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A 63-year-old male underwent a sleeve pneumonectomy with partial pericardiectomy for a squamous cell carcinoma of the right upper bronchus invading the trachea. The pericardial defect was closed primarily. The initial postoperative course was uneventful until we performed endotracheal suction with bronchoscopy in that evening. After severe coughing, he was noted to have a decrease in blood pressure following bradycardia and premature ventricular contraction. He soon fell in shock. A chest X-ray film revealed the cardiac shadow shifted to the right hemithorax. Immediately he was taken back to the theater and rethoracotomy was performed. The heart was found to have herniated into the right hemithorax. As soon as it was repositioned, his general condition improved. The pericardial defect was repaired with a GORE-TEX patch. He recovered. The cardiac herniation after pneumonectomy is one of the fatal complications unless prompt diagnosis and surgical reduction should be done. Repair of the pericardial defect with strong prosthetic patches and careful postoperative management are indispensable for the prevention of the cardiac herniation after pneumonectomy.

The effects of liposomes on the phagocytic activity of mouse peritoneal macrophages were investigated using IgG-opsonized sheep red blood cells (SRBC). The highest ingestion index of opsonized SRBC via Fc receptors of macrophages from BALB/c mice was observed for macrophages harvested on day 4 following the intraperitoneal injection of liposomes (2.27 mumol lipid/mouse). An increase in the ingestion index was observed irrespective of liposomal charge. Binding parameters of Fc receptors of macrophages from liposome- or saline-injected mice were determined using horseradish peroxidase-conjugated IgG, and an increase in the number of binding sites with the same binding constant was observed in macrophages from liposome-injected mice. The activation mechanism of mouse peritoneal macrophages by liposomes differed from that by lipopolysaccharides. Liposomes thus appear to contribute to the activation of immune response.

Valsa canker is the most serious wood rot disease of apple in Japan. Dormant, excised twig assay in vitro was used to determine resistance to Valsa canker. ‘Fuji’,’ starking Delicious’, ‘M.26 EMLA’, and ‘MM. 106’ were considered to be highly susceptible, while Malus sieboldii showed moderate resistance. Several cultivars belonging to M. prunifolia, M. baccata, and M. × domestica showed comparative resistance. The phloridzin content in the bark of Malus species was studied in relation to Valsa canker resistance. Phloridzin content of M. sieboldii was lower than in M. × domestica. Comparatively resistant cultivars had similar or higher phloridzin content compared to susceptible cultivars. No clear correlations were found between resistance and phloridzin contents in the bark of Malus species.

Total cholesterol levels, obesity index and blood pressure were measured in 6,278 school-age children living in Ibaraki Prefecture in 1991, and children with high risk for atherosclerosis were identified. The frequencies of the school-age children with hypercholesterolemia (total cholesterolor = 200 mg/dl), obesity (obesity indexor = 40%) or hypertension were 7%, 5%, 1%, respectively. In half of the area where the children lived, lipid measurements were also obtained in the parents of hypercholesterolemic children. Twenty-nine out of ninety fathers (32%) and 22 out of 140 mothers (16%) were hypercholesterolemia (total cholesterolor = 240 mg/dl). Among them five families of familial hypercholesterolemia were diagnosed. Seventy children with hypercholesterolemia and 81 obese children, who were screened and received health counseling, were re-examined after one year. The levels of LDL-cholesterol, triglyceride and atherogenic index were significantly decreased and HDL cholesterol level was significantly increased in the children with hypercholesterolemia. Obesity index, triglyceride level and atherogenic index were significantly decreased and HDL cholesterol level was significantly increased in the children with obesity. In addition, the frequencies of the children with dyslipidemia or liver dysfunction were significantly decreased in the obese children after one year. These data suggested that the screening system and the plans after the examinations described here were effective in reducing risk factors for atherosclerosis in children.

The efficacy of intrathoracic administration of pirarubicin (THP-ADM), a derivative of adriamycin, was evaluated in 20 patients with malignant effusion due to lung cancer. All 20 patients had no previous intrapleural therapy. According to the criteria of ECOG, eight patients were at performance status 1 (P.S.1), nine were P.S.2, and three were P.S.3. Fourteen patients were clinical stage IIIB, and six stage IV. The effusions were first completely drained by thoracocentesis or tube thoracostomy drainage, and 30 mg/m2 THP-ADM was instilled. Overall response rate was 50.0%. The response rate for treatment with tube thoracostomy drainage was 69.2%, which was significantly higher than that for treatment with thoracocentesis (14.3%). Significant difference in survival was not seen between the tube thoracostomy drainage group and the thoracocentesis group. There were no severe side effects. In conclusion, intrapleural administration of THP-ADM with tube thoracostomy drainage was considered to be useful for the control of malignant pleural effusion due to lung cancer.

We described a very rare case of malignant hemangiopericytoma of the chest wall, which was surgically resected. The patient, a 50-year-old woman, came to our hospital because of an abnormal shadow in the right chest wall of X-ray film without any symptom. The diagnosis of hemangiopericytoma was made with preoperative cytologic examination by means of transcutaneous aspiration biopsy. The tumor was a 47 x 36 x 25 mm, round and sessile mass originating from the 5th intercostal tissue without pulmonary adhesion, and the patient underwent en bloc resection of the tumor with the 16 x 12 mm sized chest wall including the 4th, 5th and 6th ribs. Pathological diagnosis was malignant hemangiopericytoma. Postoperative course was uneventful, and the patient is now doing well without local recurrence and distant metastasis for 11 months after the operation. We reviewed 8 cases of this tumor reported in the Japanese literatures.

To evaluate the usefulness of liposomes as a carrier for the targeted delivery of antigens to gut-associated lymphoid tissue, liposomal stability and uptake by rat Peyer's patches were investigated. Liposomes composed of distearoylphosphatidylcholine, phosphatidylserine, and cholesterol (DSPC-liposome), or dipalmitoylphosphatidylcholine, phosphatidylserine, and cholesterol were stable in acidic solution (pH 2.0), diluted bile, and pancreatin solution. Following the oral administration of liposomes to rats, rhodamine B-PE incorporated in the lipid phase of DSPC-liposomes was preferentially taken up by Peyer's patches in the lower ileum. The uptake of rhodamine B-PE from DSPC-liposomes larger than 374 nm in mean diameter was high. Orally administered DSPC-liposomes of a large diameter thus appear to serve effectively as a vehicle for delivering antigens to Peyer's patches.

Uptake of the nonabsorbable marker 6-carboxyfluorescein was investigated both free and encapsulated in liposomes as a function of their surface charge and hydrodynamic diameter in rat Peyer's patch and nonpatch tissue. Significant uptake of the marker occurred only when encapsulated in liposomes consisting of at least 25 mol% phosphatidylserine and was highest in Peyer's patches. 6-Carboxyfluorescein encapsulated in liposomes equal to or greater than 374 nm was preferentially taken up by Peyer's patches. There was a trend to higher uptake in lower intestinal segments. These findings were supported by fluorescence microscopic observations. Uptake by Peyer's patches was specific for negatively charged liposomes as judged from competition studies.

We report a case of pure choriocarcinoma of the left testis in a 27-year-old male. He consulted a physician with left back pain in August, 1990. Intravenous pyelography (IVP) revealed left hydronephrosis. Abnormal computerized tomography (CT) revealed para-aortic lymph node swelling. The chest X-ray revealed bilateral multiple coin lesions. The genital examination revealed a left testicular nodule 8 mm in diameter. Left high inguinal orchiectomy was performed. Histopathological diagnosis was pure choriocarcinoma. After 4 courses of the PVB (cisplatin, vinblastine, bleomycin) therapy, tumor regression rate of the pulmonary metastases was 41.9%. He was transferred to our hospital on December 3, 1990 and was admitted 3 days later. "COMPE" chemotherapy, consisting of cisplatin, vincristine, methotrexate, peplomycin, and etoposide, was administered. After seven courses of "COMPE" chemotherapy, he achieved a partial response (the regression rate of the pulmonary metastases and the retroperitoneal lymph node metastasis were 78.8% and 69.1%, respectively) and the residual masses in the lungs and the retroperitoneum were removed. Necrosis and xanthogranulomatous fibrosis were found in the resected material. The patient showed no evidence of disease one year after thoracotomy.

Postoperative recurrence rate and recurrence form were analyzed in two clinical forms of Crohn's disease at primary resection, one of which was perforating and the other was non perforating. Forty four patients with Crohn's disease were included in this study, 18 of them were perforating type and 26 were non perforating type. Crude recurrence rates were 39% (7/18 cases) in perforating type group and 54% (14/26 cases) in non perforating type group, which were not significantly different. Cumulative recurrence rates 5 years after initial operation were 58% in perforating type group and 47% in non perforating group without statistically significance. The recurrence form was perforating type more frequently in perforating type group (86%) than non perforating group at primary resection (29%) with statistically significance (p = 0.013). Postoperative recurrence form had a tendency to be similar to the form at primary resection. It was suggested from this study that Crohn's disease had two different disease entities; perforating and non perforating types and that postoperative recurrence should be examined carefully from the view of primary resection.

The reaction profiles of n-butenes isomerization obtained by a computer are useful to characterize and visualize the acid-base nature of the catalysts.

This study was conducted to mainly investigate physical functions such as Tinetti balance and gait evaluation, the right and left sides of the grips and legs strength, the time of length standing on leg, postural sway in standing, and also to clarify the case of falls in the institutionalized elderly. Subjects at the Hakuji Home for elderly in Ibaraki prefecture were examined. The subjects (n = 45) were classified into two groups: the higher ability of the activities of daily living (ADL) scales (n = 22) and the lower ability of ADL scales (n = 23). They were compared in a history of degrees of falls in the institution. The main results obtained were as follows: 1) The score of Tinetti balance and gait evaluation were significantly lower among elderly having a history of falls in the lower ability of ADL (p0.05). 2) The grips and legs strength were lower among all subjects expect the lower ability group of ADL scales whom rightside limbs strength was high. 3) The time length of standing on leg was shorter among elderly having a history of falls. Results of this study showed that while not statistically significant. Postual sway was more prominent among elderly having a history of falls than those without. In more cases, dementia was the cause of falls among elderly. It was suggested that nursing intervention was very important to prevent falls among the elderly of cognitive impairment in the institution for the elderly.

This study was conducted to determine what factors are related to falls, conditions contributing to falls and the associated injuries. Subjects who had lived in 3 institutions for the elderly in the western region of Shizuoka Prefecture were chosen. Subjects (n = 181) had an average age of 76.4 +/- 7.8 years, and all were interviewed regardless of their history of falls. For those who had experienced falls further interviews were conducted. The following results were obtained: 1) There were 64 subjects (35.4% of the subjects) who had experienced falls, some having experienced multiple falls (for a total count of 89 falls). 2) The frequency of falls of differed by sex or age was significantly. The frequency of females was significantly higher than that of males. The frequency for those in their 70's was lower than in other age groups. 3) At the time of experiencing falls the majority of subjects had hypertension, eye symptoms, insomnia, paralysis, functional restrictions, were going up or down stairs, working, and had difficulty reading characters in newspapers, had experiences of stumbling or need of medical attention within for the past 2 years. Results of this study showed that, while the use of tranquilizers or hypnotics were not statistically significant, they were closely connected to and increase in falls among the aged. 4) In the causes of falls, intrinsic factors figured in 34 (34.0%) cases, and the extrinsic factors in 66 (66.0%). 5) Both falls and fall-caused external injuries were higher among females than males. Furthermore, female subjects mainly suffered contusions and fractures while male subjects mainly suffered abrasions.

An interview survey was held with the purpose of grasping the problems faced by the home care elderly living in Koga city in Ibaraki prefecture. The subjects of the study were 100 cases who had been registered as elderly requiring home care in the municipality. The main results were as follows: (1) The most frequent underlying disorders that were considered as causes of disabilities in the home care elderly were cerebrovascular diseases, senile dementia and external injuries. In 67 percent of the subjects, one of these three disorders had caused the disabilities. (2) Disabilities in self care activities and in mobility were closely related to each other and the order of the difficulty in performing these activities was similar in many cases. A large number of the subjects sustaining severe disabilities expressed discontent with their daily life. (3) Forty two percent of the subjects were so-called bedridden elderly who got out of bed for less than 3 hours a day. The Barthel index score was 60 or less in all of the bedridden subjects. (4) For most of the bedridden elderly, bed rest was not required and probably exacerbated the disuse syndrome. In order to ameliorate their condition, adequate rehabilitation programs and assistance in their daily activities need to be offered. (5) Seventy eight percent of the care givers complained about the burden of care. Those who had no assistant care giver complained more frequently. Many of the care givers complaining about their burden had their own health problems. (6) The utilization of social welfare services were not always without any problems. The number of the experts who can deal with the psychosocial aspects in the elderly should be increased in order to improve the situation.

Between 1959 and 1986, 32 patients with pulmonary metastatic tumors from squamous cell carcinoma of the uterine cervix underwent pulmonary resection. The method of pulmonary resection was correlated with the pathology of the metastases. In 20 patients with pulmonary metastatic lesions 3 cm in diameter or larger, secondary lymph node involvement was observed in 65% and microscopic satellite lesions around the main metastatic lesion were seen in 50%. On the other hand, in none of 12 patients having metastatic lesions smaller than 3 cm was there accompanying lymph node involvement, and microscopic satellite lesions were observed in only one patient among them. Consequently, we concluded that wedge resection with a disease-free margin of 2 cm or a little more from the tumor edge was appropriate for lesions smaller than 3 cm in diameter, and lobectomy with lymph node dissection was necessary for lesions 3 cm in diameter or more.

Forty-five cases of PTCA with prior CABG and 14 cases of CABG with prior PTCA were studied on their pathogenesis and results. Ninety-four PTCA procedures were performed electively after CABG on 45 patients and 145 lesions. Lesion success rates were 95.8% in stenosis and 55.6% in occluded vessel. The mortality was none and no emergent surgery was needed. Causes of PTCA following CABG included the progression of coronary artery disease (13.1%), graft stenosis (15.0%), graft occlusion (31.0%), incomplete revascularization (13.8%), restenosis after the initial procedure (26.2%). Especially percentage of the progression of coronary artery disease was increased with a lapse of time, and it was 31.7% in PTCA group over 3 years after CABG. Fourteen patients with prior PTCA were received CABG because of unsuccessful PTCA (50.0%), progression to LMCD (21.4%), restenosis (21.4%), and PTCA complication (7.1%). Both interventions were appropriate and useful to reduce the recurrent ischemia and cardiac events with each other. Myocardial revascularization should not be considered either PTCA or CABG, but PTCA and CABG. In conclusion the strategy that much more benefits can be obtained from supplementary use of PTCA and CABG makes it possible to reduce the mortality and morbidity associated with intervention.

A case of hepatic encephalopathy secondary to a large-caliber porto-hepatic venous shunt in a 61-year-old woman with gastric cancer is reported. Mild confusion, flapping tremor and hyperammonemia were noted preoperatively. Abdominal ultrasonography showed a large-caliber porto-hepatic venous shunt in the left lateral segment of the liver. Percutaneous transhepatic portography and superior mesenteric angiography were confirmatory. Intraoperative portal scintigraphy was performed before and after temporary shunt occlusion to measure the intrahepatic shunt rate, which decreased markedly after occlusion. Portal pressure was also measured, and increased only slightly after occlusion. Left lateral hepatic segmentectomy, and subtotal gastrectomy with splenectomy were performed. Hepatic encephalopathy resolved postoperatively. The shunt was thought to be acquired. The relevant reports on large-caliber porto-hepatic venous shunts in the literature are reviewed.

As part of a joint study on preoperative radiotherapy for developing an optimal mode of rectal cancer therapy, ACNU sensitization was studied in a total of 120 cases, with the cooperation of 48 facilities participating nationwide. The following results were obtained. Improvement in depth of invasion was more distinct in the combination preoperative therapy-ACNU group than in the preoperative radiotherapy group, with no other significant differences between the two. This finding suggests that dose and administration method could be improved. White blood cells and platelets were reduced in some cases of the ACNU combination group, but these reductions were not serious enough to impede surgical procedures. In addition, no significant difference in complications was noted between the two.

We examined loss of heterozygosity (LOH) on all autosomal chromosomes in 53 non-small cell lung carcinomas. Frequent LOH was observed on the long arms of chromosomes 1 (37%), 2 (31%), 5 (30%), 8 (31%), and 13 (32%), and the short arms of chromosomes 3 (54%) and 17 (62%). LOH on chromosomes 3p and 17p was observed in all informative cases of squamous cell carcinoma, but was significantly less frequent in adenocarcinomas (P = 0.003 and 0.001, respectively). Similarly, LOH on chromosome 13q was observed frequently in squamous cell carcinomas (5 of 9 informative cases, or 56%), but in only 5 of 26, or 19%, of adenocarcinomas. In contrast, LOH on chromosome 2q was observed only in adenocarcinomas. In addition, this chromosomal arm was lost more frequently in poorly differentiated, compared to well differentiated adenocarcinomas. Furthermore, a correlation between fractional allelic loss and pathohistological grade was identified. These results implicate the presence of several tumor suppressor genes associated with development and/or progression of non-small cell lung carcinomas.

Serum concentration of angiotensin-converting enzyme (ACE) were measured in 34 patients with Crohn's disease. ACE was decreased in Crohn's disease compared with healthy controls. Significant negative regression between ACE and CDAI was observed. It suggested intestinal ACE may play a regulatory role in intestinal inflammation of Crohn's disease. Among the patients, ACE did not show the significant change by use of prednisolone nor by location of disease. The mechanism of ACE decrease in Crohn's disease was not known, but this phenomena may be one of the reason of persistent inflammation of Crohn's disease.

A randomized, controlled trial of adjuvant immunochemotherapy with PSK (Kureha Chemical Industry Co., Tokyo, Japan) in curatively resected colorectal cancer was studied in 35 institutions in the Kanagawa prefecture. From March 1985 to February 1987, 462 patients were registered. Four hundred forty-eight of those patients (97.0 percent) satisfied the eligibility criteria. The control group received mitomycin C intravenously on the day of and the day after surgery, followed by oral 5-fluorouracil (5-FU) administration for over six months. The PSK group received PSK orally for over three years, in addition to mitomycin C and 5-FU as in the control group. At the end of February 1990, the median follow-up time for this study was four years (range, three to five years). The disease-free survival curve and the survival curve of the PSK group were better than those of the control group, and differences between the two groups were statistically significant (disease-free survival, P = 0.013; survival, P = 0.013). These results indicate that adjuvant immunochemotherapy with PSK was beneficial for curatively resected colorectal cancer.

An antitumor antibiotic C-1027, a complex protein consisting of an apoprotein and a non-covalently bound chromophore, showed some aminopeptidase activity, 1/15 (on the basis of activity per mg protein) that of porcine kidney enzyme [E.C. 3.4.11.2] by use of L-phenylalanyl 4-methyl-coumaryl-7-amide as the substrate. Neither the apoprotein alone nor the chromophore alone were active. Amastatin and bestatin but not leupeptin inhibited the activity. The enzyme activity of the holo-antibiotic, as opposed to that of the porcine kidney enzyme, was readily lost by UV irradiation, indicating that the intact structure of the chromophore was needed to maintain the native conformation of the holo-antibiotic. The cytotoxicity of the holo-antibiotic, but not that of the chromophore, to Ehrlich carcinoma cells in vitro was reduced to 1/5 by 1 microgram/ml of amastatin which alone had no effect on cell growth. The porcine aminopeptidase was not cytotoxic at all even at higher concentrations (higher enzyme activities/ml). Amastatin possibly occupied the catalytic domain of the holo-antibiotic, interfering with the binding of the holo-antibiotic with some cell-surface protein(s). Amastatin did not inhibit the holo-antibiotic to cleave isolated DNA.

We have studied proximity effect-induced superconductivity of micro wire networks in a magnetic field for investigating topological effects of the superconducting order parameter through Little-Parks oscillation. We prepared a regular honeycomb network, which has Pb-Au bilayer structure, by standard electron beam lithography and measured variation of superconducting transition temperature (Tc) in a magnetic field. We also fabricated a honeycomb network made of Pb monolayer and measured it in the same way. In the experimental results of the monolayer network, 2.06 ± 0.02 Gauss of periodic variation of Tc in a magnetic field was observed at around 7.2 K. The area estimated from this period is 10.04 μm2 and correspond to unit honeycomb enclosed by center of the wire. While, in the results of the bilayer network, 2.66 ± 0.04 Gauss of periodic variation of Tc in a magnetic field was observed at around 4.3 K because of the proximity effect. The area estimated from this period is 7.78 μm2 and correspond to unit honeycomb enclosed by edge of the wire. In the latter case, the superconducting current flows through edge of the wire since the order parameter can be considered to be more developed and inhomogeneous on the wire cross-section at around 4.3 K less than 7.2 K. Consequently, a novel network of paths flowing through the superconducting current, which consists of loops enclosed by edge of the wire, can be realized by controlling the proximity effect.

In order to determine what factors are related to falls and the effect on the aged, a study was conducted on subjects aged 60 years and over who had undergone preventive health examinations in the western region of Shizuoka Prefecture. Subjects (n = 305) had an average age of 64.4 +/- 3.8 years, and all were interviewed regardless of their history of falls. For the 66 cases who had experienced falls, further questions prepared in advance, were included. The following results were obtained: 1) There were 66 subjects (21.6% of the subjects) who had experienced falls with some experienced multiple falls for a total count of 91 falls. 2) The frequency of falls of female subjects was significantly higher than that of males. Further, with respect to the type of injuries suffered, in the case of many of the female subjects, these took the form of contusions. 3) The majority of subjects who experienced falls were engaged in farming and most of the falls were work-related. 4) Results of this study showed that, while not statistically significant, cerebrovascular diseases are closely connected to falls and increases the falls coefficient among the aged.

A 12-year-old male patient with ataxia telangiectasia developed an acute lymphoblastic leukemia of T-cell phenotype. The lymphoblasts showed uniform surface expression of CD3, CD7, CD8, and T-cell receptor (TCR) alpha/beta chains, positive immunofluorescent staining of terminal deoxynucleotidyl transferase, complex cytogenetic aberrations including t(14;14) (q11;q32) and unique rearrangements of TCR beta and gamma chain genes, indicating the clonal expansion of leukemic cells. CD25 expression could be readily induced on the leukemic cells by mitogenic stimulation, followed by CD71 expression, but interleukin-2 production and subsequent proliferation in response to mitogens were subnormal.

The skin surface pH of 88 patients undergoing hemodialysis was investigated. The average of skin surface pH as measured at four different sites (forehead, forearm, palm and lower leg) was 4.5-5.0 and 5.0-6.0 in normal subjects and patients respectively. The difference in the two results was regarded as significant by Student's t test (p less than 0.01).

Ninety-one children were determined to have hypercholesterolemia from a screening of 1,469 school children in the community near University of Tsukuba, and family studies of these children were performed. More than 50% of the parents participated in the study. The mean cholesterol levels of parents of hypercholesterolemic children were significantly higher than that of controls. Hypercholesterolemia in parents of hypercholesterolemic children was more frequent than that in controls. Nine families with autosomal dominant hyperlipidemia including familial hypercholesterolemia and familial combined hyperlipidemia were detected by further family studies. These results indicate that genetic factors are important as causes of hypercholesterolemia of school children and that family studies of hypercholesterolemic children is an efficient method for screening for persons with increased risk for cardiovascular diseases.

Continuous hepatic arterial infusion chemotherapy using implantable reservoir was performed for liver metastases from colorectal cancer, and the therapeutic effects, side effects, and complications were evaluated. 9 patients with unresectable liver metastases were as follows, 1. Group A; 3 patients, MMC 2 mg.one shot + 5-FU 250 mg/day.continuous infusion x 14 days, and then 5-FU tablets 150 mg/day.p.o. x 14 days, 2. Group B; 4 patients, MMC 2 mg.one shot + 5-FU 500 mg/day.continuous infusion x 7 days, and then 5-FU tablets 150 mg/day.p.o. x 14 days, 3. Group C; 2 patients, 5-FU 500 mg/day.continuous infusion x 14 days, and then free from agents for 14 days. In 2 of 3 group A patients, the catheters became dislocated and one died of perforation of duodenum. In group A and group B, no severe side effects were noted. But both of group C patients showed nausea, vomiting and diarrhea. In 8 of 9 patients (89%), serum CEA level fell below the preoperative level. In 4 of 7 patients who underwent CT scan, the size of the tumor regressed. Total infused dose of 5-FU was 8.17 +/- 7.56 g in group A, 16.9 +/- 2.88 g in group B, and 21.0 +/- 9.90 g in group C on average. In 2 patients of group B, therapy was repeated seven times.

The effect of dextran sulfate of three molecular weights (1000, 5000, and 90,000) on the accumulation of gentamicin in rat kidney was investigated using a continuous infusion technique. During the infusions of both gentamicin and gentamicin-dextran sulfate mixtures, the gentamicin plasma concentration was maintained at 10 microgram/ml. The renal cortical accumulation of gentamicin was significantly lower when dextran sulfate (1000, 5000) was coadministered. The inhibition of cortical gentamicin accumulation increased with increasing dextran sulfate dose, and it was proportional to the amount of dextran sulfate excreted into the urine. Analysis by electrophoresis on cellulose acetate membrane indicated that gentamicin binds to dextran sulfate in rat urine. Therefore, gentamicin-dextran sulfate binding within the lumen of the proximal tubules may reduce the renal reabsorption and possibly the renal toxicity of gentamicin.

The selective delivery of human recombinant interferon (IFN)-gamma to isolated rat hepatocytes was studied with asialofetuin (AF)-labeled liposomes. AF-liposomes containing buffer solution were initially prepared by the detergent removal method, and IFN-gamma was subsequently encapsulated by the freeze-thawing method without loss of activity. Virtually no free [32P]IFN-gamma was internalized into isolated rat hepatocytes, whereas AF-liposomes containing [32P]IFN-gamma were taken up to a significant degree. Liposomal binding to the hepatocytes (estimated at 4 degrees C) was one-fifth of the uptake (estimated at 37 degrees C). Since the uptake was inhibited by the addition of free AF, AF-liposomes may be taken up by the action of galactose-binding protein on the hepatocytic cell surface. The liposome preparation method reported in this paper provides a useful means for the encapsulation of unstable macromolecules into AF-liposomes. AF-liposomes were found effectively to carry IFN-gamma into hepatocytes in vitro.

Despite a recent trend of rapid increase in the incidence of lung cancer in Japan, lung cancer has been detected rarely among young patients. The findings in 15 patients under 40 years of age who underwent surgery for primary lung cancer at Cancer Institute Hospital (C.I.H.) are presented. Fourteen were located in the region of the periphery. Ten of the 14 peripheral lesions were adenocarcinoma. The chances of cure or even long survival are very small. The case report presents a case with lung cancer in a 22-year-old woman who was the youngest in C.I.H. On histological examination, the excised tumor proved to be moderately differentiated adenocarcinoma.