Biological Behavior of Papillary Carcinoma of the Thyroid Including Squamous Cell Carcinoma Components and Prognosis of Patients Who Underwent Locally Curative Surgery

Thyroid carcinoma showing squamous differentiation throughout the entire lesion is diagnosed as squamous cell carcinoma of the thyroid (SCCT) in the WHO classification. This entity is a rare disease and shows a dire prognosis; however, squamous differentiation is more frequently detected in only a portion of papillary thyroid carcinoma. In this paper, we present our experience of 10 patients (8 primary lesions and 2 with recurrence in the lymph nodes) with papillary thyroid carcinoma having an SCC component (PTC-SCC). Only 3 of 8 primary lesions (38%) and none of the 2 recurrent nodes were preoperatively diagnosed as or suspected of having SCC components. All 10 patients underwent locally curative surgery. To date, 3 patients have died of carcinoma, and 2 had distant metastasis at diagnosis or had an undifferentiated carcinoma component. The other 7 are currently alive 5 to 43 months after diagnosis. Systemic adjuvant therapy after the detection of recurrence was effective for 2 patients. It is possible that some PTC-SCC patients without distant metastasis who undergo locally curative surgery can survive for a prolonged period and adjuvant therapies can be effective for local and distant recurrences

The acute effects of antidepressants on the human VEP and EEG

The acute effects of clomipramine hydrochloride (CMI), tricyclic antidepressant, were studied and compared with those of mianserin hydrochloride (MSR), tetracyclic antidepressant, by visual evoked potential (VEP), with each 16 and 12 healthy male subjects, respectively. In the two experimental session on different days, CMI (0.5mg/kg) or MSR (0.3mg/kg) were orally administered for each subject. EEGs containing VEPs evoked by flash stimuli once every 5sec were derived from the two derivations (2ch : O1→ A1 + 2, 5ch : O1→Cz) and recorded into magnetic tape. Reproducing the tape, VEPs before and 120min after the administration of each drug, with 1024msec of analysis time, were obtained by averaging 100 responses, and EEGs were subjected to the frequency analysis. The changes of the waveform of group mean VEP were studied and compared between these drugs. Individual VEPs were subjected to the component analysis, and to the statistical assessment together with EEG. The following, statistically significant, results were obtained. 1. After the administration of CMI, both latencies and peak-to-peak amplitudes of VEP did not significantly change. In EEG, the power% of α1 frequency band increased. These findings indicate that few effect of CMI on the visual system. 2. After the administration of MSR, latencies of short latency components (P3 and N3) significantly increased and peak-to-peak amplitudes of short latency components (P3-N3 and N3-P4) significantly decreased in VEP. In EEG, the power% of δ and θ frequency band increased, and that of α2 and β2 decreased. These findings indicate the inhibitory effect of MSR mainly on the lateral geniculate body and the optic radiation in the visual system. 3. From these results, it was considered that CMI has less effect on depression with anxiety or irritability than MSR

Geranylgeranylacetone and cetraxate hydrochloride increase UDP-galactosyltransferase activity in rat gastric mucosa

UDP-galactosyltransferase (UDP-Gal-T) is a key enzyme in the synthesis of mucus glycoprotein which plays an important role in gastric mucosal defensive mechanisms. Analysis of gastric UDP-Gal-T activity should clarify the mechanisms of the action of antiulcer drugs regarding gastric defensive factors. Here, we examined UDP-Gal-T activity in rat gastric mucosa treated with the antiulcer drugs geranylgeranylacetone (GGA) and cetraxate hydrochloride (CET). The effects of coadministration of indomethacin and exogenous administration of prostaglandins (PGs) were also studied. GGA and CET significantly increased UDP-Gal-T activity, and coadministration of indomethacin inhibited the increase of enzyme activity. UDP-Gal-T activity level with GGA was significantly higher than the control level, even in the presence of indomethacin. With CET, however, this was not the case. Among PGs, PGE1 significantly increased enzyme activity. Concomitant administration of PGE1 and GGA or CET increased UDP-Gal-T activity even with indomethacin to the levels achieved when these antiulcer drugs were administered without indomethacin. Our findings suggest that GGA and CET exert antiulcer effects by increasing mucus glycoprotein synthesis and that endogenous PG synthesis may be involved in this process. However, mechanisms not mediated by endogenous PGs may also exist in the stimulatory action of GGA on UDP-Gal-T activity.</p

Differences in waveforms of cerebral evoked potentials among healthy subjects, schizophrenics, manic-depressives and epileptics

The differences in the waveform of Cerebral EP (Evoked Potential)s ; SEP, VEP and AEP, among healthy subjects, schizophrenics, manic-depressives and epileptics were investigated. In 585 subjects of both sexes comprising these diagnostic groups, 6 channels of EPs, each 2 channels for each sensory modality, were recorded simultaneously/ parallelly from each subject, without assigning a mental task. Then, waveforms of the g-m (group mean) EPs of each diagnostic group were superimposed for inspection. Peak latencies and inter-peak amplitudes of individual EPs were statistically tested among (ANCOVA) and between (Scheffe’s multiple comparison test) these diagnostic groups for each channel (modality), and for each sex. The waveforms of g-m EPs of each diagnostic group differed from each other. The differences of latencies and inter-peak amplitudes among these diagnostic groups attained to the significant level (P<0.05), with more significant differences between healthy subjects and each of these pathological diagnostic groups than between each of these pathological diagnostic groups, for each sex. Thus the differences in the waveform of EPs among these diagnostic groups were confirmed even taking the effect of medication on EPs into consideration. These results might suggest the existence of a waveform for individual EPs specific to each of these diagnostic groups, for each sex

ショクドウガン ジュツゴ ソウキ ニ キカン イカンロウ オ ガッペイ シタ 1レイ

The patient was a４５-year-old man. He had suffered from nephrotic syndrome at time of his twenties and had steroid salvage treatment. But he retired the treatment by himself. Esophageal tumor was suspected at the screening, and he was referred to our hospital. Preoperative diagnosis was the adenocarcinoma of the esophagogastric junction（cT２N０M０ stage Ⅱ）． Thoracoscopy assisted subtotal esophagectomy in prone position with D２dissection was performed. Gastric role was prepared in laparoscopic approach, and pulled up to the neck via posterior mediastinal route. Although early postoperative course was uneventful and esophageal fluoroscopy on the７th day showed no leakage, sudden dyspnea appeared on the８th day. CT examination and Bronchoscopy showed tracheoesophageal fistula. Unfortunately, the fistula didn’t get well, and we considered that it was difficult to close the fistula by only conservative treatment. Esophageal covered stent was inserted on the５６th day. After that, he could start ingestion intake and was discharged from hospital on the８５th day. Now, he is being followed up in our hospital

チュウスイ ゲンパツ フクゴウガタ セン シンケイ ナイブンピツ ガン ノ イチチケンレイ

A５２-year-old man visited our hospital because of epigastralgia. The colonoscopic examination revealed an about ４cm-protruded lesion like SMT on the appendix and findings of the biopsy specimen were compatible with the disgnosis of signet ring cell carcinoma. The primary lesion was unknown by upper gastrointestinal endoscopy, CT and PET, and the tumor markers were normal revel. At laparotomy, severe peritoneal metastasis was revealed in the abdominal cavity, especially appendix. Severe stenosis of ileocecum was found, so we conducted ileocecal resection. The histopathological diagnosis was primary signet ring cell caicinoma of appendix, SE, N２, M０, P３, pStage Ⅳ. Postoperatively mFOLFOX was started, but allergic reaction was seen after１cycle. We started Panitumumab/CPT-１１and the patient attended our emergency department with shivering chill and fever on treatment day１０. The next day he became shock state and CT revealed free air. Operation might not save his life and we started supportive care. He died on the day. The cause of his death was peritonitis by cancer perforation