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Metallic titanium (Ti) particles treated with N2 plasma via the barrel-plasma-treatment system were thoroughly evaluated, to investigate changes in physical and chemical properties resulting from the treatment. The color of the Ti particles changed from gray to uniform brown upon plasma-treatment, indicating good surface uniformity. Depth profiling using X-ray photoelectron spectroscopy showed that the nitrogen implanted by plasma-treatment formed Ti-N bonds at or near the surface of the particles, resulting in the formation of a stoichiometric TiN layer. It was determined from cross-sectional transmission electron microscopy and nanobeam diffraction measurements that the resulting TiN layer had two different structures. Nanoindentation data showed that the surface of a treated sample was about five times harder than that of untreated particles.

In this work, a sensitive and robust vacuum ultra-violet (VUV) single-photon ionization (SPI) ion trap time-of-flight mass spectrometer (VUV-SPI-IT-TOFMS) for on-line, realtime monitoring of chlorinated organic compounds in waste incineration flue gas has been newly developed. The fragment-free SPI technique with 121.6-nm VUV lamp irradiated by a microwave generator and the quadrupole ion trap to accumulate and select analyte ions were combined with a reflectron time-of-flight mass spectrometer to detect chlorinated organic compounds at trace level. This measuring system was tuned up to detect dioxins precursors with the aim at an application to monitoring trace level toxic substances in flue gases from incinerator furnaces. As a result, this technology has made it possible to analyze trichlorobenzene (T3CB), a dioxin precursor, in 18 s with a sensitivity of 80 ng/m3-N (10 pptv) using the selective accumulation of analyte substances and separation of interfering substances in the ion trap. Moreover, the first field test of the continuous monitoring T3CB in an actual waste incineration flue gas had been done for 7 months. The results show that this system has an exceeding robust performance and is able to maintain the high sensitivity in analyzing T3CB for long months of operation.

We studied the usefulness of the oral 5-FU anti-cancer drug 1-hexylcarbamoyl-5-fluorouracil (HCFU) + cyclophosphamide (CPM) + tamoxifen (TAM) (HCT group) in comparison with CMF + TAM (CMFT group) in adjuvant therapy for breast cancer by a non-inferiority study based on a multi-institutional joint study. Clinical stage I, II primary breast cancers with histologically positive axillary lymph node metastasis were randomly assigned to the HCT group or the CMFT group after primary surgery. We registered 136 cases (HCT group 68 cases, CMFT group 68 cases). No significant difference in the 5-year overall survival rate (OS) and the 5-year disease-free survival rate (DFS) was found between the two groups. In the stratified analysis, DFS in cases in which the number of metastatic lymph nodes was 1-3 was significantly better in the HCT group (HCT group 84.3%, CMFT group 69.4%, log-rank test p=0.0496). No significant difference in the total incidence of adverse effects was found between the two groups, but there were significantly less adverse effects of grade 2 or over in the HCT group (p=0.034). The QOL survey at 3 months after surgery showed a significant decline of the QOL regarding lassitude, degree of difficulty in daily life, satisfaction with treatment and present mood in the CMFT group. Study results suggest that 2-year HCT therapy including the oral 5-FU anti-cancer drug HCFU is a useful adjuvant therapy which can replace CMFT therapy in early breast cancer cases with 3 or lower metastatic lymph nodes.

The prognosis of advanced hepatocellular carcinoma (HCC) is extremely poor. Patient 1 was a 43-year-old male with major portal tumor thrombi. He received combination therapy consisting of continuous arterial infusion (MTX 30 mg/m2, day 1, CDDP/5-FU 6 mg/m2: 250 mg/m2, day 1-14) and subcutaneous injection of IFN-alpha (500 x 10(4) U, 3 times a week, 4 weeks). Patient 2 was a 66-year-old male with major hepatic venous tumor thrombi. He received combination therapy consisting of continuous arterial infusion (5-FU 6 mg/m2: 250 mg/m2, day 1-14) and subcutaneous injection of IFN-alpha (500 x 10(4) U, 3 times a week, 4 weeks). Decrease in tumor was observed in both patients markers and marked regression of tumor was observed in both patients. They are still in complete response. This combination therapy is an effective strategy for advanced HCC.

The patient, who is received home enteral nutrition (HEN) for a long time in a day, has problems on moving all days. Now, we tried Portermate, which is new portable devices for HEN, in his clinical care. The patient is chronic pancreatitis, and his clinical problems becomes to be worse after he ate. He was under total enteral nutrition via jejunostomy. His clinical complications were almost controlled after HEN, but he has a few complains receiving enteral nutrition. He would not move easily, for an old HEN system was not compact to move. Portermate made him go everywhere he wanted any time. It extremely improved his QOL under HEN. He continues to use Portermate.

Objective: To find out whether the addition of 1-hexylcarbamoyl-5-fluorouracil to a postoperative regimen of oral cyclophosphamide and tamoxifen improved the prognosis of carcinoma of the breast., Design: Randomised controlled clinical trial., Setting: 127 Institutions in Japan., Subjects: 785 Patients with stage II carcinoma (palpable axillary nodes) who had total mastectomy and axillary clearance., Interventions: The control group were given oral cyclophosphamide 50 mg/day and tamoxifen 20 mg/day for 2 years; the experimental group were given these drugs plus 1-hexylcarbamoyl-5-fluorouracil 300 mg/day for 2 years., Results: There was no survival advantage (and more toxicity) in the experimental group, except in a subgroup with 1-3 axillary nodes involved., Conclusion: The advantage of triple chemotherapy in the subgroup must be substantiated by a new randomised trial confined to patients with 1-3 axillary nodes involved.

The purpose of this study was to investigate the correlation between efficacy and dose intensity of postoperative adjuvant chemotherapy with MMC and UFT. A total of 1,410 patients from 180 institutions were allocated into a low-dose group and a high-dose group. The patients in the low-dose group received MMC at 8 mg/m2 on the day of surgery and 3 capsules of UFT (300 mg in tegafur) daily for 6 months. The patients in the high-dose group received MMC at 8 mg/m2 on the day of surgery, and in weeks 4, 10, 16, and 22 after surgery and 6 capsules of UFT (600 mg in tegafur) daily for 6 months. The patients in the high-dose group tended to exhibit higher survival rates than those in the low-dose group, although the difference was not significant. For the n(+)ps(-) patients, however, the survival rates were significantly higher in the high-dose group (p = 0.043). The recurrence-free rates showed a similar tendency. The incidence rates of adverse events were significantly higher in the high-dose group than in the low-dose group. Compliance was poorer in the high-dose group. Although the number of adverse events increases, a better prognosis can be expected with a high dose. These results confirmed a dose-dependency in adjuvant chemotherapy with MMC and UFT.

We report 5 patients given enteral feeding in order to continue its nutritional supportive care of our hospital. In patients 1, 2, and 3 who were malnourished, enteral nutrition was provided due to poor oral intakes after surgical treatment. In patients 4 and 5, enteral feedings were made via the proximal jejunum in order to bypass the duodenum, for nutrients in the duodenum enhanced their biliary infection or chronic pancreatitis, respectively. All patients' nutritional status was satisfactory, but two of five patients could not be discharged from the hospital. The reason was that the patients and their families wanted to continue the hospital care in spite of the improvement in the clinical problem. They had no help at home to care for the patient. We conclude that enteral nutrition is very useful for gastrointestinal disease, but that social problems affect home care with enteral nutrition.

Photobiological activities of pinacyanol chloride (PC), which is known as a non-intercalating dye, were investigated. Irradiation of PC-sensitized yeast cells in the dark brought about marked decrease of survival and induction of "petites" which are respiration-deficient mutants caused by partial loss of mitochondrial deoxyribonucleic acid. Nuclear mutation represented by reversion from Trp- to Trp+ was also induced by photodynamic action of PC. This fact suggested photoactive dyes are not necessarily intercalated for inducing mitochondrial and nuclear mutation. Singlet oxygen production was determined in the photoirradiated PC solution by electron spin resonance spectrometry. Photobiological effects of PC might be brought about mainly by a type II photodynamic mechanism.

Seven cases of leiomyoma and two cases of leiomyosarcoma of the esophagus were presented. Review of the Japanese literature revealed a total of 260 cases of the former and only 35 cases of the latter, including our own cases. They occurred more frequently in males than females, by a ratio of 1.6:1 and 1.8:1, respectively. The patients with leiomyosarcoma distributed in higher age groups. The most frequent symptom was dysphagia in both groups of the cases, but in cases of leiomyosarcoma the incidence was much higher and the duration of the symptom was shorter. About 20% of the patients with leiomyoma were asymptomatic. Although the size of leiomyosarcoma tended to be larger, giant leiomyomas more than 10 cm in diameter were found in 18% of the cases. The lower third of the esophagus was the site of both tumors in over half of the cases, the middle third being the next frequent. The surgical removal by enucleation was the procedure of choice for leiomyoma. However, when either the tumor is densely adherent to the mucosa for considerable length or accidental extensive mucosal tear occurs, esophageal resection is recommended. Postoperative morbidity was minimal and results were generally excellent. On the contrary, esophageal resection including the tumor was indicated for leiomyosarcoma. The long-term results were poor particularly in cases of infiltrating-type lesions, though survival data could not be fully evaluated.

A multi-center study was performed to clarify the immunological effects of MY-1, a new biological response modifier, on postoperative gastric cancer patients. A total of 90 patients were randomly allocated either to an MY-1 treated or an untreated group. MY-1 was given 3 times a week from the 4th postoperative day for a period of 3 weeks. Immunological parameters of the patients, such as lymphocyte subsets measured with flow cytometry using various monoclonal antibodies, blast transformation responses against PHA, ConA, and PPD, natural killer activity of peripheral lymphocytes, and skin test for MY-1 and PPD, were evaluated preoperatively, before and after MY-1 treatment. The results of the two color staining method with flow cytometry showed that the population of lymphocytes positive for both OKT8 and Leu15 antigens (suppressor cells) was statistically less, and that the population of lymphocytes positive for OKT8 and negative for Leu15 antigens (killer cells) was statistically increased in patients treated with MY-1 compared with the control group.

The concept and term of Distance Index, a complex ratio of cell, nucleus and nucleolus has been previously reported by the author. Twenty were sampled from thirty-four advanced cancers, twenty-one early cancers and six benign atypical lesions for this stochastical diagnostics. Distance Index was proved to have better diagnostic value in separatings the gastric cancer and the benign epithelium than the nuclear cell ratio and the nucleolar cell ratio. It has been found that the value of the constant K is most suitable at 130.

To evaluate the efficacy of PSK for adjuvant immuno-chemotherapy in patients who had undergone radical gastrectomy, a randomized controlled trial has been in progress in collaboration with 46 institutions in the Chubu district of Japan. A total of 262 patients were registered for this trial during the two years from July 1985 to June 1987 with a centralized registration system, and were allocated into the 5-FU+PSK group (Group P) and 5-FU alone group (Group C) by the minimization method following the random permuted blocks method. Between the two groups, the parameters of sex, age, serosal invasion (S), lymph-node metastasis (N), and the combination of S . N factor levels were distributed without significant differences. An induction treatment with MMC 6 mg/m2 was given to all patients following curative gastrectomy and on the 7th post-operative day. Two weeks after surgery, Group P received alternately PSK 3 g/day for 4 week and 5-FU 150 mg/day for 4 weeks as one course, and 10 courses were given. Group C received 5-FU alone for 4 weeks using alternate rest interval for 4 weeks. Since both experimental and clinical studies suggested that alternate treatments using PSK and anticancer agents were effective, treatment in this trial alternated PSK and 5-FU. A final follow-up study will be completed in June 1992, when all patients shall have survived more than 5 years after surgery. The administration of 5-FU was completed by January. 1989, but PSK has been administered to group P. The period from 18 to 42 months after surgery was reached in all eligible patients (253) at the end of December 1988. The disease-free survival curves and overall survival curves of group P were significantly (p = 0.018 and p = 0.045,) better than those of group C.