Evaluation of the penetration depth of transdermally applied 3% GA MHPh 2Na-10% lidocaine gel in man

In order to estimate the penetration depth of transdermal 3% GA MHPh 2Na-10% lidocaine gel mixture, the following physiological functions of the skin were examined before and after a 60 min occulusive application of the gel in 16 adult volunteers. Thermal sweat expulsins ceased completely on the gel-treated ventral surface of one forearm in all the firs 5 subjects, though it continued on the untreated contrast area of the other forearm. Sympathetic skin response (SSR) was also no longer induced on the gel-treated middle finger in 1 of another 3 subjects and was severely depressed in the other 2 subjects, while the SSR on the untreated index finger appeared constantly. Vasomotion of the skin circulation on another 3 subjects, remained unaffected on both the gel-treated and the untreated fingers. Extraction of a leg-hair in the treated area did not induce pain sensation in all the last 5 subjects. In addition to the transcellular main roots, some of the transcutaneously applied gel seems to penetrate deeply into the skin through the appendageal roots such as the eccrine sweat glands and the pilosebaceous glands.

Systemic sclerosis in two second cousins: a case report

Abstract We describe two second cousins who developed systemic sclerosis. These patients had major histocompatibility complex (MHC) class I alleles in common, including A2, A26(10), B60(40), and Cw7 as well as class II allele DR2. This DR2 was thought to be associated with the onset of the disease. Our patients both experienced a limited type of systemic sclerosis, but the expression of autoantibodies was different.

Antigen-dependent and -independent proliferative T-cell populations in the peritoneal exudate cells of immunized mice

In vitro proliferative responses of T lymphocytes in the peritoneal exudate cells of C3H/HeN(Iak) mice immunized with horse red blood cells (HRBC) were examined by determining the uptake of tritiated thymidine [( 3H]TdR) into the cells. Although the cells showed a basal proliferative response in the absence of antigen, addition of specific antigen increased the response sharply. Both the basal response and that stimulated by antigen disappeared if the cells had been previously treated with complement and anti-Iak antibody (AIak), anti-MAC-1 antibody (AMAC-1) or anti-Thy-1 antibody, but not anti-Ig antibody. Adding macrophages prepared from the peritoneal exudate cells of normal mice to AMAC-1-treated T-cell (i.e. Iak+ plus Iak- T-cell) cultures restored both of the responses, while adding them to AIak-treated T cells (i.e. Iak- T cells) only restored the antigen-specific response. These findings indicate that the basal proliferation is due to or dependent on the proliferation of Iak+ T cells, while the antigen-specific response is mainly due to Iak- T cells. Furthermore, interleukin (IL)-2 production was also examined. Immune T cells produced some IL-2 in the absence of antigen. The production by AMAC-1- or AIak-treated cells was impaired, but adding macrophages to the AMAC-1-treated cell cultures restored production. This result also suggests that the mode of IL-2 production by the Iak+ and Iak- cells is different. Proliferative responses of AMAC-1- or AIak-treated T cells to IL-2 were also examined. The AIak-treated cells dose-dependently responded to IL-2, while the response of Iak+ cells, which could be estimated by subtracting the response of AIak-treated cells from that of AMAC-1-treated cells, did not depend on the doses. These results indicate that in the immune peritoneal exudate the Iak+ T cells are functionally different from Iak- T cells.

[Observations of capillary fluid flow rate by vibration on the small vessel model]

The vibration hazards in peripheral blood vessels as an occupational origin is caused by using pneumatic vibrating tools. In order to know that the major part of causes is whether due to the direct effects of the physical vibration or due to the effects depended on the excitations of peripheral nervous system, an model experiment was employed to estimate the direct effect of the physical vibration. In our experiments, water as fluid was used instead of blood. The silicon capillary tube as same the physical qualities and conditions as blood vessels was vibrated by oscillator. The silicon capillary tube was exposed by following three type of vibration mode to flow axis; i) sine wave of transverse vibration, ii) rectangular wave of transverse vibration, and iii) sine wave of longitudinal vibration. The range of vibration frequency covered 1-2000 Hz. The averaged acceleration by oscillating vibration and the vibration strength level were estimated about 1-200 G and 150 dB, respectively. The observed decreases of water flow rate due to vibration extremely depend on frequency. The decrease ratio of water flow rate by vibration was at maximum 12% down compare with the cases of non vibration. In these observed results by this model experiment, it should be concluded that the direct effect of the physical vibration to the blood flow was not too strong to cause the actual vibration hazards.

Effect of food on bioavailability and pharmacokinetics of theophylline following administration of two sustained release dosage forms: Part I

Bioavailability and pharmacokinetics of theophylline following administration of a marketed sustained release tablet (Theo-Dur) and a newly designed sustained release tablet (E-0686) have been studied in fifteen healthy volunteers under overnight fasting and non-fasting conditions. Higher concentrations at early absorption phase under fasting conditions than under non-fasting conditions were observed after administration of Theo-Dur, whereas little difference in plasma concentrations was noted when E-0686 was administered under fasting and non-fasting conditions. Bioequivalency was demonstrated depending upon the extent of bioavailability of the two preparations. Compared to the theophylline levels in non-smokers, significantly lower concentrations at elimination phase and AUC0-infinity values were observed in smokers in each treatment (p less than 0.05). E-0686 exhibited almost the same rate constant in dissolution in vitro and in absorption in vivo, while Theo-Dur did not. Therefore, it may be concluded that E-0686 is a well-designed sustained release preparation that releases theophylline in vivo at a given rate which can be easily determined in vitro.

[The basic study of autologous peripheral stem cell transplantation--useful application of KLI and G-CSF]

There has been increasing interest in autologous peripheral stem cell transplantation (APSCT) in the treatment of malignant disease because it is a convenient method and may have a lower risk of tumor cell contamination than autologous bone marrow transplantation (ABMT). Recently, it is reported that the number of peripheral blood stem cells increase during recovery phase of hemopoiesis after chemotherapy, and further increase is reported on the case of treatment with G-CSF. But influences of G-CSF to the residual malignant cells is still unknown. In this report, we have used clonal cell culture and kappa-lambda imaging (KLI) analysis to trace the level of CFU-GM, BFU-E, and malignant B-cell population (mBp) in peripheral blood before and after treatment with rhG-CSF. The peak level of CFU-GM in peripheral blood was a 2-fold increased when rhG-CSF was administered, and this peak appeared 5-7 days earlier than that in the case without rhG-CSF. MBp was detected in bone marrow, however, no mBp was detected before and after treatment with rhG-CSF in peripheral blood. These findings suggest that APSCT is acceptable for this patient in case of minimal bone marrow involvement. And KLI analysis might be an effective method for detecting residual malignant cells in bone marrow and peripheral blood.

Protective effect of recombinant tumor necrosis factor-alpha in murine salmonellosis

The enhancement of resistance by i.p. administration of murine rTNF-alpha into mice against i.p. challenge with virulent Salmonella typhimurium was studied. Administration of TNF-alpha (5 x 10(4) U/mouse) into mice at 6 or 12 h before the challenge with S. typhimurium organisms enhanced the bactericidal capacity in the peritoneal cavities of the mice. The diminution of the infecting organism in the peritoneal cavities of the TNF-alpha-treated mice was not due to the systemic spread of the organism inasmuch as few organism were recovered from other areas such as the spleen and liver. The TNF-alpha treatment effected a slight increase of neutrophils in the peritoneal cavity, but did not effect an increase of macrophages, including Ia-bearing macrophages. The survival rate of mice infected with Salmonella was improved by the i.p. injection of TNF-alpha before infection. Co-administration of smaller doses of TNF-alpha (5 x 10(3) U) and murine rIFN-gamma (10(2) U) at 6 h before the challenge also effectively enhanced bactericidal activity and protectivity. The cooperative effect of TNF-alpha and IFN-gamma was only seen when these recombinant cytokines were injected together at the proper time before the challenge. Injection of rabbit anti-TNF-alpha serum abolished the effects of TNF-alpha and the cooperative effect of TNF-alpha and IFN-gamma. Furthermore, the serum could abolish the cooperative effect of IFN-gamma and LPS on bactericidal activity, suggesting participation of LPS-induced TNF-alpha in the cooperation.

[Effects of amrinone on left ventricular function following open heart surgery--analysis with left ventricular pressure volume loops]

The effects of Amrinone on cardiac function soon after extracorporeal circulation (ECC) were studied in 5 patients including mitral valvuloplasty, VSD closure, Fontan operation and coronary AV fistel closure. In all patients, left ventricular volume load decreased postoperatively. To evaluate the efficacy, we obtained left ventricular pressure-volume loops (P-V loop) before and after ECC and after intravenous administration of Amrinone (1 mg/kg) following ECC. P-V loops were produced by measuring left ventricular pressure using a Miller catheter which was retrogradely advanced from the ascending aorta into the left ventricle and by measuring left ventricular diameter to calculate left ventricular volume with Teichholtz' formula. Although no apparent difference of Emax was recognized before and after ECC, Emax increased from 3.2 +/- 2.5 mmHg/cm3 to 5.9 +/- 4.7 mmHg/cm3 after the administration of Amrinone. The left ventricular "systolic" pressure-volume area (PVA) which is the sum of stroke work (SW) and elastic potential energy decreased from 34.4 +/- 16.4 gm to 30.9 +/- 17.8 gm after Amrinone. No difference was also recognized in left ventricular end-diastolic pressure. Ejection fraction increased from 50 +/- 17.5% to 56.1 +/- 17.3%. These results suggested that Amrinone could improve the left ventricular function without prominent change in myocardial oxygen consumption immediately after open heart surgery.

Selective anticancer effects of 3',5'-dioctanoyl-5-fluoro-2'-deoxyuridine, a lipophilic prodrug of 5-fluoro-2'-deoxyuridine, dissolved in an oily lymphographic agent on hepatic cancer of rabbits bearing VX-2 tumor

3',5'-Dioctanoyl-5-fluoro-2'-deoxyuridine (FdUrd-C8), one of the lipophilic prodrugs of 5-fluoro-2'-deoxyuridine (FdUrd) was dissolved in an oily lymphographic agent (Lipiodol Ultra-Fluid), which had been studied as a carrier of the anticancer drug for hepatic cancer. The prodrug was administered into the left proper hepatic artery of rabbits bearing VX-2 tumor in the liver in order to examine the anticancer effects and possible adverse effects on nontumorous hepatic cells. Lipiodol or FdUrd-C8*Lipiodol selectively remained in the hepatic cancer area but disappeared from nontumorous parts of the liver 7 days after injection. Tumor growth rates in 1 week of the untreated group, a group given injections of 0.2 ml of Lipiodol alone, and groups given injections of 0.2 ml of Lipiodol containing 30, 50, 70, and 100 mg of FdUrd-C8 were 636, 436, 34.8, 14.9, -2.4, and -10.4% of the size at the time of treatment, respectively. Pathological observation also showed that FdUrd-C8 had a strong anticancer effect on VX-2 tumor growing in the liver of the rabbits. In contrast to the effect on the cancerous cells, that on nontumorous hepatic cells was very slight. In pathological observation, necrosis or degeneration of nontumorous hepatic cells was hardly observed. Plasma glutamic-oxaloacetic transaminase and glutamic-pyruvic transaminase levels temporarily rose 1 day after injection but returned to the initial levels within 7 days in all groups.

[Evaluation and comparison of high-sensitivity immunoradiometric assay kits for thyroid stimulating hormone]

Fundamental and clinical characteristics of 3 kinds of high-sensitivity immunoradiometric assay (IRMA) kits for thyroid stimulating hormone (TSH). i.e., RIA BEADS II (kit A), TSH kit Daiichi II (kit B) and Ab tube TSH 'Eiken' (kit C) and one conventional radioimmunoassay (RIA) kit, i.e., TSH kit Daiichi (kit D), were studied. In the recovery test and the reproducibility test, there was no significant difference between the 4 kits. The sensitivities of kits A, B and C were much higher than that of kit D, and those IRMA kits were sensitive enough to distinguish hyperthyroidism from normal samples. For low concentrations of TSH (less than 5 microU/ml), the data from kits D, B, C and A tended to show higher values in that order. The correlation between the data measured by kits B and D, and the tendency of kit A toward lower values agreed well with other reports.

Fractionation of glycoproteins from porcine zonae pellucidae into three families by high-performance liquid chromatography

The glycoproteins of porcine zonae pellucidae were fractionated into three families (PZP1-3) by high-performance liquid chromatography on a gel filtration column. Their molecular weights were estimated to be 164K for PZP1, 99K for PZP2, and 55K for PZP3; and they were present in an approximate weight ratio of protein moiety of 2:3:18, respectively. Differences in carbohydrate composition position between them were found, although their amino acid compositions were similar to each other. CD spectra showed that the three families had an almost identical secondary structure of the helical form in the presence of SDS. In PBS without SDS, they had different secondary structures, predominantly in the beta-form, and probably different tertiary structures.

Suppression of lipopolysaccharide-induced polyclonal B cell activation of murine spleen with heat-aggregated murine immunoglobulin G

The effect of heat-aggregated immunoglobulin G's (HAgg-IgGs) on bacterial lipopolysaccharide- (LPS) induced polyclonal B cell activation (PBA) was studied. HAgg-IgGs (10 micrograms/ml or more) that were added to cultures of spleen cells obtained from BALB/c mice remarkably decreased the numbers of anti-trinitrophenyl (TNP) antibody-producing cells (APC) generated by LPS in cultures. This suppressive effect was seen when HAgg-IgGs were added within 1 hr after the initiation of culture. Later addition of HAgg-IgGs did not cause any effective suppression of the generation of APC. Moreover, the spleen cells, which had been pretreated with HAgg-IgGs, washed for removal of free HAgg-IgGs, and subsequently cultured, responded poorly to LPS. HAgg-IgG2b was more effective than HAgg-IgGs, but HAgg-IgG2a did not have any suppressive effect. A similar suppressive effect was observed when HAgg-IgG2b-Fc was added into culture, whereas none was noted with IgG2b-Fab. Indomethacin (IM), known as cyclooxygenase inhibitor, could completely abrogate the suppressive effects of HAgg-IgGs on LPS-induced PBA responses when it was added to the cell cultures together with HAgg-IgGs or to the cultures of HAgg-IgGs-pretreated cells. Addition of prostaglandin E2 (PGE2) showed strong suppression of the PBA responses of spleen cell cultures that had been pretreated with HAgg-IgGs and IM, but other PG analogues showed no suppression. Thus, it would appear that PGE2 has some role in the suppression of the LPS-induced PBA response.

[Intravesical bacillus Calmette-Guerin in the treatment of recurrent superficial bladder tumors]

Seven patients with recurrent superficial bladder tumors were treated by vesical and intradermal administration of BCG. All of these patients have had recurrence more than 2 times. BCG instillation was performed every weeks for 6 weeks after transurethral resection of bladder tumor. A suspension containing 120 mg BCG in 40 ml normal saline was instilled intravesically. BCG was administered into alternate upper thighs using a multiple puncture apparatus. Statistical analysis of bladder tumor in our hospital revealed the second recurrence rate to be 73.2%. The reduction of tumor recurrence rate of BCG treated patients was 43.0%. The reduction of tumor recurrence by BCG treatment was statistically significant, compared to other treatments. It seemed that patients with severe side effects such as bladder tenesmus and urinary infection, have a long tumor-free period. Therefore, we suggest that the reactive inflammation in bladder during BCG treatment plays an important role.

[Prognosis of interstitial pneumonitis (IP) in polymyositis (PM)/dermatomyositis (DM)]

IP, the major complication of PM/DM, is closely related to the life of these patients. In this study the course and prognosis of IP associated with PM/DM were investigated. Thirty IP patients with PM/DM were divided into 4 groups according to the course of IP. Clinical manifestations, laboratory data, chest radiographs and treatment were examined retrospectively. Eleven cases improved (Group I), 11 cases were exacerbated (Group E), 3 cases were unchanged (Group U), 2 cases died due to rapid progression of IP (Group D) and 3 cases dropped out. Both Group D patients were middle aged female DM patients without CPK elevation. All cases were treated with corticosteroids. The clinical manifestations, laboratory data, chest radiographs and initial dose of corticosteroid were not markedly different between Group I and E. The total dose of corticosteroids during the first 3 months tended to be higher in Group I than in Group E. Unlike idiopathic interstitial pneumonitis, the decrease in lung volume on chest radiographs improved after the treatment in 5 cases. We conclude that IP associated with PM/DM should be treated initially with high doses of corticosteroids.

Hematopoietic supportive function of human bone marrow stromal cell lines established by a recombinant SV40-adenovirus vector

We have previously reported the establishment of a variety of human bone marrow stromal cell lines using a recombinant SV40-adenovirus vector. Using this vector, we obtained more clonal stromal cells. Here, we have characterized these cells and analyzed their capacity to support the proliferation and differentiation of hematopoietic cells. The stromal cells were cocultured with nonadherent human bone marrow cells used as hematopoietic cells. The total numbers of hematopoietic cells and CFU-GM in culture were counted every week. Two of the six stromal cell lines, AA101 and HAS303, supported the proliferation and differentiation of hematopoietic cells and CFU-GM for more than 9 weeks. Further, granulocytes, macrophages, and megakaryocytes were detected when cocultured with these cells. When hematopoietic cells were cocultured but separated from the two stromal cell lines by a 0.45-microns millipore membrane to prevent their attachment, almost all CFU-GM disappeared within 7 weeks. The supportive stromal cells produced GM-CSF and IL-6. However, other cell lines producing these humoral factors did not support hematopoietic cell proliferation for such a long time. These findings suggest that these established human bone marrow stromal cell lines will be useful, in that analysis of their supportive function in hematopoietic cell proliferation and differentiation through cell-to-cell interaction will shed some light on this area.

Radical radiation therapy for adenocarcinoma of the uterine cervix

PURPOSE

Analysis of the therapeutic value of radical irradiation for patients with uterine cervical adenocarcinoma with special reference to pelvic disease control.

PATIENTS AND METHODS

20 patients with uterine cervical adenocarcinoma were treated with a combination of external beam and intracavitary irradiation (four patients stage IB, one stage IIA, three stage IIB and twelve patients stage IIIB). Seven patients were treated with high dose-rate (HDR) intracavitary irradiation, eleven with low dose-rate (LDR) intracavitary irradiation and two with HDR and LDR.

RESULTS

Six out of the 20 patients experienced pelvic recurrence (all stage IIIB patients). Analysis of the relation between pelvic recurrence and dose rate of intracavitary irradiation revealed that LDR showed a higher pelvic disease control rate than HDR (6/7 vs. 0/4) in stage IIIB patients. Intracavitary irradiation doses of LDR were 1.2 to 1.5 times higher than those of HDR. Three out of the 20 patients developed rectal complication grade 2 (two patients treated with HDR, one with LDR). The five-year cumulative survival rate was 67.2% for all, 100% for stage I and II, and 43.3% for stage IIIB patients.

CONCLUSION

These results suggest that locally advanced uterine cervical adenocarcinoma should be treated with a higher dose using LDR intracavitary irradiation. If adequate total doses can be delivered, pelvic disease control of uterine cervical adenocarcinoma is comparable with that achieved for squamous cell carcinoma.

[Role of postoperative irradiation for carcinoma of the uterine cervix: multivariate analysis of prognostic factors and patterns of failure]

We retrospectively analyzed the patterns of recurrence in 48 patients who underwent postoperative irradiation following surgery for carcinoma of the uterine cervix. The end points of pelvic control, distant metastases and disease-free survival were analyzed for parameters including FIGO stage, nodal status, degree of stromal invasion, histology and tumor size. Univariate and multivariate analyses showed that some prognostic parameters had little influence on pelvic control rate, but had a marked impact on the incidence of distant metastases and disease-free survival rate. These results suggest that postoperative irradiation improves pelvic control rate, but has little therapeutic benefit in preventing distant metastases or improving survival rate. In conclusion, we should give more consideration to adjuvant systemic therapy in addition to postoperative irradiation for high-risk patients.

[Two cases of supposed metastasizing leiomyosarcoma of the uterus]

Case 1. A 57-year-old female had hysterectomy 10 years ago because of leiomyoma uteri. She was recently found to have a clear-cut round mass shadow in the right middle lung field on her chest X-ray film 3. The mass was resected and microscopically diagnosed as metastatic leiomyosarcoma. Re-examination of the pathological specimen of the uterine tumor resected 10 years ago revealed 5-9 mitosis per 10 high-powered fields (/10 HPF). Case 2. A 54-year-old female who had undergone hysterectomy for myoma uteri 9 years previously was found to have a well-defined oval shadow in the left lower lung field which was resected and pathologically diagnosed as metastatic leiomyosarcoma. Her uterus lesion microscopically revealed 1-2 mitosis/10 HPF. The relationship between metastatic leiomyosarcoma of the lung and mitotic activity of leiomyoma uteri was discussed.