[Evaluation of diagnostic digital radiography of the chest in comparison with conventional chest x-ray films].
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Biomedical subjects
Publications and source records attributed to K Eguchi.
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Forty-one cases of adenocarcinoma of the lung with pleuritis carcinomatosa were randomly assigned to either chemotherapy alone or chemoimmunotherapy using Nocardia rubra cell wall skeleton as immunopotentiator. In 34 evaluable patients, the rates of volume decrease and the disappearance of tumor cells in pleural effusion were higher in chemoimmunotherapy group than in chemotherapy alone group, and median survival times from the beginning of treatment in chemotherapy alone and chemoimmunotherapy groups were 189 and 266 days, respectively. The survival times in patients with stage III and P.S. 0+1+2 were better than those in patients with stage IV and P.S. 3, respectively. Transient fever and mild elevation of GPT and GOT were tolerated without any treatment.
A phase II study of KW2083 [7-N-(p-Hydroxyphenyl)-Mitomycin C], a derivative of Mitomycin C, was carried out in 20 patients with carcinoma of the lung and in 19 patients with metastatic pulmonary tumor. KW2083 was administered by single intravenous injection at a dose of 20-30 mg/m2 weekly or a single 70 mg/m2 dose. Patients treated with a dose of 20-30 mg/m2 should be given at least 3 doses for eligibility. Of 17 evaluable patients with carcinoma of the lung (11 adenocarcinomas, 3 squamous cell carcinomas, 2 small cell carcinomas and 1 large cell carcinoma), two patients with adenocarcinoma showed a partial response (11.8%). Two patients who achieved PR had adenocarcinoma without prior therapy received KW2083 at a single dose of 70 mg/m2 Objective response rates were 18.2% for 11 patients with adenocarcinoma and 25% for 8 patients with adenocarcinoma treated with a single dose of 70 mg/m2 of 15 evaluable patients with metastatic pulmonary tumor, no patients showed any objective responses. The hematologic toxicities were thrombocytopenia (less than 5 X 10(4)/mm3, 41.6%) and leukocytopenia (less than 2000/mm3, 28.1%); it was observed in 19% of the patients, that thrombocytopenia continued for more than 6 weeks after stopping therapy. Gastrointestinal symptoms such as anorexia (81%), nausea (66%) and vomiting (16%) were severe in patients treated with a single dose of 70 mg/m2. Fever in 19%, alopecia in 13%, phlebitis in 9%, eruption in 6%, stomatitis in 6% and liver insufficiency in 13% were also observed.
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By simultaneously inserting three extracellular microelectrodes, separated by 1.0 mm from each other, into the cat's midbrain reticular formation (MRF), temporal cross-correlation of firing of neuron pairs was measured to investigate the mode of interaction among the MRF neurons during different states of sleep and wakefulness. None of 97 neurons pairs studied gave clear-cut cross-correlograms suggesting cascade connection between two neurons. However, 29 neuron pairs showed weakly synchronized firing which occurred periodically with a mean interval of 1.23 s. This interval was different from the respiratory cycle. The rhythmic synchronization appeared most obviously during slow wave sleep. The synchronized firing was encountered more often in the pairs of adjacent neurons picked up with a single electrode and in the pairs picked up with separate electrodes positioned along the mediolateral axis, when compared with the neuron pairs located along the rostrocaudal axis. About 80% of the neurons (37 our of 46) which showed periodically synchronized discharge had no corresponding periodicity in their auto-correlograms. Simple synaptic linkage conceivable for the observed periodic synchronization of a neuron pair would be shared inhibition with the common inhibitory source activated periodically. Some neurons in the dorsal raphe nucleus and in the solitary tract nucleus were also examined for the cross-correlation with the MRF neurons. However, no positive relationship was found.
The effect of chemotherapy on natural killer (NK) activity and antibody-dependent cell-mediated cytotoxicity (ADCC) in 15 advanced carcinomas of the lung was examined with regard to the drug, dose, route and timing of administration. The relationship between the effect of chemotherapy on the prognosis for the patients, and the changes in NK activity and ADCC, was also analysed. The NK activity and ADCC in patients with poor prognosis were significantly subnormal, even before treatment. The NK activity and ADCC began to decrease 2 weeks after the initiation of treatment and reached the lowest level during the 3rd or 4th week in all patients. Thereafter, they returned to the pretreatment level in 8 patients with stabilized disease. In contrast, they were not restored in 7 patients with progressive disease and poor prognosis. In 4 patients it was found that the effect of chemotherapy with pepleomycin and carbazilquinone on NK activity and ADCC differed according to the drug used. From this pilot study it is suggested that NK activity and ADCC are valuable prognostic factors in patients with advanced carcinoma of the lung, and that detailed analysis of the effect of each anticancer agent on NK activity and ADCC is desirable for the establishment of better treatment regimens for advanced carcinoma of the lung.
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A phase II study of Vindesine (VDS) was carried out in 20 patients with carcinoma of the lung (14 adenocarcinomas, 3 squamous cell carcinomas, 2 large cell carcinomas and 1 small cell carcinoma), and in 18 patients with metastatic pulmonary tumor (primary organ: 4 colons, 2 uteri, 2 lungs, one each tongue, pharynx, maxillary sinus, esophagus, mediastinum, bile duct, pancreas, kidney, rectum and sarcoma). VDS was given weekly by i. v. push at a dose of 3 mg/m2. Patients should be given at least three times of VDS for eligibility. Of 18 evaluable patients with carcinoma of the lung, 3 patients with adenocarcinoma showed a partial response. Response rates were 17% for patients with carcinoma of the lung, and 25% for 12 patients with adenocarcinoma. Two responders (uterine cervical carcinoma and mediastinal embryonal carcinoma) were observed in 14 evaluable patients with metastatic pulmonary tumor. In addition, one patient with metastatic maxillary sinus tumor showed a minor response. Major hematologic toxicities of VDS were leukopenia (less than 4000 cells/mm3--92%, less than 2000 cells/mm3--28%), anemia (less than 10.0 g/dl, 38%) and thrombocytopenia (less than 10 X 10(4) cells/mm3, 11%). Major non-hematologic toxicities were numbness (24%), constipation (11%), anorexia (21%), fever (16%) and liver dysfunction (21%). The dose limiting factor of VDS was leukopenia.
The morphology and population of myofibroblasts detected by electron microscopy in fibrous tumors and fibrosis in various organs have been examined. The myofibroblast was identified by characteristic features of the indented nucleus, bundles of abundant microfilaments with dense bodies, focal basal lamina and well-developed rough endoplasmic reticulum. It has been observed that myofibroblasts in a variety of fibrous tumors and fibrosis appeared predominantly in fibromatosis and reparative process of deep fibrous tissues and organs particularly in the lesions involving the fascia and subcutaneous tissue. It was suggested that myofibroblasts would be modified fibroblasts to which fibroblasts in the fascia and deeply situated fibrous tissue transformed during proliferation and differentiation.
Red blood cell polyamines were measured using high-performance liquid chromatography. Spermidine and spermine continued to increase with pregnancy and retained a high level during 24-35 weeks of gestation, then decreased at term; putrescine, however, kept the low nonpregnant level during pregnancy and puerperium. At delivery, umbilical blood showed a significantly higher polyamine level than maternal blood (p less than 0.005 or p less than 0.001). In the neonatal period, each polyamine showed a slight increase on the 1st day after birth, then spermidine and spermine decreased day by day, but putrescine kept the same level. Alterations of polyamines seemed to have some relation to the erythropoiesis in bone marrow and rapid cell proliferations.
Gestosis index score at delivery was compared with factors reflecting the fetal development in a series of 95 patients with EPH-gestosis collected in Okayama University Medical School in 1975-1979. The prediction of small for date (SFD) was performed by means of multivariate analysis of 10 variables, i.e. gestosis index, maternal body weight, height, uterine fundal length, abdominal circumference, maternal age at delivery and urinary estriol within one week prior to delivery. The result was that gestosis index was as useful as uterine fundal length in predicting SFD. The more gestosis index score increased, the more markedly the fetal development ws disturbed. Especially in the cases with scoring above 4 and in those with hypertension and proteinuria, the incidence of SFD increased obviously. No correlation between gestosis index and neonatal asphyxia was noticed. From the growth pattern of uterine fundal length and BPD, intrauterine growth retardation (IUGR) in pregnancy with EPH-gestosis occurred mainly within the third trimester of pregnancy. The functional development of the fetus with EPH-gestosis was evaluated with the use of urinary estriol level and fetal heart rate (FHR) monitoring. In the cases with EPH-gestosis scoring above 4, extreme disturbance of functional development of the fetus was observed.
The polyamines spermidine (spd) and spermine (spm), and their diamine precursor, putrescine (put) were separately determined in red blood cells (RBC) and 24-hour urine samples of gynecologic malignant and non-malignant cases using high-pressure liquid chromatography (HPLC) technique. The results are as follows: 1) Patients with malignancy (49 cases) had the polyamine levels of RBC-spd; 5.85 +/- 3.32 (mean +/- SD), RBC-spm; 7.00 +/- 5.53 (nmol/ml packed RBC), urinary put; 3.92 +/- 4.13, urinary spd; 2.17 +/- 1.74 (mg/day) in pre-therapeutic state. These levels were greatly higher than those of control cases. 2) The diagnostic rate was 100% in the fourth stage of uterine cervical cancer, and 80% in the recurrent cases. 3) Patients with long-term abnormal polyamine levels had the tendency of poor prognosis. 4) In many cases, RBC polyamines and urinary polyamines showed somewhat different fluctuations in the course of treatment. In conclusion, it is suggested that the measurement of polyamines is very useful in the diagnosis of progressive cases and recurrent cases, and can be helpful in the evaluation of therapeutic effects and prognosis.
The triglyceride concentration increased gradually after the 10th day of gestation and it increased continuously until the time of delivery. Then it decreased immediately after birth. The phospholipid concentration also increased with gestational age, but cholesterol did not. The fatty acid components of fat emulsion (Intralipids) were labeled with carbon-14 and administrated into pregnant rats, then the fate of these fatty acids in blood was followed with time. The plasma half life was 74 minutes in pregnant rats and 58 minutes in non-pregnant rats. The disappearance was slower in the pregnant rat. This results agree with human studies. The uptake of radioactivity by the fetal liver was only 1/10 that of the mother. The radioactivity level in the expired 14CO2 was examined. 18% of radioactivity appeared in expired CO2 during 5 hours in pregnant rat. While, 30% was collected in non-pregnant animals, showing slower lipid metabolism during pregnancy.
Polyamines are ubiquitously distributing amines in living organs, and have close relation to nucleic acids and cell proliferation. But there are few reports about polyamines in the obstetric field. So we measured blood polyamines, i.e. putrescine, spermidine and spermine in pregnancy, delivery, puerperium and neonatal period, using high-performance liquid chromatography (HPLC). We discuss about red blood cell polyamines because RBCs contain about 80% blood polyamines. Spermidine and spermine concentration begin to increase with pregnancy, and rapidly increase from the 5th lunar month and keep high levels during the 7-9th lunar month, the decrease at term. In puerperium, spermine, as opposed to spermidine, takes higher value than that of the term. Putrescine, however, keeps almost the same level as non-pregnangs during pregnancy and puerperium. At delivery, the umbilical blood contains significantly higher polyamines than the maternal blood, but there are no differences between umbilical artery and vein. In neonatal period, each polyamine shows slight increase at the first day after birth. Thereafter, putrescine keeps the same level till the 7th day, but spermidine and spermine gradually decrease day by day. These data suggest that polyamines are reflecting the function of bone marrow erythropoiesis and reproduction.
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One hundred nineteen cases of advanced adenocarcinoma of the lung were divided into well differentiated adenocarcinoma (72 cases) and poorly differentiated adenocarcinoma (47 cases) histologically and/or cytologically. The median survival of 72 cases of well differentiated adenocarcinoma (7.9 months) was significantly (P less than 0.025) longer than that of poorly differentiated adenocarcinoma (4.9 months) irrespective of stage, difference in treatment regimen, or response to treatment. In 9 evaluable cases, the objective response rate to chemotherapy was 25% (6/24) in poorly differentiated adenocarcinoma and 11.3% (8/71) in well differentiated adenocarcinoma, respectively. In 45 patients who received a combination of chemotherapy and radiotherapy, the median survival of 22 well differentiated adenocarcinomas (11.8 months) was significantly (P less than 0.05) longer than than of 23 poorly differentiated adenocarcinomas (5.6 months). The same tendency was observed in 74 patients who received chemotherapy alone. Analysis based on the grade of differentiation is essential for the accurate assessment of the efficacy of treatment in adenocarcinomas of the lung.
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