Effects of Gadolinium Chloride on the Rat Lung Following Intratracheal Instillation

The metabolic behavior, clearance, and pulmonary effects ofgadolinium (Gd), one of the rare earth elements, were investigatedafter single intratracheal instillation of gadolinium chloride(GdCl₃) in male Wistar rats. There was a dose-related increasein Gd content of lung tissue. Gd content in the supernatantof bronchoalveolar lavage fluid (BALF) did not exceed 5 µgGd/ BALF even at a dose of 100 µg Gd/rat. Gd in the lungtissue decreased very slowly with a biological half-life of136 days at a dose of 50 µg Gd/rat. On the other hand,Gd content in the super natant of BALF was not detectable after31 days. These results suggest that intratracheally instilledGd can be retained in epithelial lining fluid only to a limitedextent as soluble forms and is deposited in the lung tissueprobably in insoluble forms which are metabolized very slowly.Calcium (Ca) content in BALF increased more rapidly than othertoxicological indices such as lactate dehydrogenase activity,protein concentration, and inflammatory cell counts. In thelung tissue, levels of Ca in Gd-instilled groups did not differfrom the control value. Although these data suggest that theorigin of Ca may be blood plasma, biological and/or toxicologicalsignificance of increased Ca is not known. The number of neutrophilsreached the maximum at 12 hr after instillation, indicatingthat Gd has the potency to cause acute lung toxicity. Summarizingthe observation, Gd instilled intratracheally into rats wasdeposited in the lung tissue in nonsoluble forms with an extremelylong half-life, while the metal caused a rapid and selectiveinfiltration of serum Ca before acute lung toxicity.     

Severe chronic active giftein-Barr virus infection accompanied by virus-associated hemophagocytic syndrome,cerebellar ataxia and encephalitis

We present a rare case of chronic active giftein-Barr virus (EBV) infection showing various clinical outcomes. A 26-year-old man was admitted to our hospital due to persistent fever and dyspnea. Serologic response of the patient to EBV indicated chronic active infection. He showed pleuritis, parotitis, chronic hepatic dysfunction, disseminated intravascular coagulation, virus associated hemophaghocytic syndrome, acute rhabdomyolysis, acute renal failure, acute cerebellar ataxia, encephalitis and multiple brain abscesses. None of acyclovir, gancyclovir, prednisolone or interleukin-2 was effectual to abolish those abnormalities. This is the first report of transient cerebellar ataxia which aggravated to panencephalitis associated with chronic EBV infection.     

Selective effector mechanisms for the expulsion of intestinal helminths

In the middle of the era of molecular biology, much less attention is paid to in vivo phenomena. However, carefully designed experimental systems in vivo still can provide valuable information as to the mechanisms underlying the establishment and maintenance of host-parasite relationships. In this review we describe the advantage of using concurrent infections with appropriately chosen combinations of different genera or different maturation stages of parasites to segregate the cellular responses of the host. By means of simple experimental approaches we have found that mucosal mast cells and goblet cells, both of which have long been considered as non-specific effectors, are in fact highly selective and specific effector cells of the host defence mechanisms capable of acting on the establishment and the expulsion of intestinal helminths.     

Percutaneous ethanol injection for the treatment of small hepatocellular carcinoma. Study of 95 patients

Percutaneous ethanol injection (PEI) was applied to 120 lesions in 95 patients with hepatocellular carcinomas (HCC) smaller than 3 cm in the past 6 years. All main target tumours, in 67 patients who had been followed by sonography for more than 6 months after PEI, decreased in size; 28 tumours (41.8%) became undetectable and have remained so until now. The 1-, 2-, 3-, 4- and 5-year survival rates calculated by the Kaplan-Meier method were 93%, 81%, 65%, 52% and 28% respectively. These survival rates were better than those of patients with HCC smaller than 3 cm who did not receive anticancer treatment (P less than 0.01). The survival of patients of the Child's A or Child's B status was better than that of those with Child's C disease. Recurrence occurred in areas within the liver different from the original lesion in 34% in one year, 61% in two years and 66% in three years after PEI. PEI was then repeated in 61% of such patients.     

EXPRESSION OF ENDOTHELIN-1 IN PANCREATIC TISSUE OF PATIENTS WITH CHRONIC PANCREATITIS

Chronic pancreatitis is characterized by the presence of an inflammatory infiltrate, progressive destruction of acinar cells, and fibrosis. The finding that endothelin-1, an endothelium-derived peptide with vasoconstrictive and mitogenic properties, reduces pancreatic blood flow in normal rats suggested that the peptide may be associated with the reduced pancreatic flow seen in animal models of chronic pancreatitis and in the morphological abnormalities of the disease. The aim of this study was to investigate sites of endothelin-1 expression in the pancreas of normal subjects and patients with chronic pancreatitis. The techniques of immunohistochemistry, in situ hybridization, and Northern blotting were used. Endothelin-1-like immunoreactivity was localized predominantly to islet cells both in normal subjects and in patients with chronic pancreatitis. Semi-quantitative analyses of immunostaining showed that endothelin-1-like immunoreactivity in islet cells of patients with chronic pancreatitis was greater than in normal subjects. Co-localization studies with glucagon, insulin, somatostatin, and pancreatic polypeptide showed that endothelin-1-like immunoreactivity co-exists with glucagon and insulin. There was no apparent co-existence of endothelin-1-like immunoreactivity with somatostatin or pancreatic polypeptide. Endothelin-1 mRNA was expressed in sites similar to those of the immunostaining, as well as in vascular endothelial cells. Northern blot analysis showed an increase in the expression of endothelin-1 mRNA in the patient population. There was a significant correlation between intensity of endothelin-1 immunostaining and severity of fibrosis in the patients with chronic pancreatitis. These findings suggest that an elevation in local expression of endothelin-1 may be associated with the morphological and haemodynamic changes of chronic pancreatitis.     

Development of Computer Systems for Radiotherapy of Cancer

Trend of development of the computer system in the radiotherapyis presented in this paper. The real time treatement planningsystem is especially emphasized in the discussion. The systemdeveloped in National Cancer Center Hospital, using both theanalog and digital computers is introduced in detail. The automationof radiotherapy has been remarkably promoted by this research. In the future, the study will be directed to automatic controlboth in planning and in treatment which ill contribute to thebetterment of treatment result of radiotherapy.     

Interstitial tumour cell invasion in small hepatocellular carcinoma. Evaluation in microscopic and low magnification views

In order to study the process of hepatocellular carcinoma (HCC) development, and to search for a clue to histologic diagnosis of well-differentiated HCC (wd-HCC), interstitial invasion in small HCC was evaluated. The study material consisted of 35 cases of HCC that were smaller than 3 cm that comprised 17 cases of wd-HCC, 18 cases of moderately or poorly differentiated classical HCC (cl-HCC), and 20 cases of large regenerative nodules (LRN). Interstitial invasion was microscopically classified into three patterns: (i) crossing type, in which HCC was invading across fibrous septa of tumour nodules; (ii) longitudinal type, in which tumour cells were growing longitudinally within fibrous septa; and (iii) irregular type, in which the portal area was irregularly invaded by HCC. The crossing type was found in two cases (12%) of wd-HCC and 10 cases (56%) of cl-HCC while the longitudinal type was observed in 16 cases (94%) of wd-HCC and eight cases (44%) of cl-HCC. The irregular type was frequently seen in wd-HCC (15 cases, 88%), and cl-HCC (12 cases, 67%). No interstitial invasion was observed in LRN. Interstitial invasion could be recognized even in the low magnification view of histological specimens, with a detection rate of 59% (10 cases) in wd-HCC and 72% (13 cases) in cl-HCC. These results suggest that evaluation of interstitial invasion is useful in diagnosing wd-HCC independent of cellular atypia. In addition, such invasive growth is revealed to play an important role in destroying original hepatic architecture during its developmental process from the early to advanced stages.     

Reliability of the task-related component (P3b) of P3 event-related potentials

Abstract Within session and between session reliabilities of the task-related component (P3b) of the P3 measures (amplitude, area and latency) and their habituation across eight sessions separated by 7–10 days, except for an interval of 1 month between the 6th and 7th sessions, were studied based on the difference waves, which were obtained by subtracting the ignored infrequent event-related potentials (ERP) from the target ERP elicited by a standard auditory oddball paradigm with eyes-open or eyes-closed conditions in 10 normal subjects. The within session reliabilities represented as Pearson correlation coefficients ( r ) were 0.57-0.66 for the three measures except for those for the latency and amplitude under the eyes-closed condition. The between session reliabilities expressed as intraclass correlation coefficients ( R ) ranged from 0.54 to 0.60 except for that for latency under eyes-closed conditions. Long-term habituation occurred within the first six sessions for the P3b amplitude and area, and dishabituation took place in the 7th session after an interval of 1 month, whereas no such phenomenon was observed for the P3b latency. Implications of the present results are discussed in terms of the clinical application of the P3 measures.     

Results of Radiotherapy in the National Cancer Center Hospital--Second Report of the National Cancer Center Radiotherapy Computer System

Results of radiotherapy in the National Cancer Center Hospitalduring 1962–1970 were analysed by using the National CancerCenter Radiotherapy Computer System which had been developedby the authors. More than a half of the total cancer cases treatedin the hospital were given some kind of radiotherapy. The overallfive-year survival rate of radiotherapy cases corrected witha life table method were 38.4% for total cases, 44.6% for radicallytreated cases and 14.6% for palliatively treated cases. Combinedtreatment by radiation and surgery showed better results suchas 48.3% for preoperative and 57.8% for postoperative radiotherapycases. The following factors were analysed in terms of the five-yearsurvival rate: age, sex, stage, histology and double-primarycancer. In general, female cases showed much better prognosis than thatof male cases. Five-year survival rate showed its peak at 30–40years of age and was low at lower or higher ages. Inverse correlationshipsby age were observed between the incidence of cancer and thesurvival rate after treatment, and the value of correlationcoefficient was larger in males and smaller in females. The age dependency of incidence and prognosis of cancer stronglysuggested the important role of host resistance in the treatmentand prevention of cancer. ^*Present address: National Institute of Radiological SciencesChiba ^**Present address: Chiba Cancer Center Hospital hiba     

Hand-assisted retroperitoneoscopic radical nephrectomy: Initial experience

OBJECTIVES: To report our initial experience of hand-assisted retroperitoneoscopic radical nephrectomy for stage T1 renal tumors. METHODS: The clinical data on 22 consecutive patients who had undergone hand-assisted retroperitoneoscopic radical nephrectomy and 22 who had undergone open radical nephrectomy were reviewed. The operation was performed with a hand placed retroperitoneally through a pararectal longitudal 7-7.5 cm incision using a LAP DISC. RESULTS: The total operating time was between 2.3 and 5.8 h (mean: 3.4 h). The estimated blood loss was between 15 and 650 mL (mean: 170 mL). The complication rate was 9% (2/22). No conversions to open procedure occurred. In comparison to open radical nephrectomy, the operating time was similar (3.4 vs 3.9 h) whereas the estimated blood loss was significantly less in this procedure (170 vs 495 mL). During the convalescence period the patients revealed significantly less postoperative pain, shorter intervals to resuming oral intake and more rapid return to normal activities compared to the open radical nephrectomy patients. CONCLUSION: Hand-assisted retroperitoneoscopic radical nephrectomy is an effective and safe procedure for T1 renal tumors.