Disseminated intravascular coagulation in lupus erythematosus with acute liver damage.

A case of disseminated intravascular coagulation (DIC) in a patient with systemic lupus erythematosus (SLE) with acute liver dysfunction is described. A 37-year-old man with SLE developed acute DIC and marked liver damage after fracture of the right clavicle and pharyngitis. Treatment with high-dose steroids, heparin, antithrombin III, gabexate mesilate, and antibiotics resulted in prompt improvement. The recovery of an SLE patient after acute DIC and marked liver damage is considered very rare. We report here such a case and discuss the previous reports.     

Modulation of Membrane Permeability, Cell Proliferation and Cytotoxicity of Antitumor Agents by External ATP in Mouse Tumor Cells

External ATP causes a remarkable change in the passive permeability of the plasma membrane in several types of transformed cells. When mouse melanoma cells, Clone-M3, were exposed to ATP in Tris-buffered saline, a great increase in the passive permeability was induced within several minutes. Longer exposure of Clone-M3 cells to external ATP led to a decrease in cell viability. Similar results were obtained with Ehrlich ascites cells, but none of these ATP effects were noted in untransformed cells such as NIH 3T3 cells or BALB/c mouse embryonic fibroblasts. The in vitro cytotoxic effects of antitumor agents (5-fluorouracil, adriamycin, mitomicin C and nimustine hydrochloride) against Clone-M3 cells were additively potentiated by treatment with external ATP, which also synergistically enhanced the cytotoxicity of vincristine. However, the effects of these drugs on mouse embryonic fibroblasts were not modulated by ATP. These results suggest that ATP-treatment is a useful means of enhancing a selective toxicity for tumor cells.     

Primary adult T-cell lymphoma of the breast.

A case of primary adult T-cell lymphoma (ATL) of the breast is described. A 69-year-old woman presented with a painless, rapidly growing lump in her left breast. Staging procedures demonstrated no sign of generalized disease. Following a Patey's mastectomy, 10 courses of adjuvant chemotherapy (CHOP) were successfully administered. The light microscopic, immunohistochemical and molecular genetic analyses of the surgical specimen revealed a primary ATL. Seropositive mothers who breast-feed their children may facilitate the accumulation of T cells carrying HTLV-I in their breasts and thereby increase their risks of developing breast ATL.     

Cerebellar form of progressive multifocal leukoencephalopathy in a patient with chronic renal failure.

Progressive multifocal leukoencephalopathy (PML) developed in a 64-year-old woman who had undergone hemodialysis treatment due to chronic renal failure (CRF) for 6 yr. Her initial symptom was ataxia, and computed tomographic (CT) scan and magnetic resonance imaging (MRI) suggested a demyelinating disease of the cerebellum. Her cell-mediated immunity was impaired. At autopsy, the cerebellar disease was confirmed as PML by ultrastructural and immunohistochemical studies. Moreover, the JC type of papova virus infection was verified by Southern blot analysis.     

Cardiovascular Responsiveness After Isotonic Exercise in Cirrhotic Patients: Study on Sympathoadrenergic and Renin-angiotensin Systems

Objectives: The aim of this study was to evaluate cardiovascular responsiveness after isotonic exercise in cirrhotic patients. Methods: Included were 11 cirrhotic patients and 10 age-matched normal suhjects, who served as controls. Hemodynamic data were obtained on each subject before and after muscle exercise on a treadmill (7 metabolic units). Plasma noradrenaline concentration and plasma renin activity also were determined. Results: In both groups, isotonic exercise increased heart rate and systolic arterial pressure, whereas diastolic arterial pressure was not modified. The increase in heart rate and systolic arterial pressure did not differ significantly between the two groups. Plasma noradrenaline concentration and plasma renin activity also were increased. The changes in plasma noradrenaline concentration and plasma renin activity was higher in cirrbotic patients than in controls ( P < 0.05, P < 0.05), although the differences were not significant when calculated as a percentage. Conclusions: Cardiovascular responsiveness to isotonic exercise is almost intact in cirrhotic patients. However, supernormal activation of the sympathoadrenergic and renin-angiotensin systems is required to maintain cardiovascular homeostasis in these patients.     

Ossification of the posterior longitudinal ligament: MR evaluation.

PURPOSE: To investigate the MR appearance of ossification of the posterior longitudinal ligament (OPLL) of the cervical spine. MATERIALS AND METHODS: A retrospective review of MR images and conventional tomograms in 147 patients. RESULTS: In the sagittal plane, proton-density images identified the ossified lesions more clearly than did T1- and T2-weighted images. All axial sequences identified the lesions much frequently. T1-weighted images often showed areas of increased intensity within the lesions of the continuous and mixed type, especially within the thick lesions. Fat images by Dixon technique demonstrated same areas of increased intensity, which strongly suggested fatty marrow formation. On conventional tomograms, configurations of radiolucent areas within the lesions corresponded to areas of increased intensity on T1-weighted images. CONCLUSION: Proton-density sagittal and axial images are important in establishing the diagnosis of OPLL. The areas of increased intensity on T1-weighted images and radiolucent areas suggest marrow formation.     

Clinical studies on intravaginal administration of CDDP for dysplasia, carcinoma in situ and microinvasive carcinoma of the uterine cervix]

We attempted CDDP (cis-diaminedichloroplatinum) intravaginal administration by directly exposing the uterine cervix to CDDP in cases of dysplasia of the uterine cervix and cervical intraepithelial and micro-invasive carcinoma. Out of 12 patients, 7 had dysplasia of the uterine cervix (dysplasia was mild in 4, of an intermediate level in 1, 4 with mild dysplasia, 1 with and advanced in 2); 3 had carcinoma in situ, and 2 had microinvasive carcinoma. For CDDP intravaginal administration, a gauze tampon containing CDDP (5mg) was inserted into the vagina. CDDP administration was repeated daily for 10 days. The total dosage of CDDP administered was 50mg (new paragraph). During this period, vaginal cytologic examination was conducted and total plasma Pt content was determined daily for all. Following the completion of CDDP administration, the uterine cervices of those with dysplasia were histologically examined. For those with carcinoma in situ and microinvasive carcinoma, simple total hysterectomy was performed after intravaginal administration of CDDP to determine its therapeutic efficacy and the Pt concentration of the tissue; 1. In the 7 cases of dysplasia, dysplastic cell degeneration was observed 1-2 days after the start of intravaginal CDDP administration and these cells disappeared in all cases after its completion. 2. Sixteen histological sections of the resected cervical specimens from the 3 cases of carcinoma in situ showed complete disappearance of cancerous cells. 3. In the 2 cases of microinvasive carcinoma, no tumor cells were detected in one case; in the other case, tumor cells persisted in part of the resected specimen.(ABSTRACT TRUNCATED AT 250 WORDS)     

An experimental study of the surgical trauma on the rabbit's lens suspensory apparatus after cataract surgery]

Extracapsular cataract extraction (ECCE) and posterior chamber intraocular lens (PC-IOL) implantation requires that the posterior capsule and the zonules remain sufficiently intact. To assess the surgical trauma on the lens suspensory apparatus of the enucleated rabbit eye, we developed a new fine pressure gauge that could quantitate its strength. The cornea and the iris of enucleated eyes were removed to allow clear visualization of the anterior surface of the lens to the equator. Afterwards several types of anterior capsulotomy were performed for ECCE and PC-IOL implantation. And then the lens of the pseudophakic eye was vertically pressed with the plastic rod of the fine pressure transducer, and the strength of the lens suspensory apparatus was simultaneously measured. The strength of the lens suspensory apparatus of the pseudophakic eye decreased approximately 35% compared with that of the phakic eye. Moreover the integrity of the lens capsule of animals with circular capsulorhexis with tears or linear capsulotomy decreased approximately 43% compared with that of continuous circular capsulorhexis (CCC) and also zonular rupture and vitreous loss occurred as a result of the expansion of radial tears in the anterior capsule. The present study indicates that the strength of the lens suspensory apparatus decreases with cataract surgery, suggesting that much more attention to cataract surgery is needed if the anterior capsule had radial tears. It is also suggested that CCC is the best type of anterior capsulectomy procedure.     

Autopsy findings 14 years after septation for single ventricle

The autopsy findings of a patient who survived 14 years after ventricular septation for single ventricle are reported. Although the patient had been well for years, she suddenly died at 22 years of age. Her ventricular free walls had grown normally, but the ventricular septum did not. A crevice was found in the apex, and the ventricular septum consisted of only the Teflon patch. Microscopically, fibrosis was found only in the right atrium.