Direct hemoperfusion under infrahepatic inferior vena caval isolation for the Intraarterial Chemotherapy of Pelvic Tumors

A new simple technique consisting of direct hemoperfusion under infrahepatic inferior vena caval isolation for intraarterial chemotherapy of pelvic tumors is herein described. The inferior vena cava is occluded at the infrahepatic level by means of balloon inflation using a balloontipped catheter (16F), which is placed through the right greater saphenous vein. The isolated infrahepatic vena caval blood is withdrawn by a centrifugal pump through a catheter (16F) in the contralateral greater saphenous vein and is filtered by direct hemoperfusion during intraarterial infusion of anticancer drugs. Venous reentry is provided by the central lumen of the balloon-tipped catheter. This procedure was used sequentially on two different occasions to treat a patient with an extensive pelvic tumor. Good hemodynamic stability and a reduction of the systemic drug toxicities were confirmed in both trials. Therefore, we believe that this technique is technically feasible and highly effective in reducing systemic toxicities during high-dose intraarterial chemotherapy for pelvic tumors.     

An epidemiological study of lung cancer among workers exposed to bis(chloromethyl)ether

An epidemiological study of lung cancer was carried out in two dyestuff factories (Factory K and U), where bis (chloromethyl) ether, BCME, was manufactured and used in the initial process of dyestuff production in Wakayama Prefecture, Japan. BCME was used from 1955 to 1970 in Factory K, and from 1960 to 1968 in Factory U. Subjects were 35 men who had been exposed to BCME in each factory. In this study 13 lung cancer cases were found (including 5 cases reported by Sakabe (Ind Health 1973]. The main results obtained were as follows: 1) The exposure period of 13 lung cancer cases to BCME was 86.9 +/- 34.9 months (mean +/- SD) and the latent period was 13.5 +/- 6.6 yr. The age at death was 46.1 +/- 9.5 yr and 7 cases died between the age of 40 and 49. 2) The initial symptoms of lung cancer due to BCME were not different from those of non-occupational lung cancer. The identified histological types of eight cancer cases were small cell carcinoma in 5 cases, adenocarcinoma in 3 cases and large cell carcinoma in the remaining case. 3) Standardized mortality ratio (SMR) was 23.5 at Factory K and 17.9 at Factory U. An excess death due to lung cancer among workers exposed to BCME was observed. 4) The shortest exposure period of the 13 lung cancer cases was only 23 months and therefore workers who had been exposed to BCME for under 3 yr must be examined for lung cancer periodically.     

Further structural analysis of urinary metabolites of suprofen in the rat

The urinary metabolites of 2-(4-(2-thienylcarbonyl)phenyl)propionic acid (suprofen, S) in rats were analyzed by radio-GC, GC/MS, or 1H NMR technique. Radio-GC analysis of trimethylsilylated materials after TLC separation of intact urine showed the presence of three radioactive peaks with the retention times corresponding to the authentic S, 2-(4-(2-thienylhydroxymethyl)phenyl)propionic acid, and 2-(4-carboxyphenyl)propionic acid. About 40% of the total radioactivity appearing in the 0-24-hr urine was accounted for by the three metabolites and their conjugates. The identification of these metabolites was confirmed by comparison of the MS spectra of urine, in which rats were administered an equimolar mixture of S and S[phenyl-d4], with those of synthetic standards. The labile metabolites of S, corresponding to about 32% of the total radioactivity appearing in the 0-24-hr urine, were isolated and purified by ether extraction from the fresh urine and GC/MS or HPLC. GC/MS of the methylated metabolite revealed the consistent presence of the ion peaks at m/z 304, 245, 217, and 141, indicative of a dimethylated product with monohydroxy group on the thiophene ring. Analysis of the 1H NMR spectrum demonstrated the metabolite to be 2-(4-(5-hydroxy-2-thienylcarbonyl)phenyl)propionic acid.     

Clinical statistics on inpatients and operations at the Department of Urology, the Center for Adult Diseases, Osaka, 1984-1988

Statistical observation on inpatients and operations at our department between January 1984 and December 1988 revealed the following results: 1) The total number of inpatients was 1962 (male: 1658, female: 304). The most frequent diseases were bladder cancer (30.0%), benign prostatic hypertrophy (19.2%), prostatic cancer (10.6%) and renal cancer (6.7%). 2) The total number of operations was 1699. The most frequent operations were transurethral resection (TUR) of bladder tumor (22.8%), TUR prostate (20.7%), TUR biopsy (6.5%) and total cystectomy (5.4%).     

Transcatheter arterial embolization for metastatic liver tumors: A study in resected cases

We evaluated histologically the effect of transcatheter arterial embolization (TAE) in five metastatic liver tumors from gastrointestinal cancer, which were resected at surgery or removed at autopsy after TAE. TAE was carried out with cubes of gelatin sponge; in 2 cases, iodized oil was used as peripheral embolic material. Histological examination revealed three tumors to be completely necrotized. Approximately 80% of the remaining two tumors were necrotic. Our data suggest that TAE holds promised in the treatment of metastatic liver tumor from gastrointestinal cancer.     

Comparative double-blind trial of KN-7 tablet and Robaveron injection in the treatment of neurogenic bladder

The clinical effectiveness, safety and usefulness of KN-7 tablet as a new oral application of the prostatic extract, on urinary dysfunction of neurogenic bladder were compared with those of Robaveron injection by the double-blind test method. In the study, 2 tablets t.i.d. and a shot of intramuscular injection 1 ml a day were given successively for 3 weeks. A total of 233 cases were reported from 37 facilities belonging to the KN-7 Clinical Research Group. Some of them were excluded or dropped out. The number of cases used for analysing the effectiveness, safety and usefulness were 214, 232 and 215, respectively. There was no bias between the two groups with a significant homogeneity in the background. In the overall clinical effectiveness, the effective rate including excellent, moderate and slightly effective was 76.9% with KN-7 and 77.4% with Robaveron. In the clinical usefulness, the rate of usefulness of slightly useful or above was 75.0% with KN-7 and 75.7% with Robaveron. There was no significant difference between the two groups in the clinical effective and useful rates at a significant level of 5%. Side effects were observed in 1 of the 114 (0.9%) patients given KN-7 and 8 of the 118 (6.8%) patients given Robaveron. The incidence of adverse reactions with KN-7 was significantly lower than that with Robaveron. Based on the results, it was concluded that KN-7 tablets, 2 tablets t.i.d., would be as effective and useful as a Robaveron injection 1 ml daily and safer than the latter in the treatment of neurogenic bladder.     

Pancreatic pseudocyst hemorrhage controlled by transcatheter embolization

This case of massive duodenal hemorrhage through the pancreatic pseudocyst, caused by rupture of a pseudoaneurysm of the gastroduodenal artery, was successfully controlled by transcatheter embolization. Embolization is a useful alternative to surgery in high-risk patients.