A case report of an advanced ovarian cancer (stage T4) treated with a total amount of 1815 mg of CDDP

A case is reported of a 34-year-old female who complained of an adult head-sized tumor in the pelvis and was treated with a high dose of CDDP. On the first look operation, it was found impossible to perform reduction surgery because of severe adhesion and peritonitis carcinomatosa. To introduce a high concentration of an anti-cancer agent into the tumor tissue, we administered CDDP intravenously, intraperitoneally and intra-arterially to the total amount of 1815 mg. After this high dose combination chemotherapy, a second look operation was performed and the tumor was seen to be reduced. The patient is now in remission and is being followed up as an out-patient. The clinical course of this case had decided for us which route would be the most effective and would have the least side effect, also, how much of a dosage can be administered as a maximum adoptive dose of an anti-cancer agent, and what kind of a second-line chemotherapy is effective against resistant cancer cells.     

A case of seborrhoeic blepharitis.

A fifty five-year old woman suffered from itching and scaling of the edge of her eyelid. She had long used topical corticosteroid for this condition. Direct examination of the scale by Parker KOH showed numerous fungal elements of spores and hyphae of Malassezia furfur. She was treated with oral itraconazole (100 mg daily or twice a week) for 8 weeks and was cured clinically and mycologically. The result suggests the possibility of treatment with an anti-fungal drug for seborrhoeic blepharitis or seborrhoeic dermatitis.     

Magnetic resonance imaging and histopathology in femoral head necrosis

We correlated preoperative magnetic resonance (MR) images and histopathology of eight femoral heads from patients with osteonecrosis. The signal intensity of the MR image was low in the area where fibrovascular tissue, disintegrated fibrovascular tissue, or amorphous necrotic material occupied the medullary space. On the other hand, the necrotic marrow without revascularization showed high signal intensity. Osteonecrosis can be detected by MR imaging as soon as a certain amount of bone marrow is replaced by fibrovascular tissue.     

Ion specificity of rat chorda tympani fibers to chemical and electrical tongue stimulations

Responses of rat single chorda tympani fibers to ionic chemical stimuli and anodal tongue stimulations with ionic bathing solutions were examined. Fourteen out of 30 fibers showed the highest sensitivities to NaCl for both chemical and electrical stimulations, whereas the remaining 16 fibers showed almost no ion specificity for electrical stimulation even though most of them have the highest sensitivities to HCl for chemical stimulation. Ion specificity for electrical stimulation was significantly smaller than that for chemical stimulation.     

Visuo-Motor Reaction Times of Normal Subjects and Schizophrenics Using Inverting Prisms

Abstract: The visuo-motor reaction times of normal subjects and schizophrenics were measured to investigate adaptation of eye-hand coordination in schizophrenics under modified vision. Reaction time was measured in 32 normal subjects and 32 schizophrenics by using a rectangular board with 24 illuminated buttons. Subjects' task was to press an illuminated button as quickly as possible under normal and modified vision. Time elapsed from when the light was switched on to when the button was pressed was measured as the visuo-motor reaction time in msec. Three conditions were set up: control in normal vision; inverted using an inverting goggle; reversed using a reversing goggle. In general the visuo-motor reaction times of schizophrenics were slower than those of nonnal subjects. But in the reversed condition, there was no significant difference between normal subjects and schizophrenics. The visuo-motor reaction times of schizophrenics in the reversed Condition showed a large dispersion with the fastest being faster than that of any normal subjects. It is suggested that there may be a group among schizophrenics whose basic paradigm of visuo-motor association is different from that of normal subjects.     

Subcutaneous operation and examination under the universal endoscope

Endoscopes are mainly used to study the internal structures of organs and tissues with inherent space. These include the gastrointestinal tract, abdominal space and joint space. The standard endoscope, however, cannot be used to evaluate tissues without such space. We have invented a new type of operation tube to be used with the arthroscope. This combination enables us to study subcutaneous soft tissues without inherent space. Our new device is a powerful tool to be used for evaluation of subcutaneous soft tissues in any part of the body. Surgical procedures can also be carried out with this device. Areas of future applications of our device will be extremely wide including orthopaedic surgery, plastic surgery and general surgery. The presentation will discuss the procedure for utilizing this new instrument.     

Significance of residual coronary artery stenosis after reperfusion therapy in acute myocardial infarction

We evaluated the efficacy of reperfusion therapy in acute myocardial infarction in terms of postinfarction angina (PIA), reinfarction and coronary reocclusion. In 99 hospitalized patients with acute myocardial infarction within 6 hours after the onset of symptoms, 67 were treated using intracoronary thrombolysis (ICT) alone (Group T) and the remaining 32 using ICT followed by percutaneous transluminal coronary angioplasty (PTCA) (Group T + A). PTCA was performed for the arteries with high grade residual stenosis (TIMI grade 0, 1, 2) after ICT. Recatheterization was performed 28 +/- 12 days after hospitalization in 93% (62/67) of Group T and in all of Group T + A. There were no significant differences in age, sex, time interval from the onset to reperfusion, the extents of coronary artery disease and the Cohn grade of collaterals. However, anteroseptal infarction was more frequent in Group T than in Group T + A (p less than 0.05). Residual stenosis (diameter) at the end of intervention was 81 +/- 14% in Group T, and 48 +/- 15% in Group T + A, (p less than 0.01). Residual stenosis at recatheterization was 70 +/- 23% in Group T, and 55 +/- 22% in Group T + A (p less than NS). The incidence of PIA did not differ between the two groups (20.1% vs 6.2%). However, the incidence was higher in patients with residual stenosis of 70% or more than in those with residual stenosis of less than 70% (23.8% vs 2.9%, p less than 0.05). The incidence of reinfarction (re-elevation of CPK) did not differ between the two groups (7.4% in Group T, 6.2% in Group T + A); and neither did the incidence of coronary reocclusion at the time of recatheterization (14.5% vs 3.1%). We concluded that higher degree of residual stenosis at the end of intervention has a greater risk of PIA and reocclusion. Although differences were not statistically significant, the patients treated with ICT followed by PTCA seemed to have lower incidence of PIA and reocclusion compared with those treated with ICT alone, thus having better hospital prognosis.     

Peripheral blood stem cell autografts (PBSCT) in the treatment of 30 children with acute leukemias and lymphoma]

Thirty children (1-16 y.o.; median, 10 y.o.) with acute leukemia or non-Hodgkin's lymphoma (NHL) associated with high-risk features underwent high-dose chemotherapy without total body irradiation and peripheral blood stem cell autografts (PBSCT). Eighteen patients had acute lymphoblastic leukemia (ALL), 6 had acute non-lymphoblastic leukemia (ANLL), 2 had mixed-lineage leukemia and 4 had NHL. Twelve patients with two or more high-risk features (WBC greater than 10 x 10(4)/microliter, T- or B-phenotypes, infancy, massive organ infiltration, or induction failure) underwent PBSCT in 1st CR. Twelve patients underwent PBSCT in 2nd CR, and 4 in the subsequent remission greater than or equal to 3rd CR). Two patients were treated at refractory relapse. After PBSCT the number of days required to achieve a granulocyte count of 0.5 x 10(9)/l and a platelet count of 50 x 10(9)/l was 6.39 (median, 13) and 9-427 (median, 16), respectively. The disease-free survival rate was 6/12 in 1st CR group (6-41 mo) and 6/16 in the patients who underwent PBSCT in 2nd or subsequent remission (2-35 mo). The data justify the incorporation of PBSCT in the design of salvage protocol for children with leukemias or NHL. However, the application of the procedure as part of initial therapy in patients still remaining in 1st CR should be regarded as highly experimental and deserve further clarification.