Simulation Evaluation for Methods Used to Determine Muscular Internal Force Based on Joint Stiffness Using Muscular Internal Force Feedforward Controller for Musculoskeletal System

This study proposes two novel methods for determining the muscular internal force (MIF) based on joint stiffness, using an MIF feedforward controller for the musculoskeletal system. The controller was developed in a previous study, where we found that it could be applied to achieve any desired end-point position without the use of sensors, by providing the MIF as a feedforward input to individual muscles. However, achieving motion with good response and low stiffness using the system, posed a challenge. Furthermore, the controller was subject to an ill-posed problem, where the input could not be uniquely determined. We propose two methods to improve the control performance of this controller. The first method involves determining a MIF that can independently control the response and stiffness at a desired position, and the second method involves the definition of an arbitrary vector that describes the stiffnesses at the initial and desired positions to uniquely determine the MIF balance at each position. The numerical simulation results reported in this study demonstrate the effectiveness of both proposed methods.

Optimal Muscular Arrangement Using Genetic Algorithm for Musculoskeletal Potential Method with Muscle Viscosity

Muscle contractions (or equivalent mechanical elements) are responsible for joint movement in systems with musculoskeletal structure. Because muscles can only transmit force in the tensile direction in such systems, the internal force exists between the muscles. By utilizing the potential field generated by the internal force, the musculoskeletal potential method makes it possible to control the position without complex real-time calculations or sensory feedback by entering step-inputs of the balanced internal force at the target posture. However, the conditions of convergence to the target posture strongly depend on muscular arrangement. Previous studies have elucidated the mathematical conditions of the muscular arrangement; however, they provide sufficient conditions that must be satisfied by the muscular arrangement to converge to the target posture, which do not necessarily lead to optimal muscular arrangement conditions. This study proposes a method to determine the optimal muscular arrangement of a two-joint six-muscle system, wherein muscle viscosity is considered, that uses a genetic algorithm and an evaluation function considering the motion response time. The effect of the obtained muscular arrangement is verified in a simulation.

Experiment Verification and Stability Analysis of Iterative Learning Control for Shape Memory Alloy Wire

To achieve the control of a small-sized robot manipulator, we focus on an actuator using a shape memory alloy (SMA). By providing an adjusted voltage, an SMA wire can itself generate heat, contract, and control its length. However, a strong hysteresis is generally known to be present in a given heat and deformation volume. Most of the control methods developed thus far have applied detailed modeling and model-based control. However, there are many cases in which it is difficult to determine the parameter settings required for modeling. By contrast, iterative learning control is a method that does not require detailed information on the dynamics and realizes the desired motion through iterative trials. Despite pioneering studies on the iterative learning control of SMA, convergence has yet to be proven in detail. This paper therefore describes a stability analysis of an iterative learning control to mathematically prove convergence at the desired length. This paper also details an experimental verification of the effect of convergence depending on the variation in gain.

Set-Point Control of a Musculoskeletal System Under Gravity by a Combination of Feed-Forward and Feedback Manners Considering Output Limitation of Muscular Forces

This paper proposes a new control method for musculoskeletal systems, which combines a feed-forward input with a feedback input, while considering an output limit. Our previous research proposed a set-point control that used a complementary combination of feedback using a time delay and a muscular internal force feed-forward; it achieved robust and rapid positioning with relatively low muscular contraction forces. However, in that control method, the range of motion of the musculoskeletal system was limited within a horizontal plane. In other words, that system did not consider the effect of gravity. The controller proposed in this paper can achieve the reaching movement of the musculoskeletal system without requiring accurate physical parameters under gravity. Moreover, the input of the proposed method can be prevented from becoming saturated with the output limit. This paper describes the design of the proposed controller and demonstrates the effectiveness of the proposed method based on the results of numerical simulations.

Choice of Muscular Forces for Motion Control of a Robot Arm with Biarticular Muscles

The contribution of biarticular muscles to the control of robotic arms and legs has recently attracted great interest in the field of robotics. The advantages of using biarticular muscles under kinetic interaction with the external environment have been well studied; however, the contribution of the muscles to the motion control of articulated robot arms under no kinetic interaction appears to remain an unclear issue, especially for robot arms of which the muscles are directly anchored to their links, which induces a change in the moment arms to allow the muscles to generate joint torques and permit point-to-point motion control to their desired postures in a feedforward manner with constant muscular forces. This paper presents a case study in which the role of biarticular muscles in the motion control of an articulated robot arm was investigated, focusing on the feature of its redundancy actuation, which allows an arbitrary choice from infinite combinations of muscular forces, realizing motion control to a desired posture. The numerical analysis in this paper addresses three typical combination choices. Mappings from muscular forces to desired postures are calculated in the analysis of the three choices. The simulation results of motion control executed according to the three mappings are also analyzed. The analysis indicates the interesting results that biarticular muscles do not contribute to the desired postures and that a very weak dependence property of monoarticular muscles on the desired postures exists for a particular choice. The simulation results also demonstrate that the implementation of one choice results in a degraded motion control performance as compared with that of the two other choices.

Improving the electron spin properties of nitrogen-vacancy centres in nanodiamonds by near-field etching

The nitrogen-vacancy (NV) centre in diamond is a promising candidate for quantum computing applications and magnetic sensing applications, because it is an atomic-scale defect with stable coherence time (T2) and reliable accessibility at room temperature. We demonstrated a method for improving the NV spin properties (the full width half maximum (FWHM) value of the magnetic resonance spectrum and T2) through a near-field (NF) etching method under ambient conditions. The NF etching method, based on a He-Cd ultraviolet laser (325 nm), which is longer than the absorption edge of the oxygen molecule, enabled selective removal of defects on the nanodiamond surface. We observed a decrease in the FWHM value close to 15% and an increase in T2 close to 25%. Since our technique can be easily reproduced, a wide range of NV centre applications could be improved, especially magnetic sensing applications. Our results are especially attractive, because they have been obtained under ambient conditions and only require a light source with wavelength slightly above the O2 absorption edge.

Robust Visual Servoing for Object Manipulation Against Temporary Loss of Sensory Information Using a Multi-Fingered Hand-Arm

This paper proposes a robust visual servoing method for object manipulation against temporary loss of sensory information. It is known that visual information is useful for reliable object grasping and precise manipulation. Visual information becomes unavailable, however when occlusion occurs or a grasped object disappears during manipulation. In that case, the behavior of the visual servoing system becomes unstable. Our proposed method enables an object to be grasped and manipulated stably even if visual information is temporarily unavailable during manipulation. This method is based on dynamic stable object grasping and manipulation proposed in our previous work and the concept of virtual object information. A dynamic model of the overall system is first formulated. A new controller using both actual and virtual object information is proposed next. The usefulness of this method is finally verified through both numerical simulation and experiments using a triple-fingered mechanical hand.

Antimicrobial photodynamic therapy using a diode laser with a potential new photosensitizer, indocyanine green-loaded nanospheres, may be effective for the clearance of Porphyromonas gingivalis

BACKGROUND

Antimicrobial photodynamic therapy (aPDT) is a new treatment method for the removal of infectious pathogens using a photosensitizer and light of a specific wavelength, e.g., toluidine blue with a wavelength of about 600 nm. We explored a new photosensitizer and focused on indocyanine green (ICG), which has high absorption at a wavelength of 800-805 nm. We investigated the bactericidal effect of PDT on Porphyromonas gingivalis using a new photosensitizer, ICG-loaded nanospheres with an 805 nm wavelength low-level diode laser irradiation.

METHODS

We designed ICG-loaded nanospheres coated with chitosan (ICG-Nano/c) as a photosensitizer. A solution containing Porphyromonas gingivalis (10(8)  CFU/mL) with or without ICG-Nano/c (or ICG) was prepared and irradiated with a diode laser or without laser irradiation as a negative control. The irradiation settings were 0.5 W with a duty ratio of 10%, for 3-100 ms in repeated pulse (RPT) or continuous wave mode. CFU were counted after 7 d of anaerobic culture.

RESULTS

We observed that ICG-Nano/c could adhere to the surface of P. gingivalis. When ICG-Nano/c was used for aPDT, irradiation with RPT 100 ms mode gave the lowest increase in temperature. Laser irradiation with ICG-Nano/c significantly reduced the number of P. gingivalis (i.e., approximately 2-log10 bacterial killing). The greatest bactericidal effect was found in the RPT 100 ms group. However, laser irradiation (RPT 100 ms) with ICG, as well as without photosensitizer, had no effect on the number of bacteria.

CONCLUSIONS

Within the limits of this study, ICG-Nano/c with low-level diode laser (0.5 W; 805 nm) irradiation showed an aPDT-like effect, which might be useful for a potential photodynamic periodontal therapy.

Sorafenib and hepatic arterial infusion chemotherapy for unresectable advanced hepatocellular carcinoma: A comparative study

Sorafenib is a kinase-targeted drug that has high efficacy for advanced hepatocellular carcinoma (HCC). The aim of the present study was to determine whether sorafenib is more effective than hepatic arterial infusion chemotherapy (HAIC) for HCC. Twenty patients treated with sorafenib (sorafenib group) initiated at 800 mg/day and 45 patients treated with HAIC (HAIC group) for unresectable Child-Pugh A advanced HCC were investigated retrospectively. The treatment effect was assessed using the Response Evaluation Criteria in Solid Tumors (RECIST). As a result, the overall response rate was significantly lower in the sorafenib group than in the HAIC group (P=0.03), while the disease control and survival rates did not differ between the two groups. In the sorafenib group, treatment was discontinued in 19 patients, including 12 due to side effects. In subgroups of patients treated with sorafenib, the survival rate was significantly lower in patients (n=11) administered sorafenib for <60 days compared to those (n=9) treated for ≥60 days. A shorter treatment period (<60 days) was an independent risk factor for unfavorable survival [hazard ratio (HR), 3.34; 95% confidence interval (CI), 1.45-7.66 vs. HAIC], while survival in patients treated with sorafenib for ≥60 days did not differ from those treated with HAIC (HR, 0.79; 95% CI, 0.27-2.34). In conclusion, the disease control and survival rates of patients treated with sorafenib for advanced HCC were comparable to such rates in patients treated with HAIC. However, the prognosis was poor when long-term sorafenib treatment was not possible due to side effects, demonstrating the importance of patient selection for sorafenib treatment.

[Evaluation of transhepatic artery chemotherapy for highly advanced hepatocellular carcinoma]

We conducted transhepatic arterial infusion chemotherapy (TAI) was on 62 patients with highly advanced hepatocellular carcinoma without distant metastases and therapeutic outcome was compared with 18 who were untreated. TAI significantly prolonged the survival of the patients, and was the most important prognostic factor on multivariate analysis. The following 3 regimens for trans-arterial injection were compared: A, a combination of a bolus hepatic artery injection of 3 agents (cisplatin, mitomycin-C and epirubicin)+low dose 5-fluorouracil+cisplatin (FP); B, low-dose FP alone; and C, bolus intrahepatic artery injection of the above 3 agents combined without FP. Regimen A yielded in the most effective survival rate, with an efficacy rate of 41.6% and a CR of about 20%. These results indicate that TAI is an effective therapeutic modality, and the dose FP combined with a bolus intrahepatic arterial infusion may improve outcomes in advanced liver cancer.

Peginterferon-alpha-2b plus ribavirin therapy in patients with chronic hepatitis C as assessed by a multi-institutional questionnaire in Japan

BACKGROUND AND AIM

There has so far been no questionnaire report on patients who were treated with peginterferon plus ribavirin (PEG IFN+RBV) therapy. The purpose of this study was to investigate the problems of this therapy by a questionnaire survey.

PATIENTS AND METHODS

A survey of 681 patients with chronic hepatitis C who received treatment with PEG IFN+RBV was conducted in the Kyushu region of Japan. Using an original questionnaire, the survey was conducted prior to the treatment, during the third month of treatment, at the completion of treatment or the discontinuation of treatment, and at 6 months after the completion of treatment.

RESULTS

It was indicated that the patients had a high level of comprehension and understanding of chronic hepatitis C and PEG IFN+RBV treatment. However, the results also indicated that patients had a high level of anxiety. Side effects were adequately dealt with by physicians. However, dermatological symptoms were not adequately explained to the patients, although they were the second most severe side-effect. It was also revealed that side-effects were most distressing during the first and second months after the start of treatment.

CONCLUSION

The questionnaire survey provided new information that has never been reported. It is believed that understanding this information is important for future treatment.

Association between changes in body composition and the increasing prevalence of fatty liver in Japanese men

AIM

Prevalence of fatty liver is increasing. In this study, to elucidate the factor that contributes most to recent increases in prevalence of fatty liver, we determined the independent predictors for the onset of fatty liver and compared these predictors between 2000 and 2005.

METHODS

Japanese persons, aged 30-74 years, who participated in regular health checks at Kagoshima Kouseiren Medical Health Care Center (10 336 persons in 2000 and 11 011 persons in 2005) were enrolled in the study. Diagnosis of fatty liver was performed by ultrasonography. Body fat percentage (BFP) was determined using a bipedal bioimpedance instrument.

RESULTS

The prevalence of fatty liver has increased between 2000 and 2005 in men (33.3 vs 38.5% in 2000 vs 2005, respectively, P < 0.0001), but not in women (21.3 vs 21.0%, P = 0.8101). Logistic regression analysis revealed that both body mass index (BMI) and BFP are independent predictors of fatty liver in both men and women. BMI did not change in either men (23.4 +/- 2.9 vs 23.8 +/- 3.0 kg/m(2), P = 0.0528) or women (22.8 +/- 3.1 vs 22.8 +/- 3.3 kg/m(2), P = 0.9862) during the survey period. In contrast, BFP increased in men (20.6 +/- 4.7 vs 22.3 +/- 5.0 kg/m(2), P = 0.0003), but not in women (27.4 +/- 5.5 vs 28.4 +/- 5.9 kg/m(2), P = 0.3993). There was no significant change in triglycerides and glucose levels.

CONCLUSION

These results suggest that altered body composition, particularly increased BFP without an increase in BMI, has developed in men and is strongly associated with the increasing prevalence of fatty live amongst Japanese men.

Resident macrophages are involved in intestinal transplantation-associated inflammation and motoric dysfunction of the graft muscularis

Gut manipulation and ischemia/reperfusion evoke an inflammatory response within the intestinal muscularis that contributes to dysmotility. We hypothesize that resident macrophages play a key role in initiating the inflammatory cascade. Isogenic small bowel transplantation was performed in Lewis rats. The impact of recovery of organs on muscularis inflammation was investigated by comparing cold whole-body perfusion after versus prior to recovery. The role of macrophages was investigated by transplantation of macrophage-depleted gut. Leukocytes were counted using muscularis whole mounts. Mediator expression was determined by real-time RT-PCR. Contractility was assessed in a standard organ bath. Both organ recovery and ischemia/reperfusion induced leukocyte recruitment and a significant upregulation in IL-6, MCP-1, ICAM-1 and iNOS mRNAs. Although organ recovery in cold ischemia prevented early gene expression, peak expression was not changed by modification of the recovery technique. Compared to controls, transplanted animals showed a 65% decrease in smooth muscle contractility. In contrast, transplanted macrophage-depleted isografts exhibited significant less leukocyte infiltration and only a 19% decrease in contractile activity. In summary, intestinal manipulation during recovery of organs initiates a functionally relevant inflammatory response within the intestinal muscularis that is massively intensified by the ischemia reperfusion injury. Resident muscularis macrophages participate in initiating this inflammatory response.

Acute Rejection in Allogeneic Rodent Small Bowel Transplantation Causes Smooth Muscle Dysfunction via an Inflammatory Response Within the Intestinal Muscularis

INTRODUCTION

Isogeneic intestinal transplantation elicits an inflammatory response within the intestinal muscularis that is associated with dysmotility. Usually the inflammation and the postoperative motor dysfunction resolve within a few days after small bowel transplantation (SBTx). However, the onset of acute rejection in allogeneic SBTx is again associated with dysmotility. We hypothesized that dysmotility during acute rejection is based on coexpression of kinetically active mediators by the alloreactive leucocyte infiltrate.

MATERIALS AND METHODS

Rat SBTx (BN to Lew and BN to BN) was performed without immunosuppression. Animals were sacrificed at 1, 4, and 7 days after SBTx. Leukocyte infiltration was investigated in muscularis whole mounts by immunohistochemistry. Mediator mRNA expression was determined by reverse transcriptase polymerase chain reaction. Muscle contractility was assessed in a standard organ bath.

RESULTS

Transplanted animals showed a significant inflammatory response within the muscularis at day 1 after SBTx. However, allogeneic transplanted animals exhibited a significant second inflammatory peak at day 7 (mRNA induction: iNOS 150-fold; tumor necrosis factor-alpha 18-fold; interferon-gamma 397-fold), parallel to the onset of rejection. This change was associated with a significant leukocyte infiltration. Compared to controls, allogeneic transplanted animals showed a 29% decrease in smooth muscle contractility on days 1 and 4 and a 71% decrease of contractility on postoperative day 7.

CONCLUSIONS

The motor dysfunction of transplanted small bowel during acute rejection is associated with an inflammatory reaction in the intestinal muscularis. The initial unspecific inflammation process immediately after transplantation is reactivated and intensified during acute rejection.

Mechanism and Impact of Organ Harvesting and Ischemia-Reperfusion Injury Within the Graft Muscularis in Rat Small Bowel Transplantation

INTRODUCTION

Inflammatory events within the gut muscularis contribute to dysmotility. We hypothesized that manipulation during organ harvesting initiated an inflammatory response via muscularis macrophages and that this cascade was amplified during reperfusion.

METHODS

Small bowel transplantation was performed in Lewis rats. To investigate the impact of organ harvesting on muscularis inflammation, cold whole-body perfusion was performed after versus prior to organ harvesting. The role of macrophages was investigated by transplantation of the macrophage-depleted gut. Leukocyte infiltration was investigated in muscularis whole mounts. Mediator mRNA expression was determined by real-time reverse transcriptase polymerase chain reaction. Contractility was assessed in a standard organ bath.

RESULTS

Organ harvesting and ischemia-reperfusion induced leukocyte recruitment and mRNA upregulation in the muscularis: interleukin-6 12217-fold, monocyte chemoattractant protein-1 62-fold, ICAM-1 12-fold, cyclooxygenase-2: 8-fold, iNOS: 150-fold. Although organ harvesting with cold ischemia prevented early gene expression, peak expression at 3-hour reperfusion was not changed by modification of the harvesting technique. Compared to controls, transplanted animals showed a 63% decrease in smooth muscle contractility. In contrast, transplanted macrophage-depleted gut exhibited significantly fewer leukocytes and only a 16% decrease in contractility.

CONCLUSIONS

Gut manipulation during organ harvesting initiates an inflammatory response within the muscularis that is massively intensified during reperfusion. This change contributes to muscular dysfunction. Furthermore, the results suggested that resident macrophages play a key role in initiating this process.

Novel genetic variants of Anaplasma phagocytophilum, Anaplasma bovis, Anaplasma centrale, and a novel Ehrlichia sp. in wild deer and ticks on two major islands in Japan

Wild deer are one of the important natural reservoir hosts of several species of Ehrlichia and Anaplasma that cause human ehrlichiosis or anaplasmosis in the United States and Europe. The primary aim of the present study was to determine whether and what species of Ehrlichia and Anaplasma naturally infect deer in Japan. Blood samples obtained from wild deer on two major Japanese islands, Hokkaido and Honshu, were tested for the presence of Ehrlichia and Anaplasma by PCR assays and sequencing of the 16S rRNA genes, major outer membrane protein p44 genes, and groESL. DNA representing four species and two genera of Ehrlichia and Anaplasma was identified in 33 of 126 wild deer (26%). DNA sequence analysis revealed novel strains of Anaplasma phagocytophilum, a novel Ehrlichia sp., Anaplasma centrale, and Anaplasma bovis in the blood samples from deer. None of these have been found previously in deer. The new Ehrlichia sp., A. bovis, and A. centrale were also detected in Hemaphysalis longicornis ticks from Honshu Island. These results suggest that enzootic cycles of Ehrlichia and Anaplasma species distinct from those found in the United States or Europe have been established in wild deer and ticks in Japan.

Orally administered Kampo medicine, Juzen-taiho-to, ameliorates anemia during interferon plus ribavirin therapy in patients with chronic hepatitis C

BACKGROUND

Interferon plus ribavirin (IFN/Rib) therapy is currently standard treatment for chronic hepatitis C. Hemolytic anemia, however, is a serious side effect of this treatment, requiring reductions in or complete withdrawal of ribavirin.

METHODS

We retrospectively investigated the effect of the Kampo medicine Juzen-taiho-to (TJ-48), which contains bone marrow-stimulating compounds, on anemia in 67 patients with chronic hepatitis C, who received IFN/Rib therapy.

RESULTS

The reduction in hemoglobin levels was significantly ameliorated in TJ-48-treated patients (P<0.05). Consequently, only 13% (4/32) of TJ-48-treated patients received altered doses of ribavirin, while the ribavirin dose had to be reduced or withdrawn in 43% (15/35) of patients in the absence of TJ-48 administration (P<0.001).

CONCLUSIONS

These results indicate the possibility that oral administration of TJ-48 supports IFN/Rib therapy without necessitating ribavirin reduction or withdrawal.

Indoleamine 2,3-Dioxygenase is Necessary for Cytolytic Activity of Natural Killer Cells

Indoleamine 2,3-dioxygenase (IDO) is a tryptophan catabolic enzyme that is widely distributed in various tissues. In peripheral blood mononuclear cells (PBMCs), production of IDO by macrophages or dendritic cells has been reported to inhibit T-cell activation and proliferation. In the present study, we have determined that other phenotypes of PBMCs also express IDO. In cultures of PBMCs, IDO was found predominantly in monocyte by immunohistochemistry. Reverse transcriptase polymerase chain reaction analysis showed that IDO mRNA was expressed in T lymphocytes, B lymphocytes and natural killer (NK) cells and that expression was increased upon activation with interferon-gamma. The cytotoxicity of NK cells against K562 and HepG2 cells was reduced by IDO inhibitor. These results suggest that IDO in NK cells is essential for NK cells to generate killing activity against cancer cells.

Branched-chain amino acids supplements in the late evening decrease the frequency of muscle cramps with advanced hepatic cirrhosis

Eight outpatients with advanced hepatic cirrhosis were tested over 3 months for branched-chain amino acids (BCAA) supplements in the late evening. Serum albumin level (2.8+/-0.3 vs. 3.1+/-0.2 g/dl, P<0.002), serum cholin esterase activity (54+/-13 vs. 67+/-17 IU/l, P<0.02), and plasma Fischer's ratio (1.3+/-0.9 vs. 1.4+/-0.9, P<0.005) increased over the 3 months. The frequency of muscle cramps decreased (7.4+/-2.0 vs. 0.3+/-0.5 times/week, P<0.0001) dramatically. These data suggest that BCAA supplements in the late evening are of benefit to malnourished patients with hepatic cirrhosis. Relief of muscle cramping is an important outcome of BCAA supplements in the late evening.

Effectiveness of carbohydrate-restricted diet and arginine granules therapy for adult-onset type II citrullinemia: a case report of siblings showing homozygous SLC25A13 mutation with and without the disease

Case 1 is a 37-year-old Japanese man who was admitted to this hospital with a disturbance of consciousness. A diagnosis of adult-onset type II citrullinemia was made by DNA analysis of SLC25A13 (851del4/851del4) and measurement of hepatic ASS activity (2% of control value). After regaining consciousness, Case 1 was started on a dietary therapy, revealing that hypertriglyceridemia and ketogenesis impairment deteriorated on a low-protein diet and ameliorated on a carbohydrate-restricted (high-protein) diet. Case 1 could tolerate 70 g/day of protein while using arginine granules and developed hyperammonemia only after discontinuation of the administration. Case 2 (an elder brother of Case 1) is also homozygote for the same SLC25A13 mutation. The hepatic activity of argininosuccinate synthetase was about 20% of the control value. However, Case 2 exhibited neither hyperammonemia nor lipid metabolism abnormalities. These results suggest that, although adult-onset type II citrullinemia is caused by a deficiency of citrin, which plays key roles in carbohydrates, amino acids and even lipid metabolism, some other environmental or genetic factors are required for the onset of the disease, and from the authors' clinical experience, a carbohydrate-restricted (relatively high-protein) diet is advocated as a benefit to the patients, and that arginine granules are indispensable to this new dietary therapy.

DeltaFosB, but not FosB, induces delayed apoptosis independent of cell proliferation in the Rat1a embryo cell line

The fates of Rat1a cells expressing FosB and DeltaFosB as fusion proteins (ER-FosB, ER-DeltaFosB) with the ligand binding domain of human estrogen receptor were examined. The binding of estrogen to the fusion proteins resulted in their nuclear translocation and triggered cell proliferation, and thereafter delayed cell death was observed only in cells expressing ER-DeltaFosB. The proliferation of Rat1a cells, but not cell death triggered by ER-DeltaFosB, was completely abolished by butyrolactone I, an inhibitor of cycline-dependent kinases, and was partly suppressed by antisense oligonucleotides against galectin-1, whose expression is induced after estrogen administration. The cell death was accompanied by the activation of caspase-3 and -9, the fragmentation of the nuclear genome and cytochrome c release from the mitochondria, and was suppressed by zDEVD-fmk and zLEHD-fmk but not zIETD-fmk. The cell death was not suppressed by exogenous His-PTD-Bcl-x(L) at all, suggesting involvement of a Bcl-x(L)-resistant pathway for cytochrome c release.

[A patient with hepatocellular carcinoma with intraperitonial lymph node metastases in whom oral UFT treatment was markedly effective]

We report a patient with hepatocellular carcinoma (HCC) with intraperitoneal lymph node metastases in whom UFT (uracil + tegafur) was markedly effective. The patient was a 70-year-old woman with chronic hepatitis C, who developed HCC mainly infiltrating the medial segment of the liver. Arterial infusion chemotherapy and embolization were performed, and radiofrequency ablation was also conducted. Despite these interventions, the serum alpha-fetoprotein level continued to increase, and reached a level as high as 208,000 ng/ml by the second month of treatment. Abdominal computed tomography (CT) revealed no recurrence in the liver, but multiple metastases to intraperitoneal lymph nodes were identified. UFT-E treatment was initiated at the dose of 400 mg/day. A subsequent abdominal CT revealed complete disappearance of the intraperitoneal lymph node metastases 2 months after the start of UFT treatment. The serum alpha-fetoprotein level returned to normal 4 months after the start of UFT treatment. We consider that the patient described here is a good example to illustrate the remarkable effectiveness of UFT in the treatment of metastatic HCC.