The response to epidermal growth factor of human maxillary tumor cells in terms of tumor growth, invasion and expression of proteinase inhibitors

Three cancer cell lines, IMC-2, IMC-3 and IMC-4, were established from a single tumor of a patient with maxillary cancer. We examined responses to epidermal growth factor (EGF) of these 3 cell lines with regard to cell growth and tumor invasion. The growth rate of IMC-2 in nude mice was markedly faster than that of the IMC-3 and IMC-4 cell lines. Assay for invasion through fibrin gels showed significantly enhanced invasive capacity of IMC-2 cells in response to EGF, but no change for IMC-3 and IMC-4 cells. We examined response to EGF of IMC-2 cells with regard to expression of a growth-related oncogene (c-fos), proteinases and their inhibitors. Expression of c-fos was transiently increased in IMC-2 cells at rates comparable to those seen in the 2 other lines in the presence of EGF. There was no apparent effect of EGF on the expression of urokinase-type plasminogen activator and 72-kDa type-IV collagenase in IMC-2 cells. In contrast, EGF specifically enhanced the expression of plasminogen activator inhibitor-I (PAI-I) and tissue inhibitor of metalloproteinases-I (TIMP-I) in IMC-2 cells. Our data suggest that proteinase inhibitors or other related factors may play an important role in tumor growth and invasion in response to EGF.

[Clinical evaluation of hypopharyngeal cancer]

Clinical results of cases of hypopharyngeal carcinoma treated from 1966 to 1990 at Kyushu University Hospital were investigated. In 1966-1972, all cases were treated with only radical operation. We used FAR therapy since 1972, and preoperative chemotherapy (CDDP and Peplomycin) in addition to FAR therapy since 1984. The crude five-year survival rate of the operative therapy-group (25 cases in 1966-1972) was 24%, and that of the FAR therapy-group with or without operation (47 cases in 1972-1980) was 38%. Although it was cumulative survival rate by Kaplan-Meier's method, the five-year survival rate of the group (16 cases in 1984-1990) treated with a combination of FAR therapy, preoperative-chemotherapy, and operation was 76%. The improvement in the survival rate and the role of preoperative treatment (FAR therapy and chemotherapy) are discussed.

Bio-feedback and the yawning breath pattern in voice therapy: a clinical trial

A breathing technique, or effective breath method is important for both singers and speakers for effective vocalization, and also useful for helping people with a voice problem. Here a diaphragm support breath pattern was used in voice therapy for patients with vocal nodules, recurrent laryngeal nerve paralysis, and incomplete glottal closure. Singing teachers use a technique, called the diaphragm breath support. This is called the yawning breath pattern (YBP) in our voice clinic and is used in teaching the patients with some kinds of voice disorder. In order to correct patients' breath pattern, an equipment system was designed to check their breath patterns conveniently in voice therapy practice. A respiratory kinematic sensor which connected to a TV monitor was attached to the patients' rib cage near the diaphragm, and by bio-feedback, patients could observe and adjust their breath pattern to the desired pattern during vocalization. In each of the 10 outpatient sessions, the patients performed for 20 to 30 min, and were instructed to practice at home for 3 or more times daily. The YBP method was applied to 91 patients, 17 males and 74 females, with ages ranging from 17 to 79 years. Of the 91 patients 41 had vocal nodules, 20 had recurrent laryngeal nerve paralysis and 30 had incomplete glottal closure associated with chronic laryngitis and sulcus vocalis. Most of the patients could master the YBP technique successfully. The higher the patients' ability to master the YBP was the better the results of both voice tests and subjective evaluation. The scientific background of the YBP method and its clinical effects in voice therapy was reviewed.

[Radiotherapy and chemotherapy in stages I and II non-Hodgkin's lymphomas of Waldeyer's ring]

Sixty-four patients with stages I and II non-Hodgkin's lymphomas (NHL) involving Waldeyer's ring treated between 1970 and 1987 were reviewed. Patients with stage II NHL were subdivided into stage II 1 (limited type) and stage II2 (advanced type) from the state of neck nodes. Stage II1 was defined as involvement of unilateral cervical nodes less than 4 cm in diameter as well as Waldeyer's ring involvement. Other stage II cases were classified as stage II2. All 17 patients with stage I NHL were treated with radiation therapy alone. Their diseases were well controlled, and none of them died of causes related to the lymphoma. Among 14 patients with stage II1 NHL, the 5-year survival rate for the 9 patients treated with radiation therapy alone was 87.5%. Until 1982, 19 of 21 patients with stage II2 NHL treated with radiation therapy alone or radiation therapy and adjuvant chemotherapy (VEMP or COPP) died within 5 years mainly of disseminated diseases. Since 1983, CHOP has been used as the main treatment as well as radiotherapy for the 12 stage II2 NHL patients. So far, only 3 of them relapsed and 2 of them died of causes related to the lymphoma. Only 1 of these 12 patients was T-cell lymphoma compared to 7 of 9 stage II2 patients before 1982. This suggests that patients with stage I and those with limited stage II can be safely treated with radiotherapy. Also aggressive chemotherapy as well as radiotherapy should be used for patients with advanced stage II NHL involving Waldeyer's ring.

Appearance of drug-resistant tumor cells in a maxillary cancer patient undergoing chemotherapy and chemoradiotherapy

In this study, we examine drug resistance and sensitivity in tumor cell lines cultured from a patient undergoing prolonged chemotherapy. Four serially established primary tumor cell lines (KKM-A, -B, -C, and -D) were cultured from a case of maxillary sinus carcinoma: KKM-A from the nontreated primary tumor; KKM-B from the residual tumor after chemotherapy with cisplatin (CDDP) and 5-fluorouracil (5-FU); KKM-C from the local tumor that recurred following complete remission with chemoradiotherapy (combination of 5-FU, vitamin A, and radiation); and KKM-D from a metastatic lymph node tumor after further chemotherapy with CDDP and peplomycin. The sensitivity of the four cell lines to CDDP, 5-FU bleomycin (BLM), carboquone (CQ), and colchicine was assessed according to the reduction in colony formation. The KKM-A cell line was very sensitive to CDDP, BLM, CQ, and colchicine, whereas the posttreatment cell lines were resistant to these four drugs. The resistant cell lines were probably selected as a result of chemotherapy and radiotherapy. The nontreated KKM-A cell line was naturally somewhat resistant to 5-FU. The 5-FU-resistance of the KKM-B, -C, and -D cell lines was reduced in that order, corresponding to their relative degree of treatment. The KKM-D cell line from the metastatic lymph node showed a different sensitivity from the KKM-B and -C cell lines from the primary site, suggesting a heterogeneity in drug sensitivity between primary and metastatic tumor cells.

[Study on determination of the imaginary axis of the tooth crown. 1. Measuring procedure]

The state of inclination and the change under various conditions of the imaginary axis of the tooth crown of upper jaw and lower jaw right and left first molar can be determined by the measuring apparatus and method of this study. 2. The measurement error of this method was not more than 0.1 degree. This value was sufficient for the purpose of this study.

Establishment of tumor cell lines from a patient with head and neck cancer and their different sensitivities to anti-cancer agents

The authors established five cell lines from a human head and neck tumor. The five cell lines (HC-2, HC-3, HC-4, HC-7, and HC-9) exhibited different sensitivities to Adriamycin, cisplatin, bleomycin, 5-fluorouracil, vincristine, and daunomycin. The D50 was 200 ng/ml Adriamycin (doxorubicin) for HC-7 and 45 ng/ml for HC-2. At the inception of long-term culture (11 months) in the absence of any drug, the sensitivity to Adriamycin of HC-7-5 (subcloned from HC-7) was 3.4 times greater than that of HC-2-6 (subcloned from HC-2); by 11 months, it decreased to 1.6 times that of HC-2-6. The cytocidal action of Adriamycin on HC-2-6 and HC-7-5 was potentiated when Adriamycin was combined with verapamil or cepharanthine. Cepharanthine also potentiated daunomycin and vincristine (VCR) against HC-2-6 and HC-7-5 cells, and it almost completely overcame drug-resistance to daunomycin and vincristine in HC-7-5/VCR, a multidrug-resistant variant isolated after long exposure to vincristine of HC-7-5 cells in culture. The cellular accumulation of [3H]-daunomycin by HC-7-5 cells was about 70% that of HC-2-6 cells. By Northern blot analysis, using a multidrug-resistance gene (mdr-1) probe, neither HC-2-6 nor HC-7-5 expressed the mdr-1 gene, but HC-7-5/VCR or other multidrug-resistant variants showed active expression of the mdr-1 gene. Differential sensitivities among the five cell lines to 5-fluorouracil, cisplatinum, and bleomycin appear to be mediated through other mechanism beside the mdr-1 gene.

Cell wall proteins from sugar beet cells in suspension culture

Several proteins were extracted from the purified cell walls of suspension-cultured sugar beet cells with 0.5% EDTA (pH 6.8) after prior extraction of the walls with 0.5% deoxycholate and then with 2 molar NaCl. Two abundant proteins (P-I and P-II protein) were separately purified to homogeneity by procedures that included fractionation with ammonium sulfate, column chromatography on DEAE-cellulose and butyl Toyopearl, and preparative polyacrylamide electrophoresis. P-I exists as a dimer of identical subunits, and P-II is composed of four different subunits. Analysis by sodium dodecyl sulfate-polyacrylamide gel electrophoresis showed that quite different polypeptides are present in the culture medium and in the NaCl and EDTA extracts of the wall.

Muscle repair for esophageal speech

IT IS generally believed that satisfactory esophageal speech is only obtained in 40 to 65% of patients. We concentrated on manipulation ofthe constrictor muscle in laryngectomy as being the key to solving the problem of difficulty in esophageal speech. Thus, we have been devising ways to suture the constrictor muscles. Retrospectively, the patients could be grouped into three categories. In the first group the ends of the thyropharyngeus as well as the cricopharyngeus were sutured tightly together. The patients in the second group had only the thyropharyngeus sutured, while the cricopharyngeus as left as it was. In the third group both muscles remained free after removal of the larynx. Percentages of patients acquiring effective esophageal speech were: 40% (6/15) for Group 1, 80% (33/41) for Group 2 and 88% (15/17) for Group 3.

[Improved survival rates in Hodgkin's disease]

Results of treatment of 25 Hodgkin's disease patients at Kyushu University Hospital from 1981 to 1985 were reviewed. Total nodal irradiation or MOPP chemotherapy was used mainly. The actuarial 5-year survival rate, 87.2%, was significantly better than the 41.0% of 61 patients treated between 1966 and 1980 (P less than 0.01). However, 12 of the 24 patients in remission eventually relapsed. To further improve the survival rates of patients with Hodgkin's disease, technical improvements in total nodal irradiation and altering Adriamycin-containing chemotherapy protocol from MOPP chemotherapy are advisable.

On buying a telescope for videolaryngoscopy

The purpose of this article is to compare aspects of the performance of three widely-used rigid laryngoscopy telescopes. The Nagashima SFT-I, Wolf 4450.57, and Karl Storz 8702 D were used with a JVC GX-N8U camera and Panasonic PV 8600 VCR to make recordings of a one-tenth-inch grid at various distances between the lens and the grid and at two telescope holding angles. Measurements were made of the anteroposterior and mediolateral viewing fields at all distances and holding angles on maximum and minimum zoom. The telescopes were compared for viewing field, lens angle effects, holding angle effects, plane distortion effects, effects due to lens distance, color, edge definition, focus control, light source compatibility, stroboscopic use, cross-sectional diameter, fogging, and cost. An overview enables laryngologists to assess their needs before buying.

Cellular retinol-binding proteins in head and neck tumors and their adjacent tissues

The levels of cellular retinol-binding protein (CRBP) were examined by Scatchard analysis in 17 surgically resected human head and neck tumors and their adjacent normal tissues (normal tissues corresponded to muscle tissue). The center area and the marginal area of tumors were tested for their levels of CRBP in 17 cases, and the adjacent tissue was tested in 13 of the 17 cases. Only a small difference (if any) in the dissociation constant (Kd values) was seen in some cases between tumor and adjacent tissue; in most cases the Kd values in both areas were similar, and these values were also similar between the central and marginal areas of tumors. The average level of CRBP in the marginal area of the tumors was higher than that in the center area of the tumors in all the 17 cases. Among the 13 tumor cases whose adjacent tissues were tested, 12 showed CRBP levels more than two times higher in the marginal area of tumors; whereas in only one case was the level in the marginal or the center area of tumor similar to that in the adjacent tissues.

[Multidisciplinary treatment of the head and neck cancer--FAR therapy and its modification and application]

Treatment of the head and neck cancer has surprisingly developed in the last decade. The most possible reasons were the development of the more effective anticancer drugs and new combination therapy including immunotherapy. FAR therapy, which was applied to the head and neck cancer in our clinic since 1972, was a combination of vitamin A, 5-FU and radiation. We have already reported the results and the problems of FAR therapy. But, recently we have developed the clinical application of vitamin A to the chemotherapy so as to overcome the resistance of the tumor cells to the anticancer drugs. In this paper, vitamin A was focused as a potentiating agent and the possible material to overcome the resistance to the anticancer drugs.

Potentiation by vitamin A of the action of anticancer agents against murine tumors

Combinations of retinol palmitate (RP) and six different anticancer agents were examined to determine their effects on the life-span of mice bearing ascites sarcoma 180 or P388 leukemia. With ascites sarcoma 180, administration of a fixed dose of RP (3.3 mg/kg) considerably enhanced the antitumor effects of 5-fluorouracil (5-FU) (5 mg/kg, or 20 mg/kg), methotrexate (MTX) (0.5 mg/kg, or 1 mg/kg) and 1-(4-amino-2-methyl-5-pyrimidinyl)methyl-3-(2-chloroethyl)-3-nitrosourea (ACNU) (12.5 mg/kg), when given by intraperitoneal injection. However RP failed to potentiate the antitumor effects of adriamycin (ADM) and 6-mercaptopurine (6-MP) against sarcoma 180. With P388 leukemia, RP (167 mg/kg, or 333 mg/kg) enhanced the antitumor effects of 6-MP (25 mg/kg, or 50 mg/kg), MTX (1 mg/kg, or 2 mg/kg), ADM (0.2 mg/kg), ACNU (5 mg/kg) and cis-dichlorodiammine-platinum (CDDP) (1 mg/kg) to a considerable extent, but it did not potentiate the antitumor effect of 5-FU. The combination of RP with ACNU or CDDP was particularly effective against P388 leukemia.

Potentiation by squalene of the cytotoxicity of anticancer agents against cultured mammalian cells and murine tumor

Squalene (SQ) was examined for ability to potentiate the cytotoxicity and antitumor activity of anticancer agents. The dose-response curves of cell survival of cultured HeLa or V79 cells in the presence of various anticancer agents [adriamycin (ADM), 5-fluorouracil (5-FU), bleomycin (BLM) and cis-dichlorodiamminoplatinum (CDDP)] showed that SQ potentiated the cytotoxicity of these anticancer agents. SQ may enhance the cytotoxic effect of ADM by interfering with the efflux of ADM from the cells. The antitumor activities of these anticancer agents combined with SQ were tested against sarcoma 180 (S180) ascites cells. Some combinations were found to show synergistic antitumor effects: ADM, BLM or CDDP with SQ was effective against S180, but only slight if any synergistic effect was observed with the combination of 5-FU and SQ. The antitumor activity of BLM was most strongly potentiated by SQ, among the tested agents.