RSR13: Effects on tumor oxygenation and response to therapy

RSR13,[2,4-[[(3,5-dimethylanilino) carbonyl]methyl]phenoxy]-2-methylpropionic acid], is a new allosteric effector of hemoglobin which causes hemoglobin to off-load oxygen more readily. Intravenous administration of RSR13 to rats bearing the 13762 mammary carcinoma resulted in a decrease in the hypoxic fraction (percent of pO₂ readings <5 mmHg) of the tumor that was dependent upon RSR13 dose and was maximal at 30 min after RSR13 administration. Breathing carbogen (95% oxygen/5% carbon dioxide) along with RSR13 administration markedly increased tumor oxygenation. Intravenous infusion of RSR13 (200 mg/kg) over 60 min resulted in maximal tumor oxygenation at 40 min into the infusion. By 30 min after completion of the infusion, tumor oxygenation had returned to baseline. RSR13 was very modestly cytotoxic to EMT-6 murine mammary carcinoma cells when administered to tumor-bearing animals in doses up to 500 mg/kg and was not toxic toward the bone marrow colony forming unit-granulocyte-macrophage (CFU-GM) from the same animals. Administration of RSR13 to animals bearing the Lewis lung carcinoma prior to each fraction of a fractionated radiation therapy regimen resulted in dose modification with dose-modifying factors up to 1.66. RSR13 administration also resulted in decreased numbers of lung metastases in these same animals. When RSR13 was administered on days 4–18, the modification of fractionated radiation remained the same but the number of lung metastases was decreased further. The combination of RSR13 with chemotherapy (cyclophosphamide, adriamycin, 5-fluorouracil, or cis-diamminedichloroplatinum II) resulted in 1.2–1.5-fold increases in the response of the primary tumor and marked decreases in lung metastases. In animals bearing the MB-49 bladder carcinoma, administration of RSR13 resulted in increased responses to both fractionated radiation therapy and chemotherapy and marked decreases in lung metastases. RSR13 was effective in decreasing the number of lung colonies formed by intravenously injected tumor cells if administered on the day prior to, on the same day as, or on the day after the tumor cells. Further investigation of this interesting new drug is warranted. © 1996 Wiley-Liss, Inc.     

Fatigue,depression, maternal confidence,and maternal satisfaction during the first month postpartum: A comparison of Japanese mothers by age and parity

The aim of the study was to assess fatigue, depressive symptoms, and maternal confidence or satisfaction among older primiparae during the first month postpartum. The number of older Japanese primiparae has rapidly increased. Older primiparae are believed to be at high risk for puerperal morbidity. A multicentre prospective cohort study design was used. Data were examined from 2854 Japanese women who participated in a 6‐month prospective cohort study conducted between May 2012 and September 2013. The women were classified into 4 groups based on maternal age and parity. All participants completed the Postnatal Accumulated Fatigue Scale, Japanese Edinburgh Postnatal Depression Scale, Postpartum Maternal Confidence Scale, and Postpartum Maternal Satisfaction Scale. Primiparae in all age groups were more severely fatigued and had a higher risk of postpartum depression than multiparous mothers during the first month postpartum. Older primiparae had significantly lower scores on maternal confidence and maternal satisfaction than the other 3 groups at 1 month postpartum. These findings suggest that postpartum nursing should focus on promoting adequate sleep, providing emotional support, and fostering the process of maternal role adaptation among older Japanese primiparae, particularly during the first postpartum month.     

Portal vein thrombosis in liver cirrhosis

Portal vein thrombosis(PVT) is considered to be a frequent complication of liver cirrhosis. However, unlike PVT in patients without cirrhosis, very few data are available on the natural history and management of PVT in cirrhosis, despite its association with potentially life-threatening conditions, such as gastroesophageal bleeding and acute intestinal ischemia. Moreover, no consensus regarding PVT in cirrhosis exists. Suggested causes of PVT in cirrhosis include reduced portal blood flow velocity, multiple congenital or acquired thrombophilic factors, inherited or acquired conditions, and derangement of liver architecture. However, the understanding of PVT in cirrhosis is incomplete. In addition, information on the management of PVT in cirrhosis is inadequate. The aims of this review are to:(1) assemble data on the physiopathological mechanism, clinical findings, diagnosis and management of PVT in cirrhosis;(2) describe the principal factors most frequently involved in PVT development; and(3) summarize the recent knowledge concerning diagnostic and therapeutic procedures.     

The treatment outcomes of synchronous and metachronous esophageal squamous cell carcinoma and head and neck squamous cell carcinoma

Background

The treatment outcomes of patients with esophageal squamous cell carcinoma (ESCC) and head and neck squamous cell carcinoma (HNSCC) have been poorly documented.

Patients and methods

We investigated 50 patients with synchronous and metachronous ESCC and HNSCC. We focused on the treatment results of 20 patients with synchronous ESCC and HNSCC who received simultaneous chemoradiotherapy (CRT).

Results

There were 34 patients (68.0?%) with stage 0?CI ESCC and 40 patients (80.0?%) with stage II?CIV HNSCC. A total of 13 (26.0?%) patients underwent endoscopic mucosal resection and 28 (56.0?%) underwent CRT for ESCC, and 35 (70.0?%) of the patients with HNSCC were treated with CRT. The 5-year overall survival rates of the 50 patients with synchronous and metachronous ESCC and HNSCC was 57.8?%. For the 20 patients with synchronous ESCC and HNSCC who received simultaneous CRT, the CRT was completed in 19 (95.0?%) patients. Although grade 3?C4 adverse events were observed in five (25.0?%) patients, there were no therapy-related deaths. Complete responses (CRs) of both ESCC and HNSCC were observed in ten (50.0?%) patients. The 5-year overall survival rate of the 20 patients was 60.0?%. CRs of both ESCC and HNSCC were obtained in seven (58.3?%) patients by using a cisplatin/5-FU regimen (n?=?12), and in the other three (37.5?%) patients by a platinum-based monotherapy regimen (n?=?8).

Conclusion

The surveillance of double cancer and the use of radical treatment contributed to the favorable outcome of the patients with ESCC and HNSCC. The optimal chemotherapy regimen for simultaneous CRT remains to be determined.     

Degradation of human secretory immunoglobulin A by protease isolated from the anaerobic periodontopathogenic bacterium, Bacteroides gingivalis

This bacterium is implicated in periodontal diseases of human adult type. Secretory immunoglobulin A (IgA) purified from human colostrum (HC-IgA) was incubated with Bacteroides gingivalis cells or protease isolated from the culture supernatant of B. gingivalis; the digestion of IgA was determined by immunoelectrophoresis and sodium dodecyl sulphate-polyacrylamide gel electrophoresis. B. gingivalis cells almost completely degraded HC-IgA; protease isolated from the culture supernatant cleaved both HC-IgA and secretory IgA in human parotid saliva. Thus by degradation of IgA, the protease may mediate in part the periodontopathogenic role of B. gingivalis by decreasing the oral defence mechanism.     

Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding

Purpose

Although laparoscopic liver resection has been widely adopted, performing a pure laparoscopic right hepatectomy remains a challenging procedure. The aim of this report is to evaluate the efficiency of a pure laparoscopic right hepatectomy (PLRH) in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver.

Methods

Pure laparoscopic right hepatectomy was performed in the semi-prone position with the use of an intrahepatic Glissonian approach and modified hanging maneuver for patients with primary liver cancer (n = 3) and metastatic liver cancer (n = 1).

Results

The intraoperative total blood loss was only 95?C140 g (mean: 126.2 g). None of the patients required a blood transfusion, and no serious complications were encountered. The durations of the surgeries ranged from were 308 to 445 min (mean: 394.8 min). The postoperative hospital stay was 8?C11 days (mean 9.5 days).

Conclusion

Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver is thus considered to be a safe modality, which minimizes intraoperative bleeding.