A case report of venous aneurysm of the neck vein

We treated a 37 year old woman with venous aneurysm along left side of the neck. In the beginning, she was asymptomatic and with increase in size of the venous aneurysm she experienced severe pain. Pathohistological examinations revealed a destructive change of the venous wall and thrombosis. Therefore, in cases of venous aneurysm along the neck, such aneurysm should probably be treated surgically to prevent the occurrence of pulmonary embolism.     

Current status and problems in the chemotherapy of our outpatient clinic in the department of clinical oncology

The department of clinical oncology performed an analysis of the current situation and problems inherent to 4500 chemotherapies of the outpatient clinic for the last 20 months using a new department of the outpatient clinical treatment. Divided into primary organs and the application of chemotherapy are as follow: breast cancer 49%, and gastrointestinal cancer 47% (esophageal cancer 4%, stomach cancer 28%, colorectal cancer 15%) and others 4%. In terms of time consumed by chemotherapy, there were differences in the tumors, regimens and ages. Within one hour, 40% of all chemotherapies mainly included those of breast cancers. From one to two hours, 40% included half breast cancers and half gastro-intestinal cancers, two to three hours, 15% the same as one to two hours. Over 3 hours, 5% mainly include those of gastro-intestinal cancers. In outpatient clinical chemotherapy, there were no human errors such as the use of wrong drugs and wrong intravenous injections. There were a few patients with adverse effects of chemotherapy including high fever with bone marrow suppression and severe diarrhea, who had an emergency admission to the hospital. As we perform an outpatient clinical chemotherapy with safe, it is important to coordinate with family doctors. To decrease the patients' effort of outpatient clinic, we request the treatment of high fever and the dose of G-CSF for bone marrow suppression to family doctors. The outpatient clinical chemotherapy enables to offer the suitable tailor-made treatment for each individual and to control the adverse effects of any regimen. But, patients' waiting period is still longer due to lack of numbers of doctors. To improve these statuses, careful consideration will be required for the trusting relationship with paramedical staffs' in the Department of Clinical Oncology.     

Possible enhancing effects of atrazine on growth of 7,12-dimethylbenz(a) anthracene-induced mammary tumors in ovariectomized Sprague-Dawley rats

Atrazine, one of the most commonly used herbicides in the world, has been reported to have endocrine disrupting effects in vivo. In the present experiment, influence of dietary atrazine on the late promotion/progression stage of mammary carcinogenesis in ovariectomized female Sprague-Dawley rats was examined after a single intragastric administration of 7,12-dimethylbenz(a)anthracene (DMBA). When the incidence of palpable mammary tumors reached about 50%, the animals were subjected to ovariectomy and divided into tumor bearing [DMBA-Tumor(+)] and non-tumor bearing [DMBA-Tumor(-)] groups, with subgroups of each fed a soybean-free diet containing 0, 5, 50, or 500 p.p.m. atrazine for 34 weeks. At the completion of the study, the tumor volume in the 50 and 500 p.p.m. treatment Tumor(+) subgroups was greater than in the 0 p.p.m. control case. In the DMBA-Tumor(-) group, higher incidences and volumes of the mammary tumors, with or without statistical significance (P <0.05), were observed in the 50 and 500 p.p.m. subgroups. Atrazine treatment tended to increase proportion of estrogen receptor alpha-positive tumors and stimulated cell proliferation in the DMBA-Tumor(+) group, but with no clear effects on serum hormone levels. The present study indicates that atrazine has a potential for enhancing the growth of mammary tumors, partly through increasing cell proliferation in the promotion/progression stage in female rats under ovarian hormone-free conditions.     

Spinal epidural lipomatosis in children with renal diseases receiving steroid therapy

Spinal epidural lipomatosis (SEL) in patients on steroid therapy may be explained by two hypotheses: (1) steroids induce SEL and (2) steroids cause the growth of a pre-existing SEL, especially in obese children. Steroid-induced SEL (SSEL) is rarely described in children, with only six cases reported elsewhere. However, we have already reported four nephrotic children with SSEL, including one child in another hospital, in addition to the six cases. We investigated the frequency of SSEL in 125 children with renal diseases treated with glucocorticoids in a single hospital over 16 years, and examined the risk factors in 62 patients with SSEL reported in the literature. When patients complained of symptoms at the early stage of SSEL, i.e., back pain or numbness, and patients were obese, we performed spinal magnetic resonance imaging (MRI). SSEL was detected in 5 of 125 children (4.0%). Of the 5 patients with SSEL, 3 had vertebral compression fractures, and all 5 patients were on methylprednisolone pulse therapy. Our study suggests that many more patients can be detected at the early stage of SSEL by performing spinal MRI for patients with early symptoms, obesity, and those who have received methylprednisolone pulse therapy.     

Surgical management for the prevention of pancreatic fistula following distal pancreatectomy

Although the mortality rate related to pancreatic surgery has been reduced recently, the postoperative morbidity is still high, because of various complications. Pancreatic fistula is one of the most common complications following distal pancreatectomy, and is generally hard to cure. Several surgical techniques and devices, such as the use of fibrin-glue sealing, stapler closure, an ultrasonic dissector, or an ultrasonically activated scalpel have been advocated to prevent pancreatic fistula. In the present review we provide an overview of several devices used for the prevention of pancreatic fistula following distal pancreatectomy.     

Parapapillary choledochoduodenal fistula associated with cholangiocarcinoma

Parapapillary choledochoduodenal fistula is a rare disorder. We herein report a case of parapapillary choledochoduodenal fistula associated with cholangiocarcinoma. A 61-year-old woman was admitted to our hospital for further examination of a liver tumor. She had no clinical symptoms, but computed tomography scans showed an irregularly contoured liver tumor which was histologically confirmed to be adenocarcinoma, by a needle biopsy examination. Duodenal fiberscopy revealed a fistula orifice 1.0cm proximal to the orifice of the papilla of Vater, and endoscopic retrograde cholangiography through the fistula showed a communication to the common bile duct. Hypotonic duodenography demonstrated reflux of contrast material into the choledochoduodenal fistula. The bile sample collected from the common bile duct showed extremely high levels of pancreatic enzymes, including amylase, phospholipase-A2, and elastase-I. Furthermore, Helicobacter DNA was detected in bile by polymerase chain reaction (PCR) analysis. This experience suggests to us that parapapillary choledochoduodenal fistula may be a risk factor for biliary tract carcinoma, and surgical management is the treatment of choice for this rare condition, even when the patient has no significant clinical symptoms.     

Immunity in lamprey III. Occurrence of the complement-like activity

The serum of Arctic lampreys (Lampetra japonica) lyses rabbit erythrocytes (E^R), with optimal activity at 4°C. This lytic activity is relatively heat stable, is inactivated after incubation with zymosan (5 mg/ml) for 1 hr at 15°C, and is controlled by Mg⁺⁺ dependent factors present in normal lamprey serum. Hemolysis of sheep erythrocytes (E^S) was obtained with lamprey hemolysin using bullfrog serum as complement (C). The optimal conditions were established for sensitizing E^S with lamprey hemolysin to fix bullfrog C. Under the same conditions hemolysis was not induced with zymosan-treated bullfrog C and lamprey serum. These findings suggest that lamprey serum possesses components that function via the alternate pathway, instead of the classical pathway usually found in more advanced vertebrates.