A case of dermatomyositis associated with breast cancer

Presented is a case of a 48-year-old woman with dermatomyositis associated with breast cancer. A standard radical mastectomy against the breast cancer was performed in addition to the administration of adriamycin, 5-Fu, and tamoxifen as adjuvant chemoendocrine therapy. The symptoms of dermatomyositis were not that severe, so no steroid therapy was given. The patient now is ambulatory and has been discharged, and no symptoms of recurrence or exacerbations of dermatomyositis has occurred.     

MR imaging of cerebrospinal fluid rhinorrhea after operation for acoustic neurinoma.

MR was useful in verifying CSF rhinorrhea following removal of an intracanalicular acoustic neurinoma via the occipital route in a 29-year-old man. MR accurately identified the location of the CSF leak.     

Characterization of abnormalities in the gamma-globin gene arrangements of Japanese newborns

Cord blood samples from 889 healthy Japanese newborns from three districts of Honshu Island were studied with the purpose of characterizing the gamma-globin genes in the Japanese. The A gamma T gene frequency was 0.159 which is the same as that found elsewhere in Japan. The haplotype of the chromosome with the A gamma T gene was [-- ++ - + (+ or -) (+ or -)] at eight polymorphic sites. Data from analyses of DNA and the proportion of gamma chains in Hb F showed the existence of various kinds of gamma-globin gene arrangements; six genotypes were observed for individuals with high G gamma values and triple or quadruple gamma-globin gene arrangements, and seven genotypes for babies with low G gamma values and a single gamma-globin gene. The in vivo expression of the gamma-globin gene located at the third or fourth position in the multiple gene arrangement was found to be about 5% and 2.5% of the total, respectively. The haplotype for the chromosomes with a triple gamma-globin gene was [+ --(-)---- +], but that for the chromosomes with a single gamma-globin gene remains unclear. In addition, a new type of Bgl II polymorphism in the G gamma-globin gene was observed.     

Operative results of distal aortic arch aneurysms--approaching methods, bypass techniques and complications

Ten patients underwent repair of aneurysms of the distal aortic arch from 1985 to 1989. There were 8 men and 2 women: aged 58 to 77 (average age 67 years). Seven patients had sacciform aneurysms which were closed by graft patch aortoplasty, and three patients had fusiform aneurysms which were corrected by inserting tube grafts. Seven aneurysms operated since 1988 were approached through median sternotomy continued with left anterior thoracotomy, so called door open method. This approach presented good view of the diseased aorta, and effective for preventing recurrent and phrenic nerve palsy. We used temporary bypass for 4 patients, cardiopulmonary bypass for 4 patients (separate carotid artery perfusion for 2 patients) and centrifugal pump for 2 patients during aortic cross clamping. One patient died intraoperatively from intractable bleeding and two patients died postoperatively from brain damage due to embolic episodes during the operations. These patients showed the severely irregular intima in the aortic arch and were complicated with rupture of the aneurysm or dissections arising from the aneurysms. It should be noticed that careless manipulation of the aortic arch and the brachiocephalic vessels cause cerebral complications in such cases.     

Study on transfer of ceftriaxone into female genital organs

One gram of ceftriaxone (Ro 13-9904, CTRX), a new cephalosporin antibiotic, was given intravenously to a total of 25 patients prior to abdominal total hysterectomy for uterine myoma with or without small benign ovarian tumor. Bilateral uterine arteries were clamped at 0.5, 1, 2, 6, 12 and 24 hours after administration, and serum samples and uterine tissues were taken for the measurement of CTRX concentration by bioassay method. A little difference was found in the serum concentration between cubital venous and uterine arterial serum, the half-lives being 8.0 and 7.9 hours, respectively. The initial concentrations were estimated to be 153 micrograms/ml and 160 micrograms/ml, respectively. The tissue peak concentrations were obtained at 30 minutes in the myometrium, portio vaginalis, oviduct and ovary, and at 1 hour in the endometrium and cervix uteri. These were 41, 51, 51, 39, 42 and 47 micrograms/g, respectively. The tissue concentrations after peak decreased in the same manner as the serum concentrations. Judging from its favorable transfer into the uterine tissues, CTRX was evaluated to be clinically useful in the treatment of obstetrical and gynecological infections.     

Occupational therapy issues in the treatment of the long-term mentally ill.

In this paper, a single case study is used to facilitate discussion of problems encountered by occupational therapists engaged in working with the long-term mentally ill. The achievement of the long-range and multi-faceted approach necessary for the management of this population is a recognized challenge. Some of the paradoxes and dilemmas involved in programming and the measurement of outcome and success are clarified. As well, sources of stress to individuals involved in working with the long-term mentally ill are considered. Issues addressed include: philosophy of approach, professional and personal conflicts patients' wishes and involvement, and the low priority given to working with this group. Two main objectives of the paper are to: bring an appreciation for the complexity of the difficulties presented and demonstrate how occupational therapists can offer valuable contributions in working with the long-term mentally ill.     

Spinal lamina I neurons projecting to the parabrachial area of the cat midbrain

We have observed a population of lamina I neurons in the cat that has projections to the parabrachial area (parabrachial and cuneiform nuclei). A subpopulation of these neurons also projects to the contralateral thalamus. The majority of projecting cells responded exclusively to noxious stimuli, a few wide-dynamic-range neurons were also observed. Conduction velocities for antidromic activation from the midbrain ranged from 1 to 18 m/s. We stained 14 cells intracellularly with horseradish peroxidase. These findings suggest that a major nociceptive projection pathway originating in lamina I and terminating in the parabrachial area exists in the cat.     

Slow fluctuations of single unit activities of hippocampal and thalamic neurons in cats. II. Role of serotonin on the stability of neuronal activities

A series of experiments was carried out both in the hippocampal pyramidal and thalamic ventrobasal neurons to investigate the effect of serotonin level in the brain on slow fluctuations of neuronal discharges. Single neuronal activities were recorded in the following two pharmacologically treated states: (1) a 5-hydroxytryptamine depleted state by p-chlorophenylalanine administration (PCPA phase) and (2) a 5-methoxy-N,N-dimethyltryptamine administered state under the PCPA pretreatment (5-MeODMT phase). The slow fluctuations of neuronal activities in the frequency range of 0.02-1.0 Hz in both nuclei were prominent during the PCPA phase and were similar to those during the paradoxical sleep. In contrast, slow fluctuations were suppressed during the 5-MeODMT phase and neuronal activities during this phase were similar to those during slow wave sleep (SWS). The results show that serotonin in the brain definitely plays a role in stabilizing single neuronal activities.