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Oral mucositis is frequent but serious adverse event associated with radiotherapy or radiochemotherapy in head and neck cancer severely impairs health-related quality of life, leading to poor prognosis due to discontinuation of the therapy. Although a number of compounds have been tested for prophylaxis of oral mucositis, few of them are satisfactory. We investigated the effect of polaprezinc (zinc L-carnosine), a gastric mucosal protective drug, on radiochemotherapy-induced oral mucositis, pain, xerostomia and taste disturbance in patients with head and neck cancer. Patients were randomly assigned to receive polaprezinc (n 5 16) or azulene oral rinse as the control (n 5 15). The incidence rates of mucositis, pain, xerostomia and taste disturbance were all markedly lower in polaprezinc group than in control. Moreover, the use of analgesics was significantly (p 5 0.003) less frequent and the amount of food intake was significantly (p 5 0.002) higher in polaprezinc group than in control. On the other hand, tumor response rate in patients with neoadjuvant radiochemotherapy was not significantly affected by polaprezinc, in which the response rate (complete plus partial response) was 88% for polaprezinc and 92% for control (p 5 1.000). Therefore, it is highly assumable that polaprezinc is potentially useful for prevention of oral mucositis and improvement of quality of life without reducing the tumor response.

A new eigenvalue problem associated with the two-dimensional Newcomb equation in an axisymmetric toroidal plasma, such as a tokamak, has been posed and solved numerically by using a finite element method. In the formulation of the eigenvalue problem, the weight functions ͑the kinetic energy integral͒ and the boundary conditions at rational surfaces are chosen such that the spectra of the eigenvalue problem are comprised of only the real and denumerable eigenvalues ͑point spectra͒ without continuous spectra. Applications to the ideal mϭ1 mode have verified that this formulation is able to identify stable states as well as unstable states, and that the numerically obtained eigenfunctions show the singular behavior predicted by the theory at rational surfaces.

Objective-To test the hypothesis that changes in serum matrix metalloproteinase-1 (MMP-1) and tissue inhibitors of metalloproteinase-1 (TIMP-1) after acute myocardial infarction reflect extracellular matrix remodelling and the infarct healing process. Patients-13 consecutive patients with their first acute myocardial infarction who underwent successful reperfusion. Methods-Blood was sampled on the day of admission, and on days 2, 3, 4, 5, 7, 14, and 28. Serum MMP-1 and TIMP-1 were measured by one step sandwich enzyme inimunoassay. Left ventricular volume indices were determined by left ventriculography performed four weeks after the infarct. Results-Serum concentrations of both MMP-1 and TIMP-1 changed over time. The average serum MMP-1 was more than 1 SD below the mean control values during the initial four days, increased thereafter, reaching a peak concentration around day 14, and then returned to the middle control range. Negative correlations with left ventricular end systolic volume index and positive correlations with left ventricular ejection fraction were obtained for serum MMP-1 on day 5, when it began to rise, and for the magnitude ofrise in MMP-1 on day 5 compared to admission. Serum TIMP-1 at admission was more than 1 SD below the mean control value, and increased gradually thereafter, reaching a peak on around day 14. Negative correlations with left ventricular end systolic volume index and positive correlations with left ventricular ejection fraction were obtained for serum TIMP-1 on days 5 and 7, and for the magnitude ofrise in TIMP-l on days 5 and 7 compared to admission. Conclusions-Both MMP-1 and TIMP-1 showed significant time dependent alteration after acute myocardial infarction. Thus MMP-1 and TIMP-1 may provide useful information in evaluating the healing process as it affects left ventricular remodelling after acute myocardial infarction. (Heart 1997;78:278-284) Keywords: left ventriculography; ventricular remodelling; matrix metalloproteinase-1; tissue inhibitor of metalloproteinase-1; fibrosis Left ventricular volume is one of the major prognostic factors after acute myocardial infarction.' 2 Ventricular remodelling is thus important with respect to prognosis.34 The extracellular matrix plays a vital role not only in the maintenance of ventricular shape but also in ventricular function. Collagen is apparently an essential component of the extracellular matrix, and collagenases and their inhibitors play crucial roles in extracellular matrix homeostasis.5 Recent biological studies have identified several distinct matrix metalloproteinases (MMP) and tissue inhibitors of metalloproteinases (TIMP) and have delineated their characteristics.56 The important roles of MMP and TIMP in cardiovascular disease have been reviewed by Dollery et al.7 MMP-1, a 54 kDa interstitial collagenase, degrades several types of collagen and other extracellular matrix components, including types I and III collagen, the major types of collagen in the collagen matrix.57 TIMP-1, a 29 5 kDa sialoglycoprote...

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