Mesodermal mixed tumor primary in the fallopian tube

Mullerian mixed tumors, as a group, are uncommon. Only 27 cases of this tumor of the fallopian tube have been reported to date. We report the 28th case of mixed mesodermal tumor, originating in the fallopian tube. A 79-year-old woman had mistaken a bloody vaginal discharge for hematuria. Various examinations showed no evidence of malignancy. However, computerized tomography revealed an intrapelvic tumor. Laparotomy was performed, with a suspicion of tubal malignancy. The final pathologic diagnosis was mixed mesodermal tumor, originating in the fallopian tube. Postoperatively, the patient was placed on oral adjuvant chemotherapy for 34 months. At present, she is doing well. Though no definite conclusions regarding the best method of therapy can be reached, an aggressive mode of therapy is recommended. The primary therapy is surgery; however, surgery followed by chemotherapy may have a potential benefit.     

Effect of Toki-Shakuyaku-San (TJ-23) on the activity of choline acetyltransferase in the brain of menopausal rats

This study was designed to examine the effect of TJ-23 on the synthesis of acetylcholine menopausal rats. TJ-23 (500 mg/kg body weight) was administered daily through drinking water for either 1 or 3 months. Treatment with TJ-23 for 1 month resulted in an increase in the choline acetyltransferase (ChAT) activity in the ventral hippocampus, but there was no statistically significant change in the frontoparietal cerebral cortex. Treatment with TJ-23 for 3 months resulted in a decrease in the ChAT activity in the frontoparietal cortex, but there was no statistically significant change in the hippocampus. Furthermore, treatment with TJ-23 for 3 months resulted in a decrease in the ChAT activity in the amygdala-pyriform cortex complex. From these observations, it is inferred that TJ-23 treatment brings on the synthesis of acetylcholine in the frontoparietal cerebral cortex and hippocampus, and furthermore, treatment with the same regimen brings on different time sequences of acetylcholine synthesis in the frontoparietal cerebral cortex and hippocampus in menopausal rats.     

Pulmonary Fibrosis with Megakaryocytoid Cell Infiltration and Chronic Myelogenous Leukemia

The relationship between fibrosis and megakaryocytic infiltration in the lungs of patients with Philadelphia-chromosome (Ph¹)-positive chronic myelogenous leukemia (CML) is the focus of this review. Ph¹-positive megakaryocytes are thought to reach and accumulate in the pulmonary vasculature through the marrow-blood barrier. In 21 autopsied patients with accelerated phase or blastic crisis of CML, megakaryocytic infiltration to the lungs was demonstrated in 10 patients, myelofibrosis in 12 patients and both in 5 patients. In 2 of the 10 patients with increased megakaryocytes in the lungs, relatively new fibrosis and alveolar damage in the acute phase were demonstrated with the simultaneous occurrence of myelofibrosis-“myelopulmonary fibrosis.” Leakage of mitogenic factors resulting from an abnormality in the packaging mechanism of alpha-granules in these cells termed acquired grey platelet syndrome could cause Fibrosis in the lungs as well as the bone marrow.     

Hepatocellular Carcinoma with Splenic Metastasis Developing after 16 Years of Chemotherapy for Chronic Myelogenous Leukemia: A Case Report

A case of hepatocellular carcinoma (HCC), which developed duringchemotherapy for chronic myelogenous leukemia (CML), is presented.A 55-year-old Japanese man, who had received an alkylating agentfor 16 years, was diagnosed as having HCC with clinically evidentsplenic metastases. The patient died of the HCC rupture threemonths after diagnosis. The autopsy revealed the HCC to havedeveloped from the non-cirrhotic liver. In the present case,DNA damage due to the long-term chemotherapy with the alkylatingagent for CML may have endowed the HCC induced by post-transfusionhepatitis and alcohol abuse with an aggressive proliferativepotential. This is the first report on HCC in association withCML.     

High Rates of Ki-ras Point Mutation in Both Intra- and Extra-hepatic Cholangiocarcinomas

The presence of the Ki-ras gene mutations in 14 cases of intrahepaticcholangiocarcinoma (IHC) and nine cases of extrahepatic cholangiocarcinoma(EHC) were investigated by polymerase chain reaction-singlestrand conformation polymorphism analysis. To obtain enrichedtumor cell DNA, the microdissection method was used on formalin-fixedparaffin-embedded tissue sections. Point mutations at codon12 of the Ki-ras gene were detected in seven (50%) of the 14cases of IHC and six (67%) of the nine EHC cases. In all butone of the ras gene mutation cases, G to A transitions in thesecond position of codon 12 were detected, the exception beinga G to T transition in the same position in one IHC. No pointmutations were detected at codon 13 or 61 in either IHC or EHC.Furthermore, there was no demonstrable correlation between Ki-rasmutation and patient age, tumor Stage, histological findingsor prognosis. The present results demonstrated a higherparticipationof Ki-ras gene mutations in EHC than found in previous studies,and provided a confirmation and extension of the results earlierreported by Tada et al, and Tsuda et al, for IHC.     

Epidemiologic Survey of Children with End-Stage Renal Disease

We performed an epidemiologic study on the basis of a questionnaire survey of 162 children with end-stage renal disease (ESRD). Sixty-nine (43%) of our 162 children, including 25 detected at mass screening of urine, were found by chance hematuria and/or proteinuria. The three major causes of ESRD in our children were chronic glomerulonephritis (CGN) in 56, congenital anomalies of the urinary tract in 30, and nephrotic syndrome (NS) in 27. The renal pathology in 39 children with CGN or NS was focal glomerular sclerosis in 15, diffuse mesangial GN in 7, IgA GN in 5, membranoproliferative GN in 3, membranous GN in 3, and unclassified in 6. Forms of dialysis initiated were hemodialysis in 91 children, continuous ambulatory peritoneal dialysis (PD) in 66, and intermittent PD in 5. Renal transplantation was performed on 38 children, and the graft and the patient survival rates were 76% and 89%, respectively. The survival rate of our 162 children for a mean follow-up of 8.1 years was 77%. In conclusion, an integrated program of maintenance dialysis and transplantation provides a favorable life for children with ESRD.     

Improved Outcome for Infants Weighing Less then 750 Grams at Birth: Effects of Advances in Perinatal Care, Infection Prevention and Maternal Transport for Fetus

Between 1980 and 1987, we investigated the outcome for 20 infants with birth weights <750 g, admitted to the neonatal unit of Kyushu University Hospital. All infants were delivered at the hospital. Seven infants (35%) survived and were discharged. Comparing the first and second 4 year periods, the survival rate improved from 17% (1 of 6 infants) to 43% (6 of 14 infants). Intensive perinatal care, prevention of infection and early transport of mothers of high-risk babies improved the outcome. In the long-term, among the 7 survivors, 1 had psychomotor retardation, 1 had epilepsy and the other 5 were normal neurologically. Growth in height and weight of these children remained below the -2SD levels until 2 years of age, thereafter they began to catch up. Growth in head circumference increased to a level above the -2SD value from 2 years of age. With intensive perinatal care, the outcome for infants weighing <750 g is improving, and good results may be expected.     

Expression of S-100 protein in the human fetal inner ear

The expression of S-100 protein was analyzed in the human fetal inner ear using immunohistochemical methods. In the 11-week-old human fetus, the cochlea was almost negative for S-100 protein, whereas in the 14- and 15-week-old fetuses, the spiral ligament, Reissner's membrane and spiral limbus were positive for the protein. These results suggest that S-100 protein may be a reliable marker for determining functional maturation of the fetal cochlea and the inner ear. In the l l-, 14- and 15-week fetuses, the epithelial cells of the endolymphatic sac were labelled with S-100 protein. These findings demonstrate that the endolymphatic sac, spiral limbus and spiral ligament in the fetal inner ear have a high activity of S-100 protein, with this presence possibly related to fluid and ion transport of endolymph.     

Combination chemotherapy of carboplatin and cytosine arabinoside for high-risk leukemia: A pilot study

Fourteen patients with high-risk leukemia (six with relapsed AML, three with relapsed ALL, one with AML-M0, four with CML in myeloid blastic crisis) were treated with a combination chemotherapy of carboplatin (200–300 mg/m²/day) and cytosine arabinoside (100 mg/m²/day) by 24 h continuous infusion for 5–7 days. Five patients (35.7%) achieved complete remission including two patients complicated with myelofibrosis (one with AML-M0 and one with CML in myelo-megakaryocytic crisis). Thirteen patients had nausea and vomiting, five patients had severe, prolonged neutropenia for which it was necessary to administer granulocyte colony-stimulating factor and six patients had severe thrombocytopenia. We concluded that this regimen is effective for the treatment of high-risk leukemia.