[Intra-arterial chemotherapy for locally advanced bladder cancer].

A total of 83 patients with locally advanced bladder cancer (T1, n = 5; T2, n = 28; T3a, n = 21; T3b, n = 21; T4, n = 8) were treated with intra-arterial (i.a.) cisplatin and adriamycin (or epirubicin) chemotherapy.

[Need to establish academic research organization for cancer clinical trial and clinical research system having clinical investigators and study coordinators, with special reference to promotion of medical and life science research policy].

There are two types of cancer clinical trials in Japan. One is the therapeutic trial sponsored by a pharmaceutical company for approval of clinical use of new anticancer agent, and another is the clinical trial sponsored by an investigator for establishment of standard state-of-the-art therapy. Advances in cancer chemotherapy can not be achieved without active use of both types of cancer clinical trial.

[The management of Hodgkin's disease with chemotherapy or combined modality treatment].

Systemic polychemotherapy and local radiation are two well-established treatments for Hodgkin's disease. With the use of modern techniques, the great majority of patients with pathologic stage I-II Hodgkin's disease can be cured with irradiation alone. Since the invention of the MOPP and ABVD schemes, polychemotherapy has become indispensable for the treatment of advanced-stage Hodgkin's disease.

[A severe case of acute autonomic and sensory neuropathy].

Acute autonomic and sensory neuropathy (AASN) is a rare neuropathy characterized by acute autonomic dysfunction and objective sensory disturbances. A 26-year-old pregnant woman with severe autonomic and sensory dysfunction is reported. This patient suddenly developed marked nausea and vomitting in about 2 days after having a sore throat.

Endoscopic Fibrin Glue Injection with Coaxial Double Lumen Needle for Severe Upper Gastrointestinal Bleeding.

Although endoscopic hemostasis is an effective treatment for acute upper gastrointestinal bleeding, permanent hemostasis may be difficult to achieve by conventional endoscopic treatment alone in some patients. In addition, conventional hemostatic endoscopic therapy is limited in patients with a risk of gastrointestinal ulcer perforation. We tried endoscopic fibrin glue injection in 21 patients as a new approach to control severe upper gastrointestinal bleeding.

[A case of fibromatosis needed reconstruction of the chest wall for postoperative local recurrence].

The case was a sixty-four-year-old female with a history of fibrous tumor in the right supraclavicular and neck region thirty years ago. A fibrous tumor developed in the right pleural cavity and was surgically resected. Since local recurrence occurred, the chest wall was partially resected including the tumor followed by reconstruction with a composite graft.

Japan Clinical Oncology Group (JCOG).

The Japan Clinical Oncology Group (JCOG) is a cooperative oncology group with the aims of conducting, developing, coordinating and stimulating clinical research in Japan on the treatment of cancer and related problems. The purpose of JCOG is to establish and improve the standard of cancer treatment, mainly in solid cancer, through the testing of new therapeutic regimens or combined modalities, using drugs that are newly-approved or already commercially available. Research sponsored by JCOG is accomplished mainly through the execution of large, prospective, randomized, multicenter, clinical trials.

Cerebral black blood MR angiography with the interleaved multi-slab three-dimensional fast spin echo sequence.

To overcome the disadvantages of conventional three-dimensional time-of-flight MR angiography (3D-TOF), such as saturation or intravoxel dephasing, black blood MR angiography (BB-MRA) using an interleaved multi-slab 3D fast spin echo sequence was developed and evaluated clinically. In major branches, the contrast-to-noise ratio of the flow was not as good as 3D-TOF in BB-MRA. However, in-plane slow flow and large aneurysm were visualized better on BB-MRA than on 3D-TOF.

Relationship between brainstem MRI and pathological findings in progressive supranuclear palsy--study in autopsy cases.

The relationship between the features of MRI in brainstem and pathological findings was investigated in eight autopsy cases with progressive supranuclear palsy (PSP). Features of T1-weighted images at midbrain level were atrophy of tegmentum and tectum, and dilatation of aqueduct. Histologically, these findings were consistent with atrophy of periaqueductal gray matter, quadrigeminal plate, and tegmentum.

Broncho-bronchiolitis obliterans as a complication of bone marrow transplantation: a clinicopathological study of eight autopsy cases. Nagoya BMT Group.

We identified eight patients with bronchiolitis obliterans (BO) in the autopsies of 81 bone marrow transplant (BMT) recipients. Rapidly progressive dyspnoea and cough were the main presenting symptoms in all eight patients, associated with overinflation and/or infiltrative opacity seen on chest X-ray and obstructive disorder revealed by pulmonary function tests. Early lesions were characterized by epithelial loss and an inflammatory infiltrate containing foamy histiocytes with mild luminal narrowing.

Relationship between respiratory failure and plasma noradrenaline levels in amyotrophic lateral sclerosis.

We evaluated plasma noradrenaline (NA) levels at test and during head-up tilt test in 20 patients with sporadic amyotrophic lateral sclerosis (ALS). Their fasting plasma NA levels ranged from 195 to 4227 pg/ml. The average plasma NA level was 483 pg/ml in five ambulatory patients, 341 in two wheelchair-bound patients, 1264 in 11 bedridden patients, and 208 in two respirator-dependent patients whose disability grading was the worst among the four groups.

Epithelial hyperplasia of usual type expresses both S100-alpha and S100-beta in a heterogeneous pattern but ductal carcinoma in situ can express only S100-alpha in a monotonous pattern.

Immunohistochemical identification of myoepithelial cells using alpha-smooth muscle actin provides little information about the nature of solid or quasi-solid portions of epithelial hyperplasia and ductal carcinoma in situ (DCIS) because actin-rich myoepithelial cells are usually demonstrated only in the stromal-epithelial junction of both lesions. We studied the differential distribution of alpha-subunit (S100-alpha) and beta-subunit (S100-beta) of S100 protein in actin-negative areas of usual epithelial hyperplasia and DCIS by employing the streptavidin method with monospecific rabbit antibodies against each subunit. All usual epithelial hyperplasias (n = 17) were composed of heterogeneous epithelial cell types; cells expressing S100-alpha and/or S100-beta were intermingled with non-expressing cells, resulting in a mosaic-like pattern.

Achievement of a complete cytogenetic response with hydroxyurea in a patient with chronic myelogenous leukemia.

Hydroxyurea rarely produces a complete cytogenetic remission in patients with chronic myelogenous leukemia (CML). In this report, we describe one case of the CML patient who achieved complete cytogenetic remission (no Ph chromosome in 20-25 metaphase cells) by treatment with hydroxyurea alone. By the fluorescent in situ hybridization (FISH) methodology using bcr/abl specific translocation probe, sequential bone marrow specimens from the patient showed the characteristic 9;22 translocation at a higher rate (9-10%) than the normal control range (2.

[Clinical applications of time-dependent perimetry (10) receptive field properties of glaucoma patients].

The receptive field center of double flash resolution (DFR) and of critical flicker fusion frequency (CFF) in a 3 degrees temporal visual field were examined in 11 normal subjects and 19 glaucoma and ocular hypertension patients. In normal subjects, the mean receptive field center of DFR was 2.17 log min of arc2 and that of CFF was 2.

[Treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type)].

Systemic or topical treatment with antifungal agents are applied for the treatment of chronic pulmonary aspergillosis (fungus ball type, mural thickness type). Recently, the concomitant treatment with elastase inhibitor has been studied for the purpose of relieving tissue destruction by inhibiting elastase derived from aspergillus species. In the present study, we have examined the clinical effect of the topical treatment with Amphotericin B in patients with chronic pulmonary aspergillosis, and the concomitant use of Ulinastatin has also been examined in patients with symptoms such as hemosputum and hemoptysis.

Comparison of resting beta-methyl-iodophenyl pentadecanoic acid (BMIPP) and thallium-201 tomography using quantitative polar maps in patients with unstable angina.

We compared resting beta-methyl-iodophenyl pentadecanoic acid (BMIPP) tomography with resting thallium-201 tomography in 28 patients with unstable angina. Tracer distribution was displayed on a polar map and compared with a normal standard deviation map obtained from a group of 12 normal subjects. The extent scores and severity scores obtained by BMIPP were significantly greater than those obtained by thallium-201.

A case of small cell carcinoma of the stomach.

A case of small cell carcinoma of the stomach is reported. A 53-year-old male was referred to our hospital for elective surgery for gastric cancer. Pre-operative examinations revealed no metastases.

[Introduction of anticancer agents to phase I clinical trials].

Because about half of patients with cancer could not be cured by the present standard therapy, new effective anticancer agents should be developed and introduced at the clinical level. However, there are several important and specific issues from scientific, medical, statistical, and ethical viewpoints in the design and conducting of phase I clinical trials of new anticancer agents. Clinical safety data management is critically important in phase I clinical trials.

The importance of the real-time fluoroscopic intraoperative direct cholangiogram in the laparoscopic cholecystectomy using a new instrument.

Background/aims: Laparoscopic cholecystectomy (LC) has become an accepted standard operative technique for gallstone treatment worldwide. On the other hand, complications, such as bile duct injuries, have been reported recently with the expansion of indication for LC. Intraoperative cholangiogram (IOC), to minimize the risk of bile duct injury, is now considered to be essential for safe LC.

The dual expression of minor and major bcr/abl chimeric mRNA in blast crisis of chronic myelogenous leukemia.

The hypothesis that minor bcr/abl fusion mRNA is produced in blast crisis of chronic myelogenous leukemia (CML) is examined. The RNA transcripts encoding the minor and major bcr/abl fused protein were detected by polymerase chain reaction (PCR) using RNA from peripheral blood or bone marrow cells of eight patients with blast crisis or accelerated phase of CML. The mRNA encoding for major bcr/abl was detected in all eight cases.

[Biology and clinical relevance of multidrug resistance associated antigen].

Multidrug resistance (MDR) is a main obstacle to cancer chemotherapy. P-glycoprotein(P-gp) is the first antigen discovered to be linked to MDR, and is a energy dependent plasma membrane efflux pump, which actively transports a variety of drugs and substances out of cells. P-gp can be detected by immunological or biochemical (molecular) methods, but both methods have some limitations with respect to sensitivity and specificity.

[Recent improvement of mammographic diagnosis].

The improvement of mammographic diagnosis consists of 3 factors as follows; (1) improvement of mammographic apparatus, (2) technical advancement on photographing and reading of mammograms, and (3) correlation between mammographic findings and pathology. Improvement of apparatus was achieved by molybdenum anode and faster single screen combined with a high-speed single-emulsion film combination system. These system provide the dose reduction as only one day reduction of the average future time if anyone take the mammographic screening of breast cancer once a year over 30 years old.

[Usefulness of the prick test for anaphylactoid reaction in intravenous fluorescein administration].

We examined whether a prick test was a valuable method in comparison with an intradermal skin test for predicting an anaphylactoid reaction to intravenous injection of fluorescein solution. Fifteen hundred cases were tested. The number (rate) of positive reactions to the prick test with 10% and 1.