Oral management with polaprezinc solution reduces adverse events in haematopoietic stem cell transplantation patients.

The aim of this study was to analyse the effects of gargling with and then swallowing PPAA (polaprezinc in polyacrylic acid solution), in addition to regular oral management, on patients with a haematopoietic neoplasm scheduled for haematopoietic stem cell transplantation (HSCT). A total of 120 patients scheduled for HSCT during the years 2006-2016 were recruited. Patient background, oral adverse events, the incidence and severity of systemic adverse events (sepsis/septic shock, acute graft-versus-host disease (GVHD) after transplantation), and outcomes (survival/death) were compared between groups treated with and without PPAA. The severities of oral adverse events (oral mucositis, oral pain, and dysgeusia) were significantly lower in patients treated with PPAA. There was no significant difference in the incidence of febrile neutropenia (P=0.622) or sepsis/septic shock (P=0.665) as systemic adverse events. The severity of allograft-induced acute graft-versus-host disease (GVHD) was significantly lower in the PPAA group (P=0.011). There was no significant difference in outcome between the two groups (P=0.285). Within the limitations of the study design, it may be concluded that oral management with PPAA reduces adverse events in HSCT. Oral management with concomitant use of PPAA decreased oral adverse events and reduced the systemic complication of GVHD.

Antibacterial polyetheretherketone implants immobilized with silver ions based on chelate-bonding ability of inositol phosphate: processing, material characterization, cytotoxicity, and antibacterial properties.

We developed a novel antibacterial implant by forming a hydroxyapatite (HAp) film on polyetheretherketone (PEEK) substrate, and then immobilizing silver ions (Ag(+) ) on the HAp film based on the chelate-bonding ability of inositol phosphate (IP6). First, the PEEK surface was modified by immersion into concentrated sulfuric acid for 10 min. HAp film was formed on the acid-treated PEEK via the soft-solution process using simulated body fluid (SBF), urea, and urease. After HAp coating, specimens were immersed into IP6 solution, and followed by immersion into silver nitrite solution at concentrations of 0, 0.5, 1, 5 or 10 mM. Ag(+) ions were immobilized on the resulting HAp film due to the chelate-bonding ability of IP6. On cell-culture tests under indirect conditions by Transwell, MC3T3-E1 cells on the specimens derived from the 0.5 and 1 mM Ag(+) solutions showed high relative growth when compared with controls. Furthermore, on evaluation of antibacterial activity in halo test, elution of Ag(+) ions from Ag(+) -immobilized HAp film inhibited bacterial growth. Therefore, the above-mentioned results demonstrated that specimens had both biocompatibility and strong antibacterial activity. The present coating therefore provides bone bonding ability to the implant surface and prevents the formation of biofilms in the early postoperative period.

[Bronchoplasty and pulmonary arterioplasty for treatment of lung cancer].

OBJECTIVE: We evaluated the outcomes of bronchoplasty (BP) and pulmonary arterioplasty (PAP) for treatment of patients with lung cancer. SUBJECTS: We studied 33 patients who underwent BP and/or PAP over the previous 7 years at our institution. METHODS: A telescope procedure was utilized for anastomosis of a tubular excision performed in the bronchus. One patient received induction chemoradiotherapy, in whom the anastomosis section was covered with an intercostal muscle flap to assure anastomosis completion, then PAP was performed under heparinization. RESULTS: BP including a sleeve resection was performed in 15 patients, while that with a wedge resection and partial side wall resection was performed in 7 and 1 patient, respectively. PAP was performed in 18 patients, and a combination of BP and PAP was used in 8. The seam was incomplete in 2 patients and stenosis was recognized in the anastomosis section in 1. No local recurrence at the anastomosis site was seen in any of the 33 cases. The survival rate for patients who underwent BP was similar to that of those who underwent a standard resection for primary lung cancer. CONCLUSION: Our results indicate that BP and PAP are safe and useful surgical procedures for patients with lung cancer.

[Surgical treatment for pulmonary metastasis from submandibular gland cancer].

We reviewed surgical result of 5 patients with pulmonary metastasis from submandibular gland cancer. Pathological diagnosis was adenoid cystic carcinoma in 2 patients, carcinoma in pleomorphic adenoma in 1, epidermoid carcinoma in 1, and mucoepidermoid tumor in 1. Disease free interval from resection of the primary lesion to diagnosis of pulmonary metastasis was ranging from 7 to 76 months. Lobectomy was performed in 2 patients and partial lung resection in 3. Three patients died of tumor recurrence 12 to 28 months after lung resection and 2 patients with a single metastatic lesion have survived as long as 42 and 150 months after the operation. This study suggests that surgical treatment may be effective for pulmonary metastasis, especially for a single metastatic lesion, from submandibular gland cancer.

[A case of breast cancer with multiple metastases effectively treated with long-term administration of docetaxel, aclarubicin and UFT].

A 46-year-old woman had undergone a mastectomy in 1994, and metastases to the lung, bones and liver were detected in 1998. Brain metastases were detected later. Chemotherapy consisting of docetaxel, aclarubicin and UFT was administered, and image diagnosis revealed that CR was achieved. The chemotherapy was continued on a long-term basis, both as an inpatient and outpatient. The total administered doses have reached 2,000 mg of docetaxel and 1,000 mg of aclarubicin. The CR is being maintained as of this writing, 2 years and 4 months after the detection of the metastases. The patient's course continues to be monitored.

Colocalization of neuropilin-1 and Flk-1 in retinal neovascularization in a mouse model of retinopathy.

PURPOSE: To investigate the mechanisms of the development of retinal neovascularization, the localizations of vascular endothelial (VEGF) receptors Flk-1 and neuropilin (NP)-1 mRNAs were examined. METHODS: The model of retinopathy of prematurity (ROP) was produced by ischemia-induced ocular neovascularization, by exposing postnatal day-7 mice to 75% oxygen for 5 days and then returning them to room air for 5 days. Retinal neovascularization was visualized by injection of fluorescein-dextran. Expression of Flk-1 and NP-1 mRNAs were examined by in situ hybridization with flatmount and serial sections of the retina. The localization of NP-1 was also confirmed by immunohistochemistry. Blood vessel patterns were characterized by immunohistochemical localization of von Willebrand factor (vWF). RESULTS: Flatmount in situ hybridization showed intense expression of NP-1 and Flk-1 mRNAs colocalized in the area of neovascularization. In situ hybridization of serial sections of the retina revealed that expression of Flk-1 and NP-1 was restricted to neovascularized vessels of the retina from ROP mice. CONCLUSIONS: The restricted expression of Flk-1 and NP-1 on neovascularized vessels suggests that these molecules may play important roles in retinal neovascularization. This is the first report of the colocalization of NP-1 and Flk-1 on neovascularized vessels of the retina from ROP mice.

Genomic analysis of a murine cell-surface sialomucin, MGC-24/CD164.

MGC-24 is a sialomucin originally found in human gastric carcinoma cells, and in human hematopoietic progenitor cells. In the human, soluble and transmembrane forms of MGC-24 are present, and the transmembrane form has been implicated in adhesion of hematopoietic progenitor cells to marrow stroma cells. In the mouse, we found that only the transmembrane form was expressed in many organs. Northern blotting and in situ hybridization analysis showed that MGC-24 mRNA was widely expressed in various adult and embryonic tissues. The mouse MGC-24 gene, which we isolated, spanned about 12 kb and was comprised of six exons. The transmembrane domain and the cytoplasmic domain were encoded by a single exon; the finding agrees with the absence of an alternatively spliced product of mouse MGC-24. The minimal promoter of mouse MGC-24 was embedded in GC-rich sequences, in which two Sp1 binding motifs were found, but it lacked TATA and CAAT boxes. That the promoter resembles that of house-keeping genes is consistent with the broad expression of mouse MGC-24 mRNA.

[A case report of extralobar pulmonary sequestration associated with mediastinal bronchogenic cyst].

A 48-year-old woman was admitted to our hospital because of abnormal shadow on the chest X-ray. Chest contrast CT scan showed roundly mass in the posterior mediastinum which were combined with and without contrast elements, and chest MRI (T2 weighted) showed high signal intensity. These features suggested mediastinal cyst or extralobar sequestration. The operation was performed through left 6th intercostal thoracotomy. Two different lesions connected to the mediastinum were confirmed, a cystic tumor and small accessory lung. The former was diagnosed as bronchogenic cyst and the latter as extralobar pulmonary sequestration.

[A case of thymic epidermoid carcinoma recurred in the pericardial cavity].

A 61-year-old woman with cough and sputum and right scapular pain was referred to our hospital with a suspected anterior mediastinal tumor by Chest X-rays and CT-scan. The tumor was diagnosed as thymic cancer cytologically by fine needle biopsy. At the the thoracotomy via median sternotomy, the tumor adhered to left brachial vein, superior vena cava and pericardium and it was dissected by maneuver. It was diagnosed as moderately differentiated epidermoid carcinoma by histology of the surgical specimen and involvement of the pericardium was histologically presumed. The patient received postoperative radiation therapy. A year after operation, the tumor recurred in the pericardial cavity. Inspite of resection of the recurred tumor and an anticancer chemotherapy, the patient died of cardiac failure due to the proliferated tumor around the heart. There are some reports that epidermoid carcinoma of the thymus may have different responses to radiation therapy according to histologic tumor differentiations. At resection of epidermoid carcinoma of thymus, therefore, intraoperative pathologic examination of the adhesive part of excised specimen and additional resection were essential to resect thymic cancer radically.

[The usefulness of fibrin glue spraying combined with CDDP for lung cancer].

The local slow release of an anticancer agent by one route is a form of treatment. There have been numerous reports to date that this approach might be a promising adjuvant for systemic therapy. We investigated the spraying of the operative field at a local site with cisplatin, which is considered the most effective carcinostatic in the field of lung cancer, and reported it in clinical cases selected in applying a Pilot-Study. The feature of this method is to use fibrin to spray drugs uniformly over a wide field. We expect it will be an adjuvant for postoperative purification and other uses.

[Successful chemotherapy and concurrent radiotherapy for metastatic lung. mediastinal malignant fibrous histiocytoma].

We treated a patient for malignant fibrous histiocytoma (MFH) which metastasized to mediastine and lung from left femur. The patient was a sixty-three year old man. He had his left femur, the primary lesion, resected. After the first operation, we found metastasis to his lung and mediastine and we performed twice thoracotomy. Then he was found to have the third metastasis which we decided was inoperable, this time we tried chemotherapy and concurrent radiotherapy. CDDDP and ACR with radiotherapy showed significant effect. The patient died after eight months at last because of fistula between the descending aorta and the ileum, and as we performed an autopsy on him, his MFH proved pathological CR.

[A case of leiomyosarcoma as a mediastinal tumor excised by bilateral thoracotomy].

Leiomyosarcoma as a mediastinal tumor is so rare that no more than 6 and 12 cases have so far been reported in and out Japan, respectively. The patient was 74-year-old male. While treated at the outpatient clinic of our university hospital for low back pain, he was referred to our department because of a shadow of the mediastinum on chest roentgenogram. A fist-sized tumor was found located in the posterior mediastinum behind the heart. Since it was difficult to make a preoperative definitive diagnosis, it was excised by bilateral thoracotomy. Histologically, it was compatible with sarcoma and a definitive diagnosis of leiomyosarcoma was made based on electron microscopic findings.

A model of rod outer segment derived lipofuscin.

The rod outer segments (ROS) from pig eyes were incubated with ferrous iron and albumin. The fluorescent lipid peroxides formed in the reaction were extracted with chloroform-methanol, ethanol-ether or water. After centrifugation, the fluorescence intensities of the supernatant and the aqueous solution of the sediments were measured with a Fluorospectrophotometer. The sediments were observed with a fluorescence microscope. The fluorescence spectra has an excitation maximum at 365 nm and an emission maximum at 430-440 nm. The fluorescence intensities were greater in the water soluble fraction than in the organic solevent fraction. The fluorescence microscopy showed the blue emitting fluorophores. The fluorophores from ROS peroxidized with ferrous iron have different properties from the lipofuscin in human RPE extracted with the organic solvents.

[Growth inhibition of the emulsion from to Brucea javanica cultured human carcinoma cells].

We studied the growth inhibitory activity of the emulsion from Brucea javanica fruit of B. javanica to human squamous cell carcinoma cells. The dose of 250 micrograms/ml at 96 hrs after drug exposure, it showed 42% growth inhibition, and at 500 micrograms/ml inhibited 56% of the cell growth. The effect of more than 50% of the growth inhibition was evident at more than 7 hrs after drug exposure. In the analysis of mechanism of the drug using a flow cytometry, the arrest in G1 phase of cell cycle was found during incubation of cancer cells with drug. These results suggested that the oil of B. javanica is useful as an anticancer drug.

Long-term follow up in type A insulin resistant syndrome treated by insulin-like growth factor I.

Insulin-like growth factor I (IGF-I) is a useful therapeutic agent in insulin resistant diabetes mellitus due to insulin receptor disease because of its hypoglycaemic effects through the IGF-I receptor. A girl with typical type A insulin resistant syndrome was treated with IGF-I for two years and the treatment was effective in ameliorating hyperglycaemia. Overproduction of testosterone in polycystic ovaries was aggravated with this treatment, however. Therefore, IGF-I treatment may be used for glycaemic control but with caution because of its possible side effect of aggravating hyperandrogenism in these patients.

[A clinical study of advanced cases of small sized lung cancer].

Survival rates and several effective factors for the postoperative course of 10 advanced cases of small sized lung cancer (ASLC) were evaluated. Followings were considered as characteristics of these patients: 1) ASLC were observed at the rate of 4.0% of whole lung cancers, 2) ASLC were more often seen in relatively young patients, females and adeno carcinomas than ordinary lung cancer, 3) as factors concerned to postoperative prognosis, stage III A (especially T1N2M0), few numbers of metastatic lymph nodes in N2, and performance of relative curative operation may predict good prognosis, but adenosquamous type will be a sign of poor prognosis. Satisfactory result was obtained even in a case of stage IV when complete resection of metastasis was carried out. There was no significant difference of survivals between 2 cm and 3 cm of diameter of the tumor. In conclusion, above mentioned points should be considered when operative indication of ASLC is evaluated.

[A case of gastric carcinoid tumor with coexisting adenocarcinoma in the same tumor].

A case of a gastric carcinoid tumor with a coexisting adenocarcinoma in the same tumor is reported. The patient was a 71-year-old man who complained of epigastralgia. His physical examination and routine laboratory data were unremarkable. An upper GI x-ray series and the gastroendoscopic findings, however, demonstrated a Borrmann 2-like tumor of the antrum. An endoscopic biopsy specimen from the tumor revealed that it was a gastric adenocarcinoma. Therefore, a subtotal gastrectomy with a lymph node dissection was performed. The resected specimen showed a Borrmann 2-like tumor, but also that infiltration was limited to within the submucosal layer. The pathological findings revealed that the tumor contained two differential component structures (a carcinoid and an adenocarcinoma). The carcinoid and adenocarcinoma structures coexisted with transitional changes that connected both structures. Pathohistologically, it was thought that these two differential components developed from a common origin.