A case of carcinoma in pleomorphic adenoma which developed in the deep lobe of the left parotid gland of a 75-year-old Japanese man is described.The case was clinically prediagnosed as a benign salivary gland tumor; however, examination of excised tissue revealed small areas of adenoid cystic carcinoma invading the capsule and of pleomorphic adenoma comprising almost all the tumor tissue. The surgical procedure choice included complete excision of the tumor tissue with lobectomy of the superficial part of the left parotid gland.Recurrence or metastasis has not been noted in the one year and 8 months since operation.The excised material was also examined from an immunohistochemical aspect, using the peroxidase-antiperoxidase method. The staining of S-100 protein, lysozyme, transferrin, secretary component, and keratin showed similar findings as have been already reported.
We report a case of huge colon cancer accompanied with severe hypoproteinemia. A7 4-year-old woman was referred to our hospital because of abdominal fullness. Blood examinations revealed anemia(hemoglobin 8.8 g/dL)and sever hypopro- teinemia(total protein 4.5 g/dL, albumin 1.1 g/dL). Computed tomography examination of abdomen revealed ascites and large tumor(12.5×10.5 cm)at the right side colon. By further examinations ascending colon cancer without distant metastasis was diagnosed, then we performed right hemicolectomy and primary intestinal anastomosis by open surgery. Ahuge type 1 tumor(18×12 cm)was observed in the excised specimen, which invaded to terminal ileum directly. The tumor was diagnosed moderately differentiated adenocarcinoma without lymph node metastasis(pT3N0M0, fStage II ). Postoperative course was uneventful and serum protein concentration recovered gradually to normal range. Protein leakage from the tumor cannot be proved by this case, so we can't diagnose as protein-losing enteropathy, but we strongly doubt this etiology from postoperative course in this case.
Abstract Hepatocellular carcinoma (HCC) is one of the most common fatal cancers, and chronic infection with hepatitis C virus (HCV) is thought to be one of the main causes in Japan. To identify diagnostic or therapeutic biomarkers for HCC associated with HCV (HCV‐HCC), we tried to elucidate the factors related to the products from cancerous tissues of HCV‐infected patients. From proteomic differential display analysis of liver tissue samples from HCV‐HCC cancerous tissues and corresponding non‐cancerous tissues from patients, three protein spots of the same molecular mass (42 kDa), whose expression increased in well‐differentiated cancerous tissues, were detected. Although their p I were different, they were identified as glutamine synthetase (GS) by PMF with MALDI‐TOF MS and by Western blotting using anti‐GS specific mAb. Immunohistochemical analysis showed that tumor tissue consists of two parts, GS‐positive cell and GS‐negative cell regions, suggesting that GS‐producing cells grew in the tumor tissue as a nodule in nodules. The tryptic peptides of the most acidic GS isoform lost the signal of 899.5 Da, corresponding a peptide of SASIRIPR, and gained a signal of 1059.5 Da, which was submitted to PSD analysis. PSD analysis showed the neutral loss by elimination of two phosphate groups, supposed to be on serine residues of the 899.5‐Da peptide, from serine 320 to arginine 327 in GS. PMF followed by PSD analysis is thought to be useful for the determination of phosphorylation sites of proteins showing molecular heterogeneity.
We report a case of 39-year-old man who developed tricuspid valve infective endocarditis with a complication of pulmonary embolism. He was transferred to our institution because of intermittent fever and enlargement of the vegetation of the tricuspid valve in spite of optimal antibiotics treatment. Computed tomography revealed pulmonary embolism, and transesophageal echocardiography showed a large and mobile vegetation (22×10 mm) on the tricuspid valve with moderate regurgitation. In addition, Streptococcus agalactiae was identified in blood cultures. The patient underwent surgical resection of the vegetation followed by tricuspid valve repair including De Vega's annuloplasty. Antibiotic therapy was continued for 4 weeks after surgery, and he was discharged on the 31st postoperative day. No endocarditis nor tricuspid valve dysfunction has re-occurred.
Long-standing dislocation of the temporomandibular joint is a comparatively rare occurrence, although dislocation of the temporomandibular joint itself is not infrequent. Most patients with TMJ dislocation are early diagnosed and treated by manipulation technique because symptoms are rather characteristic.This paper described a long-standing TMJ dislocation casc from the asp, t of diagnosis and treatment that occurred in a 17 year-old female with cerebral palsy, epilepsy, micrognathia, and pneumonia. At the same time several problems about the difficulty of the treatment modality were discussed.
