Alpha-fetoprotein (AFP)-producing adrenocortical carcinoma — Long survival with various therapeutic strategies including a lung resection: Report of a case

We experienced a very rare case of late pulmonary metastasis from ACC. The patient was a 40-year-old woman who had undergone a left adrenectomy 12 years earlier. Instead of a large metastatic lung tumor with hemothorax and the existence of metastases in other organs, combined therapy of repeated resections for metastases and adjuvant therapy allowed for almost a 36-month survival following the first recurrence and a good quality of life. In addition, a blood and pathological study revealed that the tumor in this case was an alpha-fetoprotein-producing ACC, which is, as far as we could ascertain, the first case of its kind.     

Reactivation of Hepatitis in a Bladder Cancer Patient Receiving Chemotherapy

Reactivation of hepatitis is a serious complication of chemotherapy in hepatitis B virus (HBV) carriers. There are many reports of this in lymphoma patients but few in urological cancer patients. A 59-year-old woman with bladder cancer who was an HBV carrier developed severe liver dysfunction after 2 cycles of chemotherapy. The diagnosis was reactivation of hepatitis. She improved with administration of lamivudine with a steroid and is currently well without disease. Care should be taken about the risk of reactivation when performing chemotherapy in HBV carriers and prophylaxis by lamivudine should be considered.     

Plasma as a scaffold for regeneration of neural precursor cells after transplantation into rats with spinal cord injury

The present study investigated whether plasma could be useful as a scaffold for cell transplantation in rats with spinal cord injury (SCI). Transplantation of cells with plasma promoted the recovery of SCI-induced motor dysfunction. Immunohistochemical analysis revealed that the grafted cells had differentiated into the neural lineage. When dissociated neural precursor cells were cultured with plasma, extensive neurite outgrowth was observed along with increased expression of p35 and NF68. Neural markers were also expressed by the cultured cells. Culture with plasma reduced thymidine incorporation, but promoted cell growth and increased the RNA contents. These findings suggest that the cells underwent differentiation into neurons in the presence of plasma. In conclusion, plasma could be a promising scaffold for cell transplantation therapy.     

ADAMTS13 deficiency,an important cause of thrombocytopenia during pregnancy

We present the case of a woman with congenital ADAMTS13 deficiency and discuss peripartum management of her fourth pregnancy. All four pregnancies were complicated by significant thrombocytopenia. Her first pregnancy ended with fetal demise ascribed to HELLP syndrome and placental abruption. During her second pregnancy, she was diagnosed with idiopathic thrombocytopenic purpura. Thrombotic thrombocytopenic purpura and congenital ADAMTS13 deficiency were diagnosed during the third pregnancy. She had recurrent thrombotic thrombocytopenic purpura during the fourth pregnancy and responded to treatment with fresh frozen plasma, with a successful outcome. The need for accurate diagnosis to ensure appropriate treatment is emphasized.     

Hepatocarcinogenic susceptibility of rasH2 mice to troglitazone in a two-stage hepatocarcinogenesis model

Six-week-old rasH2 mice were injected intraperitoneally with N-diethylnitrosamine (DEN) after partial hepatectomy and administrated 0 or 6,000 ppm troglitazone (TRG) for 10 weeks. Relative liver weight of females increased significantly in the DEN + TRG group compared to the DEN-alone group. The numbers of γ-glutamyltranspeptidase- and proliferating cell nuclear antigen (PCNA)-positive cells tended to increase in both the sexes in the DEN + TRG group; however, these changes were not significantly different from those in the DEN-alone group. Levels of gene expressions for vascular endothelial growth factor (VEGF) and VEGFB (related to angiogenesis), tropomyosin 1 (Tpm1) and transforming growth factor-β (related to ras/MAPK cascade activation), and PCNA (related to cell proliferation) in females were significantly higher in the DEN + TRG than in the untreated control group but not in the DEN-alone group. Only Tpm1 gene had significantly higher expression in the DEN + TRG group than in the DEN-alone group. These results suggest that rasH2 mice are not susceptible to TRG in a two-stage hepatocarcinogenesis model.     

Epidemiology of mandibular fractures treated in a Brazilian level I trauma public hospital in the city of São Paulo, Brazil

This article reviews cases of mandibular fractures treated at the Service of Oral and Maxillofacial Surgery of the Hospital Complex of Mandaqui (SUS/SP), which is a reference hospital complex for trauma in the northern area of the city of S?o Paulo, Brazil. Ninety-eight patients with mandibular fractures were seen at the hospital between January and December, 2001. Out of this total, 91 cases whose files were deemed adequate in terms of data accuracy and completeness were reviewed. The following data were collected for the study: age, gender, etiology, anatomical fracture site, treatment modality, relation to other facial bone fractures, hospitalization time and posttrauma complications. Motorcycle accident was the major cause of mandibular fractures followed by physical aggression and height fall. The mandibular anatomical sites of higher fracture incidence were: body, symphysis and condyle. The most commonly performed treatment modes were conservative approach or open reduction and intraosseous fixation. In conclusion, motorcycle accidents were associated with a larger number of facial fractures and most predominantly affect 21-30 year-old males. On the average, motor vehicle accident victims had more (and more severe) fractures than physical aggression victims. Complications were mostly associated with angle fractures and hospitalization period. Polytraumatized patients presented greater morbidity for complications.