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A phase II trial of a novel platinum analog, SKI 2053R, was performed in patients with previously untreated extensive-stage disease (ED) small-cell lung cancer (SCLC). SKI 2053R was administered at the dose of 400 mg/m2 every 3 to 4 weeks as a 1-h infusion. After the first cycle, the dose was escalated to 440 mg/m2 based on toxicity. Thirty-eight patients (31 male) were enrolled between June 1995 and August 1997. The median age was 61 years (range, 36-70 years). Six of 37 evaluable patients achieved a partial response (16.2%; 95% confidence interval [CI], 4.4-28.0%). The durations of response were 1.1, 1.5, 1.7, 1.9, 3.4, and 4.6 months. The estimated median survival time was 7.4 months (95% CI, 5.1-9.7 months). Grade 3 or 4 toxicities were not observed. Grade 1 to 2 leukopenia, anemia, and thrombocytopenia were seen in 5 of 68 cycles, 16 of 68, and 2 of 68, respectively. Nonhematologic toxicities included grade 1 to 2 nausea or vomiting (30 of 68 cycles), nephrotoxicity (27 of 68), and hepatotoxicity (13 of 68). SKI 2053R showed a modest antitumor activity with limited toxicities in patients with ED SCLC. Further clinical trials are warranted in SCLC with a higher dose of SKI 2053R.

In the paper the principle of physician's "Refusal to treat under six cases" was reviewed. It was the first ethical code for physician in ancient China. The emergence of ethical code for physician was the result of medical professionalism and the formation of the professional groups. The principle proposed by the famous physician Bian-Que in ancient China, like Hippocratic Oath, was an ethics of outer achievement rather than one of inner intention. It provided a framework of medical behavior, and emerges as a powerful tool seeking to safeguard the reputation of the profession for its own sake rather than, in main, seeking to promote the patients' good.

Objectives: To determine the effectiveness and toxicity when levamisole was added to the adjuvant combination chemotherapy in patients with operable gastric cancer., Methods: After en bloc resection of gastric cancer without gross or microscopic evidence of residual disease from April 1991 to December 1992, 100 patients were randomized to 6 months of 5-fluorouracil 1,000 mg/m2/day administered as continuous infusion for 5 days, cisplatin 60 mg/m2/day as intravenous infusion for 1 day with or without levamisole (50 mg every eight hours P.O for a period of three days every 2 weeks for 6 months). This chemotherapy treatment was begun within 2 to 4 weeks after the surgery. The chemotherapy consisted of discrete 5-day courses administered at 4-weeks intervals. All 100 patients are assessable., Results: The fifty patients were assigned to each treatment group. There was no statistical difference and no bias in the distribution of characteristics of the 100 evaluable patients between the two groups. A total of 274 courses of treatment were given in the levamisole group and 260 courses of treatment in non-levamisole group. Eleven patients in each group did not finish planned 6 courses of treatment mainly due to non-compliance. At median follow up of 39 months, 32 patients relapsed 19 in the levamisole group and 13 in the non-levamisole group (p = 0.284). Twenty five patients died of relapsed diseases, 15 in the levamisole group and 10 in the non-levamisole group. The levamisole group tended to show more risk of overall death rate and recurrence than the non-levamisole group. However, this result was not statistically significant at 3 years. The treatment was well tolerated in both treatment groups. The grade 2-3 toxicities were nausea/ vomiting (levamisole, non-levamisole group; 31.7%, 29.3% of treatment courses respectively), diarrhea (7.6%, 8.4%), mucositis (11.6%, 12.3%), and leukopenia (9.8%, 9.6%)., Conclusion: Levamisole had negative effects on disease-free survival and overall survival when added to adjuvant combination chemotherapy of cisplatin and 5-fluorouracil in patients with operable gastric cancer. Both treatment arms were generally well tolerated and the toxicity profile was similar with or without levamisole.

An androgen receptor (AR) gene mutation identified in the androgen-dependent human prostate cancer xenograft, CWR22, changed codon 874 in the ligand-binding domain (exon H) from CAT for histidine to TAT for tyrosine and abolished a restriction site for the endonuclease SfaNI. SfaNI digestion of AR exon H DNA from normal but not from prostate cancer tissue indicated H874Y is a somatic mutation that occurred before the initial tumor transplant. CWR22, an epithelial cell tumor, expresses a 9.6-kb AR mRNA similar in size to the AR mRNA in human benign prostatic hyperplasia. AR protein is present in cell nuclei by immunostaining as in other androgen-responsive tissues. Transcriptional activity of recombinant H874Y transiently expressed in CV1 cells in the presence of testosterone or dihydrotestosterone was similar to that of wild type AR. With dihydrotestosterone at a near physiological concentration (0.01 nM), H874Y and wild type AR induced 2-fold greater luciferase activity than did the LNCaP mutant AR T877A. The adrenal androgen, dehydroepiandrosterone (10 and 100 nM) with H874Y stimulated a 3- to 8-fold greater response than with wild type AR and at 100 nM the response was similar with the LNCaP mutant. H874Y, like the LNCaP cell mutant, was more responsive to estradiol and progesterone than was wild type AR. The antiandrogen hydroxyflutamide (10 nM) had greater agonist activity (4- to 7-fold) with both mutant ARs than with wild type AR. AR mutations that alter ligand specificity may influence tumor progression subsequent to androgen withdrawal by making the AR more responsive to adrenal androgens or antiandrogens.

Between 1976 and 1995, 11 cases of side-wall defect repairment or circumferential reconstruction of trachea were performed using chest-wall tissue flap with an intercostal vascular pedicle. The indications were benign or malignant tumors of the tracheal side wall, lung cancers of the right upper lobe involving the side wall of the trachea and/or carina. The transverse diameter of the tracheal defect after removing the tumor was less than half of the tracheal circumference. Furthermore, we foun it feasible to reconstruct the trachea by using a tissue tube created by wrapping a chest-wall tissue flap over a temporary stent in case of long-segment tracheal resection of tracheal tumor or benign stenosis where. The defect was too long to be repaired by end-to-end anastomosis. The surgical technique & instructions were described.

Sapflow sensors were used to investigate variation in sapflow velocity at different positions in the sapwood of three-year-old Eucalyptus globulus ssp. globulus Labill. trees. Sapflow velocity was measured at 5-mm intervals across the sapwood by moving two probe sets simultaneously on two opposite radii. Another probe set placed in a fixed position at right angles to the first two sets acted as a control. A sapflow velocity ratio was defined as the velocity given by each moving sensor divided by that given by the static sensor. Correlation between observations of sapflow velocity at different positions exceeded 95%, and the ratio of velocity between any pair of sensors was constant. We observed radial variation in sapflow velocity across the sapwood with the lowest velocities at the center of the tree. Variation due to sensor position was high implying the need for large numbers of sensors for accurate estimates of sap flux. To overcome this need, we used a correction coefficient, namely a simple weighted average of the sapflow ratios with depth in the sapwood, for each fixed sensor. We recommend the use of three probe sets to estimate the correction coefficient. Subsequently, two probe sets can be placed at two fixed positions for routine measurements of sap flux.

Patients with acute myelocytic leukemia (AML) have varied outlooks for survival after the diagnosis. To identify pretreatment prognostic indicators in AML, we analyzed 132 cases of AML seen at our hospital between June, 1989 and December, 1994. The median age of the patients was 40 years (range, 15-81). There were 63 male and 69 female patients. One hundred eight patients (82%) received induction chemotherapy which was based on cytarabine plus anthracyclines. Sixty six patients achieved complete remission (CR) and the CR rate among the patients given induction chemotherapy was 61%. The median duration of CR was 11.2 months. After median follow up of 6.6 months (range 0.5-51.4), 26 patients (39%) remain in continuous CR. The median duration of overall survival of the patients was 6.7 months. After median follow up of 10.6 months (range, 0.1-52.7), 41 patients (31%) are alive. Variables affecting duration of CR included the age of the patients, performance status of the patients, percentage of blast in the peripheral blood, hemoglobin level, percentage of blast in the bone marrow, FAB subtype, and CD7 marker positivity. Variables affecting survival duration included age of the patients, performance status of the patients, absolute blast count (ABC) in the peripheral blood, bone marrow cellularity, the percentage of blast in the bone marrow, and CD5 marker positivity. Multivariate analysis showed that the age of the patients and percentage of blast in the bone marrow were significant independent indicators for overall survival of the patients. Further studies utilizing cytogenetics and molecular characteristics of leukemic cell are warranted to better define the prognostic factors of patients with AML.

Veno-occlusive disease (VOD) of the liver is a clinical syndrome characterized by hyperbilirubinemia, painful hepatomegaly, and fluid retention. In the bone marrow transplantation (BMT) setting, VOD is caused by dose-intensive chemotherapy and/or radiotherapy used to prepare patients for transplant. VOD occurs in up to 50% of the patients who undergo BMT and is usually associated with a high mortality rate. Until recently, there was no proven effective medical therapy for this condition once it was clinically apparent. We report here on the frequency and treatment result of VOD with rt-PA in our allogeneic BMT patients. Eight patients (median age 28.5 years) underwent allogeneic BMT from December, 1993 to June, 1995 in Asan Medical Center. Six leukemia patients were prepared for BMT with busulfan and cyclophosphmide, while two aplastic anemia patients received cyclophosphamide and antithymocyte globulin. VOD was defined as having two of the following features before day 20 posttransplant: jaundice (bilirubin > or = 2 mg/dL), tender hepatomegaly and/or right upper quadrant pain, ascites and/or unexplained weight gain (> 2% from baseline). All patients who were diagnosed with VOD received rt-PA (10-20 mg/day) and heparin (10,000 U/day). Three (37.5%) of the eight patients developed VOD that occurred between 6 and 10 days posttransplant. All three patients developed jaundice, weight gain, and tender hepatomegaly. Ascites and renal insufficiency occurred in two patients and pleural effusion in one patient. rt-PA and heparin were begun 6 to 26 days posttransplant and rt-PA was administered for 7 to 14 days. All three patients responded to the therapy; bilirubin levels began to decrease at 4 to 13 days from the start of therapy. They are all alive at day 111, 316, and 548 days posttransplant. None of the patients had significant hemorrhagic complications after rt-PA treatment. Prolonged administration of rt-PA was feasible without bleeding episode and it seems that rt-PA may alter the natural course of VOD.

A fusion protein containing the alternately spliced Extra Domain B [ED-B(+)] sequence of canine fibronectin was expressed in E. coli and the purified protein was used to produce an antibody specific for the ED-B(+) segment. This antibody recognized canine cartilage fibronectin but not canine plasma or synovial fluid fibronectin. Using this antibody, it was determined that ED-B(+) fibronectin increased proportionally with the total fibronectin in osteoarthritic cartilage. From this result, it was concluded that the chondrocyte is the source of much of the elevated fibronectin that appears in osteoarthritic cartilage.

The results of hyperthermic isolated limb perfusion therapy in 36 patients with stage II-IV malignant melanoma of the extremities are presented. With the technique employed, neither severe complications nor functional deficiencies attributable to the perfusion therapy were observed. The findings on follow-up for up to 36 months are comparable to those reported in the literature, with survival rates of about 90% for stage II and III patients and nearly 50% for stage IV patients. Thus, our technique appears to be beneficial, especially in respect of the very low rate of side effects.

In this paper the authors report the results of a cross-over treatment of 79 case of neurosis with vacuum drugs and L-tryptophan. The therapeutic effects were evaluated respectively with four-degree scale and the rating scales of SCL-90. Sleep vs. Sleep disturbance self-checklist. Side effects were evaluated with TESS. The data show that treatment of L-tryptophan 3.0g/day for six weeks. Rate of marked improvement is 58.2%, effective rate is 91.1%. It is concluded that the effects of hypnosis and sedation are mild side effects only. Using L-tryptophan the therapeutic effects which concern somatization depression anxiety, phobia, compulsion, are analysed and discussed.

Four methods for encapsulating adenosine triphosphate (ATP) in liposomes were evaluated. Optimum entrapment required emulsifying ATP with the lipids used to form the liposome membrane in a high-speed homogenizer followed by evaporating the organic solvent with vigorous stirring. Under these optimum conditions ATP entrapment was 38.9%; i.e., the dosage form contained 38.9 g of ATP per 100 g of lipid. The distribution of positively charged liposomes loaded with ATP was studied in dogs with experimentally induced myocardial infarction. Intravenous injection of positively charged ATP liposomes caused accumulation of ATP in myocardial infarct tissue. Myocardial infarct tissue has reduced blood flow; since positively charged liposomes accumulated in infarct tissue, liposomes may be a drug delivery system for this disease state.

Two 10-channel integrated-optic device modules have been constructed and tested. The architecture common to both modules consists of a LiNbO(3) composite waveguide 1.0 cm x 2.0 cm in size in which a channel-waveguide array, a planar waveguide, a linear microlens array, an electro-optic Bragg modulator array or an acousto-optic and electro-optic Bragg modulator array, and a large-aperture lens are integrated. A novel scheme that employs a linear ionmilled planar microlens array was devised to excite the entire channel-waveguide array simultaneously, and thus greatly facilitate testing and application of the two device modules. The performance characteristics obtained in programmable correlation of binary sequences are also presented.

Successful fabrication of high performance microlenses and microlens arrays using the titanium-indiffusion and proton-exchange technique has enabled realization of a variety of integrated electrooptic Bragg modulator modules in the LiNbO(3) channel-planar composite waveguides of 0.2- x 1.0- x 1.8-cm(3) substrate size. These integrated optic device modules have been utilized successfully to perform matrix-vector and matrix-matrix multiplications. Through the channel-waveguide and the linear microlens arrays, the very large channel capacities that are inherent in the diode laser and the optical fiber as well as the photodotcctor arrays may be conveniently exploited. Consequently, such integrated optic device modules should facilitate realization of multichannel optical computing as well as communication and rf signal processing systems.