[Home care that meets the wishes of patients with terminal stage cancer and their families]

As our ward is a general surgical ward, we formerly had difficulties providing appropriate care for patients with terminal cancer. To solve the problem, we have formed a nursing study group in order to provide home care that would meet the wishes of such patients and their families. Our specific approach was as follows: 1) preparation of a form on which patient information is collected; 2) a support system for home care (such as pain control and home parenteral nutrition; and 3) a solid collaboration system between ward nurses and visiting nurses. Such a program enables us to understand the wishes of patients and families and to provide various support where needed. The project helps to lessen the anxiety and the burden that patients and families feel in home care, and improve the quality of life (QOL).

Stimulation by retinoids of the natriuretic peptide system of osteoblastic MC3T3-E1 cells

The effects were examined of treatment with retinoids of osteoblastic MC3T3-E1 cells on the natriuretic peptide system that promotes the differentiation of osteoblastic cells. Northern blot analysis revealed high levels of mRNA for the retinoid X receptor beta (RXR beta) and moderate levels of mRNAs for retinoic acid receptors alpha (RAR alpha) and gamma (RAR gamma). Exposure of MC3T3-E1 cells to 1 microM retinoid caused increases in the levels of C-type natriuretic peptide (CNP) and natriuretic peptide receptor-C (NPR-C). The activity of natriuretic peptide receptor-B (NPR-B) was unchanged after the addition of retinoid to the culture system. These results suggest that retinoids might influence the metabolism of osteoblastic cells through regulation of the natriuretic peptide system.

[Thrombotic thrombocytopenic purpura (TTP) in which plasmapheresis was ineffective but vincristine slow infusion therapy was effective with long-term remission]

A 38-year old female patient with thrombotic thrombocytopenic purpura (TTP) did not respond to plasmapheresis and treatment with corticosteroids and antiplatelet agents but did respond to subsequent high-dose gamma-globulin therapy and vincristine slow infusion therapy. Remission, thought to be due to vincristine, was achieved. The administration schedule of vincristine was 1 or 2 mg once a week by intravenous drip infusion over a period of 6 to 8 hr. Improvement tended to be seen after the 6th administration, and remission was achieved after the 12th administration (total dose: 15 mg), and continues to the time of this writing. In this case, it was thought that vincristine inhibited a certain excessive reaction in the process of PAIgG-related platelet consumption. We conclude that vincristine should be administered at least 5 to 6 times, and the therapeutic method should be established based on the experience in a larger number of clinical cases.

Detection of low molecular weight IgM by immunoblot analysis in rheumatoid arthritis

The immunoblot technique was used to detect low molecular weight IgM (LMWIgM) in the serum and synovial fluid (SF) of patients with rheumatoid arthritis (RA). LMWIgM was detected in 64% of 58 RA sera and in 47% of 17 RA SF. The levels of IgM and rheumatoid factor (RF) were significantly higher in the positive sera of LMWIgM. Sequential studies revealed that LMWIgM appeared in the serum while the titer of RF was high. Our analysis also suggested the presence of several other oligomeric LMWIgM with monomeric IgM.

Polynucleotides. XXXI1. Synthesis of AUG analogs containing 8,2'-S-cycloadenosine, 8,5'-S-cycloadenosine, 8-bromoadenosin, 8-oxyadenosine and formycin in the first position of the codon

Five AUG analogs having 8,2'-S-cycloadenosine (I), 8,5'-S-cycloadenosine (II), 8-bromoadenosine (III), 8-oxyadenosine (IV) and formycin (V) in the first position of ApUpG W were synthesized. 3'-Phosphates of I, II and V were synthesized by phosphorylation using cyanoethylphosphate and DCC. In the case of II, 2', 3'-cyclic phosphate was directly obtained. 3'-Phosphates, thus obtained, were properly protected on the 2'-OH and/or the N6-amino group and condensed with U(OBz)pGiBu(iBu)2 using DCC to give ApUpG analogs. Some properties on paper chromatography and electrophoresis, and the UV and CD spectra of these trinucleoside diphosphates are reported.

Polynucleotides. XXVIII. Stimulation of the binding of aminoacyl-tRNA to ribosomes by tri- and polynucleotide analogs

Messenger activity of synthetic tri- and polynucleotide analogs was studied by binding of 14C-labeled aminoacyl-tRNAs to ribosomes in the presence of the analogs. Synthetic messengers used were: poly(A) analogs in which adenosine was replaced by tubercidine (I), 3-deazaadenosine (II), 1-deazaadenosine (III) and 2-methyladenosine (IV); copolymers of adenosine and aristeromycin (V); cyclic triadenylate (VI); the heptanucleotide of 6,2'-O-cyclouridine (VII); the pentanucleotide of 8,2'-S-cycloadenosine (VIIIa); A-U-G analogs in which adenosine was replaced by 8,2'-O- and S-cycloadenosine (VIII), 8,5'-O- and S-cycloadenosine (IX); 8-oxyadenosine (x); 8-bromoadenosine (XI) and formycine (XII). Among these oligo- and polynucleotides, analogs which contained nucleotides of anti conformation having appropriate bases for Watson-Crick type hydrogen bonding stimulated the binding of corresponding tRNAs to ribosomes.

Studies on transfer ribonucleic acids and related compounds. 8(1). Further studies on aromatic phosphoramidates as a protecting group for phosphomonoesters

Stability of aromatic phosphoramidates was studied using 2',3'-O-dibenzoyluridine 5'-phosphoramidates and N,2',3'-O-tribenzoylcytidine 5'-phosphate. The effect of dicyclohexylcarbodiimide in this mixture was investigated. Decomposition of the anilidate was slower in the presence of DCC. Substituted anilidates of uridine 5'-phosphate were synthesized and the stability of these amidates in anhydrous pyridine was studied.2'-O-Benzoyluridine 3'-phosphoranilidate and the corresponding beta-naphthylidate were compared in their stabilities in anhydrous pyridine, 50% aqueous pyridine and 80% acetic acid. 2'-O-Benzoyluridine 3'-phosphoro-beta-naphthylidate was used for synthesis of dinucleotides.