Self-sterilizing and self-cleaning of silicone catheters coated with TiO(2) photocatalyst thin films: a preclinical work.

TiO(2) photocatalysts were successfully coated on silicone catheters or medical tubes by pretreatment of the silicone surface with a sulfuric acid solution (5 M) for 3 h. The TiO(2) film adhered to the silicone substrate strongly against tensile and bending stresses. On the TiO(2)-coated silicone-catheters under UV illumination, both the bleaching of methylene blue dye and the photocatalytic bactericidal effect on Escherichia coli (E. coli) cells were confirmed. Thus, this type of catheter can be sterilized and cleaned simply by irradiation with low-intensity UV light and can, therefore, be useful in the protection from catheter-related bacterial infections.

[A case of advanced gastric cancer producing alpha fetoprotein with multiple liver metastases responding to TS-1 after TAE].

We report a case of advanced gastric cancer producing Alpha Fetoprotein (AFP) with multiple liver metastases in which TS-1 is effective. Prognosis of gastric cancer producing AFP is well known to poor. A 74-year-old female was admitted complaining of anemia. She was diagnosed as having advanced gastric cancer with multiple liver metastases producing AFP by endoscopy, computed tomography and angiography. Her serum AFP level was 17,666 ng/ml and her serum CEA level was 5-2 ng/ml. After transarterial embolization (TAE), her family rejected her operation because it would not be curative. So, she was treated with TS-1, 40 mg, administered orally every day, followed by 14 days rest, as the first course. The next was TS-1, 80 mg orally administered for 6 courses. Her serum AFP level was down from 17,666 ng/ml to 94 ng/ml after 6 courses of TS-1. CT revealed that liver metastases did not change and endoscopy showed the primary lesion has diminished. Our report is the first to demonstrate that TS-1 is effective for patients with advanced gastric cancer producing AFP with multiple liver metastases.

New approach for detection of amplification in cancer DNA using restriction landmark genomic scanning.

We developed a new approach for detecting the gene amplification of cancer DNAs with restriction landmark genomic scanning (RLGS). In cancer research, much effort has been made to find the amplified loci of cancer DNAs, because many lines of evidence indicate association between oncogene amplification and carcinogenesis. Conventionally, such gene amplification has been detected by using Southern hybridization with DNA probes. However, only the information of one locus can be obtained by one hybridization procedure, and analysis of many loci throughout the genome is too laborious and time consuming, even if only several candidate genes are investigated. On the other hand, the "in-gel renaturation method" was reported as another alternative for detection of amplified regions. However, even though this method is much improved, it is difficult to detect less than 7-fold amplification, which is often higher than the amplification of many cancer cases. To overcome these limitations and, in addition, to locate the amplified DNA two dimensionally, we applied RLGS for analysis of DNA amplification in cancer tissues, such as breast cancer (infiltrative tubuloadenocarcinoma), neuroblastoma, meningioma (endotheliomatous meningioma), and thyroid cancer (papillary adenocarcinoma). In some cases of breast cancer, several amplified spots located on the same amplicon were detected. In thyroid cancer, in which no amplification has yet been reported, low-grade amplification was also detected. In this report, we demonstrated that RLGS allows us to screen 2000-3000 restriction landmarks distributed on the genome simultaneously, and even low-grade amplification could be detected effectively. Thus, RLGS has proven to be a very useful method in detecting DNA amplification.

[Successful treatment of disseminated breast cancer with combination therapy of 5'-deoxy-5'-fluorouridine (5'-DFUR), medroxyprogesterone acetate (MPA) and cyclophosphamide (CPA)].

A 54 year-old female patient with disseminated breast cancer refractory to various kinds of previous therapies was treated with a combination therapy of 5'-DFUR, MPA and CPA. Partial response (PR) was obtained both against pleural and liver metastases with complete disappearance (CR) of soft tissue lesions and was still being continued for the following 7 months. No serious side effects were observed except for a mild degree of diarrhea and moon face. The patient was enjoying a favorable quality of life. We confirmed that this combination regimen was effective as the second line treatment for disseminated breast cancer.

[Evaluation of chest wall resection in the patients with breast cancer involving chest wall].

Twenty-three patients with advanced or recurrent breast cancer involving bony chest wall were treated by extended full-thickness chest wall resection and immediate reconstruction. The results were as follows: 1) Distant metastases were found concurrently or subsequently in more than half of the patients. Therefore, we should regard chest wall lesions as a systemic disease. 2) Long term result was encouraging, with 73.9% local control rate. 3) Post-surgical prognosis of the patients with sternal metastasis and solitary chest wall lesions were favorable, in that order. 4) Both local control rate and survival of the patients with mediastinal invasion, however, were fairly poor. 5) Disease-free interval (D.F.I.) after mastectomy longer than 5 years correlated significantly with a long survival after chest wall resection. As a result, we confirmed that chest wall resection was the treatment of choice for the patients with long D.F.I. and solitary chest wall lesion without mediastinal invasion nor metastasis, but the postoperative systemic therapy was indispensable to improve the patient's survival.

[A case of pulmonary metastasis from colon cancer responding completely to high-dose 5'-DFUR plus MMC combination chemotherapy].

A woman born in 1924 with colon cancer initially operated on approximately four years ago showed a second recurrence in the lung. Concomitant administration of high dose 5'-DFUR plus MMC was started in February, 1990. Chest X-ray examination six weeks after the start of this therapy revealed a remarkable decrease in size of the pulmonary metastatic focus. At 13 weeks after the start of this therapy, the pulmonary metastatic focus showed nearly complete disappearance. The condition above has been maintained until this writing, eight months after the start of this therapy. No recurrence has been observed in the liver and other organs either, while CEA has normalized from 17.6 ng/ml to 0.9 ng/ml. The therapy was discontinued after five courses based on the moderate loss of appetite and complete disappearance of the lung focus. No other side effect than the loss of appetite was detected, and could be safely treated at an outpatient clinic. The above findings suggested that this was an effective and safe therapy for pulmonary metastasis from colon cancers.

[Clinical significance of a tumor marker NCC-ST-439 in breast cancer--a comparative study with CA 15-3, CEA and TPA].

We compared a new tumor marker NCC-ST-439 (ST-439) with CA 15-3, CEA and TPA for its clinical usefulness in 600 patients with breast cancer (81, primary; 49, recurrent; 470, non-recurrent), and confirmed the following results. The sensitivity of ST-439 (41.5%) was significantly higher (p less than 0.05) than that of CA 15-3 (26.2%), CEA (28.5%) and TPA (26.9%). The specificity of ST-439 (84.5%), however, was considerably lower (p less than 0.01) than these other three markers. In primary cases, the positive rate of ST 439 (34.6%) was significantly higher (p less than 0.05) than that of the other markers, and was remarkable in the early stage. As to the positive rate at the various metastatic sites, there were a few differences among these four markers. Because of no significant correlation among these markers, combination assay with ST-439, CA 15-3 and CEA showed an excellent sensitivity (57.7%). These results suggest that ST-439 is a useful tumor marker not only in monitoring the recurrence, but also in the diagnosis of primary cancer.

[A case of inflammatory breast cancer successfully treated with intra-arterial infusion of high-dose epirubicin].

A 56-year-old female with extensive inflammatory breast cancer was treated with intra-arterial infusion chemotherapy using a high dose of epirubicin. One cycle consisted of epirubicin; 150 mg (day 1, 4, 7) and daily administration of tamoxifen; 40 mg. After completion of 2 cycles of the regimen, both the main tumor and the extensive inflammatory skin lesion completely disappeared (CR). Hair loss, gastrointestinal disorders and leukopenia (nadir; 1,600) were the side effects encountered, but all of them were reversible. These findings suggested that dose-escalation of epirubicin was effective, and that cases with extensive skin involvement were also candidates for this modality.

[A case of disseminated breast cancer successfully treated with medroxyprogesterone acetate].

We reported the successful treatment of disseminated breast cancer with medroxyprogesterone acetate (MPA). The patient was a 52-year-old female with brain and bone metastasis developed 1 year after surgery. The primary tumor was ER-positive, and she had been treated previously with adjuvant therapy consisting of UFT and tamoxifen. Brain metastasis was surgically removed, but the following combination chemotherapy (epirubicin and vindesine) failed to result in further improvement. Then MPA (1,200 mg/day) was administered as the second-line therapy. After 6 months, multiple bone lesions showed remarkable calcification (PR) and disappeared completely (CR) 13 months later. But the patient was forced to discontinue MPA because of uncontrollable hyperglycemia. At this writing, CR was still being continued and the patient was enjoying favorable quality of life without any treatment. We confirmed that MPA was effective as the second-line treatment for disseminated breast cancer.

[A case of resected esophageal cancer with systemic tumor microembolism].

A 54-year-old man developed severe respiratory failure and died four months after surgery of esophageal cancer. The patient showed clinical symptoms of subacute cor pulmonale as reported by Brill and Robertson. Autopsy revealed the presence of tumor microembolism in the small arteries of the lung, heart, liver, etc. Generalized tumor embolism in the arteries, unlike those in the veins, has rarely been reported. The mechanism of systemic tumor embolism in this case was assumed to have been transpulmonary passage of tumor cells into various organs without causing pulmonary metastasis.