[A case of hepatocellular carcinoma (HCC) with lung metastasis which responded to chemotherapy with a single use of 1-hexylcarbamoyl-5-fluorouracil (HCFU)]

To our knowledge, there has been only one report pertaining to the efficacy of HCFU for treatment of metastatic lung lesion of HCC, so we reported a case of HCC with lung metastasis which responded to chemotherapy with a single use of HCFU. A 64-year-old male was diagnosed as having HCC with lung metastasis by biochemical examination, abdominal CT, hepatic arteriogram and chest X-P. He had been treated previously with gamma-interferon and mitoxantrone, which were assessed as NC and PD, respectively. Two months after last chemotherapy, HCFU was administrated at a dose of 400 mg/body everyday for 8 months. After 4 weeks metastatic lung lesions showed remarkable regression (47% decrease) and disappeared completely 9 weeks later. The size of primary liver tumor gradually decreased during therapy and revealed marked improvement (85.7% decrease) after about 2 months of this therapy. During these periods serum levels of alpha-fetoprotein dropped from 430 ng/ml to less than 10 ng/ml. He is presently still alive and the duration of the PR attained to 35 weeks. As side effects, hypoproteinemia, anorexia and hot sensation were observed.

In vitro effect of a thymic epithelial culture supernate or thymosin fraction 5 on rabbit platelet aggregation and intracellular cyclic AMP levels

Supernates of thymic epithelial cell culture (STEC) strongly inhibit aggregation induced by addition of adenosine diphosphate (ADP: 1 microM) or thrombin (0.5 unit per ml) to washed platelet suspensions and accelerated the restoration from ADP-triggered aggregation. At the same time, STEC increased the level of platelet adenosine 3',5'-cyclic monophosphate (cyclic AMP) in a dose-dependent manner. Depending on the concentration used, thymosin fraction 5 increased the level of intracellular cyclic AMP ranging between 5 and 100 micrograms per ml, as well as inhibiting ADP-induced platelet aggregation. The activities of both STEC and thymosin fraction 5 were found to act exclusively on cyclic AMP phosphodiesterase activity in platelets. In contrast the supernates from Chang, HeLa, or HCC-M cells did not affect platelet aggregation induced by ADP, but slightly increased the cyclic AMP level (Chang, HeLa). Within 2 min after the treatment with STEC, more than 50% of the maximum inhibitory activity on platelet aggregation and increases in intracellular cyclic AMP were observed. These activities disappeared following STEC treatment with pronase E. STEC activity was found predominantly in the 1,000-50,000-dalton fractions. These activities were not altered when STEC was treated by adenosine deaminase. The level of prostaglandin E (PGE) derivatives in STEC was about two times that found in the control culture medium. These data suggest that the biological activity of STEC in the platelets might be attributed to thymosinlike polypeptides and PGE1.

Abnormal mucociliary function in a mucocele of the maxillary antrum

We have examined the mucociliary function present in a mucocele of the maxillary antrum and have found certain abnormalities in the tissues studied. Our findings also indicate that the mucocele's intrinsic pathology is too complex to be improved by any conservative treatment and justifies its surgical removal.

Tape attachment therapy for correction of congenital malformations of the auricle: clinical and experimental studies

After the auricular cartilage of 5-week-old rabbits was bent and fixed by suture, the cartilage increased in thickness in a short period of time. The thickness was maximal 6 weeks later and slightly greater than that of the control cartilage 12 weeks later. At this stage, the auricle was fixed in curved form. There was no difference in the morphology of cartilage cells between the bent group and the control. Tape attachment therapy is very simple. We propose that surgical treatment should be designed after a few months of tape attachment therapy. In the present work, the effect of taping was graded good in 4 cases of Stahl ear, 1 case of atypical cryptotia, and 2 other cases. In 2 cases of cup ear the result was fair, but this deformity with marked auricular aplasia was not curable by this conservative treatment.

Asymptomatic leiomyosarcoma of maxillary sinus accompanied by primary mucocele

A case of asymptomatic leiomyosarcoma of the maxillary sinus accompanied by primary maxillary mucocele is presented together with a review of the literature. The manifestation and symptoms, pathology in special reference to electron microscopic findings, treatment and prognosis, and origin of this tumor are discussed. Initially, this tumor should be treated by extensive surgical excision, but long-term follow-up is essential in the light of this high rate of local recurrence, and radical neck surgery is indicated for metastatic nodal disease.

A simple prosthesis for correction of cryptotia

Cryptotia, which is a rather common anomaly among Japanese, is found in one of about every 400 Japanese. We tried the prosthesis method and obtained good results, with 26 cases (31 auricles). The results obtained were good for 15 cases, fair in 10, and poor in 1. By this method, complete correction including that of the cartilage is possible for the patients up to 8 years old, and correction by extension of the skin is possible for older age groups. This method can be applied to patients 2 or 3 years old without limiting it to those of less than 1 year.

Enhancement of ciliary action by a beta-adrenergic stimulant

It is known that beta-adrenergic stimulants enhance mucociliary transport in the respiratory tract. The present study clearly indicated that such an enhancement resulted from not only the alteration in secretory function but also the direct stimulation of ciliated cells. However, the enhancement of ciliary beating depended on the morphological changes in ciliated cells. On the other hand, the effect of terbutaline aerosol, a beta-adrenergic stimulant, on patients with chronic sinusitis was evaluated by paranasal sinus radiography. Consequently, marked improvements in shadows were achieved after 4 weeks in 40% of the cases examined.

[Experimental and clinical studies of cefatrizine in oral infections (author's transl)]

Investigation was made on the therapeutic effect of a new antibiotic, cefatrizine(CFT), in oral infections according to the following procedure. Results are summarized as follows. Determination was made on the MIC of CFT against 8 clinical isolates of S. epidermidis, 5 of S. aureus and 7 of E. coli in comparison with those of CEX and PBPC. MICs of CFT against S aures were demonstrated 3.13 to 6.25 mcg/ml which were superior to those of CEX and ABPC. CFT was administered orally in a dose of 500 mg at an hour and a half before the extraction of the impacted wisdom tooth in the mandibula. During the operation, gingival and blood specimens were collected and each CFT level was determined. The mean CFT level in the gingiva reached to 0.95 mcg/ml and that in the blood to 5.77 mcg/ml. According to these experimental results, CFT was administered to patients with moderate oral infection at a dose of 500 mg and clinical assessment was made according to the criteria established by Japanese Society of Oral Surgeons. As the results, the effectiveness rate of CFT was 85%. No serious side effect was observed. From the results of the present study, CFT may be effective for moderate oral surgery infections.

Copolymers of adenylic and 2-aminoadenylic acids. Effect of progressive changes in hydrogen bonding and stacking on interaction with poly(uridylic acid)

Random copolymers of adenylic acid and 2-aminoadenylic acid form both double and triple helices with poly(uridylic acid) [poly(U)]. Transition temperatures of two-stranded helices increase with 2NH2A content, exhibiting a slight positive departure from linearity and indicating that the contribution to helix stability arising from introduction of the 2-amino group does not significantly depend upon base sequence. We have shown previously that poly(2NH2A) . poly(U) does not undergo a disproportionation reaction (2 leads to 3 transition). Extrapolation from melting curves of 1:1 complexes between A,2NH2A copolymers and poly(U) indicates a Tm for the 2 leads to 3 transition of poly(2NH2A) . poly(U) which is too high to be observable under normal conditions. Addition of an organic solvent (50% ethylene glycol), however, lowers Tm by promoting unstacking of single-stranded poly(2NH2A) sufficiently to permit observation of the disproportionation of poly(2NH2A) . poly(U) for the first time. Transition breadths of 1:1 complexes of A,2NH2A copolymers with poly(U) are greater than those of either of the homopolymer complexes in the middle range of composition (67 and 48% A) but not at 25% A. These results are consistent with previous calculations on the effect of heterogeneity in base-pair stability on DNA transition breadths. In the poly(A), poly(U) system, Et4N+ counterion reduces the Tm of the double and triple helices by 26 and 41 degrees C, respectively. The larger depression in the latter case arises from the higher charge density of the triple helix and less effective counterion screening by Et4N+. In the poly(2NH2A), poly(U) system Tm,2 leads to 1 is reduced by 24 degrees C, but extrapolation of the copolymer results indicates a reduction of approximately 100 degrees C for Tm,3 leads to 2, accounting for previous failure to observe a triple helix in this system. CD spectra of A,2NH2A copolymers suggest that much of the spectral region can be regarded as a contribution of the CD spectra of the parent polymers poly(A) and poly(2NH2A) but that the region from 255 to 275 nm requires that contributions made by longer range interactions be taken into account.

[Fundamental and clinical studies of sustained release cephalexin (L-Keflex) in the field of oral surgery (author's transl)]

L-Keflex is a newly manufactured cephalexin product in order to maintain effective blood level of the drug for a long period of time. The results of the fundamental and clinical studies are as follows: 1. Mean blood levels of the drug after its single oral dose of 1 g in fasting in 22 cases before operations were: 7.19 mcg/ml at 2 hours (peak), 4.35 mcg/ml at 4 hours, 4.21 mcg/ml at 6 hours, 2.47 mcg/ml at 8 hours and 1.81 mcg/ml at 12 hours, respectively. Existence of the drug in blood was observed for a long period of time. 2. The distribution into the tissues of L-Keflex was generally good. The tissue levels in 19 of 22 samples ranged from 1.30 to 18.0 mcg/g, but 3 samples did not detect the drug in the tissues. Tissue level/blood level ratios were 0.19 approximately 2.67. 3. Half of 30 cases with mild dental infections was treated with a daily dose of 1 g with clinical response of 60.0%, and the other half with 2 g was 78.6% in clinical response. The overall efficacy rate was 69.0%. 4. As a side effect of the drug, only one of 52 cases (fundamental 22 cases, clinical 30 cases) complained of edema on both eyelids. No. abnormality was observed in blood finding, hepatic and/or renal function. From the above results, it is considered that L-Keflex is an effective antibiotic product in infections in the field of oral surgery. Also, L-Keflex has an advantage in that its administration frequence (b.i.d) is less than that of regular cephalexin (q.i.d.).