Combined cis-platinum and alpha interferon therapy of advanced hepatocellular carcinoma

To evaluate the clinical efficacy of alpha-interferon(IFN-alpha) plus cis-platinum in hepatocellular carcinoma(HCC). 56 inoperable patients with HCC were divided into IFN-alpha plus cis-platinum treated group (n = 30) and no antitumor therapy group (n = 26). The survival of IFN-alpha plus cis-platinum treated patients was significantly better than that of patients who received no antitumor therapy (p = 0.001). Median survival time was 33 weeks and 14.0 weeks, respectively. The cumulative estimated survival rates of our IFN-alpha plus cis-platinum treated group (93.5% at 3mo, 75.0% at 6mo) were for longer than that of the no antitumor therapy group (84.6% at 3mo, 57.7% at 6mo). Objective tumor regression, greater than 50% was observed in 13.3% (4 of 30) of patients receiving IFN-alpha plus cis-platinum. By the univariate analysis, the absence of portal vein thrombus (p < 0.05), alkaline phosphatase lesser than 280 U/L (p = 0.001), total bilirubin less than 2.0 mg% (p < 0.05), serum triglyceride less than 155 mg/dl (p < 0.05) were shown to be the factors most significantly favoring a better survival. By the multivariate analysis, using Cox proportional hazards model, IFN-alpha plus cis-platinum treated group (p = 0.0001), alkaline phosphatase less than 280 mg/dl (p = 0.005), the absence of portal vein thrombus (p = 0.020) were independent favorable prognostic factors. We conclude that IFN-alpha plus cis-platinum is useful in patients with inoperable HCC and the above favorable prognostic factors may also be useful in the design and analysis of future clinical trials of systemic chemotherapy for HCC.

IgA response in mice infected with Neodiplostomum seoulensis

To observe the production of IgA in Balb/c mice with neodiplostomiasis, 20 mice were infected with each 200 metacercariae of Neodiplostomum seoulenis. Sera and the duodenums were obtained 3, 7, 14, 28 days post-infection (PI) from five mice each group. Neodiplostomum specific IgA in serum by the enzyme-linked immunosorbent assay increased from 7 days PI and persisted till 28 days PI. Immunohistochemistry for IgA was done with sections of the duodenum. The IgA-positive reaction was generally seen in the lamina propria and submucosa. Some of epithelial cells were positive at 7 and 14 days PI. The present finding showed that Neodiplostomun specific IgA antibody increased in serum and that there was local reaction of IgA in the mucosa and submucosa of the duodenum but not directly related with worm expulsion.

Intestinal trematode infections in the villagers in Koje-myon, Kochang-gun, Kyongsangnam-do, Korea

An epidemiological study for the intestinal trematode infection of the villagers was done in Koje-myon, Kochang-gun, Kyongsangnam-do, Korea in March, 1994. Of 116 stool specimens examined, total helminthic ova positive cases were 13 (11.2%) and cumulative ova positive cases 21 (18.1%): Echinostoma hortense 11 cases (9.5%), Metagonimus sp. 6 cases (5.2%), and Clonorchis sinensis 4 cases (3.4%). After the treatment and purgation, variable numbers of E. hortense, 6 to 227 per person, were collected from 7 echinostome egg positive cases, together with M. takahashii in 6 cases. Three adult flukes of E. cinetorchis were collected from one person and one Stellantchasmus falcatus was recovered from another case. This mountainous village was proved to be one of the endemic foci of echinostomiasis in Korea.

A follow-up examination of intestinal parasitic infections of the Army soldiers in Whachon-gun, Korea

A follow-up stool examination was done to know the status of intestinal parasitic infections in Army soldiers who were stationing in Whachon-gun, Kangwon-do, Korea in 1993. Of 233 examined soldiers, Infections with Clonorchis sinensis (0.4%), Metagonimus spp. (0.9%), Echinostoma hortense (0.4%), Neodiplostomum seoulensis (0.4) and Giardia lamblia (3/233) were found. E. hortense and N. seoulensis infections were each 75th, and 27th cases in Korea. Regular control program of intestinal parasitic infections might be able to contribute to diminish the prevalence rate in young Army soldiers in Korea.

Intestinal parasite infections in the inhabitants along the Hantan River, Chorwon-gun

The prevalence of intestinal parasite infections in inhabitants at the reaches of the Hantan River, Chorwon-gun, Korea, was observed from August 12 to September 14, 1993. Of 465 people observed by cellophane thick smear and formalin-ether concentration method, 2 Ascaris lumbricoides (unfertilized), 1 Trichuris trichiura, 39 Clonorchis sinensis and 16 Metagonimus egg positive cases were found. After treatment, the Metagonimus egg positive cases passed out flukes of Metagonimus Miyata type. Of 68 fish caught in the Hantan River, 14 (20.6%) were infected with metacercariae of Metagonimus, while no metacercaria of C. sinensis was found. At this area, soil-transmitted nematodes are very low, but clonorchiasis and metagonimiasis are prevalent by modernate endemicity.

Effect of adenine arabinoside and alpha-interferon in patients with HBeAg-positive chronic active hepatitis

To evaluate and compare the therapeutic efficacy of adenine arabinoside (Ara-A) and alpha-interferon (alpha-INF), 40 patients with biopsy proven chronic active hepatitis B were chosen at random to receive Ara-A (15 mg/Kg, iv, for 10 day) or alpha-INF (3 million unit, sc, every other day for 12 wks) and followed up to 12 months after completion of the therapy. All patients were HBeAg positive. The clinical effects of Ara-A and alpha-INF on seroconversion of HBeAg positive. The clinical effects of Ara-A AND alpha-INF on seroconversion of HBeAg and the levels of serum aminotransferase (ALT) were closely matched and compared with those of the untreated control group (20 cases). Eighteen out of 20 patients received Ara-A, 19 patients received alpha-INF, and 19 out of 20 control cases were evaluated at 12 months after completion of treatment. Seroconversion of HBeAg in the alpha-INF treated group (19 cases) was observed in seven cases (36.8%), showing a higher seroconversion rate as compared to Ara-A-treated (2/18 cases, 11.1%) and to the control patients (1/19 cases, 5.3%). There were no effects of Ara-A on serum ALT levels in the treated patients compared with the untreated control patients. However there was a remarkable drop in serum ALT levels in the INF-treated patients (p less than 0.005, ALT levels at 12 months after treatment; 87.4 +/- 98.8 IU/L) compared to the pretreatment levels (256.7 +/- 175.8 IU/L).(ABSTRACT TRUNCATED AT 250 WORDS)

Arterialization of the liver. II. Systemic pressure gradients in rats following variously sized arteriovenous fistulae

Four groups (I, II, III, and IV) of six Wistar rats each were studied to elucidate the blood pressure changes following creation of arteriovenous fistulae (AVF) of diameters 1, 2, and 3 mm (groups II, III, and IV, respectively). Group I comprised normal rats with no AVF. Blood pressures were recorded in the carotid and femoral arteries, the femoral and portal veins, the right atrium, and the inferior vena cava (IVC) at renal vein (RV) and common iliac vein (CIV) levels. We found that AVF size did not disturb baseline carotid arterial or portal venous pressures (P greater than 0.01), but the femoral arterial pressures fell increasingly (P less than 0.01). On the other hand, right atrial pressure and that of IVC at RV and CIV levels rose substantially with increasing diameters of AVF (P less than 0.01). It was concluded that an AVF of 1 mm diameter least upset the normal blood pressures in the vessels examined.

Keratinocyte damage produced by 12-O-tetradecanoylphorbol-13-acetate in rodent epidermis

Cell damage produced by 12-O-tetradecanoylphorbol-13-acetate (TPA) was evaluated in keratinocyte suspensions obtained from TPA treated mouse epidermis using a dye-exclusion technique, and in tissue sections studied by light microscopy and quantitative enzyme histochemistry. TPA induced a maximum of approximately 25% of trypan blue stained basal keratinocytes using topical doses of 2, 20 and 200 micrograms. With the first two doses this effect was detectable at 12-24 h and disappeared 48-96 h after TPA treatment, whereas with 200 micrograms TPA the cell damage persisted for a longer time. Oxidative enzyme changes were moderate, and no changes in acid phosphatase levels could be detected. The facts that no signs of cell necrosis could be seen in tissue sections from epidermis treated with 2 and 20 micrograms TPA; that only a moderate change in oxidative enzyme pattern, without statistically significant variations in succinic dehydrogenase and cytochrome oxidase, could be detected, and that no shift of the damaged basal keratinocytes into the suprabasal compartment was evident, are indicative of moderate, probably sublethal damage induced by TPA. Although eventually committed to terminal differentiation, the epidermal cells do not show the cytologic and metabolic features of lethally damaged cells, suggesting that the membrane damage detected by the dye exclusion technique may be sublethal. Thus, it is possible that TPA can induce a reactive or regenerative type of epidermal hyperplasia without the prerequisite of extensive keratinocyte necrosis.