[Choleretic effects of taurine on experimentally-induced intrahepatic cholestasis]

When a lymphokine, the cholestatic factor, is intravenously injected into rats through a mesenteric vein, remarkable reductions in bile flow and bile acid excretion are observed. However when taurine was injected with the cholestatic factor, the reduction in bile flow and bile acid excretion were significantly suppressed. Moreover, injection of taurine with cholestatic factor resulted in the decreases of both bile acid-dependent bile flow and vesicular transport but not bile acid-independent bile flow. Not significant choleretic effects were noted when taurine alone was administered to normal rats.

[Successful treatment of intrapericardial administration of carboplatin in a case of squamous cell lung cancer with malignant pericardial effusion]

A 74-year-old male developed cardiac tamponade due to malignant pericardial effusion six months after he was diagnosed as primary lung cancer. Carboplatin was administered into the pericardial cavity six times with the total dose of 1,100 mg. Pericardial effusion disappeared without severe toxicities and response duration was about three months. Upon recurrence, he was again successfully treated with single intrapericardial administration of 300 mg of carboplatin. He survived for seven months after being diagnosed as cardiac tamponade.

[Intrapleural administration of pirarubicin in the treatment of malignant pleural effusion]

Pirarubicin, a new antineoplastic antibiotic of anthracycline derivative, was injected into the pleural cavity in 15 patients with malignant pleural effusion. The dose of pirarubicin was 40 mg or 80 mg/body. All 15 patients were evaluable for both efficacy and toxicity. Since one evaluable patient received two courses of intrapleural administration of pirarubicin, we evaluated a total of 16 courses. Overall response rate was 81.3% with 7 CR cases, 6 PR cases and 3 NR cases. As toxicities, transient elevation of fever was observed in 81.3%, chest pain in 37.5%, appetite loss in 18.8%, nausea in 12.5% and bone marrow suppression in 6.3% of 16 courses, but no alopecia was observed. Between 40 mg group (n = 8) and 80 mg group (n = 8), no significant difference was observed in response rate, response duration, survival duration or toxicities except for fever. Fever over 38 degrees C was observed in all (100%) the 80 mg group, which was significantly higher than 50% in the 40 mg group. Response duration in cases with fever over 38 degrees C (n = 12) was significantly longer than in cases with maximum fever under 38 degrees C (n = 4). Intrapleural administration of pirarubicin was considered to be effective for the treatment of malignant pleural effusion without severe toxicities.

[Evaluation of carboplatin administration into the serous cavity in the treatment of malignant effusion]

Carboplatin, a new analogue of cisplatin, was administered into the serous cavity in nine primary lung cancer patients with malignant effusion, consisting of six malignant pleural effusions, two malignant pericardial effusions and one malignant ascites. Clinical effects, toxicities and pharmacokinetics were studied. The doses of carboplatin were 300 mg/m2 in seven patients, 200 mg/m2 in one patient and 1,100 mg/body in one patient. In seven evaluable patients, consisting of four non-small cell lung cancers and three small cell lung cancers, the response rate was 85.7% with 3 CR cases, 3 PR cases and 1 NR case. As toxicities, thrombocytopenia was observed in 57.1%, leukopenia in 57.1%, anemia in 71.4%, anorexia in 42.9%, nausea or vomiting in 28.6%, and low grade fever in 14.3%. However local pain, renal or liver dysfunction were not observed. The pharmacokinetics of free platinum concentration was analyzed with a two-compartment model (t1/2 beta = 18.60 hours) and 14.8% of total platinum remained free in effusion 24 hours after intracavitary administration. A high level of free platinum in effusion was maintained over a long period after carboplatin administration. This method was considered to be effective for the treatment of malignant effusion from the viewpoint of pharmacokinetics and less toxicity.

[Syndrome of inappropriate antidiuretic hormone secretion following cisplatinum and vindesine administration in a patient with squamous cell carcinoma of the lung]

We report a patient with squamous cell carcinoma of bronchus who developed the syndrome of inappropriate antidiuretic hormone secretion (SIADH) after receiving cisplatinum (CDDP) and vindesine (VDS). The 75-year-old man developed right chest pain and was found to have a squamous cell carcinoma of bronchus (stage IIIA, T3N1M0). He was treated by CDDP and VDS. The serum sodium concentration decreased from 136 mEq/l to 120 mEq/l after drug administration. SIADH was diagnosed on the basis of hyponatremia with corresponding serum hypoosmolality and an inappropriately high urinary osmolality due to continued sodium excretion. In our case, SI-ADH was probably induced by CDDP or VDS. Fluid restriction and sodium supplement resulted in a progressive rise in the serum sodium level to 134 mEq/l in 4 days.

[A case of disseminated atypical mycobacteriosis with multiple bronchial polyps]

A 55-year-old male was admitted with fever, productive cough and dyspnea for a month. Chest X-ray revealed infiltration in the right lower lung field and right pleural effusion. Cultures of sputum, bone marrow and peripheral blood disclosed mycobacterium avium-intracellulare complex. The specimens of the liver, gallbladder wall and mesenterium obtained on cholecystectomy revealed epithelioid granulomas. Fifteen months after the admission, bronchoscopic finding showed a pedunculated polyp in the right main bronchus, and three other bronchial polyps in the truncus intermedius, right basal bronchus and B6. These bronchial lesions improved with combination chemotherapy containing cycloserine (CS) and other antituberculosis drugs. He was discharged 36 months after the admission. Perforation of the involved hilar lymph-nodes was considered to play an important role in the development of the multiple bronchial polyps. Cases of disseminated atypical mycobacteriosis accompanied with multiple bronchial polyps are extremely rare.

Accumulation of technetium-99m MDP in pseudomyxoma peritonei

An ovarian mucinous cystadenocarcinoma which moderately accumulated Tc-99m MDP was imaged during a whole body bone scan. The primary tumor and its implants in the peritoneal cavity were both visualized and correlated with US and TCT scan findings. As a result, the radiopharmaceutical distribution accurately delineated the primary tumor and the region of tumor involvement within the peritoneal cavity. Therefore, a whole body bone scan offers a potential method for assessing neoplastic size and spread.

[Hereditary stomatocytosis of the hydrocytosis type: a report of one family and red cell membrane studies]

A case of hereditary stomatocytosis with hemolytic anemia, increased autohemolysis, increased osmotic fragility, and shortened erythrocyte survival is reported. The erythrocytes were abnormally permeable to sodium and potassium; the sodium concentration of the erythrocytes was high, and the potassium level was low. This case was different from the first reported Japanese case of hereditary stomatocytosis of the hydrocytosis type in the Na(+)-K+ ATPase and Mg+ ATPase activity. In the first reported Japanese case, these activities were within normal limits, but in this case, they were increased. The findings indicate that membrane transport in hereditary stomatocytosis of the hydrocytosis type may vary from case to case.

[A case report of widely recurrent carcinoid tumor of the thymus]

We performed wide resection of recurrent carcinoid tumor of thymus. A 62-year-old male patient admitted to our department because of swelling of anterior chest wall. He had received extirpation of thymic carcinoid tumor 5 years ago and he was pointed out large mass formation in anterior mediastinum before admission. Wide resection of tumor including pericardium, chest wall, left lung and left brachiocephalic vein was performed. Left brachiocephalic vein was reconstructed and pericardium was replaced with Gore-Tex patch. The carcinoid tumor of thymus sometimes invade to adjacent organs and is apt to recur long time after first operation.

[Three cases of endobronchial hamartoma]

We reported three cases of endobronchial hamartoma. There were some difficulties in diagnosis of the disease by bronchoscopic examination, because the tumors were covered with normal bronchial epithelium. But X ray film and CT film contributed to the diagnosis when calcification of intra-bronchial tumor was observed. Three different modes of operation were performed as extirpation of tumor by wedge resection of upper lobe bronchus, sleeve resection of left S6 segmental bronchus, and right middle lobectomy.

[Multilocular epidermoid cyst of the spleen--report of a case observed with an electron microscope]

A 27-year-old female, complaining of left hypochondralgia, underwent a splenectomy and a partial pancreatectomy. The spleen, 18.5 x 14 x 6 cm in size and weighing 1060 g., was occupied by a large multicystic mass. The cystic cavities contained turbid chocolate-colored fluid or a yellowish creamy substance. The cysts varied in size and were lined by stratified squamous epithelium. By means of an electron microscope, a few Langer hans cells were seen in the stratified squamous epithelium, but melanocytes and Merkel cells were not noticed. Twenty-eight cases of splenic epidermoid cysts reported in Japan are briefly reviewed.

New streptothricin-group antibiotics, AN-201 I, II and III. II. Chemical structures

The new, belonging to the streptothricin-group antibiotics AN-201 I, II and III were found to be produced by a soil actinomycete identified as Streptomyces nojiriensis C-13. The chemical structures and the physical and spectroscopic properties of these compounds are reported here. On the basis of NMR and fast atom bombardment mass spectrometry (FAB-MS) spectra the antibiotics were identified as N beta-acetylated derivatives of streptothricins E, D and F.

A trial of semiquantitative analysis of whole body bone scintigraphy in renal osteodystrophy

Four color processed whole body bone scintigraphy with 99mTc-methylene diphosphonate was performed in six patients on maintenance hemodialysis, and the results of semiquantitative colorimetric analysis were compared with those of a normal group. The difference between the two (control and patient group) was statistically significant (P less than 0.01). Furthermore, the effect of 1 alpha-hydroxyvitamin D3 treatment on renal osteodystrophy was evaluated by this method. The results indicated that this method provides a useful method for assessing the response of renal osteodystrophy to treatment. Two representative cases of renal osteodystrophy are presented to illustrate the usefulness of this approach to semiquantitative whole body bone scanning.

Myocardial and vascular uptake of a bone tracer associated with secondary hyperparathyroidism

A patient on chronic hemodialysis, with secondary hyperparathyroidism was referred for a radionuclide bone-imaging study. Deposition of 99mTc-methylene diphosphonate (99mTc-MDP) was apparent in the myocardium and abdominal blood vessels, as well as in the skeleton by four-color processed scintigraphy. Plain radiographs of the chest and abdomen demonstrated no calcification in the myocardium or abdominal blood vessels. Several possible mechanism for this uptake are discussed briefly.

Accumulation of 111In-bleomycin in metastatic lesions from carcinoma of the uterine cervix and the ovary

Cases are presented in which 111In-bleomycin accumulated in Virchow's gland metastasis from squamous cell carcinoma of the uterine cervix, and in paratracheal lymphatic gland metastasis from embryonal carcinoma of the right ovary. Thus, this radiopharmaceutical was found to be of great use for assessment of metastatic lesions from malignant tumors.

Preoperative scintigraphic evaluation of the location of juxtaglomerular cell tumor

Juxtaglomerular cell tumor is a rare condition which cannot be correctly diagnosed preoperatively. In the only previously reported case in which scintigraphy has been used, this method failed to detect the tumor. We present a case of juxtaglomerular cell tumor in which renal scintigraphy revealed a well-defined cold area in the hilar region of the left kidney.

Demonstration of collateral pathways in superior vena cava syndrome by means of radionuclide venography

Radionuclide venography was used to study lesions producing obstruction in the superior vena caval system. This procedure is a simple and safe diagnostic method; it offers precise information regarding the site and degree of venous obstruction and the extent of the collaterals. It is useful not only in diagnosis, but also in radiotherapy planning and follow-up evaluation.