The diagnosis of lung cancer using 1064-nm excited near-infrared multichannel Raman spectroscopy

PURPOSE: Raman spectroscopy is based on Raman scattering of light from molecules. Because the wavelength of Raman scattered light depends on molecular composition, Raman spectra provide highly useful information about molecular composition. It has already been shown that Raman spectroscopy is potentially useful for the clinical diagnosis of malignant tumors. However, this technique had never been applied to the diagnosis of lung cancers, primarily because of interference from the strong fluorescence emitted from lung tissues. Our purpose was to examine the effectiveness of near-infrared Raman spectroscopy for the diagnosis of lung cancers. METHODS: We constructed a new near-infrared multichannel Raman system that is capable of measuring high signal-to-noise ratio, fluorescence-free Raman spectra of lung tissues within a measurement time of 1 second. Using this system, we collected a total of 210 Raman spectra from cancerous and non-cancerous lung tissues and analyzed these spectra by a least-squares fitting procedure for cancer diagnosis. RESULTS: The resultant sensitivity of cancer prediction was as high as 91%, with 97% specificity and an error margin of p<0.0001 according to Fisher's exact test. CONCLUSIONS: A method of diagnosing lung cancer efficiently and objectively using Raman spectroscopy has thus been established.     

Biweekly administration regimen of docetaxel combined with CPT-11 in patients with inoperable or recurrent gastric cancer

Background. Both docetaxel (TXT) and irinotecan (CPT-11) are active chemotherapeutic agents for gastric cancer. We designed a biweekly administration regimen of TXT combined with CPT-11 for 4 weeks as one cycle in patients with inoperable or recurrent gastric cancer, and conducted a dose-escalation study. Methods. Patients with histologically confirmed gastric cancer were treated with the regimen. The dosage levels of TXT and CPT-11 were as follows: level 1, 30mg/m² and 50mg/m²; level 2, 35 and 50mg/m²; level 3, 40 and 50mg/m²; level 4, 40 and 60mg/m²; and level 5, 50 and 60mg/m². The dose escalation was based on the dose-limiting toxicity (DLT) observed during the first cycle. Results. Grade 4 neutropenia was observed at level 3, but no other DLT was observed at less than level 4 during the first cycle. However, three patients at level 3 could not continue treatment without a decrease in the dosage after the second cycle. Based on these results, level 2 was considered to be the clinically recommended dosages. Conclusion. Biweekly TXT and CPT-11 was well tolerated. The recommended dosages of TXT and CPT-11 for a phase II trial are 35mg/m² and 50mg/m², respectively.     

The role of spectral change detectors in temporal order judgment of tones

Human listeners can judge the temporal order of acoustic events quite accurately in certain conditions. We hypothesized that this accuracy is realized by coding temporal order as a single neural code of spectral change in the auditory system. To test this hypothesis, we examined whether adaptation to linear frequency glides affects subsequent temporal order judgment of brief tones. We found that the point of subjective simultaneity between two tones shifted depending on the direction of spectral change of the adaptor, as predicted by the hypothesis. The amount of aftereffect was significantly reduced when adaptor and test tones were presented in different frequency regions or to different ears, suggesting that the relevant neural units exist predominantly in a frequency-selective monaural pathway.     

Cerebellar superoxide dismutase expression in Menkes' kinky hair disease: an immunohistochemical investigation

This comparative immunohistochemical study deals with the expression of the cytosolic Cu/Zn-binding and mitochondrial Mn-dependent superoxide dismutases (SODs) in the cerebella of five patients with Menkes' kinky hair disease (MKHD) and five age-matched controls. Several cell types, including Purkinje cells and reactive astrocytes, of all MKHD patients examined were intensely stained by an antibody to Mn SOD, but not by an anti-Cu/Zn SOD antibody. By contrast, the cells of the five controls reacted very weakly or not at all with the anti-Mn SOD antibody, but were strongly reactive with the antibody to Cu/Zn SOD. These results suggest that the increased Mn SOD immunoreactivity in MKHD reflects enzyme induction as a protective mechanism against the highly toxic superoxide anion generated under the disease conditions.     

Deep cerebral venous thrombosis: a report of three cases and review of the literature]

Three cases of cerebral deep venous thrombosis (CDVT) were reported with review of the literature. A 47-year-old female had taken estrogen-derived drug. The other two patients had no specific past history. On MRI, T2-weighted and fluid-attenuated inversion recovery (FLAIR) images showed high signal intensity lesions at basal ganglia and thalamus. Diffusion-weighted image (DWI) detected only slightly high signal spots but apparent diffusion coefficient (ADC) images indicated mild increases of the ADC value. MR venogram and cerebral angiogram revealed obliteration of internal cerebral veins, great vein of Galen, and straight sinus. The two severely impaired patients received systemic heparinization, in which one patient preceded percutaneous transvenous angioplasty of straight sinus. One patient suffered cognitive disturbance and the other two patients fully recovered from their illness. The high signal intensity lesions on both T2-weighted image and FLAIR image disappeared and deep cerebral veins reappeared. The diagnosis of CDVT based on clinical symptoms is not simple but modern technology of MRI is very useful for diagnosis of CDVT. Once CDVT is detected, appropriate therapy should be started as soon as possible to avoid devastating outcome.     

Case of Gastric Lymphoma Diagnosed by Laparoscopic Excision Biopsy

Primary gastric lymphoma is a relatively uncommon disease and sometimes forms submucosal growth causing difficulty of diagnosis. We have reported a case of primary gastric lymphoma successfully diagnosed by laparoscopic wedge resection, after repeatedly performing endoscopic forcep biopsies. Diagnostic laparoscopy for obtaining definite histological diagnosis can be regarded as minimally invasive, accurate and safe.     

Trends in Subarachnoid Haemorrhage in Elderly Persons from Nagasaki, Japan: Analysis of the Nagasaki SAH Data Bank for Cerebral Aneurysm, 1989–1998

Summary.  Background: Many industrialized countries are facing a volumetric growth of the senior population. We studied the trends in the incidence and outcome of subarachnoid haemorrhage (SAH) in patients aged ≥70 years.  Method: We retrospectively reviewed the cases of 1030 patients registered in the Nagasaki SAH Data Bank from 1989 to 1993 and 1274 patients registered from 1994 to 1998.  Findings: The annual age-adjusted incidence of SAH per 100,000 increased only in women, from 15.4 in the 1989–1993 period to 19.7 in the 1994–1998 period. The average annual incidence of SAH per 100,000 women in the elderly aged ≥70 years increased significantly from 44.3 in the first period to 58.2 in the second period. In patients aged ≥70 years, the proportion of high-grade SAH (Hunt & Kosnik Grade IV and V) significantly increased from 27.2% in the first 5 years to 38.2% in the second 5 years. In patients aged<70 years, it increased slightly from 23.4% to 26.7%. The rate of favorable outcomes significantly fell from 43.9% (first period) to 30.9% (second period) in patients aged ≥70 years but was stable in patients aged<70 years.  Interpretation: Although the incidence of elderly patients with SAH in our study is compatible with or higher than that of other reports, we believe that elderly patients (especially women) with high-grade SAH may not have all been identified. When we discuss the management of ruptured and unruptured aneurysms in the elderly, we should bear these trends of SAH in mind. Published online October 31, 2002 Correspondence: Makio Kaminogo, M.D., Department of Neurosurgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan.     

Diagnosis of fetal heart rate without referring to uterine contraction

The purpose of this study is to evaluate intrapartum fetal condition only with reference to fetal heart rate (FHR) change. Sixty-five cases who had no severe complications were examined at 36 weeks to 42 weeks of gestation. Major cardiotocographic abnormalities were baseline bradycardia and severe variable deceleration. Late deceleration was not observed. The conventional program of automatic FHR diagnosis and a new computer program excluding uterine contraction (UC) algorithm were used. Digitalized FHR and UC data stored in a floppy disk were reproduced and analysed by either of the programs with and without UC. FHR scores and FD index obtained by the 2 programs were highly correlated with each other. Both the FHR score and FD index showed a correlation to PO2, PCO2, BE and pH of umbilical artery blood. There were no significant differences between the correlation coefficients for the 2 methods. The sensitivity of the FD index which predicted a pH of umbilical artery blood lower than 7.25 was 86.4% in both groups. And the specificity was 88.4% in the results obtained with UC and 90.7% without UC. There was no significant difference in sensitivity or specificity in both groups.     

Genomic DNA Analysis of Rat Retinal Tumor Induced by Adenovirus Type 12

To elucidate the pathogenesis of human retinoblastoma, we investigated the genomic expression in retinal tumors induced by human adenovirus type 12 in rats, using various DNA probes. Seven rats received a single intraocular inoculation of concentrated virus fluid within 24 hours after birth. Intravitreous tumors were induced in two out of seven animals (28.5%) within 30 to 64 days after the inoculation. A remarkably uniform histologic feature, i.e., neuroblastic cells in association with Homer-Wright pseudorosettes, was present in all cases. The adenovirusrelated oncoprotein gene E1A and human retinoblastoma susceptibility gene were detected in the tumors by Southern blot hybridization. In situ hybridization analysis demonstrated expression of adenovirus type 12 E1A gene in the inner granular layer of the retina. It was suggested that integration of adenovirus type 12 E1A fragment with the host genome and expression of the gene were required for induction of this tumor.