Adult T-cell leukemia/lymphoma (lymphoma type) with remarkable gastric lesions: a case report.

We report a case of a 53-year-old woman with adult T-cell leukemia/lymphoma (ATL) (lymphoma type) with multiple gastric lesions, admitted to our hospital because of systemic lymphadenopathy and epigastralgia. Gastroscopy showed a variety of gastric lesions including thickened folds, ulcerations and polypoid lesions. Biopsy specimens obtained from the stomach and lymph nodes revealed diffuse infiltration of pleomorphic mononuclear cells and the integration of HTLV-1 proviral DNA. We demonstrated through the investigation of 30 previously reported cases of ATL that this is a rare case of the lymphoma type of ATL presenting remarkable gastric lesions.     

Clinical study of multiple primary cancers including lung cancer

Out of a total of 506 lung cancers treated between 1977 to 1988, a total of 27 (5.3%) multiple primary cancers were uncovered. The patients consisted of 20 males and 7 females and their average age was 67 (48-81) years. The frequency seen in the histological type of patient with multiple primary cancers was the same as that seen in their background lung cancers. Twenty-one (78%) patients were smokers. Thirteen patients (45%) had a family history of cancer. Two cases had 3 family members who had a cancer history. The tumor DNA contents of 2 cases with multiple primary cancers were analyzed. In both cases, the DNA indices were found to differ between the first and the second cancer. Thus, it may be possible to identify multiple primary cancers by determining the tumoral DNA content.     

A case report of the pathognomonic relationship between idiopathic interstitial pneumonia and silicosis

A 67 year-old male complaining of cough and exertional dyspnea was hospitalized for evaluation of an abnormal chest shadow. Chest X-ray films revealed bilateral diffuse nodular shadows, honeycombing in the lower lung fields and pleural thickening suggestive of idiopathic interstitial pneumonia. He had worked as a boilerman and painting using various materials. Transbronchial lung biopsy did not reveal silicotic nodules or asbestos bodies. Analytical electron microscopic study demonstrated amounts of free silica without other elements and asbestos fibers. This case suggests a pathognomonic relationship between idiopathic interstitial pneumonia and silica inhalation.     

Selective venous sampling for primary hyperparathyroidism: how to perform an examination and interpret the results with reference to thyroid vein anatomy

Primary hyperparathyroidism (pHPT) causes hypercalcemia. The treatment for pHPT is surgical dissection of the hyperfunctioning parathyroid gland. Lower rates of hypocalcemia and recurrent laryngeal nerve injury imply that minimally invasive parathyroidectomy (MIP) is safer than bilateral neck resection. Current trends in MIP use can be inferred only by reference to preoperative localization studies. Noninvasive imaging studies (typically preoperative localization studies) show good detection rates of hyperfunctioning glands; however, there have also been cases of nonlocalization or discordant results. Selective venous sampling (SVS) is an invasive localization method for detecting elevated intact parathyroid hormone in the thyroid and/or internal jugular and brachiocephalic veins. SVS was developed mainly for postoperative patients with persistent or recurrent pHPT; however, SVS could also be useful before initial operations due to its high sensitivity to pHPT. Currently, SVS is generally indicated for recurrent HPT, and for cases with negative imaging study results for HPT or discordant results. Multi-detector row helical CT is useful for imaging the anatomy of the jugular and thyroid veins. Knowledge of the thyroid vein anatomy enables the creation of sampling points in the internal jugular and brachiocephalic veins for catheterization of the thyroid veins and venous anastomoses.     

The relationship of the proliferating cell nuclear antigen protein to cis-diamminedichloroplatinum (II) resistance of a murine leukemia cell line P388/CDDP

We investigated whether the proliferating cell nuclear antigen (PCNA) protein takes part in cis-diamminedichloroplatinum (II) (CDDP) resistance, using a murine leukemia cell line P388 and its CDDP resistant cell line. P388/CDDP was 4 times more resistant to CDDP than P388. The cell lines were maintained in the DBA/2 female mouse peritoneal space. In total cells, the amount of the PCNA protein decreased to 90% in P388 after 1 h CDDP treatment, but that of P388/CDDP increased to 127%. The difference was statistically significant (p = 0.012, n = 5). As for G2/M phase cells, the difference was also significant at 1 h (p = 0.016, n = 5) and at 2 h (p = 0.036, n = 5) after treatment. In P388 the amount of the PCNA protein decreased in accordance with the inhibited cell proliferation, whereas in P388/CDDP, the amount of the PCNA protein increased in spite of the inhibited cell proliferation. This increase of the PCNA protein suggests that the PCNA protein is involved in CDDP resistance of P388/CDDP through enhanced DNA repair synthesis.     

Pulmonary function in normal Japanese children 6 to 16 years of age

We measured pulmonary function on 182 healthy Japanese children 6 to 16 years of age living in the Tokyo area. Static lung volumes, RV/TLC (%), FRC/TLC (%), FVC, FEV1, FEV1/FVC (%), MMFR, MVV, f, VE and VO2 were measured. Multiple regression equations were obtained and the results were compared with those derived from the other equations (Kanagami (1958), Ishida (1955]. The predicted values were about 10 approximately 25% higher with our equations than those obtained from the other equations which were made more than 30 years ago. These differences were attributed to the recent improvement in growth of the Japanese children. For this reason we think it is better now to adopt new equations for the prediction of normal values in Japanese children.     

Fulminant type 1 diabetes complicated by leukemoid reaction

A 28-year-old woman with severe ketoacidosis was admitted to our hospital on day 11 after giving birth. However, her HbA(1C) level was normal (5.2%) and both GAD and anti-insulin autoantibody were negative, and the WBC count was extremely high (57,500/ml) with immature leucocytes in the peripheral blood. Her WBC count decreased along with control of ketoacidosis and reduction of the plasma glucose level, and was normalized on day 5 after admission. Bone marrow aspiration subsequently showed no malignant cells, so the final diagnosis was fulminant type 1 diabetes combined with a leukemoid reaction. This is the first report of a patient with both fulminant type 1 diabetes and a leukemoid reaction. The mechanism that triggered the leukemoid reaction could not be clarified, but severe ketoacidosis may have been involved.     

Sodium channel-blocking properties of flecainide,a class IC antiarrhythmic drug,in guinea-pig papillary muscles An open channel blocker or an inactivated channel blocker

Summary Effects of flecainide (a class IC antiarrhythmic drug) on the maximum rate of rise ( ) of action potentials (APs) were studied in guinea-pig papillary muscles, with special reference to their time, voltage, and action potential duration (APD) dependence in the presence and absence of nicorandil. Nicorandil was used to shorten APD, i.e., the time period of inactivation state of sodium channels. APs were recorded from the preparations using standard microelectrode techniques. Flecainide (5 mol/l) reduced without changing resting potential, AP amplitude, APD₅₀, and APD₉₀ examined at 1 Hz. The drug shifted the normalized -membrane potential curve (examined at 1/60 Hz) in the hyperpolarizing direction by 3.1 ± 0.8 mV (n = 6) (voltage dependence). The drug caused a frequency-dependent reduction of at 0.1 Hz, developed a use-dependent reduction of at 1 Hz with an onset time constant of 11.7 ± 0.4 s (n = 6), and slowed the recovery process of , whose resultant recovery time constant was 19.9 ± 1.2 s (n = 6) (time dependence). These flecainide-induced time-dependent reductions of were not antagonized by nicorandil (1 mmol/1) which shortened APD to about 1/4 of control (APD independence). These results suggest that flecainide is primarily an open channel blocker because its channel-blocking actions are independent of APD or the time period of inactivation.