Volume change after maxillary sinus floor elevation with apatite carbonate and octacalcium phosphate

PURPOSE

Maxillary molars have low alveolar bone height diameter due to the presence of the maxillary sinus; thus, a sinus lift may be required in some cases. Changes in the volume of bone substitutes can affect the success of implant therapy. Therefore, this study aimed to compare the changes in the volume of two different bone substitutes-one based on carbonate apatite and the other on octacalcium phosphate-used in maxillary sinus floor elevation.

METHODS

Nineteen patients and 20 sites requiring maxillary sinus floor elevation were included in the study. Digital Imaging and Communications in Medicine data for each patient obtained preoperatively and immediately and 6 months postoperatively were used to measure the volume of the bone grafting material using a three-dimensional image analysis software. The immediate postoperative volume of octacalcium phosphate was 95.3775 mm3 per piece of grafting material used. It was multiplied by the number of pieces used and converted to mL to determine the immediate postoperative volume.

RESULTS

The mean resorption values of carbonate apatite and octacalcium phosphate were 12.7 ± 3.6% and 17.3 ± 3.9%, respectively. A significant difference in the amount of resorption of the two bone replacement materials was observed (P = 0.04).

CONCLUSIONS

The results of this study indicate that both bone substitute materials tend to resorb. The two bone grafting materials that are currently medically approved in Japan have not been in the market for a long time, and their long-term prognosis has not yet been reported. Further clinical data are warranted.

Comparative Verification of the Accuracy of Implant Models Made of PLA, Resin, and Silicone

Polylactic acid (PLA) has gained considerable attention as an alternative to petroleum-based materials due to environmental concerns. We fabricated implant models with fused filament fabrication (FFF) 3D printers using PLA, and the accuracies of these PLA models were compared with those of plaster models made from silicone impressions and resin models made with digital light processing (DLP). A base model was obtained from an impact-training model. The scan body was mounted on the plaster, resin, and PLA models obtained from the base model, and the obtained information was converted to stereolithography (STL) data by the 3D scanner. The base model was then used as a reference, and its data were superimposed onto the STL data of each model using Geomagic control. The horizontal and vertical accuracies of PLA models, as calculated using the Tukey-Kramer method, were 97.2 ± 48.4 and 115.5 ± 15.1 μm, respectively, which suggests that the PLA model is the least accurate among the three models. In both cases, significant differences were found between PLA and gypsum and between the PLA and resin models. However, considering that the misfit of screw-retained implant frames should be ≤150 µm, PLA can be effectively used for fabricating implant models.

Fit accuracy of resin crown on a dental model fabricated using fused deposition modeling 3D printing and a polylactic acid filament

Purpose We considered the possibility of reducing industrial waste by fabricating and reusing dental models prepared using a fused deposition modeling (FDM) 3D printer and polylactic acid (PLA) filaments. The purpose of this study was to verify the accuracy of models fabricated using FDM and PLA.Methods The same provisional crown was used to check the marginal fit on PLA models prepared using an intraoral scanner (IOS) and FDM, plaster models made with silicone impression material and plaster, and resin models prepared using an IOS and stereolithography apparatus (SLA) 3D printer. The marginal fit was measured using micro-computed tomography at four points on the tooth: the buccal center (B), palatal center (P), mesial center (M), and distal center (D) points.Results At point B, the marginal gaps were 118 ± 21.7, 62 ± 16.4, and 50 ± 26.5 μm for the PLA, resin, and plaster models, respectively, with a significant difference between the PLA model and the other two. However, the marginal gap at all other measurement points was not significantly different between the models (P > 0.05).Conclusions We compared the accuracy of the models fabricated using the FDM, SLA, and conventional methods. The combination of FDM and PLA filaments showed no significant differences from the other models, except at point B, indicating its usefulness. Therefore, FDM and PLA may become necessary materials for dental treatment in the future.

Validation of an implant stability measurement device using the percussion response: a clinical research study

Background

Several devices have been developed to measure implant-bone stability as an indicator of successful implant treatment; these include Osstell®, which measures the implant stability quotient (ISQ), and the more recent AnyCheck®, which relies on percussion for the implant stability test (IST). These devices make it possible to measure implant stability. However, no studies have compared the performance of AnyCheck® and Osstell® (i.e., IST and ISQ values) in clinical practice. Therefore, this study aimed to determine the correlation between primary and secondary implant stability using the Osstell® and AnyCheck® devices.

Methods

Ten patients (7 women; age [mean ± standard deviation]: 49.1 ± 13.3 years) with partially edentulous jaws who received a total of 15 implants were included. IST (AnyCheck®) and ISQ (Osstell®) values were measured immediately after implantation and at 1, 2, 3, 4, and 6 weeks post-implantation. Each measurement was performed three times, and the average value was used as the result. The correlation between measurements obtained using the two devices was determined using Spearman's rank correlation coefficient.

Results

The IST values ranged from 79.1 ± 2.87 to 82.4 ± 2.65. The ISQ values ranged from 76.0 ± 2.8 to 80.2 ± 2.35. Spearman's rank correlation coefficient was r = 0.64 immediately after implantation, r = 0.29 at 1 week, r = 0.68 at 2 weeks, r = 0.53 at 3 weeks, r = 0.68 at 4 weeks, and r = 0.56 at 6 weeks. A positive correlation was found in all cases, except at week 1 when the correlation was weak; the IST and ISQ values decreased the most during the first postoperative week and increased during the second week. The IST values were also slightly higher at all measurement points.

Conclusion

The ability to assess implant stability without removing the abutment during healing is essential for determining the timing of loading without the risk of bone resorption. The results of this study suggest that AnyCheck® is useful for determining primary and secondary implant stability.

Comparison of digital and silicone impressions for single-tooth implants and two- and three-unit implants for a free-end edentulous saddle

Background

The use of intraoral scanners (IOS) has facilitated the use of digital workflows for the fabrication of implant-supported prostheses not only for single missing teeth, but also for multiple missing teeth. However, the clinical application of IOS and computer-aided design/manufacturing (CAD/CAM) in implant-supported prosthodontics remains unclear. This study aimed to compare the accuracy of digital and silicone impressions for single-tooth implants for bounded edentulous spaces and two-unit and three-unit implant-supported fixed dental prostheses for free-end edentulous spaces.

Methods

This study enrolled 30 patients (n = 10 for each of the three groups) with an average age of 61.9 years. Conventional silicone-based and digital IOS-based impressions were made for all patients, and the implant superstructures were fabricated. We measured the scan-body misfit and compared the accuracy of the impressions for single-unit, two-unit, and three-unit implant prostheses with a bounded edentulous space by superimposing the standard triangulated language (STL) data obtained from IOS over the STL data of the plaster model used for final prosthesis fabrication. The scan bodies of the superimposed single-molar implant, two-unit implant prosthesis without teeth on the mesial side, two-unit implant prosthesis without teeth on the distal side, three-unit implant prosthesis without teeth on the mesial side, and three-unit implant prosthesis without teeth on the distal side were designated as A, B1, B2, C1, and C2, respectively. The misfit for each scan body was calculated and the accuracies were compared using the Tukey–Kramer method.

Results

The average scan-body misfit for conditions A, B1, B2, C1, and C2 was 40.5 ± 18.9, 45.4 ± 13.4, 56.5 ± 9.6, 50.7 ± 14.9, and 80.3 ± 12.4 μm, respectively. Significant differences were observed between the accuracies of A and B2, A and C2, and C1 and C2 (P < 0.001).

Conclusions

IOS and CAD/CAM can find clinical applications for implant-supported prostheses of up to three units for a bounded edentulous saddle. The use of IOS could render implant treatment easier, benefiting both the surgeons and patients. Prosthesis maladjustment may lead to peri-implantitis and prosthetic fracture. Therefore, further validation of the accuracy of IOS impressions is required in patients with multiple missing teeth in long-span implant prostheses.

Accuracy of guided surgery using the silicon impression and digital impression method for the mandibular free end: a comparative study

Background

Implant treatment using guided surgery is becoming widespread in clinical dental practice. Furthermore, the development of digital technology has enabled the use of intraoral scanners (IOSs) to fabricate surgical guide plates. The objective of this study was to compare the accuracy of guided surgery using the silicone impression method with a three-dimensional (3D) scanner and the digital impression method with IOS for one side of the mandibular free end. In addition, we compared the accuracy of tooth-supported vs tooth/mucosa-supported surgical guide plates.

Results

The accuracy of the tooth-supported surgical guide plate using the new IOS method instead of the method of obtaining impressions with conventional silicone resulted in better measurements of 3D deviation at the crest, 3D deviation at the apex, and angular deviation. In terms of the accuracy of the tooth/mucosa-supported surgical guide plate, there were no significant differences in all measurements. The surgical guide plate using an IOS and the tooth/mucosa-supported surgical guide plate may enable more accurate guided surgery.

Conclusion

Tooth/mucosa-supported guided surgery involving preparation with an IOS may result in more accurate implant surgery.

Dental implant care and trouble among dependent patients based on the questionnaire survey among Japanese dental practitioners

Background

Self-care and professional care of implants may prove difficult for elderly people who require nursing care. However, the actual state of care and problems remains unknown. In this study, we investigated the actual state of implant problems in elderly people living in their own home or in a nursing home who received visiting dental treatment.

Methods

We mailed questionnaire survey forms to 2339 representatives or specialists who were members of the Japanese Society of Oral Implantology, the Japanese Society of Gerodontology or the Japan Prosthodontic Society. We narrowed down the respondents to those who provided visiting dental treatment, and analyzed the actual state of implants observed during visiting dental treatment (type, care, problems, countermeasures, etc.).

Results

Of the 924 dentists who responded to the questionnaire survey, 291 (22%) provided visiting dental treatment. While the majority of implant types encountered in the previous 12 months were root-form implants, there were still a certain number of blade and subperiosteal implants. Daily implant care involved mostly cleaning with a toothbrush + auxiliary tools. The most frequent implant problems encountered in the past were difficulty in cleaning and peri-implantitis. Medication and antiphlogistic treatment were most frequently adopted as countermeasures to implant problems, followed by observation. When we classified the results into those for the dentists who provided implant treatment and those for the dentists who did not, we found that many of the dentists who did not provide implant treatment opted for observation or medication, while those who provided implant treatment also implemented removal of superstructure, retightening of screws, repair and so forth.

Conclusions

We found that many of the implant troubles encountered by dentists who provided visiting dental care were difficulty in cleaning or peri-implantitis, and that the actions taken against these troubles varied depending on the experience of the dentist performing the implant treatment. Our study also revealed that dentists who provide visiting dental care need to acquire knowledge and skills of implant treatment, to have actions prepared in case they encounter such cases, or to closely coordinate with dentists who specialize in implants.

A preliminary report on dental implant condition among dependent elderly based on the survey among Japanese dental practitioners

Background

The objective of this study was to ascertain the situation relevant to implants, the status of oral self-care, the status of aftercare provided by the dentist who placed the implant, and the usage status of the implant card, in homebound or institutionalized older adults who are receiving home-visit dental care due to the inability to visit a dental clinic on their own.

Methods

A survey questionnaire was sent by post mail to 2339 people who are representative members or dental specialists belonging to any of the following three academic societies: Japanese Society of Oral Implantology, Japanese Society of Gerodontology, and Japan Prosthodontic Society. The survey questions asked were about provision/no provision of implant treatment, provision/no provision of home-visit dental care, the situation of patients after implant treatment, the situation of implants in the context of home-visit dental care, and the usage status and recognition of the implant card.

Results

No less than 30% of the dentists had patients who were admitted to the hospital or became homebound after receiving implant treatment at their clinic. Twenty-two percent of the dentists had been consulted about the implants. Dentists who continued to provide post-operative implant care through home-visit dental care accounted for approximately 80%. On the other hand, however, 40% of the dentists did not know the post-implantation status of their implant patients. Of the patients receiving home-visit dental care, approximately 3% had implants (identified mainly by visual inspection). It was found that more than 50% of the dentists offering implant treatment did not use the implant card, and even in cases where it was used, most of the cards were not in the standardized format.

Conclusions

Within the limitation of low response rate to the questionnaire in this preliminary study, we concluded that many of practitioners including specialists indicated the need of universal record of implant for dependent elderly cares.

Methods used to assess implant stability: current status

Successful osseointegration is a prerequisite for functional dental implants. Continuous monitoring in an objective and quantitative manner is important to determine the status of implant stability. Historically, the gold standard method used to evaluate degree of osseointegration was microscopic or histologic analysis. However, due to the invasiveness of this method and related ethical issues, various other methods of analysis have been proposed: radiographs, cutting torque resistance, reverse torque, modal analysis, and resonance frequency analysis. This review focuses on the methods currently available for the evaluation of implant stability. (More than 50 references.)

Methods used to assess implant stability: current status

Successful osseointegration is a prerequisite for functional dental implants. Continuous monitoring in an objective and quantitative manner is important to determine the status of implant stability. Historically, the gold standard method used to evaluate degree of osseointegration was microscopic or histologic analysis. However, due to the invasiveness of this method and related ethical issues, various other methods of analysis have been proposed: radiographs, cutting torque resistance, reverse torque, modal analysis, and resonance frequency analysis. This review focuses on the methods currently available for the evaluation of implant stability. (More than 50 references.)

Clinicogenetic study of PINK1 mutations in autosomal recessive early-onset parkinsonism

The authors performed PINK1 mutation analysis of 51 families with autosomal recessive Parkinson disease (ARPD). They found two novel PINK1 mutations: one was a homozygous deletion (13516-18118del) and the other a homozygous missense mutation (C388R). Clinically, the patients with the deletion had dementia. Thus, early-onset PD with dementia may be considered PINK1-linked parkinsonism. Furthermore, patients with PINK1 mutations form 8.9% of parkin- and DJ-1-negative ARPD families.

Acute facial diplegia and hyperreflexia: A Guillain-Barre syndrome variant

Two patients with acute facial diplegia and hyperreflexia are described. Both patients had serologic evidence of preceding Campylobacter jejuni infection and antiganglioside IgG antibodies as well as other laboratory and electrophysiologic findings suggesting Guillain-Barré syndrome (GBS). IV immunoglobulin produced recovery. Hyperreflexia does not necessarily exclude the diagnosis of a GBS variant. Antiganglioside antibodies can help with diagnosis in difficult cases.

Graph-theoretical analysis of tunneling electron transfer in large polycyclic aromatic hydrocarbon networks

Effect of a single nitrogen atom substitution to a number of large polycyclic aromatic hydrocarbon (PAH) molecules was calculated systematically, and it was found that especially in parallelogram-type PAH abnormal electron transfer (called tunneling electron transfer, TET) was observed. That is, fairly large amount of pi-electron is withdrawn to an electronegative nitrogen atom from almost the farthest end of a conjugated aromatic hydrocarbon molecule, leaving almost no change in the interior of the molecule. This change can be simulated by the Kekulé structure counting for subgraphs of the parent molecule.

Mental disturbances during isolation in bone marrow transplant patients with leukemia

The mental status of 39 leukemia patients, who received bone marrow transplants (BMT), was studied during the period of isolation. Mental disorders (diagnosed according to DSM-IV criteria) occurred in 16 patients (41%) during the observation period. The most frequent diagnoses were adjustment disorders, with anxiety and/or depression. Logistic regression analysis suggested higher Tension-Anxiety score in the Profile of Mood States (POMS) prior to isolation (P = 0.011), donation of the bone marrow from unrelated subjects (P = 0.026) and in female patients (P = 0.033). The results are preliminary, but indicate a high frequency of mental disturbances and highlight the importance of psychiatric intervention in BMT patients. Bone Marrow Transplantation (2000) 25, 315-318.

Amount of enterotoxigenic Clostridium perfringens in meat detected by nested PCR

The incidence and quantity of enterotoxigenic Clostridium perfringens in beef, pork, and chicken meat were determined and compared with that of the total enterotoxigenic and nonenterotoxigenic C. perfringens. The method for the detection and quantification of enterotoxigenic C. perfringens consisted of a combination of the most probable number (MPN) method and a nested polymerase chain reaction after culturing of the sample. The results obtained by this method for inoculated meat samples were significantly correlated with those obtained by the plate count method. When the method was applied to the detection and quantification of enterotoxigenic C. perfringens found in randomly selected meat samples, the organism was found in 2% of the beef pieces (< 10(2) MPN/100 g) and 12% of the chicken pieces (< 10(2)-4.3 x 10(2) MPN/100 g) out of the 50 pieces of each meat tested. No enterotoxigenic C. perfringens was found in pork. Total C. perfringens was found in 16% of the beef (< 10(2)-4.3 x 10(2) MPN/100 g), 10% of the pork (< 10(2) MPN/100 g), and 84% of the chicken (< 10(2)-9.3 x 10(3) MPN/100 g) when 50 pieces of each meat was tested by the conventional MPN method. As shown in the above methods, the majority of cells were not enterotoxigenic cells in the population of C. perfringens. A small number of enterotoxigenic cells of C. perfringens co-existed with a large number of nonenterotoxigenic cells in the same meat sample.

Possibilities and limitations of endoscopic resection for early gastric cancer

BACKGROUND AND STUDY AIMS

To date, the accepted criteria for endoscopic resection of early gastric cancer have been: a) elevated-type mucosal cancer less than 2 cm in size, and b) depressed-type mucosal cancer without ulceration less than 1 cm in size. In this study, we attempted to expand these indications.

PATIENTS AND METHODS

Sixty patients with early gastric cancer who did not meet the above criteria underwent endoscopic treatment, and were divided into four groups: those with elevated tumours larger than 2 cm with submucosal invasion (group 1 a); those without submucosal invasion (group 1 b); those with depressed tumours larger than 1 cm (group 2); and those with ulcerated tumours (group 3). The patients were treated with endoscopic resection using a two-channel scope, followed by additional laser irradiation or heater-probe coagulation (combination therapy) if residual cells were found. Follow-up was by endoscopy and biopsy for more than two years.

RESULTS

Endoscopic treatment was effective in 87% of the patients (52 of 60), half of whom required combination therapy. In submucosal cancers, endoscopic treatment was effective in 76% of patients (13 of 17). However, tumours with deep invasion into the submucosa could not be cured. Mucosal cancers larger than 20 mm could be completely resected in 44% of patients (eight of 18) using endoscopic resection, but all five patients with tumours larger than 30 mm had incomplete resections.

CONCLUSIONS

These results indicate that complete resection using endoscopic resection alone is possible in early gastric cancers measuring up to 30 mm in diameter. Tumours larger than 30 mm, and those with deep submucosal invasion, cannot be curatively treated by the current endoscopic modalities.

Anaplastic Ki-1-positive large cell lymphoma of the pancreas: a case report and review of the literature

A case of Ki-1-positive anaplastic large cell lymphoma of the pancreas is presented. The patient complained of abdominal pain and was jaundiced. Examination of a biopsy specimen obtained by duodenal endoscopy revealed malignant lymphoma, and surgery confirmed a large mass located in the region from the intra-pancreatic tissue around the lower common bile duct to the peri-pancreatic lymph nodes. Histologically, this tumor was composed mainly of large and giant neoplastic cells. Immunohistochemically, these cells were diffusely positive for Ki-1 and CD45RO antigens, indicating the features of Ki-1 anaplastic large cell lymphoma with a T-cell phenotype among non-Hodgkin's lymphoma. The histologic types of the majority of malignant lymphomas of the pancreas reported previously were considered to be diffuse-type non-Hodgkin lymphoma (probably with predominance of the B-cell phenotype), except for a single Japanese lymphoma case with a T-cell phenotype. This is therefore the first known case of Ki-1 anaplastic large cell lymphoma of the pancreas.

Most probable number method combined with nested polymerase chain reaction for detection and enumeration of enterotoxigenic Clostridium perfringens in intestinal contents of cattle, pig and chicken

The most probable number (MPN) method combined with a nested polymerase chain reaction (nested PCR) for the detection and enumeration of enterotoxigenic Clostridium perfringens in the intestinal contents of cattle, pig and chicken was examined. Ten-fold serial dilutions of samples were added to three tubes of enrichment medium, which were incubated at 37 degrees C for 20-24 hr, and the C. perfringens enterotoxin gene was detected by nested PCR from the enrichment culture without isolating the organism. The results obtained by this method with artificially contaminated intestinal contents were significantly correlated with those obtained by a plate count method. When the method was applied to the detection and enumeration of indigenous enterotoxigenic C. perfringens, the organism was found in two, two and three samples of 10 intestinal contents of cattle, pig and chicken, respectively. Most of the positive samples contained fewer than 10 MPN/g of enterotoxigenic C. perfringens, except one sample of chicken, which contained 1.5 x 10(2) MPN/g. The MPN method combined with nested PCR is easy to perform and may be a useful tool for the detection and enumeration of enterotoxigenic C. perfringens in intestinal contents.

Modulation of in vivo immune response by selective depletion of neutrophils using a monoclonal antibody, RP-3. I. Inhibition by RP-3 treatment of the priming and effector phases of delayed type hypersensitivity to sheep red blood cells in rats

Recent studies on neutrophils have revealed that these cells produce various cytokines, and may be involved in regulation of the immune response. We examined whether neutrophils are involved in delayed type hypersensitivity (DTH) to SRBC in rats by selective depletion of in vivo neutrophils using a mAb designated RP-3. When the rats had been treated with RP-3 at the time of priming with SRBC, DTH to these cells was inhibited. Furthermore, RP-3 treatment was effective in inhibiting the effector phase of the DTH response to SRBC. When spleen cells from rats that had been treated with RP-3 at the time of immunization were used for local transfer of DTH, footpad swelling was significantly less than that induced by spleen cells from the RP-3-untreated immune rats.

Modulation of in vivo immune response by selective depletion of neutrophils using a monoclonal antibody, RP-3. I. Inhibition by RP-3 treatment of the priming and effector phases of delayed type hypersensitivity to sheep red blood cells in rats

Recent studies on neutrophils have revealed that these cells produce various cytokines, and may be involved in regulation of the immune response. We examined whether neutrophils are involved in delayed type hypersensitivity (DTH) to SRBC in rats by selective depletion of in vivo neutrophils using a mAb designated RP-3. When the rats had been treated with RP-3 at the time of priming with SRBC, DTH to these cells was inhibited. Furthermore, RP-3 treatment was effective in inhibiting the effector phase of the DTH response to SRBC. When spleen cells from rats that had been treated with RP-3 at the time of immunization were used for local transfer of DTH, footpad swelling was significantly less than that induced by spleen cells from the RP-3-untreated immune rats.

A novel tumor-associated protein: clinical significance of serum levels in various clinical conditions with special reference to gynecological malignant diseases

A novel tumor-associated protein (TAP), that was originally detected immunologically through the use of a monospecific antiserum against a placental antigen, was quantified by means of the rocket technique of Laurell. Four hundred and fifty-seven serum samples were obtained from healthy female subjects (55), and patients with leiomyomas (162), benign ovarian tumors (78), pelvic endometriosis (45), cervical cancer (73), endometrial cancer (18) and ovarian cancer (26), respectively. Statistical analysis showed that TAP exhibited the closest relationship in ovarian cancer patients in whom the appearance of TAP and its high level were most prominent. The present preliminary study suggests the clinical usefulness of this protein as a clinical adjunct for the management of ovarian cancer.

A case report of juvenile polyposis with adenomatous change and a review of 34 cases reported in Japan

It has recently come to be thought that cases of juvenile polyposis have a natural tendency to develop adenoma and/or carcinoma. Here we present a case of juvenile polyposis coli with adenomatous change in a 21-year-old male, with a review of 34 cases of juvenile polyposis in the Japanese literature, and discuss the pathogenetic development of the polyps and their malignant potential. In this case, focal or entire adenomatous areas were found in large part of the polyps in the resected sigmoid colon and rectum, though these findings had not been recognized in 23 polypectomy specimens from the rectum 10 months prior to the operation. It was suggested that adenomatous change developed quickly in a very short time.

Pigmentary dysplasias in long survivors with mosaic trisomy 18: report of two cases

We describe two patients, a 19-year-old girl and a 19-year-old boy, with mosaic trisomy 18 and pigmentary dysplasias. Both patients had profound growth and mental retardation, marked kyphoscoliosis, bushy eyebrows, bulbous nose, simple ears, and joint contractures - clinical manifestations of long survivors with mosaic or non-mosaic trisomy 18. In addition, the boy showed total asymmetry. Pigmentary dysplasias of the skin with hypopigmented whorls and streaks, initially absent or overlooked at the ages 2 and 15 years, were detected on close examination. It is advisable to check closely every long survivor with mosaic or purportedly non-mosaic trisomy 18 for pigmentary dysplasias.

Quantitative analysis of a novel pregnancy-associated protein in trophoblastic diseases, normal pregnancy and healthy female subjects

By means of the Laurell rocket technique, a novel pregnancy-associated protein was measured in the serum of patients with trophoblastic diseases as well as in pregnant women. In 52 normally-menstruating women, the serum levels were below the detection limit in 40 (76.9%); 50 women (96.2%) had levels of less than 2.0 U/ml, and none had levels above 2.1 U/ml. Of 25 patients with a hydatidiform mole, 23 (92.0%) had elevated levels (greater than 2.2 U/ml). In 84 healthy pregnant women, the levels rose from being undetectable before 5 weeks to a plateau in the second trimester. The results suggest that the appearance of this protein in serum is associated with trophoblastic activity.

[A complete response in squamous cell carcinoma of the lung to combination chemotherapy by cisplatin and vindesine]

A 75-year-old male was admitted to our hospital for further investigation of a large mass shadow in the left hilum that was seen on an X-ray film of his chest. Cytological examination of his sputum revealed keratinized squamous cell carcinoma and combination chemotherapy using cisplatin and vindesine was administered. Later, both a chest X-ray and a CT scan showed a remarkable reduction in the size of the lung cancer. Complete response was obtained on the 90th hospital day, and was maintained with UFT administration. No sign of recurrence has been observed for over 9 months.

Measurement of the alpha 2 component of a novel oncodevelopmental antigen by a rapid electroimmunoassay

A method was required for the quantification of a novel oncodevelopmental antigen which increases in the serum of pregnant women as well as patients with ovarian cancer. The native antigen is composed of two components having alpha 2 and beta electrophoretic mobilities. An assay method, involving electroimmunodiffusion according to Laurell, was developed for the measurement of the alpha 2 component of the antigen. The method is sufficiently sensitive to determine significant differences in the levels of antigen in the serum of non-pregnant and pregnant subjects, and patients with ovarian cancer. In addition to routine quantitation, the technique will also be an indispensable analytical tool in the purification of the protein.

Detection of a pregnancy-associated protein

Monospecific antiserum was produced with the use of a placental extract showing high activity of a proteinase which hydrolyses a synthetic substrate, N-benzoyl-D,L-arginine p-nitroanilide, used for measuring tryptic activity. An immunological study showed that antibodies were not generated against the component with this activity but against an antigen which was not related to several well-known pregnancy-associated proteins. Pregnancy sera contained an antigen which immunologically was completely identical to the antigen of placental origin. Single radial immunodiffusion showed an elevated level of reactive antigen in pregnant subjects: 70% of 333 cases were positive. Cross-reacting antigen was also detected in sera as well as ascitic fluid from cases of advanced ovarian cancer. Sephadex G-200 gel filtration indicated that the antigen has an apparent molecular weight of 94000, and immunoelectrophoresis showed the molecule to be of beta-mobility. These properties suggest that the substance may represent an additional pregnancy-associated protein entity. Partial purification and some immunological properties of this antigen are described.

Interferon activity and its characterization in the sera of patients with head and neck cancer

The interferon (IFN) assay of the sera from the 40 patients with head and neck cancer was performed by the plaque-reduction assay with vesicular stomatitis virus in FL cells derived from human amniotic membrane. The patients mainly had Stage III or IV lesion without distant metastasis, and previously had not received any cancer therapy. All of the patients were histologically diagnosed as squamous cell carcinoma. When the serum IFN activity was characterized by acid treatment, significant increases of IFN-alpha/beta/gamma (n = 24, P less than 0.05) and acid-labile IFN (n = 24, P less than 0.001), and significant decrease of acid-stable IFN (n = 24, P less than 0.001) in the cancer patients of 50-to-79-year age group were found, as compared with those in the normal controls of the same age group (n = 20). When IFN titers including various immunologic parameters of the patients and normal controls were simultaneously assayed prior to the beginning of the cancer therapy, the titers of IFN-alpha/beta/gamma, acid-stable IFN, and acid-labile IFN were significantly correlated with some immunologic parameters such as natural killer (NK) activity, the absolute number of T gamma lymphocytes, the percentages of beta- and gamma-globulin, and the amounts of IgA, IgG, IgM, and beta 2 microglobulin. To define further the nature of this IFN, both sera of the patients and normal donors of 50-to-79-year age group were characterized by a neutralization assay with an antiserum to HuIFN-alpha and HUIFN-beta. The IFN activity left when the testing sera were neutralization with these antisera was expressed as gamma-like IFN. The titers of gamma-like IFN in the sera of patients (n = 24, P less than 0.0001) showed a highly significant increase as compared with the normal controls (n = 20). When the correlation between prognosis of the disease and titers of serum IFN were investigated by measuring gamma-like IFN and acid-stable IFN in the sera of patients, all of nine patients with good prognosis after the cancer treatment showed significant decreased levels of gamma-like IFN (P less than 0.01) and acid-stable IFN (P less than 0.05) as compared with those on the time before cancer therapy. On the other hand, titers of gamma-like IFN in the sera of six patients with recurrent disease showed a significant increase as compared with those on the IFN measurement before cancer therapy (P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)

Effects of intradermal administration of streptococcal preparation OK-432 on interferon and natural killer cell activities in patients with oral cancer

The streptococcal preparation OK-432 was used by intradermal administration as an immunotherapy in 18 patients with oral cancer, and the sera from patients during OK-432 treatment were serially assayed for interferon (IFN) activity by the plaque-reduction method with vesicular stomatitis virus in FL cells derived from human amniotic membrane. The type of serum IFN was characterized by acid-treatment and neutralization test with anti-IFN-alpha and anti-IFN-beta antisera. IFN-gamma was expressed for its titer as the residual IFN activity after neutralization with both antisera. An intradermal injection of OK-432 transiently induced IFN activity and 3 patterns in the type and level of the produced IFN were observed. Although most of the patients induced IFN-gamma and acid-stable IFN or only IFN-gamma, 2 patients seemed to be unresponsive to OK-432. When we examined the relationship between natural killer (NK) activity and IFN titer, a sharply declined NK activity was found immediately post OK-432 administration, and then NK activity stayed around the pretreatment level. Most of the tested patients' induced IFN-gamma, preceding the step toward the gradual increase in NK activity, decreased with OK-432. However, even in the patients showing no IFN induction with OK-432, a significant decrease of NK activity occurred.