c-erbB-2 and c-erbA-1 (ear-1) gene amplification and c-erbB-2 protein expression in Japanese breast cancers: their relationship to the histology and other disease parameters

We studied c-erbB-2 and c-erbA-1 (ear-1) gene amplification, and c-erbB-2 protein expression in 123 primary Japanese breast cancers. c-erbB-2 amplification was found in 19 of the 123 tumors (15%), and c-erbA-1 was coamplified in 7 of the 19. The presence or absence of c-erbB-2 amplification correlated with the grade of cellular atypism (P = 0.008), or that of mitotic index (P = 0.002), but not with the histologic types. The tumor size (P = 0.04) and the lymph node status (P = 0.06) were associated, but the patients' age, the TNM stage, or the presence or absence of estrogen or progesterone receptors was not associated, with c-erbB-2 amplification. There were no differences in the histologic type, cellular atypism, mitotic index, and other disease parameters between tumors with c-erbB-2 amplification only and those with coamplification of c-erbB-2 and c-erbA-1. Paraffin sections from all 19 tumors with c-erbB-2 amplification, and those from only one of 104 tumors without the amplification were positively stained with polyclonal anti-c-erbB-2 protein antibody. Since the correlation between the amplification and the protein expression was excellent, such immunohistochemical studies may be substituted for the time-consuming DNA studies using Southern blotting.     

An autopsy case of triple cancers including signet-ring cell carcinoma of the breast —Report of a rare case with reference to a review of the literature—

A 67 year old Japanese woman who had been suffering from general fatigue was diagnosed as having metastasis of signet-ring cell carcinoma of the bone marrow from a biopsied specimen. A clinical effortive search to the systemic organs revealed a tumor of 4×3 cm in size in the lower part of her left breast, which was subsequently diagnosed as the primary site histopathologically. The patient was immediately treated surgically, however, her general condition generally deteriorated and she expired 5 months after the operation. Autopsy revealed dissemination of tumor cells in the bone marrow, bilateral pleura, and soft tissue around the operated site. The autopsy additionally revealed squamous cell carcinoma of keratinizing type in the uterine cervix and well differentiated tubular adenocarcinoma in the gallbladder. A review of the literature revealed this case to be the first reported case of triple cancers including signet ring-cell carcinoma of the breast, proven by autopsy in Japan.     

Molecular cloning and chromosomal localization of a gene coding for human cardiac myosin heavy-chain

A human cardiac myosin heavy-chain (MHC) gene, cloned in a charon 4A phage, was isolated using two rat cardiac pCMHC DNA clones (pCMHC26: alpha-MHC type; and pCMHC5: beta-MHC type) as probes and shown to correspond to cardiac myosin heavy-chain of the alpha-type. The 4.3-KB cardiac genomic DNA clone was used as a probe in the Southern analysis of human genomic DNA from human-Chinese hamster or human-mouse somatic cell hybrids. The results show that the human cardiac MHC gene is assigned to chromosome 14 and the human cardiac and skeletal MHC genes do not cosegregate as do the mouse cardiac and skeletal MHC genes.     

Clinical study on cefteram pivoxil in pediatric field

Cefteram pivoxil (CFTM-PI, T-2588) was administered to pediatric patients with acute infectious diseases, and a summary of the results obtained are as follows. 1. Pharmacokinetic parameters determined in 1 patient appears to be comparable to those of adults. 2. Clinical efficacy was studied on 16 children with acute urinary tract infections, acute upper respiratory infections, acute sinusitis, acute otitis media and acute cervical lymphadenitis. Responses to the treatment were excellent in 7 (43.8%) and good in 9 (56.3%). 3. No adverse reactions were noted in this study.     

Amyotrophic lateral sclerosis with prolonged survival and degeneration of the spinocerebellar tracts,substantia nigra and dentatorubral system

We report on a case of sporadic amyotrophic lateral sclerosis (ALS) with prolonged, respirator-assisted survival and clinical signs limited to the upper and lower motor neuron systems. Autopsy revealed degeneration of the upper and lower neuron systems and Bunina bodies, both characteristic of ALS. In addition, we found degeneration of the spinocerebellar tracts, the substantia nigra and the dentatorubral system. Our case is an additional example of multisystem degeneration in ALS associated with prolonged, respirator-assisted survival. These findings suggest that sporadic ALS comprises heterogeneous subgroups with patterns of degeneration that depend, in part, on survival time.     

Methods and Nutritional Interventions to Improve the Nutritional Status of Dialysis Patients in JAPAN—A Narrative Review

Patients receiving dialysis therapy often have frailty, protein energy wasting, and sarcopenia. However, medical staff in Japan, except for registered dietitians, do not receive training in nutritional management at school or on the job. Moreover, registered dietitians work separately from patients and medical staff even inside a hospital, and there are many medical institutions that do not have registered dietitians. In such institutions, medical staff are required to manage patients’ nutritional disorders without assistance from a specialist. Recent studies have shown that salt intake should not be restricted under conditions of low nutrition in frail subjects or those undergoing dialysis, and protein consumption should be targeted at 0.9 to 1.2 g/kg/day. The Japanese Society of Dialysis Therapy suggests that the Nutritional Risk Index-Japanese Hemodialysis (NRI-JH) is a useful tool to screen for older patients with malnutrition.     

Delayed platelet recovery after allogeneic hematopoietic stem cell transplantation: Association with chronic graft‐versus‐host disease and survival outcome

Delayed platelet recovery (DPR) despite prompt neutrophil engraftment is frequently observed after allogeneic hematopoietic stem cell transplantation (HSCT). However, few studies have evaluated the risk factors and long‐term outcome. Therefore, we retrospectively analysed 219 adult patients who underwent their first allogenic HSCT with neutrophil engraftment. Of these 219 patients, 50 (22.8%) had DPR that was defined as relapse‐free survival at day 60 after HSCT without primary platelet recovery despite neutrophil engraftment. The results of a multivariate analysis showed that a high‐risk underlying disease (odds ratio [OR], 2.38; 95% confidence interval [CI], 1.04‐5.48; P = .041) and human leukocyte antigen–mismatched HSCT (OR, 2.63; 95% CI, 1.28‐5.43; P = .009) were associated with an increased risk of DPR. In univariate analyses, the occurrence of DPR was significantly associated with inferior overall survival, high nonrelapse mortality, and a low incidence of chronic graft‐versus‐host disease (GVHD), despite a comparable relapse rate. In multivariate analyses, DPR was associated with inferior overall survival (hazard ratio [HR], 2.00; 95% CI, 1.23‐3.27; P = .005) and a low incidence of chronic GVHD (HR, 0.42; 95% CI, 0.22‐0.78; P = .002). In conclusion, DPR was a strong predictor of shorter survival but also less frequent chronic GVHD.