Mesenteric panniculitis: sonographic findings.

BACKGROUND: Mesenteric panniculitis (MP) is a relatively rare disease, and sonographic (US) and color Doppler findings have been infrequently reported. METHODS: We reviewed the clinical data and US and Doppler results of three cases of MP to determine the role and limitations of these techniques. RESULTS: The sole presenting clinical sign was a soft mass. On US the lesion was imaged as a poorly margined echogenic mass with hypoechoic areas. Color Doppler US visualized the nondeviated mesenteric vessels within the mass, which enabled us to perform a safe guided biopsy. CONCLUSIONS: US is useful as an initial diagnostic tool, but its results must be interpreted carefully. Color Doppler US is very useful in demonstrating fine vessels and helps in performing a safe needle biopsy.

A multicentre randomized controlled trial of recombinant interferon-alpha-2a in the treatment of patients with chronic hepatitis C.

Sixty-one chronic hepatitis C patients were randomly assigned to receive either 6 x 10(6) or 9 x 10(6) U of recombinant interferon-alpha-2a (IFN alpha-2a) six days a week for the first two weeks of treatment, followed in both cases by 6 x 10(6) U three days a week for the next 22 weeks. In the low dose group, 11 patients showed a complete response maintained for at least six months, 12 responded but then relapsed and nine did not respond; the corresponding figures in the high dose group were 10, 15 and five patients, respectively. The differences between groups are not statistically significant. Thus, this study provides no evidence of therapeutic benefit from increasing the initial dose of IFN alpha-2a. In both treatment groups, complete responders had significantly lower pretreatment viral titres than nonresponders and were significantly more likely to be infected by type 2a versus type 1b virus.

[A case of recurrent hepatocellular carcinoma after hepatic resection surviving over five years by hepatic arterial infusion of lipiodol-anticancer drug suspension].

A 63-year-old male with four intrahepatic recurrences of surgically resected hepatocellular carcinoma was admitted to our hospital in June 1985. He underwent lateral segmentectomy of the liver in November 1983. Pathologic finding of Edmondson II with liver cirrhosis had been confirmed by the operative specimen. Sizes of four recurrent tumors were assessed by CT as 3.5 x 2.2 cm, 2.6 x 2.2 cm, 2.2 x 2.2 cm and 2.2 x 2.2 cm, respectively. During five years until July 1990, the patient was treated with hepatic arterial infusion of Lipiodol-anticancer drug suspension eight times (total 5-FU 900 mg, ADM 77 mg, MMC 73 mg, and Lipiodol 36 ml) and hepatic arterial chemoembolization of MMC microcapsules one time. In addition, two hepatic arterial infusions of CDDP (total 70 mg) were given and 5-FU (total 10 g) was administered intravenously. Partial response (PR) was obtained for 19 months. Hepatic arterial infusion of Lipiodol-anticancer drug suspension was given only once every 6 months, and he maintained a good quality of life for over four and half years. The man died in July 1990. In general, multiple intrahepatic recurrence of surgical resected hepatocellular carcinoma has a poor prognosis. Therefore it was considered that hepatic arterial infusion of this drug brought about the relatively long survival of more than five years.

Multi-institutional clinical studies on hyperthermia combined with radiotherapy or chemotherapy in advanced cancer of deep-seated organs.

Multi-institutional studies on clinical hyperthermia of deep-seated tumours were undertaken using 8 MHz radiofrequency capacitive heating devices (Thermotron RF-8) at seven institutions. Each institute was designated to treat specific organs. This paper contains the accumulations of the results obtained at different institutions charged for different tumours. Deep-seated tumours in the lung, stomach, pancreas, liver, urinary bladder and rectum were treated. A total of 177 cases examined from January 1985 to December 1988 included 96 cases (54%) treated with radiotherapy plus hyperthermia, among which 14 cases were pre-operative. Of 177 cases, 81 (46%) were treated with chemotherapy plus hyperthermia. Complete response (CR) and partial response (PR) were obtained in 80% of the cases with lung cancer, 39% with stomach cancer, 56% with liver cancer, 35% with pancreas cancer, 71% with urinary bladder cancer, 100% with primary rectal cancer, and 47% with recurrent rectal cancer. Thermometry was performed using two techniques; one is direct measurement of intratumour temperature in lung and liver cancers, the other is indirect measurement of intracavitary temperature for stomach, pancreas, urinary bladder and rectal cancers. Intratumour temperatures were measured in 30 of the 43 tumours of the lung and liver. The maximum tumour temperature was greater than 42 degrees C in 23 (77%) of the 30 tumours. Intracavitary temperatures were measured in 133 (99%) of the 134 tumours of stomach, pancreas, urinary bladder and rectum. An intracavitary temperature greater than 42 degrees C was obtained in 98 (73.7%) of the 133 tumours. The contribution of hyperthermia in improving the quality of life of patients under terminal care was also investigated. It was indicated that hyperthermia was one of the most effective treatment techniques for advanced or inoperable cases. In this study local control rate (LCR) was mainly discussed because the period of follow-up was only 3 years. Side-effects were observed in 37 cases (21%); main side-effects were fatty induration, pain during treatment and burn. However, no side-effects were severe enough to interrupt therapy.

[Efficacy of UFT in advanced gastric carcinoma under comparative study of MMC + UFT and MMC + tegafur therapies].

Antitumor effect of MMC + UFT(A) and MMC + tegafur(B) therapies for advanced gastric carcinoma was compared from February 1985 to March 1988. UFT and tegafur were orally given at dose of 400 mg/m2 daily, and MMC was intravenously administered at dose of 6-8 mg/m2 every two weeks. The following results were obtained. 1. Twenty-nine cases entered in this study were divided into A or B therapies at random. All cases entered were eligible. Fourteen of 29 cases were randomized into A therapy and 15 cases into B therapy. One case treated with B was evaluated as incomplete. 2. There were no differences in the characteristics of patients between A and B therapies. 3. Among 29 eligible cases, a partial response was obtained in 3 out of 14 cases (21.4%) treated with A and in 3 out of 15 cases (20.0%) treated with B. Among 28 cases evaluated completely, a partial response was obtained in 3 out of 14 cases (21.4%) treated with each A and B. 4. Response rate with every ps or for every lesion did not differ between A and B therapies. 5. Median survival day treated with A and B therapies was 223 and 181 days, respectively. The survival curve did not differ significantly between the two therapies. 6. The frequency of adverse reactions within eight weeks after beginning the therapy was 64.2 and 73.3% with A and B therapies, respectively. From the results mentioned, it was concluded that the antitumor effect of UFT was not superior to that of tegafur for advanced gastric carcinoma.

[Thermochemotherapy of cancer of the stomach]. / Termokhimioterapiia raka zheludka.

Short-term results of chemo-hyperthermia of gastric carcinoma were reported. Complete regression was noted in 15%, partial regression in 42% of cases.

Reproducibility of the MS-2 system for identification of members of the family Enterobacteriaceae: a collaborative study with blindly assigned reference stains.

The reproducibility of identification and biochemical reactions for five different reference organisms of Enterobacteriaceae; Proteus vulgaris, Klebsiella pneumoniae, Escherichia coli, Serratia marcescens, and Enterobacter cloacae, were evaluated using the updated MS-2 system software (Abbott Laboratories, Diagnostic Division, Irving, Tex.) in a collaborative study involving 11 laboratories. When a total of 220 randomly coded test organisms were blindly examined, the MS-2 system correctly identified 92.7 and 86.8% for over 80 and 90% probability identification, respectively. Four organisms, P. vulgaris, K. pneumoniae, E. coli, and S. marcescens, were correctly identified in all laboratories with high probability, but 9 of 44 tests of Enterobacter cloacae resulted in misidentifications or low-likelihood (less than 80%) identifications. Accuracy was directly related to level of experience and familiarity with the MS-2 system in the individual laboratories. Biochemical reactions varied among the identification trials, especially in the identification of S. marcescens and Enterobacter cloacae. Among a total of 44 subcultures for each organism, 10 different biochemical patterns for P. vulgaris, 6 for K. pneumoniae, 9 for E. coli, 15 for S. marcescens, and 14 for Enterobacter cloacae were obtained. The results indicate that the MS-2 system performs with high accuracy and reproducibility in identifying Enterobacteriaceae, except for Enterobacter cloacae.

Distribution of alpha-fetoprotein and immunoreactive carcinoembryonic antigen in human hepatocellular carcinoma and hepatoblastoma.

The distribution of alpha-fetoprotein (AFP) and immunoreactive carcinoembryonic antigen (CEA) in 62 hepatocellular carcinomas (HCC) and five hepatoblastomas (HBL) all surgically removed was studied by an immunohistochemical method, and the results were compared with the levels of the antigens in the patients' serum. AFP was present as coarse granules in the cytoplasm of immature tumor cells. AFP-positive tumor cells were detected in 34/43 cases (79.1%) with serum AFP levels higher than 400 ng/ml and in 1/24 (4.2%) of the remaining cases. They were present in 8/32 (25%) cases of relatively well-differentiated HCC (Edmondson's grade I or II), 22/32 (68.8%) of relatively poorly differentiated HCC (Edmondson's grade III or IV), and 5/5 of HBL. An antigen immunoreactive with a conventional rabbit anti-CEA immunoglobulin (DAKO) but not with a murine monoclonal anti-CEA antibody (Hybritech) was present on the surface of bile canaliculi of both non-neoplastic and neoplastic hepatocytes. This CEA cross-reactive differentiation antigen was more often found in relatively well-differentiated tumors, and the presence of this antigen in tumors did not correlate with patients' serum CEA levels. In conclusion, CEA of an oncofetal nature was not produced by either HCC or HBL.

Quantitation of nasal secretory IgA by enzyme-linked immunosorbent assay.

A simple and sensitive technique, enzyme-linked immunosorbent assay (ELISA) was used for the quantitation of secretory IgA (sIgA) in order to study the synthesis and transport of sIgA in the nasal secretion from patients with chronic sinusitis. Rough-surface glass beads coated with antisecretory component antibody were employed as the solid phase. The minimal detectable concentration of sIgA was 50 ng/ml in this study. sIgA averaged 226.3 +/- 217.4 mg/dl and total IgA averaged 302.0 +/- 137.5 mg/dl.

Production of alpha-fetoprotein, normal serum proteins, and human chorionic gonadotropin in stomach cancer: histologic and immunohistochemical analyses of 35 cases.

By immunoperoxidase histochemical staining of formalin-fixed paraffin-embedded sections, the production of alpha-fetoprotein(AFP), albumin(ALB), transferrin(TF), alpha-1-antitrypsin(AAT), and human chorionic gonadotropin(HCG) was examined in 35 operatively resected stomach cancers with elevated serum AFP levels (higher than 20 ng/ml as determined by radioimmunoassay). Cells positive for AFP were found in 19 cases (54%). In 29 cases (83%), some tumor cells contained normal serum proteins (ALB, TF, or AAT). All 19 tumors with AFP-positive cells also stained positively for two or three kinds of normal serum proteins. In some cases, AFP and normal serum proteins were localized in the same cells. There were two cases in which metastatic tumors produced AFP, whereas the primary sites did not. In nine cases (26%), HCG was present in tumor cells and HCG- and AFP-positive cells were coexistent in six tumors. Histologic examination of AFP-producing stomach tumors revealed medullary or papillotubular arrangements with marked nuclear atypia and eosinophilic granular or clear cytoplasms containing no glycogen or mucin. Some tumors with medullary patterns resembled liver cell carcinomas. Concordant phenotypic expression of AFP and normal serum protein production appears to be a general feature of AFP-producing tumors such as liver cell carcinoma, yolk sac tumor, and stomach cancer.

Immunoglobulin G heavy-chain allotypes as possible genetic markers for human cancer.

Serum samples from 343 unrelated, healthy Japanese, 194 hepatitis B surface antigen (HBsAg)-positive healthy carriers, 96 patients with primary hepatoma, 91 patients with lung cancer, 94 patients with breast cancer, and 87 patients with gastric cancer were examined for IgG heavy-chain allotypes (Gm). The Gm phenotypes of the sera from patients with breast cancer exhibited a distribution similar to that of the normal controls. However, compared to that of normal controls, the Gm phenotype (1,2,21,13,15,16) was significantly increased in the patients with primary hepatoma(chi 2 (1) = 15.12, corrected P less than 0.01) and in the patients with lung cancer (chi 2 (1) = 10.97, corrected P less than 0.05). Compared to that of normal controls, the haplotype Gm 1,2,21 was significantly increased in the patients with primary hepatoma (chi 2 (1) = 22.34, corrected P less than 0.01). Increased frequency of Gm 1,2,21 in primary hepatoma was also significant compared to that of HBsAg-positive healthy carriers (chi 2 (1) = 9.25, corrected P less than 0.05).