Non-genomic inhibitory effect of glucocorticoids on activated peripheral blood basophils through suppression of lipid raft formation

We investigated the non-genomic effects of glucocorticoids (GCs) on inhibition of plasma membrane lipid raft formation in activated human basophils. Human basophils obtained from house dust mite (HDM)-sensitive volunteers were pretreated with hydrocortisone (CORT) or dexamethasone (Dex) for 30 min and then primed with phorbol 12-myristate 13-acetate (PMA, 10 ng/ml) or HDM (10 µg/ml). The expression of CD63, a basophil activation marker, was assessed by flow cytometry. Membrane-bound GC receptors (mGCRs) were analysed by flow cytometry and confocal laser microscopy. Lipid rafts were assessed using a GM1 ganglioside probe and visualization by confocal laser microscopy. Pretreatment of basophils with CORT (10(-4) M and 10(-5) M) and Dex (10(-7) M) significantly inhibited CD63 expression 20 min after addition of PMA or HDM. The inhibitory effects of GCs were not altered by the nuclear GC receptor (GCR) antagonist RU486 (10(-5) M) or the protein synthesis inhibitor cycloheximide (10(-4) M) (P < 0·05). CORT coupled to bovine serum albumin (BSA-CORT) mimicked the rapid inhibitory effects of CORT, suggesting the involvement of mGCRs. mGCRs were detectable on the plasma membrane of resting basophils and formed nanoclusters following treatment with PMA or HDM. Pretreatment of cells with BSA-CORT inhibited the expression of mGCRs and nanoclustering of ganglioside GM1 in lipid rafts. The study provides evidence that non-genomic mechanisms are involved in the rapid inhibitory effect of GCs on the formation of lipid raft nanoclusters, through binding to mGCRs on the plasma membrane of activated basophils.

Apnoea–Hypopnoea Index during Rapid Eye Movement and Non-Rapid Eye Movement Sleep in Obstructive Sleep Apnoea

This study investigated the differences in apnoea-hypopnoea index (AHI) during rapid eye movement (REM) sleep (AHI-REM) and AHI during non-REM (NREM) sleep (AHI-NREM) in patients with obstructive sleep apnoea (OSA). Nocturnal polysomnography was performed in 102 Japanese OSA patients and their AHI along with a variety of other factors were retrospectively evaluated. Regardless of the severity of AHI, mean apnoea duration was longer and patients' lowest recorded oxygen saturation measured by pulse oximetry was lower during REM sleep than during NREM sleep. Approximately half of the patients ( n = 50) had a higher AHI-NREM than AHI-REM. In subjects with AHI ≤ 60 events/h, AHI-NREM was significantly higher than AHI-REM. On multivariate logistic regression, severe AHI ≤ 30 events/h was the only predictor of a higher AHI-NREM than AHI-REM. This may indicate that important, but unknown, factors related to the mechanism responsible for the severity of OSA are operative during NREM sleep.

[Evaluation of spinal cord ischemia in endovascular stent graft repair and surgical operation of descending thoracic or thoracoabdominal aortic aneurysms]

Between October 1996 and June 2003, endovascular stent graft repair was performed in 87 patients with descending thoracic aortic aneurysms, graft replacement was performed in 24 patients with thoracoabdominal aortic aneurysms, and endovascular stent graft repair with concomitant surgical bypass of abdominal visceral arteries was performed in 3 patients with thoracoabdominal aortic aneurysms. The retrievable stent graft was inserted and evoked spinal cord potential were monitored in order to predict spinal cord ischemia for stent graft repair. There was no paraplegia or hospital death, although 3 patients had paraparesis in stent graft repair. Two of the 3 patients with paraparesis made a full neurologic recovery. There were no cases of paraplegia or paraparesis in surgical operations with thoracoabdominal aortic aneurysm. The concomitant surgical procedure was a good technique for patients in whom cardiopulmonary bypass could not be used. Our results of stent graft repair and surgical operation for descending thoracic or thoracoabdominal aortic aneurysms were acceptable. The retrievable stent graft was useful for prediction of spinal cord ischemia before endovascular stent graft repair of descending thoracic or thoracoabdominal aortic aneurysm.

Multi-elemental concentrations in tissues of Japanese common squid (Todarodes pacificus)

Forty-five elements were determined in mantle muscle and liver of juvenile Japanese common squid, Todarodes pacificus, collected from three locations in and near Japanese coasts, using a high-resolution inductively coupled plasma mass spectrometer (HR-ICP-MS) and an inductively coupled plasma atomic emission spectroscope (ICP-AES). Multivariate statistical techniques were applied to discriminate populations of squids from these three locations by treating absolute and relative concentrations of trace elements. Significant differences were found in the concentrations of elements, particularly for some alkaline and alkaline earth elements in the muscle and liver and for some 3d transition elements in the liver of three groups of squids. Squids from the Pacific Ocean could be distinguished from those of the Sea of Japan by discriminant function analysis of elemental concentrations. Based on the analysis, the squids collected from the Nemuro Strait in Japan were predicted to belong to those from the Sea of Japan. Elemental concentrations and discriminant function analysis can be used to identify subpopulations and migratory routes of squids.

Multielemental analysis of purpleback flying squad using high resolution inductively coupled plasma-mass spectrometry (HR ICP-MS)

Forty-four elements were analyzed in 21 tissues of purpleback flying squid, Sthenoteuthis oualaniensis, by high resolution inductively coupled plasma-mass spectrometry (HR ICP-MS) and inductively coupled plasma atomic emission spectrophotometry (ICP-AES). Greater concentrations of V, Fe, Co, Ni, Cu, Ag, Cd, Pb, and Bi were found in liver, pancreas, and ink sac than in other tissues. Ink sac concentrated remarkable levels of Ca and Sr in addition to the above-mentioned elements. Several alkalis, alkaline earth, and rare earth elements preferentially accumulated in muscle. Among the hard tissues, accumulation of V and U in beak, Ni, Zn, and Cd in gladius and Cr in skin was prominent. K, Rb, Cs, Pb, Bi and some transition elements (V, Co, Cu, Zn, Ag, Cd) were significantly (p < 0.05) higher in the livers of adult than in juvenile squids. Sodium, alkaline earth, and rare earth elements were higher in the livers of juveniles than in adult squids.

ICP/MS and ICP/AES elemental analysis (38 elements) of edible wild mushrooms growing in Poland

Thirty-eight elements, including toxic cadmium, lead, mercury, silver and thallium, were determined in 18 species of wild edible mushrooms collected from several sites in Pomorskie Voivodeship in northern Poland in 1994. Elements were determined by double focused high resolution inductively coupled plasma mass spectrometry (HR-ICP-MS) and inductively coupled plasma atomic emission spectroscopy (ICP-AES), after wet digestion of the dried samples with concentrated nitric acid in closed PTFE vessels using a microwave oven. K, P and Mg were present at levels of mg/g dry matter; Na, Zn, Ca, Fe, Cu, Mn, Rb, Ag, Cd, Hg, Pb, Cs, Sr, Al and Si were present at microg/g levels, while Tl, In, Bi, Th, U, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, La, Lu and Ba were present at ng/g levels.

Growth-related changes in heavy metal accumulation in green turtle (Chelonia mydas) from Yaeyama Islands, Okinawa, Japan

Concentrations of nine heavy metals (Fe, Mn, Zn, Cu, Pb, Ni, Cd, Co, and Hg) were determined in liver, kidney, and muscle of 50 green turtles (Chelonia mydas) collected from Yaeyama Islands, Okinawa, Japan, to elucidate growth-related changes in heavy metal accumulation during different growth stage. Considerably high Cu concentrations were found in the liver of smaller turtles. Mean hepatic concentration of Cu was 50.2 microg/g wet weight which varied widely (4.27-113 microg/g wet weight). Cadmium concentrations decreased with increasing the carapace length. The juvenile green turtles in the pelagic ocean are likely feed on zooplankton, while adult coastal inhabiting green turtles mainly feed on sea grasses and seaweeds. Concentrations of Cd in sea plants are lower than those in zooplankton. The specific accumulation of Cd found in the green turtle seems to be attributable to their feeding habit, which is a shift from carnivore to herbivore at different growth stages.

[Mineral composition of selected tissues and organs of white-tailed sea eagle]

The analysis of the concentrations of K, S, P, Mg, Na, Ca, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Rb, Sr, Y, Ag, Cd, In, Cs, La, Ce, Pr, Nd, Sm, Eu, Gd, Tb, Dy, Ho, Er, Tm, Yb, Lu, Hg, Tl, Pb, Bi, Th and U in tissues and organs of white-tailed sea eagle collected dead in Poland has revealed that the metal of risk is lead, and to a somewhat degree also mercury. An intoxication of white-tailed sea eagles with lead is due to ingestion of lead pellets from the waterfowl injured or killed by the hunters, which than become recaptured by the birds. In the case of mercury a source of elevated concentrations of that element in tissues and organs of some white-tailed sea eagles examined is their food (waterfowl and fish) originating from a coast of the Baltic Sea and the Firth of Szczecin.

[Clinical results of acute closing aortic dissection]

The therapeutic outcomes of 43 patients with acute closing aortic dissection treated during the past 10 years were evaluated. The patients consisted of 30 men and 13 women with a mean age of 65 +/- 9 years. Ten were classified as Stanford type A, and the remaining 33 as type B. During follow-up (6 to 120 months; average 55 months), recanalization and an enlarged ulcer-like projection (ULP) were observed in 5 and 2 type a patients. Although recanalization was not observed in type B patients, enlarged ULP was observed in 10 of them, in 6 of whom developed aneurysm. During the follow-up period, ULP was observed at 30 sites in 26 patients. Monitoring the change in ULP over time showed that the ascending and the proximal descending aorta frequently tended to be enlarged and progressed to aorta frequently tended to be enlarged and progressed to aneurysm. Surgery was performed in 3 patients with recanalization, 5 with enlarged ULP, and 3 with atheroscloerotic aortic aneurysm. Although one patient died of cerebral complications, the other 10 patients showed favorable postsurgical courses. Among 8 patients who died, the actuarial survival rate was favorable, being 96, 91 and 83% at 1, 3 and 5 years. However, the survival rate free from complications related to aortic dissection, defined as rupture, ercanalization, enlarged ULP and aneurysmal change, was 78, 58 and 54% at 1, 3 and 5 years, indicating that aortic dissection-related complications are likely to develop within 3 years. This being the case, conservative therapy may be selected for closing aortic dissection when there are no serious complications in the acute phase. However, closely following patients with diagnostic imaging techniques is essential as there may be complications such as recanalization or enlarged ULP. Such complications should be surgically treated because they may affect long-term prognosis.

[Prospective controlled study on the usefulness of Carmofur as a postoperative adjuvant chemotherapy for colorectal cancer]

A prospective controlled study, the 7th cooperative study of the Japanese Foundation for Multidisciplinary Treatment, was conducted to evaluate the usefulness of concomitant therapy with MMC + HCFU as a postoperative adjuvant therapy in patients with colorectal cancer who had undergone curative resection for a period of 2 years and 11 months from February, 1986. The Dukes B and C patients with colorectal cancer classified by macroscopic examination who had an intravenous MMC 6 mg/m2 on the day of operation and followed by oral HCFU for 12 months from 2 weeks after operation (Group X) were compared with patients who had operation only (Group Y). Some 978 patients with colon cancer and 713 patients with rectal cancer were enrolled in the study, 85 (5.0%) of whom were not eligible. The 5-year survival rate of Group X in colon cancer was 79.3% and that of Group Y was 76.4%: thus the survival rate of Group X was slightly better than that of Group Y, but no significant difference was found between the two groups. Subset analysis revealed that the survival rate of Group X in advanced cancer of stage III b + IV, according to the General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus in Japan, was 62.4% and that of Group Y was 46.2%. Thus, the survival rate of Group X was significantly better than that of Group Y (logrank test: p = 0.035, generalized Wilcoxon test: p = 0.025). The disease-free survival rate was not significantly different between the groups with colon cancer and rectal cancer. The above results suggest that HCFU is useful for patients with a high risk of recurrence who had advanced colon cancer (stage III b + IV). However, additional prospective studies are required to verify them.

Fully-automated roller bottle handling system for large scale culture of mammalian cells

A fully automatic and continuous cell culture system based on roller bottles is described in this paper. The system includes a culture rack storage station for storing a large number of roller bottles filled with culture medium and inoculated with mammalian cells, mass-handling facility for extracting completed cultures from the roller bottles, and replacing the culture medium. The various component units of the system were controlled either by a general-purpose programmable logic controller or a dedicated controller. The system provided four subsequent operation modes: cell inoculation, medium change, harvesting, and medium change. The operator could easily select and change the appropriate mode from outside of the aseptic area. The development of the system made large-scale production of mammalian cells, and manufacturing and stabilization of high quality products such as erythropoietin possible under total aseptic control, and opened up the door for industrial production of physiologically active substances as pharmaceutical drugs by mammalian cell culture.

Trial of docosahexaenoic acid supplementation on a Japanese patient with a peroxisome biogenesis defect

A female Japanese patient diagnosed with peroxisome biogenesis defect (PBD), who had hypotonia and craniofacial dysmorphism, was given supplementation of docosahexaenoic acid (DHA). Accumulation of very long chain fatty acids was revealed, and a diagnosis of PBD was made at 2 months of age because of the absence of peroxisomes, a defect in peroxisomal beta-oxidation enzymes and a decreased level of DHA in the erythrocytes. Supplementation of DHA was introduced at 3 months of age. For the first several months, psychomotor development was fairly good. The patient could laugh, brush off a blanket and play with toys at 6 months of age. However, neurological regression and convulsions occurred after 7 months of age. After recurrent respiratory infections and disturbance of the circadian rhythm, the patient died of liver failure and disseminated intravascular coagulopathy at 20 months of age. DHA may have a favorable effect on the early development of patients with PBD, but neurological deterioration cannot be prevented. Patients with a milder phenotype would be better candidates for DHA supplementation.

Life-threatening cardiac involvement throughout life in a case of Costello syndrome

Costello syndrome is characterized by poor postnatal growth, mental retardation, curly hair, coarse face, loose skin of the hands and feet, and nasal papillomata. Patients with Costello syndrome have a high incidence of cardiac involvement, such as arrhythmias, hypertrophic cardiomyopathy, or congenital anomalies. The importance of cardiac involvement in Costello syndrome has not been strongly emphasized thus far, although arrhythmia and hypertrophic cardiomyopathy are both serious forms of cardiac involvement. We report the case of a Japanese girl with Costello syndrome, who experienced life-threatening cardiac involvement throughout her life.

Metal accumulation in tissues of seabirds from Chaun, northeast Siberia, Russia

Concentrations of four essential elements (Fe, Mn, Zn, and Cu) and two toxic metals (Cd and Hg) were determined in selected tissues of 11 seabird species collected in Chaun, northeast Siberia. In oldsquaw, arctic tern and herring gull, zinc concentrations were correlated with Cd concentrations. Cadmium concentrations in all the species were highest in kidney and Hg in liver. Cd levels in the liver and kidney of herring gulls were higher than those observed from other breeding areas. Similarly, Hg concentrations were also high in the liver of herring gull. High concentrations of Cd and Hg found in some birds from Chaun might have arisen from exposure on migration.

Trace element accumulation in Baikal seal (Phoca sibirica) from the Lake Baikal

Trace element concentrations (Fe, Mn, Zn, Cu, Pb, Ni, Cd, Co and Hg) were determined in 60 Baikal seals and in fishes collected from Lake Baikal in 1992. Low levels of Hg and Cd were found in Baikal seals in comparison with those of marine mammals and it was due to their low concentrations in dietary fish. These results suggest that pollution by Hg and Cd was low in Lake Baikal and these toxic elements were unlikely to be the causative factors for mass mortality of Baikal seal in 1987-1988. Significant correlation of Hg concentration between hair and internal tissues suggested the use of hair for Hg monitoring in pinnipeds. Among essential elements, higher Fe and lower Cu levels were specifically found in the liver of Baikal seal. The noticeable accumulation of essential elements might be related to the unique and specific environment of Lake Baikal.

Distribution of heavy metals in muscle, liver and kidney of northern fur seal (Callorhinus ursinus) caught off Sanriku, Japan and from the Pribilof Islands, Alaska

The concentrations of iron, manganese, zinc, copper, cadmium, and mercury were determined in muscle, liver and kidney of 67 northern fur seals (Callorhinus ursinus) collected off Sanriku, Japan, and from the Pribilof Islands, Alaska. Almost all the elements except cadmium were highest in liver. Cadmium levels in kidney were higher than those in liver and muscle for all animals analyzed. Concentrations of mercury increased significantly with age in muscle, liver and kidney, as did iron levels in muscle and liver and cadmium levels in muscle, while manganese concentrations decreased with age in muscle and kidney. The kidney also showed decreased copper concentration with age. Cadmium concentrations of the northern fur seals in this study were higher than the other otariids, reflecting a predominantly squid diet. Concentrations of manganese and mercury were found to be higher in the fur seals caught off Sanriku than in animals from the Pribilof Islands, while those of zinc and cadmium were found to be lower. Variable concentrations of cadmium might have been attributed to those in seawaters. Discriminant analysis of heavy metal concentrations was used to identify habitat. Sixty-three of 67 animals (94%) were correctly classified using this technique. Heavy-metal concentrations in tissues may provide a useful method to elucidate the primary feeding grounds of fur seals.

Enhanced chemiluminescence of lucigenin with epinephrine in cationic surfactant micelles containing periodate

Epinephrine (EP) species involved in the lucigenin chemiluminescence (CL) were identified in alkaline solution by comparing the time course of the CL response and the formation of EP oxidation products. EP quinone and adrenolutine (AL) were found to be responsible for the lucigenin-CL reaction. The mechanism of the lucigenin-CL enhancement was investigated using cationic micellar hexadecyltrimethylammonium hydroxide (CTAOH), periodate, and a mixture of micellar CTAOH and periodate. The CL enhancement in the presence of micellar CTAOH and periodate could be explained in terms of increases in the oxidation rate of EP to EP quinone and the intramolecular oxidation rate of adrenochrome to AL.

Characterization of peroxidases in luminol chemiluminescence coupled with copper-catalysed oxidation of cysteamine

Hydrogen peroxide formed during the course of the copper(II)-catalysed oxidation of cysteamine with oxygen was continuously determined by a peroxidase (POD)-catalysed luminol chemiluminescence (CL) method. Horseradish peroxidase (HRP), lactoperoxidase (LPO) and Arthromyces ramosus peroxidase (ARP) were used as a CL catalyst. The respective PODs gave specific CL intensity-time profiles. HRP caused a CL delay, and ARP gave a time-response curve which followed the production rate of H2O2. LPO gave only a weak CL flash which decayed promptly. These differences of CL response curves could be explained in terms of the different reactivities of PODs for superoxide anion and the different formation rate of luminol radicals in the peroxidation of luminol catalysed by POD.

Heavy metal concentrations in sediments from Manila Bay, Philippines and inflowing rivers

Concentrations of Fe, Mn, Zn, Cu, Pb, Ni, Cd and Co were determined in surface and core sediments collected from Manila Bay and in surface sediments from inflowing rivers. Core profiles revealed highly fluctuating and enriched Pb, Cd, Zn and Cu concentrations on the surface, suggestive of recent inputs coming from anthropogenic sources. Concentrations of Pb, Zn, and to a lesser extent Cu and Cd were higher in riverine sediments as compared with marine sediments, which may be attributed to the proximity of these riverine sites to pollutant sources. Comparison of metal concentration levels obtained with other areas in the world revealed elevated values for Pb and Cd, indicating a considerable amount of pollution in the area. Continuous monitoring and further studies of the area are recommended to ascertain long-term effects that may have not yet been reached.

Rare earth elements (REEs) in naturally grown plants in relation to their variation in soils

The concentrations of rare earth elements (REEs) in plant leaves, soils in which they grow, and mother rocks were determined using Inductively Coupled Plasma-Atomic Emission Spectrometry (ICP-AES). Concentration levels of REEs in most plants were low. However, one of the herb species, pokeweed (Phytolacca americana) and two species of ferns (Dicranopteris dichotoma and Athyrium yokoscence) revealed relatively high concentrations of REEs. In the case of pokeweed, the REE distribution pattern reflected well that of its soils. On the whole, high concentrations of REEs in plants were related to REE concentrations in the soils in which they grow. These observations are promising to evaluate the possible contamination of environment by REEs resulting from their increased usage in modern industry.

A case of the Rett syndrome with acute encephalopathy induced during calcium hopantenate treatment

We report a girl with the Rett syndrome who had acute encephalopathy probably induced by calcium hopantenate (HOPA). This 4-year-6-month-old girl had a history of moderate developmental delay and had received HOPA administration when first admitted at 2 years 6 months of age with hypoglycemia, hyperammonemia, lactic and pyruvic acidemia, and non-ketotic dicarboxylic aciduria. After this episode, she showed the rapid destructive stage of the Rett syndrome, i.e., severe psychomotor retardation with loss of speech, peculiar stereotypic hand movements, autistic behavior and seizures. Despite subsequent investigations, including analysis of urinary metabolites of organic and amino acids, measurement of serum carnitine and a muscle biopsy, we could not clarify the primary metabolic abnormalities in this girl.

[Cooperative study on surgical adjuvant immunochemotherapy for prevention of postoperative recurrence of gastric cancer (II). Cooperative study group on surgical adjuvant immunochemotherapy for prevention of postoperative recurrence of gastric cancer supported by the Ministry of Health and Welfare (Kondo's group])

A cooperative study on surgical adjuvant immunochemotherapy for prevention of postoperative recurrence of gastric cancer was carried out by Kondo's group from July 1974 to December 1977. A total of 848 patients with gastric cancer underwent curative resection were eligible. Of 848 patients, 819 cases with complete description of patient's background were evaluable: Group A (surgery + MMC + 5-FU:chemotherapy) 253 cases, group B (surgery + MMC + 5-FU + OK-432 or PSK:immunochemotherapy) 282 and group C (surgery alone) 284. The 5-year corrected survival rates of total cases using Cox's proportional hazard model were 76.2% with group A, 73.6% with group B and 73.3% with group C. And the 10-year survival rates were 67.6% with group A, 64.3% with group B and 63.9% with group C. The difference in survival rate among groups A, B and C was not statistically significant. In the evaluation of prognostic factors by Cox's proportional hazard model, level of curative resection, extent of resection, histological stage and Kajitani's classification had an influence upon survival rates, in which degrees of metastasis in lymph node and serous infiltration were also involved. The significance of postoperative adjuvant immunochemotherapy has not been clarified.

[Clinical evaluation of cefdinir in pediatric field]

We studied the clinical efficacy of cefdinir (CFDN), a new oral cephalosporin, in 18 children with ages 2 years and 4 months to 11 years and 4 months with pediatric infections. The diagnoses consisted of respiratory tract infections in 15 cases, impetigo in 2 and balanoposthitis in 1. Clinical efficacies were excellent in 11 patients and good in 7, with an efficacy rate of 100%. Bacteriologically, 9 (64.3%) of the 14 strains of clinical isolates were eradicated. No side effects nor abnormal laboratory findings were observed. We have concluded that CFDN is a useful antibiotic for the treatment of mild to moderate pediatric infections.

[Evaluation of norfloxacin in the pediatric field. Pediatric Study Group for Norfloxacin]

Norfloxacin (NFLX, AM-715), a new quinolone antibiotic agent, was evaluated clinically and bacteriologically for its efficacy and safety in pediatrics by a study group organized with pediatricians from all over the country. A summary of the results of the evaluation is as follows. 1. Incidence of NFLX-resistant strains (MIC over 12.5 micrograms/ml) isolated from children with various infections was 1.6% (8/512). One resistant strain was observed among 45 isolates of Staphylococcus aureus, and none among 30 isolates of Pseudomonas aeruginosa. 2. After single oral administration of 1.5-2.9, 3.0-4.8 and 5.1-6.1 mg/kg NFLX in tablet form at fasting, mean peak values of serum concentration of 0.37, 0.56, 0.92 micrograms/ml, T1/2 of 2.5, 2.6, 2.6 hours and urinary recovery rates in 8 hours at 25.3, 25.3, 27.1% were observed, respectively. 3. Clinical effects were studied chiefly in intestinal and urinary tract infections. Among 317 patients from whom pathogens had been isolated, responses to the treatment were excellent in 187, good in 79, fair in 9, poor in 7, and unknown in 35 cases. The overall efficacy rate was 94.3% (266/282) and the efficacy rate for excellent responses was 70.3% (187/266). Among all the 406 patients treated, including those with undetermined pathogens, responses were excellent in 233, good in 106, fair in 11, poor in 11, and unknown in 45 cases. The overall efficacy rate was 93.9% (339/361). 4. Clinical effects of NFLX classified by diseases with identified pathogens were 81.8% (9/11) for acute pneumonia, 80.8% (21/26) for other respiratory infections, 95.8% (23/24) for bacillary dysentery, 98.6% (70/71) for Campylobacter enteritis, 100% (24/24) for Salmonella enteritis, 100% (6/6) for other acute enteritis and 98.1% (104/106) for urinary tract infections. Including other infections as high as 94.3% (266/282) of efficacy rate was obtained in total. There was no significant difference in NFLX efficacies between unidentified and identified pathogens. Thus, the total clinical efficacy rate was 93.9% (339/361). 5. The total eradication rate of 325 pathogens evaluable was 84.3%, with identical eradication rates for Gram-positive cocci (GPC) (43/51) and for Gram-negative rods (GNR) (231/274). 6. The optimal daily dose of NFLX seemed to be in a range between 6.0 and 12.0 mg/kg, and the optimal duration of treatment to be 7 days for children over 5 years old. 7. The clinical efficacy in treating P. aeruginosa infections in 12 patients was 100% (11/11) and the eradication rate was 83.3% (10/12).(ABSTRACT TRUNCATED AT 400 WORDS)

[Clinical studies of cefteram pivoxil in pediatric infection]

The usefulness of a new cephem antibiotic, cefteram pivoxil (CFTM-PI, T-2588), was evaluated in the field of pediatrics. 1. Thirty-one patients were enrolled in the study. They included 20 boys and 11 girls with ages 8 months to 8 years 7 months. 2. The patients were treated with CFTM-PI at a dose levels ranging 3.0-4.2 mg/kg in 3 divided portions. The administration was done orally for a duration between 3 and 13 days, with a total dose between 27.3 and 130.0 mg/kg. 3. The patients were diagnostically classified into the following categories: 11 with acute pharyngitis, 1 with acute nasopharyngitis, 6 with acute tonsillitis, 9 with acute bronchitis, 2 with scarlet fever, 1 with purulent parotitis and 1 with purulent cervical lymphadenitis. 4. Clinical responses to the treatment were excellent in 14, good in 13, fair in 1 and poor in 3 patients with an overall efficacy rate of 87.1%. 5. Bacteriological responses were as follows: of 29 bacterial strains presumed to be pathogens, 23 were eradicated, 2 unchanged and 4 unknown, with an eradication rate of 92.0%. 6. Neither adverse reactions nor abnormal changes in laboratory test values were observed with the medication in any patients during and after the end of the treatment. None of the patients refused the medication. CFTM-PI was found very effective and safe in treating pediatric infections: it is a useful drug in the field of pediatrics.

[An effect of adjuvant immunochemotherapy using krestin and 5-FU on gastric cancer patients with radical surgery (first report)--a randomized controlled trial by the cooperative study group. Study Group of Immuno-chemotherapy with PSK for Gastric Cancer]

To evaluate the efficacy of PSK for adjuvant immuno-chemotherapy in patients who had undergone radical gastrectomy, a randomized controlled trial has been in progress in collaboration with 46 institutions in the Chubu district of Japan. A total of 262 patients were registered for this trial during the two years from July 1985 to June 1987 with a centralized registration system, and were allocated into the 5-FU+PSK group (Group P) and 5-FU alone group (Group C) by the minimization method following the random permuted blocks method. Between the two groups, the parameters of sex, age, serosal invasion (S), lymph-node metastasis (N), and the combination of S . N factor levels were distributed without significant differences. An induction treatment with MMC 6 mg/m2 was given to all patients following curative gastrectomy and on the 7th post-operative day. Two weeks after surgery, Group P received alternately PSK 3 g/day for 4 week and 5-FU 150 mg/day for 4 weeks as one course, and 10 courses were given. Group C received 5-FU alone for 4 weeks using alternate rest interval for 4 weeks. Since both experimental and clinical studies suggested that alternate treatments using PSK and anticancer agents were effective, treatment in this trial alternated PSK and 5-FU. A final follow-up study will be completed in June 1992, when all patients shall have survived more than 5 years after surgery. The administration of 5-FU was completed by January. 1989, but PSK has been administered to group P. The period from 18 to 42 months after surgery was reached in all eligible patients (253) at the end of December 1988. The disease-free survival curves and overall survival curves of group P were significantly (p = 0.018 and p = 0.045,) better than those of group C.

[Study of efficacy, safety and dosage on cefpodoxime proxetil in pediatric infections]

Cefpodoxime proxetil (CS-807, CPDX-PR), a new cephalosporin antibiotic, was investigated for its usefulness in pediatrics. 1. The total number of patients treated were 21 with their ages ranging from 3 months to 9 years and 1 month, consisting of 5 male and 16 female infants. 2. Single dosages of the drug ranged between 4.4 mg and 5.8 mg/kg with oral administration for 3 times daily in fasting. A total aggregated dosage was between 46.4 mg/kg and 200.0 mg/kg. The length of administration was 3 to 12 days. 3. The breakdown of symptoms were 9 cases of acute pharyngitis, 5 cases of acute tonsillitis, 3 cases of acute bronchitis, and 1 case each of impetigo + purulent rhinitis, cervical lymphadenitis, scarlet fever, and urinary tract infection. 4. The clinical efficacy rate was 100% with 18 excellent responses and 3 good responses. 5. The bacteriological efficacy rate was 90.9% in eradication rate, based on results on 17 strains of suspected causative microorganism among which 10 strains were eradicated, 1 strain was decreased, and 6 strains were unknown. 6. There was no side effect during the treatment and after the discontinuation, while, in clinical laboratory tests, GOT and GPT were elevated in 1 case which was judged as abnormal. No patient refused the drug. CPDX-PR was considered to be very useful drug because of its excellent efficacy and safety in pediatrics in treating infectious diseases.

[Assessment of chemosensitivity tests of human tumor cells]

It is clear that if we could predict a sensitive drug against an individual tumor the therapeutic effect would be much improved. For this purpose, many kinds of chemosensitivity test have been devised and investigated. The five kinds of test used currently are based on the measurement of enzyme activities (enzyme assay), measurement of inhibition of radioactive precursors incorporation, and measurement of clonogenic cells in a tumor cell population. In vivo assay systems are xenografts of human tumor in nude mouse and the subrenal capsule of the mouse (SRC assay). In vivo and in vitro correlations reported by several authors are summarized in which positive predictivity rate revealed around 50% and negative 90%. Among five kinds of chemosensitivity test enzyme assay and SRC assay are recommended for clinical use.

[A new chemosensitivity test for cancer cells by measuring intracellular ATP content]

Several in vitro chemosensitivity tests have been developed to select effective anticancer agents for individual cases. However, none of them is used routinely because of the low evaluability or the time consuming nature. We developed a new practical method which is simple, rapid, and applicable to fresh human tumors. The principle of the method is to measure the ATP content of cancer cells by bioluminescence after drug exposure. A linear relationship was observed between either the number of cells or their viability and light intensity. Four established human stomach cancer cell lines and five colon cancer cell lines were examined for their chemosensitivity with a test plate having 96 wells. A clear dose-dependent response was seen with almost all drugs tested in this study, and each cell line showed an identical response to drugs. For the clinical application, cancer cells taken from three human solid tumors were tested. In all cases, the chemosensitivity was clearly evaluable. This simple, rapid and sensitive method can be a good indicator for the determination of anticancer agents in cancer chemotherapy.

[A randomized controlled trial comparing short-term MF chemotherapy with MF plus long-term HCFU chemotherapy as an adjuvant to a curative resection of stomach cancer: Mifurol Study Group for Stomach Cancer]

In order to clarify the clinical response of long-term adjuvant chemotherapy using Carmofur (HCFU), a comparative multicenter trial has been performed by a randomized controlled method. Curative resected patients suffering from stomach cancer were randomly allocated into two arms. Arm A consisted of short-term MF chemotherapy (mitomycin C 0.04 mg/kg plus 5-fluorouracil 5.0 mg/kg x 6 bolus i.v.) and arm B consisted of arm A plus long-term HCFU chemotherapy (HCFU 6-12 mg/kg/day over 12 weeks, p.o.). The difference of overall survival probability between the two studied arms significantly supported arm B therapy (generalized Wilcoxon test: p = 0.0405) up to 5 years after surgery. The difference of the survival curves was clearer in the case of patients with cancers in the advanced stage, such as a positive serosal inversion and a lymph node metastases [ps(+).n(+)]. The side effects of HCFU, most patients experiencing subjective symptoms such as gastrointestinal toxicities, polyuria, and hot sensation, were reversible. Our results suggest that HCFU maintenance therapy has effect on preventing the postsurgical recurrences of stomach cancer and elongating the patient's survival.

Characteristics of three human gastric cancer cell lines, NU-GC-2, NU-GC-3 and NU-GC-4

Three human gastric cancer cell lines, NU-GC-2, NU-GC-3 and NU-GC-4 were established in vitro from the cancer tissues obtained from 3 patients during surgery. The pathological findings of the gastric tumors of these cases revealed poorly differentiated adenocarcinoma (and partial signet-ring cell carcinoma in the case of NU-GC-4). NU-GC-2 and NU-GC-4 were originally obtained from metastatic paragastric lymph nodes and NU-GC-3 was obtained from a metastatic tumor in the brachial muscle. The cells of NU-GC-2 and NU-GC-3 are polygonal in shape and grow as a monolayer sheet. NU-GC-4 cells, however, are mainly spherical in shape with a few free floating cells. Electron microscopy revealed epithelial characteristics in all 3 cell lines. The average doubling time of NU-GC-2 was 36.1 hours, that of NU-GC-3 was 38.2 hours and that of NU-GC-4 was 29.9 hours. The modal chromosome number of NU-GC-2 was 62, that of NU-GC-3 was 58 and those of NU-GC-4 grown in in vitro and in vivo were 52-54 and 53, respectively. In vitro and in vivo lines of NU-GC-4 were established from the same tumor. These two cell lines are quite similar in morphology, but slightly different in karyotype. The in vitro sensitivity to anticancer agents was highest in NU-GC-4 and lowest in NU-GC-2. Of the anticancer agents, mitomycin C and adriamycin were most effective on the cells of all 3 cell lines.

[Studies on efficacy, safety and dosage of rokitamycin in the treatment of pediatric infections]

The usefulness of a new macrolide antibiotic rokitamycin (RKM, TMS-19-Q) was evaluated in the field of pediatrics. 1. Twenty seven patients were enrolled in the study. One patient was excluded from the study because the illness was due to a viral infection. They included 14 boys and 13 girls with ages 7 months to 9 years 11 months. 2. The patients were treated with RKM at daily doses ranging 19.2-41.1 mg/kg, divided into 3 equal portions. The administration was done orally at fasting, lasting 2-15 days, with total doses of 22.2-500.0 mg/kg. 3. The patients were diagnostically classified into the following categories: 9 with acute pharyngitis, 15 with acute bronchitis, and one each with pneumonia, purulent lymphadenitis and Campylobacter enteritis. 4. The clinical response to the treatment was good or excellent in 22 of the patients with an overall efficacy rate of 81.5%. An efficacy rate of 88.9% was achieved for the patients with acute pharyngitis, 80.0% for those with acute bronchitis, and 100% for the patient with purulent lymphadenitis and the patient with Campylobacter enteritis. From the patient with pneumonia whose response was evaluated "fair" was Haemophilus influenzae isolated by culturing pharyngeal material. This organism was found resistant to RKM by the disk method. 5. Bacteriological responses were as follows; of 26 isolates presumed to be pathogens, 9 were eradicated, 5 decreased, 7 unchanged and 5 unknown, with an eradication rate of 42.9%. 6. Neither adverse reactions nor abnormal changes in laboratory findings were observed with the medication in any patients during and after the end of the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

[The minimization method in a medium size clinical trial. Study of immunochemotherapy with PSK in gastric cancer]

One of the objectives of randomization is to balance the number of patients in each level and combination of levels of prognostic factors. However, as the number of possible prognostic factors increases, some imbalance may occur and make the results of the analysis less interpretable. In order to balance the marginal distribution of each factor and to facilitate more interpretable trial results, the "minimization method" reported by Pocock was applied in our multi-center immunochemotherapy clinical trial. Balancing in every institution was achieved by using Zelen's prespecified value d = 3 for replacing provisional assignment in the individual institution. Nonmetric principal component analysis in S, N factors which were used in minimization process showed good equilibration between groups. Also, in uncontrolled background factors, such as cancer pathology or Borrmann types, acceptable balance was obtained spontaneously at the end of the trial.

[Prospective adjuvant chemotherapy of mitomycin C plus HCFU for colorectal cancer (2d report)--6-year survival after surgery: Tokai Cooperative Study Group of Surgical Adjuvant Chemotherapy]

A prospective randomized controlled trial of adjuvant chemotherapy for colorectal cancer was performed in forty-one institutions in Tokai district. In this study, effect of postoperative administration of mitomycin C (MMC) and followed by HCFU for more than 3 months (group B) was on the survival time compared with MMC alone (group A). Of 173 patients subjected to curative resection (group A = 80, group B = 93) for colorectal cancer, 148 patients including 69 cases of group A and 79 cases of group B were eligible for survival study. At six years after surgery, Kaplan-Meire's life table showed that the survival of group B was superior to that of group A (generalized Wilcoxon test: p = 0.0446). The difference of survival curves was more distinct (generalized Wilcoxon test: p = 0.0226) for patients of advanced stage those to have lymph node metastasis time and serosal inversion.

A stomach oncofetal antigen recognized by monoclonal antibody GC302

A monoclonal antibody, GC302, was established by fusing murine myeloma NS/1 cells with the splenocytes of a BALB/c mouse immunized with a human gastric cancer cell line, NU-GC-3. The serological specificity of GC302 was analyzed by an anti-mouse Ig mixed-hemadsorption (MHA) test on a panel of human cell lines, and an immunoperoxidase method using the frozen sections of tumors and normal tissues of adult and fetus. GC302 reacted with cancers of the stomach and colorectum but did not react with hepatocellular carcinomas, melanomas, or astrocytomas in the MHA tests. By the immunoperoxidase method, GC302 was found not to react with normal adult gastric mucosa, but to react with the mucosa in the fetal stomach, intestinal metaplasia, and almost all of the cancer of the stomach. GC302 also reacted with the normal mucosa of the intestine, colon, and rectum as well as with cancers of these origins. In normal liver sections, the antibody reacted with the bile ducts, but not with the hepatic cells. These results indicate that the antigen detected by GC302 is characterized as an oncofetal antigen in the stomach, and also as a differentiation antigen whose localization discriminates between the gastrointestinal tracts of the forgut origin and those of the midgut and hindgut origin. The molecular weight of the GC302 antigen was estimated to be ca. 40,000 by the Western blot analysis. Periodic acid treatment on the antigen suggested that the antigenic determinant is a carbohydrate.

[Clinical results of a randomized controlled trial on the effect of adjuvant immunochemotherapy using Esquinon and Krestin in patients with curatively resected gastric cancer--7-year survival--Cooperative Study Group for Cancer Immunochemotherapy, Tokai Gastrointestinal Oncology Group]

A randomized controlled study was carried out on curatively resected gastric cancer patients in a cooperative study involving 16 institutions in order to evaluate the effect of an alternative long-term adjuvant immunochemotherapy using Esquinon (CQ) and Krestin (PSK). One week after surgery, CQ was given at a dose of 2mg/m2 once a week for 3 weeks and this was repeated every 6 weeks. CQ was administered intravenously in the 1st course and thereafter orally up to 9 courses. Three postoperative week, immunotherapy was then started in which PSK was given orally in 3 divided doses of 2g/m2/day from the day when CQ therapy ended for 4 consecutive weeks, and this performed for every course. Estimated survival rate and cumulative survival curves were compared utilizing the data up to 7 years after surgery in the chemotherapy group given CQ alone and in the immunochemotherapy group given CQ + PSK. The survival curve in all cases showed a favorable form in the CQ + PSK group for up to 36 months, and thereafter it crossed with that of the CQ group for up to 68 months. Both curves twisted at 68 months and then deviated from each other, showing that the effect in the CQ + PSK group beneficial. The curve showed a twisting configuration throughout the treatment period. There was no statistically significant difference between the survival curves of the two groups. Retrospective survival analysis was then performed on separate subgroups classified into the category of S1, S2, N1, and N2. The CQ + PSK group was better than the CQ alone group in its survival rate for the S1 + S2 (N1-2) group, the percentage being 11.5%, and a statistically significant difference was observed between the two groups (p = 0.089).

Phase I study of recombinant human tumor necrosis factor

A phase I clinical and pharmacokinetic study of recombinant human tumor necrosis factor (rH-TNF) was conducted in a single dose schedule in 33 patients with advanced cancer. rH-TNF was given by i.v. infusion over 30 min with a starting dose of 1 x 10(5) units/m2. The dose was escalated up to 16 x 10(5) units/m2 according to the modified Fibonacci scheme. Toxic effects were similar but not identical to those reported with interferons and interleukin-2, and included fever, rigors, nausea and vomiting and anorexia in a non-dose-dependent manner, and hypotension, leukocytosis, thrombocytopenia and transient elevation of transaminases (SGOT and SGPT) in an approximately dose-dependent manner. DIC syndrome was observed in one patient who had received 16 x 10(5) units/m2. The dose-limiting toxicities were hypotension, thrombocytopenia and hepatotoxicity, and the maximum tolerated dose in a single i.v. infusion of rH-TNF appeared to be 12 x 10(5) units/m2 when thrombocytopenia and elevation of SGOT and SGPT were taken as the dose-limiting toxicities. However, if hypotension was included, the maximum safely tolerated dose appeared to be 5 x 10(5) units/m2.

Radioimmunoscintigraphy of human gastric carcinoma xenografts with 125I-labeled monoclonal antibody

A monoclonal antibody (GC 302) established in our laboratory, which was reactive with gastric carcinoma and other epithelial carcinoma but not with normal gastric mucosa or other malignant tumors of mesenchymal origin, was used to investigate the radioimmunolocalization of tumors. Various kinds of target cells (5 X 10(5)) were incubated with 125I-labeled GC 302, and radioactivity was determined with a gamma counter. It was shown that there was a 500- to 1,000-fold increase in counts for gastric carcinoma (NUGC-2, NUGC-4, MKN-28 and MKN-45) as compared to those of normal lymphocytes and about 100-fold increase as compared to melanoma or leukemia. These findings were consistent with those obtained from the study of immunohistochemistry using GC 302. An in vitro assay was also carried out using nude mice bearing gastric cancer and inoculated with 125I-labeled GC 302. There was a 2- to 3-fold increase in radioactivity in the tumor and a 4- to 5-fold increase as compared with the visceral organs. Although the tumor:blood ratio was relatively low, radioimmunoscintigraphy could be done successfully with the aid of computed radiography. We thus conclude that further testing of GC 302 is worthwhile to establish whether or not it is useful for radioimmunoscintigraphy of metastatic lesions of gastric cancer for possible clinical application.

A simple and rapid in vitro test for determining sensitivity of cancer cells to anticancer drugs

For practical utilization of chemosensitivity tests of malignant cells to anticancer drugs in clinical studies, we developed a new method which is simple, rapid, and applicable to fresh human tumors. The principle of the method is to measure the content of ATP of living cells by chemoluminescence, after drug exposure. A straight linear relationship was observed between the number of viable cells and the light intensity. This method seems to be a good indicator for the selection of anticancer drugs in cancer chemotherapy.

[Clinical evaluation of imipenem/cilastatin sodium in the pediatric field]

Imipenem/cilastatin sodium (MK-0787/MK-0791) was evaluated for its safety and efficacy in 7 pediatric patients with infections. The clinical efficacy ratio was 100 percent. No side effect was observed except for elevations of S-GOT and S-GPT and eosinophilia in 1 patient. It may be considered that MK-0787/MK-0791 is a safe and useful antibiotic for the treatment of pediatric infections.

Correlation of an in vitro chemosensitivity test using [3H] incorporation with the response in case of human tumor chemotherapy

We developed a method for performing in vitro drug testing using [3H] incorporation into a primary human tumor. The test was applied to specimens from 60 patients with advanced malignancies, mainly gastrointestinal cancers. Forty-six specimens had sufficient growth for the drug testing. Forty-seven per cent of the gastric cancer specimens and 67 per cent of those from patients with colorectal cancer demonstrated an in vitro chemosensitivity. Among 9 chemotherapeutic drugs tested, ara-C, 5-fluorouracil, and mitomycin C showed the high percentages of positive sensitivity for gastric cancer, whereas actinomycin D, carboquone, and nimustine hydrochloride were sensitive in case of colorectal cancer. Clinical responses were compared with the results of the test. In 46 drug assays, in vitro/in vivo drug responses correlated in 78 per cent, with a true-positive rate of 47 per cent and a true-negative rate of 94 per cent. This test appears to be a reliable indicator for the clinical response to the same chemotherapeutic drugs in cases of the malignant diseases seen clinically.

[Clinical application of chemosensitivity testing using radioactive precursors]

In vitro drug testing using (3H) incorporation was utilized for specimens from 60 patients with advanced malignancies, mainly gastrointestinal cancers. Forty-six specimens had sufficient growth for drug testing. Forty-seven percent of stomach cancer specimens and 67% of colorectal cancer specimens demonstrated in vitro chemosensitivity. Among 9 chemotherapeutic agents tested, ara-C, 5-fluorouracil, and mitomycin C had higher percentages of positive sensitivity for stomach cancer, whereas actinomycin D, carboquone, and ACNU had a more pronounced effect on colorectal cancer. A comparison was made between the results of chemosensitivity tests and clinical response. In 46 drug assays, in vitro/in vivo drug responses were correlated in 78% with a true-positive predictive rate of 47% and a true-negative rate of 94%. This test appears to be a reliable indicator for clinical response to the same chemotherapeutic agents in human malignant disease.