Biomedical subjects
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The lung function after lung resection was studied in 18 patients using ventilation and perfusion scintigraphy. All patients underwent posterolateral thoracotomy. Scintigraphy was performed before and 1 month after surgery in 8 lobectomized patients and in 4 partially resected ones. Another 8 patients underwent scintigraphy 6.5 to 43 months after lobectomy. Mean transit time (MTT) on scintigraphy was used to estimate a regional washout function in lung. The value of MTT on the operated side minus MTT on the contralateral side increased after surgery. This change was more remarkable in lobectomized patients than in partially resected ones. MTT on the operated side lung was even more prolonged after operation. Reduction of %V and %Q was observed on the operated side of remaining lung after surgery, and Q decreased more than V after lobectomy.
The flexible bronchoscopy has not yet been popular in the foreign body in the airway, especially in children. We performed the flexible bronchoscopy for 27 patients with foreign bodies in the airway including 22 patients who had not been removed foreign bodies by the rigid bronchoscopy. Nineteen of 27 patients were children. The success rate of flexible bronchoscopy was 81% (22/27 cases) in all patients, 77% (17/22 cases) in patients failed by the figid bronchoscopy, and 82% (9/11 cases) in young children of 2 years old or less. For the removal of foreign bodies under the flexible bronchoscope, a biopsy forceps and a Fogarty balloon catheter were effective. The flexible bronchoscope is useful for foreign bodies in the airway, even in young children.
Genistein inhibited topoisomerase II and I; it increased the enzyme-DNA complex in L1210 cells at 1 micrograms/ml, and interfered with pBR322 DNA relaxation by the enzymes. To test the role of topoisomerase in the transformation by oncogenes, the effect of genistein on the transformation of NIH 3T3 cells by transfection with [Val 12]Ha-ras was compared with that of N-alpha-tosyl-L-lysyl-chloromethyl ketone (TLCK), since genistein inhibits tyrosine kinase as well as TLCK. Genistein reduced the number of foci of the transformed cells, and suppressed selectively the growth of ras-transformed NIH 3T3 cells but not normal NIH 3T3 cells. In contrast, TLCK did not affect the transformation. It inhibited the growth of the normal cells but not the transformed cells.
The authors examined the binding nature of mibolerone in cytosols of hypertrophic prostates from 15 patients to androgen receptor using Dextran-charcoal assay, analyzed it by the method of Scatchard, and compared it with that of R1881. The addition of triamcinolone acetonide into the incubation medium induced specific single binding of mibolerone to androgen receptor with high affinity as well as R1881. The receptor contents obtained with mibolerone were higher than those of R1881, and both of them correlated well. The dissociation constants of both ligands showed good correlation and no significant differences. Mibolerone seems to be as suitable a ligand as R1881 for measuring the androgen receptor.
The binding to hemoglobin of synthetic 2-hydroxyamino-6-methyldipyrido[1,2-a: 3',2'-d] imidazole from the carcinogenic product of L-glutamic acid pyrolysis 2-amino-6-methyldipyrido[1,2-a: 3',2'-d] imidazole were investigated in vitro. The hydroxylamine required oxidation to its nitroso derivative to bind to rat hemoglobin through thiol groups. Oxidation of the hydroxylamine to the nitroso form was found to be enhanced by oxyhemoglobin and superoxide dismutase at pH 7.4 under aerobic conditions. Since these conditions might also enhance this oxidation in vivo, the conversion of the DNA-reactive arylhydroxylamines to the DNA-non-reactive nitroso compounds and their subsequent binding to highly abundant thiol groups of proteins could be considered as a process for detoxification of toxic arylhydroxylamines.
In 175 women with mucinous carcinoma (MC) of the breast, the morphologic features, the clinicopathological features (age, tumor size, and nodal status) and prognoses were investigated. They were divided into two types, those with "unmixed type" (n = 140) showing no component of invasive ductal carcinoma (IDC) and "mixed type" (n = 35) including an IDC component. The unmixed type showed less frequent (P less than 0.01) nodal involvement and a higher degree (P less than 0.005) of extracellular mucus production than the mixed type. The presence of nodal metastases showed no correlation with the degree of mucus production. The 10-year survival rate of the unmixed type (90.4%) was better (P less than 0.001) than in the mixed type (66.0%). In the unmixed type, a higher level of mucus production showed trends toward a better prognosis, younger age and smaller tumor size (P less than 0.01). In the mixed type, the degree of mucus production showed no significant correlation with either the age, tumor size, or prognosis. It is more important for the prognosis of patients with MC to have no IDC component than to show abundant mucus within the tumor.
Of 134 patients with thymoma, 79 (59%) also had myasthenia gravis (MG). The thymoma with MG differed from that in the absence of MG in the following aspects: The ratio of lymphocytes to epithelial cells in the tumor was larger, the polygonal cell type was more prominent (i.e., in 83% of the MG patients this cell type predominated), and the differentiation of epithelial cells in the tumor was more advanced in the group with MG than in the group without MG. Furthermore, the clinical stage of thymoma was earlier, the recurrence rate was lower, and the survival curve was better in the group with MG than in the group without MG. These findings suggest that the thymoma with MG is less malignant than that without MG.
The case of a 12-year-old girl with an anterior mediastinal tumor is reported. A mass grew rapidly and occupied the anterior mediastinum after menarche. Resected material was diagnosed as a mature teratoma. Both estrogen receptors and progesterone receptors were detected in the resected tissue. The titer of estrogen receptors was 2-11.3 femtomoles per milligram of protein and that of progesterone receptors was 9.5-15.7 fmol/mg protein. Based on these data, it was surmised that sex hormones may affect the growth of the tumor in this case. The change in sex hormones after menarche may have played a role in the rapid growth of this tumor.
The aim of this study was to establish the role of estrogen receptor (ER) and progesterone receptor (PgR) as prognostic indicators for early recurrence and survival. In all, among breast cancer patients, 166 patients who had undergone radical or extended radical mastectomy were studied. These patients were treated with adjuvant chemotherapy alone for 2-3 years after surgery. No patients had adjuvant endocrine therapy. Local recurrence and/or distant metastases were treated by endocrine therapy and/or chemotherapy. The relapse-free interval was not different between the ER-positive and ER-negative patients. The postrelapse survival curve was significantly different between the two groups. There was no significant difference in the relapse-free interval and the postrelapse survival curve between the PgR-positive and PgR-negative patients. These results suggest that ER is a good predictor of the response to endocrine therapy given after relapse, but not of early recurrence.
We studied the effect of a decrease in vital capacity (VC) on the blood lactate threshold detected during exercise in 16 preoperative (PRE) and 10 postoperative (POST) lung cancer patients who had undergone lobectomy or pneumonectomy. The PRE patients were selected on the basis of having normal preoperative pulmonary function. The POST patients were selected on the basis of having normal preoperative pulmonary function and a postoperative VC of less than 80%. The oxygen consumption/body surface area at a 2.2 m.mol.l-1 arterial lactate concentration (VO2/BSA at La-2.2) was adopted as the blood lactate threshold. VC/BSA in the POST group significantly correlated with VO2/BSA at La-2.2 (r = 0.85, P less than 0.01), but not in the PRE group. SaO2 at La-2.2 was 95.4 +/- 1.5% in the PRE group and 95.2 +/- 1.3% in the POST group. SaO2 at La-2.2 did not correlated with VC/BSA in either group. The hemoglobin concentration (Hb) in the arterial blood correlated significantly with VC/BSA in the POST group (r = 0.65, P less than 0.05) but not in the PRE group. These results indicate that VO2/BSA at La-2.2 was restricted by VC in patients with restrictive pulmonary function disorder. Of the three elements of oxygen delivery, Hb was a limiting factor for VO2/BSA at La-2.2 but SaO2 was not. Cardiac output, which was not measured in our study, was speculated to be another limiting factor for VO2/BSA at La-2.2.
Tamoxifen was administered over a period of 4 weeks to 19 female Sprague-Dawley rats bearing 20 DMBA-induced mammary tumors. Consequently, 13 tumors (65.0 per cent) regressed and showed a reduction in their estradiol receptor (ER) and progesterone receptor (PgR) concentrations. In spite of subsequent treatment given to the rats bearing the regressed tumors, 6 new tumors occurred. The ER and PgR concentrations of these tumors were lower than those of the tumors before tamoxifen therapy, and histochemical study showed these tumors to be composed mostly of ER-negative cells. These results suggest that: (a) the hormone dependency of breast cancer is reduced by tamoxifen therapy; (b) breast cancers recurring during tamoxifen therapy show reduced hormone dependency.
A case of a 47-year-old woman with pulmonary varix is reported herein. Saccular dilatation of the inferior pulmonary vein resembled a pulmonary perihilar mass which could not be palpated at the time of thoracotomy. Aneurysmal dilatation of the pulmonary vein, otherwise known as pulmonary varix, is rare. Only 71 such cases, including 17 cases in Japan, have been reported. Pulmonary varices may be classified into three types, namely: saccular type, tortuous type and confluent type. Most of the varices seen in patients with valvular disease have been of the confluent type (62 per cent), however tortuous type varices have also been seen in some cases (19 per cent). Pulmonary venous hypertension may be one of the major causes of confluent type pulmonary varices as regression of pulmonary varices after mitral valve replacement has been reported. None of the saccular type cases, however, were accompanied by valvular disease. This indicates that local factors may also be an important cause of saccular type varices.
A 49-year-old woman who had previously undergone hysterectomy was found to have multiple pulmonary masses and cysts and experienced respiratory failure. Bronchoscopic study revealed an endobronchial mass obstructing the left main bronchus and protruding into the trachea. She was treated with an endoscopic laser to eliminate the airway obstruction. After recovery from the respiratory failure, two-stage thoracotomies were performed at six-month intervals. The endobronchial mass originated from a tumor in the left basal segment. The histologic findings on the cysts and nodules of both lungs were compatible with fibroleiomyoma. The final diagnosis was pulmonary leiomyomatosis with myoma uteri.
A simple technique for drainage for a giant bulla with balloon catheter using chemical irritants and fibrin glue is described. This method allows physical and functional improvement without major surgery in compromised patients with giant bullae.
The electrical bio-impedance of 17 breast tumors including 12 breast cancers and 5 fibroadenomas, were measured in vivo with three-electrode method in the frequency range of 0 to 200 KHZ. The three-electrode consists of a coaxial needle electrode inserted into the tumor and a large reference electrode on upper abdominal wall. The tissue can be regarded electrically as a equivalent consisted of extracellular resistance (R1), intracellular resistance (R2), and electric capacitance of the cell membrane (C). These three parameters were calculated from the measured values of electrical bioimpedance. It was found that R1, and R2 of breast cancers were significantly higher than those of fibroadenomas (p less than 0.001), and that C of breast cancers was significantly lower than that of fibroadenomas (p less than 0.001). The measurement of the electrical impedance of breast tumor in vivo may be useful for the differential diagnosis of breast lesions.
A case is reported of a patient who developed a histological unusual sarcoma in the chest wall 5.3 years after postoperative radiation therapy (5,000 rads) for breast cancer. This sarcoma showed microscopic features of malignant fibrous histiocytoma (MFH). A review of the literature disclosed 16 other cases in which MFH developed under similar circumstances. An analysis of these 16 cases and the case reported here showed that the mean radiation dose was 5,623 rads, that the time period between irradiation and the development of MFH ranged from 2 to 27 years and that wide resection offered better prognosis than chemotherapy.
5'-DFUR was administered orally to recurrent breast cancer patients at a daily dosage of 1,200 mg given 3 times a day for more than 8 weeks. Out of 16 evaluable cases, 1 CR, 5 PR, 5 NC and 5 PD were observed, and the overall response rate was 37.5%. There was no significant difference in the response rate between the patient with or without prior fluorinated pyrimidine therapy, or between sites of the lesion. Toxic effects consisted of gastrointestinal toxicity such as diarrhea (25%), anorexia (12.5%), abdominal pain (12.5%) and nausea and vomiting (6.3%). No other severe side effect was observed. These results suggest that 5'-DFUR can be useful for the treatment of breast cancer.