Diffuse Endobronchial Wall Spread of Metastatic Breast Cancer

We present here a case of diffuse tracheobronchial wall spread of metastatic breast cancer who was successfully treated with trastuzumab plus vinorelbine chemotherapy. The patient had a left radical mastectomy for breast cancer in March 2000 and developed persistent cough and dyspnea in November 2006. Pulmonary function test demonstrated an obstructive pattern. Chest computed tomography showed a wall thickening of trachea and right side bronchus, but radiographic findings including 18F-fluorodeoxyglucose positron emission tomography failed to detect the locations of disease in the lung. The findings on bronchofiberscopy showed edematous tracheobronchial mucosa, but also failed to visually detect direct masses. Transbronchial biopsy specimens revealed involvement of metastatic breast cancer. The patient was treated with trastuzumab plus vinorelbine chemotherapy and the wall thickening of bronchial tree and clinical symptoms were improved. Although endobronchial metastasis in metastatic breast cancer is not uncommon, diffuse spread without forming intraluminal mass is extremely rare. The pattern of endobronchial metastasis should be considered in patients with malignancies even when radiographic abnormalities are undetectable

Effect of Propofol Continuous-Rate Infusion on Intravenous Glucose Tolerance Test in Dogs

Hyperglycemia causes perioperative complications and many anesthetics impair glucose metabolism and cause hyperglycemia. We evaluated the effects of propofol on blood glucose metabolism and insulin secretion during an intravenous glucose tolerance test (IVGTT) in dogs. Blood glucose, insulin, triglyceride, cholesterol, and free fatty acid (FFA) levels were measured in dogs during IVGTT in a conscious state and under the effect of 2.0% isoflurane, low-concentration propofol (0.2 mg/kg/min), and high-concentration propofol (0.4 mg/kg/min) anesthesia. Plasma glucose levels significantly increased in all of the treatment groups when compared with those in the conscious group. The prolonged half-life period of plasma glucose suggested that isoflurane and propofol attenuated glucose metabolism in dogs. Plasma insulin levels were significantly lower in the isoflurane group when compared with those in the other groups, whereas blood FFA levels were increased in the propofol groups when compared with the other groups. These results suggest that propofol itself does not directly raise plasma glucose levels, but attenuates glucose metabolism by accumulating FFA

Studies on the morphology of the inner ear and semicircular canal endorgan projections of ha, a medaka behavior mutant.

The morphology of the inner ear was investigated in the mutant strain ha of medaka (Oryzias latipes). The ha is a recessive mutant and ha homozygotes are viable but show abnormal circular swimming behavior. In adult ha/ha medaka, more than one semicircular canals are absent. In the most abnormal cases, no canals are present at all and the membranous labyrinth of the inner ear exhibits a simple rugby-ball-like structure. In spite of the apparent absence of the canals, however, receptor endorgans of the canals (crista ampullaris) and the nerves innervating the cristae (ampullar nerves) are present. Otoliths and associated receptor epithelia (maculae) as well as octaval nerve branches innervating maculae are also present, except utricular otoliths that are absent or extremely small if present. Projections of the ampullar nerves were also investigated, because central connections of the nerves may be also abnormal. Tract-tracing studies, however, revealed similar central projection patterns of primary afferents in the mutant and wild-type brains. These results suggest that membranes of prospective semicircular canals fail to form tubular structures and fuse with the membrances of otolith organs in ha/ha medaka. These results also suggest that abnormal morphology of the semicircular canals as well as the utricular otolith underlies the abnormal swimming behavior of the ha/ha medaka, in spite of apparently normal central projections of the ampullar nerves

Pseudo-Dynamic Tests on an Existing Steel Model Structure for Seismic Monitoring

特集 ERS(耐震構造学