For the aim of adoptive immunotherapy in mice bearing transplanted sarcoma and in cancer patients, we performed secondary in vitro sensitization to obtain functionally active T cells. Specific tumor antigens, cytokines, viable irradiated tumor cells, an anti-CD3 monoclonal antibody and others were used. We preferred the method of complex stimulation with PHA, T-cell growth factor or IL-2, in small doses, and 3 M KCl tumor extract. In patients with cancer, many authors reported for an activity of cells with suppressor function. CD4⁺CD25⁺ regulatory T cells increased in number in peripheral blood and lymph node lymphocytes, and among tumor-infiltrating cells. In our investigations, production both of factor, inhibiting Ehrlich-cell migration and suppressor factor was revealed from T cells, in vitro sensitized with 3 M KCl cancer extract containing solubilized cancer antigens. The suppressor factor decreased or abrogated the effect of the inhibitory Ehrlich-cell migration factor. It is important to further scrutinize the spread and clonal proliferation of in vitro sensitized, transferred T cells, thus, their subsequent invasion in cancer node, in the host.

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Good oral health is considered essential in maintaining of individual's good overall health. Information on oral problems and the behavior in visiting dentist is important for promoting oral health of the elderly. To elucidate the oral health status of the elderly in rural areas and factors affecting their oral health, we studied 147 people aged 60 years or over in a rural area of Nagasaki prefecture, Japan. We examined the dental status (dentate or edentate) and denture adaptability, and collected the information on socio-demographic variables, habits, chewing ability, visit to dentist for oral problems, self-perceived general health, and self-perceived oral health. About one-third of the subjects (47/147) had poor self-perceived oral health. Most socio-demographic variables were not associated with poor self-perceived oral health. Logistic regression analysis showed that poor chewing ability (odds ratio (OR): 3.4; 95% confidence interval (CI): 1.4-8.7), being dentate (OR: 6.6, 95% CI: 2.2-24.0), inadequate denture adaptability (OR: 3.7; 95% CI: 1.7-8.8), and no visit to dentist for oral problems (OR: 4.8; 95% CI: 1.8-14.2) were significantly associated with poor self-perceived oral health. In rural areas in Japan, adequate dental care and its good accessibility would be important for promoting the oral health in the elderly.

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The aim of the present study was a clinical analysis of small bowel obstruction caused by bezoars surgically treated. Seven patients with small bowel obstruction caused by bezoars were retrospectively reviewed. Two patients had undergone gastric surgery. The symptoms before surgery lasted from 1 to 3 days in the non-ileus tube group and from 9 to 30 days in the ileus tube group. Four patients were preoperatively diagnosed with bezoar ileus, and one had intestinal tumor. The remaining two patients were diagnosed with postoperative adhesive ileus. The operative procedure was evacuation of bezoars for all patients. One patient needed incisions of the small intestine and the stomach for the complete evacuation of bezoars. The site of the small bowel obstruction was the ileum in all patients, and bezoars ranged from 30 to 60 mm in diameter. Morbidity was present in one patient who underwent insertion of ileus tube for a long-term treatment. Small bowel obstruction caused by bezoars is not uncommon in patients without any gastric surgery. It is important, preoperatively and intraoperatively, to examine the entire gastrointestinal tract for the presence of bezoars. When bezoars ileus was suspected, insertion of ileus tube should be avoided.

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Exposure to ionizing radiation increases the risk of cancer in humans. Russian nuclear workers receive low and middle level accumulated dose for the entire period of their occupational activities. The methodology of UNSCEAR model and estimates of attributable risk was implemented for generating potential risk group among the "Mayak" plant personnel. There are 5,858 workers covered by individual dosimetry monitoring, who have received radiation doses since 1949. It was stated that 2% of the "Mayak" plant personnel covered by individual dosimetry monitoring should be included in the group of potential risk for radiation-induced cancer. UNSCEAR recommendations for estimating individual radiation risks can be used for generating groups of potential risks among Russian nuclear workers.

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Extent of hepatectomy for liver tumor is often limited in case the patient has an impaired liver function. We report here our experience in 2 patients with carcinoma involving hilar bile duct who have undergone limited liver resection. Case 1. 76-year-old male, who have had hepatitis C cirrhosis, showed in segment 4 a hepatocellular carcinoma of 4 cm in diameter. The tumor involved the right and left main hepatic ducts and obstructive jaundice was progressed. The patient had liver and respiratory dysfunctions and, therefore, limited resection of lower segments 4 and 5 and resection of hilar hepatic duct and the common bile duct were performed to avoid postoperative morbidity including liver failure. Histopathological diagnosis showed the tumor invasion and thrombus in major hepatic ducts and severe fibrosis in non-cancerous liver. In spite of long-term ascites, gastrointestinal bleeding or sepsis, liver functions were relatively maintained and the patient was discharged 3 months after surgery. Case 2. 64-year-old male, who had obstructive jaundice, showed a carcinoma in the common hepatic duct. After biliary drainage, however, liver dysfunction was not improved for a long period. The common hepatic duct including gall bladder was resected, and superficial spreading of the tumor to the right and left main bile duct was confirmed by the pathologic examination. Therefore, limited hepatic resection of lower segments 4 and 5 and resection of main hepatic ducts were additionally undergone. Although bile leakage of left hepatic duct occurred for 1 month, hepatic function was reserved and the patient was discharged 2 months after surgery. In conclusion, hepatic resection may be limited even in patient with carcinoma invading hilar bile duct in case the hepatic functional reserve is poor for major hepatectomy.

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We report a successful treatment of photodynamic therapy in patients with remnant ampullar carcinoma who underwent local resection of duodenal papilla. A 56-year-old male patient showed ampullar carcinoma without invading pancreas or duodenum. Pancreatic body and tail were obviously atrophic and local resection of duodenal papilla was performed at associated hospital 3 months ago. However, a resected specimen showed the remnant carcinoma at the edge, and the follow-up endoscopy showed a protruding tumor in the resected portion. Similar to the resected specimen, endoscopic biopsy showed a well differentiated adenocarcinoma in this tumor. Since additional resection was difficult because of the pancreatic function, photodynamic therapy with laser beam of 630 nm wavelength by eximer dye laser (4 mJ/pulse, 40 Hz) was applied to the ampullar carcinoma through endoscope for consecutive two days. Follow-up endoscopy performed 4 weeks after photodynamic therapy showed a remarkable reduction of the tumor, and no cancer tissue was observed by a biopsy. Ablation with argon beam laser was additionally applied to the remnant mass region. Tumor recurrence was not observed for 8 months after photodynamic therapy.

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