Generation and Characterization of Inhibitory Antibodies Specific to Guinea Pig CXCR1 and CXCR2

CXCR1 and CXCR2 are chemokine receptors that have different selectivity of chemokine ligands, but the distinct role of each receptor is not clearly understood. This is due to the absence of specific inhibitors in guinea pigs, which are the appropriate species for investigation of CXCR1 and CXCR2 because of their functional similarity to humans. In this study, we generated and evaluated monoclonal antibodies that specifically bound to guinea pig CXCR1 (gpCXCR1) and guinea pig CXCR2 (gpCXCR2) for acquisition of specific inhibitors. To assess the activity of antibodies, we established CHO-K1 cells stably expressing either gpCXCR1 or gpCXCR2 (CHO/gpCXCR1 or CHO/gpCXCR2). CHO/gpCXCR1 showed migration in response to guinea pig interleukin (IL)-8, and CHO/gpCXCR2 showed migration in response to both guinea pig IL-8 and guinea pig growth-regulated oncogene α. The receptor selectivities of the chemokines of guinea pigs were the same as the human orthologs. The inhibitory activities of the anti-gpCXCR1 and anti-gpCXCR2 monoclonal antibodies on cell migration were observed in a concentration-dependent manner. In conclusion, we successfully obtained inhibitory antibodies specific to gpCXCR1 and gpCXCR2. These inhibitory antibodies will be useful to clarify the physiological roles of CXCR1 and CXCR2 in guinea pigs.

Aberrant Right Gastric Vein Directly Communicating with Left Portal Vein System

In 3 patients with primary hepatic malignancies, a communication between the right gastric vein and the left portal vein system was recognized at angiography. The right gastric vein entered directly into the left lateral portal veins in 2 patients and into the left medial portal veins in one. Portal angio-CT performed in one patient demonstrated a specific defect only in the left lateral superior area of the liver, consistent with the segmental opacification of the portal vein branch recognized on the angiogram. This rare communication was seen in 3 (1.5%) of 200 consecutive patients who underwent celiac angiography and is most likely an anomaly in which the right gastric vein directly enters the left portal vein instead of the portal vein trunk. When interpreting a filling defect not associated with a mass lesion on portal angio-CT for hepatic neoplasms or the right gastric vein communicating with the left portal vein system on the angiogram, this particular anomaly should be considered.

Wide application of a novel topoisomerase I inhibitor-based drug conjugation technology

To establish a novel and widely applicable payload-linker technology for antibody-drug conjugates (ADCs), we have focused our research on applying exatecan mesylate (DX-8951f), a potent topoisomerase I inhibitor, which exhibits extensive antitumor activity as well as significant myelotoxicity, as the payload part. Through this study, we discovered a promising exatecan derivative (DX-8951 derivative, DXd), that has the characteristics of low membrane permeability and shows considerably less myelotoxicity than that shown by exatecan mesylate in an in vitro human colony forming unit-granulocyte macrophage assay. DXd was further used for drug conjugation by using commercially or clinically useful monoclonal antibodies to evaluate the potency of the ADC. The result revealed that the DXd-ADCs targeting CD30, CD33, and CD70 were effective against each of their respective target-expressing tumor cell lines. Moreover, a novel DXd-ADC targeting B7-H3, which is a new target for ADCs, also showed potent antitumor efficacy both in vitro and in vivo. In conclusion, this study showed that this novel topoisomerase I inhibitor-based ADC technology is widely applicable to a diverse number of antibodies and is expected to mitigate myelotoxicity, thereby possibly resulting in better safety profiles than that of existing ADC technologies.

Specific electronic absorptions of alternate layered nanostructures of two metal oxides synthesized via a thiol–ene click reaction

Absorption properties of alternate stacked structures of niobate and tungstate nanosheets were continuously altered by a change of the interlayer distance.

Evaluation of 18F-2-deoxy-2-fluoro-glucose positron emission tomography for gastric cancer screening in asymptomatic individuals undergoing endoscopy

(18)F-2-deoxy-2-fluoro-glucose Positron Emission Tomography (FDG-PET) has been recently proposed as a promising cancer-screening test. However, the validity of FDG-PET in cancer screening has not been evaluated. We investigated the sensitivity of FDG-PET compared with upper gastric endoscopy in gastric cancer screening for asymptomatic individuals. A total of 2861 consecutive subjects (1600 men and 1261 women) who were asymptomatic and who underwent both FDG-PET and upper gastrointestinal endoscopy between 1 February 2004 and 31 January 2005 were included in this study. Both endoscopists and a radiologist were unaware of the results of the other diagnostic tests. The FDG-PET images were examined using criteria determined by the pattern of FDG accumulation. Sensitivity and specificity of FDG-PET were calculated compared with endoscopic diagnosis as the gold standard. Among 2861 subjects enrolled in the study, there were 20 subjects with gastric cancer, of whom 18 were T1 in depth of cancer invasion. Positive FDG-PET results were obtained only in 2 of the 20 cancer subjects. The calculated sensitivity and specificity for overall gastric cancers were 10.0% (95% confidence interval (CI): 1.2-31.7%) and 99.2% (95% CI: 98.8-99.5%), respectively. (18)F-2-deoxy-2-fluoro-glucose Positron Emission Tomography was poorly sensitive for detection of gastric cancer in the early stages.

Clinical utility of FDG-PET for evaluation of the viability in post-chemotherapeutic residual lesions in pediatric solid tumors

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Background: Exact evaluation of viability in post-chemotherapeutic residual lesions in patients with solid tumors should allow us to select the appropriate therapeutic options. F-18 fluorodeoxyglucose position emission tomography (FDG-PET) is one of the promising modality to evaluate it without invasive procedure. Methods: The cohort is a total of 14 patients with pediatric solid tumors (rhabdomyosarcoma 7, Ewing sarcoma 4, Wilms tumor 2 and neuroblastoma 1), which are either newly diagnosed or newly relapsed between January 2005 and December 2005. A total of 15 residual tumors from the 14 patients after chemotherapy underwent 51 FDG-PET scans. Seven residual tumors out of 6 patients, who were newly diagnosed, and another 8 tumors out of 8 patients, who were relapsed, were evaluated after induction or reinduction chemotherapy. Parameters of FDG-PET were assessed by area of FDG uptake and standardized uptake values (SUV). Results of FDG-PET were compared either with histological examination of the residual tumors (n=11) or with the clinical status 6-month after the last FDG-PET (n=4) in order to judge whether the findings of FDG-PET were true or false. Results: Three of 15 residual lesions showed increased SUV, while 12 lesions obtained negative SUV. Three lesions with positive SUV consisted of 2 true-positive and 1 false-positive lesions. Among twelve lesions were negative SUV, 11 lesions were true-negative, and 1 was false-negative. The sensitivity and specificity of FDG-PET in predicting the viability of residual lesions were 66% and 91%, respectively. A lesion of rhabdomyosarcoma which obtained negative SUV in FDG-PET histological showed viable cells. A lesion of another rhabdomyosarcoma which showed positive SUV was evaluated as inflammatory lesion. Conclusions: Although FDG-PET showed excellent sensitivity and fair specificity in predicting the viability of residual lesions in patients with pediatric solid tumors, possibility of false-negativity should give us a caution not to rely on FDG-PET to judge the termination of therapy.

No significant financial relationships to disclose.

[Neoadjuvant intraarterial chemotherapy with nedaplatin, peplomycin and mitomycin C for advanced cervical cancer]

The aim of the present study was to examine the usefulness of neoadjuvant intraarterial chemotherapy (NAC) using nedaplatin as key drug to improve the prognosis in case of advanced cervical cancer. Twenty-five cases of advanced cervical cancer (15 cases of stage II with high risks, 10 of stage III, referred to as the 254-S group) treated by NAC using nedaplatin, mitomycin C and peplomycin were compared with 30 cases (22 cases of stage II with high risks, 8 of stage III, referred to as the CDDP group) treated using cisplatin and mitomycin C which is the conventional regimen, in terms of measurable response, pathological response, rate of lymph node metastasis, cumulative survival rate, side effects and relapse style. According to the evaluation by measurable responses, the response rate was 90% (CR 52%) in the 254-S group and 75% (CR 15%) in the CDDP group. For pathological response of the specimen, the CR rate was 16% in the 254-S group and 23% in the CDDP group. The rate of lymph node metastasis extracted surgically was 33% and 41%, respectively. The cumulative survival rate in the 254-S group was about 10% better than in the CDDP group, but no significant difference was found. Leucopenia of both groups was of the same grade. In the 254-S group, although thrombocytopenia was more critical than in the CDDP group, there was a slight tendency to kidney toxicity. The locoregional recurrence rate was 12% in the 254-S group and 30% in the CDDP group. The distant metastasis rate was 16% and 27%, respectively. Although neoadjuvant intraarterial chemotherapy using nedaplatin as a key drug was useful to improve the prognosis of advanced cervical cancer, measures against recurrence outside the pelvis and individualization of medical treatment were considered to lead to a further improvement of the prognosis.

Visualization of bubble-fluid interaction by a moving object flow image analyzer system

This paper deals with interaction between a bubble and fluid around it, visualized by a moving object flow image analyzer (MOFIA) consisting of a three-dimensional (3D) moving object image analyzer (MOIA) and two-dimensional particle image velocimetry (PIV). The experiments were carried out for rising bubbles of various sizes and shapes in stagnant water in a vertical pipe. In the MOFIA employed, 3D-MOIA was used to measure bubble motion and PIV to measure fluid flow. The 3D position and shape of a bubble and the velocity field were measured simultaneously. The experimental results showed that the interaction was characterized by the shape, size and density of a bubble. Concretely, they showed the characteristics of bubble motion, wake shedding, and flow field.

l-Menthol-induced [Ca2+]i increase and impulses in cultured sensory neurons

We investigated the effects of l-menthol on cultured dorsal root ganglion (DRG) cells, instead of free nerve endings of sensory fibers. Using Fura-2 microfluorimetry, we identified a few DRG neurons that showed an increase in intracellular free Ca2+ concentration ([Ca2+]i) in response to l-menthol. They made up only 10% of the neurons activated by a high K+ solution. l-Menthol induced the [Ca2+]i increase in a dose-dependent manner, with an EC50 of 37.9 microM and a Hill coefficient of 0.97. A related compound, cyclohexanol, had no effect. When extracellular Ca2+ was removed, l-menthol did not induce the [Ca2+]i increase. Whole-cell current-clamp recordings revealed that l-menthol induced depolarization (13.2 mV, receptor potential) leading to impulses. We conclude that l-menthol induced the impulses through activation of menthol receptors in a small subset of the cultured sensory neurons.

[Anuria due to bilateral renal artery spasm during hysterectomy and oophorectomy]

A decrease in urinary volume during surgery is often encountered. Usually it can be treated with intravenous fluid or diuretics. We here report a rare case of intraoperative anuria in which renal blood flow ceased totally. The patient was 36 year old female (166 cm 50 kg), who was admitted for a investigations of long-term severe hypertension of unknown origin. Radiographic examination showed no adrenal tumor but a right ovarian cyst was found and suspected to be malignant, for which oophorectomy was indicated. After epidural catheterization, general anesthesia was induced by intravenous propofol and vecuronium, and maintained with epidural lidocaine and the inhalation of isoflurane and nitrous oxide mixed with oxygen. During surgery, urinary outflow decreased gradually leading to total anuria, which was resistant to intravenous fluid and furosemide. Intraoperative pyelography was performed and both kidneys and urinary tracts were not visualized. After the surgery, when the patient returned to the ward, urine began to flow. Postoperative pathological examination of the removed ovary showed a presence of renin excreting tumor cells. The anuria was considered to be the result of transient spastic obstruction of bilateral renal arteries, presumably in response to a high level of plasma renin.

Determination of peptide phi angles in solids by relayed anisotropy correlation NMR

A solid state NMR method is presented for determination of a backbone dihedral angle phi in peptides, being based on the previously reported method, relayed anisotropy correlation (RACO) NMR [Y. Ishii et al., Chem. Phys. Lett. 256 (1996) 133]. In the present method, the 15N-1H and the 13C-1H dipolar tensors in the 1H-15N-13C-1H system are two-dimensionally (2D) correlated via polarization transfer from 15N to 13C under magic angle spinning (MAS). This method was applied to N-acetyl[1,2-13C,15N]D,L-valine, and the H-C-N-H dihedral angle was determined to be 154.0 +/- 1.4 degrees or 206.0 +/- 1.4 degrees, the former agreeing with the X-ray value of 154 +/- 5 degrees.

Comparison of Tc-99m pertechnetate with Tl-201 and Ga-67 scintigraphy of malignant soft-tissue tumors

Tc-99m pertechnetate scintigraphy was compared with Tl-201 chloride and Ga-67 citrate to evaluate the avidity of Tc-99m pertechtate for malignant soft-tissue tumors. Twenty-three patients with malignant soft-tissue tumors underwent scintigraphic studies. All 23 received Tc-99m and Tl-201, whereas 14 also were injected with Ga-67. In 21 (91%) of the 23 patients, Tc-99m accumulated extensively in the tumors. Tl-201 accumulated in 12 (52%) of the 23 tumors. Ga-67 accumulated in only 5 (36%) of the 14 tumors. The avidity of Tc-99m for myxoid tumors was markedly different from the other two agents. Tc-99m accumulated in all eight myxoid tumors, while neither Tl-201 or Ga-67 showed marked accumulation except for one patient with increased accumulation of Tl-201. This study shows that Tc-99m pertechnetate has the potential to localize malignant soft-tissue tumors and may be useful in the evaluation of these tumors.

Thallium-201 scintigraphy to assess effect of chemotherapy in osteosarcoma

Imaging results in patients with high-grade osteosarcoma of the extremities were reviewed to determine whether scintigraphic appearance correlated with histologic response to preoperative chemotherapy.

METHODS

Histologically, the percent tumor necrosis in specimens from 30 patients were classified into three grades: grade 1 = necrosis less than 60%, grade 2 = 60%-89% necrosis and grade 3 = diffuse necrosis greater than 90% based upon whole transverse sections. Scintigraphically, we analyzed 201TI uptake before and after preoperative chemotherapy. The changes in the tumor-to-background ratio were defined by an alteration ratio.

RESULTS

Of the 11 patients with a grade 1 response, the ratio showed -67.1% +/- 45.4% (mean +/- s.d.). Of the 9 patients with a grade 2 response, the ratio showed 37.9% +/- 29.9% of the 10 patients with a grade 3 response the ratio showed 105.5% +/- 12.4%. The ratios correlated well with the histologic grades (p < 0.0001; analysis of variance).

CONCLUSION

Thallium-201 scintigraphy accurately assesses the effect of chemotherapy on osteosarcoma.

Role of technetium-99m pertechnetate scintigraphy in the management of extra-abdominal fibromatosis

The purpose of this study was to investigate technetium-99m pertechnetate (Tc-99m) as a tumor-scanning agent in patients with extra-abdominal fibromatosis, and to establish the sensitivity of this type of scintigraphy. Eleven patients with extra-abdominal fibromatosis were studied: all but one having postsurgical recurrences. Of the 11 patients, diagnosed histologically, 5 underwent repeated Tc-99m scintigraphic follow-up examinations. The injected 370 MBq Tc-99m gave us an early scintigram within 10 min and a delayed one 2 h later. For adequate comparison, the region of interest (ROI) of the scintigram was placed over the tumor. The tumor-to-background (T/BG) count ratio was computed. Extra-abdominal fibromatoses, even recurrences, were demonstrated scintigraphically in both the early and the delayed phase, in all 11 patients. The average T/BG ratio was 2.11 in the early scintigram and 2.15 in the delayed one. The sensitivity and the specificity were both 100%. Tc-99m scintigraphy has proved useful in detecting extra-abdominal fibromatoses and in the follow-up of patients.

CT diagnosis of early hepatocellular carcinoma: sensitivity, findings, and CT-pathologic correlation

OBJECTIVE

The purpose of this study was to determine the sensitivity of CT in detecting early hepatocellular carcinoma and to evaluate its CT appearance. An early hepatocellular carcinoma is a nodular lesion with no fibrous capsule composed of well-differentiated tumor histologically. It differs from a small hepatocellular carcinoma, which is an overt tumor that is moderately to poorly differentiated and has a fibrous capsule. Size is not a criterion for distinguishing between early and small hepatocellular carcinomas.

MATERIALS AND METHODS

Thirty-one patients with 39 histopathologically proved early hepatocellular carcinomas (mean diameter, 1.7 cm) found by sonography, MR imaging, and/or intraoperative sonography were included in a retrospective study. We reviewed unenhanced CT scans of the entire liver in 30 patients (37 lesions) and early and late (35 sec and 5 min after the beginning of injection of contrast material) contrast-enhanced CT scans of the entire liver in all 31 patients (table incremental CT in 21; helical CT in 10; 39 lesions). Eighteen histologically proved small hepatocellular carcinomas (< or = 3 cm; mean diameter, 2.3 cm), present in the same patients, served for comparison. Histopathologically, nine patients had chronic hepatitis, and 22 had cirrhosis.

RESULTS

The overall sensitivity of CT in detecting early hepatocellular carcinoma was 56%. These tumors were usually isodense with respect to surrounding liver on unenhanced, early enhanced, and late enhanced CT scans (iso-iso-iso). This pattern was seen in 17 (46%) of 37 lesions; thus, these 17 histologically proved early hepatocellular carcinomas were not detected with CT. An iso-iso-low density pattern was recognized in eight (22%), a low-low-low pattern in seven (19%), and several different patterns in five (13%) of the 37 lesions. Only two (5%) of 39 early hepatocellular carcinomas had a high-density appearance on early enhanced CT scans. In comparison, the most common pattern of small overt hepatocellular carcinomas on CT scans was low-high-low, seen in 17 lesions (94%) detected with CT. When the density of lesions on unenhanced CT scans was compared with the histopathologic appearance of the masses, low-density lesions showed mild to moderate fatty change and isodense lesions showed no or minimal fatty change (p = .006).

CONCLUSION

The sensitivity of CT in detecting early hepatocellular carcinoma is poor (56%). However, the diagnosis of early hepatocellular carcinoma should be considered if CT scans show a small lesion with an iso-low or low-low density enhancement pattern on early and late contrast-enhanced CT scans, respectively, in patients with chronic liver disease.

On clinical usefulness of Tl-201 scintigraphy for the management of malignant soft tissue tumors

The purpose of this study was to investigate Tl-201 as a tumor scanning agent in patients with malignant soft tissue sarcomas and to establish the sensitivity of this type of scintigraphy concerning local recurrences or metastases that may remain clinically suspected. Seventy-eight patients with malignant soft tissue sarcomas and 22 with benign soft tissue tumors were studied. Of these 78 malignant soft tissue sarcomas patients, the sensitivity of Tl-201 (81.2%) was higher than that of Ga-67 (68.8%). Thirty-three out of 78 patients received a total of 95 consecutive scintigraphic follow-up examinations. Therapeutic effects was assessed by comparing the results of Tl-201 examinations with the clinical findings. Of these 33 patients, the therapeutic effects observed were as follows: complete remission 1, partial remission 8, progress of disease 1, and no remarkable change 23. Tl-201 scintigraphy has proved itself very useful not only in clinically detecting the malignant soft tissue sarcomas and in assessing therapeutic effects on these diseases, but also in assessing the follow-up patients with malignant soft tissue sarcomas.

Lymphoscintigraphy of head-and-neck cancer

To achieve the visualization of regional lymph nodes by lymphoscintigraphy, 21 patients with head-and-neck cancer were studied with the aid of 99mTc-labeled rhenium sulfur colloid (99mTc Re). Four injection sites were selected; the injections were given into the subcutaneous tissue of the parietal area of 11 patients, into the submucosa of the retromolar area of 6 patients, into the subcutaneous tissue of the postauricular area of 2 patients, and into the thyroid glands of 2 patients. Lymphoscintigraphy was done three hours after the injection. The cervical regions were visible in 85.7% of the patients on the affected side and in 90.5% on the healthy side. The visualization comprised the following regions: submental, submandibular, deep cervical, accessory, and supraclavicular regions. In total, 102 nodes were visualized on the affected side (average 4.8 per patient) and 110 nodes in the healthy side (average 5.5). Histologically, 15 of 21 patients had lymph nodes metastases and 6 did not. Of these 21 patients, 66.7% (14/21) had confirmed lymph node metastases in the visualized regions. This technique appears to be a relatively easy and efficient method of imaging the regional lymph nodes in head-and-neck cancer both before treatment and after neck surgery.

Comparison of Indium-111-labeled leukocyte scintigraphy and Technetium-99m joint scintigraphy in rheumatoid arthritis and osteoarthritis

This study was undertaken to evaluate the use of Indium-111-labeled leukocyte (111In-WBC) imaging compared with Technetium-99m pertechnetate (99mTcO4-) imaging in 19 patients with rheumatoid arthritis (RA) and 8 with osteoarthritis. Knee and wrist joints were evaluated for both radionuclides. The results indicated a good correlation of the clinical assessment of pain and swelling with joint uptake ratio (JUR) between 111In-WBC and 99mTcO4- in RA and osteoarthritis patients. We observed a discrepancy in both imagings in "burned out" cases. It was concluded that a JUR of 111In-WBC could distinguish active RA from inactive RA or osteoarthritis at a value of 1.15 and that the use of 111In-WBC was a more reliable procedure than 99mTcO4-.

[Usefulness of 111In labeled leukocytes scintigraphy combined with 99mTc phytate liver scintigraphy for diagnosis of hepatic abscess comparing with CT and US]

111In labelled leukocyte scintigraphy (ILLS) was performed in five patients with hepatic abscess. For the accurate diagnosis of hepatic abscess, ILLS was superimposed on 99mTc phytate liver scintigraphy. The results of ILLS were compared with CT and US findings. Four of five patients (80%) showed abnormal accumulations in the liver. The smallest abscess detected was 46 mm x 43 mm. CT scan showed rim enhancement, which was a specific finding for hepatic abscess, in three patients. It was rather difficult to diagnose hepatic abscess by US. In two cases without definite rim enhancement on CT, the abscesses were diagnosed as hot spots by ILLS. We conclude that ILLS combined with 99mTc liver scintigraphy is useful for the diagnosis of hepatic abscess.

[Hepatoblastoma: clinico-radiological study of fifteen cases]

From January 1976 to October 1989, 15 patients with hepatoblastoma who underwent surgery at the National Cancer Center Hospital were evaluated by clinico-radiological techniques. Eight patients were boys and seven were girls; their average age was 3 years and 5 months. Abdominal mass or distention was initially noted in 12 patients. Alpha-fetoprotein level was extremely high (average, 327 micrograms/ml) in all cases but one. Hepatitis B surface antigen was negative in all cases. Tumors occupied mainly the right lobe of the liver in 67% of patients, and the mean tumor diameter was 11.1 cm. Of 15 hepatoblastomas, 10 were grossly classified as massive type and five as multinodular. Histopathological diagnosis was well differentiated (fetal type) hepatoblastoma in 10 patients and poorly differentiated (embryonal type) hepatoblastoma in five. Fibrous capsule was also recognized in eight. The noncancerous liver was normal in all cases. Ultrasonography (US) (n = 7 patients) demonstrated an inhomogeneous internal echo with well demarcated margin in five cases and without such margin in two. Nonenhanced CT (n = 6) showed an isodense or low density mass in all cases. Drip infusion CT (n = 5) revealed isodensity in the early phase. Dynamic CT performed in one patient showed a well enhanced mass that appeared hypervascular on angiography. Preoperative chemotherapy and radiation therapy provoked histological changes such as necrosis, fibrosis and calcifications. These changes were reflected on CT images. Both US and CT demonstrated the characteristic internal structure and gross appearance of hepatoblastoma.

[Clinical application of helical scanning CT of upper abdomen]

The helical scanning CT unit, in which an X-ray tube continuously rotates at the rate of one revolution per second with constant movement of the table on which the patient is placed, was clinically tested in scanning of upper abdomen. Quality of the images obtained was equal to that of conventional CT. The images were particularly good at an X-ray beam width of 5 mm and table movement of 5 mm/sec with scan parameters of 120 kvp, 200 mA. Because of limitation of the X-ray tube capacity. X-ray beam width of 5 mm and table movement of 10 mm/sec with scan parameters of 120 kvp, 150 m, would be the most appropriate clinically. Application of the helical scanning CT will result in examination times shorter than in the case of conventional high-resolution CT and be obtained images at early vascular enhancement phase through the whole scanning area, so that it can be expected to be extremely useful in clinical diagnosis involving upper abdomen.

[Imaging diagnosis of small hepatocellular carcinoma by CT during arterial portography and Lipiodol-CT]

To evaluate the rates of detection for CT during arterial portography (CTAP) and Lipiodol-CT in small hepatocellular carcinoma (HCC), including early stage HCC, a comparative prospective study was performed in 24 candidates for surgery with 39 histopathologically proved lesions: eight lesions of early HCC, four of early advanced HCC and 27 of advanced HCC. The following results were obtained. 1) Ten of 24 patients had multiple primary HCC foci, 70% of which were, moreover, located in different segments. 2) Detection rates for digital subtraction angiography (DSA), CTAP and Lipiodol-CT were 67%, 87% and 72%, respectively. For 13 lesions undetected by DSA, the detection rates for CTAP and Lipiodol-CT were 62% and 31%. 3) For small HCC (n = 16) of less than 2 cm in diameter, CTAP (75%) tended to be superior to Lipiodol-CT (44%). 4) For early HCC (n = 8), CTAP (63%) showed a significantly higher detection rate than Lipiodol-CT (25%). 5) In contrast, detection rates for small (less than or equal to 2 cm) early advanced (n = 3) and advanced HCCs (n = 5) were almost the same: 67% and 100% by CTAP and 67% and 80% by Lipiodol-CT, respectively. To diagnose multiple primary HCCs in a candidate for surgery, CTAP is imperative following angiography.

New plastic-coated coaxial catheter system for superselective hepatic catheterization: technical note

With the use of a new improved coaxial catheter system, superselective hepatic catheterization has become easier. The improvements consist of a decrease in the outer and an increase in the inner diameters of the coaxial catheters from 0.98 to 0.96 mm and from 0.55 to 0.65 mm, respectively, and thickening of core guidewire material from 0.014 inch (0.35 mm) to 0.018 inch (0.40 mm). With this new catheter system, it is possible to inject contrast medium (iopamidol 300) at a higher rate (3 ml/sec) and gelatin sponge particles instead of gelatin powder for arterial embolization. The success rates for superselective catheterization using conventional (n = 10 procedures) and the improved coaxial catheter systems (n = 7) were 30% and 86%, respectively.

Aberrant right gastric vein directly communicating with left portal vein system. Incidence and implications

In 3 patients with primary hepatic malignancies, a communication between the right gastric vein and the left portal vein system was recognized at angiography. The right gastric vein entered directly into the left lateral portal veins in 2 patients and into the left medial portal veins in one. Portal angio-CT performed in one patient demonstrated a specific defect only in the left lateral superior area of the liver, consistent with the segmental opacification of the portal vein branch recognized on the angiogram. This rare communication was seen in 3 (1.5%) of 200 consecutive patients who underwent celiac angiography and is most likely an anomaly in which the right gastric vein directly enters the left portal vein instead of the portal vein trunk. When interpreting a filling defect not associated with a mass lesion on portal angio-CT for hepatic neoplasms or the right gastric vein communicating with the left portal vein system on the angiogram, this particular anomaly should be considered.

[A clinical study of a multiregression analysis on the NK activity and related clinical factors in patients with lung cancer]

Using 24 lung cancer patients (20 males and 4 females) who had received radiotherapy, a multivariate analysis has been performed in relation to 19 factors suspected of exerting an effect on natural killer (NK) cell activity. As influencing factors, two factors of the disease, the stage (p less than 0.05) and the leukocyte count (p less than 0.08), were calculated to be significant. In the univariate analysis, the NK activity was found to be significantly low (p less than 0.05) when the leukocyte count was 7,000 or higher. In addition, patients who had died during the course of radiotherapy showed an NK activity which was significantly lower (p less than 0.05) than the activity manifested in both the disease-free patients and the relapsed progressive disease patients. Moreover, the patients with a PS of 40% or less had a significantly lower NK activity than the patients with a PS of 50% or more, though no correlation was found between the NK activity and the disease stage. In the use of this radiotherapy, the NK activity was found to be more strongly influenced by the size of the irradiated field than by the irradiated dose.