Significance of immunosuppressive acidic protein in the diagnosis and follow-up of patients with ovarian cancer, in particular as a marker for chemotherapeutic effects

Serum immunosuppressive acidic protein (IAP) was determined in patients with ovarian cancer and was examined as a marker for ovarian cancer when, chemotherapy in particular, was applied. Samples were sera obtained from 68 ovarian cancers, 74 benign ovarian tumors, 54 cervical cancers, 57 uterine myomas and 88 healthy controls. Elevated levels of IAP were found in 89.5% of patients with ovarian cancer and this high positive ratio was not affected by tumor histologic features. The measurement of the serum IAP level is useful for the initial diagnosis of ovarian cancer because of low false positive rates (8.1%) in benign ovarian tumors and high positive rates even in the early stage of ovarian cancer. Serial determinations of serum IAP levels were well correlated with the response to the treatment (chemotherapy in particular) and the prognosis of cancer patients, even in the case of patients with leucocytopenia induced by the intensive chemotherapy. In case of recurrent patients (whose lesions were observed in the intraperitoneal space), IAP values tended to increase earlier than other conventional tumor-derived markers. Therefore, IAP may also be a useful follow-up marker for patients with ovarian cancer (particularly, for the early detection of recurrence).     

Clinical significance of sialic acid determinations in patients with gynecologic cancer

Sialic acid (SA) levels were measured in human sera by the enzymatic procedure using neuraminidase. Sera were obtained from healthy controls (70 females), patients with uterine myoma (27 cases), cervical cancer (53 cases), benign ovarian tumor (36 cases) and ovarian cancer (70 cases). The upper normal limit of 72mg/dl was obtained from the mean +2SD for healthy controls. The mean value for serum SA in patients with primary ovarian cancer (71.2 +/- 20.6mg/dl) was statistically higher than those for both uterine myomas (59.0 +/- 12.4mg/dl) and controls. The mean level for SA in patients with ovarian cancer was further elevated and it was statistically higher than that for benign ovarian tumors (58.8 +/- 14.3mg/dl), uterine myomas and cervical cancers. SA levels were not well correlated with tumor histologic types or clinical stages of cancer patients. As to the relationship between SA and the clinical course of cancer patients, changes in SA values were well correlated with the curability of tumor resection. The lack of specificity, however, will require careful interpretation of the SA value to assure that inflammation is not causing changes in the test values, because SA shows a transient increase due to the inflammatory reaction during the postoperative period even in patients with benign tumor. These results indicate that SA determination is highly recommended as an addition to the conventional diagnostic methods.     

Tumor Necrosis Factor-α Mediates the Blood–Brain Barrier Dysfunction Induced by Activated Microglia in Mouse Brain Microvascular Endothelial Cells

The present study was designed to elucidate the involvement of tumor necrosis factor-α (TNF-α) release from activated microglia in the induction of blood–brain barrier (BBB) dysfunction in an in vitro co-culture system with mouse brain capillary endothelial cells (MBEC4) and microglia. Lipopolysaccharide (LPS)–activated microglia increased the permeability of MBEC4 cells to sodium-fluorescein, and this hyper-permeability was blocked by a neutralizing antibody against TNF-α. LPS stimulated microglia to facilitate TNF-α release. These findings suggested that TNF-α released from activated microglia is attributable to BBB dysfunction.     

Association of Estimated Salt and Miso Intake with the Prevalence of Obesity in People with Type 2 Diabetes: A Cross-Sectional Study

Salt intake is often estimated by the amount of sodium excreted in urine, and miso has been reported to increase it. This cross-sectional study investigated the relationship between obesity and high estimated salt intake with and without habitual miso consumption. Estimates of salt intake (g/day) were calculated using urinary sodium excretion, and a high estimated intake was defined as greater than the median amount of 9.5 g/day. Participants were divided into four groups based on estimated salt intake and miso consumption. Among 300 people, the proportions of obesity were 77.8% (n = 14/18), 40.2% (n = 53/132), 26.0% (n = 33/127), and 34.8% (n = 8/23) in the (+/−), (+/+), (−/+), and (−/−) groups of high estimated salt intake/habitual miso consumption, respectively. Compared with the (+/−) group, the adjusted odds ratios for obesity were 0.07 (95% confidence interval (CI): 0.02–0.26, p < 0.001), 0.16 (95% CI: 0.03–0.76, p = 0.022), and 0.14 (95% CI: 0.04–0.51, p = 0.003) in the (−/+), (−/−), and (+/+) groups, respectively. The presence of obesity was not much higher in people with high estimated salt intake with habitual miso consumption than that in people without. Clinicians should be aware that miso consumption promotes salt excretion, which may lead to an apparently higher estimated salt intake than actual.     

Examination of dynamic body balance using the body tracking test in cases of vestibular neuronitis

Body Tracking Test (BTT) is a testing method of the dynamic body balance function wherein movement of the center of gravity in accordance with a moving visual target stimulus is examined to evaluate the tracking function of the body. The objects were the patients who were diagnosed as having vestibular neuronitis at the Department of Otolaryngology in Toho University medical center Sakura hospital, and were undergoing hospital treatment. Lateral BTT was performed in 31 subjects, and antero-posterior (A-P) BTT in 45 subjects. Although gaze nystagmus was noted, inspection was enforced when a standing position posture was possible. In lateral BTT, the average (cm/second) horizontal direction body sway speed was compared, however, no clear lateral difference was noted. In the antero-posterior (A-P) BTT, it inquired using the direction body sway average center displacement (cm) of X. Deviation was seen by the affected side in stabilometry. Deviation was seen by the unaffected side in the antero-posterior (A-P) BTT. This phenomenon differs from the deviation pattern until now and is considered to involve participation of the higher centers.     

Consecutive intra-arterial infusion of cis-diamminedichloroplatinum with continuous intra-arterial infusion of 5-fluorouracil in locally advanced ovarian cancer

Consecutive intraarterial infusion of cis-diamminedichloroplatinum (CDDP) with continuous intraarterial infusion of 5-fluorouracil (5-FU) (250 mg/day) was administered to 10 patients with locally advanced (peritonitis carcinomatosa) ovarian cancer. The dose of CDDP was 10 mg/5 min/body/day and it was administered for about 10-20 consecutive days per one course. Each course was repeated at about 3-week intervals. The main dose-limiting factor was the number of peripheral leucocytes. The results were 6 PR, 1 MR and 2 NC out of 9 evaluable cases, all of whom had had previous therapy. The antitumor effect needed over 200 mg of intraarterial CDDP and the response lasted from 2 to more than 9 months. Among 6 patients who obtained PR, 4 had failed to respond to intravenous or intraperitoneal infusion of CDDP, which suggested that a high concentration and a critical drug gradient across the tumor cell membrane were more essential for a significant tumor cell kill, with CDDP, than the time of exposure. The toxic effects of intraarterial infusion of CDDP were almost absent as compared with those of intravenous infusion, which consisted of nausea and vomiting. Renal dysfunction was also mild. Other toxic effects were not different from those observed in intravenous infusion. Our results with intraarterial infusion of CDDP clearly indicate that this approach can deliver a high therapeutic efficacy in patients with advanced ovarian cancer with markedly less toxic effects.     

Evaluation of the immune function assay in pediatric living donor liver transplantation

The immune function (ImmuKnow) assay is a measure of cell‐mediated immunity based on the peripheral CD4+ T cell ATP activity. The efficacy of ImmuKnow in pediatric LDLT is not well documented. The aim of this study was to assess the correlations between the ImmuKnow and the clinical status in pediatric LDLT recipients. A total of 716 blood samples were obtained from 60 pediatric LDLT recipients (one month to 16 yr of age). The recipient's status was classified as follows: stable, infection, or rejection. The ImmuKnow values in the pediatric LDLT recipients with a clinically stable status had a lower immune response (IQR 85–297 ATP ng/mL) than that previously reported in adults. Meanwhile, the ImmuKnow values of the stable patients were not correlated with age. Furthermore, a significant difference was found in the ImmuKnow values between the bacterial or fungal infection and stable groups, but not between the CMV or EBV infection and stable groups. The ImmuKnow levels in the pediatric LDLT were lower than those observed in the adult LDLT. The proposed reference value is between 85 and 297 ATP ng/mL in pediatric LDLT recipients. We conclude that the ImmuKnow assay could be helpful for monitoring pediatric LDLT recipients with bacterial or fungal infections.