Photodynamic therapy with hematoporphyrin derivative in cancer of the upper gastrointestinal tract

An historical overview is given of the development of photodynamic therapy (PDT) with hematoporphyrin derivative for the treatment of malignant tumors. Results in patients with superficial, and non-superficial esophageal cancer and with early gastric cancer is described, with case illustrations and follow-up. Due to the difficulty in early stage diagnoses and in determining all cases of lymph node involvement, this form of treatment should be employed primarily in inoperable early-stage cancer, to reduce the extent of resection, or to render previously inoperable cases operable. Combination with other treatment modalities and the effects of PDT on histologically different tumor types, need to be further examined.

A trial of adjuvant combination chemoimmunotherapy for stage III carcinoma of stomach

A chemoimmunotherapy program designed on the basis of experimental results was administered to 27 patients with stage III carcinoma of stomach following curative resection. The treatment regimen consisted of active immunotherapy with Vibrio cholerae neuraminidase (VCN)-treated autologous tumor cells admixed with bacillus Calmette-Guérin (BCG) and chemotherapy with drugs such as cyclophosphamide (CY), mitomycin C (MMC), and 5-fluorouracil (FU) which proved to enhance the immune response when administered at optimal dose and timing. Then, it was followed by long-term administration of tegafur (FT) and immunomodulators. This treatment significantly improved survival when compared to that of 41 historical control patients treated with surgery alone (P less than 0.001). As compared to 31 control patients concurrently treated with a bolus dose of MMC followed by long-term FT and immunomodulators, survival had a tendency, but not significantly, to be improved in patients treated with this therapy (P less than 0.1). However, the survival rate at 4.5 years was significantly higher than that of control patients (P less than 0.01). These results appeared to show that this type of adjuvant combination chemoimmunotherapy may be of benefit for this group of patients with gastric carcinoma.

Combination chemoimmunotherapy for advanced gastric carcinoma

Eighty-nine patients with advanced gastric carcinoma were treated with a combination chemo-immunotherapy regimen that consisted of active immunotherapy with Vibrio cholerae neuraminidase (VCN) treated autologous tumor cells admixed with BCG and drugs including cyclophosphamide, mitomycin C (MMC) and 5-fluorouracil, followed by long term tegafur (FT) and immunomodulators. This treatment significantly improved survival rate of patients in Stages III, IV and unresectable or recurrent carcinoma, compared to that of historical controls. As compared to controls treated with MMC followed by long term FT and immunomodulators concurrently, survival rate of those in Stage III tended to improve (P less than 0.1) and survival rate at 4.5 years in Stage III was significantly higher (p less than 0.01), although it was not improved in Stage IV. In patients with unresectable or recurrent tumor, survival time was not significantly lengthened with this therapy when compared with that in patients given BCG alone in the same treatment schedule (CCI-BCG group). However, none of 19 patients in CCI-BCG group survived more than 15 months, although 4 of 28 patients receiving this therapy survived. These results suggest that this combination chemo-immunotherapy is effective for a selected group of patients with advanced gastric carcinoma.

Inhibition of p-aminohippurate transport by cyclic GMP in rat kidney cortical slices

The effect of cyclic GMP on the accumulation of p-aminohippurate (PAH) was investigated by using rat kidney cortical slices. When the slices were preincubated with cyclic GMP and thereafter incubated in the absence of the cyclic nucleotide for the assay of PAH transport, cyclic GMP inhibited PAH accumulation in the slices in a dose-dependent fashion. Pretreatment of the slices with dibutyryl cyclic GMP induced no inhibition of PAH uptake, but that with the combination of cyclic GMP and butyrate inhibited the accumulation to the same extent as did cyclic GMP. Guanosine and its monophosphate (GMP) had no effect on PAH accumulation in the slices. Inhibitory effect of cyclic GMP on PAH accumulation was not due to the changes of electrolyte content and water distribution in the slices. The slices pretreated with cyclic GMP at 0 degree C failed to decrease PAH accumulation. Cyclic GMP had no effect on organic cation (tetraethylammonium, TEA) transport in the slices. These evidence suggest that cyclic GMP may be able to modulate the rat renal transport system for PAH although this study does not explain the mechanism of inhibition of PAH transport by the cyclic nucleotide.

Effects of dimercaprol or thioctic acid on the distribution and excretion of Na374AsO3 injected subcutaneously in rats

This report dealt with the effects of dimercaprol (BAL) and thiotic acid (TA), antidotes against arsenical, on the distribution and the excretion of 74As in several organs of the rat. Each organ was removed and served for quantitative analysis of 74As five days after subcutaneous injection of Na374AsO3 5 microCi/100 g. Administration of BAL or TA was performed intraperitoneally with a single administration or five consecutive administrations for five days before animals were sacrificed. 74As content in each organ of the rat decreased to a greater extent in the five consecutive administration group of BAL or TA than in the non-treated or single administration groups. Moreover, the excretion of 74As in a digestive tract increased more remarkably in the five consecutive administration group than in the non-treated or single administration groups. There were no differences in the excretion or the content of 74As in each organ between the single administration group and the non-treated group.

Capacitation inducing activity of serum albumin in fertilization of mouse ova in vitro

The role of serum albumin in in vitro fertilization of mouse ova was studied relating to the fertilization inhibitory activity of Zn2+. The time required for mouse sperm capacitation was dependent on the concentration of serum albumin which was added to the medium. The majority of Zn2+ added to the medium was shown to be bound to serum albumin (95% out of 200 microM) by means of equilibrium dialysis. Furthermore, it was suggested that the serum albumin was necessary for the initiation of the sperm capacitation process by the periodic observation of sperm penetration through zona pellucida.

Effect of operation on cell-mediated immune response to autologous tumor extract in cancer patients

Utilizing lymphocyte proliferation assay, effects of operation on cell-mediated immune response to autologous tumor extract were studied in 33 patients with gastric or colon carcinoma. To evaluate the lymphocyte proliferation response to autologous tissue extract preoperatively, the lymphocytes were left in culture for 24-30 hours before addition of the extract while 3 M KCl extract of autologous tissue was being processed. A significant level (P less than 0.001) of correlation was observed between stimulation index values to autologous tumor extract added at the initiation of culture and after a 24-30-hour period of incubation. Using this type of assay system, lymphocyte proliferation response to autologous tumor extract was examined immediately before operation and 1, 2, and 4 weeks after operation serially. Data comparing the responses of 20 patients who had curative resection and 13 patients who underwent noncurative resection appeared to fall into three categories in each group. The clinical courses of these patients in each category might clarify the significance of changes in the response following operation.

Superficial spreading carcinoma of the esophagus

Superficial spreading type of carcinoma of the esophagus was defined as lesions with intramucosal extension of carcinoma 20 mm or more from the main lesion. Eleven (6.1%) of 179 cases were thus selected for this investigation. These cases were further divided into two groups: Group A, consisting of four cases (2.2%) with the main lesion confined to the submucosa, representing a relatively early stage; and Group B, consisting of seven cases (3.9%) with the main lesion invading the muscular layer or deeper. One of the most characteristic features in the four cases belonging to Group A was an unexpectedly high incidence of lymphatic permeation and lymph node metastases leading to a poor prognosis. Another feature that may be important, particularly for surgeons performing esophagectomy, was the difficulty in deciding the proximal resection line of the esophagus because the boundaries between involved and uninvolved portions were frequently indistinguishable in this particular pathologic entity, not only in Group A but in Group B.

Indirect macrophage migration inhibition response to 3-M KCl extract of gastric carcinoma

With the use of indirect macrophage migration inhibition (MMI) test, the MMI response to 3-M KCl extract from gastric carcinoma or adjacent normal tissue was studied in patients with gastric carcinoma, in patients with other types of carcinoma, and in normal controls. The migration index (MI) of less than 75, which was 2 SD below the mean MI of normal controls, was considered positive. Twelve (23%) of 52 patients with gastric carcinoma showed positive response to autologous tumor extract, whereas only 2 (6%) of 35 patients responded to autologous normal tissue extract (P less than 0.03). Positive response to allogeneic gastric carcinoma extract occurred in 4 (9%) of 47 patients with gastric carcinoma and in none of 25 patients with other types of carcinoma. None of 39 patients with gastric carcinoma and 19 patients with nongastric carcinoma responded to allogeneic normal tissue extract. These results appeared to show a lower degree of sensitivity but a relatively higher degree of specificity in the indirect MMI test, as compared to those in the direct leukocyte migration inhibition test, for detection of the cell-mediated immune response to tumor-associated antigens in patients with gastric carcinoma.

[Relationship between arsenic-induced hypothermia and brain monoamines. (2). The roles of noradrenaline and dopamine]

It has been reported that hypothermia induced by intravenous administration of As2O3 3 mg/kg in rabbits is due to a decrease of noradrenaline (NA) in the hypothalamus. In this paper, the role of NA or dopamine (DA) on As2O3-induced hypothermia in rabbits were investigated. As2O3-induced hypothermia was not inhibited by pretreatment with FLA-63, a potent dopamine-beta-hydroxylase inhibitor, which produces an increase of DA and a decrease of NA in rabbit brain; and it was also inhibited by pretreatment with haloperidol or pimozide, potent DA-receptor blocking agents. On the contrary, pretreatment with phenoxybenzamine or dibenamine, alpha-receptor blocking agents, completely inhibited these hypothermia. These findings indicated that NA took an important part in thermoregulation in rabbits and certified that DA or DA-receptors were not involved As2O3-induced hypothermia.

Simple, direct measurement of lipoprotein X in serum

This relatively simple method for quantitative estimation of lipoprotein X is based on assay of phospholipids in precipitates of lipoprotein X. We first remove other lipoproteins by precipitation with phosphotungstic acid solution. Lipoprotein X is then precipitated from the supernatant fluid with an alkaline solution of magnesium ion, and phospholipid is determined in this precipitate. Results are linearly related to concentration of lipoprotein X. The CV is less than 3%. Results correlated well with those for agar gel electrophoresis.

Simple, direct measurement of lipoprotein X in serum

This relatively simple method for quantitative estimation of lipoprotein X is based on assay of phospholipids in precipitates of lipoprotein X. We first remove other lipoproteins by precipitation with phosphotungstic acid solution. Lipoprotein X is then precipitated from the supernatant fluid with an alkaline solution of magnesium ion, and phospholipid is determined in this precipitate. Results are linearly related to concentration of lipoprotein X. The CV is less than 3%. Results correlated well with those for agar gel electrophoresis.

Relationship between lymphocyte proliferation and migration inhibitory factor production in response to autologous tumor extract in cancer patients

In forty-nine patients with various carcinomas, cell-mediated immune response to 3M KCl extract of autologous tumor was studied with the use of both lymphocyte proliferation (LP) assay and macrophage migration inhibition (MMI) assay simultaneously. There was no correlation between stimulation index in LP assay and migration index in MMI assay in these simultaneous tests. The results of this study indicate dissociation between cell proliferation and migration inhibitory factor production of lymphocytes in response to autologous tumor extract in patients with various carcinomas.

Digestion of asparagine-linked oligosaccharides by endo-beta-N-acetylglucosaminidase in the human skin fibroblasts obtained from fucosidosis patients

The substrate specificity of human endo-beta-N-acetylglucosaminidase was studied by using the homogenate of cultured skin fibroblasts of fucosidosis patients as an enzyme source. The results indicate that biantennary complex type asparagine-linked sugar chains as well as high mannose type sugar chains are cleaved by the enzyme action. None of the sugar chains with a fucosyl residue on the proximal N-acetylglucosamine of their N,N'-diacetylchitobiose moieties was cleaved. These results proved enzymatically the mechanism of production of oligosaccharides detected in the urine of various exoglycosidase deficiencies.

Zinc effects on mouse spermatozoa and in-vitro fertilization

The fertilizing ability of mouse epididymal and capacitated spermatozoa was tested by mixing with normal or zona-free ova. In the presence of Zn2+, the epididymal spermatozoa failed not only to penetrate the zona pellucida but also to fuse with zone-free ova, while no effect was observed on capacitated spermatozoa. Zn2+ also inhibited fertilization with spermatozoa preincubated in Ca2+-free medium. However, shortly after the addition of Ca2+ to the preincubated spermatozoa, Zn2+ lost its fertilization inhibitory activity.

Sequential combination chemoimmunotherapy for various malignant tumors: clinical and laboratory results

A chemoimmunotherapy program designed on the bases of the results of animal experiments was designed for 139 patients with various advanced malignant tumors. The treatment regimen consisted of cyclophosphamide (CY) 200 mg intravenously on day 1, Vibrio cholerae neuraminidase (VCN) treated autologous tumor cells admixed with BCG 5 to 10 mg intradermally on day 4 and mitomycin C (MMC) 10 to 16 mg and 5-fluorouracil (FU) 500 mg intravenously on day 7, of each course. Thereafter, maintenance treatment was started on day 14 with tegafur (FT) 600 mg and immunostimulants, such as OK432, PSK or levamisole. In the group of patients with gastric carcinoma, as compared to historical control patients, this treatment significantly improved survival in those with stage III disease (p less than 0.02), stage IV disease (p less than 0.05) and recurrent or unresectable tumor (p less than 0.001). Immune reactivities as measured by PPD skin test and PHA lymphocyte blastogenesis increased slightly following the therapy. After completion of the treatment, cellular immunity to autologous tumor extract could be detected in vitro by macrophage migration inhibition technique in 12 of 42 patients. The relationship of immune reactivity before or after therapy to patient survival was examined. Analysis of survival curves according to PPD skin test showed significant prolongation of survival in patients with positive reaction as compared to those with negative response following the treatment.

A new antitumor antibiotic, stubomycin

A new antibiotic, stubomycin, was isolated from the culture broth and mycelia of Streptomyces strain No. KG-2245. Stubomycin was prepared as colorless plates and has the empirical formula C29H35NO5. The antibiotic possesses growth inhibitory activity against Gram-positive bacteria and transplantable murine tumors, such as Ehrlich carcinoma, and leukemia P388. The antibiotic also shows direct cytotoxic activity against HeLa cells in vitro.

Electron microscopic study on the amoeboid microglial cells in the roof plate of the early chick embryo brain

The amoeboid microglial cells (AM cells), which were acid phosphatase-positive histochemically, present in the rhombencephalon coated with the leptomeninges of the 8--day incubation chick embryos were investigated by electron microscopy. It was found the the AM cells occurred simultaneously in the leptomeninges, in the roof plate, and in the ventricle. Considering the distribution of the cell in these three sites along with the present author's earlier findings of ACPase reactions for the AM cells, it is highly probable that in the rhombencephalon the AM cells originate from the leptomeninges and then enter the ventricle through the roof plate.

Lymphocyte blastogenic response to autologous tumor cells pretreated with neuraminidase in patients with gastric carcinoma

The effect of Vibrio cholerae neuraminidase (VCN) treatment of tumor cells on lymphoblastic response was studied using the assay of mixed lymphocyte-tumor cell reaction in 24 patients with gastric carcinoma. Lymphoblastic responses as indicated by stimulation index were significantly augmented in cultures with autologous tumor cells pretreated with mitomycin (MMC) and VCN as compared to those pretreated with MMC alone when cultured in the presence of normal plasma (p < 0.05). In autologous plasma cultures, however, the mean stimulation index in MMC-VCN-treated cell cultures was only slightly higher than that in MMC-treated cell cultures. Accentuation of the response was not observed in any type of cultures using MMC-VCN-treated normal tissue cells. In 20 of these patients, the blastic response to nonviable frozen stored tumor cells was measured simultaneously and significant increase in blastic transformation by pretreatment of the cells with VCN was also observed in normal plasma cultures (p < 0.05). There was significant correlation between the response to nonviable frozen VCN-treated cells and to these, not frozen, viable cells (p < 0.001). These results indicate that lymphoblastic response to autologous tumor cells could be enhanced by pretreating the cells with VCN in patients with gastric carcinoma and the freezing could render the cells nonviable without interfering with the augmented immunogenicity of VCN-treated tumor cells.

[Studies on As2O3-induced rabbit hypothermia and brain monoamines (author's transl)]

It has been suggested that hypothermia induced in rabbits by As2O3 3 mg/kg (i.v.) depends mostly on the blocking of the thermo-regulatory center. The relationship between hypothermia induced by As2O3 and brain monoamine levels in rabbits was investigated. To clarify the mechanism of the hypothermia, the influence of pretreatment with several agents on As2O3-induced hypothermia and on monoamine levels in the hypothalamus was examined. The core temperature was measured by inserting the thermister probe into the rectum and noradrenaline(NA), 5-hydroxytryptamine(5-HT) and 5-hydroxyindoleacetic acid(5-HIAA) levels in the hypothalamus were estimated fluorometrically. Pretreatment with p-chlorophenylalanine(PCPA), alpha-methyl-p-tyrosine(alpha-MPT) or 5-hydroxytryptophan(5-HTP) did not inhibit the hypothermia induced by As2O3 but did decrease NA levels in the hypothalamus. On the contrary, pretreatment with barbital sodium, pheniprazine, 1-DOPA and 1-tyrosine significantly inhibited the hypothermia or exhibited the hyperthermia. As2O3-induced hypothermia in rabbits was followed by a decrease in NA levels and an increase in 5-HT levels in the hypothalamus. On the other hand, when the hypothermia induced by As2O3 was inhibited by pretreatment with barbital sodium, pheniprazine, 1-DOPA and 1-tyrosine, both NA and 5-HT levels in the hypothalamus were significantly increased. These results suggest that As2O3-induced hypothermia is due to a decrease in NA levels and inhibition of the hypothermia is due to an increase in NA levels, in the rabbit hypothalamus.

Cellular hypersensitivity to autologous tumor extract in patients with breast carcinoma

The indirect macrophage migration inhibition technique was used to study cellular hypersensitivity to autologous tumor extract in relation to the progress and prognosis of breast carcinoma. Cellular immune response, evidenced by production of a macrophage migration inhibitory factor (MIF), was noted preoperatively in 21 of 63 patients (33 per cent). This reactivity was used at the time of surgery to determine the grade of the primary tumor, lymph node involvement and the stage of the disease according to the TNM system. The five-year survival rate was 76 per cent for patients whose lymphocytes responded preoperatively and 54 per cent for patients whose lymphocytes did not respond, indicating that this assay may be valuable in detecting cellular immune response to breast carcinoma and in evaluating the immunological status of patients.

The effect of zinc ions on fertilization of mouse ova in vitro

The fertilization rate of mouse gametes in a Krebs-Ringer bicarbonate medium was 60%. The rate fell to 0% when 250 micron-ZnCl2 was added, but MgCl2, CaCl2, MnCl2, FeCl2, and CuCl2 (each at 250 micron) had no effect. The inhibitory effect of Zn2+ was not evident if the spermatozoa or eggs were preincubated with Zn2+ or if previously capacitated spermatozoa were used. The Zn2+ is thought to act by interference with capacitation.

A case report of surgical repair of traumatic rupture of the pericardium and diaphragm

A 55 year-old male with traumatic rupture of the pericardium, diaphragm and spleen, and with crush of the pancreas was successfully operated upon. The diagnosis of rupture of the diaphragm was done on the chest X ray on admission, and the rupture of the pericardium was diagnosed at the time of laparotomy and thoracotomy. The ruptured spleen and the crushed pancreas tail were removed, and the ruptured pericardium and diaphragm were closed successively.

Effects of autologous plasma from patients with malignant tumor on macrophage migration inhibition with tumor extract

By the use of the indirect migration inhibition technique blocking or inhibitory effect of autologous plasma on the production of migration inhibitory factor (MIF) from lymphocytes contacted with autologous tumor extract was studied in 45 patients with malignant tumor. When autologous plasma was added to the lymphocyte culture incubated with autologous tumor extract in 44 of these patients, inhibition of migration was completely abrogated in 9 of these patients whose lymphocytes produced MIF when cultured in plasma-free medium. MIF activity was not abolished when autologous plasma was added to the supernatant of lymphocyte culture incubated with autologous tumor extract. Inhibition of migration was not affected by the addition of allogeneic plasma from a normal subject to the lymphocyte culture. In 15 patients, MIF was not produced when lymphocytes were cultured with autologous plasma alone. These results appeared to indicate that autologous plasma of patients with malignant tumor might block or inhibit the production of MIF from lymphocytes contacted with autologous tumor extract.

Clinical and pathophysiological evaluation of esophageal and reconstruction using gastric tube and pedicled colon segment

Pathophysiological and nutritional conditions were compared after esophageal reconstruction in 15 patients with a gastric tube and in 12 patients with a pedicled colon segment for the treatment of esophageal cancer. There was no significant difference in the postoperative nutritional index, iron and vitamin B12 metabolisms. On the other hand, the long gastric tube from the greater curvature of the stomach used as an esophageal substitute retained some secretory functions of both exocrine and endocrine although the effect of truncal vagotomy may have to be taken into consideration.