Small-cell-type poorly differentiated squamous cell carcinoma of the lung. Cytologic, immunohistochemical and nuclear DNA content analysis

The relationship between the nuclear DNA content, the immunohistochemical findings, the clinical characteristics (tumor volume doubling time and survival) and the cytomorphologic features of small cell poorly differentiated squamous cell carcinoma of the lung was studied in ten cases. There were no significant correlations between the immunohistochemical stainings for neuron-specific enolase and keratin and the clinical characteristics in these cases. The DNA histogram patterns were classified as type I or type II, depending on the degree of dispersion of values. There was no relationship between the immunohistochemical findings and the DNA histogram patterns. Only the DNA histogram patterns were related to some of the clinical characteristics: patients with type II histograms had significantly shorter tumor volume doubling times than did patients with type I histograms. Such information may aid in distinguishing the small cell type of poorly differentiated squamous carcinoma from classic small cell carcinoma of the lung, with which it may be confused.

Pulmonary drug-metabolizing enzyme in alveolar macrophages in relation to cigarette smoking

We measured the aryl hydrocarbon hydroxylase (AHH) activity in alveolar macrophages (AMs) and the AHH inducibility in peripheral blood lymphocytes (PBLs) of 56 subjects with and without lung cancer. There were no differences in the AHH inducibility in PBLs whether or not the host had lung cancer, regardless of a smoking history. The AHH activity in AMs in the current smoker group was significantly higher than in the non-smoker group. The AHH activity in AMs in the lung cancer group was higher than that in the non-lung cancer group, and the central-type group was significantly higher than the peripheral-type group. These results suggest that the AHH activity in AMs is associated with the development of lung cancer and a history of cigarette smoking.

[Three cases of effective hepatic arterial infusion with OK-432, mitomycin C and 5-fluorouracil in liver metastasis from gastric cancer]

A combined therapy with OK-432. mitomycin C (MMC) and 5-fluorouracil (5-FU) by administration through hepatic arterial infusion was performed in three patients with liver metastasis from gastric cancers. A catheter was introduced into hepatic artery by laparotomy. The dosage was 250 mg/day for 5-FU continuously, 10 mg/week for MMC and 5 KE/week for OK-432, respectively. Two cases with advanced gastric cancer and synchronous hepatic metastasis were treated by hepatic arterial infusion after surgical removal of primary lesion. Metastatic lesion in liver was completely eliminated. Another case with metastatic liver tumor from gastric cancer was also treated by the same protocol. The reduction rate of this case was 70% by CT scan. These results suggested that combined therapy with OK-432, MMC and 5-FU by hepatic arterial infusion is a good modality for liver metastases from gastric cancers.

[A case of pulmonary sarcoidosis with calcification in the lung]

A 35 year-old male farmer presented with complaints of productive cough and sputum. The chest X-ray films showed reticulonodular shadows bilaterally in the upper and middle lung fields, segmental infiltration in the right lung, and no BHL. Tuberculin reaction was negative. Serum angiotensin converting enzyme level was 26.5 IU/ml. Precipitating antibodies for Thermophilic actinomycetes and M.f. were negative. BAL showed moderate lymphocytosis (24.3%), and CD 4/8 was 1.67. A biopsy specimen of right scalene lymph node showed epithelioid cell granulomas and TBLB epithelioid cell granulomas and spot-like calcification. Pulmonary sarcoidosis with calcification in the lung is very rare.

Distribution of movement-related cortical potential upon jaw-biting in humans

We examined the cerebral location of the readiness potential (hereinafter referred to as "RP") upon activation of the masseter muscle by voluntary and unilateral jaw-biting movement. Four normal adults served as subjects. Five scalp electrodes were placed according to the international 10-20 method at CZ, C3, C4, T3 and T4. In addition, in one of the subjects, RPs were recorded by 12 scalp electrodes in order to study changes occurring in the distribution of RPs with time. The maximum amplitude of the RP was located at T4 in the temporal area, which was involved in the biting movement as a negative slow potential occurring 1.4-0.8 s before the beginning of the discharge to the masseter muscle. The maximum amplitude of the RP on the contralateral side was located at T3. This meant that the amplitude of the RP tended to be higher on the same side as the biting movement than on the contralateral side in all subjects. From scalp topography, the maximum amplitude of the RP was shown to be confined to T4, and was especially marked immediately before the beginning of discharge to the masseter muscle. From these results it is thought that in the case of voluntary biting movement, the RP reflects activities of the pyramidal cells in the masticatory area of the cortex, and that strong descending impulses from both sides then reach the masseter muscles.

Lupus cystitis and performation of the small bowel in a patient with systemic lupus erythematosus and overlapping syndrome

We describe a patient with systemic lupus erythematosus (SLE) and overlapping syndrome who had repeated gastrointestinal (GI) symptoms such as nausea, vomiting and malabsorption. With a subacute process, she developed paralytic ileus and contracted bladder, and died of perforation of the ileum. When 13 reported cases with lupus cystitis were reviewed, an extremely strong correlation between GI and urinary tract symptoms was observed, indicating the presence of a unique subgroup of SLE.

Modulation of prostaglandin metabolism by K-MAP and prevention of toxic effect of cyclosporin on pancreatic islet cells

The injection of 25 mg/kg i.p. cyclosporin (CsA) for 3 wk caused marked functional and morphological deteriorations of pancreatic islet cells in Wistar rats that were prevented by the combined administration of p-aminobenzoic acid-N-D-mannoside sodium salt (K-MAP). In this article, the toxic effect of CsA on pancreatic islet cells and the preventive effect of K-MAP on CsA-associated islet cell toxicity were investigated. Prolonged hyperglycemia and depressed insulin secretion after the glucose challenge observed in CsA-treated rats could be prevented by the combined administration of 300 and 900 mg/kg K-MAP. Cytoplasmic vacuolizations and a decrease in the number of mitochondria, intact endoplasmic reticula, secretory granules, and insulin-positive cells, as revealed by peroxidase-antiperoxidase staining, could also be prevented by the administration of 900 mg/kg K-MAP. This preventive effect of K-MAP on CsA-associated islet cell toxicity may suggest the combined use of K-MAP with CsA in pancreas transplantation and treatment of insulin-dependent diabetes.

[A case of gastric carcinoma remarkably responding to etoposide, adriamycin and cisplatin (EAP) therapy]

A 47-year-old male was diagnosed as having gastric cancer with metastases to liver, para-aorta node and Virchow node. He was treated with EAP (Etoposide, Adriamycin, Cisplatin) therapy, as a result of which a partial response was obtained according to the criteria of the Jpn. Soc. Cancer. Ther. The response was disappearance of subjective symptoms and Virchow's metastasis and reduction of chief tumor and liver metastases. However, this therapy was accompanied by severe side effects such as leucopenia and thrombocytopenia, but in this case, these side effects improved within 20 days.

Forty-eight hour liver preservation using an artificial blood substitute

Forty-eight hour hypothermic continuous perfusion preservation was attempted using a perfusion technique with an artificial blood substitute, a pyridoxylated hemoglobin-polyoxyethylene conjugated solution (stabilized hemoglobin, PHP). After preservation each of the 10 canine livers was orthotopically transplanted. Postoperative graft function was estimated by parameters such as activated clotting time (ACT), bile excretion, consciousness level, survival period, histologic findings, and adenosine triphosphoric acid (ATP) content of the perfused liver. Four of ten livers displayed good function, with bile excreted immediately after revascularization, and animal survival for over 24 hr. Cellular structure of the liver was well maintained, although atrophy of the hepatocytes and swelling of the mitochondria were seen. PHP solution is therefore considered suitable as a perfusate for long-term liver preservation.

Long term liver preservation using artificial blood substitutes

Twenty-four hour hypothermic perfusion preservation of the liver was aimed using an artificial blood substitutes. A canine liver was harvested and preserved using originally designed perfusates. In group 1, Perfluorotributylamine solution (Oxypherol solution) was used. In group 2, (Pyridoxylated hemoglobin)-(Polyoxyethylene) conjugate solution (Stabilized Hemoglobin, PHP-1). In group 3 and in group 4, modified Stabilized hemoglobin, PHP-3 and PHP-4 was used. After the preservation, each liver was transplanted orthotopically. Postoperative graft function was estimated the following parameter, such as bile excretion, consciousness level, activated clotting time, and survival rate. In group 1 and group 2, improvement of such factors were not fully observed. On the contrary, in group 3 and 4, complete recovery of the function was seen and in group 4, longer survival was obtained. PHP solution was considered suitable perfusate for liver preservation.

Experiments on the quick-relief medical communications via the Japan's domestic communication satellite CS-2 for the case of disasters and emergencies

Experiments on the quick-relief medical communications via the CS-2 satellite were carried out by using two types of 30/20 GHz small transportable earth stations whose antenna diameters are 1 and 2 m. As the terminal equipments, FM-SCPC systems with a one-telephone-equivalent channel were prepared for the transmission of voice, color freezed picture (9.6 kbps), supersonic echo signal and heart sound from a electrocardiograph. Signals from various medical equipments were transmitted by an FM-SCPC system from Simizu harbour (1 m station) to Tokyo transportable station (2 m), assuming that a person was injured in the ship and the ship came alongside the pier. Transmitted materials are mainly various kinds of pictures of affected parts, X-ray films and electrocardiograph with breathing sounds. It was found possible to send various medical information mentioned above via CS-2 by the 30/20 GHz simple communication systems with one-telephone-equivalent channel. Doctors suggested it would be possible to judge very well about the patients' emergency conditions and to give quick consult with inevitable treatment procedures for them. However, a few problems were found in the Hi-Fi reproduction of original colors and in the transmission of heart sounds in the very low frequency band less than 300 Hz.

The effect of load alteration on the biological and biomechanical performance of a titanium fiber-metal segmental prosthesis

The effect of overloading and underloading on tissue ingrowth into the porous-coated titanium segmental prosthesis was studied in a canine femoral model. The prosthesis has modular components that are connected by a conical coupling joint. One of the dog's hind legs was immobilized and suspended for three weeks using an external fixator to minimize loading and prevent weight-bearing, while the contralateral leg was allowed to bear weight freely, simulating an overloading situation. Five dogs reached the final study period of twelve weeks without complication. There were no significant differences between the non-weight-bearing and weight-bearing sides on radiographic assessments. However, the immobilized side had significantly higher stem-push-out strength and energy to failure. Bone ingrowth was variable, and a fibrous layer was commonly demonstrated at the prosthetic stem-bone interface. The orientation of the fibrous tissue was more organized, in a penetrating pattern, on the immobilized side. The mean concentration of titanium was insignificant in all tissue examined. Reduced implant loading for the porous-coated segmental bone prosthesis during the initial period of implantation was found to be beneficial as compared with an overloading situation in achieving intramedullary fixation.

Distribution of pattern-evoked potentials in the facial area

We studied the spatial distribution of the pattern-evoked potentials on the face with a simultaneous 16-channel recording system. The results showed that the responses had their first positive component at the peak latency of 52.0 +/- 1.9 (S.E.) msec. The maximum potential value within the equipotential maps was in the region around the stimulated eye in eight normal subjects. One patient with one enucleated eye showed the maximum value within the map only around the fellow eye; much later, at a peak latency of approximately 100 msec, we obtained a response with a maximum on the scalp around the inion. In another patient with long-standing optic nerve disease, the pattern-evoked potentials were absent but the flash-evoked potentials were normal, showing the maximum value in the region near the stimulated eye.

A clinical study of the results of cementless total hip replacement

We introduce our total hip prosthesis, its operation technique, and report the clinical results. Ours does not use bone-cement, but its design, together with the use of original bone and new bone formation surrounding it, results in a biological anchoring. Since 1978, we developed for this new type of total hip prosthesis 6 sizes of stem to fit more rigidly within the intramedullary canal of femur. The new femoral component also has larger notches on its surface than did the old one. Our results of 144 cases (147 joints) ranging from 2 to 10 postoperative years giving an average of 4.4 years, are quite satisfactory. Blood loss during the operation is as little as 480 ml. The few complications observed differ from those of the Charnley type, and will be reduced greatly when the operation is yet more cautiously and skillfully done. Unilateral replacement in bilaterally affected patients improved the condition of the unoperated side in 30% of the cases.

Comparative studies of cerebral vasodilators on relaxation activities in isolated basilar, mesenteric and pulmonary arteries of rabbits

Effects of cerebral vasodilators such as bencyclane, cinnarizine, and papaverine were comparatively studied using helically cut basilar and superior mesenteric arteries and radial muscle preparations of pulmonary arteries with the sympathetic nerve isolated from rabbits. The order of relaxation activities on high K+-induced contractures was cinnarizine>bencyclane>papaverine in basilar strips and cinnarizine>papaverine>bencyclane in mesenteric strips. Relaxation responses of basilar strips to cinnarizine and bencyclane were faster and more marked than those seen in mesenteric strips. Responses to papaverine were equipotent in both preparations. The action of cinnarizine alone was irreversible. In mesenteric strips, the order of the sensitivity of contractile responses to cumulatively applied biogenic amines was serotonin>noradrenaline>histamine. Cinnarizine produced an antihistaminergic action, while bencyclane produced an antiserotonergic action. In pulmonary arteries, 6 x 10(-6) g/ml papaverine inhibited contractile responses to 2, 5, and 25 Hz nerve stimulation in a frequency-independent manner together with inhibition of responses to noradrenaline. Bencyclane at 6 x 10(-6) and 10(-5) g/ml selectively inhibited in a dose-dependent manner contractile responses only to 25 Hz without inhibition of responses to noradrenaline. These results were discussed in comparison with findings of the cerebral vasodilators obtained using other experimental techniques. Spiral strips of basilar arteries from rabbits in combination with peripheral arteries may be used as a simple quantitative, and reproducible screening method in a preclinical stage for drug evaluation of cerebral vasodilators.

[Experimental and clinical studies concerned with the Jikei femoral head prosthesis (author's transl)]

For experimental purposes, femoral head prostheses for dogs, using both high density polyethylene (HDP) or titanium as the material for the head, were developed. Periodic observations of the acetabular cartilage influenced by the prosthetic head were done. The results showed that HDP was not suitable as a material for the artificial head because of rapid degeneration of the acetabular cartilage and marked wear and deformity of the HDP femoral head as soon as the surgery was done. On the other hand, the titanium femoral head was seen as causing much less damage to the acetabular cartilage in those cases where the diameter of the prosthetic head was quite adequate in its size. These findings indicated that the metal prosthetic head was useful for clinical cases. It was also clarified that the fixing of the stem to the bone could be achieved with our self-locking design instead of the use of bone cement. In follow-up studies of clinical cases used by the Jikei titanium femoral head prosthesis based upon our experimental results, it was found that better results could be expected when care is taken to use a femoral head which is not larger against the acetabulum. In addition, it was proved the procedure with the femoral head prosthesis is not indicated in cases where degeneration in acetabular cartilage has already occurred.