Muir-Torre syndrome associated with endometrial carcinoma

Muir-Torre syndrome (MTS) is an autosomaldominant skin condition of genetic origin, characterized by tumors of the sebaceous glands or keratoacanthomas that are associated with malignant visceral diseases. MTS associated with gynecologic malignancy has rarely been reported. Here we report a woman with no family history of colorectal cancer who developed endometrial carcinoma, stage 3a, at 49 years of age and at age 51 years, developed two skin tumors, a nasal squamous cell carcinoma and a sebaceous carcinoma of the right eyelid. The appearance pattern of these skin tumors suggested MTS. Although MTS associated with endometrial carcinoma is rare, patients with endometrial carcinoma should undergo evaluation for visceral malignancies (mainly colon cancer) and sebaceous skin lesions, regardless of whether or not there is a family history of colorectal cancer.     

Antimicrobial effect of an ultrasonic levitation washer disinfector with silver electrolysis and ozone oxidation on methicillin‐resistant Staphylococcus aureus

Methicillin‐resistant Staphylococcus aureus (MRSA) has rapidly emerged as a cause of severe and intractable skin infection. At present, there are no effective topical treatments, and infection or colonization by MRSA of the skin raises serious medical problems. We developed an ultrasonic levitation washer that generates silver ions (Ag⁺) and ozone (O₃) to clean and sterilize medical devices. We report the effect of ultrasonic levitation (levitation) with Ag⁺ and O₃ on MRSA in vitro and in vivo. Antimicrobial effect against six MRSA strains of all agr types was examined under three in vitro conditions; cells floating in a water tank, cells infiltrating‐, and cells forming a biofilm on an atelocollagen membrane. In the in vivo studies, we assayed the number of MRSA organisms that survived treatment on murine skin ulcers and evaluated the ulcer size. Levitation with Ag⁺ dramatically decreased the survival of MRSA floating in a water tank. Levitation with Ag⁺ and O₃ significantly decreased the viability of MRSA that had infiltrated or formed a biofilm on atelocollagen membranes regardless of the level of biofilm production. In vivo studies showed that the number of MRSA on murine skin ulcers was significantly decreased when 15‐min treatment was performed for 7 consecutive days and that the ulcer size was significantly decreased after the seventh treatment course. Levitation with Ag⁺ and O₃ may be a valuable tool for treating MRSA infestation of the skin and for accelerating wound healing.     

Nodal metastases from laryngeal carcinoma and their correlation with certain characteristics of the primary tumor

5O cases of carcinoma larynx were included in a prospective study to detect the incidence and pattern of nodal metastases (both clinical and occult) and to study the influence of certain characteristics of the primary tumor on the incidence of nodal metastases. In our study 66% (33 cases) of the lesions were transglottic as compared to 24% (12 cases) supraglottic and 10% (5 cases) glottic lesions. The most common age group affected in our study was 51-60 years comprising 50% of the cases. The most common symptoms were hoarseness, breathlessness and difficulty in swallowing. The incidence of clinically positive neck at the time of presentation was 42% while the incidence of occult nodal metastases was found to be 27.6%. The most common levels of lymph nodes involved in our study were levels II and III (87.5% cases). Multiple level lymph node involvement was seen in 71.4% of the eases at the time of presentation. A high incidence of cervical nodal metastases was associated with the following characteristics of the primary lesion-extralaryngeal spread, infiltrating or endophytic peripheral growth pattern, poor cellular differentiation and advanced T stage. In view of the high incidence of occult nodal metastases, use of selective lateral neck dissection is advocated in patients with a clinically negative neck at the-time of presentation (early glottic carcinomas being excluded).     

Association between Family History and Gastric Carcinoma among Young Adults

The relationship between family history of gastric carcinoma and gastric carcinoma in Japanese under 40 years of age was analyzed. The subjects were 108 gastric carcinoma patients (86% were diffuse type) at 9 hospitals in the Kanto area of Japan. Firstly, incidence of gastric carcinoma among the parents of the subjects were compared with that in the general population. Observed/expected (O/E) ratios (P-value) were 1.8 (0.06) for all subjects, 1.3 (0.62) for male subjects, 2.1 (0.04) for female subjects, 0.5 (0.41) for early carcinoma, 2.6 (P<0.01) for advanced carcinoma, 2.3 (0.22) for intestinal-type carcinoma and 1.7 (0.13) for diffuse-type carcinoma. Association between gastric carcinoma and parents' history of gastric carcinoma was strong among women and regarding advanced carcinoma, and the difference in O/E ratios between early and advanced carcinoma was remarkable. Secondly, factors related to advanced-stage gastric carcinoma were analyzed. Histological type (diffuse and intestinal types) was not related, but family history of gastric carcinoma among parents and grandparents was related to advanced stage, and the relationship was independent of other factors. The odds ratio (95% confidence interval) was 3.3 (1.1–9.9). Family history may be related to stage of gastric carcinoma through its relationship to the manner or speed of the tumor's progression. We hypothesis that some genetic factor exists which is involved both in progression from early to advanced stage and in occurrence of gastric carcinoma.     

Distribution of neocarzinostatin conjugated to biotinylated chimeric monoclonal antibody Fab fragments after administration of avidin.

We have developed chimeric Fab fragments of MAb A7 (chA7Fab) and have reported on their potential usefulness as a carrier of neocarzinostatin (NCS). However, a large amount of chA7Fab accumulates in the kidneys which might cause renal failure. This was one of the major side-effects of the chA7Fab-NCS immunoconjugate administered to humans. To decrease the kidney accumulation of chA7Fab, chA7Fab was biotinylated and administered with a subsequent injection of avidin to nude mice with pancreatic cancer. The accumulation of biotinylated chA7Fab in the blood and the kidneys decreased significantly after the injection of avidin. In a separate experiment with biotinylated chA7Fab-NCS, the blood and kidney accumulation decreased significantly after the injection of avidin. These findings suggest that the injection of biotinylated chA7Fab complexed with NCS followed by avidin may be safer and may permit the administration of larger doses of NCS without the subsequent development of renal failure.     

Nasal teratoma in a neonate associated with an acardiac amorphous twin

Nasopharyngeal teratomas are uncommon neoplasms found in neonates. A rare case of a teratoma arising from the nasal septum of a newborn associated with an acardiac amorphous twin is described. Antenatal ultrasonography suggested a fetal anomaly, for which a cesarean section was performed. Immediately after birth the tumor was excised, thereby eliminating life-threatening respiratory distress. The postoperative course was uneventful. Correspondence to: H. Takehara     

Antitumor effect of neocarzinostatin conjugated to human/mouse chimeric fab fragments of the monoclonal antibody A7 on human pancreatic carcinoma

The anticancer agent neocarzinostatin (NCS) was bound covalently to human/mouse chimeric Fab fragments of the monoclonal antibody A7 to form the conjugate chA7Fab-NCS. The antitumor effect of chA7Fab-NCS was tested by measuring the inhibition of ³H-thymidine incorporation into human pancreatic carcinoma cells. The chA7Fab-NCS was approximately 2.3 times as effective as free NCS against human pancreatic carcinoma cells which reacted with the monoclonal antibody A7. The antitumor activity of chA7Fab-NCS was inhibited by excess chA7Fab. ChA7Fab-NCS had an antitumor effect equivalent to free NCS on human pancreatic carcinoma cells which did not react with the monoclonal antibody A7. ChA7Fab-NCS appears to be a potentially useful conjugate for immunotargeting chemotherapy against pancreatic carcinoma. © 1994 Wiley-Liss, inc.