We have investigated the intracellular levels of the nucleic acids, especially intracellular RNA to determine whether or not they could be used as indicators of cell proliferation kinetics and thereby enable an investigation into the biology of tumor cells. HeLa and COLO 205 were the cell lines used in this experiment, and normal human peripheral lymphocytes were used as the control. Cells were stained with acridine orange and subjected to flow cytometry. Based on the cytograms obtained, changes in the DNA and RNA contents in the cell lines were expressed as a ratio of the mean channel to that of the control. The intracellular RNA concentration was reflected in changes in the mean RNA channel ratio on the DNA and RNA cytograms. An increase in the mean RNA channel ratio represented a logarithmic proliferation of the tumor cells. Changes in the mean RNA channel ratio could be noted in cell samples containing as little as 20% logarithmic growth phase cells. There was a close correlation between the RNA content and the proliferative potential, and an increase in the RNA content was predictive of subsequent cellular proliferation. These results suggested that an increase in the intracellular RNA content on flow cytometry could be used as indicator of tumor proliferative potential, suggesting that this method could be useful for assessing the biological properties of tumor cells.

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A total of 1, 272 patients with gastric cancer were admitted to our institute for surgery during 12 years (1975-1986). Of these, 1, 059 (83.4%) underwent gastrectomy. Among these, 252 (23.8%) were total gastrectomy (TG), involving 160 (63.5%) cases of cancer mainly located in the upper third of the stomach, 81(32.1%) in the middle third and 11(4.4%) in the lower third. Radical TG was performed in 65.9% and palliative TG in 34.1%. Roux-en-Y reconstruction was selected in 80%, jejunal interposition in 17.6% and double tract in 2.4%. The survival rate was improved by introducing extended lymph node dissection, especially in the cases of stage III & IV cancer in which a combined pancreatico-splenectomy could lead to cure when associated with lymphadenectomy. In cases of a positive serosal exposure, the 5-year survival rate was increased by extended lymphadenectomy from 21% to 46% (p<0.02) . Anastomotic leakage occurred in 4.2%. The postoperative mortality rate was 1.6%, occurring in only 4 patients.

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Intra-arterial infusion chemotherapy is commonly used to treat hepatocellular carcinomas (HCC) and metastatic liver cancer after hepatectomy or in unresectable patients, and it has been adopted at Kurume University Hospital as a treatment for HCC. As complications of reservoir implantation have been encountered, the implantation procedure needs improvement. Procedures were compared in a study with 109 patients who were available for follow-up observation among 116 patients who underwent reservoir implantation. Fifty-six of the patients received intraoperative implantation through the gastroduodenal artery (GDA catheterization), 31 received external catheterization (EXT catheterization) and 22 received catheterization using a saphenous vein graft (SVG catheterization). The complication rates were 75.0%, 9.7% and 13.9% and the one-year patencies were 44.1%, 70.6% and 79.4%, respectively. GDA catheterization was no better than the other two procedures and it had a higher incidence of complications and a lower patency. SVG catheterization achieved good patency, although it had a little higher incidence of complications than external catheterization. It was presumed to be a procedure that would ensure reservoir implantation even in patients with a winding or variation of hepatic artery.

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Estimation of amniotic fluid volume is an important part of routine obstetric sonography. A relationship between polyhydramnios and poor perinatal outcome has been reported. This study correlates the severity of polyhydramnios .with perinatal morbidity and mortality. Among 67 cases of polyhydramnios detected in singleton pregnancies, 8 were associated with maternal conditions including noninsulin-dependent diabetes (5 cases), insulin-dependent diabetes (1 case) and gestational diabetes (2 cases). Forty-four were associated with fetal conditions, including fetal anomalies (31 cases), fetal chromosomal disorders (10 cases) and fetal functional disorders (3 cases). Fifteen of the 67 cases had no apparent underlying fetal or maternal cause. Perinatal death occurred in 19 cases (28%) and was associated with fetal anomalies (12 cases), chromosome disorders (6 cases) and a functional fetal abnormality (1 case). Severe polyhydramnios with amniotic pocket dimensions ≥ 120 mm (91%) or with a need for amniocentesis (91%) were associated with fetal abnormalities in most cases. The rate of perinatal death was not increased, indicating that severe polyhydramnios does not always result in lethal abnormalities.

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A rare case of a carcinoma in situ arising from an endocervical polyp is described. The covering epithelium of the polyp transformed gradually into a carcinoma in situ via squamous metaplasia and dysplasia, spreading horizontally with glandular involvement, and colliding with the surface columnar cells. The lack of tumor tissue in the pedicle and adjacent cervical region confirms the case was a carcinoma in situ originating from the surface epithelium of the endocervical polyp.

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The incidence of hepatitis virus type C (HCV) in an area, Futase, of Iizuka city in Chikuho province in the northeastern part of Fukuoka prefecture in Kyushu, Japan, was estimated by screening sera for anti-HCV antibodies. Titers of anti human T-lymphotropic virus type I (HTLV-I) antibodies and hepatitis virus type B surface antigens (HBs) were also determined. The area of the present study is known to have a particularly high prevalence of chronic liver diseases, because coal mining was the key industry until a few decades ago. Also, in the old days it was rather isolated from the neighboring vicinities by surrounding mountains. The subjects of the present survey were 310 patients (117 males and 193 females) with various chronic diseases who visited Futase Social Insurance Hospital during a two year period from 1991 to 1992. Anti-HCV antibodies were detected in the sera of 55 patients, which is an overall positive rate of 18% (26% in male and 14% in female patients). This is extremely high compared to an estimated nationwide average positive rate of 1.6%. Even in 270 patients with normal liver function, the incidence was as high as 10%. The incidences were particularly high in groups of patients aged 40 through 49, 50 through 59 and 60 through 69, ranging from 20 to 23%, while they were as low as 13 and 17% in those aged 70 through 79 and 80 through 89 years, respectively. A high incidence, 57%, was estimated for the patients with impaired liver function due to chronic liver diseases, especially in those concomitantly having diabetes mellitus (DM), 91%. The incidence of anti-HCV antibodies was the highest, 100%, in patients having both liver cirrhosis (LC) and DM. This was followed by those having chronic hepatitis (CH) and DM concomitantly and by those with LC alone, 86% each, and by those with CH alone 44%. Furthermore, the genotypes of the HCV in the sera of nine randomly selected carrier patients who had anti-HCV antibodies, even though they had diseases other than hepatic diseases and their liver functions were normal, were examined by the polymerase chain reaction method employing type-specific primers for DNA amplification. As a result, all the HCV strains were type II. On the other hand, there were no apparent differences in the incidences of HTLV-I in the area of the present study and in neighboring provinces of the same prefecture, Fukuoka. From the facts described above, it can be suggested that HCV and HTLV-I were transmitted by routes other than blood transfusion. The high incidence of HCV among the Futase residents in Chikuho is probably related to the high prevalence of chronic liver diseases. The endemic situation of HCV in this area is very similar to that found in eastern Saga, a neighboring prefecture.

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