Basaloid squamous carcinoma of the larynx: Report of a case

Basaloid squamous carcinoma (BSC) is a rare neoplasm. We present a case of basaloid squamous carcinoma of the larynx in a 57-year-old male patient. The diagnosis before treatment was supraglottic carcinoma (T3N1MO) and biopsy of the larynx revealed a poorly differentiated squamous cell carcinoma. Total laryngectomy and right radical neck dissection were performed, and pathological studies of a specimen removed from the larynx revealed BSC of the larynx. The patient's postoperative progress was uneventful, however, 12 months later he developed lung metastasis of the left side. The patient underwent partial resection of the lung. He developed recurrence of lung metastasis 6 months later. Chemotherapy with cisplatin (CDDP) and vindesine sulfate (VSD) was administered in two courses, but the efficacy was evaluated as no change (NC). At present, 26 months after the first visit, he has been asymptomatic with lung metastasis, and there was no evidence of recurrence in the neck.     

Meniscal tearing after ACL reconstruction

The knees of 72 patients with unilateral anterior-cruciate- ligament (ACL) injury were analyzed before ACL reconstruction as well as by follow-up arthroscopy on the day of staple removal. At ACL reconstruction 31 lateral menisci and 40 medial menisci were found to be normal. 28 lateral menisci and 24 medial menisci were treated surgically, while 13 lateral menisci and 8 medial menisci with small or incomplete meniscal tearing were not treated. At follow-up arthroscopy there were 3 new cases of lateral meniscal tearing and 3 new cases of medial meniscal tearing in the groups diagnosed as normal prior to surgery. Two of the 13 cases with small or incomplete lateral meniscal tearing required resection, 8 healed and the other 3 demonstrated no progressive change. Four of the 8 cases with small or incomplete medial meniscal tears healed, 3 exhibited no progressive change and one required surgical treatment. There was no correlation between meniscal tearing and knee instability as indicated by a positive Lachman test or a positive pivot shift sign. The results of the present study indicate that ACL reconstruction prevents progressive changes in meniscal tears and will prevent secondary osteoarthritis, and that some small tears of the lateral meniscus require no surgical treatment.     

Clinicopathological significance of galectin-3 expression in ductal adenocarcinoma of the pancreas.

PURPOSE: Galectin-3, a member of the beta-galactoside-binding lectin family, has multiple biological functions including cell-cell interactions and cell-extracellular matrix adhesion, cellular proliferation, cellular differentiation, and apoptosis. The aim of this study was to determine the relationship of galectin-3 expression to clinicopathological findings and patient prognosis in ductal adenocarcinoma of the pancreas. EXPERIMENTAL DESIGN: We examined galectin-3 expression in 104 surgically resected pancreatic ductal adenocarcinoma cases with stages I through IV using immunohistochemistry and investigated the relationship of it to overall survival. RESULTS: Patients were divided into two groups: a low expression group, where <60% of tumor cells were positive; and a high expression group, where > or =60% of tumor cells were positive. Cases in the low expression group had a significant tendency to be at later stages, to have distant metastasis, and to have less differentiated tumors, compared with cases in the high expression group (P = 0.001 for stage, P = 0.001 for metastasis, and P = 0.006 for differentiation). Postoperative overall survival was worse in the low galectin-3 expression group than in the high galectin-3 expression group (P = 0.004). Multivariate analysis showed that the risk ratio of prognosis was 2.06 among patients in the low galectin-3 expression group compared with the high galectin-3 expression group (P = 0.006). CONCLUSIONS: Decreased expression of galectin-3 was associated with advanced stage, tumor de-differentiation, and metastasis in ductal adenocarcinoma of the pancreas. Galectin-3 expression might be a useful prognostic marker for survival in ductal adenocarcinoma of the pancreas.     

Pharmacokinetic Study on the Hepatic Uptake of Indocyanine Green in Cirrhotic Patients

The mechanism by which the mean blood clearance (CLtot,B) of indocyanine green (ICG) was reduced in cirrhotic patients was examined pharmacokinetically. It was demonstrated that the reduction in the CLtot,B of ICG in cirrhosis would be mainly due to the decrease in the hepatic uptake clearance and partly due to the increase in the efflux clearance from the liver to plasma. It is suggested that the decrease in the hepatic uptake clearance in cirrhosis mainly reflects the decrease in the intrinsic clearance of hepatic uptake rather than the decrease in hepatic blood flow.     

Peroneal island flap for skin defects in the lower extremity

Two types of peroneal island-flap transfer were used in fourteen patients with a large defect in the soft tissues of the lower extremity. The peroneal artery and vein and their cutaneous branches form the pedicle, and an extensive transfer of skin is possible either from above the knee or from the lateral side of the leg to as far distal as the foot. Two methods were used: in the first we severed the peroneal artery and vein distally, with an island of skin attached, and elevated them proximally, and in the second we severed the proximal portions of the peroneal vessels, with an island of skin attached, and elevated them distally. The largest flap that we used in this series measured fourteen by 16.5 centimeters and the smallest, 2.5 by five centimeters. All fourteen transfers healed, with no necrosis of the flap.     

Pyridazinones. 2. Synthesis and antisecretory and antiulcer activities of thiourea and 2-cyanoguanidine derivatives

In an effort to develop new types of antiulcer agents, we synthesized a series of novel 2-[omega-(thioureido)alkyl]- and 2-[omega-(cyanoguanidino)alkyl]-3(2H)-pyridazinone derivatives. All target compounds were evaluated for gastric antisecretory activity in the pylorus-lygated rat by the method of Shay, and selected compounds were evaluated in the stress-induced ulcer test in rats. Structure-activity relationships were established. Two series of the compounds had significant activity in antisecretory and/or antiulcer tests. The molecular features essential for the activities are a thiourea group or a 2-cyanoguanidine group, a phenyl group in the C-6 position of the 3(2H)-pyridazinone ring, a four-carbon chain length between the 3(2H)-pyridazinone ring and the functional group, and a methyl group at the N-3 position of the functional group. Among them, the three thiourea derivatives (24, 26, and 38) and the six 2-cyanoguanidine derivatives (61, 62, 65, 75, 85, and 86) had the most potent antisecretory and/or antiulcer activities. These compounds are not histamine H2-receptor antagonists.     

Reflex changes in sympatho-adrenal medullary functions in response to baroreceptor stimulation in anesthetized rats

Effects of increased and decreased blood pressure on adrenal sympathetic nerve activity and catecholamine secretion were examined in anesthetized Wistar rats. Efferent nerve impulses were counted and adrenal venous plasma was collected just before and 30 s after the onset of hypotensive stimulation induced by bleeding (average decrease in systolic blood pressure over the stimulation period was 38 mm Hg) or a hypertensive stimulation induced by phenylephrine administration (average increase in systolic blood pressure over the stimulation period was 41 mm Hg). While nerve activity and epinephrine and norepinephrine secretion were not significantly altered by the change in blood pressure in baroreceptor denervated animals, there were increases in these variables (131.1% of control levels for epinephrine, 117.5% for norepinephrine, and 127.1% for nerve activity) in response to bleeding and a marked decrease (to 63.0% of control levels for epinephrine, 53.9% for norepinephrine, and 54.0% for nerve activity) in response to phenylephrine administration with baroreceptors intact. These changes were significant both with respect to control blood pressure levels and with regard to the effect of stimulation in the baroreceptor-denervated animals. The reflex responses in adrenal nerve and catecholamine secretion were generally proportional in magnitude. The present results are discussed with regard to the effects of somatic stimulation on nerve activity and catecholamine secretion.     

Analysis on the dispersal pattern of newly introduced Latrodectus hasseltii (Araneae: Theridiadae) in Japan by spider diagram

The dispersal pattern of the widow spider Latrodectus hasseltii (Araneae: Theridiadae), in Osaka Prefecture, Japan, was analyzed from accumulated survey data of spider distribution. All confirmed infested points from 1996 to 2002 were plotted on a map, and infested points in each survey year were connected with the nearest previously confirmed points. Expansion patterns of the confirmed habitats were analyzed by year and dispersion distances were classified by using spider diagram, one of method of geographical information system spatial analysis. L. hasseltii moves by walking step by step on the ground, mainly in coastal areas during early stages of infestation, and also can be conveyed over distances by various vehicles, mainly in inland areas. These analyses show L. hasseltii does not move by ballooning.