Pre-treatment with ketamine reduces incidence and severity of pain on propofol injection

The purpose of this study was to evaluate the effect of pre-treatment with ketamine on the reduction of pain during injection of propofol in adult patients. We conducted a prospective, randomized, double-blinded trial. Forty-three patients were randomly allocated to one of two groups according to the agents administered before hand; Group C, normal saline 2 ml and Group K, 1% ketamine 2 ml. The pain on injection was rated as none, mild, moderate, or severe. Sixty-eight percent of patients in the C group experienced pain, while 33% of patients experienced pain in the K group. Thirty-six percent of patients in the C group complained moderate to severe pain but only 9% of patients in the K group. The mechanisms of prevention by ketamine of the pain on propofol-injection could not be clarified from our study, but it may be related to central effects of ketamine. In conclusion, ketamine pre-treatment before propofol administration significantly reduces incidence and severity of pain associated with propofol injection.     

Carotenoids in cancer chemoprevention

Various natural carotenoids, besides -carotene, were proven to have anticarcinogenic activity, and some of them showed more potent activity than -carotene. Thus, these carotenoids (-carotene, lutein, zeaxanthin, lycopene, rbeta -cryptoxanthin, fucoxanthin, astaxanthin, capsanthin, crocetin and phytoene), as well as -carotene, may be useful for cancer prevention. In the case of phytoene, the concept of 'bio-chemoprevention', which means biotechnology-assisted method for cancer chemoprevention, may be applicable. In fact, establishment of mammalian cells producing phytoene was succeeded by the introduction of crtB gene, which encodes phytoene synthase, and these cells were proven to acquire the resistance against carcinogenesis. Antioxidative phytoene-containing animal foods may be classified as a novel type of functional food, which has the preventive activity against carcinogenesis, as well as the ability to reduce the accumulation of oxidative damages, which are hazardous for human health.     

Apoptosis and apoptosis-associated gene products related to the response to neoadjuvant chemotherapy for gastric cancer

To evaluate the effect of neoadjuvant chemotherapy on gastric cancer, we examined the correlation between induction of apoptosis and expression of p53, Bcl-2, and Bax. Eighty-five patients with advanced gastric cancer were retrospectively divided into the following two groups: 54 patients received 5-fluorouracil (5-FU) at 300 mg/body/day for 14 days and cisplatin (CDDP) at 15 mg/body/day for 2 days as group A; 31 patients without any preoperative chemotherapy as group B. According to histological changes in tumors due to neoadjuvant chemotherapy, the therapeutic effects on tumors were evaluated. The apoptotic index (AI) of group A was significantly higher than that of group B (1.12+/-0.40 vs. 0.67+/-0.24; p<0.01). In group A, the AI of p53-positive cases was significantly lower than that of negative cases (0.92+/-0.32 vs. 1.39+/-0.32; p<0.01). The AI of histological responders was significantly higher than that of non-responders (1.34+/-0.35 vs. 1.02+/-0.38; p<0.01). There was no significant correlation between AI and expression of Bcl-2 or Bax. In group A, histological responders, Bcl-2 positive, and high AI patients had better prognosis, respectively. In conclusion, neoadjuvant chemotherapy for gastric cancer enhanced induction of apoptosis, and AI might be useful to evaluate the effect of neoadjuvant chemotherapy.     

Rapid accumulation and internalization of radiolabeled herceptin in an inflammatory breast cancer xenograft with vasculogenic mimicry predicted by the contrast-enhanced dynamic MRI with the macromolecular contrast agent G6-(1B4M-Gd)(256)

The rapid blood flow and perfusion of macromolecules in the inflammatory breast cancer xenograft (WIBC-9), which exhibits a "vasculogenic mimicry" type of angiogenesis without the participation of endothelial cells and expresses high levels of the HER-2/neu antigen, was evaluated in mice using 3D-micro-MR angiography using a novel macromolecular MR contrast agent [G6-(1B4M-Gd)(256)]. Herceptin, which recognizes the HER-2/neu antigen and has similar size (10 nm) to G6-(1B4M-Gd)(256), accumulated and internalized in the WIBC-9 tumors more quickly than in the control MC-5 tumors that progress with normal angiogenesis. Three dimensional micro-MRI with the G6-(1B4M-Gd)(256) macromolecular MRI contrast agent distinguishes between the different types of angiogenesis and is predictive of the rapid accumulation and internalization of Herceptin in the WIBC-9 inflammatory breast cancer xenograft.     

Poor prognosis associated with thrombocytosis in patients with gastric cancer

Background Thrombocytosis is commonly associated with malignant disease and has recently been suggested to be a poor prognostic indicator in patients with lung cancer and gynecological cancers. The prevalence of thrombocytosis in patients with gastric cancer was reviewed, and its association with poor prognosis was investigated. Methods Platelet count (PLT) and hemoglobin concentrations (Hb) were reviewed in 369 consecutive patients with histologically verified gastric cancer from 1994 to 2000. Differences between categories were analyzed with analysis of variance, and survival was compared by using the log-rank test on the Kaplan-Meier life table. Multivariate Cox regression analysis was used to evaluate whether thrombocytosis is an independent prognostic marker. Results Thrombocytosis was found in 42 patients, and anemia was found in 200 patients. PLT was negatively correlated with Hb. Mean PLT was significantly increased in patients with noncurative operations. There was a positive correlation between the depth of tumor invasion and PLT. One- and 3-year survival expectancies in patients with or without thrombocytosis were 52.4% and 23.4% and 85.7% and 72.9%, respectively. PLT was identified as an independent prognostic factor after lymph node metastasis and depth of tumor invasion. Conclusions Thrombocytosis is an independent prognostic indicator of survival in patients with gastric cancer. Presented at the 4th International Gastric Cancer Congress, New York, New York, April 29–May 2, 2001.     

Intrapericardiac instillation of epirubicin for carcinomatous cardiac tamponade from breast cancer

Three cases of carcinomatous cardiac tamponade from breast cancer are presented. All patients have had another recurrence and history of treatment. Though the prognoses were considered to be unfavorable, pericardiac drainage and the instillation of epirubicin were effective. Side effects of fever and dyspnea were experienced temporarily by two patients with no serious events. Following the systemic chemotherapy, two patients needed no supplemental drainage. All patients had a sufficient quality of life for about 1 year or longer. We found that positive therapy can be significant for such patients with advanced disease.     

Evaluation of seminal vesicle characteristics by ultrasonography before and after ejaculation.

Twenty males underwent transrectal ultrasonography before and after ejaculation to examine possible alterations that could influence interpretation of seminal vesicle ultrasonography. The preejaculation length of 35 mm was significantly (p < 0.05) decreased to 30 mm after ejaculation. The mean width of the seminal vesicles was 13 mm before and 11 mm after ejaculation. The seminal vesicle volume was significantly diminished after ejaculation (p < 0.05). It therefore seems important to maintain a period of abstinence when evaluating the seminal vesicles by ultrasonography.     

Thyroid involvement by malignant histiocytosis of Langerhans' cell type

Involvement of the thyroid gland by Langerhans' cell histiocytosis is quite rare. We describe the case of a 58-year-old man referred for treatment of a progressively enlarging goitre. The trachea was severely stenotic and adjacent structures such as the left carotid vein and the thyroid cartilage were also involved. Central diabetes insipidus and severe combined immunodeficiency were associated. Although fine needle aspiration biopsy of the thyroid was initially interpreted as papillary carcinoma, anaplastic thyroid cancer was suspected. Treatment with prednisolone, doxorubicin and irradiation controlled the tracheal compression. A diagnosis of thyroid Langerhans' cell histiocytosis was finally made on the basis of the presence of Birbeck granules and CD1a and CD4 antigen in the thyroid tumour cells. Furthermore, positive staining for CD68 and lysozyme suggested that the tumour cells may have had the character of phagocytic cells in addition to their dendritic cell nature. This is the first case of thyroid involvement by malignant histicytosis of Langerhans' cell type with unusual phagocytic markers.