Localized malignant peritoneal mesothelioma containing rhabdoid cells

A case Is presented of localized malignant peritoneal mesothelioma appearing as a liver neoplasm. The patient underwent tumor resection but developed a recurrent growth and died 10 months after the Initial surgery. The primary tumor showed sarcomatous features with rhabdoid cells. Examination revealed the presence of hyaluronic acid, co-Immunoreactivlty for cytokeratln epithelial membrane antigen and vlmentln, cellular contacts with small desmosomes, and intracytoplasmic lumina. These findings supported the mesothelial nature of this tumor. The recurrent tumor was composed of predominantly tubulopaplllary proliferation. It was concluded that the present tumor was a localized malignant mesothelioma of a blphasic type showing a predominantly sarcomatous component in the primary tumor.     

The PNB classification for treatment of fingertip injuries: the boundary between conservative treatment and surgical treatment

The PNB classification, which was advocated by Evans and Bernadis, separates the injuries into their effects on 3 components of the fingertip: pulp, nail, and bone. Because each component is subdivided into 7 or 8 items, this can describe fingertip injuries more precisely. Between 1997 and 2003, we treated 381 fingertip injuries (279 males, 102 females; average age, 41.2 years) in our facilities. A 3-digit number was provided for each of the 381 cases in accordance with the PNB classification. We extracted patients in whom amputated tissues did not exist, and predicted the boundary between conservative treatment and surgical treatment by individually comparing the curative results of the same type of injuries. In conclusion, PNB 355-366 and PNB 455-466 were most suitable for surgical treatment, and the boundaries between surgical treatment and conservative treatment were PNB 386 and 666 and 700. The results, which are the criteria for surgical treatment, are summarized as follows; 1) More than two thirds of the distal phalanx remains. 2)The nail bed defect ranges from one third to half. If the defect is more or less than the criteria, the surgical treatment is less significant. Recognition of the boundary and prevention from unnecessary surgical treatment leads to minimum invasive surgery for fingertip injuries.     

The study of urinary tract infection with a possible cause of fungi and evaluation of the efficacy of 5-FC

Prior to clinical investigations, in vitro activities of 5-fluorocytosine (5-FC), ofloxacin (OFLX), and the combination on a strain of E. coli and of C. albicans were tested. The two drugs showed highly active on each target strain without any interaction. In clinical studies, 5 female adult patients with persistent uncomplicated UTI (3 of cystitis, 2 of pyelonephritis) caused by polymicrobial organisms (including bacteria and fungi) were treated in combination of 5-FC and oral chemotherapeutic agent. The results were both bacteriologically and symptomatically successful in all of 5 cases. Those had been poor by other antibiotic drugs in single use or 5-FC alone. Consequently, 5-FC and oral antibacterial drug combination was useful in therapy on even uncomplicated UTI due to polymicrobial organisms including fungi.     

Three young adult patients with Pelizaeus-Merzbacher disease who showed only waves I and II in auditory brainstem responses but had good auditory perception

Three young adult males with Pelizaeus-Merzbacher disease have been followed up since childhood. This disease is thought to be a dysmyelinating disorder of the brain during the prenatal period caused by gene mutations. The patients manifested horizontal nystagmus and severe rigidity of the extremities. Although the patients showed only waves I and II in auditory brainstem responses, they had relatively good hearing ability at approximately equal to dB. They could not speak words at all but could hear well and enjoy listening to conversation and music. One of them had a normal hearing threshold in pure-tone audiometry and a normal speech discrimination rate in speech audiometry. This can be explained by a nerve conduction blockade through dysmyelinated axons or the desynchronization of neurons and nerves responsible for the waves following waves I and II. At present, all three patients are living with their families. We report their present hearing, speech and language abilities.