[A combination chemotherapy of mitoxantrone, etoposide, carboplatin, and prednisolone (MECP) in recurrent or refractory non-Hodgkin's lymphomas]

Twenty-two patients with recurrent or refractory non-Hodgkin's lymphoma were treated with a combination chemotherapy of mitoxantrone, etoposide, carboplatin, and prednisolone (MECP). Of 22 evaluable patients, 11 (50%) responded to MECP and 7 (32%) achieved complete remission. Particularly in relapsed cases, 9 (75%) responded and 6 (50%) achieved complete remission. Myelosuppression was the major toxicity. Thirteen patients (59%) experienced WBC counts under 1,000/microliters, and thrombocytopenia under 50,000/microliters was seen in 12 patients (55%). During myelosuppression, 2 patients developed sepsis and 1 showed intestinal bleeding. Other gastrointestinal toxicities were well tolerated. There was no death due to chemotherapy. These results show that MECP is a well-tolerated treatment regimen, and effective for recurrent or refractory non-Hodgkin's lymphomas.

[The first report of traveler's diarrhea associated with a newly described toxigenic Vibrio cholerae O139 strain in Japan]

A newly described Vibrio cholerae O139 was isolated from a patient who had traveled in India on April 1993. The patient experienced 5 to 6 watery diarrhea per day after he returned to Japan. The isolated strain registered as K111 did not agglutinate with O1-O138 antiserum and agglutinated with O139 antiserum. This strain resembled V. cholerae O1 strain in biochemical characters and had ctx and zot, although was resistant to the vibrio static agent O/129. This is the first report of cholera-like illness by the newly described toxigenic V. cholerae O139 strain in Japan.

[Acute mixed lineage leukemia showing resistance to AML and ALL therapy]

A 51-year-old female was who admitted complaining of cough and slight fever and lower limb petechia. The laboratory examinations revealed leukocytosis (49,400/microliters) with blasts (71%) in the peripheral blood. The NCC was 30 x 10(4)/microliters with 84.8% blasts in the bone marrow. Myeloperoxidase staining was positive for 6% of blasts. Auer rods were not seen in some blasts. Thus, acute myeloblastic leukemia (M1) was diagnosed according to FAB classification. In the peripheral blood, 43.3% of blasts expressed CD19, 10.3% of blasts expressed CD20 and 55.6% of blasts expressed CD33 on admission. Though she received two courses of DCMP according to the DCMP-85 protocol, and one combined course of mitoxantrone, etoposide, and Ara-C. The NCC was 20.0 x 10(4)/microliters with 70% blasts in the bone marrow. CD19 was expressed by 72.4% of blasts and 35.0% expressed CD20. The ALL-90 protocol was started, but remission was not achieved. Thus this case was considered to be acute mixed lineage leukemia.

[Accordance of the chemosensitivity between clinical specimens and their xenografts in nude mice by SDI test and the value of in vivo chemosensitivity test using nude mice]

We assessed the sensitivity to anticancer drugs by SDI (succinate dehydrogenase inhibition) test with 11 clinical specimens obtained from operated patients. The results were compared with those of xenografted specimen in nude mice, using the adjuvant part of the specimens assayed. Chemosensitivity of clinical specimens against 3 drugs is mitomycin (MMC), adriamycin (ADM) and cisplatin (CDDP), showed a good accordance (73%) with those of xenografted tumors. The drug sensitivity was considered to be one of the features of original tumors and to be well preserved in the xenografts in nude mice. We also studied in vivo experimental chemotherapy on 19 tumor lines in nude mice to compare the chemosensitivity with clinical response to the same chemotherapy observed in each donor patient. A close correlation (83% on responder, 100% on non-responder and the overall predicting accuracy rate were 95%) was shown, suggesting in vivo nude mouse assay having an excellent predictability for clinical results.

Swelling controlled zero order and sigmoidal drug release from thermo-responsive poly(N-isopropylacrylamide-co-butyl methacrylate) hydrogel

Thermo-responsive hydrogels of poly(N-isopropylacrylamide-co-butyl methacrylate) (poly-(IPAAm-co-BMA)) are capable of swelling-deswelling changes in response to external temperature. As poly(IPAAm-co-BMA) gels swell larger at a lower temperature, the degree and rate of the swelling could be controlled by temperature without altering the chemical structure. Therefore, drug release profiles were remarkably changed by alternation of temperature. The release profiles of indomethacin from poly(IPAAm-co-BMA) were observed to be zero-order at 20 degrees C. This release profile was explained in terms of a Case-II diffusion mechanism; which indicates relaxation of polymer chains with swelling was rate-determining. In the case of 10 degrees C, release demonstrated a sigmoidal profile. The acceleration of drug release was due to a rapid increase in swelling with disappearance of the glassy core which had constrained swelling. The regulation of the water-uptake process by changing external temperature remarkably affected drug release and resulted in several different release profiles.

Functional integrity of hepatocyte canalicular membrane transport of taurocholate and bilirubin diglucuronide in Eisai hyperbilirubinuria rats

Eisai hyperbilirubinuria rats (EHBR) are characterized by conjugated hyperbilirubinemia, and impaired or defective excretion of bilirubin, reduced glutathione and other organic anions from hepatocytes. Hepatocyte canalicular membrane vesicles (CMV) from EHBR and normal SD rats were studied with regard to taurocholate (TC) transport driven by ATP or a membrane potential and bicarbonate-stimulated bilirubin diglucuronide (BDG) transport. ATP-dependent uptake or association of BDG with CMV was also studied in both strains of rats. No significant differences in the uptake of TC and BDG by CMV were observed. This indicates the functional integrity of the canalicular transporters for both organic anions in EHBR. Biliary excretion of taurolithocholic acid sulfate (TLCS) is defective in EHBR. However, TLCS inhibited ATP-dependent TC uptake by SD rat CMV competitively, which may be against the hypothesis that a common organic anion carrier is defective in canalicular membranes of jaundiced rats.

Superoxide is involved in the pathogenesis of paraquat-induced injury in cultured rat liver slices

We examined whether superoxide is a factor responsible for paraquat-induced liver injury in terms of superoxide dismutase using cultured rat liver slices exposed to various concentrations of paraquat. The degree of liver injury was assessed by measurement of percentage of lactate dehydrogenase leakage into the medium and lipid hydroperoxides in the liver slices and by direct histopathological observation. Paraquat produced concentration- and time-related liver injury in the cultured rat liver slices. Notably, after exposure to 5 mmol/L paraquat, a significant increase of the percentage of lactate dehydrogenase leakage occurred from 4 hr (p less than 0.05 vs. control group), and this gradually increased up to 8 hr (p less than 0.01 and p less than 0.001 vs. control group at 6 and 8 hr, respectively). Changes in lipid hydroperoxides in the liver slices were similar to those in percentage of lactate dehydrogenase leakage (p less than 0.05 and p less than 0.01 vs. control group at 6 and 8 hr, respectively). Liver injury was located around the central vein at 6 hr and gradually spread at 8 hr. Paraquat-induced liver injury was aggravated both biochemically and histopathologically by pretreatment with 5 mmol/L diethyldithiocarbamate, an inhibitor of copper- and zinc-containing superoxide dismutase activity (percentage of lactate dehydrogenase leakage: p less than 0.01 and p less than 0.001 vs. paraquat group at 6 and 8 hr, respectively; lipid hydroperoxides: p less than 0.01 vs. paraquat group at 8 hr). Incubation of liver slices with liposome-encapsulated superoxide dismutase increased the augmentation of superoxide dismutase in the liver slices.(ABSTRACT TRUNCATED AT 250 WORDS)

[Antitumor activity of HO-221, a derivative of benzoylphenylurea against human cancer xenografts in nude mice]

HO-221, a derivative of benzoylphenylurea, is a newly developed anticancer drug which was found to show an excellent antitumor effect against transplantable murine tumors by the novel mechanism of action. This study was designed to evaluate the antitumor effect of HO-221 and to establish the optimum regimen, using seven human gastrointestinal and breast cancers xenografted in nude mice. Better antitumor effect of HO-221 by oral administration was observed when it was suspended in larger volume of the vehicle. Moreover, the effect increased by the multiple intermittent administration compared to the single treatment. Best antitumor effect was observed by oral administration of 75 mg/kg (0.1 ml/10 g mouse body weight) repeated twice weekly for a total of eight times or 300 mg/kg (0.2 ml/10 g mouse body weight) repeated once weekly for a total of four times. The antitumor effects of these two regimens were approximately equal except against H-31, the former regimen being more effective. When the tumor growth inhibition rate (IR) over 58% was rated as "effective", the above two regimens were equally effective against 4 of 7 cancers, H-111, H-154, H-143 and H-31. While HO-221 was not effective to a gastric cancer line, H-81, which was most susceptible to the variety of existing anticancer agents, but effective to another gastric cancer line, H-111, which was relatively resistant to conventional cytocidal agents. From the aspect of chemosensitivity spectrum, this drug revealed a rather different pattern compared to other antimetabolites. Although oral administration volume is limited in small animal model, enhancing its antitumor effect may be possible in clinical application by contriving the method of administration. HO-221 is, thus, considered to be a promising drug for further study.

[Combination chemotherapy of HO-221, a derivative of benzoylphenylurea with various anticancer agents against human cancer xenografts in nude mice]

Antitumor effect of HO-221, a derivative of benzoylphenylurea, has been previously studied against seven human cancer xenografts in nude mice established and maintained in our laboratory. In this study, the effect of combination chemotherapy was examined with six of the above seven human cancer cell lines. These consisted of four gastric cancers (H-55, H-111, H-81 and H-154), one breast cancer (H-31) and one pancreatic cancer (H-48). HO-221 was used in combination with one of the following widely used anticancer drugs; mitomycin (MMC), adriamycin (ADM), CDDP, VP-16 and 5-fluorouracil (5-FU). When the tumor growth inhibition rate (IR) by combination of two drugs (at 1/2 MTD for each drug) exceeded both of IR obtained separately with single drug at 1/2 MTD, the combination regimen was rated as showing an additive effect. When IR by combination of two drugs at the same dose level exceeded both of IR obtained separately by MTD of each single drug, the regimen was rated as showing a synergistic effect. Histological changes and side-effects were also taken into consideration for the evaluation of the drug. Combination of HO-221 and MMC produced an additive effect against H-55 and H-111, a synergistic effect against H-81. In the treatment of H-31 which was highly susceptible to these drugs, a remarkable effect was shown in both IR and cellular changes even by combination using 1/2 MTD and 1/4 MTD doses. Combination with ADM at 1/2 MTD for both produced an additive effect against H-111 and H-48. Combination at MTD produced a marked antitumor effect against H-111 and a strikingly remarkable combination effect was confirmed. Combination with CDDP produced an additive effect against H-81 and a synergistic effect against H-154. Moreover, the weight loss by this combination regimen was far less than that by single administration of CDDP at MTD. An additive effect was demonstrated by combination with VP-16. Combination with 5-FU produced minimal combination effect. HO-221 was thus found to have a high antitumor effect by combination with various anticancer agents that are at present widely used clinically. HO-221 is expected to be a promising anticancer drug in its clinical application.

[Isolation trends on group A streptococci isolated from clinical specimens in hospitals in Saitama, 1979-1989]

On 4,864 group A streptococci isolated from throat culture of patients in hospitals in Saitama from 1979 to 1989, we have done an epidemiological analysis of the T-type detection rates and the T-type epidemic, the monthly isolation rates, and the isolation rates by sex and age of patients. 1. The T-type detection rates of 4,864 isolates of group A streptococci showed type T12 in 22.6%, type T4 in 16.4%, type T1 in 10.8%, type T13 in 8.5%, type T6 in 7.6%, type T28 in 6.9%, type T3 in 6.1% and type T18 in 5.3% etc, and the largest number of isolates was type T12 among 16 T-types. 2. The main epidemic T-type during the investigation was type T12, and it was at the top from 1980 to 1981 and from 1984 to 1985. The others, type T4 was at the top from 1982 to 1983 and from 1983 to 1989, type T3 was in 1986, type T6 was in 1987, and type T1 was in 1988, especially it has been suggested that there are the high epidemic T-types and low epidemic T-types among the T-types of throat group A streptococci. 3. Monthly epidemic pattern of throat group A streptococci in each year showed two small epidemic peaks on March and June, a large epidemic peak from November to December since a turn on August. Further, the monthly epidemic pattern has been repeated every year. 4. Throat group A streptococci isolated from patients occupied 87 per cent by the patients from 0 to 14 years, the peak of age distribution showed by age group from 5 to 7 years. The sexual ratio of male to female was in the ratio 1:0.9. Further, the throat group A streptococci isolated from patients of age greater than 15 years was occupied about 50 per cent by age group from 30 to 39 years. A sexual ratio of male to female in the age group was in the ratio 1:1.8.

[Changes of Cu, Zn-SOD and LPO in the regenerating liver after partial hepatectomy--effect of coenzyme Q10 administration]

We have investigated the effect of CoQ10 to lipid peroxide (LPO) and Cu, Zn-SOD in the regenerating liver in rats. Cu, Zn-SOD was investigated in biochemical activity, and immunohistochemical localization. In normal control liver, Cu, Zn-SOD was diffusely stained throughout the hepatic lobules, with predominance in the centrilobular area and with vicinity of thick portal vein. In early stage of regenerating liver. LPO was increased and Cu, Zu-SOD was decreased. Destruction of the membrane of hepatocyte was confirmed by electron microscopy in the early stage of regenerating liver, Cu, Zn-SOD might be speculated to leak out into extra cellular spaces. CoQ10 suppressed the mentioned phenomenon in regenerating liver.

[Aging effects on blood biochemical parameters in aged women: a longitudinal study using principal component analysis]

In order to examine the aging effects on blood biochemical parameters, 25 aged females (70 +/- 8 years old at the beginning of this investigation) were studied prospectively for 7 years. Biochemical parameters were measured in 1982, 1985, 1987, and 1989. Component scores were obtained by principal component analysis applied to all of these 100 data. The data of 13 biochemical parameters and 4 component scores were analyzed for aging, cohort, and time effects by utilizing 3 types of approach i.e., longitudinal, cross-sectional, and time-series. Positive aging effects were observed on blood urea nitrogen and 4th component score. Fourth component score had positive relations to blood urea nitrogen and total bilirubin, and a negative relation to total protein. This 4th component score increased with longitudinal age changes among all cohorts divided by decade, and it increased markedly over 70 years old. These results suggest that the aging effects on biochemical parameters are related with both the decrease in glomerular and hepatocellular functions and the increase in breakdown of tissue protein.

Early gastric cancer. Endoscopic diagnosis of depth of invasion

In order to decide on a treatment strategy against gastric cancers, an accurate preoperative evaluation of the depth of cancer invasion is essential. Preoperative endoscopic diagnosis of the depth of invasion was compared with pathological results of the resected specimen in 206 early gastric cancers and 32 early-like advanced gastric cancers. The endoscopic distinction between early and early-like advanced cancers was correctly made in 83.6% of the cases. Among the early gastric cancers, mucosal and submucosal invasion was correctly presumed in 71.9% of the cases. When the tumor was an elevated type, or located in the antrum, the endoscopic diagnosis tended to be deeper than the true depth. The size of tumor contributed little to the depth diagnosis. Pathomorphological changes on the tips of converging folds were the important clue for diagnosing depth.

Proliferation kinetics of rat Kupffer cells after partial hepatectomy. Immunohistochemical and ultrastructural analysis

In an effort to settle the conflicting views on the proliferation kinetics of Kupffer cells (Kc), we performed 2/3 partial hepatectomy on rats injected with Pelikan ink. Using an anti-rat macrophage monoclonal antibody, ED 2, we evaluated the numerical changes in total, carbon-positive ED 2+ cells and carbon-negative ED 2+ cells in the portal and central area. We also analyzed the ultrastructure and peroxidase cytochemistry of various types of cells observed during regeneration. The total numbers of ED 2+ cells in the remaining liver increased rapidly from day 2 to 5, and the number of dividing ED 2+ cells reached a maximum on day 2. Thus, the numerical increase in ED 2+ cells corresponded to the division phase. In contrast, the carbon-labeling experiment showed a continuous increase of carbon-negative ED 2+ cells from day 2 to 7. In the central area where division was less frequent, the proportion of carbon-positive cells decreased markedly to 50% on day 7, as against 97% in control rats. These findings suggest the possibility of an influx of carbon-negative Kc in addition to cell division. Ultrastructurally, the presence of carbon-negative "small Kc" and "immature Kc" with morphological features different from those of carbon-positive Kc was demonstrated. Such carbon-negative Kc with a high nucleus-to-cytoplasm ratio and rather few phagosomes, were not observed in control rats. Furthermore, we demonstrated two types of possible precursor cell, i.e. "transitional" forms between monocytes and Kc, and "immature macrophages". The former showed peroxidase activity in some lysosomes as well as in the rough endoplasmic reticulum and nuclear envelope. Our result indicated that the proliferation kinetics of Kc depend upon both local proliferation and influx.

[Tumor imaging using 99mTc-hexamethylpropyleneamine oxime]

Tumor imagings have been performed in 32 tumor sites in 28 patients with a variety of malignancies by using 99mTc-HM-PAO. They have been compared with radionuclide angiography and conventional tumor imagings such as 67Ga citrate or 201TlCl scanning, and then their possible values have been evaluated for the investigation of tumor blood flow. Tumors were clearly visualized in 19 out of 32 sites, with 59% of positive rate. Good correlation was observed between the radioactivity in the tumor site on static image of 99mTc-HM-PAO and the radioactivity at arterial phase on radionuclide angiography, which represents tumor blood flow. The radioactivities in the marginal regions tended to be stronger than those in the center of large tumors. These results indicated that tumor imaging by 99mTc-HM-PAO mainly reflected tumor blood flow. On the other hand, 99MTc-HM-PAO imagings were not well correlated with 67Ga-studies, while they were coincided with all 201Tl scannings performed. It suggested that the affinity of 99mTc-HM-PAO to capillary wall also involved in its accumulation in the tumor. In conclusion, tumor imaging by 99MTc-HM-PAO was able to estimate tumor blood flow, and this examination would be helpful for the management of malignancies.

[The persistence and proliferation of tumor-xenografts implanted under the renal capsule of immunocompetent mice, cyclosporin A-treated mice and nude mice]

The subrenal capsule assay for cancer chemotherapy was performed, using tumor-specimens of 19 patients' cancers. Twelve tumor-specimens were implanted simultaneously under the renal space of immunocompetent CDF1 mice, cyclosporin A (CsA) 60 mg/kg treated mice, and BALB/c-nu/nu (nude) mice. The persistence and growth of implanted tumor-xenografts of each mouse, was evaluated, on day 6 and 9 after inoculation. The tumor-xenografts implanted under the renal space of immunocompetent mice, grew larger on days 6 in 9 cases, but histological evaluation showed tumor tissues were in various degree replaced by host reactive tissues. Host reaction in CsA-treated mice or nude mice was suppressed almost completely, but the persistence and proliferation of tumor-xenografts of both mice was varied, depending on the nature of original tumors. The judgment for cancer chemotherapy on our modified SRC assay was almost similar between CsA-treated mice and nude mice, but there were some cases in which macroscopical judgment didn't correspond with histological effect. The DNA synthesis of tumor-xenografts of 7 patients, was examined by using sequential changes of BrdU labeling index (LI) in the renal space of CsA-treated mice. It was showed LI rather indicated the nature of original tumors itself.

[Experimental studies on subrenal capsule assay using cyclosporin A treated mice--the optimal treatment schedules of CsA and anticancer agents (mitomycin C and 5-fluorouracil)]

We studied fundamentally subrenal capsule assay, using human tumor specimens (breast, gastric and colon cancers) serially transplanted in nude mice. When cancer anticancer agents such as mitomycin C (MMC) and 5-fluorouracil (5-FU) were injected into immunocompetent mice treated with various dosages of cyclosporin A (CsA) after tumor implantation, optimal schedule of each drug was examined on the points of effects and toxicity against host mice. The following results were obtained. Control groups were set up as immunocompetent mice which treated daily with 60 mg/kg CsA from day 1 after tumor implantation. Optimal treatment schedule was judged as MMC 3 mg/kg i.v. injection on day 1 following by daily 60 mg/kg CsA treatment, and 5-FU was injected 25 mg/kg subcutaneous injection every day from day 1 without CsA treatment, each schedule showed an appropriate anti-tumor activity profiles against implanted tumor xenografts, and had less toxicity to the hosts.

[Quantitative assessment of arterial capacitance in human by noninvasive method]

The purpose of this study was to determine the magnitude of arterial capacitance in human by noninvasive method. In 60 patients (Age: 62.1 +/- 13.4 years) without cardiovascular disease first-pass radionuclide angiography was performed using a digital gamma camera to calculate cardiac output and stroke volume (SV). Systolic interval (ts), diastolic interval (td) and arterial blood pressure were measured using ECG, phonocardiography and sphygmomanometer. We assumed a simple model in which all capacitance (C) lumped into one site with a resistance (R) in parallel to the C. C was calculated by the following basic equations. (Formula; see text) arterial diastolic pressure, E: left ventricular external work. Our results showed: 1) Arterial capacitance ranged from 0.38 ml/mmHg to 2.10 ml/mmHg and more than 60% of stroke volume was pooled in the arterial capacitor during systole. 2) Arterial capacitance fell linearly with age (C = 2.37-0.02 x Age, r = -0.680, p less than 0.001). It is concluded that the capacitor played an important role in arterial circulation.

Prevalence of depressive symptoms in a Japanese occupational setting: a preliminary study

We measured the prevalence of depressive symptoms in 2,190 Japanese tax office workers using the Japanese version of the Center for Epidemiologic Studies Depression Scale (CES-D). Score distribution by sex was more symmetrical and the mean score of each sex was higher than in the United States population. A high level of depressive symptoms was found in 15.2 percent of males and 10.6 percent of females by controlling for age and marital status. Males aged 50 years and over had more depressive symptoms than other male age groups. Perceived stress, related both to family life and the workplace, was associated with a high level of depressive symptoms. "Long-distance marriage" ("business bachelorhood"), peculiar to Japanese occupations, had little influence on depressive symptomatology.

[The trends of hemolytic streptococci isolated from clinical specimens in hospitals in Saitama during the period of 1979-1987]

In order to analyze the trends of hemolytic streptococcal infections, we have investigated the source of clinical specimens, monthly isolation rates, and the isolation rates by sex and age o patients of 6,440 hemolytic streptococci (group A, B, C and G) isolated from clinical specimens in hospitals in Saitama during the period of 1979-1987. 1) Serological group of 6,440 hemolytic streptococci isolated from clinical specimens were 4,691 (72.9%) isolates of group A, 1,535 (23.8%) isolates of group B, 47 (0.7%) isolates of group C, and 169 (2.6%) isolates of group G. 2) The main clinical sources of hemolytic streptococci, group A streptococci were 4,243 (90.7%) isolates from throat swabs, 117 (2.5%) isolates from ear secretions, 87 (1.9%) isolates from nose secretions, and 58 (1.2%) isolates etc., group B streptococci were 647 (42.2%) isolates from urines, 446 (29.1%) isolates from vaginal swabs, 127 (8.3%) isolates from throat swabs, 118 (7.7%) isolates from semen, 55 (3.6%) isolates from urethral secretions, 13 (0.8%) isolates from blood, and 9 (0.6%) isolates from cerebrospinal fluid etc.. 3) The monthly isolation rates of hemolytic streptococci, showed that group A streptococci had a general trend by the season, that is, the highest ratio in winter and the lowest ratio in summer, group B streptococci was not influenced by the season. 4) The isolation rates by sex of patients showed that group A streptococci had no difference between male and female, however, group B streptococci showed that the isolation rate of female was higher than that of male with the ratio of 7 to 3.(ABSTRACT TRUNCATED AT 250 WORDS)