A sporadic case of multiple endocrine neoplasia type 2B in a twenty-six year old man who manifested medullary thyroid carcinoma, multiple mucosal neuromas of the tongue and a marfanoid habitus is reported. At the time of diagnosis, he also had multiple liver and lung metastases. Genetic analysis of his lymphocytes revealed a point mutation in exon 16 of the RET proto-oncogene. Since multiple endocrine neoplasia type 2B has a relatively poor prognosis because of the occasional aggressive behavior of medullary thyroid carcinoma, the necessity of the genetic diagnosis of multiple endocrine neoplasia in the early stage is suggested.
We evaluated a soluble tetrazolium/formazan assay using 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)-carbonyl ]-2H- tetrazolium hydroxide (XTT) for chicken cell growth. Fifty microliter of solution containing 1 mg/ml of XTT and 0.025 mM phenazine methosulfate was added to the cells in a well of 96-well microplate. After 4 hr incubation at 37 degrees C, the absorbance was measured at 490 nm. Under this condition, absorbances were well correlated with cell number of Marek's disease tumor cells and chicken embryo fibroblasts. Proliferation of chicken lymphocytes stimulated with mitogens was also effectively measured. The formazan of XTT is water-soluble and can be quantitated in culture medium without the necessity for extraction with organic solvents. Thus XTT assay is simple and useful for the quantity assay with chicken cells.
Menaquinone-4 (K2) or Phytonadione (K1) was given to rabbits with hypoprothrombinemia caused by 2-4 mg/kg orally administered Warfarin potassium, the coagulation time was measured every 3 hours for first 12 hours then every 6 hours for 18 hours. The group orally given 1-2 mg/kg of K2 was more rapidly improved in pr o thrombin time compared with the group given same dosage of K1, as well as intramuscular administration of 0.2-2 mg/kg of the drugs.
Forty-six cases of breast cancer, autopsied at the Tokai University Hospital, between 1975 and 1993, were studied. Forty of the patients had undergone surgery, and 27 of them had been surgically treated in the Tokai University Hospital. The major causes of death were respiratory failure, cancer-related complications, and hepatic failure. Frequently involved organs were lymph node, lung, liver, and bone. The survival time after surgery ranged from 1 day to 137 months, with the patients being divided into two groups based on survival of more or less than three years after surgery. Frequently observed in individuals surviving less than 3 years were larger tumor sizes, extensive lymph node metastases, advanced stages, and negative reactions for estrogen and progesterone receptors, as compared to individuals surviving for more than 3 years. The patterns of tumor metastasis were also different in two groups. Local recurrences were more frequently observed in short-term survivors whereas disseminated spreading was encountered in the long-term survivors. These findings seem to indicate that not only survival time but also pattern of recurrence are related to the status of the original tumor.
Six-month recipient mortality after adult-to-adult living-donor liver transplantation (LDLT) remains high. Early and accurate prediction of recipient outcome and continuous monitoring of recipient severity after surgery are both essential for guiding appropriate care. This study was designed to identify early post-transplant parameters associated with 6-month mortality, and thereby to construct a discriminatory prognostic index (PI).We retrospectively analyzed 400 consecutive primary adult-to-adult LDLTs in our center (2006-2017). Perioperative variables were comprehensively analyzed for their accuracy in predicting recipient mortality by comparing the area under the receiver operating characteristic (AUROC) of each factor.The AUROCs of preoperative predictive factors, for example, Model for End-stage Liver Disease (MELD) score and donor age, were 0.56 and 0.64, respectively, whereas those of post-transplant platelet count (PLT), total bilirubin (T-BIL), and prothrombin time - international normalized ratio (INR) on postoperative day (POD)-7-14 were 0.71/0.84, 0.68/0.82, and 0.71/0.78, respectively. Logistic regression analysis provided a formula: PIPOD-14 = 3.39 + 0.12 × PLTPOD-14 - 0.09 × T-BILPOD-14 - 1.23 × INRPOD-14 , indicating a high AUROC of 0.87. Recipient 6-month survival with PIPOD-14 < 2.38 (n = 173) was 71.7%, whereas that with PIPOD-14 ≥ 2.38 (n = 222) was 97.7% (P < 0.001). The AUROCs of PIPOD-7 were as high as 0.8 in the subgroups with younger donors (<50 years of age), right lobe grafts, ABO-identical/compatible combinations, or low MELD score (<20), indicating usefulness of PI to identify unexpectedly complicated cases within the first week.A novel, post-transplant survival estimator, PI, accurately predicts recipient 6-month mortality within 1-2 weeks after adult LDLT. Daily monitoring of PI could facilitate early interventions including retransplantation in critically ill patients.
The influence of aztreonam (AZT), a new monobactam antibiotic, on blood coagulation was compared with latamoxef (LMOX), cefoperazon (CPZ), cefotetan (CTT) and ampicillin (ABPC). These antibiotics were administered intraperitoneally once a day for 7 days to rats fed a vitamin K-deficient diet. On the 8th day, blood coagulation activity and bacteria in the caecum were observed. 1) One hundred mg/kg and 300 mg/kg of LMOX prolonged the blood coagulation time and decreased normal prothrombin in a dose-dependent manner. CPZ, CTT and ABPC (300 mg/kg each) decreased both of these parameters, but not as much as LMOX did. AZT (300 mg/kg) had no effect on these parameters. 2) Three hundred mg/kg of ABPC and LMOX decreased the viable cell counts of all aerobic G (+), aerobic G (-), and anaerobic bacteria and yeast, while AZT decreased only aerobic G (-) bacteria. These results suggest that AZT may be less likely to induce hypoprothrombinemia than other antibiotics in clinical use.
Value of MR cholangiopancreatography in evaluating choledochal cysts.H Irie, H Honda, M Jimi, K Yokohata, K Chijiiwa, T Kuroiwa, K Hanada, K Yoshimitsu, T Tajima, S Matsuo, S Suita and K MasudaAudio Available | Share
