Inhibition of ICAM2 induces radiosensitization in oral squamous cell carcinoma cells.

We recently identified genes and molecular pathways related to radioresistance of oral squamous cell carcinoma (OSCC) using Affymetrix GeneChip. The current study focused on the association between one of the target genes, intercellular adhesion molecule 2 (ICAM2), and resistance to X-ray irradiation in OSCC cells, and evaluated the antitumor efficacy of combining ICAM2 small interfering RNA (siRNA) and X-ray irradiation. Downregulation of ICAM2 expression by siRNA enhanced radiosensitivity of OSCC cells with the increased apoptotic phenotype via phosphorylation (ser473) of AKT and activation of caspase-3. Moreover, overexpression of ICAM2 induced greater OSCC cell resistance to the X-ray irradiation with the radioresistance phenotype. These results suggested that ICAM2 silencing is closely related to sensitivity of OSCC cells to radiotherapy, and that ICAM2 may be an effective radiotherapeutic target for this disease.

Analysis of complications of permanent transvenous implantable cardiac pacemaker related to operative and postoperative management in 717 consecutive patients.

A retrospective study on complications especially related to operative or postoperative management was carried out in 1000 pacemaker implantations in 717 patients between September, 1972 and December, 1986. In 33 of our series (4.8%), 24 pacing failure occurred within two weeks of implantation. Flange-type leads had the highest incidence of complications. Wedging the electrode close to the longitudinal axis of the heart was found to be the best placing, assuming that the tip of the electrode and the section immediately adjacent were pointing downward. There were 6 cases of diaphragmatic pacing which could not be corrected through programming. No relation with the position of the electrode could be found. We recommend using bipolar pacing to lower the incidence of diaphragmatic pacing. We also had 9 patients with lead fractures (1.3%); these included 3 cases with silicone insulation breaks and 6 cases with wire fractures which occurred closely proximal to the area where the lead was fixed to the vessels. No relationship between the ratio of lead fractures and their brand was found. Five patients developed infections, all of them late postoperatively, over a period of 8 months to 5 years postop. Of these, there were 3 cases with postoperative prolonged hematoma at the pocket site, and 4 cases which had required lead repositioning because of pacing failure. The incidence of infection in our series was low when compared to previous reports, probably due to local use of one gram of Kanamycin during the operation and active chemotherapy performed short term postoperatively. To manage infection of the skin pocket, the pacemaker was removed and a new pacemaker was implanted in the opposite side. There was 7 early postoperative deaths. One of them due to cardiac tamponade caused by perforation of the cardiac wall by temporary electrode lead. The resustation was unsuccessful.

[Experimental and clinical studies of cefotiam in thoracic surgery].

The pharmacokinetics of intravenously administered cefotiam (CTM), using a two-compartment or three-compartment open model, have been investigated in patients undergoing thoracic surgery. Patients (Group 1) given 1 hour drip infusion of 1 g of CTM, had the peak serum level (32.8 micrograms/ml) at 1 hour, and the peak pleural effusion level (8.3 micrograms/ml) was achieved at 2.08 hours. Patients (Group 2) given an one-shot intravenous injection of 1 g of CTM, had the maximum pleural effusion concentration (8.35 micrograms/ml) at 2.67 hours. Patients (Group 3) given 1 hour drip infusion of 1 g of CTM, had the mean concentration (2.3--2.5 micrograms/g) in the pleural tissue for 2 to 3.5 hours. Clinical study comprising 20 patients was performed to evaluate the effects of CTM as a prophylactic antimicrobial agent in the thoracic surgery. Patients received intravenous administration of 4 g/day of CTM for 7--10 days. Each patients was evaluated daily for fever, signs of allergic reaction, and wound infection and so on. No infections occurred in these thoracic surgery except 1, and no serious side effects was observed in this study.

[Prophylactic effects of cefmenoxime against postoperative infections after thoracotomy. Studies of cefmenoxime transfer from serum to pleural fluid and of clinical effects of cefmenoxime].

Cefmenoxime (CMX) at a dose of 1 g was administered intravenously to each of 10 patients undergoing thoracotomy, and concentrations of CMX in the serum and pleural fluid were measured. Serum concentration of CMX reached its peak of 43.71 micrograms/ml at 1 hour and decreased to 4.15 micrograms/ml at 3 hours after the administration. The concentration of CMX in the pleural fluid reached its peak of 7.61 micrograms/ml at 3 hours and decreased slowly 5.26 micrograms/ml at 7 hours after the administration. A clinical study with 21 patients was performed to evaluate the effect of CMX as a prophylactic antimicrobial agent in thoracotomy. Patients received intravenous administration of 4 g/day of CMX for 7-10 days following operations. Each patient was evaluated daily for fever, sign of allergic reaction, and wound infection and other symptoms. No apparent infection occurred in those clinical patients except 1 patient with a suspected infection, and 1 case of allergic reaction as exanthema was observed during this study. Prophylactic effect of CMX against postoperative infection after thoracotomy was good.

[The prophylactic effects of latamoxef against the postoperative infections to open heart surgery. Studies on the penetration of latamoxef into the pericardial fluid and the auricle of heart].

Latamoxef (LMOX, Siomarin) at a dose of 2 g was intravenously administered to each of 23 patients undergoing the open heart surgery and the concentrations in serum, pericardial fluid and auricle of heart were measured. Pharmacokinetic observations are summarized below. The peak serum concentration (t = 0) was 227.3 micrograms/ml and the serum half-life (T1/2 beta) was 1.74 hours. In pericardial fluid, LMOX reached the peak concentration of 28.44 micrograms/ml at 4.9 hours and the half-life was 9.99 hours. In auricle of heart, LMOX reached the peak concentration of 42.78 micrograms/g at 6.9 minutes and the half-life was 1.74 hours. It was shown that LMOX penetrates well into the pericardial fluid and the auricle of heart, and it is considered that their levels exceed the minimal inhibitory concentration against a majority of clinical isolates except Pseudomonas aeruginosa.

[A case of acute massive pulmonary embolism successfully treated with transvenous pulmonary embolectomy by catheter].

A 78-year-old woman, suffering from acute massive pulmonary embolism, was successfully treated with transvenous pulmonary embolectomy by catheter. This patient had been suffering from oppressive chest sensations during exercise, and diagnosed and treated as angina pectoris at a nearby clinic. She consulted our hospital complaining that her chest pains were increasing in frequency. She was admitted to our hospital on July 7, 1988, for coronary angiography (CAG), which she underwent on July 8 by the right femoral approach. After the CAG, she was ordered to rest in bed overnight, with the right inguinal region compressed. 18 hours later, the compression was removed and she was allowed to walk. Soon after she walked to the toilet, she complained of chest discomfort and fell into shock (systolic blood pressure was 60 mmHg). An ECG examination showed a right bundle branch block and an inverted T wave in lead V1-3. An echocardiography showed normal contraction of the left ventricle, but an enlargement of the right ventricle and a flattened interventricular septum. An analysis of arterial blood gas showed hypoxia (Pao2 52.5 mmHg, Paco2, 30.9 mmHg). Acute pulmonary embolism was suspected. 240,000 units of urokinase were administered intravenously, and pulmonary angiography was performed immediately. It revealed that the bilateral pulmonary arteries were almost completely obstructed. Although 720,000 units of urokinase were infused into the pulmonary artery, the obstruction did not improve. At that time, we performed a transvenous pulmonary embolectomy. We used a Judkins R 4 guiding catheter for PTCA made by USCI. The catheter was inserted into the pulmonary artery and clots were aspirated with a syringe.(ABSTRACT TRUNCATED AT 250 WORDS)