[Surgical treatment for Pancoast tumors--significance of surgical approach and induction chemoradiotherapy].

We analyzed 46 patients with Pancoast tumor who underwent surgical resection. Anterior approach was employed for 16 patients and hook approach for 30 patients. Twenty-one patients received preoperative treatment; chemotherapy for 1 patient, radiotherapy for 11 patients, and chemoradiotherapy for 9 patients. Complete resection was achieved in 59% (27/46) of patients. The overall 5-year survival rate was 10.9%. Five-year survival was significantly higher in the patients received complete resection than the patients received incomplete resection (18.5 vs 0%, p=0.0016). The complete resection rate has improved in recent cases, and one of the reasons seems to be the adoption of preoperative chemoradiotherapy. But postoperative complications occurred more frequently in patients who received induction therapy than the others. Optimal selection of surgical approach and induction chemoradiotherapy for Pancoast tumors appear to provide improved complete resection rate and long term survival.

[Gallbladder metastasis of large cell lung cancer].

A man, who received right upper lobectomy of the lung due to stage IIB large cell carcinoma 7 and half years ago, visited our hospital complaining of right upper abdominal pain. Computed tomography (CT) revealed gallbladder tumor and extended resection of the gallbladder was performed. Pathological diagnosis was adenosquamous cell carcinoma After 1 year and 4 months later, left adrenal gland tumor was found by CT scan, and the surgery was conducted. Pathologically, it was diagnosed as metastasis from lung cancer. By reevaluation of pathology of the gallbladder, the tumor was found to have similar component of resected lung cancer, suggesting the possibility of the tumor to be metastatic.

[Evaluation of tracheobronchoplasty for lung cancer].

Tracheobronchoplasty has become one of the standard procedures for lung cancer. In this study, we examined the incidence of complications and survival of tracheobronchoplasty and compared with these of pneumonectomy. In 119 patients underwent tracheobronchoplasty, bronchopleural fistula occurred in 6 (5.0%) and anastomotic stenosis occurred in 5 (4.2%). Five-year survival rate of 119 patients underwent tracheobronchoplasty was 47.3%, and the median survival time was 49.3 months. We compared the sleeve or wedge lobectomy and pneumonectomy, the incidence of complications and 30-days death were similar, but the rate of in-hospital death and the prognosis of the sleeve or wedge lobectomy were better than these of pneumonectomy. So to preserve a respiratory function, we should use a bronchoplastic procedures to avoid pneumonectomy.

Synthesis of alcoholic ZnO nanocolloids in the presence of piperidine organic base: nucleation-growth evidence of Zn5(OH)8Ac2.2H2O fine particles and ZnO nanocrystals.

Piperidine as a new free OH* organic base has been successfully used to prepare Zn5(OH)8(Ac).22H2O particles (named Zn-HDS) or concentrated alcoholic ZnO sols. Considering the applications of Zn-HDS and ZnO compounds, as well as interests of these synthesis mechanisms for fundamental chemistry, such investigations are of importance. This strategy not only allows preparing Zn-HDS compounds at room temperature but also brings evidence of some new nucleation-growth, and permits the preparation of well crystalline ZnO nanocrystals at low temperature (maximum 60 degrees C). It was possible to convincingly prove that the formation of Zn-HDS phase is concomitant to the ZnO nanocrystals formation and that Zn-HDS could be considered as an intermediate initiator of ZnO nanocrystals. A parallel approach was used for the fast screening of the synthesis progress.

Study of the formation of perovskite type lanthanum ruthenates by heating their hydrous precursor.

Emanation thermal analysis (ETA), differential thermal analysis (DTA), thermogravimetry (TG), evolved gas analysis with mass spectrometric detection (EGA-MS), and X-ray diffraction (XRD) were used to investigate the formation of perovskite type lanthanum ruthenates on heating their hydroxide precursor in argon from 20 to 1200 degrees C. The co-precipitated lanthanum-ruthenium mixed hydroxide containing a small amount of carbonates was used as a precursor. The mass loss corresponding to the release of water and CO(2) from the precursor was determined by TG and EGA (MS), respectively. The ETA characterized the exposure of sample surface after release of water and CO(2), as well as microstructure development corresponding to the crystallization and structure ordering of LaRuO(3) and La(3.5)Ru(4.0)O(13) perovskite phases. The obtained information on formation of phases and their transformation is useful for optimizing their synthesis protocols for achieving the desired physical properties, and to estimate the thermal stability of these materials to be used as catalysts.

Self-assembly prismatic aggregates formed during the calcination of ZnO powders: in situ monitoring by ETA technique and their photocatalytic properties.

This paper describes a unique phenomenon occurred during the calcination of ZnO powders, i.e., the ZnO particles self-assembled to form prismatic aggregates with a clear edges and faces. Field-emission scanning electron microscopy (FE-SEM) and X-ray diffraction (XRD) were used to characterize the particle morphology and crystal structure of the calcined sample. The emanation thermal analysis (ETA) technique was used to monitor the changes of ZnO particle surface and subsurface microstructure irregularities and the occurrence of interparticle compaction phenomena under in situ conditions of heating and cooling. It was assumed from the ETA results that the driven force of the self-assembly of ZnO particles towards prismatic aggregates originated from the solid state diffusion and migration of grain boundaries. The photocatalytic tests indicated that the prismatic aggregates of ZnO calcined at 800 degrees C demonstrated a highest photocatalytic activity for acetaldehyde decomposition because of the enhancement of the surface-exposed high-active crystal face of (101 0).

Emanation thermal analysis study of the preparation of ruthenia-titania-based finely dispersed powders.

Emanation thermal analysis (ETA), thermogravimetry (TG), differential thermal analysis (DTA), X-ray diffraction analysis (XRD), and transmission electron microscopy (TEM) were used for the characterization of thermal behavior of hydrous oxides (RuO(2))(x)-(TiO(2))(1-x).nH(2)O and dehydrated oxides (RuO(2)) (x)-(TiO(2))(1-x), respectively (x=1, 0.9, and 0.7) on heating in argon and argon +10% hydrogen, respectively. The samples were heated in the range 20-600 degrees C at the constant heating rate 6 K/min. From the TG and DTA results the temperature intervals of dehydration and/or reduction of ruthenium dioxide into Ru metal were determined. ETA (based on the measurement of radon previously incorporated into the sample) brought about the information about surface area development and microstructure changes in the near surface layers up to 80 nm under in situ conditions of the heating. The temperature intervals of the annealing of near surface and structure defects serving as diffusion paths for radon were determined from the ETA results.

[Effect of FP inhalation and airway inflammation assessed by ECP in asthma].

We studied the effects of fluticasone propionate (FP) inhalation and the airway inflammation in beclomethasone dipropionate (BDP)-resistant bronchial asthma. Twenty-five patients who had used BDP and whose mean PEF was less then 80% were enrolled in this study. After 2 weeks of BDP inhalation. FP inhalation was administered. The total eosinophil count in the peripheral blood (/microliter), their percentage of the total WBC count (% Eos), the count in induced sputum, the serum ECP content and the induced sputum ECP content were measured before and after 6 weeks of FP treatment. There was a significant increase of morning and evening PEF, from 63.1% to 76.1% and from 63.6% to 76.2%, respectively. There was a significant positive correlation between the peripheral blood % Eos and the % increase of PEF (p < 0.01). There was also a significant positive correlation between the induced sputum % Eos and the % increase of PEF (p < 0.05). The induced sputum ECP content was still as high as 180 micrograms/l after FP treatment. The mean % PEF did not reach 80% after FP treatment. This study suggests that airway inflammation persists in some severe asthma patients despite inhalation of FP 800 micrograms.

[An early phase II trial combining cisplatin, carboplatin and vindesine in patients with inoperable non-small cell lung cancer].

We conducted an early phase II trial of advanced non-small cell lung cancer (NSCLC) to evaluate the response efficacy of a combination of cisplatin (CDDP), carboplatin (CBDCA) and vindesine (VDS). The twenty-four patients in the study had had no previous treatment. CDDP (15 mg/m2), CBDCA (200 mg/m2) and VDS (3 mg/m2) were administered on Day 1, CDDP (15 mg/m2) was administered on Days 2-5, and VDS (3 mg/m2) was administered on Day 8. We observed 9 partial responses (PR), with a total response rate of 39%. The overall median survival was 72 weeks, and the 1-year survival rate was 57%. Major toxicities were hematologic; leukopenia of grades 3 and 4 occurred in 25% patients, and thrombocytopenia occurred in 21%. Therefore, the combination of CBDCA with CDDP and VDS chemotherapy was effective against inoperable NSCLC with tolerable toxicities and a favorable median survival time.

[Wide resection and reconstruction of chest wall: usefulness of A-O metal plate].

A 53-year-old male was admitted to our department with a chest tumor due to infiltration of lung cancer. Right upper lobectomy and a wide en bloc excision of the right upper chest wall were performed, including the 2nd, 3rd, 4th, and 5th ribs with upper lobectomy of right lung. The defect was replaced with three A-O metal plates, which joined both stumps of the ribs, from the third to the fifth rib. These metal plates were very useful because it was easy to bent and twist them to fit the defect in operation. And curved metal plates preserved a cone from of chest cage. Postoperative course was favourable without mechanical ventilation and wound infection.

A secondary amyloidosis associated with systemic lupus erythematosus.

Secondary amyloidosis associated with systemic lupus erythematosus has rarely been reported. A 57-year-old female had been diagnosed as having possible systemic lupus erythematosus, although her clinical course was not typical. About one year after the diagnosis, treatment was begun with prednisolone because of progressive renal dysfunction, thrombocytopenia and low serum levels of complements. Recurrent diarrhea and gastrointestinal bleeding soon developed, then amyloidosis was revealed in the stomach and duodenum. Postmortem examination confirmed systemic amyloidosis. We discuss the significance of this rare association of systemic lupus erythematosus and secondary amyloidosis.

Reduced drug accumulation in a newly established human lung squamous-carcinoma cell line resistant to cis-diamminedichloroplatinum(II).

A human lung squamous-carcinoma cell line resistant to cis-diamminedichloroplatinum(II) (CDDP), designated PC10-B3, has been established from the original cell line PC10 by a stepwise increment of the CDDP concentration. This is the first report, to our knowledge, to establish a CDDP-resistant lung squamous-carcinoma cell line. PC10-B3 has continued to proliferate in the presence of 0.5 micrograms/mL CDDP, whereas PC10 could not survive. A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay revealed that PC10-B3 was 11.4-fold more resistant to CDDP than PC10 and cross-resistant to diammine(1,1-cyclobutanecarboxylate)platinum(II) (CBDCA) and 254-S, but not to doxorubicin or etoposide. PC10-B3 was characterized by a smaller DNA index and a larger cell size compared to PC10. The level of intracellular platinum accumulation was reduced by about 5- to 8-fold in PC10-B3 when compared with PC10, suggesting that reduced drug accumulation may be one of the important factors in contributing to CDDP resistance in PC10-B3.

Accuracy of the bronchoscopic DNA content analysis of non-small-cell lung carcinoma.

To assess the accuracy of the bronchoscopic DNA content analysis, samples of non-small-cell lung carcinomas (NSCLC) were investigated by means of flow cytometry. Samples were dissociated using the detergent Triton X-100. In 58 NSCLC cases, 39 (67%) had DNA aneuploid tumors. We compared the DNA indices of bronchoscopic brushing samples with 21 corresponding surgical samples. In 16 (76%) cases, DNA ploidy of both bronchoscopic and surgical samples were in concordance. In 3 (14%) cases, both bronchoscopic and surgical sample showed DNA aneuploidy, but the number of the DNA aneuploid stem cell lines was different. The cause of these differences was ascribed to the intratumor DNA heterogeneity. In 2 (10%) cases, the bronchoscopic sample showed DNA diploidy, but the surgical sample showed DNA aneuploidy. In these cases, tumor cells obtained by bronchoscopic brushing were so few that the small DNA aneuploid peak was undetectable in the DNA histogram. But the tumor DNA ploidy was evaluated correctly in 90% of 21 cases using bronchoscopic samples. Consequently, despite some drawbacks, the DNA ploidy diagnosis using bronchoscopic samples in this relatively small study, was almost as reliable as surgical samples.

Prognostic value of nuclear DNA content and expression of the ras oncogene product in lung cancer.

We evaluated the prognostic significance of nuclear DNA content by flow cytometry and ras oncogene expression in paraffin-embedded sections of tumors obtained surgically from 112 non-small cell lung cancer patients. Sixty-five (77%) of the 84 tumors had DNA aneuploid patterns that were statistically higher in adenocarcinoma than in squamous cell carcinoma. Of the 91 patients analyzed immunohistochemically using anti-ras Mr 21,000 protein (p21) monoclonal antibody rp-35, positive reactions (weak and strong) were observed in 56% of squamous cell carcinomas and 68% of adenocarcinomas. A better 5-yr survival rate was observed in the DNA diploid group (61%) than in the DNA aneuploid group (35%) (P less than 0.01). Patients with p21-negative tumors survived significantly longer (5-yr survival rate of 64%) than did those with p21-weak tumors (38%, P less than 0.05) or those with p21-strong tumors (12%, P less than 0.01). Cox's multivariate analysis showed that DNA ploidy, ras p21 expression, and the stage of the disease were significant prognostic factors for survival. However, the DNA content was not a major independent prognostic factor in adenocarcinoma. The intensity of ras p21 expression was not correlated with nuclear DNA content. These results suggest that DNA content or enhanced ras p21 expression may be different biological markers indicating the malignant potential of lung tumors.

[Ureteral cancer resembling pulmonary edema induced by recombinant human tumor necrosis factor].

A 73-year-old woman with ureteral cancer and multiple systemic metastasis was admitted complaining of dyspnea on exertion after administration of recombinant human tumor necrosis factor (rH-TNF). On chest examination, coarse crackles were heard during inspiration throughout the lungs. Chest roentgenogram revealed a ground glass infiltration, an air bronchogram in the right lung field and an ill-defined right pulmonary artery. Her symptom and chest roentgenological finding improved and coarse crackles were not heard after discontinuation of rH-TNF. Neutrophils and lymphocytes of bronchoalveolar lavage fluid increased and transbronchial lung biopsy specimens showed slight thickening of alveolar septa with infiltration of inflammatory cells. The pulmonary edema was thought to be caused by rH-TNF which induces adherence of neutrophils to endothelium and stimulates them to increase lysosomal enzyme release and oxygen radical production. As a results, it is thought pulmonary permeability might be increased.

The relationship of the proliferating cell nuclear antigen protein to cis-diamminedichloroplatinum (II) resistance of a murine leukemia cell line P388/CDDP.

We investigated whether the proliferating cell nuclear antigen (PCNA) protein takes part in cis-diamminedichloroplatinum (II) (CDDP) resistance, using a murine leukemia cell line P388 and its CDDP resistant cell line. P388/CDDP was 4 times more resistant to CDDP than P388. The cell lines were maintained in the DBA/2 female mouse peritoneal space. In total cells, the amount of the PCNA protein decreased to 90% in P388 after 1 h CDDP treatment, but that of P388/CDDP increased to 127%. The difference was statistically significant (p = 0.012, n = 5). As for G2/M phase cells, the difference was also significant at 1 h (p = 0.016, n = 5) and at 2 h (p = 0.036, n = 5) after treatment. In P388 the amount of the PCNA protein decreased in accordance with the inhibited cell proliferation, whereas in P388/CDDP, the amount of the PCNA protein increased in spite of the inhibited cell proliferation. This increase of the PCNA protein suggests that the PCNA protein is involved in CDDP resistance of P388/CDDP through enhanced DNA repair synthesis.

[Studies on the mechanism of protective effect of selenium on nephrotoxicity of cis-diamminedichloroplatinum (CDDP) in mice].

The mechanism of protective effect of sodium selenite (Se) on the nephrotoxicity of cis-diamminedichloroplatinum (CDDP) was studied with mice. CDDP and Se concentrations in the plasma, blood cell, kidney and liver were measured in mice given CDDP alone and those given both CDDP and Se. The nephrotoxicity of CDDP was observed in mice fed Se deficient diet (SDD). The activities of glutathione peroxidase (G-Px) in the plasma, blood cells, kidney and liver were measured in mice mentioned above. Co-administration of Se did not influence on the concentration of CDDP in the blood, kidney and liver. In mice fed SDD, the nephrotoxicity of CDDP increased and G-Px activities of the blood and kidney decreased. In mice given Se, G-Px activities was not increased. These results suggest that interaction between CDDP and Se differs from that between mercury and Se, or between cadmium and Se (formation of compound). Intake of Se is related to the appearance of the nephrotoxicity of CDDP. G-Px may be related partially to the protective effect of Se on the nephrotoxicity of CDDP.

[Clinical and pathological characteristics of lung cancer with chronic obstructive pulmonary disease].

Forty-two lung cancer patients with COPD (7.9% of 534 lung cancers), and 84 age- and sex-ratio-matched controls who were randomly selected from lung cancer patients without COPD were examined. Lung cancers with COPD consisted of 25 cases of squamous call carcinoma (59.5%), 11 of adenocarcinoma (26.2%), 2 of small-cell carcinoma (4.8%), and 4 of large-cell carcinoma (9.5%). Squamous cell carcinoma occurred more in patients with COPD than in controls (35.7%) (p less than 0.01). In squamous cell tumors with COPD, 12 cases (48.0%) were centrally located and 13 cases (52.0%) were peripherally located. Squamous cell carcinoma of peripheral origin occurred more in patients with predominant emphysema (76.9%) than controls (36.7%) (p less than 0.05). Our results suggest that the COPD patients with predominant emphysema may be at greater risk for squamous cell tumors of peripheral origin.

Prognostic and therapeutic significance of the flow cytometric nuclear DNA content in non-small cell lung cancer.

To evaluate prognostic and therapeutic significance, tumor DNA content was determined by flow cytometry in 310 paraffin-embedded tissue samples obtained surgically from 130 patients with non-small cell lung cancer. Ninety-six (76.8%) patients had DNA aneuploid patterns that were statistically higher in adenocarcinoma than in squamous cell carcinoma. A better 5-year survival rate was observed in Group A (DNA diploidy, 69.6%) than in Group B (DNA aneuploidy and DNA peridiploidy, 33.2%; P less than 0.001). The survival curves of the patients in Group B continued to decrease during the next 2.5 years. Cox's model analysis showed that both the pathologic stage and the DNA content were the significant prognostic factors for survival. However, the DNA content was an independent prognostic factor in squamous cell carcinoma, but not in adenocarcinoma. These results indicate that DNA content analysis is useful for the evaluation of clinical behavior and prognosis, and that the clinical value of the DNA content must be differentiated between squamous cell carcinoma and adenocarcinoma.