Phase II Study of Mitoxantrone in Patients With Non-Small Cell Lung Cancer

A phase II study of mitoxantrone was performed in 24 patientswith non-small cell lung cancer (NSCLC). Mitoxantrone was administeredby intravenous drip infusion of 12 mg/m² every three weeks.There were no responders among the 21 evaluable patients includingfive patients without prior therapy. The major hematologicaltoxic effect was leukocytopenia. Thrombocytopenia and decreasein hemoglobin were slight. A change in the electrocardiogramwas observed in one patient and one patient experienced cardiogenicshock. Mitoxantrone is not acceptable for the treatment of NSCLC becauseof its low antitumor activity, and careful observation is neededfor administration of this agent to patients with pre-existingrisk factors, such as prior anthracycline exposure, mediastinalradiation or underlying cardiovascular disease.     

Moyamoya disease associated with bilateral renal artery stenosis

Recent research has suggested that an association exists between moyamoya disease and fibromuscular dysplasia which involves systemic vessels, including renal arteries. We report a 3 year old girl with moyamoya disease associated with bilateral renal artery stenosis. This case may support the common etiology of these two clinical conditions. To our knowledge this is the youngest case of moyamoya disease associated with bilateral renal artery stenosis.     

Hydrogen peroxide mobilizes Ca^2＋ through two distinct mechanisms in rat hepatocytes

Aim： Hydrogen peroxide （H2O2） is produced during liver transplantation. Ischemia/reperfusion induces oxidation and causes intracellular Ca^2＋ overload, which harms liver cells. Our goal was to determine the precise mechanisms of these processes. Methods： Hepatocytes were extracted from rats. Intracellular Ca^2＋ concentrations （[Ca^2＋]i）, inner mitochondrial membrane potentials and NAD（P）H levels were measured using fluorescence imaging. Phospholipase C （PLC） activity was detected using exogenous PIP2. ATP concentrations were measured using the luciferin-luciferase method. Patch-clamp recordings were performed to evaluate membrane currents.
Results： H2O2 increased intracellular Ca^2＋ concentrations （[Ca^2＋]i） across two kinetic phases. A low concentration （400 μmol/L） of H2O2 induced a sustained elevation of [Ca^2＋]i that was reversed by removing extracellular Ca^2＋. H2O2 increased membrane currents consistent with intracellular ATP concentrations. The non-selective ATP-sensitive cation channel blocker amiloride inhibited HRO2-induced membrane current increases and [Ca^2＋]i elevation. A high concentration （1 mmol/L） of H2O2 induced an additional transient elevation of [Ca^2＋]i, which was abolished by the specific PLC blocker U73122 but was not eliminated by removal of extracellular Ca^2＋. PLC activity was increased by 1 mmol/L H2O2but not by 400 μmol/L H2O2.
Conclusions： H2O2 mobilizes Ca^2＋ through two distinct mechanisms. In one, 400 μmol/L H2O2-induced sustained [Ca^2＋]i elevation is mediated via a Ca^2＋ influx mechanism, under which H2O2 impairs mitochondrial function via oxidative stress, reduces intracellular ATP production, and in turn opens ATP-sensitive, non-specific cation channels, leading to Ca^2＋ influx. In contrast, 1 mmol/L H2O2-induced transient elevation of [Ca^2＋]i is mediated via activation of the PLC signaling pathway and subsequently, by mobilization of Ca^2＋ from intracellular Ca^2＋ stores.     

A case of Behçet's disease aggravated by gingival infection with methicillin-resistant Staphylococcus aureus

We report a case of Behcet's disease aggravated by gingivitis and carious teeth infected with methicillin-resistant Staphylococcus aureus. Recurrent severe ulcers in the mouth, and on the genitalia and legs were closely linked with the infection, and dramatically improved after extraction of the carious teeth and administration of systemic vancomycin hydrochloride.     

The Usefulness of Endoscopic Color Doppler Ultrasonography (ECDUS) for Endoscopic Injection Sclerotherapy (EIS)

Abstract: We studied 12 patients using endoscopic injection sclerotherapy (EIS) guided by endoscopic color Doppler ultrasonography (ECDUS). The ECDUS was performed with a PENTAX FG-32UA (7.5MH2, convex type) and a HlTACHl EUB 565 as a display machine. The EIS needle, as well as changes in intramural blood flow before and after EIS were clearly observed with the ECDUS. When the sclerosant was injected properly into the esophageal varices, the blood flow in the esophageal varices could not be detected with color Doppler flow imaging nor with fast-Fourier transform (FFT) analysis. Therefore EIS was safely performed with an adequate volume of sclerosant having been accurately injected into the varices. Of the disadvantages of this technique, the forceps channel was found to be a bit narrow, and the anterior view was somewhat oblique. Even so, EIS guided by ECDUS is surely a promising method for the treatment of esophageal varices, especially once the technical difficulties are overcome. (Dig Endosc 1994; 6 : 39–44)     

An Application of Endoscopic Color Doppler Ultrasonography (ECDUS) in the Diagnosis of Hemodynamics of Gastric Varices,and the Therapeutic Effect of Endoscopic Therapy

Abstract: We studied 14 patients using endoscopic color Doppler ultrasonography (ECDUS) to evaluate the hemodynamics of gastric varices, and evaluated the endoscopic therapeutic effects on gastric varices in 8 patients. Three patients had F₃ type gastric varices and eleven had F₂. The ECDUS was performed with a PENTAX FG-32UA (7.5MHz, convex type) and a HITACHI EUB 565 was used as a display machine. The intramural blood flow in the gastric varices and inflows from the extra-gastric wall were clearly observed with the ECDUS in all 14 patients. The extramural blood flow (gastro or spleno-renal shunts) was detected in 9 of 14 patients. The velocity of the intramural flow in tumorous type varices (F₃) was higher than in the nodular or flat elevated type (Fa). Next, we evaluated the therapeutic effects on gastric varices of the ECDUS. The successful disappearance of intramural blood flow was observed in 6 of 8 patients who had this endoscopic therapy. In two of the 8 patients, there was not enough therapeutic effect on the intramural blood flow. The extramural blood flow, however, did not change before or after endoscopic therapy with the ECDUS. Therefore, we concluded that ECDUS is a very useful modality for the diagnosis of hemodynamics and to evaluate the therapeutic effects on gastric varices.     

The prevalence of sensitivity to constituents of dental alloys

Ninety-five participants were epicutaneous patch tested in order to determine the prevalence of sensitivity to components of dental alloys. Seventeen individuals (17.9%) developed allergic reactions, which were caused by mercury (10.5%), copper (2.1%), nickel, cobalt, tin, gold and zinc (1.1%). Eight of 17 allergic responders had a history of dermatitis from metal contact. The results show that there is a need for careful immunological considerations during the selection of suitable alloys, particularly in the case of patients with lesions suspected of being caused by dental alloys.     

Visualization of palisade veins in esophageal varices by endoscopic color Doppler ultrasonography

Background: Endoscopic color Doppler ultrasonography (ECDUS) is a useful modality for obtaining color flow images of esophageal varices. Levovist is a microbubble echo‐enhancing agent that improves Doppler ultrasound examination. This study is designed to evaluate the usefulness of ECDUS using Levovist in diagnosing palisade veins of esophageal varices. Methods: The study involved 67 patients with esophageal varices using ECDUS. All 67 patients received Levovist intravenously at a concentration of 300 mg/mL. A 7.5‐mL dose of the contrast agent was injected at a slow infusion rate of 1 mL/min. We compared vessel images detected with precontrast with those detected by enhanced ECDUS. Results: Color flow images of palisade veins were obtained in 16 (23.9%) of the 67 patients with precontrast ECDUS. Vessel images of palisade veins were detected in 15 of 61 F2 type varices (24.6%) and in one of six F3 varices (16.7%). The color flows of these vessels showed a continuous wave on fast‐Fourier transform analysis. Sixteen palisade veins had velocities in the 3.3 cm/s?11.6 cm/s range. Color flow images of palisade veins were obtained in 27 (40.3%) of the 67 cases by enhanced ECDUS using Levovist. Palisade veins could be delineated after Levovist contrast in 11 patients who could not be detected on precontrast ECDUS. After Levovist contrast, color flow images detected with precontrast ECDUS were enhanced in all patients. Conclusion: Endoscopic color Doppler ultrasonography with Levovist contrast can improve the diagnostic quality of the palisade veins in esophageal varices.     

Pulsatile Wave in Esophageal Wall Blood Vessels after Endoscopic Therapy for Esophageal Varices

Abstract: This study was designed to evaluate the clinical significance of the pulsatile wave in esophageal wall blood vessels after endoscopic therapy using endoscopic color Doppler ultrasonography (ECDUS) in 53 patients with esophageal varices. Ten of the 53 had recurrent intramucosal venous dilatation (F₀ type) of the esophagus, four of F₃ type and 39 of F₂ type. The endoscopic therapy techniques used in this study included endoscopic injection sclerotherapy (EIS) and heat-probe coagulation treatment (HPT) in 23 cases, endoscopic variceal ligation (EVL), EIS and HPT in 14, EVL and HPT in six, and HPT only in ten. The pulsatile wave in esophageal wall blood vessels was delineated in 10 of 53 (18.9%) patients using ECDUS after endoscopic therapy. Herein, we describe the ECDUS findings of pulsatile wave-positive cases. The esophageal wall was thickened yielding a low echoic pattern, and the pulsatile wave in blood vessels was delineated by color flow from the extra to the intra-esophageal wall in all patients. We calculated the maximum velocity (V_max), minimum velocity (V_min) and pulsatility index (PI). V_max of the pulsatile wave in blood vessels was found to be 9.7–24.0cm/sec (16.9±4.8cm/sec), V_min 3.0–14.3cm/sec (5.6±3.4cm/sec), and PI 0.81–1.72 (1.33±0.28). We also investigated the prognosis of pulsatile wave-positive patients. Esophageal varices recurred in two of the 10 cases. The PI of these cases were 0.81 and 0.98. There was no recurrence of esophageal varices in cases with PI values over 1.0.