Enhancement of chemotherapeutic effects with focused shock waves: extracorporeal shock wave chemotherapy (ESWC)

The effects of shock waves in combination with various anti-cancer agents i.e. Bleomycin (BLM), Cisplatin (CDDP) and 5-fluorouracil (5-FU) on tumor cells suspended in media containing these agents were examined. GCIY cells derived from human gastric cancer and LS 174T and SW480 cells derived from human colon cancers were used for in vitro experiments; GCIY and SW480 cells were also transplanted into nude mice for in vivo study. It was only with BLM that enhancement was evident in all three cell lines, with a degree of chemotherapeutic enhancement proportional to the amount of shock wave energy applied. Ladder formation of DNA in GCIY cells was observed only when treated with both BLM and shock waves in combination. When SW480 and GCIY cells transplanted into the backs of nude mice were treated with a combination of intravenously (i.v.) injected BLM and regional exposure to shock waves, a significant enhancement of chemotherapeutic effects was observed in terms of the tumor growth curve.

Low grade astrocytoma in the medial part of the frontal lobe manifesting as paroxysmal speech disturbance--case report

A right-handed 48-year-old female had clustered groups of seizures characterized by speech disturbance (attacks of verbal repetition and speech arrest) over a period of 7 years. Later, speech arrest was accompanied by perioral focal seizures. Magnetic resonance imaging and surgery found a low grade astrocytoma, centered in the left supplementary motor area. Postoperatively, no seizures or speech disturbances occurred for 3 years. This case confirms the main function of the supplementary motor area of the dominant hemisphere is connected with the initiation of speech and the setting into motion of the mechanism of speech.

Lead contact lens for crystalline lens shielding in electron therapy for eyelid tumors

In radiotherapy for eyelid tumors, a sufficient dose is required in the target tissue while preserving the crystalline lens. A I-mm thick, 20-mm diameter lead contact lens was prepared for crystalline lens protection. The lens was coated with an acrylic polymer and weighted 5.5 g. Six MeV electron therapy was scheduled using a 10 mm bolus on the eyelid. A simulation experiment proved that 0.78 +/- 0.04 percent of the maximal eyelid dose was given at the crystalline lens portion. A total of 14 eyelids in eight patients with cutaneous lymphoma, angiosarcoma, or basal cell carcinoma were treated with the contact lens. No cataract was found after irradiation over an average period of 24.3 months. The combination of the lead contact lens, bolus, and 6 MeV electron beam was a simple procedure and provided adequate dose distribution in the treatment of various eyelid tumors.

Clinical application of diffusion-weighted magnetic resonance imaging to intracranial disorders

Diffusion-weighted magnetic resonance imaging was performed to determine the changes in water diffusion and to investigate the detectability of diffusion anisotropy in patients with intracranial disorders. Diffusion maps of the apparent diffusion coefficient (ADC) were created of 19 patients with cerebral infarction, five with intracerebral hematoma, four with glioma, four with meningioma, four with hydrocephalus, and five with subdural hematoma. ADC was increased in chronic cerebral infarction and glioma, and decreased in acute cerebral infarction, meningioma, and the marginal area of glioma compared with the ADC of the normal gray matter. There was a significant difference in ADC between the marginal and internal areas of glioma. Increased ADC may be due to increased vasogenic edema in infarction and a lack of significant restriction of diffusion within glioma. Decreased ADC can be attributed to restricted diffusion caused by cytotoxic edema in infarction and the underlying histological pattern of densely packed tumor cells in glioma. Diffusion anisotropy of the internal capsule was less detectable in pathological than normal hemispheres. Diffusion anisotropy was less detectable in patients with hydrocephalus and subdural hematoma. Intracranial lesions were thought to have influenced the compression of the brain structures and cells, resulting in decreased diffusion. The measurement of ADC by diffusion-weighted magnetic resonance imaging has the potential for greater understanding of the biophysical changes in various intracranial disorders, including correct diagnosis of cerebral infraction, and histological diagnosis of brain tumor.

A rudimentary system for automatic discrimination among basic skin lesions on the basis of color analysis of video images

BACKGROUND

Detection of differences in color is necessary for an automatic diagnostic system for skin lesions.

OBJECTIVE

The purpose of this study was to examine whether color analysis of an image obtained with a videomicroscope can be used as a key to distinguish basic skin lesions.

METHODS

We carried out quantitative color analyses of nine kinds of natural or artificial skin lesions. After images of the lesion and adjacent normal skin were obtained, the difference in the mean quasiabsorbance (logarithm of the inverse reflectance) values between the two were examined in each color band of red, green, and blue by an image analytic method.

RESULTS

We could determine a set of thresholds of quasiabsorbance values to distinguish between basic lesion colors. On the basis of these results we developed a rudimentary system that automatically offers possible diagnoses of a test site.

CONCLUSION

The algorithm that we developed may be of value in an initial screening of skin lesions in an automatic diagnosis system.

Postmarketing surveillance on side-effects of cefminox sodium (Meicelin)

A postmarketing surveillance of cefminox sodium (Meicelin, CMNX) for intravenous injection was conducted for about 4 years from August 1987 through June 1991, and 13,431 patients were followed up to evaluate the safety of the drug. The incidence of side-effects was 1.76%. By organ, the most frequently observed were hepatic and of the bile duct system (0.87%) followed by those on leukocytes and reticuloendothelial system (0.24%), skin and adnexa (0.24%) and digestive tract (0.16%) indicating a tendency similar to that of other injectable cephalosporins. The incidence of the side-effects among elderly patients (65 years old or older) was 2.12%, whereas among patients 64 years old or younger it was 1.58% with no significant differences between the two groups. No side-effects specific to the elderly were observed. Among children 15 years old or younger the incidence was 0.59%, which was lower than that for patients 16 years old or older (1.90%). Potential side-effects on pregnant women (n = 101) and their babies were also checked. No side-effects occurred among the 52 pregnant women evaluated and no abnormalities were detected in their babies who were followed up for up to 4 years. Cefminox is thus considered to be a highly safe cephalosporin antibiotic.

The degrees of UVB-induced erythema and pigmentation correlate linearly and are reduced in a parallel manner by topical anti-inflammatory agents

To examine whether it is possible to evaluate the degree of ultraviolet B (UVB)-induced inflammation by measuring the degree of hyperpigmentation, we investigated the relationship between UVB-induced erythema and the subsequent pigmentation quantitatively. At 24 h and 7 d after irradiation with erythemogenic doses of UVB to the backs of 16 Japanese subjects, the degree of induced erythema (delta erythema index) and that of pigmentation (delta melanin index) were examined by an image analytic method using a videomicroscope interfaced with a computer. The relationship between two indices was linear in each subject, and the correlation coefficient was 0.83 when evaluated using whole data. The slope of the regression line for the delta melanin index against delta erythema index tended to become steeper as non-irradiated skin color became darker (r = 0.63), suggesting that more efficient melanogenesis takes place after the same level of inflammation in the subject with darker skin. Both erythema and hyperpigmentation were suppressed significantly and in a parallel manner by corticosteroids and indomethacin applied topically immediately after UVB irradiation. These results imply that the post-inflammatory hyperpigmentation correlates closely with the severity of the prior inflammation and that chemical mediators released in the inflammatory process have considerable influence on the melanogenesis. We conclude that the measurement of UVB-induced hyperpigmentation can be utilized for the assessment of topical anti-inflammatory agents, unless these have direct actions on the tyrosinase activity of melanocytes.

[Ultrastructural consequence of shock wave exposure on VX2 cancer implanted to the urinary bladder]

In order to clarify the ultrastructural consequence of the VX2 cancer cell exposed to underwater shock waves. The VX2 cancer implanted to the urinary bladder of rabbit was received the shock waves (1000 shots, 100 MPa, 5/sec.) generated by the piezo-ceramics. Damage to the cancer cell were manifested by the three kind of findings: the one was the cell junction failure which caused the isolated cells; the second was the destruction of organelle which seemed to form the vacuole in cytoplasm; and the last finding was the emergence of moth eaten appearance in the exposed cell. We conclude that underwater shock wave exposure induces lethal injury in VX2 implanted cancer.

Quantification of erythema and pigmentation using a videomicroscope and a computer

We report a method for quantitative analysis of erythema and pigmentation using a videomicroscope interfaced with a computer. The analysis was carried out by examining the brightness intensity of every picture element, composed of an image picked up from each band of red, green, and blue, and by deriving the quasi-absorbance value (absorbance index) from the mean brightness for each band. In assessments of UV-induced erythema and tanning, excellent linear correlations were found between the results obtained with our system and those with a narrow-band reflectance spectrometer. Moreover, the absorbance indices of haemoglobin and melanin solutions showed linear relationships with their concentrations in in vitro examination. As the monitored picture becomes out of focus if incorrect pressure is exerted on the skin, and as regions of interest can be chosen from a magnified image, this system offers excellent interobserver reproducibility, and is suitable for the evaluation of erythema or pigmented lesions which are too small or irregular to quantify by conventional methods such as colorimetry.

Concurrent subarachnoid hemorrhage due to ruptured aneurysm and hypertensive intracerebral hemorrhage--case report

A 64-year-old female presented with hypertensive thalamic hemorrhage concurrent with subarachnoid hemorrhage (SAH) due to a ruptured aneurysm manifesting as sudden onset of right hemiparesis followed by severe headache. The aneurysm was located in the basilar artery at the origin of the superior cerebellar artery, remote from the thalamic hematoma. The aneurysm was clipped 3 weeks after SAH. She was discharged with slight right hemiparesis. The method and timing of surgery for such patients depend on hematoma size, location of the aneurysm and hematoma, and neurological status. The intracerebral hemorrhage remote from the ruptured aneurysm should be treated initially if necessary, and the aneurysm clipped after the brain swelling has reduced.

Self-expandable metallic stent therapy for superior vena cava syndrome: clinical observations

PURPOSE

To study clinical and physiologic aspects of Z-stent therapy for superior vena cava (SVC) syndrome secondary to malignant disease.

MATERIALS AND METHODS

Signs and symptoms of SVC syndrome were classified, graded, and scored in 11 cases. Six patients with caval pressure higher than 22 mm Hg peripheral to the stenosis underwent stent therapy.

RESULTS

Immediately after Z-stent implantation into the stenotic lesion, the diameter of the constriction increased from 3.3 mm +/- 2.0 (mean +/- standard deviation) to 14.0 mm +/- 3.2, the mean caval pressure peripheral to the stenosis decreased from 26.6 mm Hg +/- 2.5 to 8.9 mm Hg +/- 0.7, and the symptom score decreased from 6.7 +/- 1.8 to 1.3 +/- 1.4. The caval pressure, lesion diameter, and symptom score correlated highly with each other. One complication--transient pulmonary edema attributable to volume overload caused by reperfusion--was observed. Mean survival exceeded 7.1 months.

CONCLUSION

Stent placement could be a useful treatment for refractory SVC syndrome.

An Alkalophilic Bacillus sp. Produces 2-Phenylethylamine

A large amount of 2-phenylethylamine was produced in cells of alkalophilic Bacillus sp. strain YN-2000. This amine is secreted in the medium during the cell growth. The amounts of 2-phenylethylamine in both cells and medium change upon changing the pH of the medium.

Gadolinium-enhanced magnetic resonance angiography in the planning of supratentorial glioma surgery

The utility of gadolinium (Gd)-enhanced magnetic resonance (MR) angiography in the planning of supratentorial glioma surgery was evaluated. MR angiograms of the arterial and venous anatomy visualized the anatomical relationship of the main arteries to the tumor, especially on three-dimensional images. Combination with data from surface anatomical images allowed the tumor location to be determined preoperatively. Gd-enhanced MR angiography can be used non-invasively prior to tumor surgery to ascertain the spatial relationship of the vessels to the tumor mass.

Design and evaluation of low-cross-talk twisted nematic liquid-crystal cells for optical switches

A design method is proposed for low-cross-talk twisted nematic liquid-crystal optical switches. In this method the transmission spectrum of a liquid-crystal cell is simulated by using parameters such as wavelength, refractive index of the liquid crystal, cell thickness, and spacer density. With this simulation, it becomes possible to define the parameters that give the lowest cross talk at a given wavelength. Liquid-crystal cells are fabricated by using the simulation results, and the transmission spectra are characterized. A very low cross talk of -32 dB is achieved for a wavelength of 633 nm.

An acidic polysaccharide having immunological activities from the rhizome of Cnidium officinale

An acidic polysaccharide, designated as cnidirhan AG, was isolated from the rhizomes of Cnidium officinale Makino. It was homogeneous on electrophoresis and gel chromatography, and its molecular mass was estimated to be 5.1 x 10(4). It showed pronounced reticuloendothelial system-potentiating activity in a carbon clearance test, and had a remarkable effect on both anti-complementary and alkaline phosphatase-inducing activities. It is composed of L-arabinose: D-galactose: D-glucuronic acid in the molar ratio of 2:6:1, in addition to small amounts of O-acetyl groups. Methylation analysis, carbon-13 nuclear magnetic resonance, controlled Smith degradation and limited acid hydrolysis indicated that the core structural features of cnidirhan AG include a backbone chain composed of beta-1,3-linked D-galactose residues. Some of the galactose units in the backbone carry beta-D-galactosyl side chains at position 6. Both alpha-L-arabinosyl arabinose side chains and terminal beta-D-glucuronic acid residues are linked to the core galactan units.

[The pathogenesis of hypercalciuria from the aspect of the response to human parathyroid hormone in Ca containing stone formers]

In order to clarify the pathogenesis of hypercalciuria, the response to extrinsic human parathyroid hormone (h-PTH) was studied the 21 patients with calcium containing urinary stone(s) and 5 normal controls (NO). The stone patients were classified into 3 groups from the result of the oral calcium loading test, i.e. Non-hypercalciura (NH, n = 8) and absorptive hypercalciuria (AH, n = 8) and renal hypercalciuria (RH, n = 5). Only in the AH group, urinary excretion of calcium (u-Ca) was strongly correlated to that of sodium (u-Na) in pre-load of h-PTH, and both increments were also correlated in post-load of h-PTH. As of this fact the increase in Na excretion seems to be responsible for a cause of hypercalciuria in the AH group. There was a significant correlation between the value of %TRP in pre-load of h-PTH and the rate of urinary phosphorus (P) increment between pre-load and post-load of h-PTH in the NO and NH groups. However, this relationship was not found in the AH and RH groups. These findings indicate that there is response disorder of P to h-PTH. In addition, serum P was low, plasma 1,25 (OH)2D was high, N-c-AMP was low in the AH group, whereas both serum P and %TRP were low in the RH group in pre-load of h-PTH. These findings are compatible with the primary renal P leak.(ABSTRACT TRUNCATED AT 250 WORDS)

Shock wave and THP-adriamycin for treatment of rabbit's bladder cancer

Focused high-energy shock waves (6,000 to 10,000 shots) were targeted under ultrasound guidance onto implanted urinary bladder cancer in rabbits to elucidate its effect. Although only focal necrosis of the tumor was seen following 6,000 to 10,000 shots daily for 3 days or following chemotherapy (THP-adriamycin) alone, almost total tumor necrosis was observed following a combined shock-wave therapy for one day and THP-adriamycin administration, demonstrating an additive and/or synergetic effect on rabbit urinary bladder cancer.

[Ultrastructural renal damage after shock wave exposure]

This report clarified the direct damage to renal cell ultrastructure on shock wave exposure. The renal cortex of the rabbit was exposed to the shock waves (1200 bar) generated by the piezo-ceramics. The change was examined by electron microscopy immediately after 20 shots exposure and 500 shots exposure as well as one week after 500 shots exposure. In all groups, the most critical damage was observed in the proximal tubule. Immediately after 20 shots exposure, large vacuoles were found to be enclosed by infoldings in the proximal tubular cell. The damaged cell lost its brush border and jutted out into the lumen. The ruins of organelles (nuclei, mitochondria, etc.) were seen in the lumina of proximal and distal tubules. The damage progressed, in the 500 shots exposure group, to include the distal tubular cytoplasm. One week after the 500 shots exposure, a few of atrophic tubular cells were found in wide scars. The tubular cell which contained a deformed nucleus and destroyed organelles was desquamated from the basement membrane. The change in the tubular cell after shock wave exposure was apparently different from that after such intervention as one hour ischemia. It was concluded that the direct damage to renal cells by underwater shock wave exposure was really present.

Central nervous system metastasis from gallbladder carcinoma--case report

Systemic metastases from gallbladder carcinoma occur frequently, but involvement of the central nervous system is rare. We describe such a case in a 68-year-old female. Solitary brain metastasis from gallbladder carcinoma was completely removed 4 months after operation for the primary tumor. Planned chemotherapy was then given to prevent recurrence. She was leading a normal life 4 years later. Patients with solitary brain metastasis from gallbladder carcinoma can achieve a better outcome and longer survival after removal of the brain metastasis if there is no other metastasis.

[Developmental mechanisms of congenital eye abnormalities]

Experimental teratology in mice was studied to clarify the developmental mechanisms of congenital eye abnormalities. Pregnant Jcl: ICR mice were treated intraperitoneally with ochratoxin A on day 7 of pregnancy. The offspring were grossly observed on day 9, 10, 11, 12, 13, 14, 16 or 18 of gestation, or at the second or fourth week after birth. Then, the eyes were histologically examined in serial sections. Mother mice were injected with ochratoxin A on day 8, 9, 10 or 11 of pregnancy, and the eyes of fetuses were examined on day 16 of gestation to determine the critical periods for the congenital eye abnormalities. Pregnant C57BL/6NJcl mice were also given an intraperitoneal injection of ochratoxin A on day 7 of pregnancy, and the eyes of offspring were observed grossly and histologically on day 16 or 18 of gestation, or at the second or fourth week after birth. Fetal and postnatal eyes showed various kinds and degrees of developmental abnormalities histologically. They included anophthalmia, microphthalmia, aphakia, mesenchymal dysgenesis of the anterior segment, faulty separation of the lens vesicle, developmental abnormalities of the vitreous, faulty closure of the embryonic fissure, retinal rosette formation and aberrant optic nerve fiber. Since anophthalmia, microphthalmia and aphakia caused by the developmental disturbances of the optic and lens vesicles were not established in the fetuses whose mothers were treated with ochratoxin A after day 9 of pregnancy, the critical periods for these abnormalities were considered to be on day 8 of gestation or earlier. Mesenchymal dysgenesis of the anterior segment, faulty separation of the lens vesicle and developmental abnormalities of the vitreous were frequently observed in the fetuses whose mothers were injected with ochratoxin A on day 7, 8 or 9 of pregnancy. It was considered that there was a correlation between the critical periods for these three abnormalities and the stage of the neural crest cell migration around the optic vesicle. Mesenchymal dysgenesis of the anterior segment observed in mice corresponded to the Axenfeld-Rieger syndrome or Peters' anomaly encountered clinically. Processes of production of these abnormalities based on the faulty migration of the neural crest cells which form the ocular anterior segment were demonstrated.(ABSTRACT TRUNCATED AT 400 WORDS)

Initial experience using a new type extracorporeal lithotripter with an anti-misshot control device

Initial clinical trials using a new overhead piezoelectric extracorporeal lithotripter is presented. The advantages of this machine are the installation of an anti-misshot control device (AMCD) to prevent misshots to renal tissue, simplicity for ultrasound stone localization by the overhead type applicator, and elimination of necessity for anesthesia. Thirty patients with upper urinary tract calculi were treated by this machine with a success rate of 77% and stone destruction rate of 93%. No serious complication was observed. The AMCD functioned in such a manner that shock waves were generated only when the stone was in the focal region. Although there were AMCD nonfunctioning cases (small and deeply located stones), it is indicated that this machine is favorable for safe, extracorporeal lithotripsy.

[Estimation of glomerular filtration rate from the urinary excreted contrast medium concentration]

In the animal experiments, glomerular filtration rate (GFR) values were estimated from the urinary response to the intravenously administrated iopamidol. By introducing some reasonable assumptions, mass balance equations about the contrast medium were transformed and GFR was defined as the ratio of logarithm of urinary concentration by time. Urinary concentrations were determined by measuring the photodensity on the X-ray film of urine specimens. Obtained values of GFR were well fitted to those obtained by the analysis of the plasma disappearance curve. The advantage of this method is that measurement of urinary volume is not necessary.