[Intermittent intra-arterial chemotherapy for the treatment of patients with bladder cancer or prostate cancer using implantable injection pump]

BACKGROUND

The objective of this study is to evaluate the usefulness of intra-arterial chemotherapy using an implantable injection system for the treatment of bladder or prostate cancer.

METHODS

Twenty-four patients with bladder cancer and 13 with prostate cancer were treated with intermittent intra-arterial chemotherapy using a totally implantable injection pump. A heparinized catheter was percutaneously fixed through the femoral artery with the tip 2 or 3 cm above the bifurcation of the common iliac artery, and the pump was placed in a subcutaneous pocket.

RESULTS

The total number of infusion sessions for bladder cancer ranged from 4 to 38 times (mean 20.8), and 15 of the 24 patients were injected from 2 to 19 sessions (mean 8.5) as outpatients. The tumor response for 15 patients with newly diagnosis muscle-invasive bladder cancer were 12 patients in CR, 1 in PR, and 2 in NC, and 9 patients with recurrent bladder cancer were 6 patients in CR, 1 in PR, and 2 in NC. The total number of infusions for prostate cancer ranged from 6 to 35 times (mean 20.2), and 10 of the 13 patients were injected from 1 to 11 times (mean 6.3) as outpatients. All 13 patients with prostate cancer were treated with hormone therapy and irradiation, and achieved PR. Complications of this drug delivery system were obstruction of the catheter or pump observed in 7 patients, dislocation of the catheter in 2, and obstruction of right external iliac artery in 1.

CONCLUSION

These findings suggest that favorable therapeutic efficacies and an improved quality of life for patients can be obtained by intra-arterial chemotherapy using an implantable injection pump.

[Pulmonary lymphangiomyomatosis with tuberous sclerosis and endolymphatic stromal myosis of the uterus]

Pulmonary lymphangiomyomatosis is a rare disorder that affects only women of reproductive age. The lung shows numerous cystic changes and striking proliferation of smooth muscle around the airways, blood vessels, and lymphatic channels. We encountered a patient with pulmonary lymphangiomyomatosis who had repeated pneumothorax and bloody sputum over 10 years. The patient also had other lesions, including intracranial calcification, renal angiomyolipoma and endolymphatic stromal myosis of the uterus. The first two findings are known as tuberous sclerosis, and lymphangiomyomatosis is considered to be a form fruste of tuberous sclerosis. However, we know of no previous reports of uterine lesions in this disease. Lymphangiomyomatosis may be a systemic disorder of smooth muscle.

Identification and mapping of functional domains on human T-cell lymphotropic virus type 1 envelope proteins by using synthetic peptides

To identify the regions that are important in human T-cell leukemia virus type 1 (HTLV-1) envelope function, we synthesized 23 kinds of peptides covering the envelope proteins and examined the inhibitory effect of each peptide on syncytium formation induced by HTLV-1-bearing cells. Of the 23 synthetic peptides, 2, corresponding to amino acids 197 to 216 on gp46 and 400 to 429 on gp21, inhibited syncytium formation induced by HTLV-1-bearing cells but did not affect syncytium formation induced by human immunodeficiency virus type 1-producing cells. The peptide concentrations giving 50% inhibition of syncytium formation for gp46 197 to 216 and gp21 400 to 429 were 14.9 and 6.0 microM, respectively. A syncytium formation assay with overlapping synthetic peptides containing amino acids 175 to 236 and 391 to 448 of the envelope proteins showed that syncytium formation was inhibited by peptides that contained the amino acid sequences 197 to 205 (Asp-His-Ile-Leu-Glu-Pro-Ser-Ile-Pro) and 397 to 406 (Gln-Glu-Gln-Cys-Arg-Phe- Pro-Asn-Ile-Thr). These observations suggest that the two regions corresponding to amino acids 197 to 216 and 400 to 429 are involved] in HTLV-1 envelope function.

Modified antigen-binding of human antibodies with glycosylation variations of the light chains produced in sugar-limited human hybridoma cultures

We have characterized the effects of serum and N-acetylglucosamine in a glucose-deprived condition on the glycosylation of antibody light chains, as well as the resulting biological properties of those antibodies. We have chosen for our investigation the human hybridoma lines producing monoclonal antibodies reactive to lung adenocarcinoma. Each antibody possess a N-glycosylated carbohydrate chain in the hypervariable region of the light chains. When the cell lines were grown in the absence of glucose, variant light chains with varying molecular masses were found to be secreted. Analysis of these light chains produced in a glucose-deprived condition revealed that the changed molecular-mass of the variant light chains is due to different glycosylation. Addition of N-acetylglucosamine or fetal calf serum to the glucose-free medium led to the creation of other light chains that exhibit increased antigen binding activity.

AL0671, a new potassium channel opener, inhibits nonenzymatic glycation of protein and LDL oxidation

1. The effects of AL0671, a novel potassium channel opener, on protein glycation and low-density lipoprotein (LDL) oxidation were tested. 2. AL0671 dose-dependently inhibited both fluorescence development of bovine serum albumin and cross-linking of lysozyme. These inhibitory effects for glycation were no less potent than aminoguanidine. 3. AL0671 dose-dependently inhibited both increase in negative charge and apo B-100 fragmentation during incubation of LDL with Cu2+. In addition, AL0671 significantly decreased the LDL degradation in rat peritoneal macrophages. 4. Neither pinacidil nor levcromakalim inhibited protein glycation and LDL oxidation. 5. Antioxidant properties of AL0671 might be due to its potent electron-donating ability, and this agent is expected to be useful for hypertensive diabetes.

Dynamic changes in expression of glutamate transporter mRNAs in developing brain

Developmental changes in gene expression for three glutamate transporter subtypes in the mouse brain were analysed by in situ hybridization. During embryonic stages, GluT-1 and GLT-1 mRNAs were expressed at high levels in the ventricular zone, whereas EAAC1 mRNA was not detected in the zone. In the mantle zone, transcription levels of three transporter mRNAs were low during embryonic stages, and these levels, especially those of the GluT-1 and GLT-1 mRNAs, displayed remarkable increases postnatally to reach maximal levels at 14 days of age. These dynamic developmental regulations suggest that the glutamate transporter not only regulates the excitatory synaptic transmission at mature stages, but might also be intimately involved in the brain development.

Cloning of the cDNA encoding the mouse ATBF1 transcription factor

We have isolated a mouse ATBF1 cDNA which is 12-kb long and capable of encoding a 406-kDa protein containing four homeodomains and 23 zinc-finger motifs. Mouse ATBF1 is 94% homologous to the human ATBF1-A transcription factor. Northern blot and RNase protection analysis showed that levels of ATBF1 transcripts were low in adult mouse tissues, but high in developing brain, consistent with a role for ATBF1 in neuronal differentiation.

Induction, localization, and purification of a novel sialidase, deaminoneuraminidase (KDNase), from Sphingobacterium multivorum

Recently, we reported the discovery of a new type of sialidase, KDNase, which specifically hydrolyzes the ketosidic linkages of 2-keto-3-deoxy-D-glycero-D-galacto-nononic acid (KDN), but not N-acylneuraminyl linkages. We now report that this enzyme, designated KDNase SM, is an inducible enzyme that is localized in the periplasm of Sphingobacterium multivorum. Growth of S. multivorum in the presence of KDN-containing oligosaccharide alditols, KDNalpha2-->3Galbeta1-->3GalNAc alpha1-->3[KDNalpha2--> (8KDN alpha2-->)n-->6]GalNAcol, as a sole carbon source induced KDNase SM activity 15 40-fold, compared with growth in the absence of inducer. KDN, Neu5Ac, or Neu5Ac oligomers were ineffective as inducers. The enzyme was released from the periplasm of induced cells by cold osmotic shock and purified 700-fold to homogeneity. The specific activity of the pure enzyme was 82,100 units/mg of protein. KDNase SM activity resided in a single polypeptide chain with an estimated molecular weight of approximately 47,500. Enzyme activity was maximal at near neutral pH. The availability of pure KDNase will now make it possible to study the structure and functional role of KDN-glycoconjugates and to determine the molecular mechanism whereby the enzyme can discriminate between KDN and N-acylneuraminic acid.

Interleukin 11 levels in patients with disseminated intravascular coagulation

We assessed the blood interleukin 11 (IL-11) levels in patients with disseminated intravascular coagulation (DIC). The IL-11 level exceeded the detection limit, i.e., IL-11 was positive, in 14 of the 21 patients in the group with DIC complicated by sepsis, with a mean value of 20.4 pg/ml. In the group with DIC uncomplicated by infection, IL-11 levels were above the detection limit in 8 of the 17 patients, and the average level was 10.6 pg/ml. The difference between the IL-11-positive rate in the two groups was not significant. Although IL-11 levels tended to be higher in the group with sepsis as a complication, the difference was not significant. The elevated IL-11 levels observed in patients with DIC, with or without complication by infection, seem quite appropriate as a biological response to increased platelets.

Captopril, an angiotensin-converting enzyme inhibitor, induced pulmonary infiltration with eosinophilia

In this study, we investigated the association between the drug-induced pulmonary infiltration with eosinophilia (PIE) syndrome in a patient with hypertension and the angiotensin-converting enzyme inhibitor (ACE-I) captopril. Although the patient developed diffuse lung field infiltrates accompanied by productive cough and striking peripheral eosinophilia, these symptoms disappeared after termination of the administration of captopril, pronase and cephalexine. Furthermore, the results of the peripheral lymphocyte stimulation test, skin patch test and provocation test under informed consent showed a positive reaction only for captopril. Therefore, this patient was diagnosed as captopril-induced PIE syndrome.

Impairment of suckling response, trigeminal neuronal pattern formation, and hippocampal LTD in NMDA receptor epsilon 2 subunit mutant mice

Multiple epsilon subunits are major determinants of the NMDA receptor channel diversity. Based on their functional properties in vitro and distributions, we have proposed that the epsilon 1 and epsilon 2 subunits play a role in synaptic plasticity. To investigate the physiological significance of the NMDA receptor channel diversity, we generated mutant mice defective in the epsilon 2 subunit. These mice showed no suckling response and died shortly after birth but could survive by hand feeding. The mutation hindered the formation of the whisker-related neuronal barrelette structure and the clustering of primary sensory afferent terminals in the brainstem trigeminal nucleus. In the hippocampus of the mutant mice, synaptic NMDA responses and longterm depression were abolished. These results suggest that the epsilon 2 subunit plays an essential role in both neuronal pattern formation and synaptic plasticity.

Correlation of the OSR/ZRCI gene product and the intracellular glutathione levels in Saccharomyces cerevisiae

The OSR (oxidative-stress-resistance) gene was cloned as the gene which enhances resistance against oxidative stress caused by lipid hydroperoxide in Saccharomyces cerevisiae. The nucleotide sequence of the gene was determined and found to be identical with the zinc-resistance-conferring (ZRCI) gene, which was cloned as the gene enhancing the resistance against zinc and cadmium. A knockout mutant of the OSR gene showed increased sensitivity to lipid hydroperoxide. The intracellular glutathione content in the knockout mutant decreased approx. 40% compared with that of wild-type cells, whereas it increased 3-fold in yeast overexpressing the OSR gene. Therefore the OSR/ZRCI gene product seems to regulate the intracellular glutathione content.

A numerical model for the analysis and evaluation of global 137Cs fallout

Fallout 137Cs from atmospheric nuclear detonation tests has been monitored worldwide since the late 1950's. The deviation and the correlation among these monitoring data were analyzed, and their surface deposition characteristics were estimated by the compartment model developed in this research. In the analysis, the scale of space (i.e., size of each compartment) and the degree of detail (i.e., number of compartments) were statistically determined using the global distribution data of 137Cs. The mathematical model was evaluated by comparing the numerically stimulated results with the fallout monitoring data including the 137Cs concentration in sea water. The major findings obtained in this research include that the deposition pattern of 137Cs is dependent on the latitude zone but not on the longitude, the mathematical model is promising for evaluating the dynamic performance of 137Cs in global atmospheric environment and its surface deposition, 137Cs is accumulated more in both the surface and deep ocean water of the North Pacific Ocean and the North Atlantic Ocean than that of other oceans, the 137Cs inventory is decreasing after the peak time in 1965, and the 137Cs inventory in the deep ocean water is decreasing more slowly than that in the surface ocean water.

[Usefulness of estriol for the treatment of bone loss in postmenopausal women]

To assess the effect of estriol (E3) on bone loss in Japanese postmenopausal women, twenty-five women within 10 years after menopause received 2 mg/day of E3 and 2 g/day of calcium lactate (Ca) daily (n = 17; Group-E3 + Ca) or 2 g/day of Ca daily (n = 8; Group-Ca) for one year. Bone mineral density (BMD) at the lumbar spine L2 - L4 was evaluated by dual energy X-ray absorptiometry (DXA). In Group-Ca, BMD was significantly reduced (p < 0.05 vs. pretreatment) at the end of the study period. In contrast, in Group-E3 + Ca, the mean percent increase in BMD was 1.66%, which was significantly higher than that of Group-Ca (-3.08%; p < 0.001). As for the biochemical markers of bone metabolism, bone specific alkaline phosphatase (ALPIII) reflecting bone formation, and pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) reflecting bone resorption, were significantly decreased (p < 0.001) in Group-E3 + Ca after six months of treatment. These data indicate that the acceleration of bone turnover usually observed after menopause was prevented by treatment with E3. As to the side effects of E3, only one of the 17 patients experienced a slight increase in vaginal discharge, but no other side effects were observed. Accordingly, reasonable compliance can be expected among postmenopausal women treated with E3 to prevent bone loss.

[Two cases of long-term survival with hepatocellular carcinoma following targeting therapy with SMANCS/lipiodol]

We performed arterial infusion of SMANCS/Lipiodol in nineteen cases with hepatocellular carcinoma (HCC). We report two of these cases who survived for more than five years after the initial treatment. In case 1, HCC responded very well to the initial subsegmental infusion of SMANCS/Lipiodol with a prominent decrease in AFP level. In case 2, a 63-year-old male, repeated subsegmental infusion of SMANCS/Lipiodol for the local recurrence controlled the tumor well. In both cases, an approximately three-year period of complete remission passed until the tumor recurred. Arterial infusion of SMANCS/Lipiodol is expected to be a potent treatment for HCC. Its administration should be subsegmental, if possible, and should be repeated for local recurrence with a careful follow-up study.

Deletion in the 190 kDa antigen gene repeat region of Rickettsia rickettsii

The 190 kDa outer membrane protein of Rickettsia rickettsii is a major immunodominant protective antigen which contains 13 tandem nearly identical repeating sequences. We have identified a deletion in the 190 kDa antigen gene of R. rickettsii strain Smith maintained in the laboratory. The deletion occurred within the repeat region of this gene and the mutated repeat region corresponded to one repeating unit in size.

Thermoregulatory responses of prepubertal boys and young men in changing temperature linearly from 28 to 15 degrees C

To examine thermoregulatory responses of prepubertal children to cold stress, 11 boys (aged 8 years) and 11 young men (aged 19-23 years), wearing only trunks, participated in this study. They sat in air at 28 degrees C for 30 min (equilibrium period) and then in conditions where air temperature (Ta) was decreased linearly from 28 to 15 degrees C (at a constant rate of 0.22 degrees C.min-1) for 60 min, at a fixed relative humidity of 65%. In the equilibrium period there was no significant difference between the groups for rectal temperature [Tre, mean 37.30 (SEM 0.10) and mean 37.43 (SEM 0.14) degree C in the boys and the men, respectively] or for the respective skin temperatures (except for the forehead), but metabolic heat production (M) was significantly greater for the boys [mean 57.1 (SEM 1.2) and mean 52.0 (SEM 0.9) W.m-2, P < 0.005]. With declining Ta, the skin temperatures decreased in both groups (P < 0.001), but the decrease was significantly greater for the boys (P < 0.05), especially on the limbs as represented by the thigh and forearm. No significant correlations were observed between the limb skin temperatures compared to surface area-to-mass ratio or limb skinfold thicknesses in either group. The rate of increase in M as Ta decreased was significantly lower for the boys (P < 0.01) largely because of a higher M before the cold exposure. Thus, the mean M during the cold exposure did not differ between the groups [mean 63.6 (SEM 1.1) and mean 61.6 (SEM 1.1) W.m-2 in boys and men, respectively]. When the Ta was lowered, Tre in the boys started falling (P < 0.001), whereas the Tre in the young men did not change for 60 min. The Tre during the 60-min exposure was significantly lower (P < 0.001) for the boys [mean 37.01 (SEM 0.13) and mean 37.48 (SEM 0.18) degree C at the end of the exposure]. It was concluded that when Ta was lowered, the prepubertal boys appeared to vasoconstrict more in their limbs and to be somewhat more hypothermic, compared to the young men.

Oestradiol-induced relaxation of rabbit basilar artery by inhibition of voltage-dependent Ca channels through GTP-binding protein

1. Effects of oestradiol on the electrical and mechanical properties of the rabbit basilar artery were investigated by use of microelectrode, patch-clamp and isometric tension recording methods. 2. Oestradiol (10 nM-100 microM) relaxed arterial tissue pre-contracted by excess [K]o solution (30 mM) in a concentration-dependent manner. In Ca-free solution, histamine (10 microM) and caffeine (20 mM) each produced a phasic contraction, but oestradiol (10 microM) did not significantly affect their amplitude. 3. Oestradiol (< or = 100 microM) did not change the resting membrane potential of the artery whether in the presence or absence of TEA (10 mM). Action potentials observed in the presence of 10 mM TEA were abolished by oestradiol (100 microM). 4. Oestradiol (1 microM-100 microM) inhibited the voltage-dependent Ba current in a concentration-dependent manner. Oestradiol (100 microM) inhibited the Ba current observed in the presence of nicardipine (1 microM) more than that in the absence of nicardipine (to 31.0% vs 62.0% of control). 5. GTP gamma S (30 microM) in the pipette enhanced the inhibitory actions of oestradiol on the Ba current. On the other hand, with GDP beta S (1 mM) in the pipette, oestradiol failed to inhibit the Ba current. Pertussis toxin (PTX 3 micrograms ml-1) in the pipette totally prevented the inhibitory action of oestradiol on the Ba current. 6. Oestradiol (< or = 100 microM) had no significant effect on the outward K currents evoked by a membrane depolarization. 7. These results strongly suggest that oestradiol relaxes arterial tissue by inhibition of voltage-dependent Ca channels and that it inhibits both nicardipine-sensitive and -resistant Ca currents via a PTX-sensitive GTP-binding protein. The main target of oestradiol among the arterial Ca channels seems to be the nicardipine-resistant Ca channel, rather than the nicardipine-sensitive one.

Antihypertensive and metabolic effects of doxazosin in hypertensive patients with concomitant non-insulin-dependent diabetes mellitus

In this multicentre, non-randomized clinical study, 35 hypertensive patients with concomitant non-insulin-dependent diabetes mellitus were treated with the selective alpha 1 adrenoceptor blocker doxazosin mesilate for 24 weeks, either alone or together with existing antihypertensive therapy. The effects of the drug on blood pressure, glucose and lipid metabolism were examined. Daily administration of 0.5-8 mg doxazosin caused a significant reduction in both systolic and diastolic blood pressure decreased from 172 +/- 15/90 +/- 11 mmHg at the beginning, to 149 +/- 19/80 +/- 12 mmHg at the end of the trial. Heart rate was not affected. The plasma glucose level showed no change, whereas the haemoglobin A1c level decreased significantly from 7.4 +/- 1.2% to 7.1 +/- 1.2% (P < 0.01). Total and high-density lipoprotein cholesterol levels remained unchanged. The triglycerides level, however, decreased from 113 +/- 54 mg/dl at the beginning to 98 +/- 49 mg/dl at the end of the trial (P < 0.05). In a subgroup of patients, who showed hypercholesterolaemia ( > or = 220 mg/dl, n = 9) at the beginning, the total cholesterol level decreased from 252 +/- 33 mg/dl to 220 +/- 33 mg/dl (P < 0.05). Two patients complained of abdominal fullness or diarrhoea, but both were easily manageable. The results indicate that doxazosin is effective and safe in the treatment of hypertension in non-insulin-dependent diabetics and does not affect glucose metabolism. As for lipid metabolism in non-insulin-dependent diabetic patients, doxazosin seems to have a beneficial effect.

Visual inputs to cerebellar ventral paraflocculus during ocular following responses

The activity of cerebellar Purkinje cells was recorded in the ventral paraflocculus (VPFL) of alert monkeys during ocular following responses induced by brief movements of the visual scene. The mossy fiber input evoked 'simple-spikes' which increased their activity during either ipsiversive or downward motion of the visual scene. On the other hand, the 'complex-spikes' evoked by the climbing fiber input increased their activity during either contraversive or upward movement. To further define the sources of the visual input to the VPFL, we recorded single units in the dorsolateral pontine nucleus (DLPN), which is known to project to the VPFL as mossy fibers, and in the pretectal nucleus of the optic tract (NOT), which is known to project to the inferior olive whose neurons project to the cerebellum as climbing fibers. In both areas, most neurons were directionally selective, and responded to the moving visual scene with very short latencies (approximately 40-60 ms). These results suggest that both DLPN and NOT neurons deliver information concerning movements of the visual scene to the VPFL through different pathways.

Impaired synapse elimination during cerebellar development in PKC gamma mutant mice

PKC gamma is highly expressed in Purkinje cells (PCs) but not in other types of neurons in the cerebellum. The expression of PKC gamma changes markedly during cerebellar development, being very low at birth and reaching a peak around the third postnatal week. This temporal pattern of PKC gamma expression coincides with the developmental transition from multiple to single climbing fiber innervation onto each PC. In adult mutant mice deficient in PKC gamma, we found that 41% of PCs are still innervated by multiple climbing fibers, while other aspects of the cerebellum including the morphology and excitatory synaptic transmission of PCs appear normal. Thus, elimination of multiple climbing fiber innervation appears to be specifically impaired in the mutant cerebellum. We suggest that the developmental role of PKC gamma may be to act as a downstream element in the signal cascade necessary for the elimination of surplus climbing fiber synapses.