T-lymphocyte subsets in patients with AJCC stage III gastric cancer during postoperative adjuvant chemotherapy. American Joint Committee on Cancer.

BACKGROUND AND AIMS: Advanced neoplastic diseases alter the immune response in cancer patients. The aim of this study was to evaluate the changes of T-lymphocyte subsets during postoperative adjuvant chemotherapy, and the relationship between T-lymphocyte subsets and tumor recurrence in AJCC stage III gastric cancers. MATERIAL AND METHODS: Analysis of T-lymphocyte subsets was performed in 39 patients with stage III gastric adenocarcinoma who had undergone a curative gastric resection and postoperative chemotherapy. CirculatingT-lymphocyte subsets were measured on venous blood by using flow cytometry and monoclonal antibodies on preoperative day 1, and postoperative months 1, 3, and 6. RESULTS: The 5-year disease-free survival rates of patients with stage 3a and 3b gastric cancer were 57.1% and 33.3%, respectively (p = 0.06). Values of CD3+ and CD4+ T-cells, and CD4+/CD8+ ratios were consistently lower in the recurrence group throughout the observation period. CD4+ T-cell counts were significantly lower in the recurrence group on preoperative day 1, and postoperative months 1 and 6. However, most values of the T-lymphocyte subsets showed no statistically significant difference when comparing the stage 3a and 3b disease patient groups. CONCLUSIONS: The results of this study suggest that immunosuppression associated with CD3+ and CD4+ T-cell depression is a risk factor for postoperative recurrence in patients with stage III gastric cancer.

The Seoul experience of splenic artery aneurysms.

BACKGROUND AND AIMS: Aneurysms of the splenic artery (SAA) are the most common type of aneurysms found in the splanchnic arterial bed (1) and are second in frequency only to aortic and iliac artery aneurysms among intra-abdominal aneurysms (2). Historically rupture occurs in 6-9.2% of asymptomatic cases and in pregnant women rupture occurs in 95% of afflicted women further emphasizing the importance of early diagnosis (3-5). Possible treatments are surgical resection or trans-catheteral arterial embolization. MATERIAL AND METHODS: The relationship of SAA to pregnancy, pancreatitis and the outcome after surgical resection or arterial embolization was studied. Fifteen patients were diagnosed with SAA between January, 1992 and December 1999. The patients were classified by their clinical characteristics, etiology, size, and location of the aneurysm, relationship to pregnancy in women, clinical outcome of ruptured aneurysms and treatment. RESULTS: Fifteen patients, male to female ratio of 1.1:1 (eight men, seven women), with splenic artery aneurysm were treated. Patients were mostly in their sixty's and the mean age was 49.07. Chronic pancreatitis and pseudocysts were found in four cases (26.7%). Acute pancreatitis, portal hypertension, splenomegaly, and bronchitis were comorbidities found each in one case (6.7%). Eight cases (53.3%) were without associated disease CONCLUSIONS: SAA has historically shown predominance in women, but in this study, men showed predominance and no relation to pregnancy could be found. In cases were the aneurysms ruptured and treatment was initiated, one of four patients died. One patient refused treatment and subsequently died. As most of the aneurysms measure over 2 cm at the time of detection, operative resection was recommended in all cases. In the high-risk patients, arterial embolization using coiling can be effective early in treatment, but arterial embolization in SAA secondary to pancreatitis was shown only to be palliative and needed to be complimented with surgical intervention. Arterial embolization is the method of choice in high-risk patients.

Chiral analysis of baclofen by alpha-cyclodextrin-modified capillary electrophoresis and laser-induced fluorescence detection.

An enantioselective method for baclofen (4-amino-3-p-chlorophenylbutyric acid) based on capillary electrophoresis (CE) separation and laser-induced fluorescence (LIF) detection has been developed. Naphthalene-2,3-dicarboxaldehyde (NDA) was used for precolumn derivatization of the nonfluorescent drug. alpha-Cyclodextrin (alpha-CD) was included in the buffer as a chiral selector for the separation of NDA-labeled S-(+)- and R-(-)-baclofen. Optimal resolution and detection were obtained with an electrophoretic buffer of 50 mM sodium borate (pH 9.5) containing 7 mM alpha-CD and a He-Cd laser (lambda ex = 442 nm, lambda em = 500 nm). Combined with a simple cleanup procedure, this method can be applied to the analysis of baclofen enantiomers in human plasma. The relative standard deviation (RSD) values on peak areas of a plasma sample containing 1.0 microM racemic baclofen were 6.4 and 4.9% (n = 8) for the S-(+)- and R-(-)-enantiomer, respectively. The RSD value on migration times of both enantiomers was 0.5% (n = 8). Calibration graphs for S-(+)- and R-(-)-baclofen in plasma showed a good linearity (r > or = 0.999) in the concentration range of 0.1-2.0 microM. The limit of detection of baclofen in plasma was about 10 ng/mL.

Tris(2,2'-bipyridyl)ruthenium(III)-based electrochemiluminescence detector with indium/tin oxide working electrode for capillary electrophoresis.

A novel tris(2,2'-bipyridyl)ruthenium(III) [Ru(bpy)3(3+)]-based electrochemiluminescence (ECL) detector for capillary electrophoresis (CE) has been developed. The detector was of the wall-jet configuration and an indium/tin oxide (ITO)-coated glass plate was used as the working electrode for end-column detection. Potential control of the ITO electrode was provided using a DC battery, without decoupling the detector from the CE field. Electrochemical behavior of Ru(bpy)3(2+) at the ITO electrode was found to be analogous to that at a Pt electrode. In the presence of tertiary or some secondary amines, ECL emission due to reaction between in situ generated Ru(bpy)3(3+) and analytes can be observed at the ITO surface. With 15 mM sodium borate (pH 9.5) plus 1 mM Ru(bpy)3(2+) present in the detection cell and the ITO electrode biased at 1.5 V (vs. Pt wire reference), a detection limit of 1 microM proline with a theoretical plate number of 4000 was obtained using the developed CE-ECL detection system. The detector response was found to be analyte-dependent, e.g. tryptophan gives no response, and the response for histidine is about 13-fold lower than that of proline.

Analysis of baclofen by capillary electrophoresis with laser-induced fluorescence detection.

A new analytical method for baclofen (4-amino-3-p-chlorophenylbutyric acid) based on capillary electrophoretic separation and laser-induced fluorescence detection has been developed. Naphthalene-2,3-dicarboxaldehyde was used for precolumn derivatization of the non-fluorescent drug. Optimal separation and detection were obtained with an electrophoretic buffer of 50 mM sodium borate (pH 9.5) and a He-Cd laser (excitation at 442 nm, emission at 500 nm). Linearity (r > or = 0.99) over three orders of magnitude was generally obtained and the concentration limit of detection was in the nanomolar level. Coupled with a simple cleanup procedure, the method was successfully applied to the analysis of baclofen in human plasma. Recovery of spiked baclofen in plasma was 98%. The relative standard deviation values on peak size and migration time were 7.9% and 0.4%, respectively. The limit of detection of baclofen in plasma was 10 ng/ml.

Capillary electrophoresis of monoamines and catechol with indirect chemiluminescence detection.

A capillary electrophoresis (CE)/indirect chemiluminescence (CL) detection method is described for monoamines, viz., serotonin (5-HT), dopamine (DA), epinephrine (EP), and norepinephrine (NE) and for catechol (CA). Optimal separation and detection were obtained with an electrophoretic buffer of 10 mM sodium borate (pH 9.5) containing 5 mM luminol and 25 mM H2O2, and a catalyst solution of 30 microM CuSO4 in 30 mM borate buffer (pH 10.0). Complete separation of 5-HT, DA, EP, NE and CA was achieved in less than 5 min. The Cu(II)-catalyzed luminol CL reaction was employed to provide the high and constant background. Since monoamines and catechol can form stable complexes with Cu(II), inverted analyte peaks due to decreased catalytic activity of Cu(II) can be detected. The degree of CL suppression is proportional to the analyte concentrations. Linearity (r> or =20.99) over two orders of magnitude was generally obtained. The concentration limits of detection (CLODs) for the monoamines and catechol studied were between 0.5 and 3.1 uM. The relative standard deviation (RSD) values on peak size and migration time were in the ranges 3.2-4.4% and 0.4-0.5%, respectively. The applicability of the method for the analysis of pharmaceutical and biological samples was examined.

Macroamylasemia in a patient with acute appendicitis: a case report.

Macroamylasemia is a condition of persistent, elevated serum amylase activity with no apparent clinical symptoms of a pancreatic disorder. In Korea, however, no such case has been reported to date. We report a case of a 17-year-old female diagnosed with macroamylasemia and acute appendicitis. One day earlier, she developed epigastric and right lower quadrant abdominal pain. She was characterized by high level of serum amylase, but normal lipase. Amylase isoenzyme analysis demonstrated increased fraction of salivary type and follow-up amylase level was persistently increased. Immunofixation disclosed the macroamylase binding with an immunoglobulin, consisting of IgA and kappa chain. The patient was treated by appendectomy, and the abdominal pain subsided.

Capillary electrophoresis of arsenic compounds with indirect fluorescence detection.

A capillary electrophoresis (CE)-indirect fluorescence detection method for arsenic compounds is described. The five arsenic species, viz., arsenite (As(III)), arsenate (As(V)), monomethylarsonate (MMA), dimethylarsinate (DMA) and phenylarsonate (PhA), were efficiently separated by CE in 8 min with an 1.5 mM fluorescein solution at pH 9.8. Fluorescein also functioned as a background fluorophore for the indirect detection of these nonfluorescent arsenic species. Linearity (r> or =0.996) of more than two orders of magnitude was generally obtained. The relative standard deviation (RSD) values were in the ranges 0.4-0.7% and 2.2-8.2% for migration times and peak areas, respectively. The concentration limits of detection (CLODs) for the arsenic compounds studied were between 0.04 and 0.16 microg/mL (as arsenic). The detection sensitivity was generally dependent upon the transfer ratio (TR, defined as the number of moles of fluorescein ions displaced by one mole of analyte ions) of each arsenic species. The applicability of the method for the analysis of ground water was examined.

Capillary electrophoresis of organotin compounds with indirect UV detection.

A capillary electrophoresis (CE)-indirect UV absorbance detection method for organotin compounds is described. The five triorganotin cations, viz., trimethyltin (TMT), triethyltin (TET), tripropyltin (TPT), tributyltin (TBT) and triphenyltin (TPhT), were efficiently separated by CE in 10 min with a 5 mM acetate buffer (pH 4.5) containing 3 mM 4-aminopyridine (4-AP). 4-AP also functioned as a UV-absorbing coion for the indirect detection of these UV-transparent organotin species. Simultaneous separation of di- and triorganotins was achieved with the addition of alpha-cyclodextrin (alpha-CD) as a modifier in the electrophoresis buffer. Linearity (r > or = 0.995) of about two orders of magnitude was generally obtained. The concentration limits of detection for the organotin compounds studied were between 2 and 20 microM (as tin). The relative standard deviation (RSD) values were in the range 1.3-7.1%. The applicability of the method for the analysis of marine sediment was examined.

Cancer of the stomach: a review of two hospitals in Korea and Japan.

The records of 525 patients with primary adenocarcinoma of the stomach treated at Korea University Hospital (K.U.H.), Seoul, Korea, and 1,932 patients treated at National Cancer Center Hospital (N.C.C.), Tokyo, Japan, over a 7-year period were reviewed to study biologic characteristics and treatment results in the two hospitals. More than 70% of the patients were 41 to 70 years old in both hospitals, though K.U.H. had more younger patients and N.C.C. had more older patients. Comparison in regard to clinicopathologic features showed significant differences in type of cancer, tumor size, depth of invasion, lymph node metastasis, stage, and histologic type. Such a difference mostly was due to a greater frequency of early gastric cancer in N.C.C. patients (51.2%) than in K.U.H. patients (19.0%). Patients of K.U.H. were more likely to have advanced cancer, large invasive tumors, a higher percentage of lymph node metastasis, a higher stage, and more undifferentiated tumors. The 5-year survival rate of all resected cases was 69.5% in N.C.C. and 54.2% in K.U.H. (p > 0.05). Those factors which showed a significant difference in clinicopathologic features did not affect the survival difference between the two hospitals except in stage IIIb and signet-ring-cell cancer. The 5-year survival rate for stage IIIb was 18.0% in K.U.H. and 36.8% in N.C.C. It would seem that survival difference in stage IIIb related to extensive lymph node dissection in N.C.C. Survival difference in signet-ring-cell gastric cancer (31.2% in K.U.H. and 91.0% in N.C.C.) was related to the fact that 79.1% of signet-ring-cell gastric cancer patients in N.C.C. had early gastric cancer.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative study of cefoperazone and amikacin.

A comparative study of cefoperazone and amikacin in severe surgical infections was conducted with 60 patients equally allocated to two groups. The daily dosage of cefoperazone ranged from 2 to 4 gm in two equally divided doses, and the daily dosage of amikacin ranged from 900 to 1,000 mg in two equally divided doses. All patients were given antibiotics for five to ten days. With cefoperazone, there were satisfactory clinical responses in 83% (29/35) of the infections; with amikacin, 74% (23/31). Cefoperazone was more effective than amikacin in biliary tract infections. On bacteriological examination, 7.5% of the organisms isolated were resistant to cefoperazone and 10% to amikacin. In mixed infections, cefoperazone and amikacin had failure rates of 29% and 36%, respectively. Further trials are needed to define the role of cefoperazone in anaerobic and in mixed infections.