A Case of Pancreatic Cancer With Liver Metastasis Which Responded to Chemotherapy

A case of pancreatic cancer with liver metastasis is reported,in which chemotherapy had a marked effect, with the responsesclearly documented. The patient was a 59-year-old male who experienced epigastricpain in February 1985, upper gastrointestinal X-ray examinationrevealing extragastric compression by the pancreas. He visitedthe National Cancer Center Hospital, Tokyo, in April 1985 andthe diagnosis of pancreatic cancer with liver metastasis wasmade using the imaging procedures of ultrasonography, computedtomograph scanning and endoscopic retrograde cholangiopancreatographyas well as by biochemical and serological tests. At the timea 5 cm tumor was palpable in the middle upper abdomen. The patient was treated with Cis-diaminedichloro platinum, tegafur,and 5-fluorouracil, successively, and the abdominal tumor graduallydiminished, finally becoming impalpable. The response was evaluatedas one of partial responses (PR) by ultrasonography, and theimprovement substantiated by computed tomography and tumor markers.     

Point mutations in the c-K-ras 2 gene in multiple colorectal carcinomas

Abstract The c-K-ras 2 gene mutations were examined in colorectal tumours from patients with synchronous or metachronous tumours in order to investigate tumorigenesis. Sixty-seven colorectal carcinomas from patients with a single lesion, 50 from patients with synchronous lesions, and 12 from patients with metachronous lesions were analysed for the presence of point mutations in codons 12 and 13 of c-K-ras proto-oncogene. In the patients with metachronous or synchronous lesions, the finding of the mutation in one tumour was not associated with a greater frequency of the mutation in other carcinomas from the same patient. In the patients with tumours that each contained the mutation, the mutations were not always the same. In tumours from the patients with original and synchronous lesions, the mutation frequency was significantly lower in advanced carcinomas invading through the entire muscularis propria (10.5%) than in early carcinomas confined to the mucosa (47.8%), and the mutation frequency in carcinomas invading through the entire muscularis propria was significantly lower in patients with synchronous lesions (10.5%) than in patients with a single lesion (37.7%). These results suggest that the tumorigenesis of colorectal carcinomas from patients with synchronous lesions is different from that in patients with a single lesion.     

β-Thalassemia with the IVS-l-1 (G → T) mutation in a Japanese girl

We analyzed the hemoglobins of a Japanese girl with β-thalassemia and those of her immediate family. DNA sequencing of the cloned β-globin gene from this patient revealed a point mutation at the IVS-I position 1 (G → T). This rare point mutation has been found in Asian Indians, but this is the first reported Japanese case.     

Interferon-α potentiates priming-dependent FMLP-induced neutrophil superoxide generation in a patient with chronic myeloid leukemia

13 year old girl diagnosed as having chronic myeloid leukemia (CML) was treated with interferon-α (IFN-α) alone and 4 months later hematological remission was obtained. In the course of the IFN-α treatment there was neither infectious sign nor side effects. In this study we have examined the effect of IFN-α on superoxide O₂^? generation by polymorphonuclear neutrophils (PMN). The PMN of the patient generated less O₂^? than PMN from normal controls. When patient PMN were cultured in the presence of 1000 U/mL IFN-α, enhancement of the formyl-methionyl-leucyl-phenylalanine induced O₂^?generation following priming with tissue necrosis factor-α was observed. Over the course of the IFN-α therapy, such O₂^? generation was gradually restored. It is suggested that CML PMN are in the resting condition in terms of their ability to generate O₂^? and that IFN-α is effective in inducing O₂^? generation by CML PMN.     

Phase II Study of Orally and Rectally Administered Tegafur in Liver Metastases from Gastric Carcinoma

Twenty-four eligible and evaluable patients with measurableliver metastases from gastric cancer were treated with oralor rectal Tegafur. Objective responses were seen in 8 of thepatients (33.3%), lasting between 1.5 and 15 months. The mediansurvival period was 10 months for the responders and 2.6 monthsfor non-responders. No complete response was observed. The survivalof responders was significantly longer than that of non-responders(p<0.01). Toxicity was mild and consisted principally ofgastrointestinal and hematological side effects. No centralnervous system toxicity was seen.     

Angioscopic Detection of Pulmonary Thromboemboli: with Special Reference to Comparison with Angiography,Intravascular Ultrasonography,and Computed Tomography Angiography

Introduction: Pulmonary embolism (PE) is often fatal and its incidence is increasing worldwide. Detection of thromboemboli (TEi) is essential for a definitive diagnosis of PE. The detection of TEi using most imaging methods is low in patients clinically suspected of having PE. This study was carried out to detect TEi in the pulmonary arterial trees by angioscopy (AS); to classify TEi; and to compare the sensitivity of detection for TEi among AS, angiography (AG), intravascular ultrasonography (IVUS), and computed tomography angiography (CTA) in patients with clinically suspected PE. Methods: After CTA, AG, and IVUS, the pulmonary arterial trees were surveyed by AS in 49 patients clinically suspected of having PE. Results: TEi were found by AS, AG, IVUS, and CTA in 81.6%, 24.4%, 34.8%, and 22.5% of 49 patients, respectively. The 48 TEi classified by AS were globular (35%), mural (10%), cap‐like (8%), web‐like (4%), patchy (33%), and micro (18%). Cap‐like, patchy, and micro‐TEi were not detectable by AG, IVUS, and CTA in any subjects. TEi color was classified as red, white, yellow, and red‐and‐yellow in a mosaic pattern in 10%, 31%, 38%, and 18%, respectively. Red and white globular TEi were observed in acute, and red‐and‐yellow TEi in both acute and chronic PE patients. TEi other than globular were observed in both patient groups. Conclusion: Although invasive, AS is superior to AG, IVUS, and CTA for the detection of TEi, and therefore is a helpful imaging method for the definitive diagnosis of PE. (J Interven Cardiol 2010;23:470–478)     

High intensity in the globus pallidus on proton and T2-weighted MRI in a case of dentato-ruburo-pallido-luysian atrophy of myoclonus epilepsy type

Although marked atrophy of the tegmentum of the mid-brain is a known computed tomography (CT) and magnetic resonance imaging (MRI) feature in patients with dentato-ruburo-pallido-luysian atrophy (DRPLA), this is the first report of marked high signal intensity of the globus pallidus on proton and T₂-weighted MR images in a patient in the early stage of DRPLA of the myoclonus epilepsy type. We suggest that the globus pallidus may be involved in the early stage of DRPLA of this type. Magnetic resonance imaging is considered to be useful for the early detection of involvement of the globus pallidus and in the clinical diagnosis of DRPLA.