Interventional bronchology in the lung cancer

Patients with advanced bronchogenic carcinomas that obstruct the central airway have been treated by Nd-YAG laser and tracheobronchial prostheses. The Nd-YAG laser delivers radiation at 1,064 nm, acts directly on malignant tissues causing thermonecrosis and vaporization. Tracheal and endobronchial prostheses have used as additional means for establishing and maintaining patent airway. These palliative therapies contribute to improving and maintaining the QOL of the patients. Methods of treatment for early superficial occult squamous cell carcinoma of the lung are bronchoscopic photodynamic therapy (PDT) and brachytherapy. PDT is used by photosensitizing agents (hematoporphyrin) that accumulate in malignant tissue and can be activated by a laser energy. Brachytherapy is technique for endobronchial irradiation involves the use of 192Ir. Both treatments are well effective for early superficial occult squamous cell carcinoma of the lung (CR rate is approximately 80%). They are safe and preserve pulmonary parenchyma

DNA adduct formation by 2-amino-3-methylimidazo [4,5-f] quinoline (IQ) in rat colon

A food-born carcinogen, 2-amino-3-methylimidazo [4,5-f] quinoline (IQ) induces cancer in the rat colon. The mechanism for colonic DNA adduct formation leading to cancer by IQ was studied using a colostomized F344 rat model. In this model, the transverse colon of the rat was colostomized, which produced a fecal stream-positive proximal colon and a negative distal colon were produced. When IQ (50 mg/kg) was administered into the distal colon of the colostomized rats (n=5), the ratio of the DNA adduct level of the distal colonic mucosa to the paired muscular layer 24 hr after dosage was 2.02, whereas that was 1.51 and 1.37 when IQ was administered into the stomach (n=6) and the vein (n=5), respectively. This suggested that luminal exposure of IQ induced DNA adduct formation. Since IQ (an amine form) has no reactivity toward DNA, these findings suggested that IQ was immediately activated in the absorbed mucosal cells and reacted with DNA. However, most of the IQ absorbed was metabolically activated in the liver, distributed by blood circulation, and formed DNA adducts in the colonic mucosa and muscular layer

Human calgizzarin ; one colorectal cancer-related gene selected by a large scale random cDNA sequencing and Northern blot analysis

A cDNA library was constructed from COLO 205 and 1056 clones randomly selected from this library were partially sequenced. Two hundred and two (38.4%) out of 526 independent genes had more than 80% similarity to the genes reported in GenBank. In Northern blot analysis, 96 out of 98 genes were shown to be expressed at the same level in colon and lung carcinoma cell lines and control fibroblasts. Only two clones, including human synovial phospholipase A-2 and a homologue to rabbit calgizzarin, were expressed at different levels among these cell lines. The full sequence of human calgizzarin was determined and its expression was remarkably elevated in colorectal cancers compared with that in normal colorectal mucosa

Effects of interferon-α and γ on development of LAK activity from mononuclear cells in breast cancer patients

We examined the effect of recombinant IFN-α and IFN-γ on induction of LAK cells from peripheral blood mononuclear cells (PBMNCs) in 7 pre-operative breast cancer patients and 4 healthy volunteers. Significant LAK activity was developed from PBMNCs of pre-operative breast cancer patients and healthy volunteers after incubation for 4 days with IL-2 (presence of IL-2 vs. absence of IL-2). Incubation of PBMNCs of pre-operative breast cancer patients with 1000 U/ml of IFN-α for 4 days suppressed the LAK activity significantly (P<0.05). By contrast, incubation of PBMNCs of pre-operative patients with 1000 U/ml of IFN-γ for 4 days increased the LAK activity significantly (P<0.05). Significant cytotoxicity againstMCF-7 cells (estrogen receptor positive human breast cancer cell line) was developed from PBMNCs of pre-operative breast cancer patients at 20:1and 40:1E/T ratios after incubation for 4days with IL-2 (absence of IL-2vs. 20:1or40:1, P<0.05, P<0.05), whereas PBMNCs of healthy volunteers did not. Stimulation of LAK cells with IFN-γ produced a significant augmentation of cytotoxic activity against MCF-7 (P<0.05), while IFN-α suppressed the cytotoxicity significantly (P<0.05). These findings suggested that combined stimulation by IFN-γ and IL-2 might be a reasonable treatment for breast cancer patients

Novel bronchofiberscopic catheter spray device allows effective anesthetic spray and sputum suctioning

AbstractStudy objectives: To evaluate how serum lidocaine concentrations (SLC) rise when lidocaine is administered by a Bronchofiberscopic Catheter Spray Device (BCSD), and to demonstrate the effect on the aspiration speed of a substitute for sputum when a catheter spray remains in the channel of the bronchofiberscope (BF).Methods: This is a prospective randomized clinical study. After lidocaine ultrasonic nebulizer, the BF was inserted orally. During the procedure patients received 4% lidocaine by two methods. In Group 1, 11 patients received lidocaine by bronchofiberscopic (BF) injection. In Group 2, 15 patients received lidocaine by spraying from the ∅1.06mm catheter through the BF channel. SLC were measured at 40min from onset of nebulization. Separately, we examined how effectively sputum was aspirated through the BF channel with a catheter.Results: Total lidocaine dose (TLD) is the total dose used for nebulization and for the BF injection or spray. The TLD for Groups 1 and 2 were 698.2±162.1mg (mean±sd) and 498.7±103.8mg, respectively (P=0.03). The SLC for Groups 1 and 2 were 1.28±0.72 and 1.48±0.70mg/l, respectively (P=0.49).Conclusions: Using BCSD allows easier in administration of lidocaine and is not associated with a significant increase in SLC in comparison with BF injection. Although sputum aspiration using the BF inserted with our catheter was somewhat slow, we did not feel inconvenient so much. Compared to the conventional method, using BCSD may be preferable for patients and bronchoscopists

Effect of ursodeoxycholic acid on azoxymethane-induced aberrant crypt foci formation in rat colon : in vitro potential role of intracellular Ca2+

The studies were conducted to examine the precise nature of the suppressive effect of ursodeoxycholic acid (UDCA) on colonic aberrant crypt foci (ACF) formation. Fischer 344 rats were treated with a single dose of azoxymethane (AOM) (20 mg/kg, s.c.) and fed basal diet (MF) supplemented with UDCA (0.4%) during an initiation or a post-initiation stage. ACF were enumerated at the 2nd, 5th and 8th weeks after AOM administration (15-18 rats/group).The number of ACF in the UDCA treated group was decreased significantly in the initiation and post-initiation stages at the 2nd (Plt0.01, Plt0.0001) and 8th weeks (Plt0.001, Plt0.0001),respectively, compared with untreated controls. In the time-course experiments, the effect of continuous feeding of UDCA (0.4%) on ACF formation was evaluated. ACF number was decreased significantly (Plt0.005) until the 16thweek.UDCAshowed a significant dose-dependent suppression of ACF number from a range of 0.1-0.4%UDCA.To approach the subcellular mechanisms of the effect of bile acids, the intracellular free Ca2+ concentration ([Ca2+]i) of bile acid-treated rat colonic cancer cells (ACL-15) was examined. DCA and CDCA, which are promotive on ACF formation, induced a rapid increase in [Ca2+]i, while UDCA and CA, which are suppressive or non-effective on ACF formation, did not. These findings suggest that the promotive effect of bile acids may involve intracellular Ca2+ signaling

Estimation of free calcium levels after thyroidectomy

Total calcium is routinely measured after thyroidectomy in a clinical setting, while the measurement or calculation of the free calcium level is not generally performed. We reviewed total and free calcium levels in patients who underwent lobectomy (n=15), subtotal thyroidectomy (n=15) and total thyroidectomy (n=15). Postoperative total calcium levels decreased significantly in comparison to preoperative levels in all thyroidectomies (p<0.01), and this fall was significantly related to the extent of surgery (p<0.01). In contrast, there was no significant difference between preoperative and postoperative free calcium levels in patients undergoing lobectomy, although we found a decrease in free calcium levels after both subtotal and total thyroidectomy. Total protein levels decreased regardless of the type of operation. Serum total calcium levels were thought to be altered by serum protein levels through the change of protein-bound calcium levels. When examined for free calcium levels, some patients were administered unnecessary calcium supplementation because hypocalcemia had been judged from the total calcium level. Since the wrong diagnosis may be given with regard to hypoparathyroidism by measurement of total calcium levels alone, we propose that free calcium levels should be routinely measured or calculated after thyroidectomy

トクシマ ダイガク ビョウイン ニ オケル ジュウショウ キンムリョクショウ 101 レイ ノ ケントウ

Thymectomy is an established treatment for seropositive（ACh-R antibodies positive） myasthenia gravis（MG）in younger patients, but an review described the effectiveness of thymectomy without thymoma remains as uncertain. To investigate the clinical course of MG in association with thymus and to develop a better strategy for MG treatment, we reviewed 101 MG patients who had taken therapies in our hospital between 1986 and 2006. Recently, late-onset MG patients had increased. A few MG patients without thymoma, in particular, hyperplasia had good clinical courses after thymectomy. So, we can’t exclude thymectomy from therapeutic options in patients without thymoma. We should select an appropriate strategy for individual cases, because MG has heterogeneous characters with in age at onset, thymic changes, and patterns of muscle weakness

Late recurrence of acinic cell carcinoma of the parotid gland

Acinic cell carcinoma of the salivary glands is a rare cancer representing a low grade malignancy. The recurrence of a tumor is sometimes encountered, usually within 5years of initial operation. We describe an unusual recurrence after a long interval following primary surgery. In1987, a 60-year-old woman underwent excision of a mass in the superficial lobe of the right parotid gland under the preoperative diagnosis of a benign tumor. A histologic diagnosis of acinic cell carcinoma was made by examining sections from the resected mass. The patient noted several small nodules in the right parotid region in 1995, but she did not visit our clinic until 1998 when tenderness developed. A locally recurrent tumor and cervical lymph nodes containing metastases were resected and postoperative radiotherapy was given11years after the first operation. At least 10years of follow-up may be necessary for patients with acinic cell carcinoma because of slow-tumor growth