Inhibitory Effect of Potassium Citrate on Rat Renal Tumors Induced by N-Ethyl-N-hydroxyethylnitrosamine Followed by Potassium Dibasic Phosphate

Potassium dibasic phosphate (PDP) was administered at a concentration of 10% by weight in basal diet to unilaterally nephrectomized Wistar rats previously given 1000 ppm N-ethyl-N-hydroxyethyl-nitrosamine (EHEN) in the diet for 2 weeks. To study the effect of alkalinization on renal mineralization, some animals concomitantly received 5% potassium citrate (PC). Feeding PDP alone promoted adenomatous hyperplasias, which were regarded as preneoplastic lesions, as well as renal cell tumors in EHEN-initiated rats, whereas the addition of PC to PDP diets reduced the promoting effect. Histopathology, serum biochemistry and urinalysis indicated retardation of renal calcium crystallization by PC. Two other phosphate salts, sodium phosphate (SP) and calcium phosphate (CP), were also administered. SP showed a slight promoting effect on adenomatous hyperplasias and a 2-fold increase in the yield of renal cell tumors, while CP induced a clear reduction of both lesions, over EHEN alone. The promoting effects of both PDP and SP and the inhibitory effect of PC were somewhat correlated to 5-bromo-2'-deoxyuridine labeling indices, the degree of nephropathy, and mineralization in the kidney. Immunohistochemically, the nephropathy induced by phosphate salts was not linked to α_zu-globulin. A pathogenesis for renal carcinogenesis is suggested in which nephropathy associated with mineralization enhances the development of renal cell tumors.     

Concomitant cardiac and pulmonary operation in a case of lung tumor with unstable angina]

The patient, a 55-year-old male, suffered from malignant lung tumor with complaints of bloody sputum and anterior chest pain. Angina pectoris was detected during neoadjuvant chemotherapy, because of total obstruction at #7 and 99% stenosis at #12, as disclosed by CAG. As he complained frequently anginal chest pain in the course of time, the concomitant cardiac and pulmonary operation was decided via median sternotomy and fourth intercostal thoracotomy. The operating procedure was as follows: 1) mediastinal lymph nodes dissection before extracorporeal circulation, 2) aorto-coronary bypass (#8, #12), 3) final left lower lobectomy. He was histopathologically diagnosed as a rare case of endobronchial type of leiomyosarcoma. He has achieved a remarkable recovery, without tumor recurrence or angina pectoris for ten months postoperatively, and has been allowed to resume a normal life.     

Acute leukemia with two cell populations of lymphoblasts and monoblasts

A 46-year-old man had acute leukemia with two cell populations of lymphoblasts and monoblasts (L1 and M5-b in FAB classification, respectively), which were characterized by morphological, cytochemical and cell marker studies. At the time of diagnosis about 80% blasts were terminal deoxynucleotidyl transferase (TdT) positive lymphoid cells, while the rest were TdT negative monocytoid cells. After induction chemotherapy of vindesine and prednisolone for 15 days, almost all blasts were TdT negative monocytoid cells. Therefore, an additional course of the chemotherapy with the protocol for acute nonlymphocytic leukemia was given and one month later the patient achieved complete remission.     

Development of new methods in suppressing brain infarction--combined administration of mannitol and perfluorochemicals (author's transl)

Various therapeutic methods have been attempted for cerebral infarction, but the development of more effective methods is still awaited. We have investigations of the effect of mannitol in preventing the development of cerebral infarction and have reported it effects in clinical cases of operated cerebral aneurysms. In recent years, our attention has been drawn to the so-called red cell substitute, perfluorochemicals (FC), which has a high oxygen-carrying capacity and a small particle less than 0.1 mu. In the present studies, using infarction models in dogs which have previously developed and reported, observations are made on recovery of brain electrical activity in severe ischemia, suppressing brain swelling following recirculation of cerebral blood flow and protection upon the hemorrhagic brain infarction, due to administration of mannitol or FC. These experimental results indicate that the combined administration of mannitol and FC is effective in protecting the brain from cerebral ischemia.     

Modification of skin temperature by biofeedback procedures

The modification of finger skin temperature by biofeedback procedures was studied. Forty subjects were divided into four groups of 10: (1) temperature increase group, (2) temperature decrease group, (3) control group A—subjects instructed to be seated without receiving feedback, and (4) control group B—subjects given false feedback. The subjects were not informed of the aim of the experiment, but told to keep the red light (indicating rise of temperature) or the green light (fall of temperature) on as long as possible. Our results suggest that it is possible to have voluntary control of finger skin temperature by biofeedback procedures.     

Altered expression of members of the IGF-axis in clear cell renal cell carcinoma

Renal cell carcinoma (RCC) is a heterogeneous disease and its biology is poorly understood. The commonest subtype identified is clear cell RCC. The insulin-like growth factor axis is intimately involved with many cellular roles including that of renal development. Dysregulation of this axis has frequently been demonstrated in cancer. In this study, we examine the expression of several IGF-axis components, including receptors, ligands, and binding proteins in clear cell renal cell carcinoma. A series of clear cell RCCs with matched normal kidney from the same individuals were obtained. Total RNA was extracted and expression levels of genes examined using RNase protection analysis. We confirm the dysregulation of the IGF-axis within clear cell renal cell carcinoma including the upregulation of IGFBP-3, which is further validated by immunohistochemical staining on a tissue array containing 50 RCC: positive staining in 29/30 clear cell; 1/10 papillary and 0/10 chromophobe. In addition, we demonstrate that the expression of the A isoform of the insulin receptor is significantly upregulated, while that of IGFBP-5 are significantly downregulated in this tumour subtype.     

Health-related quality of life and treatment outcomes for men with prostate cancer treated by combined external-beam radiotherapy and hormone therapy

Background Health-related quality of life (HR-QOL) is important when considering the treatment options for prostate cancer.Methods From 1992 to 1998, 57 patients were treated by radiotherapy plus hormone therapy (median age, 79 years; median prostate-specific antigen concentration, 15.0ng/ml; median radiotherapy dosage, 60Gy). General HR-QOL was measured by the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, and a newly developed disease-specific QOL survey was used to assess urinary and bowel functions. QOL was also measured in a control group of patients admitted for prostate biopsy.Results The general HR-QOL scores in the radiation group ranged from 70.0 to 91.3, with sexual problems showing the lowest (i.e., worst) score (38.5). Compared with the control group, the scores in the radiation group were worse for physical function and sexual problems. For disease-specific QOL, the radiation group had worse urinary function than controls, but were more satisfied with their urinary function. There was no difference between the radiation group and controls in satisfaction with bowel function. When the control group was subdivided at into two groups: age 75 years or less, and age over 75 years, the QOL score in the radiation group was the same as that in the subgroup aged over 75 years. In subgroups of the radiation patients, according to survey period, there was no difference between the first and last surveys in longitudinal HR-QOL evaluations. The 5- and 10-year overall survival rates were 67.6% and 41.6%, respectively, and the 5- and 10-year cause-specific survival rates were 97.9% and 94.7%.Conclusion The combination of radiotherapy and hormone therapy has a good outcome and patients do not experience poor HR-QOL, except for sexual problems. Moreover, the disease-specific QOL is good, especially for urinary bother.     

Pharmaceutical terms reflecting the change in practice in Japan

The implementation of Iyaku Bungyo, the changed regulations for drug distribution and the proposed change of pharmacy education from a four-year program to a six-year program are rapidly changing the practice of pharmacy. However, pharmacists' activities still remain at the level of simple dispensing and selling of drugs. Also, the terms that describe the essence of pharmacists' activities, such as services in patient care areas are still unclear. In order to solve and improve the problem of terminology for pharmacists' activities the use of terms related to pharmacists' services were examined in historical context. It was found that the terms "Rinsho yakugaku" and "Iryo yakugaku" have been used as having a similar meaning. Further, the term "Iryo yakugaku" was used to denote the comprehensive scope of pharmacists' services including "Rinsho yakugaku". It was verified that "Rinsho yakugaku" is a valid translation for "clinical pharmacy". "Iryo yakugaku" has a more comprehensive translation than "pharmaceutical care", therefore, it appears that "Iryo yakugaku" is a suitable translation for "pharmaceutical services". Hence, we proposed "Iryo yakugaku" as the English translation for "pharmaceutical services" and "Chiryo yakugaku" as the Japanese translation for "pharmaceutical care". There is a need, however for further clarification and definition of pharmacists' activities.     

Factors influencing the overestimation of plasma vancomycin concentrations measured by the Abbott TDx technique

The Abbott TDx technique (TDx) has been reported to overestimate the plasma concentration of vancomycin (VCM) in patients with renal failure and also in those with normal renal function. The aim of this study was to investigate factors influencing the overestimation of plasma VCM concentrations measured by TDx compared with high-performance liquid chromatography (HPLC) as a reference technique. First, the precision and accuracy of TDx and HPLC were compared using 5 weighed-in concentrations of VCM. The coefficients of variation (CV) for both TDx and HPLC were less than 3% at weighed-in concentrations of 3.0, 7.5, 15.0, 30.0, and 60.0 microg/mL. The authors did not find overestimation of VCM concentrations by TDx in any weighed-in sample. Next, VCM concentrations measured by TDx were compared with those measured by HPLC in 253 plasma samples obtained from 83 patients receiving VCM. Regression analysis showed that VCM concentrations measured by TDx were closely correlated with those measured by HPLC, with a correlation coefficient of 0.963. Then, the authors divided plasma samples into 2 groups based on the time of sampling, ie, pre- and postdose. The mean TDx/HPLC ratio was significantly higher in the predose group (1.23 +/- 0.22) than in the postdose group (1.11 +/- 0.16) (P < 0.01). An Eksborg plot showed that the TDx/HPLC ratio decreased slightly with increased total bilirubin concentrations in the predose samples. These results indicated that plasma VCM concentrations measured by TDx were influenced by the time of sampling and the plasma bilirubin concentration. The overestimation of VCM concentrations in the predose group may have resulted from metabolites of VCM because the relative concentrations of the metabolites were likely to be greater in the predose group than in the postdose group. Thus, VCM postdose samples may provide useful information in cases in which a good clinical outcome has not been obtained using monitoring of the predose concentration alone.