Preoperative evaluation of the chemosensitivity of breast cancer by means of double phase99mTc-MIBI scintimammography

The chemosensitivity of breast cancer is important for its management, but it is difficult to evaluate preoperatively. Tc-99m hexakis-2-methoxyisobutylisonitrile (MIBI) scintimammography has been reported to indicate the expression of P-glycoprotein, which is one factor concerned with multidrug resistance. We developed a chemosensitivity assay by using surgical specimens to investigate whether^99mTc-MIBI scintimammography findings before the operation are related to chemosensitivity according to our assay. Fifteen patients with primary breast cancer were enrolled into the study. Early and delayed images were obtained at 10 and 120 minutes after intravenous injection of^99mTc-MIBI, respectively. Regions of interest were placed on the tumors and the contralateral healthy breasts in each patient to estimate^99mTc-MIBI uptake in the tumor, and retention indices were then calculated to assess the washout of^99mTc-MIBI. Chemosensitivity assay was performed by incubating surgical specimens with anticancer agents such as doxorubicin, epirubicin, pinorubicin, mitomycin C, cisplatin and 5-fluorouracil.^99mTc-MIBI washout on scintimammography was successfully related to inhibition ratios on chemosensitivity tests when compared with^99mTc-MIBI uptake by the tumor. In particular, high correlation coefficients were obtained between the retention index of^99mTc-MIBI and the inhibition ratios of doxorubicin (r = 0.75), epirubicin (r = 0.60) and pinorubicin (r = 0.62), but poor correlation was found for mitomycin C (r = 0.44) and cisplatin (r = 0.31). Our results indicate that the retention index of^99mTc-MIBI is closely correlated to chemosensitivity to anthracyclines, suggesting that double-phase scintimammography allows preoperative prediction of chemosensitivity of breast cancer.     

Aneurysm of the nonpatent ductus arteriosus in the adult —A report of the case and review of the literature—

Aneurysm of the ductus arteriosus in adult is rare. 28 cases have been previously reported in the Japanese literature. A new 73-year-old male case, preoperatively diagnosed and successfully repaired, are presented. The patient with hoarseness was admitted to our hospital. Contrast-enhanced CT scans and aortograms made a diagnosis for the aneurysm of the ductus arteriosus. Operation was done through left thoracotomy with the aid of partial cardiopulmonary bypass. The pulmonary arterial end of the ductus arteriosus was closed and a Ligamentum artriosus was identified. A 3 by 2.7 cm saccular aneurysm was resected and segmental replacement of the aorta with woven dacron graft was performed. Because of it’s critical location and the high incidence of complications, aneurysm of the ductus arteriosus in the adult should be surgically corrected when diagnosed.     

Primary leiomyosarcoma of the heart, report of a case and review of the literature

Primary cardiac neoplasms are unusual and are found in only about 0.0017% of autopsies. Approximately 25% of primary cardiac neoplasms are malignant. A case of primary leiomyosarcoma arising from the right ventricle and the pulmonary artery is reported. A 37-year-old man had sudden dyspnea and chest pain. Angiocardiography and MRI revealed moving masses throughout the right ventricle and the pulmonary arteries. An emergent surgery was performed. The multiple tumors were observed and incomplete resection was done. The patient was survived with the aid of a veno-arterial bypass as an assisted circulation on the first postoperative day. However, he gradually became deteriorated again and died 8 days after the operation due to the right ventricular failure. Eleven cases of the primary cardiac leiomyosarcoma including our case in the Japanese literature were reviewed briefly.     

Generation of 8-hydroxydeoxyguanosine from DNA using rat liver homogenates

In relation to carcinogenesis, aging and other pathologic conditions, urinary 8-hydroxydeoxyguanosine (8OHdG) is widely used as a marker for evaluating the effect of oxidative stress on DNA. Because no reports have described how 8OHdG is generated from DNA in vivo or by biological materials, and how it is excreted into urine, the authors investigated the generation of 8OHdG from DNA, using rat liver homogenate. Oxidatively damaged DNA samples containing different levels of 8OHdG were prepared using ultraviolet irradiation with three different concentrations of riboflavin. Following incubation of damaged DNA samples with rat liver homogenates, the generation of 8OHdG from the DNA was determined using high-performance liquid chromatography with electrochemical detection after ultrafiltration of the incubation mixtures. The generation of 8OHdG was also tested with an anti-8OHdG antibody. The quantity of 8OHdG generated from the DNA by rat liver homogenates was dependent on the 8OHdG levels in the DNA: almost all 8OHdG in the DNA was released as 8OHdG by rat liver homogenates. Generation of 8OHdG correlated with the degradation of DNA. Interestingly, the generated 8OHdG was stable in the presence of rat liver homogenates, whereas deoxyguanosine (dG) rapidly disappeared in the same conditions. Less than 1/10,000 of dG was converted to 8OHdG when dG was incubated with rat liver homogenate. Incubation of 8-hydroxyguanine with rat liver homogenates did not generate 8OHdG. These findings suggest that most of the 8OHdG in DNA is released as 8OHdG during DNA degradation and that, because of its stability, 8OHdG is excreted into urine, thus providing a convenient measure of oxidative damage to DNA.     

A case of prostatic stromal tumor of uncertain malignant potential

Sarcomas and related proliferative lesions of specialized prostatic stroma are rare. Lesions have been classified into prostatic stromal tumor of uncertain malignant potential (P-STUMP) and prostatic stromal sarcoma based on the degree of stromal cellularity, presence of mitotic figures, necrosis, and stromal overgrowth. STUMPs are considered neoplastic, based on the observations that they may diffusely infiltrate the prostate gland and extend into adjacent tissues, and often recur. Although most cases of STUMPs do not behave in an aggressive fashion, occasional cases have been documented to recur rapidly after resection and a minority have progressed to stromal sarcoma. Here we describe a case of P-STUMP. A 57-year-old male went to his family doctor because of pollakisuria. Digital examination revealed abnormal findings in the prostate, then he was referred to our medical center. The mass was palpable in the left lobe of the prostate; it was elastic hard, surface smooth, about 2 cm in diameter. Serum PSA was elevated slightly (5.42 mg /dl). We diagnosed firstly leiomyosarcoma by transrectal ultra sound guided needle biopsy of the prostate. Then we performed radical prostatectomy. Finally we made the pathological diagnosis of P-STUMP. After 11 months, there is no sign of metastasis or recurrence.     

Clinical studies of intrarectal administration of 5-FU emulsion as an adjunct to surgical treatment for rectal cancer

Preoperative intrarectal administration of 5-FU emulsion was attempted as an adjuvant chemotherapy to surgery for rectal cancer. The drug concentrations of resected specimens were determined and histological examinations of them were carried out in order to evaluate the effect of anticancer drugs on the metastatic lymph nodes as well as on the primary tumors. 5-FU levels both in the regional lymph nodes and primary tumors of 18 patients with rectal cancer, who were given with the 5-FU emulsion (emulsion group) or 5-FU suppository (suppository group) intrarectally two hours before surgery, was found to be much higher in emulsion group than in suppository group. 46 patients with rectal cancer were treated preoperatively with intrarectal administration of 5-FU emulsion (25 cases) or 5-FU suppositories (21 cases) for a period of 10 days before surgery, and the histological effect of this regimen on the metastatic lesion in the lymph nodes, as well as in the primary tumor was examined. No detectable difference was found in the primary lesions between the emulsion group and the suppository group. In the metastatic lesions, however, the rate of effectiveness was higher in the emulsion group than in the suppository (68 percent versus 33 percent).     

Orderly arrangement of hepatocyte spheroids on a microfabricated chip

This article describes a novel method for preparing several spherical multicellular aggregates (spheroids) that have almost the same diameter on a microfabricated chip. The chip, fabricated by a simple method that uses a micromilling system, consisted of several thousand cavities, 100-500 microm in diameter, in a triangular arrangement on a polystyrene plate. Although no spheroid was formed on any chip when cultured under stationary conditions, hepatocytes formed spheroids in the cavities when turning force was applied with a rotary shaker. Especially on the chip with cavities 300 microm in diameter, one spheroid formed in each cavity; an orderly array of spheroids (1100 spheroids/cm(2)) of almost the same diameter was constructed. Ammonia removal and albumin secretion by the spheroids on the chip continued to occur at initial levels for at least 14 days of culture. Enzyme P-450 activity of the spheroids was also maintained and detected on this transparent chip by fluorescence of resorufin converted from ethoxyresorufin. The spheroid microarray chip seems to be a promising cellular platform for various biomedical applications such as in cell-based biosensors for toxicological and pharmacological examinations, and in bioartificial livers.     

Stem durability testing of interdental brush

The purpose of the present study was to determine the ability of interdental brush to withstand repeated use and to relate this property to clinically observed fractures of such brushes. The stem durability test was conducted according to ISO (International Standards Organization) standard by using a bending at 90 degrees under a 500-g controlled load (ISO/TC106/SC7/ WG3). Two sizes (ss, m) of each of the five commercially available interdental brushes (D, B, P, I, S) were used. The cycle number at the time of fracture was noted for all interdental brushes. The fractured surfaces of the stem wire following the stem durability test were also observed under a scanning electron microscope. The specimens, when ranked in decreasing order of the number of cycles at which fracture occurred, were D-m, D-ss, B-ss, B-m > P-m, P-ss, I-ss, I-m, S-m, S-ss (P < 0.05). L-type interdental brushes (P-m, P-ss, I-ss, I-m, S-m, and S-ss) showed significantly decreased fracture resistance when compared with straight-type interdental brushes (D-m, D-ss, B-ss, B-m). In all cases, the fracture was found to be of ductile nature.