A method to convert HDTV videos of broadcast satellite to RealSystem multimedia contents

Recently, the Internet is widely used in the field of medicine. Daily use of e-mail for medical communication is very common. Also various information regarding hospitals can be accessed via the network. Apart from this practical use of the computer network, the mediums of telemedicine, tele-education, and telecare are also available. The Medical Information Network via Communications Satellite for University Hospital (MINCS-UH; http://www.umin.ac.jp/mincs/) was constructed by the Ministry of Education, Culture, Sports, Science and Technology. These programs feature high quality images viewed on High Definition Television (HDTV) through the Broadcast Satellite (BS). We have compiled a video library of MINCS-UH program contents with W-VHS tapes for HDTV and VHS or S-VHS tapes for NTSC, available to medical staff in our university hospital through the Hospital local area network (Hospital intranet). We have also constructed a web-based streaming system that is a low cost, user-friendly multimedia delivery system capable of providing medical lectures. This system was constructed using the RealSystem package with the Internet Protocol (IP) network. Although the image quality of RealSystem is inferior to that of the original video, users can review lectures and medical congress presentations with video and audio through Hospital intranet, at any time that is convenient to them. This system can also be an efficient tool for distance learning and supports the diffusion of up-to-date information and technology to busy physicians via the Internet.     

Phase I-II study of biweekly paclitaxel administration with fixed-dose-rate cisplatin in advanced gastric cancer

Background Both paclitaxel (TXL) and cisplatin (CDDP) show efficacy against gastric cancer. The aim of this phase I-II study was to determine the maximum tolerated dose (MTD) and to evaluate the toxicity and efficacy of combination chemotherapy with these two agents. Methods Nineteen patients entered the phase I part of the study, and 21 patients entered the phase II part. TXL infusions were administered on days 1 and 15, with a fixed 3mg/m² dose of CDDP. Results In the phase I part of the study, we determined dose level 5, which represented a TXL dose of 18mg/m², with CDDP 3mg/m², to be the MTD. The recommended dose (RD) was level 4, with a TXL dose of 16mg/m² with CDDP, 3mg/m². In the phase II part of the study, the response rate was 25.0%; five patients had a partial response, seven had stable disease, 6 had progressive disease, and 2 were not evaluable. Grade 3 or 4 neutropenia was the most common adverse event and occurred in 65% of the patients. During treatment, 25% of the patients received granulocyte colony-stimulating factor, but febrile neutropenia was not shown in any of the patients. Major nonhematological toxicities were nausea/vomiting, anorexia, fatigue, alopecia, and sensory neuropathy. Adverse reactions of grade 3 or 4 were shown by two patients, one with anorexia (5%) and the other with sensory neuropathy (5%). Conclusion The RD was determined to be TXL 14mg/m², with CDDP 3mg/m².     

A case of intracystic carcinoma of the breast: the importance of measuring carcinoembryonic antigen in aspirated cystic fluid

Summary We report a case of intracystic carcinoma of the breast in which a correct preoperative diagnosis was achieved on the basis of an increased level of carcinoembryonic antigen (CEA) in the aspirated cystic fluid.A 62-year-old woman was admitted with a 10 × 10 cm painful mass occupying the right breast. Ultrasonography revealed a cystic lesion with papillary projections arising from the cyst wall. Cytological examinations showed no malignant cells in the hemorrhagic aspirated fluid. However, the CEA level in the fluid was 5.5 times higher than the serum CEA level using a murine anti-CEA monoclonal antibody. The high level of CEA led to the preoperative diagnosis of intracystic carcinoma. Histological examinations confirmed the diagnosis of intracystic carcinoma after a modified radical mastectomy. Immunohistochemical staining by an anti-CEA monoclonal antibody elicited a strong positivity with diffuse intracytoplasmic distribution in the carcinoma cells, although heterogeneity of staining was observed.It is suggested that the measurement of the CEA value by anti-CEA monoclonal antibody in the aspirated fluid is easy, safe, and helpful for the definitive diagnosis of intracystic carcinoma of the breast.     

Adult T-cell leukemia with leukemia cell infiltration into the gastrointestinal tract

Five cases of untreated adult T-cell leukemia (ATL) with leukemia cell infiltration into the gastrointestinal (GI) tract were reported. X-ray findings of the GI tract showed diffuse abnormal mucosal patterns throughout the GI tract in all five patients. Endoscopic findings corresponded well with the x-ray findings. Pathologic examination of biopsied specimens from all five patients revealed diffuse and extensive leukemic infiltration into the stomach and/or the large intestine.     

Anterior resection following posterior transsacral stapling and transection of the anal canal for low-lying rectal cancer in males

(Received for publication on Apr. 10, 1997; accepted on Nov. 6, 1997)     

A case of anal fistula cancer probably developing from intraluminal dissemination of rectal cancer

A 63-year-old man with a history of anal fistula was admitted to our hospital because the anal pain didn't disappear after the operation. On digital examination, a hard mass measuring 3.0 cm in diameter was found at the anal canal. Biopsy of the mass showed moderately differentiated adenocarcinoma. Colonoscopy revealed another rectal cancer at 15 cm from anal verge. Biopsy of the tumor also showed moderately differentiated adenocarcinoma, resembling the anal canal tumor. Because the histological findings of both tumors were nearly identical, we considered that cancer cells from the rectal cancer had been implanted and developed the metastatic tumor in the anal fistula. The patient underwent anterior resection for the rectal cancer, and a local resection for the anal canal cancer. Immunohistochemical staining for Ki-67, p53, Muc2, CD10, CK-7, and CK-20 revealed similar patterns in both tumors. Additionally, genetic analysis for p53, K-ras, and MSI revealed similar patterns in both tumors. We may suggest from these results that cancer cells from the rectal cancer had been implanted and developed the metastatic tumor in the anal canal.     

A case report of hepatocellular carcinoma (Vp4)--an attempt to reduce residual tumor thrombus using combination therapy (hepatic arterial infusion, hepatic arterial embolization and radiation)

A 57-year-old man was found to have elevated levels of HCC markers during an observation of chronic hepatitis C. Diffused hepatoma was involved in the posterior lobe, and tumor thrombus extended into the main portal vein (Vp4). Posterior segmentectomy and tumor thrombectomy were performed. But, CT scan 45 days after the operation showed an enhancement at the residual tumor thrombus in the posterior branch. The patient received a hepatic arterial infusion of 5-FU, followed by hepatic arterial embolization. Then, we chose radiation therapy to the tumor thrombus. The most recent CT showed no enhancement at the reduced tumor thrombus. There have been almost no reports of treatment for residual portal thrombus. Careful observations are necessary in such patients.     

Vitamins K1 and K2 potentiate hyperthermia by down-regulating Hsp72 expression in vitro and in vivo

Hyperthermia is used to treat various malignancies, including esophageal, stomach and rectal cancer. Since hyperthermia alone has produced limited results, much attention has been focused on combining hyperthermia with chemotherapy and on searching for substances able to sensitize tumor cells to hyperthermia-induced damage. Here, we show that vitamins K1 and K2 (VK1, VK2) inhibited the expression of heat-shock protein 72 (Hsp72) but did not affect the constitutive expression of Hsc70 or calnexin in vitro and in vivo. VK1 and VK2 sensitized A549 cells to heat-shock induced cell death, while the compounds alone had no effect on cell viability. The suppression of Hsp72 was apparently at the protein level because the mRNA expression of Hsp72 was unchanged. Moreover, the chaperone activity of Hsp72 was compromised after heat-shock when cells were pre-treated with VK2. The effect of VK2 on Hsp72 suppression, however, was also observed in normal mouse tissue after the mice were subjected to whole-body hyperthermia. To eliminate this side effect, local hyperthermia was performed on tumors in mice. The pre-treatment with VK2 potentiated the effect of local hyperthermia on tumor growth suppression. The findings here that VK1 and VK2 inhibit heat-shock-induced Hsp72 suggest their possible use as an adjuvant for hyperthermia in cancer therapy.