Does Neuroticism Influence Oral Health-Related QOL in Patients with Removable Partial Dentures?

This prospective cohort study investigated the relationship between patient neuroticism and oral health-related quality of life (OHRQoL) before and after prosthetic treatment as well as changes in OHRQoL-namely, treatment efficacy. Sixty-three patients (23 men and 40 women; mean age 67.2 ± 8.6 years), who were scheduled to receive new removable partial dentures (RPDs), were recruited. OHRQoL was assessed using the Japanese version of the Oral Health Impact Profile (OHIP-J). The Japanese version of the NEO Five-Factor Inventory (NEO-FFI) was used to assess neuroticism. Spearman's rank correlation coefficient was calculated to determine the association between neuroticism and OHIP-J scores before and after treatment. After stratifying patients according to neuroticism score, the Wilcoxon signed-rank test was used for intragroup comparison of OHIP-J scores before and after treatment. Moreover, logistic regression analysis was used to determine the impact of covariates on treatment efficacy such as age, sex, Eichner classification, neuroticism, changes in maximal occlusal force, and OHIP-J scores before treatment. Statistical analyses showed that higher neuroticism scores were associated with higher total OHIP-J scores before treatment ( r = 0.41, P = 0.001) but were not associated with OHIP-J scores after treatment ( r = 0.07, P = 0.566). When the effect of all independent variables was analyzed in multivariate analysis, neuroticism and OHIP-J scores before treatment affected treatment efficacy. These results suggest that OHRQoL of patients with higher levels of neuroticism was low before prosthetic treatment but significantly improved by oral rehabilitation with RPDs to the same level as patients with lower levels of neuroticism. Knowledge Transfer Statement: The results of this study may change the clinical perception of the effect of prosthetic rehabilitation with removable partial dentures in patients with higher levels of neuroticism. The study concluded that prosthetic rehabilitation could contribute toward satisfaction even in neurotic patients, who are presumed to show less satisfaction with their oral status.

Long-term survival in patients with para-aortic lymph node metastasis with systematic retroperitoneal lymphadenectomy followed by adjuvant chemotherapy in endometrial carcinoma

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Background: The purpose of this study was to assess modified radical hysterectomy including systematic pelvic and para- aortic lymphadenectomy followed by adjuvant chemotherapy in patients with para-aortic lymph node metastasis in endometrial carcinoma and to identify the multivariate independent prognostic factors for a long-term survival over the past 10 years. Methods: Between December 1987 and December 2002, we performed modified radical hysterectomy with bilateral salpingo-oophorectomy including systematic pelvic and para-aortic lymphadenectomy, and peritoneal cytology in 284 endometrial carcinoma patients who gave an informed consent at the Department of Gynecologic Oncology of Shikoku Cancer Center. The patients with a tumor confined to the uterus (stage Ic and II) were treated by 3 courses of CEP (cyclophosphamide 750 mg/m2, epirubicin 50 mg/m2, cisplatin 75 mg/m2) regimen 3–4weeks apart, extrauterine lesions involving adnexa and/or pelvic lymph node (PLN), and para-aortic lymph node (PAN) metastasis were treated by 5 and 10 courses, respectively. Multivariate analysis was performed for the prognostic factors and actuarial technique for the survival rate. Results: PLN and PAN metastasis were 9.2% (26/284) and 7.4% (21/284), respectively. The univariate analysis of prognostic factors revealed that FIGO clinical stage, histology, myometrial invasion, adnexal metastasis, lymphvascular space invasion, tumor diameter, peritoneal cytology and retroperitoneal lymph node (RLN) metastasis were significantly associated with 10-year overall survival. A multivariate analysis showed that adnexal metastasis (p=0.0418) and lymphvascular space invasion (p=0.0214) were significantly associated with 10-year overall survival. The 5- and 10-year survival in patients with negative and positive para-aortic lymph node were 96%, 72% and 93%, 62%, respectively (p=0.006). Conclusions: We conclude that surgery with systematic pelvic and para-aortic lymphadenectomy followed by adjuvant chemotherapy might improve a long-term survival in patients with PAN metastasis in endometrial carcinoma.

No significant financial relationships to disclose.

A phase II study of irinotecan and docetaxel in patients with platinum-resistant relapsed epithelial ovarian cancer

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Background: Patients with epithelial ovarian cancer are often diagnosed with advanced-stage disease. Although clinical complete remissions are obtained in the majority of patients through a combination of cytoreductive surgery and chemotherapy, relapse is common. Relapsed patients with a short treatment-free interval (TFI) after prior chemotherapy have a poor prognosis. We conducted a pilot study of irinotecan (CPT-11) and docetaxel (DTX) in patients with platinum-resistant relapsed epithelial ovarian cancer. Methods: Eligible patients must have at least one platinum and paclitaxel-containing regimen, and recur with a TFI of less than 6 months. CPT-11 60 mg/m2 and DTX 30 mg/m2 were administrated on days 1, 8, 15 of a 28-day cycle. Eligibility included preserved organ function, aged 20–75, and ECOG performance status 0 or 1. The primary endpoint was response rate, and secondary objectives were duration of response, time to progression (TTP) and safety. Toxicity was assessed using NCI-CTCAE ver.2.0. Results: Between 12/2000 and 4/2005, 26 patients were enrolled, 24 of whom were eligible. The median age was 57.5 years (range 35–75). A total of 99 cycles were analyzed, median number of cycles was 3 (range 1–12). Grade 3/4 hematologic toxicities occurred in 33.3% for anemia, 4.2% for thrombocytopenia, 50.0% for leucopenia, and 62.5% for neutropenia. Non-hematologic grade 3/4 toxicities were not observed. Efficacy based on RECIST criteria was available for 20 patients, and the overall response rate was 10% (2 PR) with SD in 40%. In addition, of 4 patients with no measurable diseases, 2 patients had a confirmed PR by CA125 criteria (GCIG). Over all, clinical benefit (PR, SD) was seen in 63.6% of patients. The median duration of response was 17 weeks (range 2–49). The median TTP was 31 weeks (range 7–86). Conclusions: These results suggest that weekly treatment with CPT-11 and DTX is feasible and effective chemotherapy regimen for platinum-resistant relapsed ovarian cancer.

No significant financial relationships to disclose.

Isolation and structure of five new cancer cell growth inhibitory bufadienolides from the Chinese traditional drug Ch'an Su

Five new bufadienolides, 3beta-formyloxyresibufogenin (1), 19-oxobufalin (2), 19-oxodesacetylcinobufagin (3), 6alpha-hydroxycinobufagin (4), and 1beta-hydroxybufalin (5), have been isolated together with the previously known bufadienolides 6-20 from the Chinese traditional drug "Ch'an Su". The structures were elucidated employing spectroscopic methods. Bufadienolides 1-5 provided significant inhibitory activity against the KB and HL-60 cancer cell lines. In addition, bufadienolide 1 was found active against the MH-60 cancer cell line.

Prognostic value of carcinoembryonic antigen (CEA) in tumor tissue of patients with colorectal cancer

To establish the prognostic value of carcinoembryonic antigen (CEA) concentration in tumor tissue (T-CEA), normal colonic mucosa (N-CEA) and pre-operative serum (S-CEA), we studied 79 patients who underwent resections for colorectal cancer. The patients were separated into groups reflecting laboratory values lower or higher than a diagnostic value (S-CEA) or the median value of the entire population (T-CEA, N-CEA). A high S-CEA predicted for more advanced stage (p = 0.028), whereas no association was noted between stage and CEA concentration for T-CEA and N-CEA groups. The high S-CEA and T-CEA groups had a worse clinical outcome (p=0.0036 and p=0.024, respectively), while survival of high versus low N-CEA groups did not differ. By Cox's regression analysis, high T-CEA concentration was an independent variable for poor outcome (Hazard ratio, 3.15), while S-CEA and N-CEA were not. In conclusion, a high T-CEA concentration was the only independent predictor of poor outcome after resection for colorectal cancer.

Adenovirus-mediated p16 gene transfer changes the sensitivity to taxanes and Vinca alkaloids of human ovarian cancer cells

BACKGROUND

Deletions and point mutations of the p16 gene are detectable in more than 50% of ovarian cancer cells. In this study, we examined the effect of p16 gene transduction on the growth of ovarian cancer cells and on the effect of anti-cancer agents.

MATERIALS AND METHODS

p16-null human ovarian cancer cell lines, SKOV-3 and OVCAR-5, were used in this study. We transduced the full-length human p16 gene using recombinant adenovirus (AxCA-hp16).

RESULTS

The spontaneous growth of these cells was significantly inhibited by hp16 transduction. MTT assay revealed that AxCA-hp16 infection induced chemoresistance in both cell lines. Flow cytometric analysis revealed that only hp16 -transduced SKOV-3, were arrested at the G1-phase for 3 days whereas those infected with AxCA-mock and OVCAR-5 infected with both recombinant viruses did not. Western blot analysis showed increased microtubule-associated proteins 4 (MAP4) in both cell lines.

CONCLUSION

These results suggest that in SKOV-3 cells, G1-arrest induced by p16-transduction prevents paclitaxel- and vindesine-induced cell death, and in OVCAR-5 cells, the other unknown mechanisms play a role of chemoresistance.

[Weekly paclitaxel and cisplatin in recurrent ovarian cancer]

This study was performed to assess the feasibility of weekly paclitaxel (TXL) and cisplatin (CDDP) in patients with recurrent ovarian cancer. Ten of eleven patients experienced recurrence after more than 6 months after first line CDDP-based chemotherapy. TXL and CDDP were given at initial doses of 60 mg/m2 and 30 mg/m2 on days 1, 8, and 15 in 2 patients and an increase in the respective dose level was planned to 60/35 in 5 patients, 70/35 in 2 patients, and 70/40 in 2 patients. Toxicities were well tolerated. None of the patients suffered from neurotoxicity or myalgia of more than grade 2. Gastrointestinal disorder was recognized as grade 1-2, and grade 3-4 hematological toxicity included leucocytopenia (64%), anemia (36%), and thrombocytopenia (9%). We set the recommended dose of TXL at 70 mg/m2 and that of CDDP at 35 mg/m2, considering toxicity and performed planned schedule. Of eleven patients, nine were assessable by computed tomographic scan. The overall response rate was 67% (CR: 1, PR: 5, NC: 1, PD: 2). One of two patients with standard TXL/CDDP therapy showed PR by switching to a weekly schedule. The median follow-up duration was 490 days and the median response duration was 371 days. From the results presented here, it is suggested that this regimen with increased DI might be quite effective and well tolerated in patients who experience relapse after CDDP-based chemotherapy.

Efficient cleavage of RNA at high temperatures by a thermostable DNA-linked ribonuclease H

To construct a DNA-linked RNase H, which cleaves RNA site-specifically at high temperatures, the 15-mer DNA, which is complementary to the polypurine-tract sequence of human immunodeficiency virus-1 RNA (PPT-RNA), was cross-linked to the unique thiol group of Cys135 in the Thermus thermophilus RNase HI variant. The resultant DNA-linked enzyme (d15-C135/TRNH), as well as the d15-C135/ERNH, in which the RNase H portion of the d15-C135/TRNH is replaced by the Escherichia coli RNase HI variant, cleaved the 15-mer PPT-RNA site-specifically. The mixture of the unmodified enzyme and the unlinked 15-mer DNA also cleaved the PPT-RNA but in a less strict manner. In addition, this mixture cleaved the PPT-RNA much less effectively than the DNA-linked enzyme. These results indicate that the cross-linking limits but accelerates the interaction between the enzyme and the DNA/RNA substrate. The d15-C135/TRNH cleaved the PPT-RNA more effectively than the d15-C135/ERNH at temperatures higher than 50 degrees C. The d15-C135/TRNH showed the highest activity at 65 degrees C, at which the d15-C135/ERNH showed little activity. Such a thermostable DNA-linked RNase H may be useful to cleave RNA molecules with highly ordered structures in a sequence-specific manner.

Multicenter randomized prospective study of adjuvant chemotherapy with UFT and mitomycin C in advanced colorectal cancer

BACKGROUND

A randomized prospective trial was performed to determine the efficacy of preoperative and postoperative adjuvant oral UFT, administered with mitomycin C (MMC) after resection for advanced colorectal cancer.

MATERIALS AND METHODS

A total of 126 patients were entered in the study. The patients received UFT (400 mg daily) administered orally for seven days prior to surgery and were randomly assigned to two groups immediately following surgery. Group A received MMC postoperatively; Group B received the same regimen as Group A, plus administration of UFT orally at a dose of 400 mg daily for one year.

RESULTS

The survival results revealed no significant difference between groups A and B. In patients with nuclear DNA aneuploid tumors, the hematogenous recurrence rate after curative surgery was lower in Group B than in Group A (P = 0.0656).

CONCLUSIONS

Preoperative and postoperative adjuvant oral UFT, administered with MMC after curative resection, may be effective in preventing hematogenous recurrence in colorectal cancer patients with nuclear DNA aneuploidy tumors.

Preoperative UFT administration for patients with advanced colorectal cancer--increased uptake of 5-fluorouracil by tumor tissue is a prognostic factor

The aim of this study was to clarify whether increased 5-fluorouracil (5-FU) uptake by tumor tissue following preoperative UFT administration is a prognostic factor after surgery in colorectal cancer patients. We examined the concentrations of 5-FU in tumor or normal tissue of 96 colorectal cancer patients who received UFT (400 mg/day) orally for 7 days prior to surgery. Patients were divided into two groups with high or low 5-FU concentrations in tumor tissue (defined as higher or lower than the cut-off value, respectively). The cut-off value of 5-FU was established based on the upper limit of the 95% confidence interval of the median of the concentration found in normal tissue (0.106 microg/g). Of the 96 patients, 62 (64.6%) were in the low-5-FU group and 34 (35.4%) in the high-5-FU group. The latter had a more favorable clinical outcome (p=0.0465). Cox regression analysis revealed that two independent variables, stage and 5-FU status in tumor tissue, were significant for prediction of survival. These findings suggest that increased uptake of 5-FU by tumor tissue following preoperative oral administration of UFT is an independent prognostic factor in colorectal cancer patients. This variable needs to be considered in the design of future therapeutic trials.

[A case of left main bronchus obstruction due to recurrent esophageal cancer successfully treated by Nd-YAG laser followed by radiotherapy, low-dose CDDP and continuous infusion of 5-FU]

A 63-year-old female patient with obstruction of left main bronchus due to recurrent esophageal cancer was treated by emergency Nd-YAG laser therapy under bronchoscopy. Severe dyspnea subsided dramatically and she was the given radiotherapy with a total dose of 50 Gy (2 Gy/f and 25 f/5 wks). Concurrent chemotherapy was performed at the 3rd week of radiation therapy. In this chemotherapy of CDDP plus 5-FU, CDDP (10 mg/day) was given for 5 days by intravenous and 5-FU (500 mg/day) for 5 days by continuous infusion the same week. By this treatment, a partial response (PR) was obtained, and the patient returned to normal life. But after 4 months, she had a recurrent lesion at the same place, and underwent only palliative laser therapy. Nd-YAG laser therapy for obstructive lesion of trachea due to recurrent cancer is the most useful one, but some subsequent treatment is required.

[CDDP-resistant early recurrent uterine cervical cancer successfully treated with low-dose oral etoposide: a case report]

A 36-year-old woman with early recurrence of uterine cervical cancer had received radiotherapy and a CDDP-containing chemotherapy regimen. She was treated with oral etoposide by administration of 50 mg/day for 21 consecutive days at 14-day intervals. After two courses, complete remission was demonstrated by disappearance of the cervical tumor mass and pelvic lymph node enlargement on MRI. Leukopenia (grade 3) occurred after five courses, as well as alopecia (grade 2) and gastrointestinal discomfort (grade 1) after two courses. The patient has shown no sign of recurrence for 1.5 years. This method might be quite effective for patients with recurrent cervical cancer as well as allowing outpatient treatment and improving the quality of life.

[Study on peripheral blood stem cells mobilized by different chemotherapies with granulocyte-colony stimulating factor in ovarian cancer]

A new therapeutic strategy for advanced ovarian cancer is to administer ultra-high doses of anticancerous drugs, followed by peripheral blood stem cell transplantation (PBSCT) to recover normal marrow functions. There are, however, no clear regimens to induce mobilization of peripheral blood stem cells (PBSCs). We therefore used three different chemotherapies and granulocyte colony-stimulating factor (G-CSF) to produce a rebound increase in PBSCs during myelosuppression by apheresis. Eleven patients with advanced ovarian cancer (FIGO Stage; IIc-1, IIIc-5, IV-4, Recurrence-1) received chemotherapy with CEP (cyclophosphamide: 500-750mg/m2, epirubicin: 50-70mg/m2, cisplatin: 70mg/m2), CEE (cyclophosphamide: 2,000mg/m2, epirubicin: 50mg/m2, etoposide: 300mg/m2, and PEC salvage (cisplatin: 75mg/m2, etoposide: 300mg/m2, cyclophosphamide: 1,000mg/m2) followed by lenograstim (G-CSF; 2 micrograms/kg subcutaneous injection daily for 14-18 days) to mobilize PBSCs. A range of 0-38.2 x 10(4) (mean +/- S.D.; 11.1 +/- 5.0 x 10(4) colony forming unit granulocyte-macrophage (CFU-GM)/kg in the CEP regimen (n = 15), 1.6-40.8 x 10(4) (mean +/- S.D.; 12.3 +/- 3.6 x 10(4) CFU-GM/kg in the CEE regimen (n = 11), and 8.6-11.4 x 10(4) (mean +/- S.D.; 10.0 +/- 2.0 x 10(4) CFU-GM/kg in the PEC salvage regimen (n = 2) were recruited by a single apheresis. Although the CEE regimen to mobilize PBSCs was much more efficient than the CEP regimen, a large number of PBSCs showing 38.2 x 10(4) CFU-GM/kg were mobilized by the CEP regimen with a dose-escalation of cyclophosphamide 750mg/m2 and epirubicin 70mg/m2. The number of CFU-GM/kg correlated well with that of CD34+ (r = 0.693).(ABSTRACT TRUNCATED AT 250 WORDS)

Functional imaging of the human olfactory cortex by magnetic resonance imaging

Our understanding of the neural mechanism of human olfaction is still equivocal. Several recent reports document that functional magnetic resonance imaging (MRI) has a potential to visualize dynamic brain function in humans without invasion. In the present study, we applied functional MRI with odor stimulation for the purpose of clarifying the localization of olfactory cortices in the human. We obtained a significant increase in cerebral blood flow in the piriform cortex, orbitofrontal cortex, and inferior medial frontal lobe, corresponding to olfactory cortices. These results suggest that, in the near future, precise diagnosis of the patients with olfactory disorders will be possible using functional MRI with odor stimulation.

Tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region--case report

A 44-year-old female presented with a rare tuberculous hypertrophic pachymeningitis involving the posterior fossa and high cervical region manifesting as progressive multiple cranial nerve pareses and myelopathy developing over 6 months. Magnetic resonance imaging demonstrated the thickened dura mater and associated syrinx. Despite decompressive craniectomy and antituberculous treatment, she died of disseminated intravascular coagulation. Hypertrophic pachymeningitis is probably best treated by the most extensive excision of affected dura mater possible, unless medical treatment can be instituted for an identifiable underlying causative disease.

Multiple cerebral arteriovenous malformations--case report

Multiple cerebral arteriovenous malformations occurred in a 48-year-old male complaining of headache, after orthopedic treatment for a leg fracture. He was free from neurological deficits and signs of hereditary hemorrhagic telangiectasia. Postcontrast computed tomography showed two abnormally enhanced lesions in the right occipital and left parietal regions. Magnetic resonance imaging showed these lesions as tiny vascular flow void signs, with neither new nor old hemorrhages. Angiography showed these lesions to be arteriovenous malformations. He declined treatment, and was followed as an outpatient.

[The usefulness of UFT administration in colorectal cancer with emphasis on postoperative administration (Part 3)]

To investigate the usefulness of the postoperative administration of UFT for colorectal cancer, 109 patients with a history of colorectal cancers from Nagasaki University First Department of Surgery and seven affiliated facilities were selected as subjects. After administering UFT 400 mg/day to both A and B groups one week prior to surgery, MMC 20 mg during surgery and 10 mg on the first day after surgery, the groups were divided into an A group, not administered UFT, and B group, administered UFT 400 mg/day. In addition, both groups were administered MMC 6 mg/m2 six times a month starting the first month after surgery. Although the A group consisted of 54 patients and the B group 55, 52 patients of the A group and 46 patient of the B group, for a total of 98, qualified as subjects for this investigation, and the following results were obtained. 1) Postoperative administration of UFT was useful in prolonging the survival period in non-curable resection cases, in Dukes C group cases, and in cases that exhibited a nuclear DNA aneuploid pattern. It was especially useful in improving the postoperative survival rate from the second year on. 2) When recurrent cases were examined, it was found to be effective in preventing remote metastasis in those cases administered UFT postoperatively. 3) There were no serious adverse effects and the majority of those that did occur were anorexia and diarrhea.

Changes in the latency of the maximum positive peak of visual evoked potential during anesthesia

The relationship between the latency of visual evoked potential (VEP) and the anesthetic concentration was investigated in surgical patients in order to examine the applicability of VEP in monitoring of the depth of anesthesia. The VEP was recorded with a standard EEG electrode from the midline parietal region in reference to both earlobes linked to the ground. An array of light-emitting-diodes mounted in opaque goggles was used to stimulate both eyes simultaneously and photic stimuli were delivered at random inter-pulse intervals with uniform distribution ranging from 2 to 5 seconds. Fifty trials of data were averaged to estimate that Pmax latency, i.e., the latent period from the photic stimulus to the maximum positive peak arising after 170 msec. Increases in the Pmax latency following the administration of anesthetics and restorations to preanesthetic values after recovery from anesthesia were found. A significant correlation was demonstrated between the Pmax latency and the inspiratory concentration of enflurane. The latency of the Pmax showed a drastic and a sensitive prolongation from about 200 msec in the awake state up to about 600 msec at the stage where the EEG exhibits large-voltage slow waves. Thus the measurement of the Pmax latency of VEPs was found to be useful for monitoring the depth of anesthesia.

[Synchronous double cancers in the ovary and kidney--a case report]

A first case of synchronous double cancers in the ovary and kidney is presented. The patient is a 37-year-old woman complaining of an abdominal mass. Histopathological findings showed a mucinous cystadenocarcinoma of the right ovary and a renal cell carcinoma, common type, clear cell subtype of the right kidney. A metastatic renal cell carcinoma was found on the pelvic peritoneum and characteristic renal cancer cells were identified in the ascitic fluid. (

EVALUATIONS

ovarian cancer, stage Ia; renal cancer, stage IV) The patient received postoperative chemotherapy and, after recovery, was discharged in a healthy condition. Her 11-month postoperative evaluation revealed no evidence of disease.

A quantitative analysis of mitochondria during fetal mouse oogenesis

A quantitative analysis of mitochondrial populations during the meiotic prophase of mouse oogenesis was carried out. The mean absolute area occupied by mitochondria and the mean number of mitochondria per cell increases in a linear fashion from pachytene through dictyate. The mean area occupied by mitochondria increases at pachytene and thereafter. Both small and large aggregations of mitochondria are seen, particularly during the later stages of prophase. Vacuolated mitochondria are present from preleptotene through pachytene. Mitochondria show major dynamic changes throughout fetal mouse oogenesis, which may suggest significant functional activities yet to be elucidated.

Clinical observations in the acute phase of cerebellar hemorrhage and infarction

Three cases of cerebellar hemorrhage and 5 of cerebellar infarction, diagnosed by brain CT, were examined from the early phase of the onset. All of our cases were mild to moderate in severity and were cured satisfactorily within 3 to 8 weeks of medical treatment. Dizziness and nausea were the commonest symptoms and cerebellar and other CNS signs could be detected only for a short period in some of the cases. Although neuro-otological examinations, especially gaze nystagmus, eye tracking and positional nystagmus tests, were useful for diagnosing the central vestibular lesion, no definite indication could be drawn in order to differentiate between cerebellar hemorrhage and infarction. Therefore, it is considered difficult in such mild cerebellar strokes to establish correct diagnosis by physical examinations alone. It was concluded that if central vestibular disorder is suspected, prompt brain CT examination is necessary in order to diagnose mild cases of cerebellar vascular diseases.

Chromosome 21 behavior during fetal oogenesis in Down's syndrome

Oogenesis of four cases of 47,XX,+21 at gestational ages of 19 and 20 weeks was studied using pachytene cytogenetic methods. We found a variable pattern of pairing behavior of the 21 chromosomes among the cases, which included partially synapsed trivalents, a bivalent plus a univalent, and three univalents. The bivalent/univalent conformation of 21 chromosomes predominated. Pachytene chromomere maps were normal for all autosomal bivalents in 84 oocytes analyzed, except for minor variations in some 21 chromosomes. This complex system of pairing behavior of the 21 chromosomes theoretically affects subsequent disjunctional behavior and therefore may account for the observations of normal and trisomic progeny observed for Down's syndrome mothers. Further study of meiotic behavior during all stages of oogenesis in such patients would provide essential data for predicting chromosomal outcome of pregnancy in this population.

Clinical trial with authentic recombinant somatropin in Japan

Recombinant somatropin, produced by recombinant DNA technology, was administered by injection in daily doses of 8 IU to six healthy young volunteers. Daily injection for 4 days did not cause any significant change in the results of physical examination, blood count or urinalysis. Non-esterified fatty acid levels increased significantly from 0.45 +/- 0.16 to 1.08 +/- 0.12 mEq/litre (mean +/- SEM) at 4 hours after the first injection (p less than 0.001). Plasma IGF-1 levels increased from 0.80 +/- 0.14 units/ml to 1.72 +/- 0.50, 3.22 +/- 1.02, 3.17 +/- 1.20 and 3.63 +/- 0.78 units/ml at 24 hours after each daily injection for 4 days (p less than 0.001). Plasma hGH reached peak levels at 3 hours after intramuscular injection of recombinant somatropin, 4 IU, and this peak value was 57.3 +/- 2.8 ng/ml. A total of 21 patients with pituitary dwarfism were also treated with recombinant somatropin for 6 months at a dose of 0.5 IU/kg/week. Their heights increased by 2.2-5.0 cm during the 6 months of treatment, which was calculated to be equivalent to 4.4-10.0 cm/year with a mean growth rate of 7.4 +/- 0.4 cm/year. Anti-hGH antibody with a titre of 10 was observed in two patients at the end of 6 months of treatment.

Vaginal hemangiopericytoma: a light microscopic and ultrastructural study

A case of a vaginal hemangiopericytoma in a 20-year-old woman was studied by light and electron microscopy. The neoplastic cells had round-to-oval nuclei with one or two nucleoli; fine chromatin; a foamy, cyanophilic cytoplasm; and an increased nuclear cytoplasmic ratio. Light microscopically, the tumor was composed of spindle-shaped or round cells proliferating around vascular spaces. Mitotic figures, necrosis, and hemorrhage were difficult to find. Electron microscopically, the neoplastic cells occurred in clusters, each of which was enclosed by a basal lamina. The cytoplasm contained abundant free ribosomes, flattened elements of rough endoplasmic reticulum, small Golgi apparatus, round or elongated mitochondria, lysosomes, glycogen particles, and sometimes pinocytotic vesicles and bundles of microfilaments with large dense spots. Desmosomes were also seen. In addition, the cytoplasmic process of the benign vascular pericytes was directly in contact with the neoplastic cells which had varying degrees of cytodifferentiation. The neoplastic cells in this lesion are consistent with an origin from pericytes, confirming the findings of this neoplasm when it arose in other sites.

[Clinical trial of fosfomycin for Campylobacter enteritis]

Forty-three children and 4 adults with Campylobacter enteritis were studied in the treatment of fosfomycin (FOM). FOM was administered per orally in doses ranging from 50 to 100 mg/kg/day for children and 3 g/day for adults for 5 days. Main symptoms such as diarrhea and fever were disappeared within 2 days on the average. Campylobacter jejuni in stool specimen disappeared within a week in 95% of these patients. The duration of main symptoms and the period of positive stool culture were evidently shortened in FOM-treated group compared with non-treated group. All of the isolated strains were sensitive to FOM by mono-concentration disk method. MIC50 of these strains remained between 1.56 and 3.13 micrograms/ml. None of these MIC was beyond 12.5 micrograms/ml.

[Kinetics of protein synthesis in the human granulosa lutein cell during pregnancy as revealed by electron microscopic autoradiography of 3H-leucine]

Kinetics of protein synthesis in the human granulosa lutein cell during pregnancy were investigated using the electron microscopic autoradiography of 3H-leucine. The corpus luteum of early pregnancy was chased at 10 and 30 min, 1, 3, 6, 12, 24 and 48 h after pulse labelling (10 min) with 100 microCi of 3H-leucine. Although the whole silver grains were very few at 10 min postpulse, silver grains were localized mainly over the rough endoplasmic reticulum (r-ER, 34.3%) and there were no silver grains over the smooth endoplasmic reticulum (s-ER). At 30 min postpulse, the ratio of the grain number to r-ER is decreased (18.7%) and silver grains begin to appear over the s-ER (5.4%). The total number of silver grains over the cell increases with the lapse of time, the ratio of the grain number over the r-ER slightly increases and then decreases afterwards, while that over the s-ER continues to increase gradually. From these facts, it is felt that some protein synthesized on the r-ER might be transported to the s-ER in the human granulosa lutein cell during pregnancy showing steroidogenic activity.

Histogenesis, cytodifferentiation, and its subcellular steroidogenic sites in the virilizing ovarian Leydig cell tumor: light microscopic dry-mounting radioautography for [3H]cholesterol and electron microscopic cytochemistry for 3 beta-hydroxysteroid dehydrogenase activity

A case of a virilizing ovarian Leydig cell tumor in a 38-year-old woman with a marked elevated plasma testosterone level was investigated using light microscopic dry-mounting radioautography and electron microscopic cytochemistry. Following a total abdominal hysterectomy and bilateral salpingo-oophorectomy, the plasma testosterone level decreased abruptly. Light microscopic dry-mounting radioautography for [3H]cholesterol showed silver grains localized mainly over the cytoplasm of the neoplastic Leydig cells which were of three different cell types: fibroblast-like cells, Leydig cells (steroid-secreting cells), and transitional cells (partially or incompletely differentiated Leydig cells). Reaction products for 3 beta-hydroxysteroid dehydrogenase activity were localized on the tubular or lamellar cristae and inner membranes of the mitochondria, and on the membranes of smooth endoplasmic reticulum in the transitional cell as well as in the Leydig cell. From these observations, it is suggested that the Leydig cell tumor is derived from the fibroblast-like cell and from the transitional cell, morphologically falling between the fibroblast-like cell and the Leydig cell, has fine structural evidence of steroidogenic activity, and has an ability to secrete testosterone.

[Histogenesis on the ovarian Leydig cell tumor--light microscopic dry-mounting radioautography for 3H-cholesterol and electron microscopic cytochemistry for 3 beta-hydroxysteroid dehydrogenase activity]

A case of a virilizing ovarian Leydig cell tumor in a 38 year-old woman with a markedly elevated plasma testosterone level was investigated using light microscopic dry-mounting radioautography and electron microscopic cytochemistry. Following total abdominal hysterectomy and bilateral salpingo-oophorectomy, the plasma testosterone level fell abruptly. Light microscopic dry-mounting radioautography for 3H-cholesterol showed silver grains mainly localized over the cytoplasm of the tumor cells. In the Leydig cell tumor there were three different cell types: Fibroblast-like cells, Leydig cells (steroid-secreting cells) and transitional cells (partially or incompletely differentiated Leydig cells). Reaction products for 3 beta-hydroxysteroid dehydrogenase activity were localized on tubular or lamellar cristae and inner membranes of the mitochondria, and on the membranes of smooth endoplasmic reticulum in the transitional cell as well as in the Leydig cell. From these facts, it is suggested that the Leydig cell tumor is derived from the fibroblast-like cell and the Leydig cell, already has a steroidogenic activity in secreting testosterone.