Juvenile Secretory Carcinoma and Juvenile Papillomatosis

Two cases of juvenile secretory carcinoma associated with juvenilepapillomatosis are reported. One patient's disease was initiallydiagnosed at the age of 13 and she died 12 years later withextensive metastases. The contralateral breast at autopsy showedfindings indicative of juvenile papillomatosis. The second caseis that of an 18-year-old girl who had multiple juvenile secretorycarcinomas in the left breast associated with juvenile papillomatosis.     

Colo-Rectal Carcinoma in Young Adults

A study of 25 young adults under the age of 29 treated by surgeryfor carcinoma of the large intestine was made to compare with693 older-age group of patients. The incidence of adenocarcinomaof the large intestine in the first thirty years of life was3.5%. At the time of surgery, 64% of the patients had metastaticdisease, and the five-year survival rate for 19 curatively treatedcases was 37%. The coincidental second and third carcinoma ofthe large intestine and the association of familial polyposiscoli were significantly frequent in the younger age group. Onthe other hand, the association of ulcerative colitis or Crohn'sdisease could not be found in either of the group. The highincidence of mucin-producing tumors in the younger group wasalso confirmed. The Cumulative No Evidence of Disease (NED)rate after the curative surgery was lowest among patients ofthe first-three-decade age group and showed; stepwise high valueas the decade of age increased.     

STUDIES ON PEPTIDES LXXXI. Application of a New Arginine Derivative,NG-Mesitylene-2-Sulfonylarginine,to the Synthesis of Substance P and Neurotensin

A new devised arginine derivative, N^G-mesitylene-2-sulfonylarginine, Arg(Mts), was employed for the synthesis of hypothalamic substance P and neurotensin. The former was obtained in 74% yield by treatment of the protected undecapeptide amide, Z - Arg(Mts) - Pro - Lys(Z) - Pro - Gln - Gln - Phe - Phe - Gly - Leu - Met(O)-NH₂, with methanesulfonic acid in the presence of anisole followed by reduction of the sulfoxide with 2-mercaptoethanol. The latter was obtained in 54% yield by the similar treatment of the protected tridecapeptide ester, Z-Pyr-Leu - Tyr - Glu(OBzl) - Asn - Lys(Z)-Pro-Arg(Mts) - Arg(Mts) - Pro - Tyr-Ile-Leu-OBzl, with methanesulfonic acid. As scavenger, a mixture of anisole-thioanisole-o-cresol (1:1:1, by vol.) was employed to suppress the side reaction, O-mesitylene-2-sulfonation of the Tyr residue.     

A quantitative assessment of serum chylomicron by light scattering intensity: Application to the intestinal fat absorption test

A novel fat absorption test to clarify the malabsorption syndrome was developed using a micronephelometric technique and compared with the classic conventional technique using ¹³¹I-triolein. An integrity of time-sequential light scattered from chylomicron-related turbidity in serum was determined between 0 and 300 min after butter fat load, being expressed in terms of the light scattering intensity (LSI). A good correlation was obtained between LSI and the serum level of chylomicron-triglyceride determined by an ultracentrifugation technique (r=0.819, P < 0.001). The maximal LSI was consistently observed at 180 min after administration of a test meal in the normal group (n= 39), whereas the malabsorption syndrome group (n= 35) was distinctly different and could be further classified according to four patterns of LSI changes. In addition, an inverse correlation was found between this fat absorption test and the ¹³¹I-triolein absorption test. It was concluded that the micronephelometric technique which does not use a radionuclide is advantageous in its simple and safe evaluation of fat malabsorption syndrome.     

HCV infection and its clinical features in recipients of blood screened for HCV (C100-3) antibody

Abstract After adoption of the anti-hepatitis C virus (C100-3) test, the incidences of definite and suspected cases of post-transfusional hepatitis (PTH) were 3.3% (7/209) and 7.2% (15/209), respectively. Four patients with definite PTH and seven patients with suspected PTH became positive for hepatitis C virus (HCV)-related antibodies or HCV-RNA after transfusion. These cases that became positive for anti-HCV or HCV-RNA showed a peak of alanine aminotransferase (ALT) more than 4 weeks after operation. Only rare cases that showed ALT peaks within 4 weeks after operation became positive for HCV-related antibodies or HCV-RNA. The peak ALT levels in cases showing positive conversion tended to be higher than those in cases showing no conversion. Judging from these results, cases of suspected PTH include those of transient liver disease attributable to surgery as well as clear cases of HCV infection. Thus new diagnostic criteria are required including data on HCV antibodies or HCV-RNA.     

Perinephric angiomyolipoma: A unique development pattern surrounding the kidney

We report a case of a 31-year-old man with extrarenal angiomyolipoma of the perinephric space. He presented with asymptomatic macrohematuria. Computed tomography of the abdomen revealed a large perinephric mass which was separated from the right kidney and its unique growth appeared to have surrounded the kidney. Extrarenal angiomyolipomas of the perinephric fat are rare and they should be considered in the differential diagnosis of a retroperitoneal mass where asymptomatic macrohematuria was presented at the onset.     

A case of well-differentiated minute hepatocellular carcinoma with extrahepatic metastasis

A rare case of well-differentiated minute hepatocellular carcinoma (HCC) metastasizing to distant sites in a 77-year-old man with hepatitis C virus (HCV)-related cirrhosis is presented. Ultrasonography (US) disclosed a 9 mm hypoechoic lesion in segment seven (S₇) of the liver, although computed tomography (CT), magnetic resonance imaging (MRI) and angiography did not reveal any space-occupying lesion. Ultrasound-guided biopsy showed the histological features of well-differentiated HCC. A plain film of the abdomen and CT revealed osteolytic changes in the sacrum and the lumbar vertebra. Ultrasound-guided biopsy of the sacrum revealed well-to-moderately differentiated HCC metastasizing from the liver. Percutaneous ethanol injection therapy (PEIT) effected complete response and completely eliminated the abnormal findings on US. Three months after PEIT, metastasis to the thoracic vertebra was revealed by CT, despite negative α-fetoprotein-mRNA in serum. This is the first report describing a well-differentiated HCC with metastatic potential. Further studies may provide insights into metastasis of well-differentiated HCC.