Incidence of hepatitis virus infection and severe liver dysfunction in patients receiving chemotherapy for hematologic malignancies

Hepatitis virus infection through virus reactivation has a high risk of mortality in patients with hematological malignancies receiving chemotherapy. We examined the incidence of both hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and severe liver dysfunction (alanine aminotransferase >ten times the normal upper limit and total bilirubin >5 mg/dl) during chemotherapy in 268 patients with hematological malignancies. Eight patients (3.0%) were infected with HBV and 22 patients (8.2%) were infected with HCV. One patient (0.4%) was infected with both HBV and HCV. HBV- or HCV-infected patients showed severe liver dysfunction at a significantly higher incidence than non-infected patients (11/31 (35.5%) vs. 0/237 (0%), p<0.0001). Furthermore, the incidence of severe liver dysfunction in HBV-infected patients was significantly higher than in HCV-infected patients (6/8 (75.0%) vs. 4/22 (18.2%), p<0.01). Three of eight HBV-infected patients were initially negative for hepatitis B surface antigen (HBsAg) by latex agglutination and became positive for HBsAg during chemotherapy. Furthermore, all three patients developed severe liver dysfunction and two developed fatal fulminant hepatitis. From an examination of the original stock of serum samples before chemotherapy, two patients were found to be positive for HBV-DNA by polymerase chain reaction (PCR). Although post-transfusion HBV infection was suspected in the one remaining patient, the cause of HBV infection could not be clarified due to the impossibility of examination in blood donors. Since HBV-infected patients develop severe liver dysfunction at a higher incidence than either patients not infected with virus or HCV-infected patients before chemotherapy for hematological malignancies, it is recommended that HBV-DNA should be tested by PCR to detect HBV marker-negative carriers and liver function tests should be carefully monitored.

Frequency of and risk factors for epistaxis associated with exercise-induced pulmonary hemorrhage in horses: 251,609 race starts (1992-1997)

OBJECTIVE

To determine the frequency of epistaxis during or after racing among racehorses and identify factors associated with development of epistaxis.

DESIGN

Retrospective study.

SAMPLE POPULATION

247,564 Thoroughbred and 4,045 Anglo-Arab race starts.

PROCEDURE

Race start information (breed, age, sex, racing distance, and race type) was obtained for Thoroughbred and Anglo-Arab horses racing in Japan Racing Association-sanctioned races between 1992 and 1997. All horses that raced were examined by a veterinarian within 30 minutes of the conclusion of the race; any horse that had blood at the nostrils was examined with an endoscope. If blood was observed in the trachea, epistaxis related to exercise-induced pulmonary hemorrhage (EIPH) was diagnosed.

RESULTS

Epistaxis related to EIPH was identified following 369 race starts (0.15%). Frequency of EIPH-related epistaxis was significantly associated with race type, age, distance, and sex. Epistaxis was more common following steeplechase races than following flat races, in older horses than in horses that were 2 years old, following races < or =1,600 m long than following races between 1,601 and 2,000 m long, and in females than in sexually intact males. For horses that had an episode of epistaxis, the recurrence rate was 4.64%.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggested that frequency of EIPH-related epistaxis in racehorses is associated with the horse's age and sex, the type of race, and the distance raced. The higher frequency in shorter races suggests that higher intensity exercise of shorter duration may increase the probability of EIPH.

Determination of oral dosage and pharmacokinetic analysis of flecainide in horses

To determine oral dosage and to evaluate the pharmacokinetics in horses of orally administered flecainide, an antiarrhythmic drug, the correlations between its plasma concentration and PR, QRS and QT intervals in equine electrocardiograms (ECG) were investigated. Six healthy horses were administered a randomly ordered dose of 4 or 6 mg/kg of flecainide acetate. The ECG was monitored (heart rate (HR), PR, QRS, and QT intervals) and blood was taken at timed intervals to measure the plasma flecainide concentrations pre- and post-administration. The maximum plasma concentration reached 1014+/-285 (SD) ng/m/ in 45+/-13 min and 1301+/-400 ng/ m/l in 60+/-37 min for doses of 4 and 6 mg/kg flecainide, respectively. From the pharmacokinetic analysis, clearance rates were 14.6+/-6.4 and 11.7+/-5.2 ml/kg/min and terminal elimination half-lives were 228+/-53 and 304+/-87 min. The QRS and QT intervals increased significantly for both doses following administration, though HR and PR intervals did not change. Plasma flecainide concentrations were significantly correlated with QRS (r=0.935, P<0.001) and QT intervals (r=0.753, P<0.001). In conclusion, plasma concentrations of flecainide for treating equine atrial fibrillation were obtained by oral administration of 4 and 6 mg/kg, and the drug was rapidly eliminated from plasma in horses.

Potentially protective effects of the Ser447-Ter mutation of the lipoprotein lipase gene against the development of coronary artery disease in Japanese subjects via a beneficial lipid profile

Several DNA variants at the lipoprotein lipase (LPL) gene locus have been found to be associated with the plasma lipid levels and the prevalence of coronary artery disease (CAD). In particular, the Ser447-termination (Ter) mutation at the exon 9 of the LPL gene has the potential to elevate the plasma high-density lipoprotein (HDL) levels, but it remains unknown in the Japanese population. The present study investigated 93 CAD patients and 96 age- and sex-matched healthy controls. The Ser447-Ter mutation was determined by polymerase chain reaction restriction fragment length polymorphism method. The allelic frequency of the Ser447-Ter mutation was 0.103 in all subjects. The Ser447-Ter (GG and CG) group was associated with significantly higher levels of plasma HDL-cholesterol (p<0.001) and lower levels of plasma triglyceride than the CC group (p<0.02). The peak particle size of low-density lipoprotein (LDL) was significantly larger in the Ser447-Ter (GG and CG) group than in CC group (p<0.05). The frequency of the Ser447-Ter genotype in GG and CG was significantly lower in CAD than in the controls (11.9% vs 26%, odds ratio = 0.38; 95% confidence interval, 0.18-0.81; p<0.02). These results suggest that the Ser447-Ter mutation of the LPL gene is associated with high plasma HDL-cholesterol levels, low plasma triglyceride levels and a larger LDL particle size. This mutation may have a protective effect against the development of CAD via its favorable lipoprotein profile.

Safe and efficacious dosage of flecainide acetate for treating equine atrial fibrillation

To determine a safe and efficacious dose of flecainide acetate for treating equine atrial fibrillation (Af), the safe dosage level was determined by injecting 1, 2, or 3 mg/kg i.v. of 1% flecainide acetate solution at a rate of 0.2 mg/kg/min to five clinically healthy horses. Clinical signs and the ECG were monitored (HR, PR, QRS, and QT intervals) and blood was taken to measure the plasma flecainide concentration pre- and post-administration. No abnormal signs were observed in the 1- or 2-mg/kg groups, while agitation was observed in three of five horses in the 3-mg/kg group. The QRS, and QT intervals for the 3-mg/kg group increased significantly. The peak plasma flecainide concentrations were 1.316 +/- 358 (SD) ng/ml, 1,904 +/- 314 ng/ml, and 2,251 +/- 387 ng/ml for the 1-, 2-, and 3-mg/kg groups, respectively. To evaluate the efficacy of flecainide, Af was induced by right atrial pacing in six clinically healthy horses, and 1% flecainide acetate solution was then administered until they converted to sinus rhythm. All horses with induced Af converted. For the conversion, a total dose of 1.40 +/- 0.63 mg/kg flecainide was required, the duration of administration was 7.00 +/- 3.15 min and plasma flecainide concentration at conversion was 1,303 +/- 566 ng/ml. In conclusion, flecainide acetate is a safe and effective antiarrhythmic agent for equine Af, and the clinically effective dosage is 1 to 2 mg/kg.

Effects of troglitazone on atherogenic lipoprotein phenotype in coronary patients with insulin resistance

Insulin resistance is associated with atherogenic lipoprotein phenotype, including small dense LDL particle, hypertriglycemia and low HDL cholesterol levels. Troglitazone, a novel insulin sensitizing agent, may improve the associated lipid profile in patients with insulin resistance. We examined the effects of troglitazone (400 mg daily for 12 weeks) in 12 non-diabetic coronary patients (60+/-10 years), all of whom had hyperinsulinemic response to an oral glucose load. Troglitazone markedly reduced the insulin response. After the treatment, plasma triglycerides decreased by 32% (P<0.05), HDL cholesterol increased by 11%, (P<0.05) and LDL peak particle diameter increased from 24.7+/-0.3 to 25.5+/-0.5 nm (P<0.01). These lipidic improvements were associated with a significant rise in postheparin lipoprotein lipase levels (175+/-52 to 217+/-69 ng/ml, P<0.01). In patients with insulin resistance syndrome, troglitazone improved the atherogenic lipoprotein phenotype as well as hyperinsulinemia. Our data suggest that troglitazone therapy could reduce the atherosclerotic risk due to insulin resistance even in non-diabetic patients.

Possible role of high susceptibility of high-density lipoprotein to lipid peroxidative modification and oxidized high-density lipoprotein in genesis of coronary artery spasm

Recent study demonstrated high susceptibility of plasma LDL to lipid peroxidative modification in patients with variant angina. Oxidized stress state, especially oxidized LDL, may induce coronary artery spasm by its impairing effect of endothelium-dependent arterial relaxation, but precise mechanisms remain unclear. Study subjects included 93 patients who underwent coronary angiographic examination: 12 patients with coronary artery spasm provoked by ergonovine without organic stenosis (group I), 11 patients who did not demonstrate coronary artery spasm or organic stenosis (group II) and 70 patients with organic coronary artery stenosis (group III). Levels of plasma HDL-cholesterol and apoA-I in group I were similar to those in III but were significantly lower than those in II, although the other plasma lipid parameters were not different among the three groups. The levels of TBARS in plasma and HDL were significantly higher in group I than in II or III (2.94+/-1.56 vs. 1.91+/-0.35 or 2.23+/-0.89 nmol MDA/ml and 1.23+/-1.00 vs. 0.54+/-0.37 or 0.70+/-0.63 nmol MDA/mg protein; P < 0.05), although the levels of TBARS in LDL were not significantly different. In the monitoring curve of diene production during copper-induced lipid peroxidation of HDL, its propagation slope was steeper and levels of maximum diene absorbance was higher in group I as compared with that in II or III, but not found in those of LDL. These results suggested that high susceptibility of HDL to lipid peroxidative modification in group I may contribute to the genesis of coronary artery spasm, and oxidized HDL rather than oxidized LDL is more likely to be related to coronary artery spasm.

Transformation of skin from larval to adult types in normally metamorphosing and metamorphosis-arrested salamander, Hynobius retardatus

Transformation of skin from larval to adult types in a salamander, Hynobius retardatus, which had been reported to show neotenic reproduction in a specific environment, was examined morphologically in normally metamorphosing, precociously metamorphosing and metamorphosis-arrested larvae. Typical larval skin was composed of an epidermis constituted by three types of cells such as apical, Leydig, and basal cells. The Leydig cells were larval specific, and thus disappeared and were replaced by adult epidermal cells during the metamorphosis. Disappearance of the Leydig cells was accomplished by apoptosis as confirmed by the terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end-labeling method and electron microscopy during the normal metamorphosis and precocious metamorphosis induced by exogenously applied triiodothyronine. Typical adult skin was composed of epidermis constituted by stratified squamous cells and of dermis mainly occupied with two types of dermal glands, mucous and serous glands. When the metamorphosis was arrested by different procedures (thyroidectomy, hypophysectomy, goitrogen treatment, and rearing at low temperature), the larval-specific Leydig cells fully remained in the epidermis, suggesting that the disappearance of these depended on the thyroid activity. Contrary to this, dermal glands behaved differently from the Leydig cells, though they developed and differentiated from epidermal basal cells and constituted the same skin. Those in the metamorphosis-arrested (thyroidectomized, hypophysectomized, or goitrogen-treated) larvae, except in the larvae reared at 4 degrees C, appeared a little later than in the controls. Thus, the aged, metamorphosis-arrested larvae had skin which consisted of larval type epidermis (Leydig cells) and adult type dermis (mucous and serous glands).

Progressive telomere shortening and telomerase reactivation during hepatocellular carcinogenesis

Telomeres shorten progressively with age in normal somatic cells in culture and in vivo. The maintenance of telomere length is assumed to be an obligatory step in the progression and immortalization of most human tumor cells. To understand the role of telomere dynamics in the development of hepatocellular carcinoma (HCC), we examined the length of terminal restriction fragment (TRF), as an indicator for telomere length, in HCC and surrounding tissues with chronic active hepatitis (CAH) or liver cirrhosis (LC). The study was performed in 12 hepatitis C virus (HCV) antibody-positive, 12 hepatitis B virus (HBV) antigen-positive tissues, and 4 tissue samples from virus-negative patients with HCC. The peak TRFs in all 3 types of HCC were significantly shorter than those of the surrounding tissues (i.e., LC or CAH). TRFs examined in one patient with atypical adenomatous hyperplasia (AAH) also was shortened. Thus, progressive TRF shortening occurs from normal to CAH to LC to HCC(AAH). Telomerase, an enzyme that adds repeated telomere sequences onto the chromosome ends and stabilizes telomere length in immortal cells, also was examined in tissues and detected in high levels almost exclusively in HCCs. Interestingly, the intensity of telomerase activity in the AAH case was similar to that of HCC. In addition, the telomerase activity of biopsy samples with a fine 21-gauge needle also was examined in 10 HCCs, 2 adenomatous hyperplasias (AHs), 2 LCs, and 2 CAHs. We found strong telomerase activity in all the HCCs and surprisingly in the 2 cases that were pathologically diagnosed as AH. Thus, the findings strongly suggest that persistent cell proliferation or rapid cell turnover through damage of hepatic cells result in a process of multistep hepatocellular carcinogenesis. Thus, progressive shortening of telomeres and the activation of telomerase may be a useful marker for the early detection of malignant progression in liver disease.

Proliferating patterns of salivary gland adenocarcinomas with the use of PCNA labeling

Cellular proliferation activity in a series of salivary gland malignant tumors was evaluated using the index of proliferation cellular nuclear antigen (PCNA) immunoreactivity. A streptavidin-biotin immunoperoxidase method (ABC) using a monoclonal antibody PC10 demonstrated nuclear staining with varying intensity and distribution in all tumor specimens. Acinic cell carcinoma (n = 5) and polymorphous low-grade adenocarcinoma (n = 1) showed relatively low proliferation fractions. In adenoid cystic carcinoma (n = 13), PCNA-positive nuclei were mainly distributed in neoplastic myoepithelial cells which were the predominant cells in tumor growth. No statistically significant difference was found between cribriformtubular and solid subtypes. In adenocarcinoma (n = 6), a well differentiated papillary-cystic pattern expressed a significantly higher PCNA index than poorly differentiated solid pattern, showing the loss of the relationship between PCNA expression and differentiation. Tumor cell differentiation appears to be more important than proliferation in determining biological behavior and prognosis.

Expression of cytokeratins in Warthin's tumour (adenolymphoma) of parotid glands: specific detection of individual cytokeratin types by monoclonal antibodies

This study evaluated the distribution of cytokeratins detected by monoclonal antibodies directed against individual keratin proteins in normal human salivary glands and epithelial tumour cells of Warthin's tumour arising in parotid glands to determine a more precise mapping of their cellular distribution. The normal salivary ducts showed the presence of cytokeratin 7, 8, 18 and 19 in the intercalated, striated and excretory ducts, the primary keratins of stratified and simple epithelia with a profile very similar to the non-cornified epithelium of the oral mucosa. The basally located cells of salivary gland ducts other than myoepithelial cells were reactive for keratins 7 and 19 suggesting a close similarity in profile of keratin in the basal cells of the oral epithelium. In Warthin's tumour, keratins 7, 8, 18 and 19 were consistently detected in the epithelial cells of the tumour, a profile with a tendency to mimic the same in normal ductal epithelium. The distribution, however, was diverse and a heterogeneity was observed in the basal and luminal cells of Warthin's tumour which differed even in different areas of the same tumour specimen.

Heterogeneity of cytokeratin expression as revealed using monoclonal antibodies in salivary adenocarcinomas

Numerous neoplastic lesions of the salivary glands often share a number of similar histopathological features and different areas of the same tumor specimen, not infrequently, may show a diverse histomorphology. The present study evaluates expression of single keratin proteins recognized by monoclonal anti-K7, K8, K18, K19 and keratins recognized by monoclonal KL1 and K8.12 in tubular-duct-like or cribriform structures, solid nests, clear cells, microcystic, basaloid cells and squamous metaplastic histomorphology present in tissue specimens of adenoid cystic carcinoma (n=11), acinic cell carcinoma (n=5), polymorphous low grade adenocarcinoma (n=1) and adenocarcinoma, not otherwise specified (NOS, n=5) of salivary glands. Expression of vimentin in the epithelial tumor cells was further evaluated using an anti-vimentin monoclonal antibody. A great heterogeneity of keratin expression was observed in the luminal and abluminal cells forming the tubular-duct-like and cribriform structures. The abluminal cells in more than half of the instances of adenoid cystic carcinoma had immunoreactive vimentin. In addition, heterogeneity was more pronounced in tumor cells forming the solid nests, comedo-necrosis, microcysts, clear cells or squamous metaplasia. A heterogeneity of keratin profile in different histomorphologies of different tumor types and even in different areas of the same tumor specimen, in the present study, and the available evidence so far limits the use of cytokeratin immunostaining in the differential diagnosis of neoplastic salivary lesions and characterization of a particular histomorphology which, in many instances, are ubiquitous in different tumor subtypes.

[Suppressive effect of Gossypol, Gossypolone and serum from Gossypol treated rats on steroidogenesis in cultured porcine granulosa cells]

Gossypol (GP), a male antifertility agent, and Gossypolone (GN), a major metabolite of GP, have been shown to have a suppressive effect on steroidogenesis in bovine luteal cells. We examined the effect of GP, GN and serum obtained from rats given GP (GP-serum) on steroidogenesis in porcine granulosa cells (PGC). To obtain GP-serum, 50-60 day old Copenhagen rats received GP (12.5 mg/kg B.W./day, sc) for 14 days. PGC were incubated with GP, GN and GP-serum at different doses for 24 hours. GP and GN significantly suppressed Progesterone (P4) and Estradiol (E2) release in a dose-dependent manner, respectively. GP-serum also significantly suppressed P4 release in a dose-dependent manner. The magnitude of suppression of P4 obtained by GP-serum could not be explained by the amount of GP remaining in the serum. Therefore, the inhibition of P4 release by GP-serum could not be solely attributed to GP.

Restoration of the cellular senescence program and repression of telomerase by human chromosome 3

Telomeres, at the end of chromosomes, shorten with each cell division, resulting in cellular senescence. Tumor cells, unlike normal somatic cells, express a telomerase that maintains the telomere length. Deletion of a gene(s) on chromosome 3 is common in human renal cell carcinoma (RCC) and reintroduction of a normal chromosome 3 into an RCC immortal cell line restored the program of cellular senescence. The loss of indefinite growth potential was associated with the loss of telomerase activity and shortening of telomeres in the RCC cells with a normal chromosome 3. However, microcell hybrids that escaped from senescence and microcell hybrids with an introduced chromosome 7 or 11 maintained telomere lengths and telomerase activity similar to those of the parental RCC23. Thus, restoration of the cellular senescence program by chromosome 3 is associated with repression of telomerase function in RCC cells.

Expression of tenascin in odontogenic tumours

We investigated the expression of tenascin in a series of odontogenic tumours (n = 63) of epithelial and epithelial-ectomesenchymal origin by using immunohistochemical methods. A heterogeneity of expression of tenascin was observed in odontogenic tumours. The heterogeneity was most prominent in odontogenic tumours not forming calcified tissues. In these ameloblastomas and adenomatoid odontogenic tumours, tenascin was mainly localised at the epithelial tumour cell-mesenchymal tissue interface. In the calcifying epithelial odontogenic tumour, ameloblastic fibroma and odontoma, a widespread stromal immunoreactivity was observed which was, however, unreactive in the calcified masses. The stellate reticulum-like cells and granular cells of ameloblastoma also showed a positive immunoreactivity for tenascin. The results of the present study suggest that expression of tenascin in the stromal tissue of odontogenic tumours differs according to the potential of forming calcified masses by the tumour cells irrespective of tumour cell morphology.

[Adult case of aortopulmonary window with aortic regurgitation: a case report]

A 45-year-old woman was admitted to our hospital because of the evaluation of heart murmur. Her height was 152 cm and body weight was 46 kg. The physical examination showed a grade 4 continuous murmur widely audible on the anterior chest wall. The chest X-ray film was normal. The electrocardiogram showed premature ventricular contractions and left ventricular (LV) hypertrophy. The two dimensional echocardiogram demonstrated the presence of moderate aortic regurgitation (AR), however, aortopulmonary window could not be detected. The aortic valve showed neither atherosclerotic nor rheumatic changes. At cardiac catheterization, pulmonary artery (PA) pressure was 20/11 mmHg and aortic pressure was 133/60 mmHg, and a step-up of O2 saturation between right ventricule and pulmonary artery (PA) was demonstrated. The aortography revealed an aortopulmonary window between the proximal ascending aorta and the main PA, and grade 2 AR. The pulmonary to systemic flow ratio averaged 1.5:1. The coronary artery and the LV wall motion was normal. Aortopulmonary window is a very rare anomaly and often requires operation in childhood because of its large left-to-right shunt in most cases. Neither an asymptomatic adult case with this anomaly nor a case with AR has not been reported so far.

Transforming growth factor-β1 regulates differentiation of porcine granulosa cells in vitro

Transforming growth factor-beta (TGF-beta) is a potential regulator of ovarian function and follicular development. It is speculated that TGF-beta mediates the events in the follicle which culminate in ovulation of the oocyte. The complex processes which ultimately leads to this natural phenomenon must involve interactions between the 2 major follicular cell types, theca and granulosa cells, and the oocyte. Furthermore, a complex local regulatory system must exist to determine which follicles should undergo development and, eventually, which of those should ovulate or undergo atresia. To begin to understand this perplexing process, we must first understand the variables which control the function of each individual cell type. This study investigated the effect of TGF-beta(1) on FSH-induced porcine granulosa cell differentiation in vitro. Transforming growth factor-beta(1) was shown to inhibit progesterone production at high concentrations (0.1 and 10.0 ng/ml) after 12-, 24- and 48-hour treatment. However, TGF-beta(1) produced a biphasic effect on FSH-induced progesterone production during the 12-hour interval between the 36- and 48- hour treatment periods; TGF-beta(1) stimulated progesterone production at a low concentration (0.001 ng/ml) and inhibited production at high concentrations (0.1 and 10.0 ng/ml). The results obtained from the biphasic effect were not observed during any of the other incubation periods or intervals investigated. These results show that TGF-beta(1) has opposing effects on the differentiation of porcine granulosa cells as compared with those on rat granulosa cells. Moreover, TGF-beta(1) can produce opposing effects within the porcine granulosa cell itself which are specific to the concentration and treatment period used. The results of this study seem to suggest that TGF-beta(1) is species- and time-specific in its regulatory actions on FSH-induced porcine granulosa cell differentiation.

[Telomere, cellular senescence and transformation]

Telomere is the structure which is located on both ends of individual chromosomes in eukaryotes. The DNA sequence of the telomere consists of Guanine-rich tandem repeat, i.e., (TTAGGG)n in man. Telomere protects the end of the chromosome from fusion or deletion and maintains the stability of the chromosome and is synthesized by telomerase, a ribonucleoprotein. Telomere reduction is observed with cell senescence and immortalization, both in vivo and in vitro. Thus, telomere is considered to be a "clock" which measures the life span of cells, and its length is altered by cellular senescence and immortalization.

[A comparative double blind study of lenampicillin and talampicillin in the treatment of oral infections]

A comparative double blind study of lenampicillin (LAPC, KBT-1585) and talampicillin (TAPC) was carried out in order to objectively evaluate efficacy, safety and utility of LAPC in treatment of 238 patients with oral infections. Cases accepted by the Central Committee for evaluation of efficacy and utility were 218, consisting of 101 of the LAPC group and 117 of the TAPC group; safety were 234, consisting of 110 of LAPC and 124 of TAPC. Clinical effectiveness as rated by attending doctor was 84.2% for the LAPC group and 82.9% for the TAPC group. The clinical utility rating was 82.2% in the LAPC group and 82.1% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were found in 6 cases (5.5%) in the LAPC group and 5 cases (4.0%) in the TAPC group, showing no significant difference between the 2 drugs. Cases accepted by the controllers for evaluation of efficacy and utility were 236, consisting of 111 cases of LAPC and 125 cases of TAPC. Those for safety were 236, consisting of 111 cases of LAPC and 125 of TAPC. The clinical effectiveness rating was 77.5% in the LAPC group and 79.2% in the TAPC group. Clinical utility rating was 75.7% in the LAPC group and 78.4% in the TAPC group. Rate of adverse reactions was 5.4% in the LAPC group and 4.0% in the TAPC group, showing no significant difference between the 2 drugs. Cases evaluated for efficacy according to numerical rating on the 3rd day were 200 cases, consisting of 93 of LAPC and 107 of TAPC. The effectiveness rate was 83.9% in the LAPC group and 95.3 in the TAPC group, showing a significant difference between the 2 drugs. On the other hand, taking into consideration evaluation scores of the 5th day, the effectiveness rate was 88.7% in the LAPC group and 96.1% in the TAPC group, showing no significant difference between the 2 drugs. The effectiveness rate in cases of isolated organisms was 84.9% in the LAPC group and 79.7% in the TAPC group, showing no significant difference between the 2 drugs. Adverse reactions were mostly of gastrointestinal origin. Symptoms were not serious and disappeared soon after administration was discontinued or immediately after administration was completed.(ABSTRACT TRUNCATED AT 400 WORDS)

[Clinical evaluation of lenampicillin in oral and maxillofacial infections]

Clinical efficacies of newly developed synthetic oral ampicillin prodrug lenampicillin (LAPC, KBT-1585) applied to 109 cases of oral infection were studied. There were 7 dropout cases. The results as determined on a point system are as follow: Remarkably effective, 26 cases; effective, 63 cases; and not effective, 13 cases, for an efficacy rate of 87.3%. When rated by the subjective judgement of the doctors in charge, these figures are as follow: remarkably effective, 21 cases, effective, 67 cases; slightly effective, 10 cases; and not effective, 4 cases. The rate of efficacy in this way being 86.3%. In either way, the results obtained were favorable. Among 102 cases in this study, pus was aspirated with sterile needle from obstructed abscesses in 65 cases, with the result that 161 strains of bacteria were isolated and identified. Most of infections were found mixed type by aerobic Gram-positive cocci and anaerobes. Especially, cases caused by alpha-Streptococcus were observed in 48 out of 55 mixed infective cases. LAPC's MIC distribution against the detected bacteria showed strong antibacterial effect as follows: against Gram-positive cocci, less than 0.39 micrograms/ml; against Gram-negative bacteria (excluding some insusceptible strains), less than 3.13 micrograms/ml. Thus, LAPC demonstrated a superiority when compared to CEX by 4 approximately 128-fold, and when compared to AMPC by about 2-fold. Adverse reactions among the 109 cases consisted of 6 cases of gastro-intestinal disorders including 3 cases of diarrhea. Recognized cases of abnormal laboratory findings were 3 cases out of 76 (3.9%), but none were serious.

[Clinical studies on TMS-19-Q.O tablets, the preparation of a new macrolide antibiotic, in the field of oral surgery]

Multicenter clinical trial or TMS-19-Q.O tablet was performed to evaluate the usefulness in oral surgery. The results obtained were as follows: Clinical efficacy was assessed by clinical points. The patients entered into the trial were 77 cases with periodontitis, 23 with pericoronitis, 92 with osteitis of jaw and 18 with other infections, and the each effective rates were 80.5, 60.9, 83.7 and 72.2%, respectively. Overall effective rate was 79.0%. Isolation frequency of organisms were 33.8% in periodontitis, 34.8% in osteitis of jaw and 17.4% in pericoronitis. Bacteria isolated were aerobic organisms (63.1%) and anaerobic organisms (36.9%). TMS-19-Q.O tablet was well tolerated, and no adverse reaction was observed.

[Stroboscopic rotation in depth and form properties, orientation of stimulus and the position of fixation]

Stroboscopic motion between two triangles in a symmetrical relation was studied in terms of probability of seeing rotation in depth as affected by configurational properties of the triangles, the axis of symmetry and the position of a viewing point. Symmetry was found to be primarily important for seeing the rotation. Corresponding line-elements of the triangles paralleling side by side near to the axis were particularly effective. Neither the orientation of the axis (vertical, horizontal of diagonal) nor the position of a viewing point (on or out of the axis) were effective.

[Stimulus configuration and geometric transformation as determinants in two- and three-dimensional stroboscopic motion]

Geometric transformation theory which claims the correspondence between the stroboscopic motion and the geometric transformation of stimulus-figures in two- or three-dimensional rotation was examined from the viewpoint of stimulus configurational feature theory which stresses the role of parallel lines for three-dimensional stroboscopic rotation. It was found that the two theories were compatible to the extent that the "equality in length" of adjacent parallel elements powerfully contributes to the formation of an axis for three-dimensional rotation. This was true even in the case where there was no three-dimensional rotation in its geometry. The "inequality of length" of parallel lines lost the power to generate three-dimensional stroboscopic rotation but did not affect two-dimensional rotation at all. In all cases the angle of rotation in either two-dimensional or three-dimensional geometric rotation did not play any role as determinants of the types of stroboscopic rotation.

Efficacy and side effects of the regional arterial infusion of anti-cancer drugs combined with direct hemoperfusion in malignancies of the urinary tract

Regional arterial infusion of high doses of anti-cancer drugs combined with direct hemoperfusion was done in 12 patients with malignancies of the urinary tract. The perfuser contained 130 gm. activated charcoal, which was coated with cellulose. General toxicity caused by escape of the drug from the tumor area was prevented by adsorption within activated charcoal. The capacity of activated charcoal to adsorb doxorubicin hydrochloride was excellent, as determined by measurements of plasma concentration. With this method, objective tumor reduction was noted in 84 per cent of the patients with prostatic or bladder carcinoma, although results were disappointing in patients with renal cell carcinoma.

[The effect of form information and presentation order of stimuli on stroboscopic motion]

The likelihood of stroboscopic motion between different contour combinations was obtained under temporal conditions (duration, ISIs). Three kinds of contour figures were prepared; the real, the subjective and the control. Two stimulus figures for such combinations were chosen from these three; one as the first stimulus and the other as the second. The result was that the likelihood of seeing motion was reduced, when the contour figure of more form information was used as the first stimulus and that of less form information as the second than when they were in the reverse order. This was considered as the effect of order of stimulus presentation.

[Effects of subjective contours in stroboscopic motion (author's transl)]

It was tested whether "subjective" contours have functional effects similar to real contours on stroboscopic motion. The probability of seeing motion between a pair of subjective contour stimuli was compared with that between a pair of the corresponding real contour stimuli. The results were as follows: (1) For both identical shapes and disparate shapes, subjective contours had functional effects similar to real contours, but this equivalence was not enhanced increasing duration. (2) Three types of stroboscopic motion were observed when between two disparate shapes was used as stimuli (two-dimensional rotation of rigid shapes, rotation in depth and plastic deformation), dependent on geometrical transformations between stimulus pairs rather than on ISI and duration.

Regional arterial infusion of an anticancer drug combined with direct hemoperfusion

The capacity of activated charcoal to adsorb anticancer drugs, Mitomycin C, Adriamycin and Bleomycin was examined in vitro in a closed circuit through a perfuser containing uncoated activated charcoal. Samples were obtained from the inlet and outlet of the perfuser every 30 min. As in vivo experiments, regional arterial infusion of anticancer drugs combined with direct hemoperfusion was performed on dogs. In 20 male mongrel dogs a polyethylene catheter was indwelt in the internal iliac artery and anticancer drugs were infused through the catheter for 1 hr. By using the femoral vessels for the blood access, direct hemoperfusion was performed for 3 hr. The adsorptive capacity of activated charcoal was high in both in vitro and in vivo experiments. These results indicate that regional arterial infusion of anticancer drugs combined with direct hemoperfusion would be useful for preventing their toxicity.