Prognostic factors for survival in cervical cancer patients with bone metastasis

PURPOSE

To investigate the prognostic factors for survival in uterine cervical cancer patients who developed bone metastasis.

MATERIALS AND METHODS

Cervical cancer patients with bone metastasis who were treated at the present institute from April 1996 to September 2010 were identified from the authors' institutional tumor registries. Primary disease, follow-up, and recurrence data were collected and retrospectively reviewed. Univariate and multivariate analyses of prognostic factors for survival were performed.

RESULTS

A total of 37 patients that developed cervical cancer bone metastasis were included in the authors' database. The median survival time after recurrence was 12 months. Univariate analysis revealed that patients with a disease-free interval (DFI) of ten months or less achieved significantly shorter survival after bone metastasis detection than those with a DFI of 11 months or more (median: 8.5 months versus 17 months, p < 0.0001). Multivariate analysis also showed that DFI of ten months or less was a significant predictor of short survival (p = 0.0018).

CONCLUSIONS

The DFI was found to be independent prognostic factors for survival in cervical cancer patients who developed bone metastasis.

Imbalance of angiogenic factors and avascular edematous cystic villi in a trisomy 13 pregnancy: a case report

The incidence of pre-eclampsia is significantly higher in trisomy 13 pregnancies than in normal pregnancies. Soluble fms-like tyrosine kinase-1 (sFlt-1), located on chromosome 13, is an anti-angiogenic molecule derived from the placenta and contributes to the pathogenesis of pre-eclampsia. Elevated sFlt-1 and reduced placental growth factor (PlGF) are associated with trisomy 13 pregnancies and may play a pathogenic role in the subsequent development of pre-eclampsia. Here we present a case of a trisomy 13 pregnancy without any signs of pre-eclampsia that showed alterations in circulating angiogenic factors and abnormal placental appearance. The placenta developed edematous changes and contained multiple small cysts. Histology of the placenta confirmed avascular edematous cystic villi and did not show the typical appearance of a partial mole or mesenchymal dysplasia. The sFlt-1/PlGF ratio in maternal serum (134) was much higher than that in gestational age-matched women who were normotensive (2.9-7.2; mean, 5.0). Immunostaining for Flt-1 and endoglin was more intense in our case compared with gestational age-matched controls, and at a similar level to a case of pre-eclampsia. Placental findings that showed avascular edematous cystic villi in our case may be associated with angiogenic imbalance involved in the pathogenesis of pre-eclampsia in trisomy 13 pregnancies.

Maternal arterial stiffness in normotensive pregnant women who subsequently deliver babies that are small for gestational age

OBJECTIVE

To assess the association between maternal arterial stiffness and delivery of a baby that is small for gestational age (SGA) in normotensive pregnant women.

STUDY DESIGN

Pulse wave analyses were performed to assess maternal arterial stiffness at 26-33 weeks of gestation in 40 normotensive women who subsequently delivered SGA babies (SGA group) and 111 normotensive women who delivered babies with normal growth (control group).

RESULTS

Central systolic pressure (CSP), augmentation index (AIx) and AIx at a heart rate of 75 beats/min (AIx-75) were significantly higher in the SGA group compared with the control group, but this was not the case for brachial systolic pressure, brachial diastolic pressure or brachial pulse pressure. Birth weight was significantly correlated with CSP (r=-0.26, p<0.01), AIx (r=-0.33, p<0.01) and AIx-75 (r=-0.27, p<0.01), but not with brachial systolic pressure, brachial diastolic pressure or brachial pulse pressure.

CONCLUSION

Increased arterial stiffness may be involved, in part, in the pathogenesis of SGA in normotensive women, suggesting an association between fetal growth and maternal endothelial function. Pulse wave analysis may be a clinically applicable method for assessment of maternal arterial stiffness, and may be more relevant to intrauterine fetal growth than conventional brachial blood pressure.

Fullerene Derivatives as Novel Resist Materials for Fabrication of MEMS Devices by Electron Beam Lithography

The fabrication of MEMS and electronic devices relies heavily on lithography. We have explored the application of derivatives of C60, as high resolution, high etch durability resists. Spin coating was used to produce films of various methanofullerenes on silicon substrates, with thickness ranging from 20 to 200 nm. These films behave as effective high resolution negative tone electron beam resists allowing sub 20 nm patterning of silicon which compares favorably with other negative tone resists. Organic solvents such as monochlorobenzene and chloroform can be used to develop the exposed films. The films have sensitivities of 4 × 10−3 to 8 × 10−4 C/cm2 for 20 keV electrons, more than an order of magnitude higher than the sensitivity of C60,. The dry etch durabilities of these compounds are considerably higher than those of conventional resists. A silicon grid with hole depth 160 nm and wall thickness 20 nm has been fabricated to demonstrate the high resolution and high etch durability of these resists.

Synthesis of beta-substituted alpha-amino acids with use of iridium-catalyzed asymmetric allylic substitution

The asymmetric synthesis of beta-substituted alpha-amino acids with use of iridium-catalyzed allylic substitution was described. The Ir-catalyzed allylic substitution of diphenylimino glycinate with allylic phosphates proceeded smoothly even at 0 degrees C and gave branch products with high enantioselectivity (up to 97% ee), when chiral bidentate phosphite bearing the 2-ethylthioethyl group was employed. In addition, both diastereomers of the branch products were synthesized stereoselectively by simply switching the base employed. These methods were also applied to the asymmetric synthesis of quaternary alpha-amino acids.

Time-reversal symmetry-breaking superconductivity in heavy-fermion PrOs4Sb12 detected by muon-spin relaxation

We report on muon-spin relaxation measurements of the 4f(2)-based heavy-fermion superconductor filled-skutterudite Pr(Os4Sb12. The results reveal the spontaneous appearance of static internal magnetic fields below the superconducting transition temperature, providing unambiguous evidence for the breaking of time-reversal symmetry in the superconducting state. A discussion is made on which of the spin or orbital component of Cooper pairs carries a nonzero momentum.

Functional magnetic resonance imaging of human jaw movements

This study used functional magnetic resonance images (fMRI) to examine brain activity during clenching, gum chewing, and tapping tasks. It has been considered difficult to obtain sufficient fMRI data during jaw movement because the head motion associated with the jaw movements creates artifacts on the images. To avoid these artifacts, larger pixels were used, thus allowing some head motion of the subjects, and data from subjects where the heads were evaluated to have moved more than 0.5 mm were discarded. Further, all pixels obtained by fMRI were evaluated and pixels positively synchronized with the task, which were considered to show brain activity, were selected. Sufficient fMRI data was obtained from 30 experiments, 10 sets for each task. During the clenching and tapping tasks, the activated pixels were in the sensory, motor and pre-motor cortexes, and in the sensory and motor cortexes but not in the pre-motor cortex during the gum chewing task. There appears to be no significant differences between right- and left-hemispheres. It is conceivable that there are differences between voluntary jaw movements (clenching and tapping tasks) and mastication (gum chewing task) concerning the control of jaw movements.

Pd-catalyzed asymmetric allylic alkylation of glycine imino ester using a chiral phase-transfer catalyst

Pd-catalyzed asymmetric allylic alkylation of the glycine imino ester 1a has been developed using a chiral quaternary ammonium salt 3d without chiral phosphine ligands. The proper choice of the achiral Pd ligand, P(OPh)3, is important to achieve high enantioselectivity. By this method with the dual catalysts, numerous enantiomerically enriched alpha-allylic amino acids 4a-h could be prepared with comparable to higher enantioselectivity than that of the conventional asymmetric alkylation of 1a. In addition, the Pd-catalyzed reaction of 1a with 1-phenyl-2-propenyl acetate 2i afforded the branch product 6 with high enantio- and diastereoselectivity (>95% de, 85% ee).

Analysis of brain activity during clenching by fMRI

It has been considered difficult to obtain satisfactory functional magnetic resonance images (fMRI) during jaw movements because the head motion during jaw movements makes artefacts on the images. To avoid these artefacts, we chose clenching task and larger pixels to allow some head motion of the subjects. Further the study discarded all data from subjects whom the head was evaluated to move more than 0.3 mm. The study examined 10 healthy right-handed volunteers with echo-planar magnetic resonance (MR) imaging and functional MR signal intensity changes could be obtained in all subjects. However, in the analysis of each pixel of individuals, three different types of pixels were established. It was determined that the pixels that synchronized positively with the task on/off and where signal intensity increase was below 10% expressed the real brain activity. Pixels showing the real brain activity were found in the sensory, motor and pre-motor cortexes in both hemispheres in all subjects, and also in the insula region of two subjects. No pixels were found in the striatum and supplementary motor areas. From the above careful consideration and individual analysis of each pixel, it was concluded that brain activity during the clenching task could be obtained by fMRI.

Comparison of phosphocreatine concentration in the human masseter and medial pterygoid muscles by 31P-CSI

The aim of this study is to compare phosphocreatine (PCr) concentrations of human masseter and medial pterygoid muscles by a recently developed localized magnetic resonance spectroscopy (MRS) method, chemical shift imaging (CSI). The characteristic spectra of phosphorous metabolites including PCr and beta-ATP from the superficial part of the masseter (SM) and the deep part of the masseter (DM) and the medial pterygoid muscles (MPt) from 11 volunteers, 20-27-year-old were obtained. The study clearly demonstrated higher PCr/beta-ATP in the SM and MPt than in the DM both in mean values (P < 0.01) and in individual subjects. The results indicate that SM and MPt are power producers. There were no significant differences in the mean values of the PCr/beta-ATP ratios in SM and MPt, however, the PCr/beta-ATP ratios varied individually and the subjects could be divided into three distinct groups: values of MPt higher than SM (group A, 4 subjects); values of MPt almost equal to SM (group B, 3 subjects); and values of MPt lower than SM (group C, 4 subjects). There appears to be a close relationship between the PCr content as determined in the groups here and occlusal guidance.

Chiral phosphine-free Pd-mediated asymmetric allylation of prochiral enolate with a chiral phase-transfer catalyst

[reaction: see text]. A chiral phase-transfer catalyst has been applied to the asymmetric allylation of the tert-butyl glycinate-benzophenone Schiff base with various allylic acetates for the first time to give the allylated products in good yields and with comparable to higher enantioselectivity than for asymmetric alkylation at the same temperature (91-96% ee) without any chiral ligands for coordinating to the palladium.

Analyses of muscular activity, energy metabolism, and muscle fiber type composition in a patient with bilateral masseteric hypertrophy

Hyperwork of the masseter muscles due to habitual parafunction is thought to induce masseteric hypertrophy (so called work hypertrophy). However, the causes underlying this disease are not yet fully understood. Recently, we had a patient with bilateral masseteric hypertrophy, and we performed a partial excision of the masseter muscles. In this patient's case, we examined muscular activity, energy metabolism, and fiber type composition of the masseter muscles using electromyograms (EMG), 31P-magnetic resonance spectroscopy (MRS), and enzyme-histochemistry. The EMG showed no hyperactivity, and the 31P-MRS showed normal energy spectral patterns and PCr contents of the masseter muscles. The fiber type composition, however, in the muscles in this case was very different from that in muscles with "work hypertrophy" and also that in normal masseter muscles: 1. Loss of type IIB fibers; 2. Increases in type IIA and in type IM & IIC fibers; and 3. Decrease in type I fibers. The findings suggest that this is not a case of work hypertrophy but a case of compensatory hypertrophy possibly due to a lack of high-tetanus-tension type IIB fibers.

Spaciostructural analyses of mandibular and perioral soft tissue movements during mastication

We considered that elucidation of the movements of perioral soft tissues during mastication would be useful in evaluating masticatory movements. However, evaluation of movements specific to soft tissues is difficult because movements of the surface of the lower face during mastication include movements of the muscles of facial expression and mandibular movements. The aims of this study were to elucidate the influence of mandibular movements on perioral soft tissue movements during mastication using principal component analysis (PCA) and to abstract the component of movement specific to soft tissues in order to evaluate masticatory movements from the movements of perioral soft tissues. The subjects were 10 healthy persons with complete natural dentition. The experimental food used in this study was sufficiently softened chewing gum. The results of this study showed that the movements of mandibular and perioral soft tissue were closely related in the first and third PCs; in other words, the second PC was the component of movement specific to soft tissues. Thus, elucidation of the second PC is useful for evaluation of masticatory movements from movements of perioral soft tissues.

Controlling the direction of kinesin-driven microtubule movements along microlithographic tracks

Motor proteins are able to move protein filaments in vitro. However, useful work cannot be extracted from the existing in vitro systems because filament motions are in random directions on two-dimensional surfaces. We succeeded in restricting kinesin-driven movements of microtubules along linear tracks by using micrometer-scaled grooves lithographically fabricated on glass surfaces. We also accomplished the extraction of unidirectional movement from the bidirectional movements along the linear tracks by adding arrowhead patterns on the tracks. These "rectifiers" enabled us to construct microminiturized circulators in which populations of microtubules rotated in one direction, and to actively transport microtubules between two pools connected by arrowheaded tracks in the fields of micrometer scales.

Action of the novel antioxidants 4GBE43 and 2BBE43 against lipid peroxidation

The action and the effect of the newly synthesized compounds 4GBE43 [N-(1,2-diethyltetrahydro-1H-pyrazol-4-yl)-4-[(2E)-3,7-diethyl-2,6-octadienyl] oxybenzamide] and 2BBE43 [2-(benzyloxy)-N-(1,2-diethyltetrahydro-1H-pyrazol-4-yl)benzamide] against lipid peroxidation were studied. 4GBE43 and 2BBE43 quenched the ESR signal of diphenylpicrylhydrazyl (DPPH), suggesting that 4GBE43 and 2BBE43 act as scavengers of free radicals and that each compound quenched 6 free radical molecules. These compounds suppressed the oxidation of methyl linoleate emulsions and soybean phosphatidylcholine liposomes by a free radical initiator, suggesting that these compounds quench the lipid peroxyl radical. 4GBE43 and 2BBE43 also suppressed the spontaneous oxidation of rat brain homogenates. The inhibitory effect of 2BBE43 was of the same order of magnitude (IC50) as that of probucol. The IC50 of 4GBE43 was on the same order of magnitude as that of alpha-tocopherol. However, 4GBE43 at 10(-4)-10(-5) M completely inhibited peroxidation, showing it to be more effective than alpha-tocopherol. These results suggest that 4GBE43 and 2BBE43 act as antioxidants by quenching the lipid peroxyl radical.

Formation of metal-encapsulating Si cage clusters

We report the formation of a series of metal-containing hydrogenated silicon clusters using an ion trap. Mass analyses reveal that many types of transition metal ions M(+) ( M = Hf, Ta, W, Re, Ir, etc.) react with silane (SiH4) to form dehydrogenated MSi( +)(n) cluster ions ( n = 14, 13, 12, 11, 9, respectively) as an end product, indicating that the metal atom is endohedral and stabilizes the Si polyhedral cage. This finding is confirmed by our ab initio calculation that WSi12 is a W-encapsulating Si12 cage cluster, and is very stable owing to both the electronic and the geometrical shell closures.

Regional differences of metabolism in human masseter muscle by two-dimensional 31P-chemical shift imaging

Many reports have demonstrated significant region-dependent differences in the fiber-type composition of the human masseter muscle. Therefore, it is considered that there is intramuscular heterogeneity of metabolic activity in the muscle. The present study was carried out, with two-dimensional Chemical Shift Imaging, to detect differences between the deep and superficial parts of the human masseter muscle at rest. Masseter muscle from 11 volunteers, from 20 to 27 years old, was examined, and characteristic spectra of the inorganic phosphate (Pi), phosphocreatine (PCr), and alpha-, beta-, and gamma-adenosine triphosphate (ATP) from each part of the muscles were obtained. In this study, the deep and superficial parts of the masseter muscle were distinguished by the existence of aponeurosis. The Pi/PCr, PCr/beta-ATP, and Pi/beta-ATP ratios as well as the pH in the deep and superficial parts were calculated from the peak spectra. Compared with the deep part, the Pi/PCr of the superficial part was lower (p < 0.05) and the PCr/beta-ATP was higher (p < 0.01). The Pi/beta-ATP and pH showed no significant differences between the two parts. The results indicate that the superficial part of the masseter muscle contains more PCr than the deep part, and this may be related to functional differences between these two parts. In future examinations of the metabolic activity of the human masseter muscle, the deep and superficial parts must be measured separately.

Molecular weight independence of the effect of additive hyaluronic acid on the lubricating characteristics in synovial joints with experimental deterioration

OBJECTIVE

To assess the molecular weight dependence of the lubricating characteristics of additive hyaluronic acid in animal joints with experimental deterioration.

DESIGN

An experimental study in rabbits stifles in vitro.

BACKGROUND

Hyaluronic acid is used as a drug for osteoarthritis. However, the molecular weight dependence of the effect of hyaluronic acid has been unclear.

METHODS

Using a robotic arm under force-control, frictional coefficients were measured in fourteen rabbit stifles. The experimental conditions examined were: (1) intact joint surfaces; (2) after the joint surfaces were washed with physiological saline; (3) after the addition of 1% hyaluronic acid solution with a molecular weight of one million daltons and two million daltons, respectively.

RESULTS

The increased frictional coefficient produced by washing with saline was decreased significantly by the addition of hyaluronic acid to the joint surfaces. This effect was observed regardless of the molecular weight of the hyaluronic acid.

CONCLUSION

The lubricating characteristics of hyaluronic acid in synovial joints do not change with molecular weight.

RELEVANCE

Hyaluronic acid solution is used clinically for the treatment of osteoarthritis. In the present study, the molecular weight dependency of the lubricating characteristics of hyaluronic acid was tested using the friction in synovial joints.

Analysis of glycosaminoglycans in rabbit cornea after excimer laser keratectomy

BACKGROUND/AIMS

The biochemical basis for the development of subepithelial opacity of the cornea after excimer laser keratectomy has yet to be fully defined. The aim of this study was to evaluate the alterations of glycosaminoglycans (GAGs) after excimer laser keratectomy.

METHODS

Rabbit corneas were harvested on days 5, 10, 20, and 30 after excimer laser photoablation. The amount of main disaccharide units was determined by high performance liquid chromatography (HPLC). In addition, immunohistochemical studies were performed on corneal sections 20 days after the ablation.

RESULTS

The concentrations of DeltaDi-0S at 5 and 10 days were significantly lower than before the ablation. DeltaDi-6S showed a significant increase 5 days after the ablation but DeltaDi-4S did not show any significant change. There was a significant increase in DeltaDi-HA at 20 and 30 days after ablation. In immunohistochemistry, the positive staining for DeltaDi-6S and hyaluronic acid was observed in the subepithelial region. These immunohistochemical results were well correlated with the HPLC findings.

CONCLUSIONS

The increase in chondroitin-6 sulphate and hyaluronic acid may be related to corneal subepithelial opacity after excimer laser keratectomy.

[Long-term complete response in two cases of liver metastases from rectal and gastric cancer treated with intra-arterial infusion chemotherapy of leucovorin and 5-fluorouracil]

Intra-arterial infusion chemotherapy combined with leucovorin (LV) and 5-fluorouracil (5-FU) was performed in two patients with multiple metastases from rectal and gastric cancer. In each patient LV 45 mg was infused as a bolus just before and after 5-FU 1,000 mg/4 hrs administration. Thereafter 5-FU dose was decreased gradually. This regimen was principally repeated weekly on an outpatient basis. In both patients PR was detectable 3 and 4 months after the beginning of chemotherapy, and CR was obtained in 21 and 6 months, respectively. Neither patient showed any signs of recurrence and are in good health 35 and 30 months after initiation of chemotherapy. These findings suggest that our protocol has an excellent anti-tumor effect and improves the QOL in some patients for a long time.

Fluoride profiles in the cementum and root dentine of human permanent anterior teeth extracted from adult residents in a naturally fluoridated and a non-fluoridated area

OBJECTIVES

To determine the effect of water fluoride concentration on the fluoride profile across the entire thickness of the cementum and root dentine of human permanent anterior teeth in adults.

SUBJECTS

Twenty-eight human permanent anterior teeth from individuals aged from 30 to over 60 years were studied.

SETTING

Teeth were obtained from a natural high-fluoride area (West Hartle-pool, UK; 1.0-1.3 ppm F in drinking water, WHP) and the other from a non-fluoridated naturally low fluoride area (Leeds, UK; 0.1 ppm F in drinking water, LDS).

DESIGN

Cementum and root dentine were sampled using an abrasive micro-sampling technique from the cementum surface to the pulpal surface of root dentine.

RESULTS

Fluoride concentration was higher in tooth roots (the cementum and dentine) taken from the naturally fluoridated area (WHP) than from the non-fluoridated area (LDS). Age and average fluoride concentration showed a positive correlation in WHP dentine, middle region of the root (r = 0.78, P < 0.001) and in the apical region of the root (r = 0.61, P < 0.05). WHP cementum had the strongest fluoride concentration correlation with age in the cervical region of the root (r = 0.67, P < 0.01). An analysis of variance (ANOVA) showed that the area (water fluoride content), age and number of years lived in the area combined with total age were significant.

CONCLUSIONS

The fluoride content of cementum and root dentine in adult residents is related to fluoride content in drinking water.

[Effects of biochemical modulation chemotherapy with CDDP and 5-FU on metastatic brain tumor from lung cancer]

Fourteen cases of metastatic brain tumors from lung cancer underwent biochemical modulation chemotherapy with daily administration of small doses of CDDP (5 or 10 mg/day) and continuous infusion of 5-FU (300 mg/day) for three tow six weeks. All patients with metastatic brain tumors also underwent a total of 30 Gy of whole brain irradiation therapy. Of eleven patients who had metastatic brain tumors when chemotherapy started, complete and partial responses were shown in two patients each (36% response rate). Moreover, only four of twelve patients with extracranial lesions responded (33% response rate). Abnormal levels of tumor marker were improved in only three of 10 evaluable patients (30% response rate). Side effects of this chemotherapy included various WHO grades of bone marrow suppression as well as nausea and vomiting in 13 of 14 patients. Loss of appetite persisted for two months. Parkinsonism was also noted in three patients as an additional side effect. Mean survival time was 9.4 months, while 4 patients survived longer than one year. Data showing a low response rate, persistent loss of appetite and longer admission period were considered less favorable than those of other chemotherapeutic regimens.

[Intravenous anesthesia by continuous administration of midazolam and fentanyl]

We examined the amount and method of administration of midazolam and fentanyl for intravenous anesthesia. Intravenous anesthesia was induced by intravenous administration of fentanyl 0.2-0.3 mg, followed by a minimal sleeping-inducing dose of midazolam, and then an additional 0.2 mg of fentanyl before starting the operation. To maintain anesthesia, a half dose of the first dose of midazolam was administered every hour, and a continuous intravenous injection of fentanyl at 0.08 microgram-1. kg-1.min-1 was also performed. It is suggested that these doses are the most suitable for obviating the use of antagonist. Also, by using a continuous administration, the dose of fentanyl can be reduced, and it is possible to stabilize circulation. Without the use of nitrous oxide during intravenous anesthesia, it is necessary to double the dose of fentanyl administered.

Earthquake damage to a laboratory animal facility

Our seven-storey laboratory animal facility was damaged during the 1995 earthquake of magnitude 7.2. The seismic intensity experienced at our facility was estimated to be around 5 on the Japanese version of the Richter scale (a very strong shock). However, no damage was sustained to the water, gas or electricity supplies in many of the offices, the upper drawers of the steel cabinets fell to the floor. In the animal-rooms, while the floor-fixed cage-racks were hardly damaged, most of the movable cage-racks were dislodged by the shocks. We describe here our countermeasures, including those taken prior to the earthquake.

Cancer-associated retinopathy syndrome: a case of small cell lung cancer expressing recoverin immunoreactivity

Cancer-associated retinopathy (CAR) syndrome is a rare paraneoplastic neuropathy syndrome often found in patients with small cell lung cancer (SCLC). Serological studies have indicated that the process could include autoimmune reactions directing retinal antigens. Recently, the CAR antigen was identified as a photoreceptor protein, recoverin, by screening retinal proteins using the CAR patient's serum. The present case of SCLC showed rapidly deteriorated bilateral visual acuity lacking the inflammatory findings at the retina which were compatible with CAR. The immunohistochemical study revealed that the cancer cells expressed recoverin or recoverin-like immunoreactivity. This is the first observation in CAR syndrome. The presence of recoverin or recoverin-like immunoreactivity in SCLC with CAR syndrome supports the hypothesis that the cancer-retina immunologic cross-reaction contributes to visual loss in this syndrome.

Difference in CDDP penetration into CSF between selective intraarterial chemotherapy in patients with malignant glioma and intravenous or intracarotid administration in patients with metastatic brain tumor

Platinum (Pt) levels in plasma and cerebrospinal fluid (CSF) in patients with malignant glioma were determined after initiation of selective intraarterial chemotherapy with a combination of VP-16 (etoposide) and CDDP (cisplatin), and were compared with the CSF Pt levels in patients with metastatic brain tumors after intravenous or intracarotid administration of VP-16 and CDDP. CSF Pt levels were also compared for various administration routes, doses, CSF sampling routes and blood-CSF barriers in metastatic brain tumor. Changes in the blood-CSF barrier to CDDP during treatment in a patient with meningeal lymphoma and in a patient recovering from surgical removal of a metastatic brain tumor were also examined by periodic administration of CDDP. All CSF samples were taken through Ommaya reserviors placed in the anterior horn of the lateral ventricle or the postoperative cavity. The mean peak CSF/plasma total Pt ratio (T/T ratio) and the mean CSF total Pt/plasma ultrafiltrable Pt ratio (T/U ratio) were highest (15.0% and 24.4%, respectively) following selective intraarterial infusion of CDDP in patients with malignant glioma, followed by intravenous infusion in meningeal carcinomatosis (11.5% and 18.9%), intracarotid administration (5.4% and 8.7%) and intravenous infusion (60 mg/m2 2.5% and 100 mg/m2 2.9%; and 60 mg/m2 3.5% and 100 mg/m2 7.7%) in patients with the solid type of metastatic brain tumor. In CSF obtained from the postoperative cavity in cases of metastatic brain tumor, T/T and T/U ratios were extremely high (40.9% and 62.4%). However, the CSF Pt level even after selective intraarterial administration of CDDP in malignant glioma was 0.51-1.64 micrograms/ml total Pt and 0.43-1.08 micrograms/ml ultrafiltrable Pt. Even the CSF level obtained from the postoperative cavity was 1.0-4.7 micrograms/ml total Pt. These low levels of total and ultrafiltrable Pt are considered not to be cytotoxic to disseminated cells in the CSF space and to normal brain cells. As for changes in the blood-CSF barrier, repeated administration of CDDP showed that the rate of entry of Pt into the CSF decreased in parallel with improvements apparent on CT scans in the patient with meningeal lymphoma, and also showed that the blood-CSF barrier to Pt was gradually repaired after the metastatic brain tumor had been removed.

Glucose retention on the surfaces of primary teeth in 3- and 4-yr-old children

Glucose retention was determined in 38 kindergarten children ages 3-4 yr. The children rinsed their mouths with 10 ml of a 0.5 mol/l glucose solution for 15 s and then spat out. Three minutes after they put the solution in their mouths, a small paper-point was used to collect samples of saliva from the labial and buccal surfaces of the maxillary and mandibular primary teeth. The concentration of glucose in the small amount of saliva collected was measured with an immobilized enzyme system. Glucose retention was highest on the maxillary central primary incisor, second highest on the maxillary first primary molar and third highest on the maxillary lateral primary incisor. An intermediate value was seen on the maxillary and mandibular second primary molars, the mandibular first primary molar and the maxillary primary canine. A lower value was observed on the mandibular primary canine and the lowest on the mandibular incisors. It was concluded that there were site differences in glucose retention on primary teeth of 3- and 4-yr-old children.

Fluoride distribution of rat molar cementum in relation to age and fluoride levels in the drinking water

The present study was undertaken to determine the fluoride distribution profile in rat molar cementum with age in relation to fluoride in drinking water. Fifty-four female Wistar rats were used for the experiment. Before the experiment 6 rats were killed under chloroform anesthesia at 4 weeks of age as controls. The remaining 48 rats were divided into two groups: a control group given distilled water and the other group given water containing 100 ppm fluoride ad libitum. Six rats from each group were killed at the ages of 6, 12, 24, and 48 weeks. The fluoride distribution in the molar cementum was analyzed from the surface to the cementodentinal junction by abrasive microsampling. The fluoride concentrations in molar cementum from control rats on distilled water remained relatively constant until 24 weeks. A small increase then occurred between 24 and 48 weeks. The fluoride concentration in cementum from rats drinking water containing 100 ppm fluoride increased markedly with age, both in outer and inner regions of the molar cementum for all rats. On the other hand, the fluoride concentration in the cementum of older rats drinking water with 100 ppm fluoride was significantly higher in the outer than in the inner region of the cementum. It was concluded that the fluoride distribution in rat molar cementum may increase throughout life in relation to the fluoride level in the drinking water.

Opposite effects of midazolam and beta-carboline-3-carboxylate ethyl ester on the release of dopamine from rat nucleus accumbens measured by in vivo microdialysis

This report describes the effects of midazolam and beta-carboline-3-carboxylate ethyl ester (beta-CCE) on extracellular concentrations of dopamine in the nucleus accumbens of freely moving rats measured by in vivo microdialysis. The two compounds had opposite effects, midazolam (0.075 and 0.15 mg/kg i.v.) dose dependently decreasing, and beta-CCE (3 and 10 mg/kg i.p.) dose dependently increasing, dialysate concentrations of dopamine. Flumazenil (6 micrograms/kg i.v.) did not affect the efflux of dopamine but it prevented the effects of both midazolam and beta-CCE on dopamine efflux. N6-Cyclohexyladenosine (0.1, and 1 mg/kg i.p.), a selective adenosine A1 agonist, dose dependently increased the efflux of dopamine. This effect was blocked by 8-cyclopentyl-1,3-dipropylxanthine (25 mg/kg i.p.), a selective adenosine A1 receptor antagonist, a dose which given alone did not affect dopamine efflux; responses to midazolam were not affected. 3,7-Dimethyl-1-propargylxanthine (1 and 3 mg/kg i.p.), a selective adenosine A2 receptor antagonist, did not mimic the effects of beta-CCE. The results suggest that midazolam and beta-CCE modulate dopamine release in the nucleus accumbens by an action at the benzodiazepine binding site associated with the GABAA receptor complex.

[Chemotherapy for metastatic brain tumors with CDDP and other agents: correlation between chemotherapeutic effects and the results of in vitro chemosensitivity tests using collagen gel-embedded culture combined with computerized image analysis in metastatic brain tumors]

Chemotherapy with CDDP and/or other agents was performed in 15 patients after removal of metastatic brain tumors. A chemosensitivity test using a system of collagen gel-embedded culture and computerized image analysis was performed on the tumors from these patients. The clinical usefulness of the chemosensitivity test was evaluated by comparing chemotherapeutic effects with the results of the test. The rates of correlation of the chemosensitivity test with clinical response on brain MRI was 80%, and that of the chemosensitivity test with clinical response in tumor markers or on primary tumors was 75%. This observation suggests that the chemosensitivity test using collagen gel-embedded culture and computerized image analysis is useful in determining optimal chemotherapy for metastatic brain tumors. In ten multiple metastatic brain tumors, three complete responses, two partial responses, one minor response and four non-responses were observed on MRI. Only one case showed a false negative result on the chemosensitivity test and showed partial response. This result also indicates the effectiveness of chemotherapy based on chemosensitivity testing.

Myelin basic protein in the cerebrospinal fluid of patients with brain tumors

We measured the level of myelin basic protein (MBP) in the cerebrospinal fluid (CSF) of patients with various kinds of tumors, including malignant tumors, using radioimmunoassay. The CSF had been obtained by lumbar puncture through an Ommaya reservoir or a shunt device placed in the lateral ventricle. The level of MBP was high (> 4 ng/ml) in the patients with meningeal dissemination of malignant tumors, but in those who showed a good response to chemotherapy and/or radiation, it decreased or returned to the normal level, with improvement on the computed tomography and magnetic resonance imaging, cytological, general CSF, and neurological findings. Of seven malignant gliomas without CSF dissemination, six showed an elevated level of MBP before selective intra-arterial chemotherapy with a combination of etoposide and cisplatin administered via a microcatheter placed at A1, M1, P1-P2, and the basilar top. All CSF specimens obtained during the period of the intra-arterial chemotherapy showed an abnormally high (> 4 ng/ml) level of MBP that exceeded the prechemotherapy level. The MBP level decreased or returned to normal in the patients with a good response to chemotherapy after intra-arterial chemotherapy. In some patients with multiple metastatic brain tumors, the MBP level was elevated before treatment and returned to normal after treatment (surgical removal, chemotherapy, and/or irradiation) in all except one. Thus, there was a clear correlation between the timing of treatment and changes in imaging studies and MBP levels.(ABSTRACT TRUNCATED AT 250 WORDS)

[Myelin basic protein in the cerebrospinal fluid of patients with neurological disease: especially with malignant brain tumors]

Myelin basic protein (MBP) in the cerebrospinal fluid (CSF) of patients with brain tumors and other neurological diseases was measured before, during and after various treatments such as surgery, chemotherapy and irradiation. We assessed the significance of changes in the MBP levels during the course of treatment, and speculate on what the elevated level of MBP in brain tumor patients indicates. In meningeal dissemination of malignant tumors, meningeal carcinomatosis from cancer of the systemic organ showed the highest level of MBP followed by meningeal gliomatosis and meningeal lymphoma. Meningeal carcinomatosis and meningeal lymphoma, which have responded to chemotherapy, showed normal levels of MBP after chemotherapy. Six of eight patients with newly diagnosed malignant glioma showed moderate to high levels of MBP (range 4.6-35.5ng/ml) just before intraarterial chemotherapy with VP-16 and CDDP. The level increased in five patients during the course of chemotherapy and then decreased in relation to the degree of tumor reduction by chemotherapy. In the solid type of metastatic brain tumor, five of seven patients with multiple tumors showed high levels of MBP and these levels also returned to normal after treatment in four patients. As for the influence of irradiation, levels of MBP did not increase after irradiation except in three patients who developed radiation necrosis, local extensive edema or atrophic change. In other brain tumors, levels of MBP were high in a patient with a large meningioma with very extensive edema and during an unstable postoperative condition after total removal of a large craniopharyngioma.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective intra-arterial chemotherapy with a combination of etoposide and cisplatin for malignant gliomas: preliminary report

We administered selective intra-arterial chemotherapy consisting of a combination of etoposide and cisplatin to 20 patients with malignant glioma (seven with recurrent and six with enlarged tumors after initial treatment, and seven newly diagnosed patients). Evaluation of efficacy was based on computed tomographic and magnetic resonance imaging findings. In the process of establishing a safe technique for superselective intra-arterial chemotherapy, we encountered cerebrovascular accidents in two patients (after etoposide in one and after etoposide plus cisplatin in the other). In these two cases, 100 mg/m2 of etoposide and 100 mg/m2 of cisplatin were delivered via the horizontal segment of the middle cerebral artery (M1) or the tip of the basilar artery, with the infusion time reduced to 20 minutes. Thereafter, the etoposide was diluted, and the doses of both drugs were reduced to 80 or 50 mg/m2, and finally to 60 mg/m2, and both were infused over 60 minutes. In addition, for prevention of local spasm, papaverine hydrochloride and nicardipine were given via the same catheter at 5-minute intervals during administration of etoposide and cisplatin. No complications developed in the later cases. Thereafter, selective intra-arterial infusion of etoposide and cisplatin into the anterior cerebral artery, middle cerebral artery, posterior cerebral artery, or the basilar artery for malignant gliomas in the basal ganglia, internal capsule, and brainstem--a procedure generally considered risky in terms of potential complications--was performed safely, with tolerable side effects. Computed tomography and magnetic resonance imaging indicated improvement in 13 patients, including four whose tumors completely disappeared. This method of intra-arterial chemotherapy may be useful as an adjuvant treatment for malignant glioma.

[Pharmacokinetics of plasma and cerebrospinal fluid cisplatin in patients with malignant glioma and metastatic brain tumor after selective intraarterial or intravenous and intracarotid administration of etoposide and cisplatin]

CSF and plasma platinum levels were examined in patients with malignant glioma after administration of etoposide and cisplatin each at doses of 60 mg/m2 by 60-minute selective intraarterial infusion. These same factors were also examined in patients with metastatic brain tumors after administration of cisplatin at a dose of 60 or 100mg/m2 by 60-minute intracarotid or intravenous infusion. Plasma and CSF samples taken through an Ommaya reservoir placed in the lateral ventricle or postoperative cavity were analyzed for platinum content by atomic absorption spectroscopy. Plasma and CSF platinum levels were dose dependent. The overall plasma platinum curves were biphasic, with mean half-lives of 35 minutes and 56 hrs. The mean peak total CSF concentration was 10.0% of the peak total plasma platinum and 20.2% of the peak free plasma platinum in patients with malignant glioma. In patients with a solid metastatic brain tumor, the mean peak total CSF concentration was 1.9% of the peak total plasma platinum and 4.0% of the peak free plasma platinum after i.v. infusion. After intracarotid infusion, the mean peak total CSF concentration was 3.4% of the peak total plasma platinum and 7.0% for the peak free plasma platinum. In patients with meningeal carcinomatosis, the mean peak CSF concentrations were 7.7% of the peak total plasma platinum and 13.7% of the peak free plasma platinum. The free to total platinum ratio in plasma decreased quickly and that in CSF increased and was maintained at the high levels of 80% for two hours or more.(ABSTRACT TRUNCATED AT 250 WORDS)

[Penetration of potassium clavulanate/ticarcillin sodium into cerebrospinal fluid in neurosurgical patients]

Concentrations of potassium clavulanate (CVA) and ticarcillin sodium (TIPC) in the plasma and cerebrospinal fluid (CSF) of patients after neurosurgical intervention were determined at various times after a 1-hour drip infusion (3.2-g dose). Patients whose blood-brain barriers were supposed to be maintained in almost a normal condition were selected. CSF was obtained through a catheter placed in the anterior horn of the lateral ventricle in all the patients. Maximum plasma levels (micrograms/ml) of 57.6 to 384.0 with an average of 169.7 (TIPC) and 0.41 to 26.2 with an average of 6.1 (CVA) were achieved at the termination of infusion. The maximum CSF levels (micrograms/ml) were 0.61 to 18.8 (TIPC) and 0.1 to 6.81 (CVA) with mean values of 4.5 and 1.2, respectively. Plasma half lives (T1/2) (minute) were 24 to 93 (TIPC) and 32 to 227 with mean values of 58 and 127, respectively. The mean values of the CSF half lives (minute) were 237 (TIPC) and 113 (CVA). The ratios (%) of CSF levels to plasma levels in maximum concentration (Cmax), AUC (area under concentration curve) and half life (T1/2) were calculated. Cmax ratios were 0.2 to 29.2 (TIPC) and 1.4 to 69.8 (CVA) with mean values of 4.4 and 22.8, respectively. AUC ratios were 0.3 to 23.5 (TIPC) and 1.1 to 70.2 (CVA) with mean values of 4.3 and 22.4, respectively. T1/2 ratios were 1.3 to 18 (TIPC) and 1.1 to 4.3 (CVA) with mean values of 5.5 and 2.3, respectively. These values indicate that CVA/TIPC may be classified into a group of antibiotics with good penetration into the CSF.

A new prostacyclin analog, KP-10614, inhibits platelet-polymorphonuclear leukocyte interaction and limits experimental infarct size in rat heart

A chemically stable prostacyclin analog, KP-10614 [(4Z,16S)-4, 5, 18, 18, 19, 19-hexadehydro-16,20-dimethyl-delta 6(9 alpha)-9(O)-methano-prostaglandin I1], was synthesized to increase the cytoprotective activity and to decrease the hypotensive activity. We have reported that KP-10614, infused i.v. at a dose of 3 ng/kg/min for 4 hr, inhibited platelet functions and reduced the experimental cardiac infarct size significantly, but did not change hemodynamic parameters and the ischemic area of the heart induced by ligation of the left descending coronary artery in rats. Accordingly, we thought that myocardial protective effects of KP-10614 might be based on the inhibition of platelet functions and cellular metabolism produced by platelets at the site of tissue injury. KP-10614 suppressed leukotriene B4 synthesis by N-formyl-methionyl-leucyl-phenylalanine-stimulated polymorphonuclear leukocytes, which was enhanced by thrombin-treated platelets in a concentration-dependent manner, even though KP-10614 did not suppress leukotriene B4 synthesis by N-formyl-methionyl-leucyl-phenylalanine-stimulated polymorphonuclear leukocytes separately in vitro. Moreover in in vivo studies, KP-10614, which was infused at a dose of 3 ng/kg/min for 4 hr, suppressed leukotriene B4 content, myeroperoxidase activity and polymorphonuclear leukocyte counts in myocardial tissues that were infarcted by ligation of the left descending coronary artery for 4 hr in rats. These data supported the hypothesis that KP-10614, a new prostacyclin analog, had protective effects on myocardial infarction in rats by suppressing the platelet-polymorphonuclear leukocyte interaction at the site of tissue injury in vivo.

Effects of midazolam and flunitrazepam on the release of dopamine from rat striatum measured by in vivo microdialysis

We have studied the effects of midazolam and flunitrazepam on extracellular concentrations of dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in rat striatum in freely moving animals using in vivo microdialysis. I.v. injections of midazolam 0.075 and 0.15 mg kg-1 decreased striatal dopamine concentrations in a dose-dependent manner without affecting the concentrations of DOPAC and HVA. Flunitrazepam 0.015 and 0.03 mg kg-1 also decreased striatal dopamine concentrations in a dose-related manner, but the reductions in DOPAC and HVA were not significant. Flumazenil 6 micrograms kg-1 alone did not affect striatal concentrations of dopamine, DOPAC and HVA, but it prevented the effects of midazolam and flunitrazepam. Flunitrazepam 10 mumol litre-1 also decreased striatal dopamine release when infused through a dialysis probe placed into the striatum, but it failed to affect striatal dopamine release when infused into the ipsilateral substantia nigra. Central administrations of midazolam were effective only when the drug was infused into both sites simultaneously (10 and 100 mumol litre-1) or given by intraventricular injection (0.5 and 1 micrograms). These results suggest that midazolam and flunitrazepam affect striatal dopamine release in a different manner.

Beneficial effects of a new prostacyclin analogue, KP-10614, on acute myocardial infarction in rats

The potential therapeutic value of a new prostacyclin analogue, (4z, 16s)-4,5,18,18,19,19-hexadehydro-16,20-dimethyl-delta 6(9a)- 9-(O)-methano-PGI1 (KP-10614), was studied in acute myocardial infarction in rats. Myocardial infarction was induced by ligation of the left coronary artery and ischemic injury was followed up to 4 h. The infarct size, evaluated by the area unstained by 2,3,5-triphenyltetrazolium chloride, reached 41.1 +/- 1.4% of the left ventricle at 4 h. KP-10614 (3 ng/kg/min x 4 h) reduced the infarct size at 4 h significantly (26.5 +/- 2.9%). At the same dose, KP-10614 inhibited ADP-induced ex vivo platelet aggregation significantly (21.5 +/- 4.0% of the control aggregation), but did not alter the arterial blood pressure or heart rate. To assess the role of platelets in myocardial infarction, circulating platelets were reduced by about 95% with rabbit antiserum to rat platelets. In platelet-depleted rats, the infarct size decreased significantly to 24.1 +/- 4.6% of the left ventricle at 4 h. These results suggest that platelets play an important role in expression of myocardial ischemic injury resulting from coronary artery occlusion in rats, and the ability of KP-10614 to decrease the infarct size appeared to be attributable, at least in part, to the inhibition of platelet aggregation or cellular metabolic effects produced by platelets at the site of tissue injury.

Three-dimensional readout of flash x-ray images of living sperm in water by atomic-force microscopy

The imaging of living specimens in water by x-ray microscopy can be greatly enhanced with the use of an intense flash x-ray source and sophisticated technologies for reading x-ray images. A subnanosecond [corrected] x-ray pulse from a laser-produced plasma was used to record the x-ray image of living sea urchin sperm in an x-ray resist. The resist relief was visualized at high resolution by atomic-force microscopy. Internal structure of the sperm head was evident, and the carbon density in a flagellum was estimated from the relief height.

Antithrombotic effects of KP-10614, a novel and stable prostacyclin (PGI2) analog

A chemically stable prostacyclin analog, KP-10614 [(4z,16s)-4,5,18,18,19,19-hexadehydro-16,20-dimethyl-delta 6(9;alpha)-9(o)- methano-PGI1], has been compared with two other prostacyclin derivatives (Iloprost and TEI-7165) and one prostaglandin E1 derivative (OP-1206) with respect to ADP-induced in vitro aggregation of human platelets and ex vivo platelet aggregation in rats and dogs, given by bolus injection and i.v. infusion. These compounds were also tested on the systemic arterial blood pressure of rats and dogs. KP-10614 was the most potent inhibitor of in vitro platelet aggregation induced by ADP with IC50 of 1 nM among the compounds studied in this report, and it also showed ex vivo effectiveness at doses much lower than the other three compounds. KP-10614 was also orally active. At oral doses of 25, 50 and 100 micrograms/kg, this new compound caused a dose-dependent inhibition of ex vivo platelet aggregation in rats, whereas the other three compounds were effective only at 500 micrograms/kg or more. In addition, KP-10614 showed definite antithrombotic effects at a dose range of 0.1 to 1 microgram/kg i.v. in various thrombosis models in which platelet aggregation was mainly involved. These results indicate that KP-10614 possesses therapeutic potential in thrombotic diseases.