Immunoregulatory Factor Released From a Cell Line Derived From Human Decidual Tissue

ABSTRACT: The culture supernatant of the TTK-1 cell line, established from human decidual tissue, was found to contain a factor that strongly suppressed the mixed lymphocyte reaction (MLR). The mechanism of the MLR-suppressive activity as well as the biochemical characterization of this factor was analyzed. The TTK-1 supernatant suppressed the MLR much more strongly than the culture supernatants of the three other malignant cell lines examined. The molecular weight of this factor was estimated to be between 43 kilodaltons (kd) and 67 kd by gel filtration chromatography. The TTK-1 supernatant also suppressed the proliferation of the interleukin 2 (IL-2)-dependent T cell lines, but did not suppress that of the IL-2-independent T cell lines, suggesting that the TTK-1 supernatant inhibited the action of IL-2 and subsequently suppressed the MLR. The fact that the TTK-1 cell line originated from human decidual tissue might imply the important role of this factor in immunological fetomaternal balance.     

Complete response, as determined by prostate-specific antigen level, to chlormadinone acetate withdrawal persisting longer than 2 years in patients with advanced prostate cancer: Two case reports

Antiandrogen withdrawal syndrome (AWS) is a well-established phenomenon in prostate cancer. However, responses to AWS are usually of limited duration, and a complete response (CR) is extremely rare. We present two patients who exhibited a chemical CR for more than 2 years after the discontinuation of steroidal antiandrogen chlormadinone acetate use. Whether patients who respond to antiandrogen withdrawal include a group of patients with a better prognosis remains uncertain. However, considering that the usual survival period of patients with hormone-resistant prostate cancer is approximately 12 months, both of the patients reported here, who are present in excellent physical condition, exhibiting an improved quality of life, and attending their hospital as outpatients, obviously acquired a prolonged survival because of AWS.     

Incidence and growth pattern of simple cysts of the kidney in patients with asymptomatic microscopic hematuria

BACKGROUND: We examined the incidence and natural history of simple renal cysts found by ultrasonography (US) in patients referred for asymptomatic microscopic hematuria. METHODS: Among the 906 patients aged 18-78 years, 743 patients who had undergone US were included in the present study. The natural history of simple renal cysts was investigated in 55 patients who underwent periodical US examinations for more than 3 years. RESULTS: The incidence of simple renal cysts was 4.3% for ages 29 years or younger, 15.3% for ages 30-39, 21.8% for ages 40-49, 23.3% for ages 50-59 and 32.6% for ages 60 years or older; thus the incidence increased in older age groups (P = 0.0005 for men, P = 0.0020 for women). Men tended to have a higher incidence than women. The degree of hematuria did not influence the incidence of renal cysts (P = 0.9044). The annual growth rate of the mean maximum diameter was 4.2% during a 3-year follow-up period in 55 patients and 5.1% during a 6-year follow-up in 31 patients. CONCLUSION: Since the diameter of a renal cyst may increase by 5% annually, the diameter of the cyst may increase by 1.6 times in 10 years. The scheduling of follow-up examinations depends on the size at the time of disclosure, the effects on calyceal systems, or the suspicion of a concurrent malignant disease. However, the most simple renal cysts may be followed-up at an interval of more than 10 years, once a diagnosis has been established.     

Preparations,solution conformations and molecular structures of N,N′-ethylene-bridged dipeptides and their derivatives

The solution conformations of novel dipeptides, methyl (2S, 3′S)-3-methyl-2-(2′-oxo-3′-isopropyl-1′-piperazinyl)-butanoate (EVV-OCH₃), methyl (2S, 3′S)-3-phenyl-2-(2′-oxo-3′-benzyl-1′-piperazinyl) propionate (EFF-OCH₃), and their derivatives (Boc-Gly-EW-OH, Boc-Gly-EVV-Gly-OH, and Boc-Gly-EFF-OH), were studied by ‘H NMR measurements and molecular mechanics calculations (1). The molecular structures of Boc-Gly-EVV-OH, Boc-Gly-EFF-OH, and the hydrochloride of EVV-OCH₃ were determined by X-ray analyses. The conformations of the piperazinone rings and the side chains of these oligopeptides were clarified.     

EFFECTS OF MIDAZOLAM AND FLUNITRAZEPAM ON THE RELEASE OF DOPAMINE FROM RAT STRIATUM MEASURED BY IN VIVO MICRODIALYSIS

We have studied the effects of midazolam and flunitrazepam onextracellular concentrations of dopamine, 3,4-dihydroxypheny/aceticacid (DOPAC) and homovanillic acid (HVA) in rat striatum infreely moving animals using in vivo microdialysis. l.v. injectionsof midazolam 0.075 and 0.15 mg kg^*1 decreased striatal dopamineconcentrations in a dose-dependent manner without affectingthe concentrations of DOPAC and HVA. Flunitrazepam 0.015 and0.03 mg kg-1 also decreased striatal dopamine concentrationsin a dose-related manner, but the reductions in DOPAC and HVAwere not significant. Flumazenil 6 ng kg1 alone did not affectstriatal concentrations of dopamine, DOPAC and HVA, but it preventedthe effects of midazolam and flunitrazepam. Flunitrazepam 10fimol litre' also decreased striatal dopamine release wheninfused through a dialysis probe placed into the striatum, butit failed to affect striatal dopamine release when infused intothe ipsilateral substantia nigra. Central administrations ofmidazolam were effective only when the drug was infused intoboth sites simultaneously (10 and 100 /jrnol litre'7) or givenby intraventricular injection (0.5 and 1 fig). These resultssuggest that midazolam and flunitrazepam affect striatal dopaminerelease in a different manner. (Br. J. Anaesth. 1993; 70: 181–185)     

Tamoxifen Therapy for Premenopausal and Postmenopausal Japanese Females with Advanced Breast Cancer

The antiestrogenic agent tamoxifen was orally administered to74 Japanese patients with advanced breast cancer, with the followingresults: (1) Administration of tamoxifen resulted in a totalresponse rate of 43.4% (Marked response 23.0%, Moderate response20.3%), equivalent to 31.1% (Complete response + Partial response)by the criteria of the International Union against Cancer. (2)With regard to metastatic lesions, the response rate was 44.4%for soft tissue, 28.0% for skeletal, and 44.4% for pulmonaryand pleural metastases. (3) Tamoxifen induces very slight sideeffects compared to the commonly used androgens, and it hasno androgenic action. (4) Tamoxifen was shown to be effectivenot only in postmenopausal patients but also in pre menopausalpatients. (5) The appropriate dose of tamoxifen for Japanesepatients with advanced breast cancer is considered to be 20mg/day. (6) When patients with recurrent cancer were treated,many who responded to previous endocrine therapy or treatmentwith other anticancer drugs also responded well to tamoxifentherapy.     

Chemotherapy with Mitomycin-C and Cyclophosphamide Adjuvant to Surgery for Breast Cancer

The effect of adjuvant chemotherapy on breast cancer was studiedin two trials. In the first, mitomycin-C was administered intravenouslyto 203 patients and cyclophosphamide intravenously or orallyto 72 patients, within four weeks after radical mastectomy.The results were evaluated by compairing the recurrence-freerates of these patients with those of 556 patients who receivedsurgery alone. The effect of postsurgical adjuvant chemotherapy on the recurrence-freerate was statistically significantly better than that of surgeryalone when one or two axillary lymph nodes were involved inmetastasis, possibly because of the suppressive effect of chemotherapyon the establishment of hematogeneous metastases. With no orthree to seven metastases, the recurrence-free rate for patientsreceiving surgical treatment combined with adjuvant chemotherapywas higher than that for those with surgery alone, but the differencewas not statistically significant. In advanced cases havingeight or more axillary lymph node metastases, chemotherapy appearedsignificantly to reduce the recurrence- free rate compared withsurgery alone. This is possibly attributable to deteriorationin host immunity caused by chemotherapy being administered immediatelyafter surgery and affecting the host's defense mechanisms. In the second trial, which is still in progress, oral cyclophosphamidewas administered to 172 patients, 150 mg daily, for 34 daysfrom the seventh day after surgery. When compared with 179 patientshaving surgery alone, this chemotherapy increased the four-yearrecurrence-free rate in patients with no axillary lymph nodemetastases and the two-year recurrence-free rate in patientswith eight or more axillary lymph node metastases.     

Investigation of Objectivity in Scoring and Evaluating Microvascular Anastomosis Simulation Training

The increase in minimally invasive surgery has led to a decrease in surgical experience. To date, there is only limited research examining whether skills are evaluated objectively and equally in simulation training, especially in microsurgery. The purpose of this study was to analyze the objectivity and equality of simulation evaluation results conducted in a contest format. A nationwide recruitment process was conducted to select study participants. Participants were recruited from a pool of qualified physicians with less than 10 years of experience. In this study, the simulation procedure consisted of incising a 1 mm thick blood vessel and suturing it with a 10-0 thread using a microscope. Initially, we planned to have the neurosurgical supervisors score the simulation procedure by direct observation. However, due to COVID-19, some study participants were unable to attend. Thus requiring some simulation procedures to be scored by video review. A total of 14 trainees participated in the study. The Cronbach’s alpha coefficient among the scorers was 0.99, indicating a strong correlation. There was no statistically significant difference between the scores from the video review and direct observation judgments. There was a statistically significant difference (p <0.001) between the scores for some criteria. For the eight criteria, individual scorers assigned scores in a consistent pattern. However, this pattern differed between scorers indicating that some scorers were more lenient than others. The results indicate that both video review and direct observation methods are highly objective techniques evaluate simulation procedures.