Solitary Splenic Metastasis from Ovarian Cancer Successfully Treated by Hand-Assisted Laparoscopic Splenectomy: Report of a Case

Solitary splenic metastasis is an extremely rare phenomenon for which splenectomy is generally indicated because a good prognosis can be achieved if chemotherapy is given postoperatively. We report herein a case of solitary splenic metastasis from ovarian cancer, which was completely removed by hand-assisted laparoscopic surgery. Received: June 25, 2001 / Accepted: January 8, 2002     

Design, synthesis, and evaluation of opioid analogues with non-peptidic beta-turn scaffold: enkephalin and endomorphin mimetics

We have identified a mu-selective opioid receptor agonist without a cationic amino group in the molecule from libraries of bicyclic beta-turn peptidomimetics. The biologically active conformation of the lead is proposed to mimic an endomorphin type III 4 --> 1 beta-turn conformation.     

Incidence and clinical course of major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy: a prospective study

This study examined the incidence, clinical course and its risk factors for major depression in patients with chronic hepatitis type C undergoing interferon-alpha therapy. Ninety-nine subjects underwent the psychiatric interviews for diagnosis of major depressive episode according to the DSM-IV criteria before the start of interferon therapy, and once every 4 weeks during both the 24-week treatment period and 12 weeks after the end of therapy. Depressive symptoms were also evaluated using the Hamilton Rating Scale for Depression. Major depression occurred during interferon therapy in 23 patients (23.2%). In 73.9% of them depression occurred within 8 weeks after the start of therapy. Twenty-two patients with depression completed the therapy and 59.1% of them achieved remission by the end of therapy with a mean duration of 11.6 weeks. Although the other 40.9% were not in remission at the end of therapy, they achieved remission within 12 weeks thereafter. The only risk factor for depression was advanced age. Depression occurs frequently among patients with hepatitis type C undergoing interferon-alpha therapy. Such patients require careful observation, and psychiatrists should be sufficiently aware of this significant psychiatric complication of interferon therapy.     

An oral anticancer drug, TS-1, enabled a patient with advanced gastric cancer with Virchow's metastasis to receive curative resection

We encountered a patient with advanced gastric cancer, with Virchow's lymph node metastasis, who subsequently underwent curative resection after neoadjuvant chemotherapy with the newly developed oral anticancer drug, TS-1. The patient was a 67-year-old woman who had a type 2 tumor in the middle third of the stomach, and Virchow's lymph node metastasis, which was diagnosed by fine-needle aspiration cytology; she also had swollen paraaortic lymph nodes. Curative resection was considered impossible, and TS-1 (100 mg/day) was administered for 28 days in one course, mainly in the outpatient clinic. Although grade 2 stomatitis interrupted the therapy on day 21 of the second course and on day 7 of the third course, the type 2 tumor showed marked remission (partial response; PR) and the metastasis in the Virchow's and paraaortic lymph nodes had completely disappeared after the third course (complete response; CR). Eleven weeks after the completion of the TS-1 treatment, total gastric resection with D3 lymph node dissection was performed. Histopathological examination revealed tumor involvement only in the mucosal and submucosal layers of the stomach and the no. 4d lymph node. Most of the tumor was replaced with fibrosis with granulomatous change in the muscularis propria of the stomach and in the no. 3, no. 6, and no. 7 lymph nodes. This may be the first report of a patient with advanced gastric cancer with Virchow's lymph node metastasis who successfully received curative resection following neoadjuvant chemotherapy with a single oral anticancer drug. Received: August 7, 2001 / Accepted: January 28, 2002     

Mouse oocytes injected with cryopreserved round spermatids can develop into normal offspring

Purpose: This study was performed to determine whether frozen-thawed mouse round spermatids can fertilize oocytes and contribute to normal embryo development. Methods: Freshly collected mouse testicular cells were frozen in PBS containing 7.5% glycerol and 7.5% fetal bovine serum. After thawing and removal of the cryoprotectants, round spermatids were selected and injected individually into mature oocytes which had been previously activate with Sr ²⁺ -containing Ca ²⁺ -free medium. Results: After thawing, 75–85% of testicular cells were alive. About 90% of the oocytes were fertilized by intracytoplasmic injection of frozen-thawed round spermatids; 11% (17/150) of embryos transferred to foster mothers developed into normal offspring. Conclusions: Mouse round spermatids can be cryopreserved for production of normal offspring.     

Uncooked cornstarch treatment for hepatic phosphorylase kinase deficiency

A 5-year-old boy with short stature, hepatomegaly and motor weakness due to hepatic phosphorylase kinase deficiency is described. Laboratory data showed mild hypoglycaemia and metabolic acidosis, hepatic dysfunction, and a low insulin-like growth factor-I level. Mild hypoglycaemia, marked ketosis and insufficient growth hormone secretion were revealed at night. Serum total and free carnitine levels were low and the acyl/total carnitine ratio was high. Urinary acylcarnitine profile using fast atom bombardment and tandem mass spectrometry showed increased excretion of acetylcarnitine and dicarboxylylcarnitines. These endocrinological and metabolic abnormalities and clinical symptoms were improved with uncooked cornstarch treatment.     

Relationship between surgical procedure and spontaneous urination after rectal cancer surgery

OBJECTIVE: The aim of this study was to determine the relationship between surgical procedures and spontaneous urination after rectal cancer surgery. METHODS: We reviewed the time of removal of the Foley catheter in 91 patients with middle and lower rectal cancer who had undergone curative surgery, either abdominoperineal resection (APR) or sphincter-preserving operation (SPO), without pelvic lymphadenectomy (PL). We also reviewed the time of catheter removal in 40 rectal cancer patients who had undergone one of four types of autonomic nerve preserving (ANP) operations. RESULTS: The mean time of removal of the catheter was 7.3 postoperative days (POD) in patients who underwent APR and 3.1 POD in patients who underwent SPO (p = 0.01). The mean time of removal in patients who underwent ANP for the entire plexus without PL (type 1a) was 6.7 POD. It was 5.6 POD in ANP for the entire plexus with PL (type 1b), 13.8 POD in ANP for bilateral pelvic plexus with PL (type 2) and 15.8 POD in ANP for unilateral pelvic plexus with PL (type 3). CONCLUSION: The type of operation and the volume of preserved nerves could be influential factors in the time to removal of the Foley catheter after rectal cancer surgery.