Effects of surgery and chronic disease states on the concentrations and phenotype distribution of α1-acid glycoprotein: studies in patients with breast cancer and patients with chronic inflammatory disease.

OBJECTIVE: Although the concentration of α1-acid glycoprotein (AGP) in serum increases under some conditions, the behavior of the individual genetic variants is not well understood. Therefore, we studied the relative changes in AGP variants pre- and postoperatively in patients with cancer and patients with chronic inflammatory disease states, as well as the distribution of AGP phenotypes in a Japanese population. METHODS: Serum samples were taken before and after surgery from 25 female patients with early breast cancer. Serum samples were also obtained from 134 patients with rheumatoid arthritis (RA) and 33 with systemic lupus erythematosus (SLE), and from 103 healthy subjects. The relative concentrations of the individual genetic variants in the serum samples were determined by isoelectric focusing after desialylation with neuraminidase. RESULTS: The postoperative AGP concentrations in patients with early breast cancer were 2-fold higher than before surgery. The relative concentrations of the F1 and S variants were significantly increased, whereas that of the A variant was not changed significantly. The relative concentrations of all the AGP variants in patients with RA and SLE were significantly higher than those in healthy subjects. The distribution of the AGP phenotypes did not differ significantly among the groups examined in this study. CONCLUSIONS: The F1/S variants of AGP, but not the A variant, were significantly increased after early breast cancer surgery, but all the variants were increased in patients with chronic inflammatory states such as RA and SLE. The distribution of the AGP phenotypes did not differ significantly among the disease groups studied.

Avidin-biotin-immunoglucose oxidase: use in single and double labeling procedures.

We have investigated the use of an avidin-biotin-immunoglucose oxidase (AB-GO) technique for single and double antigen localization in conjunction with the avidin-biotin-immunoperoxidase (AB-P) technique in fixed, embedded specimens, using sequential monoclonal and polyclonal antibodies of the same species. The optimal technique for double labeling requires the first antibody to be applied and localized with the AB-P technique using 3,3'-diaminobenzidine (DAB) as the chromogen, followed by an optional elution step and/or incubation with mild detergent (0.01% Triton). The second antigen is localized with the AB-GO technique with nitro blue tetrazolium (NBT) as a chromogen. Effects of antigen concentration, intermediate elution steps, and the relative efficiency of the two methodologies are described.

Effects of Varidase buccal tablets on the sputum.

Samples of sputum were collected from ten patients with chronic respiratory diseases following treatment with Varidase (streptodornase and streptokinase) buccal tablets, four tablets per day for a period of seven days, and were compared with specimens obtained before the therapy in terms of rheological and cytochemical parameters. The study revealed a tendency for the respiratory secretion to show a lowered yield point and a decrease in mucous fibers after the therapy, thus suggesting, to some extent, the efficacy of the drug as an expectorant.

Features of retinal arterial macroaneurysms in patients with uveitis.

AIM: To determine the frequency and clinical characteristics of retinal arterial macroaneurysms in patients with uveitis. METHODS: A retrospective review of the clinical, photographic, and angiographic records of 1007 patients with uveitis, examined at the Osaka University Hospital uveitis clinic between January 1995 and April 2002, was performed. All of the records were examined to determine whether macroaneurysms were present, and when present, to determine the laterality, type, location, clinical course, and the presence of associated systemic and ocular diseases. RESULTS: Of the 1007 patients with uveitis, only 14 (1.4%) had macroaneurysms. 12 of these 14 patients had peripheral multifocal chorioretinitis (PMC), and five of these 12 were diagnosed with sarcoidosis and the other seven without sarcoidosis. There was only one case with sarcoidosis without PMC, and the remaining case was uveitis of unknown origin. There were 18 macroaneurysms in all cases and 17 (94.4%) were the exudative type, and the remaining one was the haemorrhagic type. Two patients had been treated for systemic hypertension but the others had no signs of systemic hypertension or cardiovascular disease. CONCLUSIONS: Macroaneurysms are not characteristically found in patients with uveitis, but the majority are found in patients with PMC. The majority of the macroaneurysms were the exudative type, and the conclusion is that patients with PMC should be carefully examined for exudative macroaneurysms.

Inhibitory effect of retinoid on esophageal carcinogenesis in rats induced by N-nitroso-N-methylbutylamine in relation to cellular retinoic acid-binding protein.

The inhibitory effect of a synthetic retinoid, ethyl alltrans-9-(4-methoxy-2, 3, 6-trimethyl-phenyl)-3, 7-dimethyl-2, 4, 6, 8-nonatetraenoate (Tigason), on esophageal carcinogenesis in F344 rats induced by N-nitroso-N-methylbutylamine (NMBA) was evaluated. The animals were given NMBA daily in their drinking water for 21 weeks at a concentration of 15 mg per liter ad libitum starting at 8 weeks of age. One week before the beginning of NMBA treatment, the rats were divided randomly into Tigason-fed and -unfed groups. Thirty-five rats were fed a diet supplemented with Tigason at a concentration of 30 mg per kg of diet, and 80 rats were given a basal diet alone. In NMBA-treated rats, multiple papillomas were seen 11 weeks after NMBA treatment and squamous cell carcinoma developed 12 weeks after NMBA; the tumors increased in number thereafter, and the numbers of papillomas and carcinomas were the same at 17 and 21 weeks after NMBA. At 21 weeks after NMBA treatment, the number of papillomas was similar, regardless of the dietary Tigason supplement, however, the number of esophageal squamous cell carcinomas was significantly lower in the Tigason-fed rats than in -unfed animals (p < 0.025). In normal esophageal tissues, a small amount of cellular retinoic acid-binding protein (cRABP) was detected throughout the experimental period, while during carcinogenesis, the levels of cRABP increased continuously until 16 weeks after NMBA; the cRABP level was higher in papillomas than in squamous cell carcinomas. As Tigason specificially blocked the progression of papillomas to carcinomas, it may be a promising candidate chemopreventive agent in esophageal carcinogenesis.

Implantable hearing aid. Report of the first human applications.

To our knowledge, this is the first report of human application of the partial implantable hearing aid. Direct driving of the stapes by an ossicular vibrator of piezoelectric ceramic bimorph is the fundamental mechanism of this device. Acoustic signals received by a microphone were transmitted to the external link coil after amplification. By means of electromagnetic induction, the internal coil placed under the retroauricular skin excited electroacoustic energy, which is transmitted to the vibrator directly coupled with the stapes. The device used in this first patient has been functioning for longer than one year. Excellent frequency response of the vibrator and highly efficient direct transmission of electroacoustic signals to the inner ear gave rise to acoustic perception of superior quality that could not be obtained by other surgical or rehabilitative measures.

Proliferating cell nuclear antigen. A marker for cell proliferation in autopsy tissues.

Antibodies to the proliferating cell nuclear antigen allow identification of proliferating cells in fresh tissue specimens using routine immunocytochemical methods. However, the use of such proliferation markers has not been verified for autopsy-derived tissue specimens, in which there is often a significant delay between the time of death and tissue specimen fixation. To assess the reliability of anti-proliferating cell nuclear antigen antibodies to identify proliferating cells in autopsy tissue specimens, an autopsy simulation was performed using fresh monkey and rat tissue specimens. These tissue specimens were kept at room temperature for predetermined numbers of hours before fixation. The proliferation specific staining was most reliable for tissue specimens obtained within 6 hours of death. There was reliable staining of proliferating regions up to 12 hours, although sensitivity was decreased. The only exception was skin, which was able to withstand much longer periods. Quantitative data from monkey spleen white-pulp regions showed 63% of the cells to stain for proliferating cell nuclear antigen when fixed immediately; this decreased to 29% of the cells after 12 hours and only 19% by 18 hours of postmortem simulation. Representative tissue specimens obtained from human autopsy material revealed similar postmortem staining patterns. Rapid procurement and fixation of tissue specimens and the use of control tissue specimens derived from the same autopsy material (eg, lymph node tissue) are recommended. These studies do suggest that anti-proliferating cell nuclear antigen antibodies can be used to identify proliferating cells in human autopsy tissue specimens obtained within approximately 12 hours of death, with some compromise in overall sensitivity.

Ca2+ channel-blocking effect of the yohimbine derivatives, 14 beta-benzoyloxyyohimbine and 14 beta-pho-nitrobenzoyloxyyohimbine.

Yohimbine possesses a relatively selective alpha 2-adrenoceptor antagonistic effect and a weak Ca2+ channel blocking activity, so two derivatives, 14 beta-benzoyloxyyohimbine and 14 beta-rho-nitrobenzoyloxyyohimbine were compared with yohimbine using those parameters. The two derivatives blocked Ca2+-induced contraction of the rat perfused mesenteric vascular bed at 3 X 10(-6) M, and developed dose-dependent shifts of the dose-response curve to the right in concentrations from 3 X 10(-6) to 10(-5) M. Yohimbine showed a weak Ca2+ channel-blocking effect only at a concentration of 10(-5) M. On the other hand, both derivatives at 3 X 10(-6) M did not affect the dose-response curve to noradrenaline-induced vasoconstriction. Furthermore, at 10(-8) M they had no effect on the dose-response curve to clonidine-induced inhibition of the twitch response of the rat isolated vas deferens evoked by electric stimulation, whereas yohimbine significantly attenuated clonidine-induced inhibition. These results indicate that introduction of bulky substituents into the 14-position of yohimbine intensely potentiated the Ca2+ channel-blocking effects and reduced alpha-adrenoceptor antagonistic effects compared with those of yohimbine, and suggest that chemical modifications of yohimbine may lead to structurally new types of Ca2+ channel-blockers.

The active principles of the branchlet and hook of Uncaria sinensis Oliv. examined with a 5-hydroxytryptamine receptor binding assay.

Of the alkaloids obtained from Uncaria sinensis Oliv., geissoschizine methyl ether, corynantheine and dihydrocorynantheine decreased specific [3H]5-HT binding to membrane preparations from rat brain and from in-vitro experiments on guinea-pig ileum, these alkaloids were found to be partial agonists for 5-HT receptors. Therefore, they might be useful in the treatment of diseases resulting from disorders of 5-HT metabolism.

[Indication and effectiveness of endoscopic percutaneous gastrostomy as a route of parenteral alimentation for the home care patient].

We are managing 8 home care patients who have a gastrostomy made using an endoscopic percutaneous technique as a route of parenteral alimentation. Based on our experience, the preconditions for an endoscopic percutaneous gastrostomy as a route of parenteral alimentation are 1. normal gastrointestinal function, 2. difficulty in swallowing, 3. possibility that the caregiver can manage the gastrostomy. When we performed an endoscopic percutaneous gastrostomy as a route of parenteral alimentation for 8 home care patients, we obtained the several advantages mentioned below. 1. Swallowing pneumonia was prevented. 2. Adequate amount of alimental liquid could be infused. 3. Patient could take a bath or shower with the gastrostomy, and good QOL was realized. 4. The home care patient with the gastrostomy could have a satisfactorily long life.

[Combination of intra-arterial administration of anticancer agent and hemocarboperfusion in treatment of advanced cancer].

Nineteen patients with malignant tumors were treated with a combination of bolus administration of mitomycin C with direct hemoperfusion over charcoal, and 15 patients were valuable. Mitomycin C of 1 mg/kg was administered via a catheter placed into the regional artery. Seven out of 14 patients with genitourinary cancers: 4 out of 9 patients with urinary bladder, 2 of 4 patients with renal and one prostate responded to the therapy. There were 4 responders out of 8 in the one-shot administration group, on the other hand, 7 cases receiving continuous infusion of 60 to 120 minutes responded. In both the one-shot group and the continuous group nausea and vomiting were observed in 21% and 11% respectively. Three patients receiving continuous administration of mitomycin C had local ulcerations. Myelosuppressions such as leukocytopenia and thrombocytopenia were observed in 37% of the both groups.

[Clinical epidemiology of bronchial asthma in children report. No. III. Comparison of prevalence of asthma with 1982 and 1990 and environmental factors].

UNLABELLED: In 1982, our group carried out a survey by the questionnaires and on the site medical check-ups to observe and occurrence of asthma and other allergic symptoms in elementary and junior high school children in Izu Ohshima island. Same procedure was repeated in 1990 for 1145 children of the same age group to see any data fluctuation. The occurrence of allergic symptoms with relation to living conditions was also researched. RESULT: 114 students (11.0%) had either suffered from asthma in the past, or were still currently exhibiting symptoms, this marked a 7.5% rise (108 students) over the 1982 research data. However, patients in need of current treatment numbered 48 (4.5%), which was similar to the 1982 data of 82 (4.3%). For other allergic symptoms, rhinitis showed a marked increase over the 1982 data. The relation between living conditions and asthma was analyzed by Multiple Factor Analysis Quantification Theory. RESULT: 1) Family history of allergy, 2) Selection of food products upon starting solids during infancy, 3) Infection of lower bronchus during infancy all seemed to have had much influence on the occurrence of asthma.

[The effect of intravenous administration of xylocaine for the treatment of tinnitus].

One hundreds and forty-nine patients (221 ears) suffering from tinnitus were treated by an intravenous administration of Xylocaine. Xylocaine, 1mg per kg, was administered once a week. The immediate effect of Xylocaine on tinnitus was evaluated subjectively for all the patients. The long term effect in 57 patients who received Xylocaine administration more than 12 times was also analyzed. The results can be summarized as follows. 1. Short and long term relief of tinnitus was obtained in 165 of 221 ears (74.7%) and in 35 of 57 cases (61.4%), respectively. 2. This therapy was more effective in old patients and in the patients with low pitch tinnitus, or with positive residual inhibition. 3. The numbers of the effective cases increased after the 8th time administration of Xylocaine. Thus we recommend the Xylocaine administration at least 8 times. 4. The results of the loudness balance test were not correlated with the change of the subjective improvements. 5. The suppressive effect of tinnitus by injecting saline solution intravenously was recognized in 24 of 73 cases. At present, repeated administration of Xylocaine would be one of the most significant therapies of tinnitus.