[Doppler ultrasonic assessment with hemodynamics of gynecologic tumor]

Color and pulsed Doppler ultrasound examinations were done on 11 normal volunteers (NU) and 286 patients that consisted of cervical carcinoma (CC), leiomyoma and/or adenomyosis (M), endometrial carcinoma (EC), trophoblastic disease (TD), benign ovarian tumor (BO), Krukenberg tumor (KT) and ovarian carcinoma (OC). The vascularity was based on the resistance index (RI) and maximum blood flow velocity (Vmax). In uterine disease, there was significant difference (p less than 0.01) among each group, except but one correspondence between NU and CC with RI, and there was significant difference (p less than 0.001) between NU and M, CC and M with Vmax. In ovarian disease, there was significant difference among each group with RI, and there was no significant difference among each group with Vmax. Therefore, Doppler ultrasound is a useful diagnostic tool for assessing gynecologic tumor vascularity.

A case of pheochromocytoma with severe paralytic ileus

We report herein a rare case of a 26 year old woman with pheochromocytoma complicated by paralytic ileus. She presented with remarkable abdominal distension and respiratory difficulty but was effectively treated by surgical removal of the tumor with preoperative and operative management using alpha and beta adrenergic blocking agents. An excessive and persistent catecholamine production from large tumors or massive metastases characterizes this rare complication, and a review of the English and Japanese literature is given following this report.

[Clinical observations of acute low-tone sensorineural hearing loss considered as cochlear hydrops]

Acute low-tone sensorineural hearing loss (ALHL) has the following three criteria; obscure origin, acute onset and sensorineural hearing loss limited to low frequencies. Sixteen cases of ALHL which were considered as cochlear hydrops using glycerol test and electrocochleogram were studied. All patients visited our department within two weeks after onset and were followed up for one year or more after initial examination. The subjective symptoms, the character of vestibular and hearing impairment and prognosis of 16 cases with ALHL were also investigated. The results were as follows. 1. Patients complained of ear fullness rather than hearing impairment. Four patients were unaware of hearing loss. 2. Recruitment phenomenon was found in all of 15 cases examined. Vestibular findings were mostly normal, except that spontaneous nystagmus was found in two cases and head-shaking nystagmus in one. 3. Recurrence and fluctuation of hearing impairment occurred in 14 cases. Three cases had an attack of rotatory vertigo once and two has diagnosed as Meniere's disease later. 4. During three months prior to last examination, hearing was stabilized in nine cases and continued to fluctuate in seven cases. In the former, hearing was improved in four cases, unchanged in three, and worsened in two. 5. Two patients underwent an endolymphatic sac operation and have had a good prognosis. 6. The authors suggest that most of ALHL should be considered as transient cochlear hydrops because the subjective symptom and audiological and vestibular findings of our cases are similar to those of cases which were reported as ALHL by other investigators. According to the findings of glycerol test and electrocochleogram, endolymphatic hydrops in ALHL is considered to exist in all turns of cochlea.

Estimation of whole body protein synthesis from oxidation of infused [1-14C]leucine

In rats infused with NaH14CO3, 14CO2 exhalation approached an asymptotic rate equal to 96.0 +/- 1.3 (SD) % of the infusion rate of 14C in a monoexponential manner with a half-time of 20 min. In rats infused with [1-14C]leucine, 14CO2 exhalation (/0.96) approached an asymptotic value, (1-F), of 16-25% of 14C infusion rate (mean 20.4%) in a monoexponential manner with a half-time of approximately 31 min. Whole body protein synthesis (S) was calculated from 1-F and urea N plus ammonia N excretion (C) as S = CF/(1-F). S was a uniform function of body weight in these rats, in six additional rats in which S was measured 6 h after single intravenous injection of [1-14C]leucine and also in previously reported rats given single injections. The relationship was S (mg.100 g-1.h-1) = 11-0.143 body wt (g) +/- 8.3. In six of these rats, S was also estimated from the plateau specific activity of plasma leucine or plasma 2-ketoisocaproate (KIC); the former estimate of S was significantly lower (by an average of 17%), but S was the same when specific activity of KIC was employed. These results support the validity of the expired 14CO2 technique for measuring S.

Secondary reconstruction of the alveolar process after correction of mandibular discontinuity defects

Mandibular defects in six patients were immediately reconstructed with pure titanium reconstruction plates and autogenous iliac bone blocks. However, an alveolar process adequate for functional fitting of a denture did not form. More than 6 months after the reconstruction, correction of the ridge deficiency was attempted using autogenous particulate iliac cancellous bone and marrow combined with hydroxylapatite particles. By this secondary reconstruction, a functional well-fitting denture could be constructed for all six patients. After more than 2 years no evidence of resorption or infection has occurred.

Perioperative change of plasma endotoxin levels in early infants

As a preliminary study to elucidate the relationship of endotoxemia to postoperative morbidity, the plasma endotoxin levels in 64 surgical neonates were quantitated by the chromogenic limulus test (Toxicolor test; Seikagaku Kogyo, Tokyo, Japan). The preoperative levels of plasma endotoxin were 64 +/- 59 pg/mL in the group of infants with perforated peritonitis (n = 9), 63 +/- 51 pg/mL in the group of infants with gastroschisis (n = 7), and 15 +/- 16 pg/mL in the group of infants with ileus (n = 28), while the mean level was 6 +/- 5 pg/mL in the remaining 20 surgical neonates who had no signs of ileus or peritonitis. In the serial determination of plasma endotoxin in 28 neonates, the levels on the first postoperative day increased significantly compared with the preoperative levels (16 +/- 18 pg/mL to 46 +/- 25 pg/mL, P less than .01). They decreased gradually to 8 +/- 5 pg/mL within a week in 15 neonates who had no postoperative complications. However, in 13 neonates who had postoperative complications such as wound infection or postoperative ileus, the postoperative levels of plasma endotoxin increased to a much higher level and remained there. In this article the relationship of clinical endotoxemia to postoperative thrombocytopenia and hyperbilirubinemia is analyzed, and the usefulness of evaluating endotoxemia in surgical neonates is discussed.

Studies on intestinal motility and mechanism of cholangitis after biliary reconstruction

Cholangitis is a serious complication of biliary reconstruction for congenital biliary atresia. To observe the effect of intestinal motility on the mechanism of cholangitis, we studied intestinal motility in dogs after experimental common duct ligation and reconstruction by Roux-en-Y or interposition cholecystojejunostomy. One year after operation, bipolar electrodes were implanted in the canine intestine and electromyograms were performed. Distinct patterns of propagation and the direction of intestinal motility characteristic of each procedure were observed. The animals with Roux-en-Y loops showed a decrease in motility of the duodenum and upper jejunum. Those with an interposed segment demonstrated stagnation in both the duodenum and jejunum, and poor coordination of intestinal movement. The myoelectric activity of the Roux-en-Y loop suggests that it is the reconstruction technique most likely to prevent reflux cholangitis.

[Changes in the electroretinogram during enflurane anesthesia]

We have investigated a method of intraoperative monitoring of anesthetic depth using the electroretinogram (ERG). The effects of enflurane on ERG were studied in 12 patients undergoing surgical procedures. Recordings were made at 0%, 0.8%, 1.7% end-tidal enflurane concentrations. There were statistically significant increases in the latencies of the a-waves, b-waves and oscillatory potentials (OP) with increasing concentrations of enflurane. The amplitudes of the a-waves were reduced with increasing concentrations of enflurane, but the amplitudes of the b-waves did not change. The latencies of OP were thought to be the most sensitive indicator of the anesthetic depth among these parameters. To apply this technique to clinical practice, there were many problems to be solved. However, this may be one of useful monitors of anesthetic depth in future.

[A case of familial, benign, recurrent and multiple pheochromocytoma whose 131I-MIBG scintigraphy was false negative]

This is a rare case of a 57-year-old-male patient with familial, benign and multiple pheochromocytoma recurring 23 years after initial surgery. His 131I-MIBG scintigraphy was false negative, but his son's 131I-MIBG scintigraphy was true positive.

WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. III. Biological characteristics and pharmacological characteristics

WS-9659 A, a novel phenazine, produced by a Streptomyces sp., had testosterone 5 alpha-reductase inhibition activity on rat, dog and human prostates. However, WS-9659 A did not show any inhibitory activities for aldose reductase on rabbit lenses and lactate dehydrogenase on pig hearts. WS-9659 A was a competitive inhibitor against testosterone 5 alpha-reductase on rat prostates by use of testosterone as a substrate. Radio receptor binding assay of androgen receptor of rat prostates revealed that WS-9659 A had no affinity for this receptor. WS-9659 A was tested subcutaneously in immature castrated rats to confirm its effect on the growth of the ventral prostates induced by testosterone propionate.

WS-9659 A and B, novel testosterone 5 alpha-reductase inhibitors isolated from a Streptomyces. I. Taxonomy, fermentation, isolation, physico-chemical characteristics

WS-9659 A and B, produced by Streptomyces sp. No. 9659, were extracted from cultured broth, purified by solvent extraction followed by chromatography on silica gel and then isolated as prisms (C22H24N2O, mp 161 approximately 162 degrees C, C22H23N2OCl, mp 152 approximately 153 degrees C). WS-9659 A and B have testosterone 5 alpha-reductase inhibitory activity. The IC50 values of WS-9659 A and B for partially purified rat prostate testosterone 5 alpha-reductase were 5.0 x 10(-7) M and 1.0 x 10(-5) M, respectively.

Comparison of recorded values from six pulse oximeters

Recorded values (SpO2) of oxygen saturation from six noninvasive pulse oximeters were compared to each other and to the value from a cooximeter. Simultaneous measurements were obtained from each instrument in eight healthy nonsmoking volunteers rendered hypoxic greater than 70% SpO2. Functional arterial oxygen saturation (SaO2), fractional SaO2 (%HbO2), and percent fraction of carboxyhemoglobin (HbCO) and methemoglobin (MetHb) were determined by a cooximeter. The difference between SaO2 and %HbO2 was 2.3 +/- 0.3 (SD) % (p less than .001) with 1.4 +/- 0.1% HbCO and 0.9 +/- 0.1% MetHb. The SpO2 values in two instruments were close to %HbO2, while the other instruments correlated approximately with SaO2. The greatest SpO2 difference among the instruments was 2.7 +/- 1.9% (p less than .001). These results may indicate that, under normal dyshemoglobin levels, some pulse oximeters are calibrated to estimate SaO2 and others to estimate %HbO2. Since the pulse oximeter using two wavelengths cannot measure accurately %HbO2 or SaO2 in the presence of dyshemoglobin, SpO2 values would be independent from %HbO2 and SaO2. A standard calibration method for pulse oximeters should be established by the manufacturers.

Utilization for protein synthesis in individual rat organs of extracellular 2-ketoisocaproate relative to utilization of extracellular leucine

Rats were given constant intravenous infusions of [3H]-leucine plus [1-14C]-2-ketoisocaproate (KIC). Specific activities of plasma leucine and plasma KIC reached plateaus by two to three hours. 3H specific activity of KIC was 85% +/- 2% of that in leucine. 14C specific activity of leucine was 36% +/- 2% of that in KIC. The 14C/3H ratios in leucine and KIC were constant from the earliest sampling time (one hour) at 0.65 +/- 0.03 and 2.20 +/- 0.07, respectively. In various tissues, 14C/3H in free leucine and in tissue protein were approximately equal, but in most organs these ratios were significantly greater than the ratio 14C/3H in plasma leucine. From these data we estimate that the fraction of leucine incorporated into protein in individual organs derived from extracellular KIC rather than extracellular leucine varies from zero (in liver and bone marrow) to 35% to 45% (in brain and heart), and comprises 12% in the body as a whole.

[Analgesia and anesthesia induced by subanesthetic concentrations of nitrous oxide]

This study was aimed to determine 1) the changes of the anesthetic and analgesic actions of inhalation of subanesthetic concentration of nitrous oxide, and 2) the possible antagonism by naloxone of these actions. Auditory response time (anesthetic action) and pain threshold (analgesic action) were examined before, during and after inhalation of subanesthetic concentration of nitrous oxide in six normal volunteers who were treated with or without intravenous administration of naloxone 1.4 mg. Analgesic action remained at 30 min after nitrous oxide inhalation, while auditory response time returned to control values. Both anesthetic and analgesic effects were unchanged during 100 min inhalation or administration of naloxone. These results indicate that the acute tolerance to these actions of nitrous oxide will not occur, and that naloxone will not show a significant antagonistic action as is observed with morphine.

A method for determining reference points in celloidin specimens for computer graphic reconstruction

For three-dimensional computer graphic reconstruction of histological sections, it is important to determine reference points. We have developed a machine that makes reference points in a celloidin block for this purpose by drilling holes straight into the block. A sliding microtome is placed under the machine, which consists of a worktable, a stand, and a motor-driven unit. The celloidin block is sectioned on a microtome to determine a plane for serial sectioning. Several holes are then drilled in the block vertical to the plane selected. Serially sectioned specimens are next stained with hematoxylin and eosin and are mounted in the usual manner. Three-dimensional reconstructions of the specimens were next done using a PC-9801 computer and CosmoZone-S software. As an example, the reconstruction of a guinea pig stapes is described.

[Is massive fluid load indispensable for the parturient immediately before regional anesthesia?]

One hundred healthy parturients scheduled for elective cesarean section were studied prospectively. Fifty patients received spinal anesthesia with 12mg of hyperbaric tetracaine and were defined as the spinal group. Other fifty patients received epidural anesthesia with 300mg of lidocaine and were defined as the epidural group. A half of patients in each group were given 1,000ml of Ringer's lactate immediately before the regional anesthesia (prehydrated). Rapid hydration was not given to another half of them (non-prehydrated). In the spinal group, ephedrine administration was needed significantly less frequently for prehydrated patients than for non-prehydrated ones. And the mean dose of this drug for prehydrated patients was significantly less than that for non-prehydrated ones. In the epidural group, though prehydration tended to prevent maternal hypotension, neither rate of ephedrine administration nor mean doses of this drug showed any significant difference between prehydrated and non-prehydrated patients. Prehydration did not improve significantly neither acid-base balances of umbilical arterial and venous blood nor Apgar scores of the neonates in either group. We conclude that massive fluid load is not indispensable immediately before the regional anesthesia for the parturient. Furthermore, because this method is not reliable, its advantages and disadvantages including the possibility of enhancing pulmonary edema should be evaluated.

Quantitation of specific mRNA by RNA-RNA hybridization kinetics with single-stranded riboprobes

A quantitative procedure by a solution hybridization involving RNA-RNA hybridization kinetics was developed for measurement of specific mRNA accumulated in particular tissues and cells. For quantitating mouse beta-tubulin mRNA two types of riboprobes were prepared: one was a truncated RNA covering only the coding portion of beta-tubulin cDNA and the other was a non-truncated RNA covering the vector portion as well as the coding portion. These antisense RNAs were hybridized with mouse brain total cellular RNA, yielding heat-stable hybrids. Both the truncated and non-truncated antisense RNA probes showed similar hybridization kinetics. Hybridization of the sense RNA, consisting of the beta-tubulin coding portion, with the antisense RNA probe gave standards for determining the proportion of beta-tubulin mRNA in total brain RNA. By this method, the amounts of beta-tubulin mRNA included in the brains of 10- and 50-day-old mice were quantitated to be 0.0056 and 0.0011% of total RNA, respectively.

[Metabolic and nutritional management after extended radical operation for pancreatobiliary carcinoma]

The physiology after extended radical operation in patients with pancreatobiliary carcinomas and the metabolic and nutritional management were studied. Twenty-four patients who underwent pancreatoduodenectomy with extended dissection were compared with 17 patients with semi-extended dissection and 44 patients with limited or no dissection. Extended dissection meant complete dissection of the nerve plexus around the superior mesenteric artery and para-aortic node dissection. The frequency of defecation (2.7 times/day) and the blood osmolarity in the extended dissection group were significantly higher than those in the other groups during the first week after operation. The level of serum protein was significantly lower in the extended dissection group. Insulin dosage during the first 14 days after surgery was significantly greater in the extended dissection group, yet no difference was recognized in the amount of glucose administered among the 3 groups. The conclusion was as follows; frequent diarrhea, a large amount of lymph loss and increased urine volume due to an osmotic diuresis were the main causes of volume loss. So a large volume of fluid containing a high concentration of protein should be injected immediately after extended dissection to normalize serum osmotic pressure. Because of increased insulin requirement and decreased endogenous insulin production, the administration of large amount of glucose immediately after operation should be undertaken carefully.

Clinical studies on a newly devised amino acid solution for neonates

In 97 neonates receiving total parenteral nutrition in the postoperative period, clinical assessment was made for a newly devised amino acid solution (PF-I-III) from the standpoint of plasma amino acid profile and nutritional effect. These amino acid solutions prepared are characterized by the high concentration of branched-chain amino acids up to 40%, increased arginine and decreased glycine, phenylalanine and methionine as compared with commercially available solutions. In the PF group, each amino acid was kept within the range of standard value. Correlation between plasma amino acid profiles and the dose of each amino acid administered was obtained, from which minimum, standard, and maximum doses for each amino acid was determined. Based on these values, we proposed new formula for neonates which elicits no abnormal plasma amino acid pattern even when amino acids are administered at the dosage level of 1.5-2.5 g/kg/day.

Evaluation of lower esophageal sphincter function in infants and children following esophageal surgery

Esophageal manometry was performed before and after the operations for esophageal disorders in children to evaluate lower esophageal sphincter (LES) function and motility of the esophagocardiac region in each disease. Patients who underwent radical operations for gross C-type esophageal atresia (EA) and those with hiatal hernias considered to have gastroesophageal reflux (GER) showed reduction in LESP and LESL and eosphagocardiac motor abnormalities. Lower esophageal sphincter pressure and length, and motility of the esophagocardiac region improved in six patients who underwent an antireflux operation. Abnormal esophageal waves in EA patients persisted even after improvements in LES function by the antireflux operation and were considered to be a congenital problem, as the literature suggests. Effects of surgical intervention on the esophagus on the LES function were studied. Lower esophageal sphincter and esophagocardiac function were preserved, and GER did not develop after Livaditis' procedure for EA or esophageal transection and sectioning the esophageal branch of the vagus nerve for esophageal varices. Anatomic abnormalities that lead to LES dysfunction are considered to cause GER.

[Effect of PMU therapy (CDDP, MMC and UFT) against terminal gastric carcinoma. Hokuriku Cisplatin Round-table Conference]

PMU therapy with 75 mg/m2 of CDDP, 10 mg/body of MMC and 400 mg/day of UFT was performed on 57 patients with terminal gastric carcinoma. The treatment resulted in CR in 2, PR in 9, MR in 1, NC in 16 and PD in 9 of 37 patients with evaluable cases, with a response rate of 30% (11/37 patients). In the 11 responders, the mean disease-free interval was 6.6 months with a median interval of 5 months, and the mean survival period was 9.2 months with a median survival period of 6 months, while in the 46 non-responders, the mean survival period was 6.7 months with a median survival period of 5 months. In all patients, the mean survival period was 7.1 months with a median survival period of 6 months. Adverse reactions to the treatment included gastrointestinal disturbance observed in 77%, nephrotoxicity in 14%, and myelotoxicity in 26% of the patients, but all reactions became normalized during the course of observation. These results have led to the conclusion that PMU therapy may be an effective treatment for terminal gastric carcinoma.

A case report of intrahepatic biliary atresia showing an unusual liver histology

The extrahepatic biliary tract of a male infant, including both the left and right hepatic ducts, was proven to be patent up until his time of death, however, histologic examination of the liver revealed severe fibrosis of the portal areas with ductular proliferation, scattered bile thrombi, and subsequent biliary cirrhosis. In this case, since the obstructive lesion occurred at the secondary branching of the bilateral hepatic duct and because fewer changes were present in the interlobular bile ducts, it seemed possible to consider that the liver histology revealed findings similar to those of extrahepatic biliary atresia.

Node dissection in gastric cancer

Three hundred patients who underwent absolute and relative curative gastrectomy and lymph node dissection for gastric cancer were reviewed with respect to postoperative mortality; proportion of patients with node involvement according to the extent of dissection; number of metastatic nodes dissected according to the extent of dissection; accuracy of macroscopic evaluation of node involvement and microscopic node involvement according to tumour location. If more nodes were dissected the proportion of patients with node involvement and the total number of metastatic nodes increased; conversely within R0 and R3 the extent of dissection did not affect postoperative survival. Finally when the presence and extent of node involvement was only macroscopically evaluated, the patients were classified incorrectly in 9.5 per cent of the N0 group and 20.2 per cent of the N1 group. The data suggest that lymph node dissection may be useful in the treatment of gastric cancer, and within the extent studied the employment of this procedure does not affect the postoperative mortality.

Monoclonal antibody 53.6 recognizes a novel proliferation-associated antigen encoded on human chromosome 11

This paper describes the characterization of a novel cell surface antigen associated with proliferation. Previous work demonstrated that monoclonal antibody 53.6 reacted with every human cell line tested, as well as with subpopulations of normal bone marrow and peripheral blood lymphocytes. Mitogen stimulation of peripheral blood lymphocytes with phytohemagglutinin resulted in increased expression of the antigen recognized by 53.6. Immunoprecipitation of biosynthetically labeled KG-1A cell extracts with 53.6 revealed that the antigen is a nonglycosylated acidic protein of Mr 34,000. Analysis of mouse-human hybrid cell lines indicated that the structural gene for the antigen is encoded on chromosome 11. The antigen recognized by 53.6 is distinct from previously described cell surface antigens based on its distribution on activated cells and biochemical characteristics. These studies indicate that the 53.6 antigen is a novel proliferation-associated antigen, and may be useful in analyzing lymphocyte activation.

Monoclonal antibody 53.6 recognizes a novel proliferation-associated antigen encoded on human chromosome 11

This paper describes the characterization of a novel cell surface antigen associated with proliferation. Previous work demonstrated that monoclonal antibody 53.6 reacted with every human cell line tested, as well as with subpopulations of normal bone marrow and peripheral blood lymphocytes. Mitogen stimulation of peripheral blood lymphocytes with phytohemagglutinin resulted in increased expression of the antigen recognized by 53.6. Immunoprecipitation of biosynthetically labeled KG-1A cell extracts with 53.6 revealed that the antigen is a nonglycosylated acidic protein of Mr 34,000. Analysis of mouse-human hybrid cell lines indicated that the structural gene for the antigen is encoded on chromosome 11. The antigen recognized by 53.6 is distinct from previously described cell surface antigens based on its distribution on activated cells and biochemical characteristics. These studies indicate that the 53.6 antigen is a novel proliferation-associated antigen, and may be useful in analyzing lymphocyte activation.

[A phase II study of UFT in non-small cell lung cancer]

A phase II evaluation of UFT, a mixture of tegafur and uracil, was performed in 13 patients with non-small cell lung cancer (eight patients with adenocarcinoma and five patients with squamous cell carcinoma). UFT at a dose of 600 mg was given per os every day for more than four weeks. Among 12 evaluable patients, one patient with adenocarcinoma of the lung showed partial response. The response rate for UFT was 8.3%. Toxic effects included anorexia (31%), nausea (15%), liver disorder (15%), and pigmentation (8%).

Male urethral tumour (condyloma acuminatum): urethrographic and endoscopic appearances

Two cases of condyloma acuminatum of the male urethra were clearly demonstrated by retrograde urethrogram and endoscopy. Characteristic urethrographic and endoscopic appearances of these cases are presented.

[Inflammatory fibrous histiocytoma of the retroperitoneum]

A 64-year-old man with the chief complaint of abdominal fullness was hospitalized on the suspicion of pancreatic tumor. The tumor was thought to be a pancreatic or retroperitoneal tumor, based on examinations of ultrasonography and CT scan of the upper abdomen, angiography of abdominal arteries, and ERCP. Laparotomy revealed that the tumor was inoperable inflammatory fibrous histiocytoma. Combined anti-cancer chemotherapy with doxorubicin, cyclophosphamide, and vincristine induced partial response. The duration of response was six months, and the patient died of tumor growth 18 months after the initial diagnosis.

Chromatin structure and developmental expression of the human alpha-globin cluster

The human alpha-like globins undergo a switch from the embryonic zeta-chain to the alpha-chain early in human development, at approximately the same time as the beta-like globins switch from the embryonic epsilon-to the fetal gamma-chains. We investigated the chromatin structure of the human alpha-globin gene cluster in fetal and adult erythroid cells. Our results indicate that DNase I-hypersensitive sites exist at the 5' ends of the alpha 1- and alpha 2-globin genes as well as at several other sites in the cluster in all erythroid cells examined. In addition, early and late fetal liver erythroid cells and adult bone marrow cells contain hypersensitive sites at the 5' end of the zeta gene, and in a purified population of 130-day-old fetal erythroid cells, the entire zeta-to alpha-globin region is sensitive to DNase I digestion. The presence of features of active chromatin in the zeta-globin region in fetal liver and adult bone marrow cells led us to investigate the transcription of zeta in these cells. By nuclear runoff transcription studies, we showed that initiated polymerases are present on the zeta-globin gene in these normal erythroid cells. Immunofluorescence with anti-zeta-globin antibodies also showed that late fetal liver cells contain zeta-globin. These findings demonstrate that expression of the embryonic zeta-globin continues at a low level in normal cells beyond the embryonic to fetal globin switch.

[PMU therapy of recurrent gastric cancer. A case report]

A 56-year-old woman with recurrent gastric cancer treated with PMU therapy, combined CDDP 75 mg/m2 i.v. MMC 10 mg/body i.v. and UFT 400mg/body/2 alpha/day p.o., was reported. She was admitted because of cervical lymph node swelling and abdominal tumor (para-aorta lymph node swelling). She was treated two times with this therapy and induced into complete remission. The serum CEA level, more than 500 ng/ml before the treatment, was reduced to 6.7 ng/ml after treatment. She has currently been free of disease for more than four weeks. We conclude that this PMU therapy is extremely effective for indurable gastric cancer.

[A case of remission in diffuse pleural mesothelioma induced by anticancer chemotherapy with cisplatin and adriamycin]

A 56-year-old man was admitted to our hospital with complaints of dyspnea and right pleural effusion. Malignant pleural mesothelioma was diagnosed, based on the high level of hyaluronic acid in the pleural fluid and manifestation of malignant cells by pleural needle biopsy. Anticancer chemotherapy with cisplatin and intrapleural injections of adriamycin against this mesothelioma was carried out because of the presence of stage III by Butchart's classification. Regression of the tumor, decrease of pleural fluid and decrease of LDH level in effusions were observed after this chemotherapy. Cisplatin was easily transported into the pleural fluid, and its concentration was maintained for a satisfactorily long period.