesis was normally observed before the 16-cell stage but not after the 16-cell stage, but dNTP contents in the embryos remained low throughout development in the presence of hydroxyurea. The achromosomal cleavage observed in the presence of hydroxyurea was reversed by the combination of extracellular dAR and dCR. Therefore, it is assumed that the synthesis of dNTPs required for DNA synthesis in the presence of hydroxyurea occurs via the salvage pathway using deoxynucleosides (dNR) (dNR to dNTP via dNMP and dNDP).