Metastasis of hepatocellular carcinoma to the supramaxillary gingiva and right ventricle

We describe a rare double metastasis of hepatocellular carcinoma to the supramaxillary gingiva and papillary muscle of the right ventricle. The patient was a 72-year-old woman who underwent three sessions of transcatheter arterial embolization for the primary lesions. Control of bleeding from the supramaxillary gingival metastasis was difficult by conservative treatment such as compression with gauze soaked in epinephrine. Therefore, radiotherapy was performed, but it failed to control the bleeding. The patient subsequently died due to hepatic failure. Autopsy revealed metastases of hepatocellular carcinoma to the papillary muscle of the right ventricle and paraaortic lymph node in the abdomen in addition to the supramaxillary gingival metastasis. Histopathological examination showed moderately differentiated hepatocellular carcinoma of both the primary site and metastatic sites to the gingiva and the heart and poorly differentiated in the paraaortic lymph node.     

The Effect of Biliary Pressure on Antibiotic Excretion into Bile

Abstract: Biliary obstruction has been recognized to inhibit excretion of antibiotics into bile. In the present study, using cefpirome sulfate (CPR), we sought to determine the effect of biliary pressure on antibiotic transfer into bile in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP). Thirty-six patients with a variety of biliopancreatic diseases (free of renal disease or hypoproteinemia) received a single intravenous dose of CPR (1 g) prior to ERCP. Under fluoroscopy a diagnostic catheter with a metal ball tip was advanced into the middle portion of the extrahepatic bile duct or, in cases of common bile duct obstruction, above the obstruction. Biliary pressure was measured via the same catheter using duodenal pressure as a reference. Subsequently, bile was aspirated, and blood was withdrawn simultaneously. The mean interval between CPR administration and the bile and blood samplings was 67±12 minutes. The bile CPR concentration and the bile/serum ratio of CPR concentrations showed a significant inverse correlation with biliary pressure, but the serum CPR concentration did not. The bile CPR concentration and the bile/serum ratio of CPR concentrations differed significantly between the group with normal biliary pressures, below 10 mmHg, and that with biliary pressures exceeding 10 mmHg. The serum CPR concentrations of the two groups were similar. These results suggest that biliary pressure plays an important role in determining antibiotic transfer into bile.     

Characteristics of antagonism between ceruletide and various central-acting drugs: investigation by means of ambulatory activity in mice

Behavioral characteristics of ceruletide, a cholecystokinin-like decapeptide, were investigated by means of ambulatory activity in mice. Ceruletide at 100 and 300 micrograms/kg, i.p. slightly but significantly decreased the mouse's activity for 20 min. Therefore, 100 micrograms/kg of ceruletide was used in the experiment of combined administration with the central-acting drugs. Ceruletide reduced the increased activity which was produced by methamphetamine (2 mg/kg, s.c.), ephedrine (80 mg/kg, i.p.), methylphenidate (4 mg/kg, s.c.), cocaine (20 mg/kg, s.c.), mazindol (2.5 mg/kg, s.c.), apomorphine (0.5 mg/kg, s.c.), bromocriptine (8 mg/kg, i.p.), scopolamine (0.5 mg/kg, s.c.), caffeine (10 mg/kg, s.c.) and morphine (20 mg/kg, s.c.) with different potencies and durations. The mice that had experienced ceruletide at 3 micrograms/kg for 5 times at intervals of 3-4 days demonstrated a significant increase in the sensitivity to methamphetamine, although the same treatment with 10-300 micrograms/kg of ceruletide was without effect. On the other hand, when 3-300 micrograms/kg of ceruletide was combined with 2 mg/kg of methamphetamine, the development of reverse tolerance to the ambulation-increasing effect of methamphetamine was inhibited dependently on the doses of ceruletide. However, the reverse tolerance to methamphetamine once established was scarcely modified by ceruletide when it was administered afterwards.     

A study of insulin and glucagon secretion from adult rat pancreatic monolayer islets

The present study confirms and extends previous observations that whole pancreatic islets form a monolayer culture in vitro. Our technique, using a medium containing 3-isobutyl-1-methylxanthine (IBMX), clearly demonstrated enzymatic disruption of the islets and cellular organization of isolated pancreatic islets. Insulin or glucagon secretion of monolayer culture was measured during incubation in a medium containing 5.5 mM D-glucose, then in 16.7 mM D-glucose, and finally in a combination of 16.7 mM D-glucose and IBMX, or of low glucose and 20 mM L-arginine. Clearly, such a technique might permit the recovery of collagenase-isolated pancreatic islets during the culture period and also an increase in glucose-induced insulin secretion and arginine stimulated glucagon secretion.     

Social support and individual styles of coping in the Japanese workplace: an occupational stress model by structural equation analysis

The aim of the present study was to ascertain the role of social support and individual styles of coping on employee well‐being. The subjects were intermediate managers working for a zipper and sash manufacturing company in Japan. Measurements were made of the following: depression using the Self‐rating Depression Scale (SDS), job demand, job control, social support using Karasek's Job Content Questionnaire, and of three coping styles: emotion‐oriented coping, task‐oriented coping and avoidance‐oriented coping using the Coping Inventory for Stressful Situations (CISS). Data was analysed by structural equation modeling. Each coping style had a direct effect on depression. Emotion‐oriented coping had a negative effect. On the other hand, task‐oriented coping and avoidance‐oriented coping had a positive effect. Moreover, there was an indirect effect that coping styles precede and determine the perception of social support as well as job demand and control. Social support showed a direct positive effect on depression. However, the overall impact on employee well‐being was greater for individual coping styles as compared to social support from either supervisors or co‐workers. The present study showed the effectiveness of coping strategies in the workplace. Copyright © 2003 John Wiley & Sons, Ltd.     

Active Specific Chemoimmunotherapy of Lymph-node Metastasis from a Poorly Immunogenic Murine Fibrosarcoma

The fibrosarcoma MCA-SP, which was recently induced with methylcholanthrene (MCA) in C3H/ HeJ mice, displays poor immunogenicity in in vivo prophylaxis. A cell variant MCA-SPN1, which bears a tumor-specific transplantation antigen (TSTA) cross-reactive with the parental line MCA-SP, was selected because of its proclivity for axillary lymph-node metastases. Although these lymph-node metastases were resistant to sinecomitant (post-excisional) immunity, they were susceptible to combined active and passive specific Chemoimmunotherapy, using tumor-specific, 1-butanol-extracted, preparative isoelectric focusing-purified, TSTA (1 fig weekly sc injections), cyclophosphamide (CY, a single intraperitoneal 20 mg/kg dose), and adoptive transfer of immune splenic T lymphocytes, which had been re-stimulated in vitro with extracted TSTA and interleukin-2. This triple regimen both reduced the incidence of spontaneous lymph-node metastases, and prolonged the survival of tumor-bearing, as well as tumor-resected hosts. The results from local adoptive transfer assay using T-lymphocyte snbpopulations of spleen and lymph nodes in these treated hosts suggested that Lyt 2⁺ cytotoxic T-lymphocytes (CTL) mediated in vivo tumor-neutralization. Thus TSTA/CY/CTL therapy activates tumoricidal host responses effective against the poorly immunogenic MCA-SP tumor and its lymph-node metastases.     

Frequency of criteria-defined borderline patients among the first-visit patients at a psychiatric clinic

Five trained psychiatrists evaluated 330 first-visit patients aged from 12 to 30 at a psychiatric outpatient facility using the DSM-III criteria (Axis-I and Axis-II). Seven cases were diagnosed as definite Borderline Personality Disorder and six cases as definite Schizotypal Personality Disorder. Hence, we had a total of 13 criteria-defined borderline patients (3.9%). Discussions were held on some methodological problems involved in collecting information and making diagnostic judgments.     

Four new macrocyclic trichothecenes from two strains of marine-derived fungi of the genus Myrothecium

Three new macrocyclic trichothecenes, named 12'-hydroxyroridin E (1), roridin Q (2), and 2',3'deoxyroritoxin D (3), were isolated from the marine-derived fungus Myrothecium roridum TUF 98F42, and a new macrocyclic trichothecene, named roridin R (4), was isolated from Myrothecium sp. TUF 02F6 together with roridins A and H and isororidin E. The structures of new compounds were determined on the basis of their spectral data. Compound 2 possessed a unique ether moiety at the 13' position of 1. Compound 4 was a 2',3'-dihydro-2'-hydroxy derivative of roridin H. The IC50 values of compounds 1, 2, and 4 against the murine leukemia cell line L1210 were 0.19, 31.2, and 0.45 microM, respectively. Compound 3 showed antiyeast activity to Saccharomyces cerevisiae at 1 microg/disc (inhibition zone: 12.2 mm), which was about 10 time more active than roritoxin D (10.2 mm at 10 microg/disc).     

Effect of oral health care program on the oral function of the elderly

In order to prepare a new prevention program under the long term care insurance from the fiscal year 2006, we have organized an oral health care program for the elderly in a town of Kagoshima prefecture. We conducted a series of oral health education, i.e., instruction on brushing and flossing, and oral function exercises. Before and after the three months program, we evaluated the unstimulated and stimulated salivary flow rate, the counts of S. mutans, the counts of repetitive saliva swallowing test (RSST), bilateral bite force and the number of permanent teeth and artificial teeth. According to the results, a statistically significant improvement was observed in RSST and the unstimulated and stimulated salivary flow rate, but not in the S. mutans level and bite force. The present research suggests the effectiveness of the oral health care program for the aged. A larger sized and longer period intervention will be necessary in order to validate our findings.     

Genetic background determines susceptibility to experimental immune-mediated blepharoconjunctivitis: comparison of Balb/c and C57BL/6 mice

Balb/c and C57BL/6 mice have been reported to be biased towards Th2 and Th1 immune responses, respectively. We investigated which strain is more susceptible to the development of experimental immune-mediated blepharoconjunctivitis (EC), which is predominantly mediated by Th2 immune responses. EC was induced by three different methods in Balb/c and C57BL/6 mice using ragweed (RW) as the antigen. The mice were thus either actively immunized with RW, passively immunized by transfer of RW-primed T cells, or passively immunized by transfer of RW-specific IgE, followed by RW challenge in eye drops. Twenty-four hours after the challenge, conjunctivas, sera and spleens were harvested for histological analysis, measurement of serum IgE and assessment of cellular immune responses, respectively. The responses of the Balb/c and C57BL/6 mice were compared. In addition, to assess the involvement of IFN-gamma in the development of EC in the two strains, IFN-gamma knockout (GKO) mice of the two strains were actively immunized and evaluated as above. Regardless of the method of induction, EC, as determined by the degree of eosinophil infiltration into the conjunctiva, was more severe in Balb/c mice than in C57BL/6 mice. Moreover, more IgE was produced by actively immunized Balb/c mice than C57BL/6 mice and RW-primed splenocytes from Balb/c mice produced more IL-4 but less IFN-gamma than those from C57BL/6 mice. EC could be induced in the GKO mice of both strains. However, when their EC was compared to that in WT mice, significantly less infiltration of eosinophils was noted in the Balb/c GKO mice. Taken together, Balb/c mice are more susceptible to EC than C57BL/6 mice and this higher susceptibility might be related to the Th2 immune response bias of Balb/c mice. Furthermore, the involvement of endogenous IFN-gamma in the development of EC in these two strains differs.