[Reticuloendothelial function as a prognostic factor in breast cancer]

Reticuloendothelial function was investigated in breast cancer by the 131I-microaggregated albumin method using the parameters of phagocytic function (K value) and metabolic function (M value). Reticuloendothelial function of the patients with breast cancer was decreased compared with that of the controls, and it was related to the peripheral lymphocyte count. This finding indicates that reticuloendothelial function is one of the prognostic factors in breast cancer.

Giant cell tumor of the bladder associated with transitional cell carcinoma

We report in detail the first giant cell tumor associated with transitional cell carcinoma of the bladder. The giant cell tumor was composed of multinucleated giant and mononuclear stromal cells, and was morphologically indistinguishable from giant cell tumor of the bone. The giant and transitional cell carcinomas showed no evidence of recurrence or metastasis 8 months after transurethral resection. No histogenetic correlation between the cancers was found.

[The case studies on oral administration of tegafur encapsulated with slow releasing granule (SF-SP) for three rectal patients]

Three rectal cancer patients with partial response (PR) were obtained by oral administration of 800-1200 mg/day of SF-SP. One of them showed I-A grade and other I-B in Karnofsky evaluation.

[Intra-arterial chemotherapy combined with noradrenaline--histopathological effect in stomach cancer]

The histological evaluation of intraarterial administration of MMC, adriamycin and noradrenalin as a preoperative treatment was performed in 24 gastric patients. The effective histological changes estimated microscopically by the Takahashi's criteria were found in 9 (37.5%) patients with the primary tumor and in 8 (50.0%) patients with the metastatic lymph nodes.

[Comparative study on cefmetazole and cefazolin in the treatment of suppurative otitis media]

Cefmetazole (CMZ) was compared to cefazolin (CEZ) for efficacy and safety in the treatment of suppurative otitis media (including acute otitis media and chronic otitis media in acute aggravating stage) under well controlled clinical trials. The therapeutic effects were analyzed statistically in 172 patients (82 administered CMZ, 90 administered CEZ). The adverse reactions were also analyzed statistically in 199 patients (CMZ 99, CEZ 100) in whom the judgement was possible. 1. The efficacy rate of CMZ (72.3% for good to excellent response) was assessed by physicians in charge to be similar to that of CEZ (59.3%). This was the same being assessed by the committee, too (CMZ 64.6%, CEZ 56.7%). 2. When patients were classified into 2 groups (acute otitis media, chronic otitis media in acute aggravating stage) with respect to diagnosis, statistically significant difference in clinical efficacy assessed by physicians in charge was observed in the cases with chronic otitis media (CMZ, CEZ). In addition, the improvements of flares on the drum membrane and the mucous membrane of eardrum were significantly better in the CMZ group than in the CEZ group. 3. Bacteriologically, 16 cases (19.8%) of S. aureus were resistant to CEZ, while only 1 case (1.2%) to CMZ. CMZ was judged to be effective in 5 of the 6 cases in which CEZ-resistant strains were detected. 4. Side effects were found in 2 cases (2.0%) treated with CMZ: one complained of retching and abdominal pain and the other developed skin eruption. On the other hand, only 1 case (1.0%) developed skin eruption in the CEZ group. These results suggest that CMZ is a new antibiotic agent which is highly valuable in the treatment of suppurative otitis media.

A new neurotological test for detecting cerebellar dysfunction

The adaptation of the vestibulo-ocular reflex (VOR) was studied in 26 normal subjects and 26 patients with cerebellar lesions, using horizontal vision-reversal prisms. In normal subjects, the adaptation of gain after wearing prisms for one hour was approximately 50% of the VOR value in the dark. In contrast to this, patients with cerebellar lesions showed less adaptation--approximately 20% after a one-hour forced adaptation task. These were type A, higher gain in the initial level and abnormal adaptation (10 cases); type B, higher gain in the initial level and normal adaptation (5 cases); and type C, normal initial level and abnormal adaptation (11 cases). The cases showing the typical type-A responses tended to have severe widespread or midline lesions of the cerebellum. Typical type-B cases had mild cerebellar lesions, and typical type-C cases tended to have lesions restricted to one side of the cerebellum. From these results, it can be speculated that reduction of VOR adaptation occurs when one side of the cerebellum has severe lesions, but it is sufficient to produce a normal vestibulo-ocular reflex if at least half of the cerebellum is intact.

New neurotological test for detecting cerebellar dysfunction. Vestibulo-ocular reflex changes with horizontal vision-reversal prisms

Adaptation of the vestibulo-ocular reflex (VOR) was studied in 26 normal subjects and 15 patients with cerebellar lesions, using horizontal vision-reversal prisms. In normal subjects, adaptation of gain after wearing prisms for one hour was approximately 50% of the VOR value in the dark. In contrast to this, patients with cerebellar lesions showed less adaptation, approximately 20% after a one-hour forced adaptation task. These cases showed three different types of abnormalities: 1) high gain before wearing prisms and normal adaptation, 2) high gain before wearing prisms and reduction of adaptation, 3) normal gain and reduction of adaptation. From these results it is suggested that observation of the effect of vision-reversal prisms on the VOR may permit the detection of cerebellar lesions of a type or subtlety which escape established tests.

Metabolism of 8-chloro-6-(o-chlorophenyl)-1-methyl-4H-s-triazolo [4,3-alpha] [1,4]benzodiazepine, triazolam, a new central depressant. II. Identification and determination of metabolites in rats and dogs

1. Eight metabolites of triazolam have been identified, namely, triazolam, dichlorotriazolobenzophenone (DCTB), 1'-hydroxytriazolam, dichloro-alpha-hydroxytriazolobenzophenone (1'-hydroxy-DCTB), Ar-hydroxytriazolam, 4-hydroxytriazolam, Ar-1'-dihydroxytriazolam and 1',4-dihydroxytriazolam. 2. Major metabolites found in the urine were 1',4-dihydroxytriazolam, 1'-hydroxy-DCTB and DCTB in rats; 1'-hydroxytriazolam, 4-hydroxytriazolam and conjugated 1'-hydroxytriazolam in dogs. 3. Major metabolites found in the faeces were 4-hydroxytriazolam in rats; 1'-hydroxytriazolam and 4-hydroxytriazolam in dogs. 4. Conjugated 4-hydroxytriazolam was the major metabolite in both the original and reabsorbed bile of rats. 5. Major metabolites in free form in the plasma were 4-hydroxytriazolam and 1'-hydroxytriazolam in rats; triazolam and 1'-hydroxytriazolam in dogs. 6. The major metabolite in the brain was triazolam, but those in the liver were 4-hydroxytriazolam and triazolam, and in the kidneys were 4-hydroxytriazolam and 1',4-dihydroxytriazolam. 7. Major metabolites in the urine, faeces, plasma and brain after 7-, 14- or 21-day repeated dosing in rats were not much different in type and ratio from those after single dosing. 8. Unchanged triazolam and 1'-hydroxytriazolam were the major metabolites in the plasma, placenta, foetus and amniotic fluid in pregnant rats. 9. There was no change in hepatic aniline hydroxylase and aminopyrine-N-demethylase activity from controls in rats given oral dose of [14C]triazolam for 14 days.

Metabolism of 8-chloro-6-(o-chlorophenyl)-1-methyl-4H-s-triazolo [4,3-alpha] [1,4] benzodiazepine, triazolam, a new central depressant. I. Absorption, distribution and excretion in rats, dogs and monkeys

1. Peak radioactivity in the blood was reached at 30 min after i.p. and 1 h after oral dosing of [14C]triazolam to rats. In dogs, peak blood level was observed at 30 min after oral dosing. 2. Daily dosing of triazolam to male rats for 21 days caused a gradual increase in blood level, with peak at 1 h after dosing. 3. The rate of binding of triazolam plus its metabolites to plasma protein of rats was about 30% at 15 min and 6 h. 4. In rats, the majority of the activity of the intra-intestinally administered [14C]triazolam was found in the small intestines in 6 h. 5. About 58% of the oral dose and 77% of the i.p. dose were recovered in the bile of rats in 48 h after dosing. When the bile from one rat was introduced into the duodenum of a second rat, approximately 37% was recovered in the bile of the second animal in 24 h. 6. In male rats, high radioactivity was seen in the liver, kidneys, adrenals and heart, and low in the CNS. By 96 h after dosing, radioactivity in the liver, blood and kidneys was very low, and was undetectable in other tissues and organs. Radioactivity levels in tissues after daily dosing for 7, 14 and 21 days did not differ appreciably from single administration. 7. In monkeys, activity was high in the liver, kidneys and skin following oral administration and low in the CNS. 8. After oral administration of [14C]triazolam to pregnant rats, the activity in the uterus and placenta was higher than that in the maternal blood. The activity in the foetus was low. 9. In rats given [14C]triazolam orally or i.p., 85% and 12% of the oral dose, and 82% and 14% of the i.p. dose were recovered in the faeces and urine, respectively, in 96 h. The rate of cumulative faecal and urinary excretion after repeated dosing was similar to the single dosing with 80% and 14% of the activity recovered, respectively, in faeces and urine in 6 days. In dogs, 50% of the oral dose was found in the faeces and 40% in the urine. 10. Radioactivity in the milk of rats was maximal at 4 h after oral dosing. It declined to 34% of the peak level 48 h later.