HLA Class I and Class II Antigen Expression in Gastric Cancer Cells and Induction of Its Expression by Local Injection of OK-432

The measurements of HLA class I and II antigen expressions were made in association with assessment of antiproliferation effects on cancer cells. Experiments were designed to measure HLA class I and II expressions by using flow cytometry in the mixed culture of WiDr cells, OK-432 and peripheral lymphocytes. The result showed that proliferation of cancer cells was suppressed in contact with OK-432, indicating augmented HLA class I and II antigen expression. It was suggested of activation of immunocompetent cells as well as induction of HLA antigen expression. HLA class I and II antigen expressions were clinically eveluated in patients with gastric cancer between with and with-out local administration of OK-432. Cancer tissues were fixed by to AMeX method and immunohistochemically stained by ABC method. The degrees of HLA class I antigen expressions were depressed in accordance with cancer progression. In contrast, they were seen in the majority of patients in this study. On the other hand, HLA class II antigen expressions were reduced (p < 0.05) with cancer progression, the increase in cancer infiltration and the decrease in differentiation. It was suggested that reduction of HLA-class II (DR) antigen expression be in association with biologically malignant potential. In addition, it was assumed that local administration of OK-432 enabled HLA class II antigen expression and lymphocyte infiltration around the tumor to enhance even in patients with advanced and undifferentiated cancers and it was suggested that OK-432 made it possible to induce tumor immunity and to become a valid method of postoperative immunotherapy

A Study of Long-Term Metabolism of Nucleic Acid in the Repair Process of Cancer Cells with Cis-diamminedichloroplatinum (II)

CDDP is one of the anticancer drugs in which the presence of the repair mechanism has been pointed out. Thus, using established pulmonary cancer cells, we evaluated the metabolism of DNA and RNA in damaged cells treated with CDDP (0.1, 1.0, 10μg/ml) by means of 3 H-TdR . 3 H-UR incorporation assay for 15 days referring to the growth curve and colony forming assay. 3H-TdR uptake inhibition rate in CDDP treatment was higher than 3H-UR uptake inhibition rate and showed good correlation with the inhibition rate of colony formation. In order to evaluate the activity of metabolism of DNA and RNA, the experimental period was divided into two parts : an early stage (2-10 days) and a later stage (7-15 days), and changing phases of uptake of 3H-TdR and 3H-UR was estimated as an increased rate. In the early stage, cells treated CDDP at lower concentrations tended to show more active DNA and RNA metabolism, especially RNA. In the later stage, cells with 0.1μg/ml CDDP which had shown only slight growth inhibition in the early stage revealed lower activity than that in the early stage. Cells with 1.0vg/ml CDDP which showed regrowth after 7 days, and cells with 10μg/ml CDDP which were not recognized with proliferation were observed with more active metabolism of RNA than that in the early stage. Those results indicated that metabolism of RNA is closely associated with the cellular repair process by CDDP

Surgery for Perforation Complicating Colon Cancers

Eleven patients with perforation complicating colon cancers were clinically analyzed with respect to perforation sites and surgical outcome. In general, perforations complicating colon cancers are divided into two categor ies, free perforation and penetration with abscess or fistula formation. It is emphasized that surgical outcome for free perforation is unsatisfactory. Therefore, two-stage operation is recommended and the aim of the treatment should be first concentrated on peritonitis. In conclusion, complete resection of carcinoma is necessary in obtaining a satisfactory result

LOCAL RECURRENCE OF RECTAL CANCER

One hundred twenty-six rectal cancers were operated upon in the First Department of Surgery, Nagasaki University School of Medicine. Local recurrence occurred in thirty-three (26.2%). In this study, contributing factors in causing local recurrence were local excision of the surgical approach, advanced stage, depth of cancer invasion, location of carcinoma of the rectum below the peritoneal reflection (Rb) or above (Rba) and nodal involvement of n2 or more. As far as advanced rectal cancer and cancer location of Rb are concerned, it is suggested on the basis of this study that the incidence of local recurrence should be high

Benefit from omentopexy on bronchial wound healing in performing concurrent esophagectomy

The healing process of bronchial wound was compared among wrapping tissues such as pedicled omentum, pericardium, and parietal pleura in terms of the degrees of revascularization of the bronchial artery interrupted by bronchoplasty itself by microangiography, including the circumstances of performing a procedure of esophagectomy. The development of neovascularity was marked and facilitated by omentopexy. The procedure of wrapping by pedicled pericardium and pleura was not so useful for promoting neovascularity as would be expected, and it was almost the same as non-wrapping one. Meanwhile, recanalization by wrapping with free pleura was delayed. When esophagectomy was combined with bronchoplasty, revascularization was apparently retarded. In conclusion, wound healing at bronchial anastomosis was markedly impaired so that omentopexy was recommended for facilitating wound healing at anastomosis

Surgery for myasthenia gravis

The effect of thymectomy on myasthenia gravis was evaluated in the 48 patients with thymectomy for myasthenia gravis in the First Department of Surgery, Nagasaki University School of Medicine. The surgical approaches were done by midsternotomy in 44, by right thoractomy in 3 and by transcervical route in 1 respectively. As a rule, extended thymectomy was mainly applied. The disease stages in most cases included the types of Osserman II b and/or II a. The effect of thymectomy on myasthenia gravis was compared between the patients with and without thymoma. The effect of thymectomy for patients without thymoma was superior to that for patients with thymoma. There was no close relationship between the suffering time and the effect of thymectomy. Interestingly enough, the surgical outcome for those who had moderate or severe formation of germinal center in the resected thymic glands was not satisfactory and some aggravated following thymectomy

Carcinoma-containing CEA in colon cancers in primary and metastatic tumors

Carcinoma-containing CEA was measured as compared with normal tissues and metastases in the lymph nodes and the liver. The high CEA production was remarkable in the potent malignant tumors and metastases in the liver and the lymph nodes as compared with those in normal colon tissues as well as in non metastatic lymph nodes. It is reasonable to consider that high plasma CEA may well indicate advancing or highly potent malignant diseases or recurrence of colon cancers due to destruction of vascular structure by cancer invasion

Histological evaluation of cancer extension along the bronchial wall in lung cancer.

The surgical specimens obtained from 39 cases in which primary lung cancers were situated in the central portion proximal to subsegmental bronchi were histologically examined as to how long cancer lesions extend along the bronchial wall, based on grossly visible lesions in the mucosa. Of 34 cases, 87% showed proximal cancer extension along the bronchial wall. The mode of cancer spread was mainly adventitioal extension and the distence was within 20mm of the sites of grossly visible lesions in the mucosa. In cases with involvement of the mediastinal lymph nodes and/or carcinoma of undifferentiated histological type, there was a tendency to spread widely. When cancer was located in the orifice of the lobar bronchus, the peripheral cancer spreading was obvious. Based on these results, it is concluded that the site of resection of the bronchus should be 20mm distant from macroscopically recognizable cancer changes in the mucosa. In most cases (71.4%), however the extent of invasion in the bronchial wall was less than 10mm from such changes

Surgery for postoperative recurrence of gastric cancer

The six patients who underwent reoperation for recurrence of gastric cancer following surgery were clinically analysed, of whom one had lung metastasis and the other five local recurrences. The conditions of resectability are that carcinoma infiltration should be limited, the disease-free interval-after the first operation should be long and there are no blood-borne metastases into the lung and the liver. The surgical outcome for lung metastasis was pessimistic. It is emphasized that multidisciplinary therapy and early detection are indispensable for improving the surgical outcome in the treatment of recurrence of gastric cancer

Primary malignant tumors of the small intestine

From 1967 through 1987, 43 of primary malignant tumors of the small intestine were experienced at the First Department of Surgery, Nagasaki University Hospital and affiliated hospital, and clinically analysed. 1) Carcinoma, leiomyosarcoma and malignant lymphoma occupied one third in number. The preferable location of carcinomas and malignant lymphomas was lower part of the small bowel although that of leiomyosarcoma was upper part. 2) Diagnosis was mainly made by means of laparotomy which was carried out by clinical signs of obstruction or peritonitis. poor prognosis attributed to extension of a disease to nodes and liver. An early and accurate diagnosis of small bowel tumors is necessary for improving the survival rate