Prognosis of the patients with high grade bladder carcinoma

The pathological features and clinical outcome of grade 3 transitional cell carcinoma of the bladder, excluding CIS, encountered between 1972 and 1988 were studied to clarify the clinical characteristics of the disease. The subjects of this study were 108 patients consisting of 76 males and 32 females aged 33-87 years, with a mean age of 66 years. The survival rate according to each factor was calculated by Kaplan-Meier method, and the survival curves were compared by generalized Wilcoxon test. Grade 3 bladder cancer was often papillary, sessile and about 3 cm in diameter and showed a tendency of multiple occurrence. Histopathologically, it was often in high stages of pT2 or above and frequently with vascular invasion. Total cystectomy is not considered to be an absolute necessity for pT1, G3 bladder cancer patient, because, in our experience, it did not improve the prognosis. However, bladder-preserving operation requires strict postoperative follow-ups. After this operation, the 5-year survival rate was higher in the no-recurrence group than in the recurrence group, and the out come tended to be better in the group that had undergone intravesical instillation chemotherapy for prevention of recurrence than in the group without this therapy. Ample intravesical instillation chemotherapy after bladder-preserving operation seems to improve the postoperative course of bladder cancer patients. Total cystectomy may be unavoidable in patients with pT2 or above, and no effect of postoperative adjuvant chemotherapy was noted in our series. The establishment of multidisciplinary approaches is considered to be needed for improvement of the prognosis of high stage bladder cancer.     

Far-field recording of the junctional potential generated by median nerve volleys at the wrist

In 20 arms from 10 healthy subjects, the orthodromic median sensory volleys crossing the wrist gave rise to a stationary, biphasic potential rendering the forearm initially positive (Pw) and subsequently negative (Nw) compared with the hand. A pair of electrodes located on each side of the wrist best detected the junctional potential, Pw-Nw, that developed across the partition. Here the hand and the forearm each, in effect, acted as a lead, connecting any points within the respective compartment to the voltage source. Thus, nearly the same potential difference appeared across the wrist regardless of the inter-electrode distance, allowing the detection of the voltage step in far-field derivation. Our data verify that not only positive but also negative peaks of scalp-recorded evoked responses could represent junctional potentials generated along the course of the conduction medium in the absence of fixed neural discharges.     

Phase-transfer catalysis of phosphonium ions derived from poly[(P-phenyl)trimethylenephosphine]

Polymeric phosphonium ion species having different content of phosphonium units ( 4a and 4b ) were prepared from poly[(P-phenyl)trimethylenephosphine] ( 3 ). Phase-transfer catalysis of 4 was examined by means of a typical S_N2 reaction (1) in a bi-phase system. The apparent rate constant (k_obs) was determined, its magnitude being smaller by about one order than that of the corresponding monomeric phosphonium ion 5 . Crosslinked polymeric phosphonium ion species were coated on powdery alumina and used as a phase-transfer catalyst for reaction (1) in a triphase system. Due to the inhomogeneous reaction, the k_obs value was much smaller (1/5) than that in presence of 4 .     

Clinical outcomes resulting from the transfer of vitrified human embryos using a new device for cryopreservation (plastic blade)

Purpose  

We attempted clinical application of a plastic blade, which is a novel cryopreservation device, for vitrification of human embryos and blastocysts.     

Laparoscopic Resection of an Epidermal Inclusion Cyst at the Vaginal Cuff

An epidermal inclusion cyst rarely occurs at the vaginal cuff, whereas it sometimes develops at the vulva and the site of episiotomy due to entrapment of the squamous epithelium. We present the case of a 58-year-old woman who developed an epidermal cyst at the vaginal cuff 6 years after laparoscopic hysterectomy. Although we could not make a precise diagnosis at imaging before the operation, the cyst was completely removed at laparoscopic surgery without any complications. To our knowledge, this is the first report of an epidermal inclusion cyst at the vaginal cuff that was successfully treated at laparoscopic surgery. Laparoscopic surgery was useful in magnifying the surgical field and in delicate manipulation of various devices to resect this pelvic floor tumor that required adhesiolysis of surrounding organs.     

Interruption of the aortic arch associated with deletion of chromosome 22q11 is associated with a subarterial and doubly committed ventricular septal defect in Japanese patients.

OBJECTIVES: The purpose of this study was to clarify the clinical characteristics of interruption of the aortic arch associated with chromosome 22q11deletion. BACKGROUND: About half of patients with interruption of the aortic arch between the left common carotid and the left subclavian artery have deletion of chromosome 22q11. METHODS: In total, 20 patients with interruption of the aortic arch were studied with fluorescence in situ hybridization using peripheral lymphocytes and a DiGeorge syndrome chromosomal probe (Oncor N25). Cardiovascular anomalies in these patients were diagnosed by cross-sectional echocardiography and angiocardiography, and were confirmed at intracardiac repair. RESULTS: Of 13 patients with interruption between the left common carotid artery and the left subclavian artery, seven had the deletion. All 7 also showed thymic hypoplasia and hypocalcemia, together with a nasal voice and peculiar facies. Six of the seven patients had complete deficiency of the muscular outlet septum, with the defect extending to the perimembranous area. Such complete absence of the muscular outlet septum was not present in any of the patients without the deletion. CONCLUSIONS: Interruption of the aortic arch between the left common carotid and the left subclavian artery, absence of the thymus, and complete absence of the muscular outlet septum, were characteristic in Japanese patients with interruption of the aortic arch associated with deletion of chromosome 22q11.     

A diary form quality of life questionnaire for Japanese patients with lung cancer and summarization techniques for longitudinal assessment

The aim of this study was to confirm the validity and reliability of a new diary-type quality of life (QOL) self-rating questionnaire tailored for use by Japanese inpatients with lung cancer receiving chemotherapy. Two kinds of summary statistics were tested in QOL analysis. The questionnaire has a four-scale structure; physical, psychological, daily activity and global scales. Fifty-three patients were enrolled to test the reliability and validity. Summary statistics were assessed using indices of the area under the curve (AUC) and the maximum fluctuations of QOL scores (Dif max) in patients receiving cisplatin or carboplatin. The questionnaire had satisfactory reliability and validity. The physical, psychological and global scales scores changed to the worst levels after treatment, continuing for 1 week in the cisplatin group, whereas those of the carboplatin group began to worsen from day 3, but returned to prechemotherapy levels by day 9. The cisplatin group showed significant decrease of QOL compared with the carboplatin group in the AUC of psychological and two global scales, in the Dif max of psychological and linear analogue global scales. These results suggested that this questionnaire reflects differences in the influence of chemotherapy, and that AUC and Dif max may be useful indices for the analysis of QOL as measures to assess multidimensional QOL.