Cerebral infarction in acute promyelocytic leukemia at initial presentation

We report on a 3 year old girl with acute promyelocytic leukemia (APL) with cerebral infarction due to disseminated intravascular coagulation (DIC) at initial presentation. She was hospitalized because of unconsciousness and petechiae on the chest wall and extremities. Cerebral ischemia and infarction were found on computed tomography scan and magnetic resonance imaging. Peripheral bood content was hemoglobin 7.3 g/dL, white blood cells 1.0 × 10³cells/μL (31% blasts) and platelet count was 12 × 10³cells/μL. Fragmented erythrocytes were frequently observed on May-Giemsa stained blood smears. Bone marrow aspirates showed normal cellularity, with 60.4% blasts, containing faggot cells. The blasts were positive for peroxidase. Therapy was begun; however, the patient died 1 week after admission.     

个旧市郊室内氡、钍射气浓度和地面γ辐射水平初步调查

目的调查个旧地区居室内氡（^222Rn）、钍射气（^220Rn）及其子体水平，明确钍射气的剂量贡献。方法考虑住宅类型和地理分布因素，从个旧市郊某村选取建筑结构有代表性的50户住宅的主卧室，采用氡-钍射气鉴别探测器测量氡、钍射气浓度，用沉积率装置测量钍射气子体浓度。其中14间居室采用连续性氡测量探测器和α谱氡、钍射气鉴别探测器测量氡、钍射气浓度，空气采样滤膜结合CR-39探测器测量钍射气衰变产物浓度，碘化钠闪烁计数器测量地表γ剂量率。结果50间居室的氡浓度为32～498Bq／m^3，平均136Bq／m^3；钍射气浓度为39～7908Bq／m^3，平均3297Bq／m^3；钍射气子体浓度为2．0～23．9Bq／m^3，平均10．2Bq／m^3。钍射气子体衰变产物致居民年平均有效剂量大于氡子体衰变产物的平均年有效剂量（2．9mSv vs 1．6mSv）。结论个旧市郊部分居室室内钍射气及其子体浓度高，钍射气子体的剂量贡献要高于氡子体的剂量贡献。在个旧开展氡致肺癌危险评价研究应当考虑钍射气子体的剂量贡献。     

Jaundice and Renal Failure Following Radical Surgery for Cancer: An Analysis of Five Autopsied Cases

An analysis of postoperative jaundice and renal failure in fiveautopsied cases is presented. Two patients had total resectionof esophageal cancer, one had a subtotal gastrectomy, and theother two had radical operations for urinary bladder carcinoma.Halothane was used for anesthesia for three patients, and allfive required blood transfusions. Postoperatively, jaundiceand azotemia developed between the 1st and 7th days, with deathsix to 10 days after surgery. Total bilirubin ranged from 1.5to 13.4mg/dl despite the normal or modest rise in hepatic enzymes.BUN varied from 46 to 288 mg/dl. Pre- and postoperative ECGrevealed a prolongation of QTc in all cases. At autopsy, theliver, kidneys and heart showed a definite increase in weight.The salient hepatic pathology included diffusely dilated spaceof Disse, centrilobular bile stasis and steatosis. This, alongwith acute tubular necrosis confirmed at autopsy, was thoughtto be due to ischemia. Although the significance of prolongedQTc remains uncertain, it is worthy of attention as one of thepreoperative checks.     

Risk of developing ovarian cancer among women with ovarian endometrioma: a cohort study in Shizuoka, Japan

Although some studies have indicated that endometriosis may increase the risk of developing ovarian cancer, there are no data from epidemiologic studies in Japan. We prospectively analyzed all cases of ovarian endometrioma enrolled in the prefecture-wide Shizuoka Cohort Study on Endometriosis and Ovarian Cancer Programme, which was initiated in 1985. To evaluate the risk of ovarian cancer by time periods subsequent to ovarian endometrioma diagnosis, a cohort of 6,398 women with a clinically documented ovarian endometrioma in Shizuoka between 1985 and 1995 was identified from the Shizuoka Cancer Registry (SCR), with follow-up through 2002. Ovarian cancer incidence among cohort members was ascertained by linkage to the SCR using a unique person-identification number. Standardized incidence ratios (SIR) and their 95% confidence intervals (CI) were computed by a use of prefecture-wide rates of ovarian cancer, adjusted for age and calendar year. During follow-up of up to 17 years of the ovarian endometrioma cohort, 46 incident ovarian cancers were identified, yielding that the ovarian cancer risk was elevated significantly among patients with ovarian endometrioma (SIR = 8.95, 95% CI = 4.12-15.3). The SIR did not increase with increasing follow-up duration. The risk increased with increasing age at ovarian endometrioma diagnosis, with a SIR equal to 13.2 (95% CI = 6.90-20.9) in women above 50 years of age. Our findings for the first time support the hypothesis that ovarian endometrioma increases the subsequent risk of developing ovarian cancer in Shizuoka, Japan.     

VACCINE-ASSOCIATED POLIOMYELITIS IN AN INFANT WITH AGAMMAGLO BULINEMIA

Abstract. Sakano, T., Kittaka, E., Tanaka, Y., Yamaoka, H., Kobayashi, Y. and Usui, T. (Department of Paediatrics, Hiroshima University Hospital and Hiroshima City Hospital, Hiroshima, Japan). Vaccine-associated poliomyelitis in an infant with agammagiobulinemia. Acta Paediatr Scand, 69:549, 1980.—We describe a female infant with agammaglobulinemia who contracted vaccine-associated poliomyelitis. Poliovirus type 2 was isolated from the initial stool specimen. In our patient, temporary changes in the cerebrospinal fluid resembled those in patients without immunodeficiencies, although gammaglobulin therapy had not yet been started. Pleocytosis was observed for a short time after viremia, but soon there was a return to normal without antibody production.     

Non-existence of a positive correlation between urinary levels of α1 -microglobulin and ulinastatin in patients with Parkinson's disease

Urinary levels of a,-microglobulin (αlM) and of ulinastatin (UT) and the αlM/UT ratio did not differ significantly between age-matched controls and patients with Parkinson's disease, and among subdivided groups based on Yahr's stages in Parkinson's disease. Furthermore, these indexes did not correlate with Yahr's stages. Although αlM and UT levels did not correlate in patients with Parkinson's disease, a positive correlation was observed in the control group. The non-existence of a positive correlation between αlM and UT levels distinguishes Parkinson's disease from other neuropsychiatric diseases such as dementia (Alzheimer-type and vascular dementia), schizophrenia and mood disorder.     

Quality of ulcer healing influences the relapse of gastric ulcers in humans

The usefulness of dye-contrast endoscopy for the evaluation of the quality of gastric ulcer healing and the prediction of relapse was investigated. Sixty consenting patients whose ulcers healed during 3 months of treatment underwent endoscopy for the identification of the pattern of mucosal regeneration. Patients were monitored for relapses for up to 18 months after antiulcer therapy had ended. The pattern of regeneration was flat in 24 patients, nodular in 25 and intermediate in 11. Internal hypoechoic areas seen by endoscopic ultrasonography were less common and histological maturity was better in the patient group with the flat pattern compared with the patient group with the nodular pattern of mucosal regeneration. Prostaglandin E, synthesis was highest in the group with the flat pattern of mucosal regeneration and the relapse rate was lowest in this group. We conclude that the evaluation of the quality of ulcer healing is possible and that findings in individuals may aid the prediction of relapse for particular patients.