[Treatment strategies of cytoreductive surgery plus intraperitoneal hyperthermic chemotherapy for gastric cancer with peritoneal metastasis: a systematic review].

Peritoneal metastasis in gastric cancer is associated with rapid disease progression. Hyperthermic intraoperative peritoneal chemotherapy (HIPEC) done immediately after cytoreductive surgery (CRS) has become an important treatment for peritoneal metastasis in gastric cancer patients. However, different treatment options for HIPEC exist with potential influence on survival rates and prognosis in patients, exist. These treatment options include open or closed abdomen technique, perfusion solution, number of catheters, temperature, duration, and drug regimens. This paper aims to provide more evidence on standardization of HIPEC treatment options and technologies by systematically reviewing different drug regimens and technical approaches. The study included 2 randomized controlled trials, 3 phase I/II clinical trials, 2 prospective cohort studies, and 34 retrospective cohort studies, involving 1511 patients. The most common HIPEC option is to dissolve 50-75 mg/m2 of Cisplatin and 30-40 mg/m2 of Mitomycin C in 3-4 L saline solution at 42-43℃. After gastrointestinal anastomosis, 2-3 catheters are used in the HIPEC system with a perfusion flow rate of 500 ml/min. The duration is 60-90 minutes. Anastomotic leakage was low in studies where HIPEC was performed after gastrointestinal anastomosis. The utilization of open HIPEC and a two-drug regimen resulted in improved overall survival rates. The future development of HIPEC aims to enhance tumor-specific therapy by optimizing various aspects, such as identifying the safest and most effective chemotherapy regimens, refining patient selection criteria, and improving perioperative care.

[Topical clonidine in prevention of intra-ocular hypertension after Nd: YAG laser therapy].

We evaluated the prophylactic effect of 0.25% Clonidine HCl on the increase of intraocular pressure after Nd: YAG laser therapy. IOP of 150 eyes using Clonidine and 119 eyes without Clonidine were measured before and 0.5, 1, 2, 24 hours after Nd: YAG application. Various stages of angle-closure glaucoma and after cataract were both included in the treated and control groups and were compared respectively. Overall, the incidence of increase of IOP in the Clonidine-treated group was significantly less (9.3%) than the group without Clonidine (63.0%); the incidence of marked increase (> 1.06kPa) was also significantly less (2.0%) than those without Clonidine (18.5%). The peak value of IOP after laser therapy in the treated group did not exceed 3.06 kPa. Therefore, topical Clonidine is recommended as an effective and safe procedure to prevent the intraocular hypertension in Nd: YAG laser therapy.

[Cultivation and ultrastructural investigation of human iris pigment epithelial cells].

UNLABELLED: The iris pigment epithelial cells of 10 human eyes were cultivated in vitro. RESULTS: The iris pigment epithelial cells obtained directly by scraping were easier to grow and to be passaged than those obtained by enzyme digestion. Under the inverted light microscope, primary cells appeared multigonal and arranged in monolayer, there were abundant pigment granules in the cytoplasm, and the nuclei each of which contained 1 or 2 nuclei were relatively transparent. Pigment granules diminished in succeeding generations. Under the transmission electron microscope, pigment granules were rich in the cytoplasm and there were plenty of microvilli at the cell membrane. There were maculae occludentes and desmosomes present in the intercellular space. The cultivated cells showed positive reaction of keratin antigen in an immunohistochemical assay. The characteristics mentioned above are consistent with the criteria of iris pigment epithelial cells.

[A pharmacokinetic study of subconjunctival polyphase liposome 5-fluorouracil].

5-Fu polyphase liposome was prepared by fusing the drug with lecithin and cholesterol, the rate of encapsulation being 52%, and 97% of the particles were less than 2 microns in diameter and stable against heat and cold. 5 mg of tritiated 5-Fu in 0.5 ml of the polyphase liposome preparation was injected subconjunctivally in rabbits. The concentrations of 5-Fu in the conjunctiva, the sclera, and the conjunctiva-Tenen's capsule-sclera en bloc 180 degrees from the site of injection were measured by the scintillation method 12, 24, 48, 72 and 96 hours after injection to be no less than 0.2 microgram, the ID50 of fibroblast proliferation. These findings suggested that 5-Fu polyphase liposome preparation might be substituted for 5-Fu solution in the filtering operation to reduce the frequency of injections and to attenuate the side effects.

Suppression of coenzyme Q10 levels and the induction of multiple PDSS and COQ genes in human cells following oligomycin treatment.

Endogenous coenzyme Q10 (CoQ10) is a lipid-soluble antioxidant and essential for the electron transport chain. We previously demonstrated that hydrogen peroxide enhanced CoQ10 levels, whereas disruption of mitochondrial membrane potential by a chemical uncoupler suppressed CoQ10 levels, in human 143B cells. In this study, we investigated how CoQ10 levels and expression of two PDSS and eight COQ genes were affected by oligomycin, which inhibited ATP synthesis at Complex V without uncoupling the mitochondria. We confirmed that oligomycin increased the production of reactive oxygen species (ROS) and decreased mitochondria-dependent ATP production in 143B cells. We also demonstrated that CoQ10 levels were decreased by oligomycin after 42 or 48 h of treatment, but not at earlier time points. Expression of PDSS2 and COQ2-COQ9 were up-regulated after 18-hour oligomycin treatment, and the expression of PPARGC1A (PGC1-1α) elevated concurrently. Knockdown of PPARGC1A down-regulated the basal mRNA levels of PDSS2 and five COQ genes and suppressed the induction of COQ8 and COQ9 genes by oligomycin, but did not affect CoQ10 levels under these conditions. N-acetylcysteine suppressed the augmentation of ROS levels and the enhanced expression of COQ2, COQ4, COQ7, and COQ9 induced by oligomycin, but did not modulate the changes in CoQ10 levels. These results suggested that the condition of mitochondrial dysfunction induced by oligomycin decreased CoQ10 levels independent of oxidative stress. Up-regulation of PDSS2 and several COQ genes by oligomycin might be regulated by multiple mechanisms, including the signaling pathways mediated by PGC-1α and ROS, but it would not restore CoQ10 levels.

Inhibition of fibroblast proliferation by human iris pigment epithelial cells in vitro: preliminary results.

BACKGROUND: The interaction between different cells plays an important role in many physiological and pathological processes. Since the proliferation of fibroblasts is very much involved in the pathogenesis of eye diseases such as proliferative vitreoretinopathy, the failure of filtration in glaucoma surgery, etc., we attempted to ascertain whether iris pigment epithelial cells (IPE) have some modulating effect on fibroblast proliferation. METHODS: Human IPE were explanted and the third-passage culture was transferred into serum-free RPMI-1640 medium. After 48 h of further incubation, the medium was collected and submitted to centrifugation; the supernatant was used as the conditioned medium of IPE (IPE-CM). Cultured fibroblasts from Tenon's capsule were seeded in a 96-well plate and incubated with IPE-CM in different concentrations. The proliferation of fibroblasts was estimated by thymidine incorporation and cell counting. RESULTS: The incorporation of tritiated thymidine by fibroblasts was reduced to 56.68% of baseline with 1:16 diluted IPE-CM and to 13.63% and 8.20%, respectively, with 1:8 and 1:2 diluted IPE-CM. These findings were in good accordance with the results of cell counting, performed in parallel. SDS-PAGE of IPE-CM revealed two specific bands with molecular weight 65 kDa and 40 kDa. CONCLUSION: IPE-CM showed an obvious dose-dependent inhibitory effect on fibroblast proliferation and was presumed to contain some active factors contributing to this effect.

[1585 cases of retinal detachment surgery with homologous skin as buckling material]. / Verwendung von homologer Kutis als Plombenmaterial in 1585 Fällen von Ablatiooperation.

From January 1963 to December 1989, 1585 consecutive cases of retinal detachment were operated with homologous skin as buckling material, the rate of operative success being 91.6%. Human skin is easy to obtain, sterilize and preserve; because of its appropriate thickness and firm but elastic consistency it satisfactorily meets the need to produce sufficient height and to maintain necessary duration of the scleral buckling; in addition to a high rate of reattachment, homologous skin implantation was well tolerated, very rarely rejected (0.06%) and infected (0.25%), and no late complications occurred. Therefore, the authors prefer using human skin as buckling agent rather than conventional synthetic material, e.g., silicon sponge etc.

Inhibition of intraocular proliferation by homoharringtonine. An experimental study.

Homoharringtonine, an alkaloid indigenous to China, was studied for its effect on fibroblast growth in cell culture and on intraocular proliferation produced in rabbits by injecting homologous fibroblasts into the vitreous. The results demonstrate that homoharringtonine reduced the cell growth by 50% at a concentration of 0.005 mg/l in vitro, significantly inhibited vitreous proliferation, and prevented the occurrence of retinal detachment in vivo. Light and electron microscopy revealed no ocular toxicity in drug-treated eyes. Homoharringtonine may be of considerable value in the prevention and treatment of intraocular proliferation in patients.

A consecutive ultrastructural study of action of homoharringtonine on fibroblasts in vitro.

The authors studied the effect of homoharringtonine (Hh), a semisynthetic Chinese herb, on the ultrastructure of in vitro cultured human conjunctival fibroblasts (HFb) and its mechanism of action. Preliminary results showed that the main characteristics of HFb damage caused by Hh were invagination of the nuclear membrane, aggregation and margination of chromatin, and massive vacuolization of the cytoplasm. In addition, Hh can inhibit the secretion of collagen fibers and the synthesis of microfilaments. Therefore, Hh might be an effective agent in the prevention and treatment of proliferative eye disorders.