Combination Chemotherapy for a Senile Patient with Adenoid Cystic Carcinoma of the Esophagus: A Case Report

Adenoid cystic carcinoma of the esophagus with multiple livermetastases was found in a 77-year-old Japanese female in October,1991. Combination chemotherapy, including etoposide (VP-16)and tegafur (FT) allowed the patient to survive for approximatelya year after the onset of the initial symptoms. During her courseof treatment, the patient improved greatly with minimal toxicity,and declines in the elevated levels of GOT and LDH were alsonoted. Since no other therapy, such as surgery or radiation,was given to the patient, the response to chemotherapy as wellas the survival advantage for the patient have been evaluated.     

Role of P-Glycoprotein in Ocular Clearance of Rhodamine 123 in Rabbits

Pharmaceutical Research -     

Malignant proliferating trichilemmal tumor in the skin over the breast: a case report

A proliferating trichilemmal tumor is relatively uncommon. It is composed of multiple cysts consisting of squamous epithelium with trichilemmal keratinization without granular layer interposition. This lesion usually occurs in the scalp of elderly women. We describe a 67-year-old woman with a malignant proliferating trichilemmal tumor in the skin over the breast. We first misdiagnosed the disease as a primary squamous cell carcinoma of the breast with a metastatic lymph node in the axilla because of the disease site and our unfamiliarity with the disease. The patient underwent radical mastectomy with axillary dissection. Eight months postoperatively, a tumor appeared in her right axilla and progressively enlarged. We subsequently excised the tumor. She is healthy as of 8 months postoperatively. To the best of our knowledge, only one case of a proliferating trichilemmal tumor occurring in the skin over the breast has been reported.     

Change of components of the metabolic syndrome in a workers' health checkup after five years--relation with elevated liver enzymes, gene polymorphisms for ALDH 2, beta3-AR and lifestyle

We previously reported that the prevalence of elevated alanine aminotransferase (ALT) increases with accumulation of metabolic syndrome components, and a greater degree of involvement of aldehyde dehydrogenase 2 (ALDH2) than beta3-adrenergic receptor gene (beta3-AR) polymorphisms. The present study was designed to clarify the effect of aging, lifestyle and the two gene polymorphisms on the relationship between 4 components of the metabolic syndrome (obesity, hypertension, dyslipidemia and impaired glucose tolerance) and elevated ALT values in a subset of 73 out of 148 male workers who were 35 years of age in the baseline study and 40 years old in the present study. Study subjects completed questionnaires about drinking and smoking habits, and underwent urinalysis, physical examination and peripheral blood tests, blood chemistry, electrocardiogram and chest X-rays each year as required by Japanese law. Information from the questionnaires and physical examinations, including liver function tests, were compared with previously reported ALDH2 and beta3-AR genotypes for the 73 workers. Of the 73 workers studied, 14 (19%) demonstrated decrease in metabolic syndrome components, 39 (53%) demonstrated no change, and 20 (27%) demonstrated an increase. Ten workers (14%) showed liver dysfunction at age 35 and 20 workers (27%) at age 40. Fourteen workers were newly diagnosed as having liver dysfunction at their 40-year checkup, thus being associated with the BMI and an active ALDH2 genotype. Accumulation of components of the metabolic syndrome were associated with the presence of liver dysfunction at 35 years. In conclusion, these findings indicate that ALDH2 genotyping as well as lifestyle habits may be important factors in causing metabolic syndrome with liver dysfunction.     

Reexamination of photoreceptor-bipolar connectivity patterns in carp retina: HRP-EM and Golgi-EM studies

On- and off-center bipolar cells were identified in the carp retina by means of intracellular recording, intracellular injection of HRP, and Golgi silver-chromate impregnation. Light and electron microscopy revealed that these functionally different bipolar cells make synaptic contacts with both rods and cones, and that both on- and off-center cells can be further divided into two subtypes (I and II) according to the relationship between the position of their dendritic processes and the synaptic ribbons in the photoreceptor terminal. The type I on-center bipolar cell is characterized by a large cell body, a thick primary dendrite, and a big swelling of the axon terminal in the innermost part of the inner plexiform layer (IPL). Dendritic processes of this cell type make predominantly ribbon contacts with rods and nonribbon contacts with cones. The type II on-center cell, having a large dendritic tree in the outer plexiform layer and a large ramification of the axon terminal extending over the inner part of the IPL makes mostly nonribbon contacts with rods and cones. Many of these type II cell processes, however, terminate very close to cone synaptic ribbons. The type I off-center cell shows two varieties in the axon terminal structure; a large terminal swelling or a large flat ramification of the terminal in the outermost part of the IPL. These cells make predominantly ribbon contacts with rods and cones. Usually, but not always, the process of a type I off-center cell runs parallel to the synaptic ridge apex of cones. The type II off-center cell, showing a large ramification of the axon terminal extending over the outer half of the IPL, makes mainly nonribbon contacts with rods and cones. The results from the HRP-EM study generally agree with those from the Golgi-EM study. A few discrepancies between the results obtained with these two techniques are noted and their implication is discussed.     

Clinical efficacy of 5-fluorouracil (5-FU) topical cream for treatment of cholesteatoma

OBJECTIVE: In order to clarify clinical efficacy of commercially available 5-fluorouracil (5-FU) topical cream, a clinical study was conducted. METHODS: Two to three cubic millimetres of 5-FU topical cream (Kyowa, Roche) was applied on 50 cases of various types of cholesteatoma (50 patients) two to five times with the interval of 2 weeks, and its clinical efficacy was evaluated by the criteria we developed. RESULTS: In total, 59% of the cholesteatomas showed good effect, 29% of them showed fair effect, and the effect was poor in the remaining 12%. It was particularly effective in cholesteatomas in the EAC, attic cholesteatomas with an aerated mastoid, and in recurrent-type cholesteatomas. CONCLUSION: 5-FU topical cream appeared effective for the treatment of cholesteatomas.     

Projections to the alimentary canal from the dopaminergic neurons in the dorsal motor nucleus of the vagus of the rat

The motility of the alimentary canal is regulated not only by neurons that contain acetylcholine or adrenaline, but also by nonadrenergic noncholinergic neurons. There are many neurons containing dopamine in the dorsal motor nucleus of the vagus (DMV). We examined the projections of these dopaminergic neurons to the alimentary canal with double-labeling immunohistochemistry for tyrosine hydroxylase (TH) and the retrograde tracer cholera toxin subunit b following its injection into the subdiaphragmatic esophagus, the cardia, the pylorus, the duodenum, the jejunum, and the ascending colon. Almost all double-labeled neurons were found in the half of the DMV caudal to the area postrema. In the caudal half of the DMV, about 58% of the TH-immunoreactive neurons projected to the cardia, about 36% projected to the pylorus, and about 28% projected to the subdiaphragmatic esophagus. Only a few TH-immunoreactive neurons projected to the duodenum, the jejunum, or the ascending colon. As a whole, less than 10% of the neurons in the DMV that projected to the alimentary canal showed TH-like immunoreactivity. These results suggest that some of the dopaminergic neurons in the DMV might regulate the activities of the stomach and the subdiaphragmatic esophagus.     

Visualization of femorotibial contact in total knee arthroplasty using X-ray fluoroscopy

The purpose of this study was to build a visualization technique of the femorotibial contact in fixed-bearing total knee arthroplasty (TKA) using X-ray fluoroscopy, and to apply this technique to a TKA patient during dynamic motion. In vivo kinametcis of the metallic knee implant was determined using a 2D/3D registration technique, which uses computer assisted design (CAD) model of the implant to estimate the 3D pose of radiopaque metallic femoral and tibial components from a single-plane fluoroscopic image. In fixed-bearing TKA, a 3D pose of radiolucent tibial polyethylene insert can be determined from the estimated pose of the tibial component. To visualize femorotibial contact, the proximity between surfaces of femoral component and tibial insert was calculated, and mapped onto the insert surface model. For the clinical application, dynamic states of contact on the tibial insert were observed including axial rotation and unilateral loading during knee flexion, and post-cam contact of posterior stabilized TKA. The present technique provided us new information and enabled us to better understand the relationship between in vivo knee kinematics and articular shape of the implant.