[The pattern of spontaneous contraction and the effects of Mg++ and terbutaline on pregnant human myometrium]

The isometric spontaneous contraction and K-contracture of pregnant human myometrium were recorded in order to study the effects of external Mg++ and the correlation between Mg++ and terbutaline. Electrical activities were also recorded with a single sucrose-gap method. Maximum tension, frequency and half duration of spontaneous contractions were not significantly different among all specimens. Maximum tension of the spontaneous contraction was lower than the longitudinal muscle of pregnant rat and higher than the circular one. The frequency was lower and the duration was longer than rat myometrium. Mg++ exhibited the inhibition of the spontaneous contraction and decreased the gradient of pacemaker potential and duration of action potentials. Phasic contraction of K-contracture was also inhibited by the pre-incubation with Mg++. Mg++ rich medium shifted the dose-response curve of terbutaline to the left and the pre-incubation with Mg++ increased the inhibitory effect of terbutaline on the tonic part of K-contracture. The results indicated that human myometrium might be constructed of plural muscle bundles with different characteristics, and Mg++ inhibited the spontaneous contraction by affecting the membrane activities and enhanced the terbutaline effect by penetrating into the membrane.

[Clinical effect of a cephalosporin derivative, cefotiam, on otorhinolaryngologic infections]

CTM was administered at dose levels of 1 to 3 g a day to 77 cases of otorhinolaryngological infections, and the following results were obtained: The effect of the drug was determined in 75 cases. The responders were 3 out of 5 (60.0%) in acute suppurative otitis media, 4 out of 11 (36.4%) in chronic suppurative otitis media, 39 out of 43 (90.7%) in tonsillitis and peritonsillar abscess and 12 out of 16 (75.0%) in other diseases, a total of 58 out of 75 cases (77.3%). The bacteriological effect of CTM was evaluated in 53 cases, and bacterial eradication was demonstrated in 41 cases (77.4%). Also, its antibacterial potency was 2 to 4 times superior in comparison to that of CEZ against isolated bacteria in which MICs were measurable. Side effects which were neither severe nor specific were recognized in 3 out of 77 cases (3.9%). In the cases with abnormal laboratory values, none was determinable to be attributed to CTM.

[The pattern of spontaneous contraction and the effects of catecholamines on pregnant human isthmic myometrium]

The spontaneous isometric contraction of human isthmic myometrium was recorded with regard to the stage of pregnancy, the run of muscle bundles and the resected part of the muscles. Then, the effects of noradrenaline or terbutaline and the relationship between beta-inhibition and Mg2+ were also studied. 1. The frequency of spontaneous contraction was lower than that of rat myometrium, and the amplitude was smaller than the longitudinal muscle of rat under the same conditions. 2. The pattern of the spontaneous contractions was almost the same in different muscle bundles resected from the serosal or endometrial side, and also at different stages of pregnancy. 3. The effect of noradrenaline (10(-12)-10(-6) g/ml) always exhibited alpha-excitatory action and terbutaline (10(-8)-10(-6) g/ml) induced beta-inhibition in every strip. These actions depended on the concentration of the drug. 4. The frequency of spontaneous contractions was gradually decreased and the beta-inhibition of terbutaline (10(-7) g/ml) was progressively potentiated with the increase in external Mg concentration. These results show the fundamental difference in the pattern of spontaneous contractions due to the difference in the arrangement of muscle bundles or species between human and rat, and also suggest that the human myometrium possesses both alpha- and beta-receptors of catecholamine, and the combined therapy using MgSO4 and beta 2-stimulants for premature labor is available, although the physiological role of adrenergic innervation is still unknown.

Cytologic findings of ascites from patients with ovarian dysgerminoma

The cytomorphologic observations of ascites from three patients with ovarian dysgerminomas are presented. As compared with those in adenocarcinoma, the cytologic findings in this rare malignant ovarian tumor showed more cells lying isolated or in sheetlike arrangements, fewer cells with discrete cytoplasmic vacuoles, less frequent thickening of the nuclear membrane and more frequent multinucleolation.

Adenocarcinoma of the uterine cervix metastatic from primary stomach cancer. Cytologic findings in six cases

The cytologic features of six cases of stomach cancer metastatic to the uterine cervix are presented. Atypical cells were found in cytology samples from four patients. Fewer atypical cells, larger cellular and nuclear areas, more discrete vacuoles, increased frequencies of thickening of the nuclear membrane and more coarsely granular chromatin patterns were the characteristic cytologic findings of metastatic cervical adenocarcinoma as compared with primary endocervical adenocarcinoma.

[FT-207 maintenance therapy of malignant gynecologic cancer]

Maintenance treatment with FT-207 was applied to 92 patients with uterine cancers after initial treatments were performed. Daily dosage of FT-207 was either 600 or 800 mg and the drug was administered orally. The duration of 6 months and the total dosage of 100 g were proposed as administration schedule and 34 patients (37%) received this regimen. Side effects during the treatment were observed in 35 cases (38%). Gastrointestinal disturbance was most frequently observed and other side effects included myelosuppression, general fatigue, hepatic dysfunction and skin toxicities. There were no serious side effects, the treatment was continued in most patients and was interrupted only in 7 cases (8%). In the cases of recurrence or advanced cancer, however, the side effect was the predominant cause for interruption of administration. As for the antitumor effect of the treatment, a survival rate of the patients with cervical cancer of early stages was evaluated. Three-year survival rate in the treatment group was higher comparing to the one reported hitherto.

Analytical study of repair cells

To establish the differential diagnosis of repair cells from malignant cells, 624 repair cells from 11 cases, 547 cells derived from 8 adenocarcinomas and 593 cells from 8 squamous-cell carcinomas were analyzed, with stress on the morphology of the nucleoli. Such planimetric data as mean cellular areas, mean nuclear areas, mean nucleolar areas, nuclear-cytoplasmic ratios and nucleolar-nuclear ratios were fairly similar among the three cell groups. However, the even distribution of nucleoli in the nuclei, the decrease in C-type nucleoli and nucleoli consistently linked with nucleolus-associated chromatin were noted to be reliable criteria for the diagnosis of repair cells along with such well-known morphologic characteristics as the sheetlike arrangement of repair cells, the lack of isolated forms, the finely granular chromatin pattern and the round, smooth nuclear configuration with a thin nuclear membrane.

[Over diagnosis of the biopsy: from the analysis of the extirpated uterus after radical hysterectomy (author's transl)]

From January, 1973 to December, 1980, 396 cases of cervical cancer were treated with radical hysterectomy under the diagnoses of stage Ib, IIa and IIb. Precise postoperative pathological examinations about the extirpated uterus revealed that 63 of them had only early invasive cancer or less advanced lesions though they had been considered as frank invasive cancer by preoperatively performed biopsies. The major causes of the misinterpretations were, 1) misjudging the glandular involvements as frank invasive lesions, or 2) misjudging the tangentially sectioned lesions of the bulky outgrowth as frank invasions. Furthermore, it is sometimes difficult to identify the invasive lesions in the biopsy specimens whether they are early invasive or frank invasive. Colposcopic and cytological examinations were simultaneously performed to each cases. Either cytology or colposcopy did not suggest frank invasions in 44.2% of cases. Both of them did not suggest frank invasions in 37.2% of cases. At least, cone biopsy should have been performed to identify the degree of invasions of these 37.2% cases. The authors emphasize that the directed biopsies are not always accurate to diagnose the early invasions, and one should use colposcopy, cytology and directed biopsy to make an accurate diagnosis.

[Combined chemotherapy of ovarian cancer with special reference to carboquone]

Carboquone (CQ) was administered to 20 patients with ovarian cancer as a main drug in the multiple chemotherapy. Picibanil and Futraful (FT-207) were medicated simultaneously. CQ was given 3 mg each, 2 times a week, up to total 30 mg intravenously or intraperitoneally. 1) The effect of CQ was evaluated in 6 cases. The response was good in 2 cases, fair in 3, and poor in 1. In the other 3 cases after surgery long-lasting remission suggested the effectiveness of this drug. 2) When compared with 43 cases of control group(historical control), apparent higher survival rate was observed until 3 years in this group. 3) Side effects were noted in 89% of the patients. In 5 patients CQ treatment was discontinued because of severe complications. These complications were more pronounced when it was administered intraperitoneally or combined with radiation.

[Histological grading of hydatidiform mole (author's transl)]

This study was performed to seek possibility of selecting the high risk group in the patients with hydatidiform mole at its delivery. The histologic specimens from 83 patients with hydatidiform mole were reviewed and classified by modified Hertig's grading. Lymphocyte count of peripheral blood was also studied as an immunological index. I. There were 36 Grade I cases, 16 Grade IIa, 23 Grade IIb, and 8 Grade III cases. Two subsequent destructive moles were found from the patients with Grade I, three from Grade IIb, and two from Grade III respectively. The incidence of developing subsequent destructive mole was 6% in Grade I, 8% in Grade II, and 25% in Grade III. II. There was no correlation between histological grading and patients age nor weeks in gestation. When the ratio of syncytiotrophoblast and cytotrophoblast was considered, most of Grade II or III cases were obtained from those in whom the cytotrophoblast prevailed over syncytiotrophoblast. III. The patients with lymphocyte less than 1500/mm3 in their peripheral blood were apt to take abnormal clinical course comparing to those with lymphocyte more than 1501/mm3. The more accurate prediction of clinical course was suggested by combination of histological grading and lymphocyte count.

Nuclear DNA content of trophoblastic tumors

The nuclear DNA content of trophoblasts was measured in 25 cases of normal pregnancy, 46 cases with hydatidiform mole, ten cases with destructive mole and six cases of chorionepithelioma (choriocarcinoma). In normal pregnancy, DNA distribution in syncytiotrophoblasts and cytotrophoblasts showed a sharp peak at the diploid region, although a few cytotrophoblasts with increased DNA content were observed in the first trimester. In chorionepithelioma the DNA content of the trophoblastic cells showed extremely wide distribution without any special peak. In destructive mole, although a wide distribution was observed, the sharp peak was usually noted at the diploid range. Cases with hydatidiform mole were divided into two categories according to the DNA distribution patterns. Type I showed the patterns similar to the first trimester of normal pregnancy and type II resembled the patterns of destructive mole. In hydatidiform mole of type II, subsequent progress towards destructive mole was frequently encountered.