Pilot study of S-1 in patients with disseminated gastric cancer.

The prognosis for patients with advanced gastric cancer remains poor. Peritoneal metastasis is the most frequent cause of death in patients with gastric cancer, but the most appropriate treatment for patients with disseminated gastric cancer remains uncertain. S-1 is a newly developed oral fluoropyrimidine derivative with unusually high activity against several tumor types. The aim of this study was to evaluate the feasibility and efficacy of S-1 for the treatment of patients with disseminated gastric cancer. A total of 31 patients with primary or recurrent gastric cancer with peritoneal dissemination were entered into this study. One course of this single-drug therapy consisted of S-1 (80-120 mg) twice daily for 28 days, followed by a 2-week period of no treatment. These treatments were repeated until disease progression or patient refusal. With a median follow-up period in survivors of 293 days, the median survival time was 357 days. Toxicities were mild and no patient withdrew from treatment before disease progression. Grade 3 hematotoxicity was observed in only one patient. S-1 showed promising activity against gastric cancer with peritoneal dissemination and acceptable toxicity. Further evaluation of S-1 treatment is warranted in this disease.

Early anchoring collagen fibers at the bone-tendon interface are conducted by woven bone formation: light microscope and scanning electron microscope observation using a canine model.

To clarify the early process of recovery at the bone-tendon interface, we used light microscopy and SEM to examine the process of anchoring of collagen fibers to bone in a canine model. At two weeks, tendon, scar tissue, woven bone and lamellar bone were present at the insertion site. SEM revealed anchoring of collagen fibril bundles of the scar to the woven bone. By 4 weeks, the number of anchoring fibers had increased and a parallel arrangement of fibers was observed. SEM demonstrated deep penetration of fibers into the woven bone layer. In addition, the fibers were observed to project into and intermingle with the scar tissue. By 6 weeks, the anchoring fibers had developed fully and were distributed densely over the interface. SEM also revealed that the collagen fibril bundles in the scar tissue had connected with the collagen fibrils of the woven bone by way of the anchoring bundles. The woven bone was identifiable throughout the early stages of recovery as the interface between soft tissue and hard tissue. Throughout all experimental periods, no staining was observed at the interface of the tendon and bone by Saffranin-O. The formation of woven bone was important during early recovery of the tendon-bone interface prior to the completion of fibrocartilage-mediated insertion.

Fibrous connection to bone after immediate repair of the canine infraspinatus: the most effective bony surface for tendon attachment.

The purpose of this histologic study was to identify the most effective bony surface for fibrous connection to bone after immediate repair of the canine infraspinatus. Light microscopic views were used to evaluate collagen fiber development. The left infraspinatus tendon of 15 dogs was transected and repaired to 3 different bone surfaces: a tendon end adjacent to the tendon insertion (group 1, n = 5), a calcified fibrocartilage layer (group 2, n = 5), and a cancellous surface (group 3, n = 5). Tendon repair to distal tendon ends restored the 4-layered enthesis in the healing period, whereas tendon repair to the calcified fibrocartilage layer considerably delayed fiber development into bone. Fiber connection to cancellous surface developed according to the remodeling of trabecular bone. Secure fiber connection into the thickened trabecular bone developed by 16 postoperative weeks. On the basis of these results, in clinical settings, ruptured tendon ends should be attached to the remaining distal tendon end or to a cancellous surface; they should not be attached to a calcified fibrocartilage layer.

[The role of endoscopic ultrasonography for gastric cancer in the cardiac area].

In order to select the most appropriate treatment for gastric cancer in the cardiac area, precise staging by determining the depth of cancer invasion, and esophageal invasion, and lymph node metastases is important. In this paper, diagnosis of these factors using endoscopic ultrasonography (EUS) and its accuracy are discussed. In 121 cases of gastric cancer in the cardiac area, EUS was performed and the findings compared with the pathological diagnosis. The depth of cancer invasion was accurately determined in 60% of mucosal cancer cases, 83% of cancer invading the submucosa, 50% of cancer invading the muscularis propria or the subserosa, 86% of cancer invading the serosa, 45% of cancer invading other organs, and overall accuracy was 77%. In cases of esophageal invasion sensitivity was 98%, specificity 93%, and overall accuracy 94%. In cases of lymph node metastasis specificity was 78%: 86% for N1 and 72% for N2. EUS therefore has an important role in diagnosis and selection of treatment.

Citrate promotes attachment of Prevotella nigrescens (intermedia) ATCC 25261 to hydroxyapatite.

Large quantities of Prevotella nigrescens (intermedia) ATCC 25261 (P. nigrescens) cells adhere to hydroxyapatite (HA) treated with citrate, but do not adhere experimental pellicle prepared from human whole saliva. To determine the nature of the citrate responsible for promoting P. nigrescens cell adhesion, the duration and frequency of citrate treatment of HA and the inhibitory effect of other carboxylates were tested. The citrate rapidly adhered to HA beads in less than 15 min. With a lower concentration (0.4 mM) of citrate, four treatments of HA were required to promote the maximum adherence to P. nigrescens cells. Citrate-enhanced P. nigrescens cell adherence to HA beads was also inhibited in the presence of cis-aconitate, oxaloacetate and oxalsuccinate. It was also found that P. nigrescens cells heated to 65 degrees C or higher for 5 min could no longer become attached to citrate-treated HA. These data suggest that citrate is one of the essential factors responsible for P. nigrescens cell attachment to apatitic surfaces, and that P. nigrescens' adhesion to citrate is extremely heat-sensitive.

[Oozing type left ventricular rupture: report of three cases].

Two cases of postinfarction oozing type left ventricular rupture and a case of oozing type left ventricular rupture due to catheter perforation for left ventriculography are reported. The technique used to repair the rupture is fibrin glue-oxycellulose fixation method. The post operative course of three cases were uneventful. But left ventricular aneurysm remained in two cases.

[A left subclavian arterial aneurysm caused by fibromuscular dysplasia: a case report].

A 70-year-old man complained left supraclavicular pulsatile tumor. Angiography and CT revealed the left subclavian arterial aneurysm that was just behind the clavicle. The aneurysm was resected through a cross-clavicle incision and an 8 mm Hemashield graft was implanted. The pathological study showed change of fibromuscular dysplasia. The post-operative course was uneventful.

Adsorption of salivary proteins to the surface of oral streptococcal cells.

Oral tissues, especially tooth surfaces, are covered with a layer of salivary proteins. Oral bacterial cells that adsorb to salivary components accumulated on the tooth surface are, as a rule, covered with the same components, especially proteins. Thus, it is possible that the salivary proteins covering the bacterial cells are related to the adhesion of bacteria to oral tissues. The aim of this study was to clarify the mechanisms of adsorption of salivary proteins to the surface of Streptococcus sanguis, S. mitis and S. salivarius using an adsorption assay with salivary proteins labeled with tritiated formaldehyde. The results showed that salivary proteins adsorbed more to S. salivarius than to S. mitis, and least to S. sanguis. It was evident that hydrophobic bonding was involved in the adsorption of salivary proteins to the bacterial cells tested. The amount of salivary proteins adsorbed to S. mitis and S. salivarius was decreased by the presence of phosphate, that to S. sanguis was increased by the presence of a divalent cation such as Ca2+, and that to all bacteria tested was inhibited in different ways by the presence of sugars. The amount of salivary proteins adsorbed to S. sanguis and S. salivarius was reduced effectively by pretreatment of the cells with trypsin, chymotrypsin and papain. In the case of S. mitis, the amount of adsorbed salivary proteins was decreased by pretreatment of the cells with chymotrypsin only, and was increased by pretreatment with lipase. These results indicate that there are different mechanisms of adsorption of salivary protein to the cell surfaces of oral streptococci.