Azelastine: its clinical application for radiation dermatitis

A retrospective analysis was performed to investigate the radioprotective effects of azelastine against radiation dermatitis for patients with head and neck cancers. The effects of azelastine were studied in 19 patients with laryngeal cancers treated by irradiation. As controls, 29 patients with laryngeal cancers treated by irradiation without the administration of azelastine were studied. All patients were irradiated using 3 MV linac X-rays. Azelastine was administered orally twice a day. Moist desquamation was observed in four of 29 control patients whereas no such moist desquamation developed after the administration of azelastine. Two cases of moist desquamation that developed before the administration of azelastine regressed during irradiation in patients placed on azelastine. Radiotherapy was completed without interruption in all patients treated with azelastine. No severe side effects were observed. Azelastine, administered orally, was a safe drug and has the potential of improving skin tolerance in irradiation therapy.

[A fundamental study of relationships between rhinomanometry and acoustic rhinometry]

A cylindrical model consisting of a single or plural acrylic plates with holes of various cross-sectional areas was ventilated by a Harvard pump. Pressure flow curves of the combinations were drawn and analyzed according to the percent expression method. The length of the cylinder through the same cross-sectional area did not influence the ventilatory resistance. Divergent flow toward the downstream part decreased the resistance, but convergent flow from the upstream part did not. Simultaneous setting of convergent flow from the upstream part and divergent flow to the downstream part decreased the resistance most effectively, as much as approximately 70% of the original resistance. Two separately positioned cross-sectional areas in a respiratory circuit increased the resistance about 1.4 times when the separation length was more than 3 cm, while the resistance remained between 1 and 1.4 times when the separation was shorter than 3 cm. The average values of the minimum areas measured by acoustic rhinometry were usually much larger than expected from the present study. One of the factors affecting this difference may be that the axis from the nostril to the choana is complicated enough to significantly modify the aerodynamics of the nasal cavity.

[Cytomegalovirus disease accompanied by severe hypoproteinemia in a patient with adult T-cell leukemia-lymphoma]

A 62-year-old Japanese man complained of fever, general fatigue, anorexia and watery diarrhea during remission of adult T-cell leukemia-lymphoma. Laboratory examinations showed severe hypoproteinemia (2.9 g/dl). However, neither intestinal lesions associated with ATL nor findings suggesting protein losing gastroenteropathy were observed. Cytomegalovirus (CMV) antigen detection assay using peripheral blood leukocytes revealed that he had an active CMV infection with hemophagocytic syndrome. Treatment with ganciclovir and methylprednisolone led to an improvement of hypoproteinemia. CMV disease and associated hemophagocytic syndrome should be considered as a cause of hypoproteinemia in an immunocompromised host.

Clinical usefulness of 3-D CT endoscopic imaging of cerebral aneurysms

Usefulness of endoscopic imaging of cerebral aneurysms is presented. 3-D luminal images were obtained using a new processing technique which extracts CT numbers in the boundary region between the vessel wall and contrast media filled in the vascular lumen. Clinical application of this technique to complicated large cerebral aneurysms showed that, with this 3-D CT endoscopic imaging, anatomical details of cerebral aneurysms such as the orifice of the aneurysm, intraluminal thrombus, and calcification of the wall could be clearly demonstrated. Using a 3-D imaging method by Helical CT virtual views of various surgical approaches were compared preoperatively. With this technique, not only virtual surgical views of aneurysms and related vasculature, but also surgical views after virtual resection of skull base bone to a desirable extent are freely available. We operated on two large, complicated aneurysms and one broad-based aneurysm after obtaining 3-D CT endoscopic images of the aneurysms. Such information was found to be very useful for determining difficult and complicated cerebral aneurysms and broad-based aneurysms for coil embolization or direct open surgery.

Tumor necrosis factor-alpha-induced expression of heat shock protein 72 in adult feline cardiac myocytes

Tumor necrosis factor-alpha (TNF-alpha) is a proinflammatory cytokine that is elaborated in a myriad of cardiac disease states. Although the biological role for TNF-alpha in the adult heart is not known, a recent study in fetal myocardial cells has shown that this cytokine increases the synthesis of low-molecular-weight stress proteins. These findings suggested the interesting possibility that TNF-alpha might play a functional role in the adult heart by increasing the expression of stress proteins in cardiac myocytes. Accordingly, the purpose of this study was to determine whether TNF-alpha would modulate the expression of heat shock protein 72 (HSP 72), a stress protein that is thought to exert protective effects in the adult heart. Stimulation of adult feline cardiac myocytes with a range of TNF-alpha concentrations (10-1,000 U/ml) for 12 h showed that concentrations of TNF-alpha < or = 10 U/ml had no effect on HSP 72 expression: increased HSP 72 expression was detected 3 h following cytokine stimulation, peaked by approximately 12 h, and then returned toward baseline by 48 h. Additional studies indicated that stimulation of the type 1 TNF receptor was responsible for the increase in HSP 72 expression. In summary, these studies constitute the initial demonstration that TNF-alpha exerts concentration- and time-dependent effects on the expression of HSP 72 in the adult mammalian cardiac myocytes, thus suggesting the interesting possibility that the elaboration of TNF-alpha may enable the heart to better withstand certain forms of stress.

Detection of species specific epitopes of mouse and hamster prion proteins (PrPs) by anti-peptide antibodies

Antisera to four synthetic peptides containing the substitutions between mouse and hamster prion proteins (PrPs) were produced in rabbits. The synthetic peptides used represent two mouse (Mo-I: residues 100-115 and Mo-V: residues 199-208) and two hamster PrP subregion sequences (Ha-I: 101-116 and Ha-V: 200-209). All antisera reacted strongly with homologous peptides but either not at all or poorly with heterologous peptides in enzymelinked immunosorbent assay (ELISA). Antisera to Mo-I and Mo-V recognized mouse PrPSc but not hamster PrpSc in western blot analysis (WB) and ELISA. Antisera to Ha-I contain antibodies specific to hamster PrPSc. The results indicate that these regions of PrPSc constitute species-specific epitopes. In contrast to these antisera, the antiserum to Ha-V recognized neither hamster nor mouse PrPSc. In this study, we identified mouse subregion-V as a species-specific epitope.

Relationship of interleukin-8 and colony-stimulating factors to neutrophil migration in aseptic meningitis

Polymorphonuclear neutrophilic leucocyte (PMNL) migration into the subarachnoid space in aseptic meningitis of probable enteroviral aetiology was evaluated in relation to cerebrospinal fluid and serum levels of interleukin-8 (IL-8), macrophage colony-stimulating factor (M-CSF) and granulocyte colony-stimulating factor (G-CSF). IL-8 levels reached a plateau within 12h of onset, while M-CSF and G-CSF levels reached a peak between 12 and 24 h after onset, corresponding to the peak increase in PMNL count. G-CSF levels had the closest correlation with PMNL count. M-CSF levels were weakly correlated with PMNL count. IL-8 levels were not correlated with PMNL count except within 12 h of onset. IL-8 and G-CSF were detected predominantly in cerebrospinal fluid, while the M-CSF levels in the two compartments were not different except between 12 and 24 h after onset. It is considered that IL-8 triggers rapid and transient migration of PMNL, and that G-CSF then promotes gradual and consistent infiltration of PMNL.

A 15.5-year cohort study on risk factors for possible myocardial infarction and sudden death within 24 hours in a rural Japanese community

A 15.5-year follow-up study of ischemic heart disease among residents 40 years and older in a rural community, A-I district, Shibata City, Niigata Prefecture, Japan, was completed in 1992. The response rate for the initial examination was 84.5% of 1,182 men and 92.6% of 1,469 women. Nine hundred and eighty-five men and 1,344 women who were initially free of ischemic heart disease were followed from July 1977 through December 1992. The person-year incidence of possible myocardial infarction (PMI) was 1.01 per 1,000 for men and 0.59 for women, and that of sudden death within 24 hours (24SD) was 1.08 for men and 0.64 for women. In the sex-, and age-stratified univariate analyses by the Cox proportional hazard regression model, statistically significant relative risk of PMI was observed for systolic (SBP), diastolic (DBP) and mean blood pressure (MBP), body mass index and smoking. For 24SD, DBP and albuminuria were selected as significant risk factors. In the multivariate analyses, MBP and smoking were selected as independent risk factors for PMI. No significant association of any factor with 24SD was detected. The influence of serum cholesterol on occurrence of PMI appeared to be subtle.

Telomerase activity in human breast tumors

BACKGROUND

The activity of the ribonucleoprotein enzyme telomerase is not detected in normal somatic cells; thus, with each cell division, the ends of chromosomes consisting of the telomeric repeats TTAGGG progressively erode. The current model gaining support is that telomerase activity in germline and immortal cells maintains telomere length and thus compensates for the "end-replication problem."

PURPOSE

Our objective was to determine when telomerase activity is reactivated in the progression to malignant breast cancer and if knowledge of telomerase activity may be an indicator for the diagnosis and potential treatment of breast cancer.

METHODS

Using a polymerase chain reaction-based telomerase activity assay, we examined telomerase activity in 140 breast cancer specimens (from 140 patients), four phyllodes tumors (from four patients), 38 noncancerous lesions (20 fibroadenomas, 17 fibrocystic diseases, one gynecomastia; from 38 patients), and 55 adjacent noncancerous mammary tissues (from 55 of the 140 breast cancer patients). In addition, 33 fine-needle-aspirated breast samples (from 33 patients) were analyzed.

RESULTS

Among surgically resected samples, telomerase activity was detected in 130 (93%) of 140 breast cancers. Telomerase activity was detected in 68% of stage I primary breast cancers, in 73% of cancers smaller than 20 mm, and in 81% of axillary lymph node-negative cancers. Moreover, the activity was detected in more than 95% of advanced stage tumors but in only two (4%) of 55 adjacent noncancerous tissues. While telomerase activity was not detected in any of 17 specimens of fibrocystic disease, surprisingly low levels of telomerase activity were detected in nine (45%) of 20 fibroadenomas. Among samples obtained by fine-needle aspiration, 14 (100%) of 14 patients whose fine-needle-aspirated specimen contained telomerase activity and who subsequently underwent surgery were confirmed to have breast cancer. Multivariate analysis of 125 specimens from patients for whom data were available on age at surgery, stage of disease, tumor size, lymph node status tumor histology, and menopausal status indicated that stage classification exhibited the strongest association with telomerase activity (for stage I versus stages II-IV: odds ratio = 1.0 versus 73.4; 95% confidence interval = 2.0-959.0; P = .02).

CONCLUSION

Telomerase activity was detected in more than 95% of advanced stage breast cancers. It was absent in 19%-32% of less advanced cancers. Since a determination of any association between telomerase activity and patient survival is not possible at the present time, it remains to be determined whether lack of telomerase activity predicts for favorable outcome.

Transport mechanism of anthracycline derivatives in human leukemia cell lines: uptake and efflux of pirarubicin in HL60 and pirarubicin-resistant HL60 cells

We studied the transport mechanism of pirarubicin (THP) in HL60 and its THP-resistant (HL60/THP) cells, which showed no expression of mdr1 mRNA on Northern blot analysis. Under physiological conditions, the uptake of THP by both types of cell was time- and temperature-dependent. The amount of drug transport in the resistant cells was significantly less than that in the parent cells within 3 min of incubation. THP uptake was significantly higher in the presence than in the absence of 4 mM 2,4-dinitrophenol (DNP) in glucose-free Hanks' balanced salt solution in both HL60 and HL60/THP cells and the increases were approximately equal. In the presence of DNP, the uptake of THP by both types of cell was concentration-dependent, and there were no significant differences in the apparent kinetic constants (Michaelis constant (Km), maximum velocity (Vmax) and Vmax/Km) for THP uptake between HL60 and HL60/THP cells. Additionally, THP transport was competitively inhibited by its analogue doxorubicin. The efflux of THP from HL60/THP cells was significantly greater than that from HL60 cells, and the release from both types of cell was completely inhibited by decreasing the incubation temperature to 0 degrees C and by treatment with DNP in glucose-free medium. In contrast, the P-glycoprotein inhibitors verapamil and cyclosporin A did not inhibit THP efflux. However, genistein, which is a specific inhibitor of multidrug resistance-associated protein (MRP), increased the THP remaining in the resistant cells, and the value was approximately equal to that of the control group in the sensitive cells. These results suggest that THP is taken up into HL60 and HL60/THP cells via a common carrier by facilitated diffusion, and then pumped out in an energy-dependent manner. Furthermore, the accelerated efflux of THP by a specific mechanism, probably involving MRP, other than the expression of P-glycoprotein, resulted in decreased drug accumulation in the resistant cells, and was responsible, at least in part, for the development of resistance in HL60/THP cells.

Preoperative diagnosis of intratemporal facial nerve tumor: high-resolution CT and otoscopic findings in 4 cases

Four cases of facial nerve tumor were treated in our clinic during the past 16 years, one of which was a recurrence 12 years after the resection. Another case presented with relapsing facial palsy of sudden onset. The others presented with slowly progressive facial palsy. In each of the four cases, the horizontal and vertical portions were included in the tumor extension, and a mass was revealed in the posterior tympanic cavity by use of otoscopy. High-resolution CT, performed in all but the earliest case, proved to be the most valuable diagnostic tool, indicating the anatomical correlation of the tumor with the facial canal. With the diagnosis preoperatively established, facial reanimation procedure could be applied immediately after the tumor resection except in the recurrent case.

Measurement of residual urine volume using a portable ultrasound instrument

A portable ultrasound unit (BladderScan BVI 2000) has been developed which offers a non-invasive procedure to determine urine volume. This study was undertaken to evaluate the accuracy of measurements by this method. A high correlation was demonstrated between the catheterized volume and ultrasound estimation (r = 0.98, p < 0.0001). In patients with residual urine of > 50 ml, the unit could correctly identify 93%. This instrument is useful in estimating the residual urine volume, and its application is recommended as an alternative to catheterization for the determination of residual urine.

Transport mechanism of anthracycline derivatives in human leukemia cell lines: uptake and efflux of daunorubicin and doxorubicin in HL60 and its resistant cells and comparison with those of pirarubicin

We examined the transport mechanisms of daunorubicin (DNR) and doxorubicin (ADR) in HL60 and HL60/THP cells which were the non-P-glycoprotein-mediated resistant clone of the parent HL60 cells and showed a low degree of resistance, and compared them with those of pirarubicin (THP). In both lines, it appeared that the uptakes of DNR and ADR were time-, temperature- and concentration-dependent and energy independent, and the transport of DNR consisted of saturable and nonsaturable components. They were pumped out from the cells time-, temperature- and energy-dependently. There were no differences in the accumulation amount of either DNR or ADR between HL60 and HL60/THP cells. Comparing the transport of DNR or ADR with that of THP, the uptake amounts of DNR and THP were approximately equal, and were greater than that of ADR in both types of cell. In cis-inhibition experiments, DNR inhibited the THP uptake noncompetitively in the parent and resistant cells, in contradiction of the previously reported result in which ADR showed competitive inhibition (Nagasawa, K. et al., Cancer Chemother. Pharmacol., in press). The THP accumulation appeared to be increased by preload of DNR and ADR, indicating a counter transport. Thus, DNR and ADR as well as THP might be incorporated via a common carrier-mediated transport system, but DNR uptake in part appeared to follow a nonsaturable transport, and its binding site in the carrier might differ from that of THP and ADR in both HL60 and HL60/THP cells.

Increased incidence of beta-lactamase-plasmid negative, high level methicillin-resistant Staphylococcus aureus (MRSA)

Recently isolated strains of methicillin-resistant Staphylococcus aureus (MRSA) have high levels of resistance to the agent and produce beta-lactamase less frequently than methicillin-susceptible strains (MSSA). This phenomenon has been observed in Japan. The majority of MSSA strains (26 of 30) isolated in 1992 produced beta-lactamase while only 18 of 31 and 25 of 67 MRSA strains, isolated in 1991 and in 1992 respectively, produced the enzyme. We analyzed the beta-lactamase gene (blaZ) in 30 strains each of MRSA and MSSA isolated from our hospital using the polymerase chain reaction. We found that 28 MSSA strains but only 14 MRSA strains possessed the gene. In addition, the present study indicates that many recently isolated MRSA strains, which lacked blaZ gene and were negative for beta-lactamase, consistently produced coagulase of type II (coagulase typing is a marker of epidemiology for Staphylococcus aureus). These beta-lactamase negative, type II coagulase producing and highly methicillin-resistant MRSA strains are considered to have an increased ability to successfully colonize individuals and an increased epidemic potential, probably because of the saving of the energy otherwise expended in beta-lactamase production and of the loss of beta-lactamase plasmid coding the mecA gene repressor, resulting in constitutive PBP2' production. These factors may contribute to the wide spread of these strains of MRSA in a nosocomial environment.

Histochemical properties of intrinsic laryngeal muscles in cats

As one means in elucidating the contractile properties of the intrinsic laryngeal muscles, we examined the histochemical properties of the posterior cricoarytenoid (PCA), thyroarytenoid (TA), lateral cricoarytenoid (LCA), arytenoid (A) and cricothyroid (CT) muscles in cats using the reaction for myosin ATPase following acid and alkali preincubation. The muscle fiber compositions of the intrinsic laryngeal muscles differed not only across the muscles but also across the muscle fascicles within a single muscle. The relative frequency of type-1 fibers was the smallest (9%) in the TA and the largest (45%) in the CT, and that of type-2A fibers was 39-48% in each muscle. The relative frequency of type-2B fibers was the smallest (9%) in the CT and the largest (42-45%) in the TA, LCA and A, and that of type-2C fibers was less than 1.0% in each muscle. Across the muscle fascicles, the TA was the most heterogeneous in muscle fiber distribution. The mediocaudal part of the TA was mainly composed of the muscle fascicles with type-1 fibers, while the laterocaudal and rostral parts of the TA were mostly composed of the muscle fascicles without type-1 fibers. The PCA was the most homogeneous in muscle fiber distribution. Our results demonstrate that the contractile properties of the intrinsic laryngeal muscles differ across the muscles and across the muscle fascicles within a single muscle and suggest that the delicate laryngeal movements are established by the coordinated activities of the intrinsic laryngeal muscle fibers with different contractile properties.

Recovery of gastrointestinal motility from post-operative ileus in dogs: effects of Leu13-motilin (KW-5139) and prostaglandin F2 alpha

Cyclical motor activity of the gastrointestinal tract, normally occurring during the interdigestive period in several mammals, is disrupted in the post-operative ileus. We determined the recovery from the disappearance of cyclical motor activity, from the stomach to the colon, in dogs after laparotomy with the force transducers. Moreover, we examined the effects of Leu13-motilin (KW-5139) and prostaglandin F2 alpha (PGF2 alpha), administered in the early post-operative period, on the gastrointestinal motility. Following laparotomy, the cyclical motor activity reappeared firstly in the ileum and the colon, then in the jejunum and the duodenum, and finally in the stomach. The reappearance time of the phase III contractions in the stomach was 105.8 +/- 10.6 h (n = 4). In the early post-operative period, KW-5139 (0.5 microgram kg-1, i.v.) induced phase-III-like contractions, whereas PGF2 alpha (50 micrograms kg-1, i.v.) induced simultaneously occurring contractions over the whole gastrointestine. The treatment with KW-5139 (0.5 microgram kg-1, i.v.) four times (twice daily on the first and the second post-operative day) significantly (P < 0.05) shortened the time required to recover the phase III contractions in the stomach (64.2 +/- 2.2 h, n = 4), whereas that with PGF2 alpha (50 micrograms kg-1, i.v.) four times did not (111.3 +/- 17.2 h, n = 4). The present results indicate that, after laparotomy, the cyclical motor activity recovers faster in the distal intestine than in the proximal intestine and the stomach, and that KW-5139, but not PGF2 alpha, shortens the reappearance time of the phase III activity in the stomach.

[Mechanism of inhibition of aldosterone secretion by a Ca2+ channel blocker in patients with essential hypertension and patients with primary aldosteronism]

Three studies were conducted in order to investigate the suppressive effects of a calcium antagonist on aldosterone secretion and a possible mechanism. Study 1: A long-term (4 weeks) treatment with slow-release nifedipine (Nif), 40-60 mg/day, was performed in 9 in-patients with essential hypertension (EHT). Mean arterial pressure (MAP), plasma renin activity (PRA), plasma angiotensin II levels (pAII) and plasma aldosterone concentration (PAC) were determined before and after Nif treatment. Study 2: In another 7 in-patients with EHT, Nif treatment (40-60 mg, 7-10 days) was carried out to study its effect on aldosterone secretion in response to 2-hour ambulation, angiotensin II (AII) infusion (2.5 ng/kg/min, for 1-hour) and ACTH injection (2.5 mg i.v.). Study 3: The effects of Nif (40-60 mg/day, for 7-10 days) on MAP, PAC, serum potassium, potassium clearance (Ck) and changes in PAC or plasma cortisol levels in response to ACTH injection (2.5 mg i.v.) were studied in 6 in-patients with primary aldosteronism (PA). In patients with EHT, MAP was reduced significantly at 1 week and 4 weeks after the administration of Nif. PRA and pAII increased significantly, though the increase of PAC was not significant. In the low-renin EHT group, PAC was reduced significantly (Study 1). The increase of PAC in response to 2-hour ambulation or AII infusion was inhibited by Nif, but no inhibition of aldosterone response to ACTH was observed (Study 2). In patients with PA, Nif lowered MAP, PAC, and Ck, and elevated serum potassium concentration significantly. On the other hand, Nif had no effect on the aldosterone or cortisol response to ACTH (Study 3). These results indicated that the hypotensive effect of Nif is due in part to the inhibition of aldosterone secretion from the adrenal gland both in patients with EHT and in those with PA. Regarding the mechanism of the inhibition of aldosterone secretion by Nif, these data suggest that in patients with EHT, inhibition of the aldosterone response to AII is the most important factor, although it was not clear from this study whether Nif inhibits the potassium-induced aldosterone release or not. In patients with PA, ACTH-induced aldosterone secretion was not inhibited by Nif and the reduction of PAC is not likely via inhibition of AII action since the renin-angiotensin system is markedly suppressed. Reduced cytosolic calcium concentration in the adenomatous tissue by Nif may have something to do with the lowered aldosterone synthesis in PA.

Clinical and serological courses of a newborn with post-transfusion hepatitis C

The clinical and serological course of a haemophilic baby who was transfused with 160 ml of blood containing the hepatitis C virus (HCV) (0.70 Meq. ml-1) on the sixth-post-natal day is described. He is the infant of an HCV-negative mother. One month after the transfusion, there was a marked increase in HCV RNA and a small amount of HCV antibody was detected. This case provides evidence that a newborn is capable of producing HCV antibodies.

[Endocrinological analysis before and after living-related renal transplantation in a patient of Bartter's syndrome]

In order to clarify endocrinological changes before and after living-related renal transplantation in a patient of Bartter's syndrome involving chronic renal failure, serial quantitative determinations of the renin-angiotensin-aldosterone system and 24-hour urinary excretion of 6-keto-prostaglandin F1 alpha and kallikrein were performed. A male patient was admitted to hospital because of a pale face and short stature at the age of 13 years. He was 126 cm in height (M-3.8SD). Blood pressure was 110/60 mmHg and edema was not observed. Laboratory findings showed that his hematocrit was 22.1%, serum potassium 2.9 mEq/1, creatinine clearance was 30.7 ml/min/1.73m2 and beta 2-microgobulin was elevated to 39.9 mg/1 in urinalysis. Plasma renin activity and aldosterone were remarkably elevated to 24.23 ng/ml/hr and 738 pg/ml, respectively. The kidney biopsy specimen showed diffuse glomerulosclerosis and hypertrophic change of the juxtaglomerular apparatus was also demonstrated. He was diagnosed as Bartter's syndrome with short stature and chronic renal failure. At the age of 18, he was introduced on hemodialysis and the living-related renal transplantation was performed the next year. Two weeks after the transplantation, plasma renin activity, angiotensin, I,II and aldosterone were markedly changed from 37.8 to 2.3 ng/ml/hr, 2400 to 220 pg/ml, 256 to 17 pg/ml and 3700 to 110 pg/ml, respectively. Urine prostaglandin F 1 alpha was improved from 860 to 321 ng/day and kallikrein was also changed from 400 to 25.2 micrograms/day. These results indicated that abnormalities of several hormones in Bartter's syndrome could be normalized by living-related renal transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)

Cyanamide-associated alcoholic liver disease: a sequential histological evaluation

This is the first study that we are aware of that followed the histopathological progression of the liver disease that was caused by the combination of both chronic alcohol use and cyanamide, an antidipsotropic agent. Two sequential liver biopsy specimens were obtained on 29 alcoholics who relapsed with varying histories of cyanamide treatment. Cyanamide induced ground-glass inclusions (GGIs) in the hepatocytes. Two groups were identified, depending on whether GGIs proliferated or regressed, which was, in turn, found contingent on the duration of cyanamide treatment and the drug-free period. Group 1 included 14 cases in which GGIs either emerged only in the second biopsy specimen or else were increased in the second specimen as compared in the initial specimen. Group 2 composed of 15 cases in which GGIs were either not observed in either specimen or decreased in the second specimen as compared in the initial specimen. Acidophilic bodies were sequentially increased in five cases (36%) of group 1 and in none of group 2. The severity of portal inflammation worsened in 10 cases (71%) of group 1 but in 2 cases (13%) of group 2, although the changes in fibrotic process did not differ between two groups. These differences could not be explained on the basis of the daily ethanol consumption and the length of relapses of the two groups. Thus, when cyanamide-treated alcoholics relapsed, the combined effect of cyanamide and alcohol produced the development of acidophilic bodies and portal inflammation along with the emergence of GGIs.