Note: Reflection-type micro multipoint laser Doppler velocimeter for measuring velocity distributions in blood vessels.

We have developed a laser Doppler velocimeter (LDV) for measuring velocity distributions in blood vessels. We converted a transmission-based LDV into a reflection-based LDV to make it suitable for clinical applications. The velocity distribution image of a serpentine flow channel obtained could be qualitatively explained by the numerical results. Finally, we evaluated the system by using it to measure injection of blood into a glass tube by a syringe pump. The results obtained demonstrate that erythrocytes can be used as seeding particles for the reflection-type micro multipoint LDV. The results obtained are useful as basic data for clinical applications.

Effects of interleukin-6 on proliferation and proteoglycan metabolism in articular chondrocyte cultures.

Interleukin-6 (IL-6) levels are markedly increased in the synovial fluid of patients with rheumatoid arthritis or osteoarthritis. However, the effects of IL-6 on proliferation and proteoglycan metabolism in articular cartilage are not known. We demonstrated here the effects of human recombinant (hr) IL-6 on proliferation and proteoglycan metabolism in rabbit articular chondrocyte cultures. In vitro, these cells proliferated and produced abundant extracellular matrices. We found that 1-10 ng/ml of hrIL-6 inhibited proliferation to approximately 65% of control levels and suppressed colony formation induced by bFGF in soft agarose. The same concentration of hrIL-6 depressed proteoglycan synthesis to approximately 60% of control levels. Moreover, hrIL-6 significantly enhanced proteoglycan degradation induced by hrIL-1beta, although hrIL-6 alone did not affect proteoglycan degradation. These findings suggest that IL-6 is a negative regulator for chondrocyte proliferation and articular cartilage metabolism.

[A case of recurrent ovarian cancer successfully treated with etoposide].

A 49-year-old woman with recurrent ovarian cancer clear cell carcinoma was treated by etoposide. The recurrence was found seven months after second operation. The etoposide (50 mg/day per os) was first given for 2 weeks and then etoposide (25 mg/day per os) for 4.5 months. After one month of treatment the target tumor mass was reduced in size, and the therapy was continued for 4 months in our Outpatient Department. A partial response was confirmed by B-Scope, and the tumor marker CA-125 was reduced to 15 U/ml from 210 U/ml before treatment. No side effects were observed in the patient. This case suggests that etoposide might be effective for recurrent ovarian cancer and the whole treatment course could be handled in the Outpatient Department.

A case of short metatarsal bones lengthened by callus distraction.

Bilateral congenitally short fourth metatarsal bones were osteotomized subperiosteally, held in neutral position for 3 weeks by a small external fixator, and then subjected to slow axial distraction (0.25 mm/12h). The overall treatment time was 11 weeks, and the final increase in length was 14 mm for the left and 12 mm for the right metatarsal bone.

Dose-response relationship of cadmium embryotoxicity in cultured mouse embryos.

Mouse embryos were exposed in vitro to 1.2 to 2.2 microM cadmium, and effects on embryotoxicity were examined after 39 h of culture. Teratogenic responses similar to in vivo were obtained at 1.2 to 2.2 microM with concomitant reduction in embryonic protein, while embryo deaths were increased from 13.8 to 93.3% at 2.0 to 2.2 microM. The response data of both teratogenicity and growth parameters, including embryonic protein, head length, crown-rump length, somite number, and protein and diameter of yolk sac, were acceptably fitted to a linear log-probit regression. These results suggest that (a) In chronic exposure conditions, the concentration of cadmium is a critical parameter in the manifestation of teratogenic potential, (b) as an estimation of interference in the growth of embryos, embryonic protein is one of the most sensitive endpoints while somite number is an insensitive criterion, and (c) a linear log-probit regression is applicable to the analyses of embryotoxicity data, including growth parameters in whole-embryo culture systems.

[Fundamental and clinical studies of imipenem/cilastatin sodium in the field of obstetrics and gynecology].

Seven patients with gynecologic infections were treated with the new carbapenem class of antibiotic, imipenem/cilastatin sodium (MK-0787/MK-0791) at a dose level of 500 mg/500 mg or 250 mg/250 mg administered intravenously every 12 hours for 5 days. The results obtained were as follows. Clinical effects of MK-0787/MK-0791 were analyzed in 7 patients, including 1 case with pelvic peritonitis, 2 cases with endometritis, adnexitis and pelvic peritonitis, abdominal abscess, vaginal cuff infection and parametritis, and pyometra. Excellent clinical response was seen in 3 cases and good response in 4 cases. No side effect nor abnormal finding in clinical laboratory values was seen in all patients.

Tissue and intracellular distribution of estradiol receptors in the uterine endometrium.

A study of the tissue and intracellular distribution of estradiol receptors was made of the uterine endometrium of the rat, using an immunofluorescence technique. It was found that nearly all cells of the uterine gland have a uniform distribution of receptors, which does not change throughout the sexual cycle from proestrus to estrus. In contrast, a dense pattern of distribution of estradiol receptors was seen in the endometrial stroma during proestrus, whereas a diffuse pattern was seen during estrus. Intracellularly, the transition from the cytoplasm to the nucleus of estradiol reacting to receptors was found to be positively correlated with the incubation temperature and the length of incubation.

[Serum levels of immunosuppressive acidic protein in gynecological cancer].

The pre-therapy serum levels of immunosuppressive acidic protein (IAP) were assayed in patients with cancer of the uterine cervix and ovarium using the single radial immunodiffusion method. These levels were normal in patients with early cancer of uterine cervix (O and Ia stage); in advanced cancer patients they were increased with cancer stage. The serum IAP levels in ovarian cancer were higher than in patients with advanced uterine cervical cancer.

[The present status of mass population screening for cancer of the uterine cervix and the therapeutic results in the detected cases in Miyagi Prefecture].

The mass screening for cervical cancer in the population of Miyagi Prefecture has covered the total 1,078,999 women by March 1981. Invasive cancer of the uterine cervix was discovered in 1032 women, carcinoma in situ in 829. 2) By methods of the examination, the institutional examination was on 72.5% of the examined in 1980. 3) With regards to the rates of examinees by age and the detection rate of the cancer of uterine cervix in 1980, the low detection rate in the age range of 30-50 years whose examination rate was over 20% compares against the high detection rate in the high age range, whose examination rate was low. 4) CAI in years 1965, 1970, 1975 and 1980 were 60.0, 116.7, 193.2 and 229.8 respectively. 5) The 302 cases of invasive cancer detected and treated before the end of 1974 were classified in clinical stages and investigated the results of treatment. The detection in Stage I was in 84.1%, this high percentage being a main factor to make the total treatment results of uterine cervical cancer pushed up to the high figure.

The effects of postoperative radiotherapy in cases of invasive carcinoma of the uterine cervix.

An investigation was made of the effects on cure rate of postoperative radiotherapy following radical hysterectomy with lymphadenectomy for cases of invasive carcinoma of the uterine cervix performed over 7 years between 1969 and 1975 at the Department of Obstetrics and Gynecology. Tohoku University Hospital. For cases in which resection was complete but the cancer extended to the pelvic wall, the 5 year survival rate was similar to that in comparable cases of the same clinical stage regardless of whether or not postoperative radiotherapy was employed. The 5 year survival rate in cases undergoing postoperative radiotherapy because of lymph node metastasis was lower than that of cases where the lesion approached the pelvic wall and for which postoperative radiotherapy was employed. An investigation of the 5 year survival rate among those cases with lymph node metastasis and receiving postoperative radiotherapy indicated that survival in cases with metastasis to only one lymph node was similar to that of cases of the same clinical stage which received the operation only, whereas the survival rate of cases with multiple lymph node involvement was markedly lower.

Effect of cytologic screening on the detection of cervical carcinoma.

An investigation has been made of the relationship between the histologic features of detected cancers of the uterine cervix and the history of previous cervical screening in 732 cases. Six hundred forty-nine of 732 (88.7%) cases with cancers of the uterine cervix were from the group of unscreened women. Frank invasive carcinoma was found in 21.0% (136 cases) of the former group and in only 3.6% (3 cases) of the latter. Adenocarcinoma of the uterine cervix was found in 0.3% (21 cases) of the unscreened women and in 7.2% (6 cases) of the screened women. Among the women who had undergone cervical screening within 3 years prior to a histologically confirmed diagnosis, invasive carcinoma (excluding adenocarcinoma) was found in 23.3% (14 of 60 women), whereas carcinoma in situ was found in 76.7%. This ratio (1:4) of invasive carcinoma to carcinoma in situ was found to be unchanged among the women of this group regardless of whether the interval from the previous screening was 1, 2, or 3 years. In contrast, when the interval between screenings was 4 or more years, the ratio of invasive carcinoma increased to 52.9% (9 of 17 cases).

Progression of malignancy of severe dysplasia of the uterine cervix.

In the follow-up studies of dysplasia of the uterine cervix, the rates at which 691 cases of mild and 654 cases of severe dysplasia progressed to malignant lesions were, respectively, 0.3% (2 cases) and 17% (111 cases). A classification of the cases of severe dysplasia was made according to the degree of maturation of the lesion into immature, premature and mature dysplasia. The rates of progression to malignancy for these three types were 28.4%, 16.7% and 5.9%, respectively. In cases of carcinoma in situ progressing from immature dysplasia, 74.4% of such cases were of the small cell type, whereas in cases progressing from mature dysplasia, 85.7% were of the large cell type. The similarity in site of the lesion within the cervix was particularly notable between immature dysplasia and carcinoma in situ of the small cell type.

Clinical and histopathological study of carcinoma of the corpus uteri.

Clinical and histopathological investigations were carried out in 71 cases of carcinoma of the corpus uteri treated at the Department of Obstetrics and Gynecology, Tohoku University Hospital over the 10 year period from 1968 through 1977. The ratio of cases of the corpus uteri to those of the cervix was 6.5/100. The average age of the former group was 58 years and 30% of them were nulligravida. The rates of accompanying hyprtension and obesity were 21% and 20%, respectively. With regard to clinical stages, 75% were Stage I, 13% were Stage II, 10% were Stage III and 1% were Stage IV. The histological grade was G1 in 61%, G2 in 26%, and G3 in 13%. In Stage I, 80% of the cases had myometrial invasion into less than 1/3 of the uterine wall, but in Stage II invasion was limited to 1/3 in less than 25%. Metastasis to pelvic lymph nodes was found in 3 of 34 cases (9%): 1 of 24 cases of Stage I (4%) and 2 of 9 (cases of Stage II (22%). All three of these cases had myometrial invasion reaching deeper than 1/3 of the uterine wall. Those with deep myometrial invasion showed a diffuse invasive pattern, as did those of G2 or G3 lesions. Cases of G1 lesions showed a relatively shallow myometrial invasion, whereas there was a tendency for cases of G2 or G3 lesions to have deep myometrial invasion. The over-all 5 year relative survival rate was 83%, while that for the Stage I patients was 98%. All 12 of the patients who died of recurrence of carcinoma of the corpus uteri died within 2 years of treatment.