CUTANEOUS MALIGNANT LYMPHOMAS

Clinical and histological findings in 37 cases of cutaneous lymphomas other than mycosis fungoides and Sezary syndrome were investigated; there were 31 in adults and 6 in children. Cutaneous lesions were the first manifestations of the diseases in all cases, and they appeared mostly as tumors or nodules. Cytomorphologically, about a half of the cases showed proliferations of large cleaved, non-cleaved cells or immunoblasts (Group I). Eight cases showed a polymorphous appearance containing convoluted cells of various size (Group II). Five cases in children demonstrated monomorphous proliferation of uniform-sized lymphoblasts (Group III). The cytologic findings in 6 cases did not fit into any lymphoid groups (Group IV). The clinical findings observed in each group were reviewed and compared. Follow-up study revealed that the prognosis of Group I was the poorest among the four groups.     

Interferon treatment for chronic hepatitis C in haemodialysis patients: Suggestions based on a small series

Chronic hepatitis C is endemic among chronic haemodialysis patients. There have been a number of reports on hepatocellular carcinoma developing in such patients in Japan. The present study reports on the treatment of 15 patients who showed elevated ALT levels due to biopsy proven chronic hepatitis C with interferon α-2a (IFN). The dose schedule was 6 mega units (MU) daily for the first two weeks followed by 3 doses per week for 5.5 months. Side effects were so severe that IFN treatment was discontinued early in one patient, the dosage reduced in 11 and only tolerated in the original schedule by three patients. Excluding one patient who only recently completed the therapy, 13 were able to be evaluated for therapy efficacy by assessment of serum ALT and viral RNA. The overall results showed that IFN was effective in eight of 13 patients, a rate somewhat higher than the reported figures in this country. It is concluded that IFN therapy is indicated in haemodialysis patients with progressive chronic hepatitis C, but the dose administered should be lower and the dose schedule more flexible, perhaps 3 MU three times a week, in order to minimize untoward side effects.     

Clinical observation of 14 cases of childhood polyarteritis nodosa in Japan

An epidemiological survey of childhood polyarteritis nodosa was conducted at 1290 hospitals followed by a secondary survey of hospitals that had therapeutic experience with the disease. Fourteen cases obtained from these surveys were studied clinically. The male-female ratio was 4:3. The mean age at onset was 10.6 years. To established the diagnosis, skin biopsy was performed in 43%, retrograde aortography in 21%, and kidney biopsy in 14% of cases. Non-specific symptoms such as fever (86%), skin eruption (50%), arthritis (50%), myalgia (50%), abdominal pain (43%) and hypertension (36%) were often noted as clinical findings at the initial visit. Throughout the clinical course, symptoms considered to be caused by local angiopathy, including interrupted blood circulation, were frequently noted. On blood tests, no specific findings other than acute inflammatory reaction were observed. Steroid preparations were used for treatment in all cases but one, and about half of them are presently free from steroids. Immunosuppressants were administered in 10 cases. As for prognosis, all patients are alive, but untoward sequelae were noted in 36% of cases. The results of the present survey reinforced the difficulty of establishing a final differential diagnosis because specific findings were scarce for this disease, as stated in previous reports. Establishing a method for early diagnosis by gathering and analyzing more data in detail will be necessary in the future.     

A long-term suppression by α-interferon of Philadelphia chromosome in children with chronic myelogenous leukemia

An 8 year old girl with adult type Philadelphia (Ph¹)-positive chronic myelogenous leukemia received natural α-interferon therapy in the chronic phase. Complete suppression of the Ph¹ clone of bone marrow cells was achieved after 1 month of therapy, which was determined by disappearance of rearranged breakpoint cluster region (BCR) gene in Southern blot analysis. Complete hematological remission was also attained following 2 months of therapy. Both the suppression and the hematological remission have been sustained for 24 months with α-interferon. in spite of the detection of the chimeric BCR/ABL mRNA in her bone marrow by polymerase chain reaction assay 12 months after therapy.     

Evaluation of a moisturising micro‐gel spray for prevention of cell dryness in oral mucosal cells: an in vitro study and evaluation in a clinical setting

OTA Y., MORITO A., FUJISAWA K., NISHIDA M., HATA H., UENO T., YURIKUSA T. & MURATA T. (2012) European Journal of Cancer Care Evaluation of a moisturising micro‐gel spray for prevention of cell dryness in oral mucosal cells: an in vitro study and evaluation in a clinical setting A moisturising micro‐gel spray for prevention of dryness was compared with commercial products and artificial saliva in vitro and in a clinical setting in patients with cancer. Survival of cultured human gingival epithelial cells was evaluated after treatment with each product for 15 min. A dry test was performed for products giving a 50% survival rate, in which cell survival was measured after drying of cells treated with each product. The survival rates of cells treated with the micro‐gel spray and artificial saliva were significantly higher than those of control cells. The micro‐gel spray was then evaluated for 1 week in patients with symptoms of dry mouth caused by cancer treatment. There was significant improvement of these symptoms at night and on awakening and of subjective symptoms of decreased salivary volume (P < 0.05). Mean visual analogue scale scores also significantly decreased (P < 0.01). These data suggest that evaluation of moisturising products for dryness prevention can be performed in cultured cells, since products that performed well in vitro also showed good efficacy for symptoms of dry mouth. The micro‐gel spray was particularly effective for relieving symptoms of dry mouth in patients with cancer.     

Nematode infection induces Th2 cell-associated immune responses in LEC mutant rats with helper T cell immunodeficiency

Long-Evans Cinnamon (LEC) rats have maturational arrest of CD4⁺8⁻ T cells from CD4⁺8⁺ cells in the thymus. Despite this, CD4⁺8⁻ T cells are always present in peripheral lymphoid organs of LEC rats, suggesting that these CD4⁺8⁻ T cells are generated by an uncommon pathway. We investigated the role of LEC rat peripheral CD4⁺8⁻ T cells in Th2-associated responses to infection with the nematode Nippostrongylus brasiliensis . After infection, the numbers of CD4⁺8⁻ TCRαβ⁺ T cells significantly increased in mesenteric lymph nodes (MLN) and the spleen, while those in the thymus were still negligible. Infection also induced significant up-regulation of IL-4 gene expression in LEC rat MLN cells. Total serum IgE levels in LEC rats were markedly increased two weeks after infection. Mucosal mast cell responses in the gut and lungs of LEC rats were induced as prominently as in control Long-Evans Agouti (LEA) rats. Faecal egg count data indicated that LEC rats rejected nematodes faster than LEA rats. These results suggested that Th2-associated responses can be induced by nematode infection in LEC rats probably through the extrathymic recruitment and proliferation of CD4⁺8⁻ TCRαβ⁺ T cells .     

远端器官缺血性预处理对心血管功能的影响

目的 :观察远端器官缺血性预处理 （RPC）对非缺血心脏功能的影响 ,初步探讨 RPC的作用机制。方法 :19只成年绵羊麻醉后随机分为对照组 （n=9）及 RPC组 （n=10 ）。测定基础状态 （BS1 ）各参数后 ,RPC组动物经历 3次左侧股动脉阻断 5 min及再灌注 5 m in,第三次再灌注后 10 min测 RPC后 （BS2 ）各参数。对照组动物不阻断股动脉 ,但于相应时间测定 BS1 及 BS2 各参数。结果 :对照组 BS1 及 BS2 各参数无显著变化。 RPC显著降低平均动脉压（MAP）、外周血管阻力 （SVR）及冠脉循环阻力 （CVR） （P<0 .0 5 ） ;轻度增加心排出量及冠脉血流量 （P>0 .0 5 ）。但RPC对心率、左房压、每搏输出量、射血分数及每搏作功无显著影响。 BS2 时 RPC组左室收缩末期压 （L VESP）、左室压力上升及下降最大速率 （± dp/ dtmax）、动脉有效弹回性 （Effective arterial elastance,Ea）均显著低于对照组 （P<0 .0 5 ） ,而心脏收缩及舒张期左室容积下降及增加最大速率 （± dv/ dtmax）无显著变化。结论 :远端器官缺血性预处理降低动脉有效弹性及循环阻力、减弱心脏收缩性的同时 ,并不减弱反而轻度增强心脏泵血功能 ,提高了心肌收缩效率。     

Device to promote pelvic floor muscle training for stress incontinence

AIM: Many patients with stress urinary incontinence do not have enough motivation to continue pelvic floor muscle training (PFMT) by themselves. Therefore, a device was created to support PFMT, and its effect was examined. METHODS: Forty-six women with stress urinary incontinence were assigned to a control group or a device group in order of presentation. A pamphlet on PFMT was given to control patients, while the same pamphlet plus the device and instructions on its use were given to patients in the device group. The device had a chime that was set to sound three times a day when exercise sessions were scheduled. PFMT consisted of fast and slow pelvic floor muscle contraction exercises that were performed for 2 min and followed a rhythm set by the device. RESULTS: After 8 weeks, 20 patients from the control group and 21 patients from the device group could be evaluated. In the control group, only the quality of life (QOL) index improved significantly. In the device group, however, the daily number of incontinence episodes, the number of pads used daily, the QOL index, and the pad weight in the pad test improved significantly. Patients in the device group said that they felt obligated to perform PFMT when the chime sounded. Forty-eight percent of patients from the device group were satisfied with the outcome of PFMT, while only 15% were satisfied in the control group. CONCLUSION: This device may be useful to support the management of stress urinary incontinence.