Jui-Tung Chen

Menopausal hot flash and calciotonin gene-related peptide; effect of Keishi-bukuryo-gan, a kampo medicine, related to plasma calciotonin gene-related peptide level

OBJECTIVES The purpose of this study is to investigate relationship of menopausal hot flash and calcitonin gene-related peptide (CGRP). Furthermore, this study evaluated the effect of the Japanese herbal (kampo) medicine Keishi-bukuryo-gan from the aspect of CGRP regulation. METHODS Plasma CGRP and vasoactive intestinal peptide (VIP) levels were measured during hot flash and CGRP reactivity was studied by cold load test in subjects with/without hot flashes. The effect of Keishi-bukuryo-gan was assessed in comparison with plasma CGRP level. RESULTS Only plasma CGRP but not VIP significantly elevated at the occurrence of hot flash (P=0.002). Stress by cold load significantly enhanced the over-secretion of CGRP in subjects with flash compared with those without flash (P=0.003) 3 min after the load. Keishi-bukuryo-gan decreased plasma CGRP level in subjects with hot flash. CONCLUSIONS CGRP but not VIP was mainly related to the occurrence of hot flash. Keishi-bukuryo-gan, Japanese herbal medicine, improves hot flash possibly affecting plasma CGRP level.

Clinical study of primary carcinoma of the fallopian tube: Experience with 15 cases

Between 1950 and 1986, fifteen cases of primary carcinoma of the fallopian tube were diagnosed and treated at the Cancer Institute Hospital, Tokyo. These cases constituted 0.14% of the total number of gynecologic malignancies at the hospital during that period. The average age of the 15 patients was 55.7 years. The most frequent symptom was atypical genital bleeding, seen in 12 cases (80%). Massive watery discharge was seen in 4 cases (27%). In preoperative cytologic examination, 6 cases (40%) were positive for cancer. All cases underwent operation as therapy. Postoperative irradiation, adjuvant chemotherapy, and/or second- or third-look operations were also performed. Histopathologically, all materials were found to be adenocarcinoma. Four cases were well differentiated, eight were moderately differentiated, and three were poorly differentiated. As for the prognosis, 7 patients were followed more than 5 years postoperatively. The 5-year survival rate was 57% (4/7). In stage I cancers, the 5-year survival rate was 80% (4/5). The prognosis of stage I cancer patients was estimated to be rather good.

Assessment of bone density in the distal radius with computer assisted X-ray densitometry (CXD)

A modified and improved radiographic absorptiometry of the distal radius which enables on-site analysis, called computer assisted X-ray densitometry (CXD), was evaluated from the viewpoint of quality assessment. Its precision and the correlation with dual energy X-ray absorptiometry (DXA) was evaluated in 12 volunteers (mean age 44.7 years). The profile of CXD-measured radial bone mineral density (RBMD) from 142 subjects (75 premenopausal and 67 postmenopausal women, mean ages 44.9 and 50.6 years, respectively) were compared with previous data by other methodologies of bone mineral analysis. The intra-assay coefficient of variation (CV) was 0.617%, the inter-assay CV was 2.064%, and the inter-observer CV was 0.673%. The correlation between CXD-measured RBMD and DXA-measured RBMD was of statistical significance (r2 = 0.733, P < 0.01). The correlation of CXD-measured RBMD with age, height or weight corresponded well with previous reports. CXD-measured RBMD and DXA-measured vertebral bone mineral density (VBMD) also had a significant positive correlation, but their correlation was not so close (r2 = 0.149, P < 0.01). The discriminative ability of osteoporosis by CXD was of acceptable level (odds ratio = 5.72, P < 0.05), when assessed by comparison with bone dystrophy score (BDS) on the plain vertebral radiogram. Although some problems remain in technical standardization, CXD could be an easy, inexpensive, and widely applicable alternative of non-weight bearing cancellous bone densitometry.

Interferon-α, interferon-γ and sizofiran in the adjuvant therapy in ovarian cancer — a preliminary trial

The study included 24 cases of negative second-look laparotomy (SLL) after operation on ovarian cancer. 12 cases were treated with sizofiran and recombinant interferon-γ before and after SLL and then with human lymphoblastoid interferon-α. The remaining 12 cases (controls) were followed up without any drug therapy after SLL.There were no recurrences in the treated group, but in 3 cases of the control group.Also significant difference in survival was noted in the treated group.

Use of angio computed tomography to evaluate extent of endometrial carcinoma

Patients with endometrial carcinoma underwent angio computed tomography (CT) prior to surgery to evaluate the extent of the carcinoma. The subjects of the study were 87 patients operated on at the Cancer Institute Hospital during the period 1983 to 1986. After preoperative bilateral internal iliac angiography, angio CT was performed using the already inserted catheters. Although the intact uterine wall was enhanced by the angio CT, the cancerous lesion was not, which permitted easy recognition of the cancerous lesion as a low-density area. To evaluate the degree of myometrial invasion, the minimal thickness of intact uterine wall was measured in the CT image, and was compared later with findings from the operative materials. The comparison showed that for all the patients, the minimal thickness of the intact uterine wall as shown in the CT image was comparable to the actual minimal thickness of the operative materials. Because depth of myometrial invasion is known as an important prognostic factor, measurement of the minimal thickness of the intact uterine wall as shown in the CT image is useful as an objective prognostic factor. Angio CT facilitates recognition of myometrial invasion preoperatively.

Maintenance of the activation of peritoneal macrophages in patients with ovarian cancer by sizofiran and recombinant interferon-γ

Four patients with ovarian cancer received 20 mg of sizofiran, a β-1,3-glucan (molecular weight: 450,000), intramuscularly one day before and 4, 7, 11, 14, 18 and 21 days after second look laparotomy and recombinant interferon-γ (rIFN-γ) intraperitoneally on the day of second look laparotomy and 4, 7, 11, 14, 18 and 21 days thereafter.The peritoneal cavity was washed with physiological saline and peritoneal macrophages (Mø) were isolated. The number of Mø increased 30-1600 times during the treatment period. The concentrations of interleukin-1, interferon-γ, tumor necrosis factor and prostaglandin E2 were also found increased in the supernatant fluid of Mø cultured for 24 hours with 10 µg/ml of lipopolysaccharide. The present study demonstrated that the activation of peritoneal Mø could be maintained and its number was increased by repeated dosing of sizofiran and rIFN-γ in combination every three or four days in patients with ovarian cancer. Peritoneal Mø thus activated may exert an antitumor effect on ovarian cancer.

New cisplatin schedule in combination with aclarubicin (ACR) with high response rate in recurrent gynecological adenocarcinomas

Abstract Fourteen patients with recurrent gynecological adenocarcinomas (nine with endometrial cancer and six with ovarian cancer) were treated with cisplatin given by 14-day continuous infusion at a daily dose of 10 mg/m 2 in combination with aclarubicin (ACR) at a dose of 20 mg/body on alternate days during each 14-day course. The daily dose of cisplatin was given with 1 liter of fluids; no diuretics were administered. The overall response rate was 71.4% (50% in endometrial cancer and 100% in ovarian cancer). It was especially interesting that a 100% response rate was obtained in five patients previously treated with cisplatin; i.e., the present cisplatin dosing schedule was highly effective as second-line therapy in these patients. No renal or gastrointestinal toxicity was observed. These results were pharmacokinetically explained by the plasma concentration of filterable platinum. A low-level, plateau-like curve with a great area under filterable [Pt]-time curve (AUC) seemed to ensure exposure of cancer cells to filterable platinum for sufficiently long periods and freedom from gastrointestinal and renal side effects.