A workshop on the high risk group and the preventive oncology of renal cell carcinoma]

A workshop on the high risk group and the preventive oncology of renal cell carcinoma was held in Kyoto on September 7, 1990. The following subjects were presented: 1. Cohort study of renal cell carcinoma (Dr. Hirayama). 2. Pathoepidemiological study on the background of occurrence of renal cell carcinoma (Dr. Aoki). 3. Case-control study on renal cell carcinoma (Dr. Watanabe). 4. Geographic distribution of renal cell carcinoma in Japan (Dr. Minowa). 5. Pathological findings of small renal cell carcinoma (Prof. Yatani). 6. Pathoepidemiological study on occurrence of renal cell carcinoma (Dr. Tsuchihashi). 7. Clinical evaluation of small renal cell carcinoma (Dr. Masuda). 8. Clinical (biological) characteristics of renal cell carcinoma (Dr. Satomi). 9. Mass screening program for renal cell carcinoma on private urological clinic (Dr. Mishina). 10. Early stage detection of renal cell carcinoma (Dr. Ohe). 11. A review on the literature of epidemiology for renal cell carcinoma (Dr. Nakagawa). Possible risk factors reported for renal cell carcinoma were as follows: 1) Work in petroleum-related and dry-cleaning industries were positive risk. A predominant lifetime occupation as a professional was negative risk. 2) Milk or coffee consumption and use of artificial sweeteners were positive. Drinking of alcohol was negative. 3) Obesity was positive. 4) Personal history of cancer was positive. 5) Cigarette smoking was positive. 6) Exposure to radiation or hydrocarbon was positive. 7) Use of estrogen, diuretic and pain relievers was positive. 8) History of myocardial infarction, hypertension and diabetes mellitus was positive.     

Two Children with Bromate Intoxication due to Ingestion of the Second Preparation for Permanent Hair Waving

We report two children who suffered from sodium bromate intoxication due to ingestion of the second preparation for permanent hair waving (the second permanent preparation). One child suffered from gastrointestinal symptoms only. The other exhibited slight acute renal insufficiency. Results of the histological examination of the kidney in the sick child with acute renal insufficiency showed sporadic epithelial separation of the proximal tubuli under light microscopy. In addition, we could demonstrate more clearly epithelial separation and unbroken tubular basement membranes under electron microscopy (EM). To our knowledge, this is the first report of EM findings in this disease. The mechanism of epithelial injuries by bromate is not clear.     

Predictive factors for vascularized iliac bone graft for nontraumatic osteonecrosis of the femoral head

We reviewed the results of 35 operations performed on 29 patients with osteonecrosis of the femoral head in which a pedicle iliac bone was utilized. The average age was 35 years (17–62). There were 28 patients of stage 2 and 7 of stage 3; there were 17 type C-1 hips and 18 type C-2 hips. The pedicle bone was inserted in the anterolateral direction of the femoral head. The average follow-up period was 8 years and 7 months. Collapse of the femoral head occurred in 19 hip joints. Although 16 of 28 stage 2 hips showed collapse, all 7 stage 3 hips resulted in collapse. Thirteen of 17 hips did not show collapse in patients with type C-1 necrosis, whereas 15 of 18 hips developed collapse in patients with type C-2 necrosis. When the bone graft was inserted in the anterolateral direction of the femoral head, incidence of collapse was reduced. These results indicate that deep circumflex iliac pedicle bone graft may be indicated for stage 2 type C-1 necrosis, and that the penetration of the graft into the anterolateral aspect of the lesion is essential for the procedure to succeed.     

Dose intensity chemotherapy in lung cancer]

Dose intensity (DI) is defined as the amount of drugs administered per unit time (mg/m2/wk). Recently this concept is thought to be one of the most important tactics to improve the chemotherapeutic results. In this article, we summarized the reports about the impact of dose intensity chemotherapy on various malignancies and the experimental results in animal models. As the application of this concept for the treatment of lung cancer, we conducted the following trials. For the patients with small-cell lung cancer (SCLC), weekly intensive chemotherapy employing cisplatin, oncovin, doxorubicin, and etoposide (CODE regimen) was performed. Fifteen (88%) of 17 patients responded to this regimen, including 5 (29%) complete responders. The median survival time for all patients was 45 weeks. For the patients with non-small cell lung cancer (NSCLC), short interval (3 weeks) MVP (mitomycin, vindesine, and cisplatin) therapy using with recombinant human granulocyte-colony stimulating factor (rhG-CSF) was performed. This study was aimed at improving the therapeutic result by reducing the cycle length of MVP regimen through the use of rG-CSF. Thirty-two out of 40 patients could receive two or more cycles of MVP regimen on schedule. These results in SCLC and NSCLC suggest that does intensity chemotherapy can improve the outcome for patients with these disease.     

The effect of 3-methylcholanthrene on postlanosterol cholesterol biosynthetic pathways in mouse skin

Repeated topical application of 3-methylcholanthrene to the backs of BALB/c mice lowered the tissue levels of lathosterol and provitamin D3, intermediates in one of the cholesterol biosynthetic pathways (the delta 7 pathway), though the activities of lathosterol 5-desaturase and provitamin D3 7-reductase were similar to those of control animals. These results seemed to indicate that carcinogen treatment exerted a depressive effect at some earlier step(s) than lathosterol synthesis. However, the content of cholesterol in mouse skin was not lowered in these animals, suggesting that another biosynthetic pathway might be activated. When diazacholesterol, which is known to inhibit the conversion of desmosterol to cholesterol, was administered together with the carcinogen, a marked accumulation of desmosterol was observed compared to animals given only diazacholesterol. Since desmosterol is an intermediate in the pathway in which the delta 24 double bond is reduced at the final step (the delta 24 pathway), this seemed to suggest that the delta 24 pathway was activated by carcinogen treatment.     

Hereditary motor and sensory neuropathy type 1 (HMSN1) associated with cranial neuropathy: an autopsy case report

A family with hereditary motor and sensory neuropathy type 1 (HMSN1) is reported. Three patients suffered only pupillary abnormality, two patients showed Adie's syndrome and peripheral neuropathy, and one had cranial neuropathy. Adie's syndrome and severe peripheral neuropathy. Autopsy of the latter revealed reduction of myelinated nerve fibers in the trigeminal, facial and hypoglossal nerves. There was extensive degeneration of the posterior column of the spinal cord. At the anterior horns, loss of motor neurons was observed, particularly at the lumbar level. The anterior and posterior roots showed loss of myelinated fibers. HMSN1 is only rarely associated with cranial neuropathy, and this is probably the first autopsy-proved case.     

Antihypertensive effects of SA446, hydralazine and the combination on renal hypertensive rats and spontaneously hypertensive rats by long-term treatment

SA446 [(2R, 4R)-2-(o-hydroxyphenyl)-3-(3-mercaptopropionyl)-4- thiazolidinecarboxylic acid] (30 mg/kg/day), an orally active angiotensin-converting enzyme inhibitor, lowered significantly indirect systolic blood pressure (SBP) of 2-kidney, 1-clip renal hypertensive rats (RHR) by consecutive oral administration over a 14 week period. Daily oral dosing of hydralazine (2 mg/kg/day) for 14 weeks had little or no effect on SBP, but potentiated the antihypertensive effect of SA446. One to two weeks after discontinuation of the drugs, SBP in SA446 and the combination groups returned to the control level. Survival rates were 64%, 30% in the control and hydralazine group, respectively, but no death was observed in the SA446 group and the combination group throughout the administration period. Twenty-four hour urine volume and water intake tended to increase in the hydralazine group through the administration period, but increased apparently in the SA446 group and the combination group after discontinuation of the drugs. Daily oral dosing of SA446 (45 mg/kg/day) for over 16 weeks completely prevented the development of hypertension in spontaneously hypertensive rats (SHR). Daily oral dosing of hydralazine (2 mg/kg/day) similarly prevented the development. The combined effect with SA446 and hydralazine on the development was also observed. SBP in the SA446 group and the combination group increased gradually after discontinuation of the drugs, but were maintained at a low level as compared with the control group 3 weeks after discontinuation, while hydralazine gave a rapid return. No influences were observed in 24 hr-urine volume and water intake during and after the administration period in SHR.(ABSTRACT TRUNCATED AT 250 WORDS)     

Correlation between plasma levels of ACTH and cortisol in basal states and during the CRH test in normal subjects and patients with hypothalamo-pituitary disorders.

Using a new ACTH-immunoradiometric assay (IRMA), we measured plasma ACTH levels in the basal states and during CRH test in normal subjects and the patients with hypothalamo-pituitary disorders. The basal levels of plasma ACTH in 76 normal young (25-45 yr) and 140 elderly (60-85 yr) subjects were 23.1 +/- 13.6, and 17.5 +/- 11.2 pg/ml, respectively. The plasma ACTH levels were less than detection limit (5 pg/ml) in 3 patients with isolated ACTH deficiency, and less than 10 pg/ml in 6 of 7 patients with hypopituitarism. A significant correlation was observed between the basal levels of plasma ACTH and of cortisol in two age groups, with almost the same regression line, showing no age-related decline in the plasma levels of ACTH and cortisol. In 2 normal subjects and 2 patients with Cushing's disease, synchronized secretions of ACTH and cortisol were observed between 0800h and 1800h. In normal subjects and the patients with pituitary disorders, a significant correlation was observed between the Area Under the Curve's for plasma ACTH and cortisol during the CRH test. The correlation constant was higher in normal subjects, but lower in the patients with acromegaly, non-functioning pituitary tumor, and Cushing's disease in this order, suggesting low sensitivity of the pituitary-adrenal axis in these patients. These results suggest that the ACTH-IRMA kit provide reliable data for clinical investigation, and that the secretions of ACTH and cortisol correlate each other in basal states and during the CRH test in the patients with pituitary disorders as well as in normal subjects.     

High resolution computed tomography of diffuse interstitial pneumonia during treatment

HRCT was carried out in twenty patients with diffuse interstitial pneumonia: 13 cases of IIP, 3 of BOOP, 2 of drug-induced pneumonia, 1 of rheumatoid lung and acute interstitial pneumonia of unknown origin. With special attention to inflammatory activity, the patients underwent HRCT periodically during the treatment. Correlative investigation between HRCT image and grade of accumulation in 67Ga scintigraphy was also performed. Response to steroid therapy was clearly reflected on HRCT image, that was shown as decreasing pulmonary density or thinning of honeycomb wall. HRCT is considered to be useful in assessing the activity of diffuse interstitial pneumonia.