[IBL-like T cell lymphoma with helper T cell phenotype in a case of myelodysplastic syndrome].
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Biomedical subjects
Publications and source records attributed to M Abe.
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For the last 6 yr, we had 47 cases of spontaneous rupture of hepatocellular carcinoma causing hemorrhage into the peritoneal cavity. Thirty-three cases were treated by supportive care and 14 cases by emergency transcatheter arterial embolization. Fourteen cases underwent emergency transcatheter arterial embolization and abdominal pain developed in 71.4%, shock in 50.0% and bloody ascites in all cases and the hematocrit of bloody ascites ranged between 1.0% and 40%. On hepatic angiogram, the mean tumor extent rate was 47.9% and the extravasation of the contrast material was noted in 35.7%. The mean survival time of 14 cases that underwent emergency transcatheter arterial embolization was 98.5 days and 13.0 days in 33 cases with supportive care. The former was significantly longer than the latter.
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Eleven cases with hypersplenism, one with liver cirrhosis and ten with hepatocellular carcinoma (HCC) associated with liver cirrhosis, underwent transcatheter partial splenic arterial embolization. In four of ten HCC cases, the spleen was accidentally infarcted during the procedure of transcatheter hepatic arterial embolization (TAE). The mean infarcted area of the spleen was 55.7%. An increase in the peripheral platelet count was particularly remarkable and continued over one year after the embolization. High fever and abdominal pain were observed in all cases. The fever was seen for 18.0 days and pain was noted for an average of 12.8 days after the embolization. Other adverse effects such as pleural effusion and ascites were transitorily observed. Splenic embolization is an effective supporting therapy for hypersplenism in patients with cirrhosis or HCC.
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Radiobiologically hypoxic fractions of 4 experimental tumors (RIF1, B16, EMT6/KU, SCCVII) of various sizes implanted subcutaneously (sc) or intradermally (id) were compared under identical conditions by using the paired survival curve assay method. The two survival curves for tumors in air-breathing and asphyxiated mice were almost parallel for EMT6/KU and SCCVII tumors, but not for RIF1 and B16 tumors. Therefore, hypoxic fractions were estimated by fitting the best parallel lines to the two sets of survival data. The values for 10 mm-diameter sc tumors in the hind legs of syngeneic mice were 4.7% for RIF1, 4.5% for B16, 14% for EMT6/KU, and 8.5% for SCCVII. The variation of the values is quite small in spite of the variety of biological characteristics of these tumors. Histological examination revealed that EMT6/KU and B16 tumors contained large necrotic areas, while SCCVII and RIF1 had small areas of necrosis. Thus, the hypoxic fraction and the proportion of necrosis in the histological specimens were not clearly correlated. The values for 6 mm and 16 mm sc EMT6/KU tumors were 5.9 and 22%, respectively, while that for 6 mm id tumors was 16%. The values for 5 mm and 18 mm sc SCCVII tumors were 0.86 and 8.4%, respectively. These results indicated that: (1) id EMT6/KU tumors had a higher hypoxic fraction than sc ones of the same size; (2) the hypoxic fraction increased with increase in tumor size in EMT6/KU tumors, while it reached a plateau at a certain size in SCVII tumors.
An experimental tumor system consisting of single cells, spheroids, and solid tumors was developed using the EMT6/KU cell-line for evaluation of new hypoxic cell sensitizers. This paper describes the radiation dose-survival curves of the system and the effects of four sensitizers [misonidazole, Ro 03-8799, KB-11 (a sulfonyltetrazole derivative), and DNIE (a dinitroimidazole derivative)] in this system. Dose-survival curves of the spheroids varied significantly depending on the irradiation conditions, but it was found that the spheroids could model the solid tumors when they were irradiated in flat-bottomed flasks. These spheroids and solid tumors contained substantial fractions of hypoxic cells, and hence were suitable for testing hypoxic cell sensitizers. Misonidazole at a concentration of 1 mM or 1 mmol/kg showed a constant enhancement ratio (ER) of 1.55 in all of the systems. The ERs of the other three compounds for single cells, spheroids, and solid tumors were 2.1, 1.9, and 1.65, respectively, for Ro 03-8799 (1 mM or 1 mmol/kg); 2.6, 1.6, and 1.0, respectively, for KB-11 (0.5mM or 0.5 mmol/kg); 1.8, 1.2, and 1.1, respectively, for DNIE (0.5mM or 0.5 mmol/kg). These results indicated that the ER for spheroids is closer to the ER for solid tumors than is the ER for single cells in most cases. It was also suggested that an efficient sensitizer in vivo shows little or no difference between its ER for single cells and that for spheroids.
The histopathological effects of hyperthermia with or without radiation were investigated in a transplanted mouse mammary carcinoma. Since the histopathological changes following hyperthermia differed greatly between the center and periphery of a tumor, we analyzed the changes in each area separately according to a semi-quantitative method developed by us. Three days after hyperthermia at 44 degrees for 45 min, undamaged tumor cells were found mostly in the tumor periphery adjacent to normal tissues. This phenomenon was observed when the entire tumor could be heated almost homogeneously. When a tumor was treated by heat alone, the thermal damage disappeared 7 days after treatment. On the other hand, treatment with hyperthermia plus radiation caused pronounced damage in the tumor center and tumor periphery 7 and 14 days after treatment. These combination effects depended on the radiation dose. The present findings demonstrate that combination of high doses of irradiation and hyperthermia is very effective for potentiating the thermal damage in the tumor periphery.
The effects of step-up (42----44 degrees sequence) and step-down (44----42 degrees sequence) heating were studied on a transplantable mammary adenocarcinoma of C3H/He mouse. Tumor-bearing legs were immersed in a water bath and the response to hyperthermia was evaluated in terms of the delay in tumor growth. Tumor growth was delayed greatly with increase in the duration of treatment with 44 degrees hyperthermia, whereas with 42 degrees hyperthermia of up to 180 min, tumor growth was delayed only slightly. The effects of step-up heating were similar to those of 44 degrees hyperthermia alone and the response was enhanced by a factor of 0.9-1.1 with the 60-min treatment at 42 degrees followed by treatment at 44 degrees. Thermal resistance developed when the preheating time at 42 degrees was longer than 30 min. On the other hand, the tumor response was markedly enhanced by step-down heating by a factor of 1.8-2.4 with the treatment at 44 degrees followed by 60-min treatment at 42 degrees. Since the enhancement factor for skin damage found previously was similar to that for the tumor, therapeutic gain cannot be expected by the use of these combined heat treatments.
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This study was an attempt to develop implantable sustained release forms of drugs, based on formulations containing chitosan, a biodegradable polymer from a natural source, and hydroxypropylchitosan (HP-chitosan), its water-soluble derivative. The possibilities were explored using uracil as a model for anticancer drugs. Enzymatic degradation of chitosan and HP-chitosan was first confirmed in vitro (using lysozyme) and in vivo by implanting both materials subcutaneously into the backs of rats. Then, using an in vitro dissolution test, we found that the release rate of uracil from chitosan membranes could be altered by the addition of HP-chitosan. Film- and stick-type implantable dosage forms of chitosan containing uracil were prepared by the 'Extrusion-in-Air' method. These gave rise to sustained release of uracil in vitro and in vivo. We conclude that chitosan and HP-chitosan have a potential as biocompatible and biodegradable vehicles in the preparation of implantable sustained release dosage forms of anticancer drugs.
Clinical efficacy and safety of S6472 (long active cefaclor (CCL)) and CCL were compared by a double-blind study using 248 patients with bacterial bronchitis. Patients were orally administered with either 375 mg of S6472 2 times or 250 mg of CCL 3 times daily for 7 days, and the following results were obtained. Clinical efficacy judged by a committee: The efficacy rates on acute bronchitis were 87.2% for S6472 and 82.6% for CCL, and the efficacy rates on chronic bronchitis were 70.3% for S 6472 and 64.7% for CCL. There was no significant difference between the 2 drugs in clinical efficacy. Clinical efficacy judged by doctors in charge: Results of the clinical efficacy judged by doctors in charge were similar to the efficacy judged by the committee. Bacteriological efficacy judged by the committee: Eradication rate for the S6472 group was 71.1% (32 of 45 patients) and that for the CCL group was 67.4% (29 of 43 patients). There was no significant difference between the 2 drugs in the bacteriological efficacy. Side effects and abnormal laboratory findings: Side effects were observed in 5 cases (4.2%) in the S6472 group and in 5 cases (4.0%) in the CCL group. These side effects, however, were not serious, and no remarkable abnormal laboratory values were observed. There was no significant difference between the 2 drugs in the incidence of side effects or abnormal laboratory findings. Clinical utility: When the clinical utility was expressed by the utility rate (very useful and useful), it was 79.5% in the S6472 group (117 patients) and 76.2% in the CCL group (122 patients) (judged by the committee). When the utility was judged by doctors in charge, it was 73.3% in S6472 group (120 patients) and 71.4% in CCL group (126 patients). From the above results, it has been concluded that S6472 taken twice daily is equivalent to CCL in effectiveness on bacterial bronchitis.
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