Serum creatinine and cholesterol levels of testicular cancer patients in long-term follow up

PURPOSE: Most patients with advanced testicular cancer can be cured with cisplatin-based chemotherapy. Therefore, the long-term effects of the treatment are clinically important. In the present study, we evaluated the serum creatinine and cholesterol levels of long-term survivors of testicular cancer. METHODS: Serum creatinine and cholesterol levels were determined in 23 testicular cancer patients who had received cisplatin-based chemotherapy more than 5 years earlier. They were compared with a control group of 16 patients who did not receive chemotherapy. In addition, follow-up data of beyond 10 years after the initial treatment was obtained from 17 patients. We also analysed the trends of both serum creatinine and cholesterol determinations over 10 or more years using a generalized linear model. RESULTS: There was no significant difference in the serum creatinine and cholesterol levels 5 years after the treatment between the chemotherapy and control groups. Analysis using a generalized linear model showed a significant trend toward an increase in serum creatinine in patients who had developed renal dysfunction during chemotherapy (P = 0.0024). The elevation of the serum creatinine level was mainly observed during the first 5 years. In addition, a significant trend toward an increase in serum cholesterol was revealed in both the chemotherapy and control groups. CONCLUSION: Patients who have developed renal dysfunction during chemotherapy may be at risk of gradually increasing serum creatinine levels even after it has become normal. Although further analysis is needed, we recommend long-term follow up in the survivors of metastatic testicular cancer patients treated with cisplatin-based chemotherapy.     

Adriamycin Therapy in a Child with Malignant Sacrococcygeal Teratoma with Special Reference to Serum Alpha-Fetoprotein

A case of a young girl with malignant sacrococcygeal teratomawas reported with special reference to serum alpha fetoproteinand chemotherapeutic effect of Adriamycin. Irrespective of theconventional chemotherapy and radiation therapy given in anotherhospital, repeated intravenous administration of Adriamycinof 20 mg/m² per dose demonstrated a very good response bothin terms of the clinical condition and the value of alpha fetoproteinin serum. But the latter which had once fallen within normallimits on radioimmuno assay, did not remain suppressed but roseagain. From this fact, it was observed that the diminution ofserum alpha fetoprotein value to normal range does not seemto necessarily guarantee the complete cure of the disease.     

Primary Anastomosis for Acute Ascending Aortic Dissection

Intimal tear resection and primary anastomosis of the aorta were used for the treatment of eight patients with DeBakey I and II type acute aortic dissection. Five patients were of DeBakey I type, and three patients were of the II type. Moderate or severe aortic regurgitation (AR) was observed in six of eight patients. The site of the intimal tear was diagnosed by intraoperative echocardiography, and the adventitia corresponding to the intimal tear was transversely opened under total cardiopulmonary bypass. While resuspension of the aortic valve was performed on only one of six patients, AR disappeared in four, postoperatively. Two of eight patients died early postoperatively. The cause of death was postoperative cardiac tamponade in one patient and cerebral herniation in the remaining one. The other six patients have been observed for a mean period of 27 months. There is no late death, and they show no dilatation of the aortic root and deterioration of AR. We believe that this operative method is a simple and safe emergency procedure for DeBakey I and II type acute aortic dissection.     

A Case of Bronchial Fibroma Associated with Subsegmental Atelectasis

A case of polypoid endobronchial fibroma which led to subsegmentalatelectasis in a 45-year-old male is reported. The diagnosiswas made pre-operatively by roentgenographic examination, bronchoscopyand biopsy. A lobectomy of the right middle lobe was performed.The polypoid tumor occupied the lumen of the subsegmental bronchusof the right middle lobe and had a stalk. Histologically, thetumor was composed mostly of collagen bundles with scant spindle-shapedfibroblastic cells and a myxomatous component. There was neithercellular atypia nor mitotic figures nor infiltration of smallround cells. The diagnosis was pulmonary fibroma of the endobronchialtype. To date, 66 cases of pulmonary fibroma have been reportedin the English literature since 1880; 21 of these were polypoidendobronchial fibroma. Only five cases of polypoid endobronchialfibroma including this case have been reported in the Japaneseliterature.     

Neonatal Plesiomonas shigelloides septicemia and meningitis: A case and review

A 3 day old neonate with septicemia and meningitis due to Plesiomonas shigelloides is described. We could not detect the source of this infection. The patient was treated with cefotaxime and survived without sequelae. Nine previously reported cases with this infection were reviewed.     

Phase 1 Study of Aclacinomycin A

A phase 1 study of aclacinomycin A was performed in a seriesof 22 patients with incurable malignant tumors. AclacinomycinA was injected intravenously at a dose ranging from 15 to 70mg/m².The toxic reactions encountered were anorexia, nausea, vomiting,leukopenia, and thrombocytopenia, but they were mild and transient.A dose-toxicity relationship was mainly observed in thrombocytopeniaand leukocytopenia. Only the transient T wave depression wasobserved when 40 mg/m² of aclacinomycin A was given intravenously.The highest non-toxic single dose of aclacinomycin A might be70 mg/m².     

Peptide Hormone Production in Small Cell Lung Carcinomas with Particular Reference to Gastrin-Releasing Peptide

Tissues of 50 small cell lung carcinomas were examined for productionof 17 peptide hormones. Only when the concentration of a peptidedetected in the tumor was 10 pmol or more per g wet weight,was the peptide considered to be produced by the tumor. Thefrequency of production of at least one of these peptide hormoneswas 84%, and that of two or more hormones was 50%. These resultsindicate that peptide hormone production is a very common phenomenonin small cell lung carcinoma. Of the peptide hormones examined,gastrin-re leasing peptide is produced with the highest frequency,suggesting that this pep- tide could play an important rolein small cell lung carcinoma.     

Inhibitory Effect of NZ-105, a 1,4-Dihydropyridine Derivative,on Cyclic Nucloeotide Phosphodiesterase Activity

Abstract— The effects of NZ-105, a 1,4-dihydropyridine calcium antagonist, on the intracellular cyclic nucleotide system were investigated in-vitro. In rabbit isolated aorta, both NZ-105 (1 and 10 μm ) and nicardipine significantly and in a concentration-dependent manner increased intracellular cyclic AMP and cyclic GMP content. NZ-105 inhibited bovine cardiac phosphodiesterase activity (K_i 30 μm ) by competitive antagonism. The concentration ranges for inhibition were consistent with the range of increases in cyclic nucleotides.     

Endoscopic ultrasonographic findings in rectal leiomyoma

Abstract A 35 year old man visiting a hospital for his annual check-up in August 1992 was found to have a large rectal tumour on digital examination. Colonoscopy revealed a bulging lesion with normal mucosa. Endoscopic biopsy showed only normal tissue. Endoscopic ultrasonography demonstrated a large hypo-echoic submucosal tumour in the fourth layer (muscularis propria) of the rectal wall. Based on this endoscopic ultrasonographic finding, we diagnosed the tumour as leiomyoma pre-operatively. The tumour was excised by a trans-sacral local excision. The histological diagnosis of the resected specimen was cellular leiomyoma.     

A Case of Early Rectal Cancer (Mucosal Cancer) with Pulmonary Metastasis Detected by Postoperative Rise of Carcinoembryonic Antigen

Polypectomy was conducted under rectoscopic observation fora patient with a small rectal polypoid cancer (mucosal cancer)on an outpatient treatment basis. The serum carcinoembryonicantigen (CEA) level, which had been high before the polypectomy,was reduced and complete cure seemed to have been attained.However, the postoperative serum CEA level at the patient'speriodical check-up proved to be abnormally high, and a closerexamination revealed a small pulmonary metastasis. Eight monthsafter the polypectomy, the metastatic focus in the lung wasresected curatively and the serum CEA level returned to normal.It was verified by immunofluorescence that the tissues in themetastatic focus were CEA-productive. As the pulmonary metastasis, which is extremely rare in thecases of early cancers, could be detected at its early stageby the periodical check of the serum CEA level, and as the serumCEA level could be returned to normal by resection of the metastaticfocus, it was thought that the resection was curative.