Insulin-like action of chromate on glucose transport in isolated rat adipocytes

The effects of chromium compounds on 3-O-methylglucose (3-O-MG) transport were studied in isolated rat adipocytes. Sodium chromate significantly stimulated 3-O-MG uptake into adipocytes in a dose-dependent manner without altering the equilibrium space of 3-O-MG in adipocytes. The stimulatory effect reached the maximum at 300 microM, and the effect was 60-70% of the maximal insulin effect that was obtained with 20 nM insulin. The chromate concentration achieving a half-maximal effect was estimated at 50 microM. The effect of the combination of 1 mM chromate and 20 nM insulin was equipotent to that of 20 nM insulin alone, which showed that these two effects were not additive. The stimulatory effects of 1 mM chromate and 20 nM insulin were entirely abolished in adipocytes deprived of ATP, which indicated that these effects were completely ATP-dependent. Judging from experiments using various chromium compounds, CrO4(2-) was responsible for the insulinomimetic action. These results indicate that the action of CrO4(2-) is exerted through a mechanism analogous to that of insulin action, and that CrO4(2-) is a novel and useful tool for studying issues involved in insulin actions.

[Clinical evaluation of cefpodoxime proxetil, a new oral cephem, in the treatment of respiratory tract infections with the special reference to community-acquired Streptococcus Pneumoniae infections]

The clinical usefulness of cefpodoxime proxetil (CPDX-PR) was investigated in the treatment of pneumonia and chronic airway infections occurring in patients first visiting our outpatient clinic or those being treated at the outpatient clinic. CPDX-PR was orally administered twice a day after meals at a dose of 100-200 mg for acute respiratory tract infections and at a dose of 200 mg for chronic respiratory tract infections. Excellent, good, fair, and poor responses were observed in 20, 33, 10, and 3 of 66 patients (4 with acute bronchitis, 27 with pneumonia, and 35 with acute exacerbation of chronic airway infection), respectively, demonstrating an 80.3% efficacy rate (53/66). Causative organisms, including Streptococcus pneumoniae, were all eradicated from the patients whose causative organisms were examined over time, although 2 of the patients were superinfected with Pseudomonas aeruginosa. There were no serious adverse reactions or abnormal changes in laboratory test results. It was concluded that CPDX-PR could be used as a first-choice drug for the treatment of respiratory tract infections at an outpatient clinic, and that this drug should acquire greater importance in particular consideration of recent increases in infections with S. pneumoniae.

[A surviving case of disseminated tuberculosis complicated with severe respiratory failure, pancytopenia, DIC, drug induced fever and pneumothorax in an elderly patient]

We reported a survival case of a 78-year-old female with disseminated tuberculosis complicated with severe respiratory failure, pancytopenia, DIC, drug induced fever and pneumothorax. Atypical symptoms and presence of chronic illness make the early diagnosis of disseminated tuberculosis in the elderly difficult. In this report, we emphasized that both a high awareness of possible clinical diagnoses and the performance of some clinical procedures including bronchoalveolar lavage were useful. Disseminated tuberculosis in the elderly with multiple complications which is rare condition, was discussed.

The pathogenic role of the NMDA receptor in hyperthermia-induced seizures in developing rats

Hyperthermia-induced seizures (HS) in rats have been used as a model of febrile seizures. Activation of the N-methyl-D-aspartate (NMDA) receptor by increased extracellular glutamate (Glu) in the cortex during hyperthermia may be involved in the induction of HS and HS kindling. To confirm this hypothesis, the effects of a potent blocker of the NMDA receptor, MK-801, on the threshold and pattern of HS were evaluated. The threshold temperatures for rats given 0.1 (low dose) and 0.5 (high dose) mg/kg MK-801 (i.p.) for the first time were 41.6 degrees C (39.7-42) (median, range) and 42.0 (41.2-42.0), respectively, which were significantly higher than the 40.5 (39.4-41.2) for rats without MK-801 administration (P < 0.01). The recurrent occurrence of HS suppressed the increase in the threshold temperature with age, and changed the seizure from partial to generalized seizures (HS kindling), whereas these effects of recurrent HS on the threshold and pattern of HS were inhibited by the high dose (0.5 mg/kg) of MK-801. MK-801 blocks HS and HS kindling. The activation of the NMDA receptor during hyperthermia plays an important role in the induction of HS and HS kindling.

Tyrosine kinase may participate in Ca2+ entry for endothelial nitric oxide production

We have suggested that cyclopiazonic acid (CPA), a Ca(2+)-ATPase inhibitor, produces nitric oxide (NO) by triggering a Ca(2+)-influx resulting from Ca(2+)-depletion in the endoplasmic reticulum of endothelial cells. The tyrosine kinase inhibitor methyl 2,5-dihydroxycinnamate, while having no effect on relaxations induced by A23187 or Na nitroprusside, did inhibit the CPA-induced relaxation and cyclic GMP formation in rat aorta. Tyrosine kinase may participate in endothelial NO synthesis through activation of a Ca2+ entry mechanism.

A case of beriberi accompanying short bowel

A case of beriberi based on short bowel is reported. A 4 year old girl, who underwent a resection of the intestine when a neonate and has had a short bowel, manifested beriberi despite eating normal Japanese food. Considering that she has had no dislikes of foods, and her family members, who have eaten meals similar to hers have been healthy, beriberi is considered in this case to have developed mainly through hypoabsorption of vitamin B1. This patient has responded well to vitamin B1 therapy with a relatively slow recovery in neural functions. Although it has not been confirmed whether short bowel syndrome is prone to be accompanied by beriberi, special attention should be given to vitamin B1 in short bowel syndrome patients.

Comparison of antibody titer to human and rat acetylcholine receptor in myasthenia gravis

Antibody titer to acetylcholine receptor (AChR Ab) was measured in 34 patients with myasthenia gravis (MG) using an immunoprecipitation method with human and rat AChR as antigens, to study the reliability of these assay systems and the cross-reactivity between human and rat AChR. There was a good correlation in the titer of Ab to AChR between human and rat (P < 0.01) when Ab titers were expressed logarithmically. The titer of Ab to human AChR was higher in a group of patients with a high concentration of AChR Ab and lower in a group with a low concentration of AChR Ab than that to rat AChR. This indicates that there may be distinctive characteristics in AChR Ab between groups of patients with high and low concentrations of AChR Ab.

Histochemical localization of copper in various organs of brindled mice after copper therapy

Copper (Cu) distribution in various organs of brindled mice (BM), an animal model of Menkes disease, was studied histochemically and by atomic-absorption-spectrophotometry 7 months after Cu injections. The results were compared with those of untreated BM. In the treated BM brain, a diffuse reduction in Cu-related staining of neurons and astroglia was still evident, though it had improved to some extent. The reduction was noticeable in the thalamus, brain stem and cerebellum, although intensely stained capillaries were noted occasionally in the retrosplenial and mediobasal temporal areas, including the hippocampus. In the treated BM liver, near normalization of Cu distribution was observed. In the treated BM intestine, the main localization of Cu accumulation was in histiocytes/macrophages in the lamina propria, while in the untreated BM it was in the absorptive and secretory epithelial cells. In the treated BM kidney, there was no clear improvement in Cu distribution. These histochemical results were consistent with the data obtained by the spectrophotometric assay. Electron microscopic histochemistry of affected renal tubular epithelial cells revealed numerous silver grains, which represent Cu++ localization, distributed only within the cytoplasm outside organella and nucleus. This suggests impaired intracellular Cu transport from cytosol to organella, which in the kidney is refractory to the Cu therapy adopted.

[Epidemiology of emphysema: analysis by autopsy in a series of elderly patients]

Epidemiologic studies indicate that various factors are involved in causing emphysema, although it is uncertain exactly how these factors contribute. Thus the correlation between pathological changes and clinical manifestations was studied. Results of autopsies done on 1940 men and 1791 women from 1978 to 1992 were analyzed retrospectively. Emphysema was graded, from macroscopic findings as follows: none (E 0), slight (E 1), moderate (E 2), and severe (E 3). The severity of anthracocsis was graded as well. Information regarding clinical diagnosis, smoking habits, and available spirometric data were obtained by reviewing the medical records. Prevalence of each grade of emphysema was: in men, E 0-48.6%, E 1-31.6%, E 2-15.8%, and E 3-4.0%; in women, E 0-81.6%, E 1-13.7%, E 2-3.7%, and E 3-0.8%. Pneumonia, lung cancer, and gastric ulcer were significant complications of emphysema, and may have contributed to the cause of death. The effects of various risk factors on the severity of emphysema were evaluated by multiple linear regression analysis. Male sex, age, smoking habit, and grade of the anthracosis were independent factors affecting the development of emphysema. Among them, anthracosis grade and smoking habit were found to be strongly contributing factors. Emphysema grade and FEV1% were significantly correlated, but several patients with moderate or severe emphysema did not show airflow obstruction. Therefore, receiver operating characteristic (ROC) curves were constructed to evaluate the value of the FEV1% in the diagnosis of emphysema. The diagnostic value of the FEV1% alone was low, so a multiple linear regression equation with three factors (sex, smoking habit, and FEV1%) was constructed.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibitory effects of diazoxide or polymyxin B on glucose transport by isolated rat erythrocytes or adipocytes

The inhibitory effects of diazoxide or polymyxin B on 3-O-methylglucose uptake were studied in isolated rat erythrocytes or adipocytes to elucidate the mechanisms of the actions of these agents. One to three mmol/L diazoxide significantly inhibited 3-O-methylglucose uptake into erythrocytes by 11-33% without altering the equilibrium space, while 0.3 mmol/L diazoxide did not. The inhibitory effect was exerted in a dose-dependent manner in this concentration range. To test whether polymyxin B affects the process of insulin action or the glucose transport activity recruited by insulin, adipocytes prestimulated with insulin and exposed to 2 mmol/L potassium cyanide (KCN) were employed since the cells, on which glucose transporters recruited by insulin were located quiescently, were useful to estimate the effect of an agent on glucose transport activity per se. Polymyxin B (100 micrograms/mL) inhibited the insulin-stimulated uptake activity in this transport system by 22.5% while it inhibited the insulin-stimulated uptake activity in intact adipocytes which were not exposed to KCN by 32.2%. These results suggest that diazoxide inhibits the function of the erythrocyte glucose transporter, GLUT1 (classified by Bell et al.), and indicate that the inhibition of the glucose transport activity recruited by insulin is the major effect of polymyxin B (100 micrograms/mL) and the inhibition of the process of insulin action is rather small.

[Pharmacokinetic and clinical studies on cefozopran in the field of pediatrics]

Blood and urine levels of cefozopran (CZOP) were determined, and its efficacy and safety profile was evaluated in the field of pediatrics. The results of this study are summarized as follows. 1. Blood levels of CZOP peaked in 30 minutes to 1 hour (initial blood collection) after intravenous administration at a dose of 20 or 40 mg/kg. Its blood levels at 6 hours after intravenous administration were 1.6 micrograms/ml (HPLC) or 1.9 micrograms/ml (bioassay) at a dose of 20 mg/kg and 2.9 to 9.1 micrograms/ml (HPLC) or 2.9 to 8.4 micrograms/ml (bioassay) at a dose of 40 mg/kg. The half-lives were 1.58 to 2.27 hours (HPLC) and 1.53 to 1.85 hours (bioassay), respectively. The rate of recovery of CZOP in the urine in the first 8 hours after intravenous administration at a dose of 20 mg/kg was 61.5% (HPLC) or 54.6% (bioassay), and urine levels of CZOP at 6 to 8 hours after administration were 157.3 micrograms/ml (HPLC) and 129.7 micrograms/ml (bioassay). 2. When CZOP was administered to 16 patients with respiratory tract infections, 2 patients with urinary tract infections, 2 patients with acute enteritis, 1 patient with skin soft tissue infection, and 1 patient with purulent lymphadenitis, the responses were excellent in 68% of patients and good in 32% with an overall efficacy rate of 100%. 3. Bacteriological effect of CZOP was excellent and the rate of bacterial eradication was 100% (9/9). 4. MICs of CZOP against clinical isolates (Staphylococcus aureus, methicillin-resistant S. aureus (MRSA), Streptococcus pneumoniae, Escherichia coli, Moraxella (Branhamella) catarrhalis) were compared to those of other injectable cephems ceftazidime (CAZ), cefuzonam (CZON), flomoxef (FMOX), cefmetazole (CMZ). The MICs of cefozopran (CZOP) against Gram-positive organisms, S. aureus, MRSA, and S. pneumoniae, were nearly as low as those of CZON and were clearly lower than those of CAZ. MICs of CZOP against Gram-negative organisms were examined and the MIC against E. coli was as low as those of other antibiotics but the MIC of CZOP against M. (B.) catarrhalis was higher, at 1.56 micrograms/ml, than those of CAZ, FMOX, and CMZ. 5. Diarrhea was experienced by 1 of 22 patients as a side effect from CZOP, and abnormal laboratory tests including increases of eosinophil counts in 2 patients (9.1%), a decrease of neutrophil counts in 1 patient (4.5%), thrombocytosis in 1 patient (4.5%), and an elevation of GPT in 3 patients (13.6%).(ABSTRACT TRUNCATED AT 400 WORDS)

A multicenter study on HLA and autoimmunity in Japanese patients with early-onset insulin-dependent diabetes mellitus (IDDM): the JDS Study

The Japan Diabetes Society (JDS) conducted a multicenter study on HLA and autoimmunity in Japanese patients with early-onset insulin-dependent diabetes mellitus (IDDM). HLA, immunoglobulin heavy-chain complex (Gm), properdin factor B (BF), and glyoxalase of erythrocytes (GLO) were typed, and organ-specific autoantibodies including islet cell antibodies (ICA) were assayed in 159 IDDM patients and their relatives and in 258 healthy Japanese subjects. The HLA-DRw9 phenotype and HLA-Bw61/DRw9 haplotype were significantly increased among the patients with autoantibodies other than ICA, whereas the DR4 phenotype and Bw54/DR4 haplotype were significantly increased in those without the autoantibodies. The DR4 phenotype was significantly increased in the patients with autoimmune thyroid diseases. The relative risk of the HLA-DRw9/DR4 genotype was highest among all DR genotypes. The Gm phenotype of g and gft were significantly increased in the patients with the autoantibodies. The BF-F phenotype was significantly decreased in the patients either with or without the autoantibodies. There was no association of GLO types with IDDM. The prevalence of ICA among IDDM patients was decreased with duration of IDDM. No significant association was found between the prevalence of ICA and sex, age at onset, or HLA type. On the other hand, the prevalence of the autoantibodies was not significantly changed with duration of the disease, and was significantly higher in females than in males.

Changes in the activities of DNA polymerases in growing rat lungs

We hypothesized that cellular proliferation and the capacity to repair DNA damage in the lung might differ during the pre- and postnatal periods, because the lung is exposed to higher oxygen concentrations and/or various mutagens after birth. In order to test this hypothesis, changes in DNA content and the activities of DNA polymerase alpha and beta were studied in the lungs of 1-day prenatal to 42-day postnatal rats. Total DNA polymerase activity reached its highest level at 1 day prenatal and 1 day after birth. The activity decreased exponentially by 28% up to 14 days of age, a change inversely related to the change in DNA content. The change in total DNA polymerase activity agreed closely with the change in DNA polymerase alpha activity, but not the activity of the beta form, although small elevations in both DNA polymerase alpha and beta were observed on day 3, possibly reflecting the mechanical effect of delivery. The activity of DNA polymerase beta remained relatively constant from 1 day before birth to 21 days after birth, varying by only about 5%. From these results, it is concluded that: (1) cellular proliferation in the lung is most active during the first 2 weeks after birth as supported by the increases in DNA polymerase alpha activity and DNA content, and (2) anticipating the oxygen enriched atmosphere after birth, the level of DNA polymerase beta, involved in the DNA repair system, is already elevated during the prenatal period and remains constant throughout the postnatal period.

Morphological studies of growth and aging in the lungs of Fischer 344 male rats

Observations by light microscopic morphometry and scanning electron microscopy were performed on the lungs from 86 specific pathogen-free Fischer 344 male rats between 1 day and 32 months of age. The distribution curve of the mean chord length of the gas exchanging area appeared as a single peak (approximately 70 microns) at day 1, and two peaks (approximately 50 and 90 microns) were seen at day 7 when the first alveoli appeared. At 3 months of age, the distribution curve peaks began to decrease gradually, becoming more flattened with a wide base to a maximum 200 microns. Between 27 and 32 months of age, ductectasia occurred and the alveolar surface appeared more irregular and rough, but no destruction of the alveolar wall was observed. From these observations, it was concluded that the first alveoli appear by 7 days of age in male Fischer 344 rats, that the alveolar size gradually increases after 3 months of age, and that ductectasia appears after 27 months of age. These changes might reflect changes in the matrix of the alveolar walls due to nutritional deterioration in old age, concomitant with cellular atrophy of this zone.

A case of Kabuki make-up syndrome with central diabetes insipidus and growth hormone neurosecretory dysfunction

A case of a 6 year old boy with Kabuki make-up syndrome with central diabetes insipidus and growth hormone neurosecretory dysfunction is reported. Magnetic resonance imaging revealed abnormal findings of the pituitary gland and stalk. Good catch-up growth was obtained by treatment with growth hormone. These findings suggest that hypothalamic-pituitary dysfunction might be involved in Kabuki make-up syndrome.

ICA and organ-specific autoantibodies among Japanese patients with early-onset insulin-dependent diabetes mellitus--the JDS study

The Japan Diabetes Society (JDS) conducted a multicenter study on the immunogenetics of insulin-dependent diabetes mellitus (IDDM) among Japanese. The previous report of the JDS study described HLA types and other immunogenetic markers in Japanese patients with IDDM. In the present report, the autoimmunity of Japanese patients was studied by measuring ICA and other organ-specific autoantibodies in patients with different durations of IDDM. The prevalences of ICA were the highest in the first year after diagnosis (73.1%) and decreased to 58.0%, 18.3% and 2.8% in 1-5 years, 5-10 years and 10 years or more after diagnosis, respectively (P < 0.01), while the prevalences of the other organ specific autoantibodies increased gradually with duration of IDDM from 20% in the first year to 35% in 10 years or more after diagnosis (P < 0.05). There were no sex differences in the prevalences of ICA but those of other organ-specific autoantibodies were significantly higher in female patients than in male patients (P < 0.01). The prevalence of ICA was not correlated with sex, age at onset or HLA types. In one of the subjects, a girl, the titers of ICA increased in parallel with a decrease in insulin secretion before the development of overt IDDM and declined thereafter. These findings suggest that IDDM might develop when the autoimmunity specific to pancreatic islets is triggered in people with underlying autoimmunity as shown by the presence of organ-specific autoantibodies other than ICA.

An extrapancreatic action of diazoxide to inhibit glucose transport activity on adipocytes

The effect of diazoxide on 3-O-methylglucose (3-O-MG) transport was studied in isolated rat adipocytes to elucidate its extrapancreatic action. Diazoxide (0.3-3 mmol/L) significantly inhibited 3-O-MG uptake into adipocytes in a basal state or an insulin-stimulated state. The inhibitory effect was mainly due to the inhibition of insulin responsiveness for 3-O-MG uptake. The insulin responsiveness is determined by the capacity in the process of insulin action and in the final glucose transport activity, and diazoxide mainly inhibited the 3-O-MG transport activity itself. Based on these findings, this extrapancreatic action of diazoxide is considered to contribute partially to raising the blood glucose level in children receiving the drug. Diazoxide, as a glucose transport inhibitor, may be a useful tool for studying the issues related to glucose transport or insulin action.

Actions of peroxovanadate or tungstate on glucose transport by isolated rat adipocytes

The effects of peroxovanadate or tungstate on 3-O-methylglucose uptake were characterized using isolated rat adipocytes to elucidate the mechanism(s) of their actions. The stimulatory effect of peroxovanadate was observed from 1 mumol/L and reached the maximum at about 100 mumol/L. The concentration showing the half-maximal effect was approximately 16 mumol/L. The maximal response of peroxovanadate was 1.19 times higher than that of insulin significantly (P < 0.01). On the other hand, the stimulatory effect of tungstate was seen only at the higher concentrations of 10-30 mmol/L. Judging from the experiments using different tungsten compounds, tungstic acid (WO4(2-)) appeared responsible for the effect. The effects of 20 mmol/L tungstate and 20 nmol/L insulin were not additive. The stimulatory effects of 1 mmol/L peroxovanadate, 20 mmol/L tungstate or 20 nmol/L insulin were not seen in the adipocytes deprived of ATP by exposure to 2 mmol/L KCN. The adipocytes which had been stimulated with insulin and further exposed to 2 mmol/L KCN were used to test whether or not peroxovanadate works directly on the function of glucose transporters. In such cells on which GLUT4-rich transporters were rendered immobile, the effect of peroxovanadate was not observed. These results indicate that the effects of peroxovanadate or tungstate are ATP or energy dependent and may be exerted through the mechanism analogous to that of insulin action, and suggest that peroxovanadate does not directly activate the function of GLUT4.

Thyroglobulin antibodies in type 1 diabetic patients and their relatives--measurement with highly sensitive assay

Autoimmunity in Type 1 (insulin-dependent) diabetes mellitus was assessed by measuring thyroglobulin antibodies (TGA) using a highly sensitive enzyme immunoassay in 65 young patients with Type 1 diabetes mellitus, 83 healthy first-degree relatives of the patients, 37 healthy control subjects and 67 healthy parents of the control subjects. TGA were found in 78.5% (51/65) of patients and were significantly more frequent in patients than in control subjects (40.5%, 15/37; P < 0.01). The prevalence of TGA in patients showed no correlation with age at onset, duration of diabetes or sex. Among the first-degree relatives the prevalence of TGA was significantly increased in mothers of patients than in mothers of the control subjects (80.0% vs. 54.3%, P < 0.05), while not significantly between fathers of patients and fathers of control subjects or between siblings of patients and control subjects. Comparing the TGA levels of TGA-positive subjects, the TGA levels in patients, their parents and their siblings were significantly higher than those in the corresponding control subjects (P < 0.05, P < 0.05 and P < 0.01, respectively). In the present study we thus more clearly demonstrated autoimmune diathesis in patients with Type 1 diabetes and in their first-degree relatives.

[Clinical study of S-1108 fine granule in the pediatric field]

S-1108 in a fine granular form was administered in 14 children and its safety and efficacy in bacterial infections were evaluated. Among them, 2 cases of cystitis and 1 case of pneumonia were considered unevaluable for the efficacy. The results obtained are summarized as follows. 1. The overall clinical efficacy rate was 81.8% in the eleven evaluable cases treated with S-1108 fine granules including 5 cases of pharyngitis, 2 cases each of tonsillitis, pertussis and cystitis. 2. Bacteriological efficacy of 100% was achieved against pathogens identified in 5 children including 1 case each of Staphylococcus aureus, Streptococcus pyogenes and Haemophilus influenzae and 2 cases of Escherichia coli. 3. The only abnormal laboratory test results observed were eosinophilia and leukocytopenia in one case each. Diarrhea was recorded in 1 case. Judging from the above results, it appears that S-1108 in the fine granular form is an effective, useful and safe antibiotic of first choice for the treatment of infections in the pediatric field.

Lung structure and elastic recoil properties in hereditary diabetes mellitus in KK-mice, C57 black mice, and F1 hybrids

To separate the effects of diabetes and inheritance on morphometric characteristics of the lung and on the variables of the pressure-volume relationship, the lungs of KK mice--a genetic model of adult-onset diabetes--were compared with the lungs of normal C57 black mice and of F1 hybrids by multivariate analysis. Hybrid mouse lungs contain more air per gram of lung tissue at total lung capacity (TLC) than the lungs of other mice (p < 0.0002) and have a lower recoil pressure at 30% to 70% of TLC. Morphometric data revealed that both the mean linear intercept and the number of alveoli per unit volume in hybrid mice fell between those in KK and C57 mice. However, the total number of alveoli per lung in hybrid mice was 155% of that in KK mice and 148% of that in C57 mice, reflecting the larger lung volume of hybrid mice. The alveolar wall thickness of the hybrids was similar to that of C57 mice, whereas KK mice had thicker alveolar walls than the other two groups. Multivariate analysis revealed that body weight, wet lung weight, volume density of blood vessels, mean linear intercept, and transpulmonary pressure at 90% TLC were affected by diabetes alone; however, the following parameters were affected by both inheritance and diabetes: lung volume, specific lung volume, femur length, volume density of alveolar air, surface area, surface to volume ratio, number of alveoli per lung, lung air per gram of lung tissue, and transpulmonary pressure at 20% to 80% TLC.(ABSTRACT TRUNCATED AT 250 WORDS)

Quality of life measurements using a linear analog scale for elderly patients with chronic lung disease

We developed a linear analogue scale (QOL Scale) to measure the quality of life (QOL) in elderly patients with chronic lung disease. In this study, the validity of the QOL Scale was assessed and QOL Scale scores were compared with the results of other conventional questionnaires. A total of 76 subjects, aged 65 years or older, divided into three groups according to disease severity, were tested by the QOL Scale and two additional questionnaires. The QOL Scale had the advantages of comprehensibility, acceptability and reproducibility. QOL Scale scores differed among the groups, while the other questionnaires showed no significant differences according to disease severity. QOL Scale scores correlated with the tendency toward neurosis shown by another index. We conclude that the QOL Scale is a practical and useful indicator of QOL in elderly patients with chronic lung disease.

Efficacy of digital subtraction angiography for confirmation of position of the infusion tube for delivery of intra-arterial chemotherapy as treatment of the head and neck cancer

This study was conducted in 47 patients with biopsy-proven cancer of the head or neck. These patients each had an intra-arterial infusion tube inserted retrogradely. Positioning in the infusion tubes had been determined by staining of the mucocutaneous area of the malignant lesion under observation with injection of blue dye. Digital subtraction angiography (DSA) was performed from the infusion tube. DSA demonstrated that infusion tubes were in the correct position in 26 patients (55%), and in an incorrect position in 21 patients (45%). The infusion tubes of all patients with cancer of the maxillary sinus were in the correct position. However, the majority (54%) of infusion tubes in patients with cancer of the tongue were in an incorrect position. Observation of arterial flow from the infusion tube using DSA should be made in all patients with head or neck cancer in order to avoid the potential complications of intra-arterial chemotherapy.