Prognostic factors in yolk sac tumors of the ovary. A clinicopathologic analysis of 29 cases.

Twenty-nine ovarian cancer patients with yolk sac tumors and germ cell tumors with yolk sac tissue as a component of their disease (16 endodermal sinus tumor, 11 mixed germ cell tumors, one embryonal carcinoma, and one polyembryoma) were treated with cytoreductive surgery and combination chemotherapy. Prognostic factors were investigated in this group. Patients with Stage I disease had a more favorable prognosis (P less than 0.003) than those with Stages II and IV disease. The difference in prognosis was significant in cases where residual tumor was absent (P less than 0.003) and in cases where ascites was either absent or less than 100 ml in volume (P less than 0.05). Endodermal sinus tumor with either an intestinal (P less than 0.05) or microcystic pattern (P less than 0.01) was more common in survivors than in those who died. The age, preoperative serum alpha-fetoprotein level, maximum tumor size, and tumor weight had no significant correlation with prognosis. In advanced cases, chemotherapy regimens including cisplatin gave better results than those containing vincristine, dactinomycin, and cyclophosphamide (P less than 0.05). The optimal treatment of yolk sac tumors or tumors with yolk sac tissue as a component of the ovary is discussed in light of these results.     

Higher Frequency of Point Mutations in the c-K-ras2 Gene in Human Colorectal Adenomas with Severe Atypia than in Carcinomas

Human colorectal carcinomas may be induced from adenomas or they may occur de novo. To examine which is the main pathway, we analyzed point mutations at codon 12 in the c-K- ras 2 gene in 73 colorectal carcinomas, 13 metastatic tumors, 72 adenomas and 30 normal tissues. The c-K- ras 2 codon 12 mutation frequency was 0/30 in normal tissues, 0/17 in adenomas with mild atypia, 3/37 (8.1%) in adenomas with moderate atypia, 15/18 (83.3%) in adenomas with severe atypia, 19/73 (26.0%) in primary carcinomas and 3/13 (23.1%) in metastatic tumors. The mutation frequency in adenomas with severe atypia was much higher than that in carcinomas. These results indicate that many colorectal carcinomas may not be induced through adenomas with severe atypia.     

Expression of Fas antigen on helper T lymphocytes in Vogt-Koyanagi-Harada disease

· Background: Our purpose was to analyze the expression of Fas antigen on CD4⁺ lymphocytes in the aqueous humor (AH) and cerebrospinal fluid (CSF) of patients with Vogt-Koyanagi-Harada disease (VKH). · Methods: Using three-color flow cytometry, we assessed T-lymphocyte subsets stained with fluorescence-conjugated anti-CD3, CD4, CD8, CD29, CD45RA, CD45RO, HLA-DR, and Fas monoclonal antibodies in AH, CSF and peripheral blood (PB) from 8 patients with active VKH. · Results: CD3⁺ T cells constituted the majority of lymphocytes in AH and CSF, in contrast to with PB. The percentages of CD4⁺ lymphocytes in uveitic AH and CSF were significantly higher than that in PB (P < 0.01). Activated CD4⁺ and CD8⁺cells were significantly more frequent in AH than in CSF and PB (P < 0.01). Although the percentages of CD45RA⁺ cells within CD4⁺ cells in AH and CSF were extremely low compared with those in PB, the proportions of CD29⁺ and CD45RO⁺ (memory) cells within CD4⁺ were much higher than those in PB (P < 0.01). Fas antigen was also highly expressed on such CD4⁺ cells in AH, as in other uveitis patients and on such cells in CSF. Moreover, the percentages of Fas⁺ and memory cells in AH were significantly higher than those in CSF. · Conclusions: The majority of CD4⁺ lymphocytes in AH and CSF from patients with active VKH were activated memory cells, on which Fas antigen was also highly expressed. Although this Fas expression may not be an apoptosis-related phenomenon, accumulation of Fas⁺ memory T lymphocytes in AH and CSF probably reflects the immunopathologic mechanism of VKH. Received: 12 June 1997 Revised version received: 6 October 1997 Accepted: 7 October 1997     

Constitutive production of interleukin 1 by human monocytic leukemia cell line JOSK-I and the production mechanism

JOSK-I is a newly established human monocytic leukemia cell line derived from the peripheral blood of a patient with acute myelomonocytic leukemia. The cells possess immature monocytic features, both cytochemical and immunochemical. It was found that a high level of interleukin 1 (IL-1) was produced by JOSK-I cells without any stimulation. The IL-1 production by JOSK-I cells has the following characteristics: constitutive; cell concentration dependent; and minimal at the logarithmic growth phase and maximal at the saturation density of cell growth. This constitutive production of IL-1 was little affected by the addition of polymyxin B. Partial purification of JOSK-I-derived IL-1 was performed by high-performance liquid chromatography on HPHT hydroxylapatite and TSK gel G3000 SW columns. The activity was found in the molecular weight range of 14,000 to 30,000 and over 70,000. In chromatofocusing, JOSK-1-derived IL-1 exhibited two isoelectric points, pI 6.9 and pI 5.9. Nearly 90% of the activity was immunoprecipitated with rabbit anti-human IL-1 antibody. These characteristics are consistent with those of human monocyte-derived IL-1. This cell line might be an ideal source of native IL-1 for investigating the biological and biochemical characteristics of human IL-1 and its clinical application.     

The discussion of the need of mediastinal lymph node dissection in the surgical treatment of lung cancer

The need of lymph node dissection in the case of operative lung cancer with negative mediastinoscopy was discussed. As a preliminary study, the N-number obtained from the mediastinoscopy and that of postoperative examination was compared. The rate of agreement of N-number was as high as 96%. Secondary, 183 cases of lung cancer with squamous-or adenocarcinoma pathologically T-1 or 2. N-0 and P-0 or 1 were picked up and examined. In those cases, the result of 3 years survival rate was 80% in the cases of absolute curative operation and 60% in that of relative non-curative cases, and 5 years survival rate was 70% and 52% respectively, and the cases of absolute curative operation was statistically excellent than that of another group. However, the background of the two groups was different to some degree on account of the advancement of the cancer and the age of the patients. Therefore, the randomized study as for the lymph node dissection in the cases of negative mediastinoscopy was finally performed. In the 30 cases of squamous cell carcinoma where dissection was carried out in 13 cases and not done in 17 cases, the result of 3 years survival was 84% (dissecting group) and 89% (non-dissecting group), and 5 years survival was 73% and 63% respectively. In 23 cases of adenocarcinoma (13; dissecting, 10; non-dissecting), the result of 3 years survival was 100%, 63% and that of 5 years survival rate was 100%, 63% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

New low temperature initiator system for dental adhesive resins. Application of peroxyesters with carboxyl group

Adhesion between dentin and MMA resin was investigated using chemically activated initiator system consisting of 1,3,5-trimethyl-2-thiobarbituric acid, cupric salt, chloride ion, and tert.-butyl peroxymaleic acid (MA) with carboxyl group which usually has affinity to tooth. The adhesive strength of the MMA/PMMA resin to bovine dentin increased significantly to 8-10 MPa by addition of MA, while the adhesive strength was 4 MPa without MA. When the bonding broke at higher than 7 MPa, the adhesive resin layer usually fractured cohesively and the interfacial fracture did not occur. The bond strength obtained in this experiment was comparable to that obtained with MMA resin using TBBO and ferric ion initiator system which is known as the best initiator system for dentin available.     

CT simulator: a new 3-D planning and simulating system for radiotherapy: Part 2. Clinical application

We have performed radiotherapy treatment planning (RTP) with a new system called CT simulator in 72 patients. With the system, RTP is performed with the patient lying on the CT couch within a short period of time. All the CT images scanned were immediately transported to the multi-image monitors and to the treatment planning device. Radiotherapy treatment planning could be performed not only at the beam center but also at any CT slice. Using a laser-beam field projector, field outlines were drawn over the patient's skin. In clinical use, the system was useful for cases in which a target lies adjacent to dose limiting organs, cases with a complicated target shape, cases with complicated dose distribution curves, and cases treated with tangential fields. This system enables us to make optimum use of CT information and to make accurate 3-dimensional treatment planning programs.     

An autopsy case of pancreatic cancer with poor performance status due to peritonitis carcinomatosa treated successfully with continuous infusion of low-dose 5-FU with octreotide

A 60-year-old man with pancreatic cancer was admitted due to massive ascites in the course of gemcitabine treatment. Cachexic condition progressed due to peritonitis carcinomatosa. Continuous infusion of low dose 5-FU with octreotide was carefully started. Almost all of ascites disappeared after 4 courses of treatment and his general condition markedly improved. This patient died of pneumonia about 13 months after diagnosis of peritonitis carcinomatosa. Autopsy was undergone, and the effect of chemotherapy was confirmed.     

Apoptosis of eosinophils and lymphocytes in allergic inflammation.

A characteristic feature of apoptosis is that the cellular contents that are biologically active are always surrounded by the cell membrane throughout the entire process. Thus the apoptotic cells are eliminated calmly and quickly without evoking inflammation. In allergic inflammation activated eosinophils and lymphocytes have been known to accumulate at the site of inflammation at least in part because of their prolonged survival. Corticosteroids are the most potent anti-inflammatory agent used for treating asthma. They inhibit the prolonged survival of eosinophils and lymphocytes directly by inducing apoptosis and indirectly by suppressing the release of cytokines supporting their survival. Theophylline, a classical bronchodilator, has been reported to have anti-inflammatory effects. Surprisingly, theophylline inhibited the prolonged survival of eosinophils in the presence of IL-5 in vitro by means of induction of apoptosis. Lymphocytes also undergo apoptosis in the presence of theophylline. One of the mechanisms for theophylline to induce apoptosis in eosinophils and lymphocytes is to elevate intracellular cyclic adenosine monophosphate because phosphodiesterase inhibitors and adenylate cyclase activators, which increase intracellular cyclic adenosine monophosphate, can cause apoptosis in those cells. Induction of apoptosis is beneficial in allergic inflammation, and the use of corticosteroids and theophylline in combination may be appropriate to induce apoptosis in eosinophils and lymphocytes.