Marked elevation of CA19-9 in a patient with idiopathic pulmonary fibrosis: CA19-9 as a bad prognostic factor

Abstract A 53-year-old Japanese female, who had been suffering from idiopathic pulmonary fibrosis (IPF) for 3 years, was admitted with dyspnoea. The important laboratory finding on admission was a serum CA19-9 level of 649 U/mL. Despite steroid treatment for IPF, her respiratory condition gradually deteriorated with the increase of serum CA19-9 level up to 3020 U/mL and she died of respiratory failure. Immunohistochemistry showed the positive stain of CA19-9 in bronchoepithelial cells. We also reviewed the Index Medics and picked up the cases who had elevation of CA19-9 more than 1000 U/mL, and six patients were listed. Five of these six patients died within 6 months, therefore the marked elevation of CA19-9 seemed to be a bad prognostic factor in patients with pulmonary fibrosis.     

Struggles of neonatology staff and the network system in the Hanshin-Awaji earthquake disaster

More than 5500 people were killed in the Hanshin-Awaji earthquake disaster. Most of the neonatal intensive care units (NICU) could not offer proper services as a result of the earthquake and the Hyogo Emergency System for Neonates could not function. No one imagined that such a great disaster would occur in their home town, Kobe; however, the devastation of the quake has raised the opportunity to examine the operation of neonatal medicine in an emergency. We sent out questionnaires to perinatologists in the damaged area 2–3 months after the quake. Some hospitals in the demolished area suffered such serious damage that they could not continue work as NICU, and some in the surrounding area had problems in a number of areas, including staff, room capacity and transport methods. Under these difficult circumstances the greatest problem encountered by staff was maintaining fundamental care in NICU, that is to say keeping temperature, formula (nutrition) and prevention of infection techniques operating. In this report we discuss the effects on neonatal medicine of the earthquake in Kobe. Medical staff struggled patiently and made great efforts to recover and maintain the functioning of NICU. We believe this information will be useful for neonatology staff in other areas which may experience an earthquake in the future.     

Efficacy of 308-nm excimer light for Japanese patients with psoriasis

Ultraviolet irradiation therapy, including psoralen and ultraviolet A therapy and narrow-band ultraviolet B (310–312 nm) therapy, is a widely used and highly efficient treatment modality for psoriasis. Therapy with 308-nm excimer light has been reported to be effective for the treatment of psoriasis vulgaris. To evaluate the efficacy of 308-nm excimer light therapy for Japanese psoriasis patients, seven patients (six men and one woman) with plaque-type psoriasis were treated with 308-nm excimer light at 7–14-day intervals. The Psoriasis Severity Index (PSI) was calculated for individual plaques in order to assess the effectiveness of the therapy. A 74.9% mean improvement in the PSI was observed after 10 treatment sessions. These results suggested that targeted irradiation with 308-nm excimer light leads to rapid and selective improvement in plaque-type psoriatic lesions without unnecessary radiation exposure to the surrounding unaffected skin.     

The effect of the slope inclination of buccal polished surface of mandibular denture base on food retention

summary The accumulation of food debris in the buccal vestibule can inhibit normal mastication and appears to be a factor that can cause patient discomfort. This study focused on the effect of the slope inclination of the buccal polished surface of the mandibular denture base on the ability to expel test-food particles from the buccal vestibule. It was revealed that an inclination of the slope steeper than 80° markedly inhibits the normal ability to expel foods from the vestibule. It was revealed that the most appropriate inclination of the buccal slope is approximately 60° or 70°. These results could be utilized for constructing a denture prosthesis.     

THE EFFECTS OF SULPHYDRYL REAGENTS ON THE NEUTRALIZATION OF LATS BY HUMAN THYROID EXTRACTS

LATS has already been shown to be neutralized by an unknown antigenic substance in human thyroid tissue. This antigen has been presumed to be a TSH receptor. To examine this hypothesis, we sought to determine whether SH reagents capable of altering the characteristics of TSH receptors in thyroidal crude membrane fractions caused an alteration in the LATS neutralization activity of the same fraction. Diamide (10^?3m ) which was shown to enhance ¹²⁵I-TSH binding to TSH receptors by increasing the binding affinity of the receptor, significantly increased the neutralization of LATS by the crude membrane fraction. Dithiothreitol (10^?3m ) which was shown to inhibit ¹²⁵I-TSH binding by decreasing the affinity of the receptor, significantly decreased the neutralization of LATS by the fraction. This indicates that TSH receptors and the thyroidal factor capable of neutralizing LATS share a common property in terms of the effects of SH reagents and is compatible with the idea that the LATS neutralizing activity of thyroidal crude membrane fraction is due to binding by the TSH receptor or its fragments.     

ANNULATE LAMELLAE OBSERVED IN HUMAN PROSTATIC CARCINOMA

Annulate lamellae (AL) were observed in only three out of 40 cases of human prostatic carcinoma, but not in 20 cases of benign prostatic hyperplasia and 11 cases of presumably normal prostatic tissues. AL showed the continuity with the rough endoplasmic reticulum and seemingly the nuclear membrane consisting of lamellar or concentric arrangement of stacked membranes and occasionally annular structures. In addition, annuli were detected in the rough endoplasmic reticulum near the stacked membranes which were devoid of ribosomal attachment. These results disclosed that in human prostatic tissues, AL could be only rarely detected in actively dividing cancer cells, and were seemingly the temporary transitional structures transforming from the nuclear membrane to the rough endoplasmic reticulum.     

Proliferative fasciitis of the forearm: Case report with immunohistochemical, ultrastructural and DNA ploidy studies and a review of the literature

A case of prollferative fasclitis arising In the left forearm of a 56-year-old man was examined. The lesion was preceded by blunt trauma, measured 1.5 times 1.3 times 1.0 cm, was poorly circumscribed and appeared white to light gray on the cut surface. Light microscopic examinations revealed that spindle cells and giant cells with one or two nuclei and abundant basophllic cytoplasm ware arranged without any organized patterns In collagenous stroma. Ultrastructurally, well-developed rough endoplasmic reticulum separated by varying amounts of fine to course fibrillar materials was detected in the giant cells. Only vimentin lmmunoreactivity was detected In both spindle and gtant cells. The Ki-67 labeling Index of spindle cells was 35% but that of giant cells was less than 5%, and this reflects the quiescent or slow-growing features of these giant cells in proliferative fasclitis. DNA content of the calls, which was examined by Image cytometry, demonstrated diploidy In both spindle (DNA Index = 1.01) and glant (DNA Index = 1.09) calls.     

A Comparative Study of DCMP versus DCcMP Combination Chemotherapy for Adult Acute Leukemia

An experimental study using L-1210 mouse leukemia indicatedthat daunomycin, cyclocytidine, and 6-mercaptopurine (DCcM)combination chemotherapy was more effective than daunomycin,cytosine arabinoside, and 6-mercaptopurine (DCM). Based on theseresults, a clinical study comparing daunomycin, cytosine arabinoside,6-mercaptopurine, and predni-solone (DCMP) combination chemotherapywith daunomycin, cyclocytidine, 6-mercaptopurine, and prednisolone(DCcMP) in the treatment of adult acute nonlymphocytic leukemiawas conducted. Patients were randomly allocated to receive eitherregimen. Ten of 15 patients treated with DCMP had complete remissionfor a median duration of 43 weeks and one had partial remission.Seven of 15 patients treated with DCcMP had complete remissionfor a median duration of 18 weeks and two had partial remission.The patient characteristics before chemotherapy, the toxicityof the chemotherapeutic regimens and the causes for differencesin antitumor activity between the experimental study and theclinical study are discussed.     

Clinical Effect of Cisplatin (NK-801) on Head and Neck Cancer

Twenty-one patients with head and neck cancer were treated withcis-diamminedichloroplatinum (cisplatin). Two kinds of regimenwere used in this study: a low-dose regimen (7 mg/m² 3-hr intravenous(i.v.) infusion or an intraarterial (i.a.) push injection, days1–5, q 3 wk) and a high-dose regimen (50 mg/m² 24-hr i.v.infusion or a 2-hr i.a. infusion, q 3 wk). Nine patients weretreated before radiotherapy or surgery for stage III or IV diseaseand the remaining 12 were treated for recurrent or metastaticdisease. The tumors were 18 squamous cell carcinomas, 2 adenocarcinomasand one adenoid cystic carcinoma. The overall response rate was 35% with two complete responsesand five partial responses ( 50% regression). With the high-doseregimen there were two complete responders and four partialresponders, while in the low-dose regimen only one partial responsewas observed. There was no difference in therapeutic effectdue to the route of administration. Toxicity was minimal: no patients had creatinine levels of >2mg/dl; there were leucopenia (<3,000/mm³) in one patient,nausea and vomiting in 62%, and minimal hearing impairment intwo patients. The most impressive point regarding this agent is that responsesare complete in some patients with long periods of remission. We conclude that cisplatin is an effective new agent for squamouscell carcinoma of the head and neck. Further studies shouldbe performed for the purpose of developing new combinationsof chemotherapeutic agents that include this one.