Thorotrast-Induced Multiple Primary Malignant Tumors of the Liver--Cholangiocarcinoma and Malignant Hemangioendothelioma

A case of multiple primary malignant tumors of the liver (cholangiocarci-nomaand malignant hemangioendothelioma) that developed 40 yearsafter Thorotrast administration is described, with radiologicaland autoradiographic findings. The estimated organ dose to theliver was approximately 580 rads.     

Esophageal Cancer in the Intermediate Stage

When we consider the prognosis of esophageal carcinoma, we cometo the conclusion that the less the invasion of the disease,the better the prognosis can be. It is quite reasonable that the prognosis of early cancer isthe most favorable. However, a relatively good prognosis wasalso found for the patients with a, cancer, in which the slightestinvasion into the adventitia had been detected, the incidenceof 5-yr survivors being 31.2%. Approximately 35% of these patientswhose cancers were resected by us were shown to have the diseasein this stage. Since there have not been many patients withearly carcinoma treated so far, we should initially aim at thedetection and treatment of the cancers in which the invasionis limited to the submucosa (sm) and the proprial muscular layer(mp), and those in which invasion reaches just to the adventitia(a, cases). However, if there has been any histological evidenceof lymph node metastasis, intravascular invasion or skip metastasisin such cases, the patients are most likely to die within 1or 2 yr after the operation because of recurrence. When thepatients show such findings postoperatively, they must be giventhe most effective systemic treatment.     

Ejaculated spermatozoa in patients with non‐mosaic Klinefelter’s syndrome

Background : Non‐mosaic Klinefelter patients are generally azoospermic and there is no therapy to improve the spermatogenesis. Some patients have a few spermatozoa in their ejaculates, which can be used for intracytoplasmic sperm injection (ICSI), but only a few cases resulting in a successful birth have been reported. Methods : Out of 52 non‐mosaic 47,XXY Klinefelter patients, four cases having spermatozoa in their ejaculates were retrospectively studied. Results : Intracytoplasmic sperm injection was performed in three cases using their ejaculates and resulted in one chemical abortion and one death in utero (8 weeks). Using testicular sperm, one patient had a healthy baby with a normal karyotype. Conclusion : Some non‐mosaic Klinefelter patients have ejaculated sperm that can result in a successful birth following ICSI. However, the birth rate is very low compared with the fertilization rate, suggesting increased risk of chromosomal abnormalities.     

Urinary Excretion Profile of Torasemide and its Diuretic Action in Dogs

The plasma concentration profile, urinary excretion rate and diuretic response were studied in anaesthetized dogs after an intravenous administration of torasemide or furosemide. The urinary excretion rate of furosemide decreased rapidly after administration. The plasma concentration, which is related to the urinary excretion profile, also decreased rapidly. The diuretic response, which reflected the excretion rate, occurred rapidly after administration but lasted for a short time. The urinary excretion rate of torasemide was much lower than that of furosemide and decreased slowly after administration. The plasma concentration also decreased slowly. The diuretic response to torasemide occurred more slowly but lasted longer than the response to furosemide. These results suggest that the diuretic response profile of either diuretic depends on their urinary excretion rate, and that the difference in the diuretic response between torasemide and furosemide may be explained by the different transfer rate of the drugs from the plasma to the nephron.     

A Case of Giant-Cell Tumour of Femoral Shaft Origin

The giant-cell tumour of a long bone is thought to occur almost exclusively in the epiphyseal region. This strict feature is regarded as one of the hallmarks of the tumour. Accordingly, the clinical diagnosis of a non-epiphyseal giant-cell tumour has to be wavering, especially with the diaphyseal occurrence as reported in this paper. The histological differential diagnosis is, therefore, very important. The diagnosis of the present case has been confirmed by D. Dahlin and A. Huvos, and supported by long-term follow-up studies. Only four such verified cases have been found (including the present case) in meticulous surveys of English and Japanese literatures.