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We analyzed 4 cases who experienced extravasation of anthracyclines and had dexrazoxane therapy in our hospital. Concerned drugs were 2 adriamycin and 2 amrubicin cases and all cases received steroid ointment therapy, and no cases showed severe condition such as skin ulcer. As dexrazoxane is known to enhance bone marrow suppression of anti-cancer drugs, the nadir of neutropenia and thrombocytopenia was observed from day 10 to 17 in our cases. We made a domestic manual and have used in various professionals. Dexrazoxane would contribute to the reduction of skin damage due to extravasation if we could manage bone marrow suppression successfully.

Adequate preoperative planning may facilitate successful procedures in cardiovascular surgery. We have developed a system named the Vesalius 3D suite, combining three-dimensional (3D) image-processing software with an optic-tracking spatial navigation, allowing quick, accessible 3D image interpretation for virtual reality (VR) exploration and measurement from one or more of a range of imaging modalities. We present a novel method of virtual imaging analysis for preoperative planning and simulation in cardiovascular surgery using this 3D-VR system. Based on unimodal or multimodal medical imaging data, digital imaging and communication in medicine (DICOM) data sets can be reconstructed for 3D visualization. Virtually reconstructed images can be viewed on flat-screen or stereoscopic display, revealing each patient's specific anatomy and the internal structures in exquisite detail. Highly accessible 3D interpretation promptly permits precise measurements of repair-relevant anatomical parameters including geometrically complex shapes. This technology may promote understanding of form and function in the cardiovascular system, and facilitate operative procedures in more challenging cases, and it seems especially valuable for any surgeon to gain experience in practicing for rarely-performed procedures or uncommon patient-specific preoperative surgical rehearsal.

Abemaciclib is a selective cyclin-dependent kinase(CDK)4 & 6 inhibitor, which induces G1 cell cycle arrest and tumour growth inhibition. Abemaciclib has been developed for use in hormone receptor positive(HR+)breast cancer, dosed daily in combination with endocrine therapy. In a phase Ⅲ clinical trial, MONARCH 2, for women with HR+ and human epidermal growth factor receptor 2 negative(HER2-)advanced breast cancer who progressed after endocrine therapy, abemaciclib in combination with fulvestrant significantly improved not only progression-free survival and objective response rate but also overall survival, and demonstrated a tolerable safety profile. Another phase Ⅲ clinical trial, MONARCH 3, for women with HR+ and HER2- advanced breast cancer, abemaciclib in combination with nonsteroidal aromatase inhibitor as an initial therapy also significantly improved progression-free survival and objective response rate. This review presents the rationale for the use of CDK4 & 6 inhibitors in the treatment of breast cancer, background on the development of abemaciclib, clinical data focusing on phase Ⅲ studies of abemaciclib, and information on ongoing clinical studies of abemaciclib.

We evaluated the incidence of proteinuria after receiving ramucirumab for the patients with advanced colorectal cancer using claim database. Among 1,706 evaluable patients, incidence proportion of proteinuria was 21.8% and incidence rate (/100 person-years)was 75.3. In patients with history of proteinuria or previous bevacizumab use, incidence rate was high and many patients tend to occur proteinuria in the early stage after initiating ramucirumab prescription. Appropriate management by periodical monitoring from the early stage after initiating ramucirumab prescription is important.

A 50-year-old woman was diagnosed as having pancreatic head cancer with multiple hepatic metastases. FOLFIRINOX therapy was initiated. After completing 18 courses of therapy, partial remission(PR)was achieved based on images, and surgery was then planed. The subtotal stomach-preserving pancreaticoduodenectomy and hepatic S7 partial resection were performed. Macroscopically, complete resection was achieved. Regarding pathological findings of the primary lesion and hepatic metastatic lesions, fibrous formation and hyalinizing condition induced by chemotherapy were noted; moreover, complete disappearance of cancer cells was detected. However, metastasis of poorly differentiated adenocarcinoma was detected in 12b lymph node tissue. One month after the surgery, postoperative adjunctive chemotherapy with S-1 was initiated. However, new hepatic metastasis was detected 3 months after the surgery. Although recurrence treatment was initiated, the disease progressed, and the patient died 11 months after the surgery.

Spinal muscular atrophy (SMA) is a common autosomal recessive disorder, caused by homozygous deletion of the survival motor neuron gene 1 (SMN1). SMN2, a gene highly homologous to SMN1, is considered to influence the severity of SMA. Patients with SMA have been classified into three types on the basis of age at onset and clinical severity. In the present study, we performed a quantitative analysis of SMN2 in 22 patients of SMA to further clarify the correlation between clinical severity and SMN2 gene dosage. We determined the SMN2 gene copy number based on real-time PCR. In 3 Type I patients with only one SMN2 copy, the clinical phenotype was the severest. The remaining 14 Type I patients had two or three copies of the SMN2 gene, and showed a variable clinical severity. A patient with 3 copies required artificial ventilation at 2 months old. Five Type II and Type III patients had at least 4 copies of the SMN2 gene. Although the SMN2 gene dosage correlates the clinical severity, the mechanism by which SMN2 shows compensation in some Type I patients remains to be determined.

The pathogenesis of the influenza and Sendai viruses is primarily determined by host cellular trypsin-type processing proteases that activate viral fusion activity and infectivity. We isolated three secretory trypsin-type proteases from rat lungs, such as tryptase Clara, mini-plasmin, and ectopic anionic trypsin, candidates for the processing proteases of viral envelope glycoproteins. These enzymes specifically cleave the precursor of fusion glycoprotein hemagglutinin (HA) of influenza virus at Arg(325) and the F(0) of Sendai virus at Arg(116) in the consensus cleavage motif, Gln(Glu)-X-Arg, resulting in the induction of infectivity of these viruses. These proteases show different localization in the airway and susceptibility for the processing of various subtypes of influenza virus HA, suggesting that these processing proteases determine the viral pathogenicity. Influenza virus readily infects and replicates in the airway epithelial cells but occasionally replicates in the central nervous system, particularly in children below 5-6 years of age and Reye's syndrome patients. We found an invasion by a non-neurovirulent influenza virus in cerebral capillaries with progressive brain edema of mice having impaired mitochondrial fatty acid metabolism congenitally or posteriorly in the newborn period. In the brain of these mice, mini-plasmin, which potentiates viral-multiplication in vivo and destroys the blood-brain barrier, accumulated with virus antigen in the brain capillaries but only a little in the control mice without impaired mitochondrial fatty acid metabolism.

Objective: To study the effect of taurine on liver fibrosis and its mechanism., Methods: Fibrosis was induced by the administration of carbon tertrachloride(CCl4) in rats. Some of the animals were treated with taurine. The rats were killed after 12 weeks of CCl4 treatment. Depositions of type I, III and IV collages, laminin and hyaluronic acid were studied in liver sections by immunohistochemical technique using specific antibody. The hepatic contents of type I, III procollage and tissue inhibitor of metalloproteinase-1(TIMP-1) mRNA were determined by Northern blot hybridization., Results: A significant elevations of hepatic collagen I, III, IV, laminin and hyaluronic acid were observed after 12 weeks of liver injury in animals without taurine treatment, and a definite increase in the amounts of hepatic type I, III procollagen and TIMP-1 mRNA was noted. Taurine prevented increases in type I, III procollagen mRNA expression as well as the accumulation of the collagens, laminin and hyaluronic acid in the liver., Conclusion: The data indicate that taurine has a protective effect in CCl4-induced hepatic fibrosis. The results suggest taurine might be of potential value in clinical practice.

A 8-year-old male with Wiskott-Aldrich syndrome was admitted to our hospital because of left hilar swelling on a chest roentgeonogram. Bronchofiberscopy and transbronchial aspiration cytology (TBAC) was performed under general anesthesia with a laryngeal mask. The specimen obtained by TBAC was immediately stained and diagnosed as malignant lymphoma. One month later, thoracotomy was performed in order to get more detail diagnosis, which is necessary to determine the regimen of chemotherapy, and the nodal specimen were diagnosed as Hodgkin's disease. The ABVD therapy was performed which induced the complete remission. The laryngeal mask is a useful device for bronchofiberscopy in children.

A total of 114 pT4 patients underwent pulmonary resection from January 1980 to December 1993 at our hospital. The overall five-year survival rate of the 114 cases was 17%. There was no significance between the five-year survival rate of squamous cell carcinoma and that of adenocarcinoma. Five-year survival rates of 17 patients with N0 disease, 29 patients with N1 disease, 51 patients with N2 disease, 1 patients with N3 disease, and 16 patients with NX disease were 40%, 21%, 21%, 0%, and 0%, respectively. Five-year survival rate of 89 cases with single factor of T4 was 24% and that of 25 cases with more than one factor was 4% (0.05 < P < 0.1). In the patients with only single factor of T4, five-year survival rates of 6 patients with left atrium invasion, 13 patients with major vessel invasion, 9 patients with trachea/carina invasion, and 18 patients with vertebral body, were 50%, 38%, 22%, and 0%, respectively. Furthermore, in 38 pT4 patients with involvement only to single adjacent structure, five-year survival rates were 47% in curative operation (n = 17) and 10% in non-curative operation (n = 21) (P < 0.05). We conclude that surgical treatment for T4 lung cancer should be performed to patients with single structure invasion which is expected to have a curative operation. N0 disease is more favorable than N1 or N2 disease.

Tc(V)-99m DMS, developed by Yokoyama et al. in 1981, has been recognized to be advantageous for the scintigraphic diagnosis of various malignant tumors and their metastasis, the aim of this study is to assess the in-vitro stability of Tc(V)-99m DMS. Thin-layer chromatography, including paper chromatography and silica gel thin layer chromatography, is performed to determine the change of radiochemical species presented in the reconstituted solution of Tc(V)-99m DMS prepared from the DMS kit (Institute of Nuclear Energy Research, Atomic Energy Council R.O.C.) and the commercial DMSA kit (Nephroscint, IRE CELLTARG Radiopharmaceuticals Japan). The bioscan imaging scanner is used to measure the Rf value and labeling efficiency of radiochemical species on the chromatographic strip. The in-vitro stability of Tc(V)-99m DMS prepared from the DMS kit and the commercial DMSA kit is studied by examining various parameters which include temperature(degree C) and time(hr) after reconstitution. The results show that the in-vitro stability of Tc(V)-99m DMS prepared from the DMS kit is actually better than that from the commercial DMSA kit. The one-step labeling method of DMS kit is much simpler than the two-step labeling method of DMSA kit.

Results of surgical treatment for 33 intrathoracic recurrence after complete resection of non-small cell lung cancer were analyzed. Prognosis of the second surgical treatment were favorable in patients with subsequent cancer with in situ component and solitary lesion in lung parenchyma. Retrospective study of 53 patients who recurred and were thoroughly followed up their clinical course until lung cancer death revealed that the solitary one tends to be confined to the intrathoracic location, and the multiple one did not confined to the intrathoracic location but also extended to the extrathoracic distant metastasis or to the supraclavicular lymph nodes.

60 patients (except parturients) suffering from shivering after receiving epidural anesthesia were randomly divided into 2 equal groups. In order to evaluate the effect of Tramadol on the shivering, i.v. Tramadol (1 mg/Kg), in contrast to distilled water (20 ml) for the control group, was administered to the patients in the experimental group. We compared the arrest time between the two groups in addition to systolic blood pressure, diastolic blood pressure, heart rate, arterial O2 saturation, respiratory rate and body surface temperature. Furthermore, the degree of shivering was also compared sequentially. The systolic pressure of the control group declined significantly in the first 30 minutes (P < 0.05). The other data, including the diastolic pressure, heart rate, arterial O2 saturation, respiratory rate and body surface temperature, showed no significant difference (P > 0.05). The arrest time in the experimental group was 179 +/- 71.25 seconds in contrast to 2790 +/- 440.23 seconds in the control group, a large significant difference (P < 0.001). 10% of the patients in the experimental group experienced nausea or vomiting and 6.67% of the patients showed sedation which did not disturb consciousness level of psychomotor status. Since the exact mechanism of shivering during epidural anesthesia is not established, we sincerely hope more information about the effect to Tramadol on shivering can be uncovered.

Unlabelled: This research was to analyze 1814 cases visited from January 1992 to December 1993 with respect to the characteristics and therapeutic effect of pain treatment in the pain clinic of Kaohsiung Government Employees' Clinic Center. The results were as follows: 1. Age level of patients ranged from 17 to 90 years old. The biggest group was of the old age group (956 cases, 52.7%). 2. Diagnostically, joint pain was the largest complain (602 cases, 33.2%). It was followed by spondylosis/spondylolithesis (324 cases, 17.9%) and myofascial pain syndrome (228 cases, 12.6%). There were 180 cases (9.9%) with two or more combined chronic pain syndrome. 3. Relationship between age and chronic pain: Old people were mostly suffered with osteoarthritis, spondylosis/spondylolithesis and post-herpetic neuralgia. Middle age people mainly had frozen shoulder, gouty arthritis and myofascial pain syndrome. Tendinitis and tension headache often occurred in young people. 4. Pre-treatment pain intensity: Most patients has Visual Analogue Scale of 7 to 8 (1622 cases, 89.4%). 5., Therapeutic Methods: Medication was mainly given to most of the patients. Some patients received nerve block (582 cases, 32.1%) and/or rehabilitation (389 cases, 21.4%). 6. Therapeutic effect was expressed by pain relief. Most patients felt moderate (708 cases, 39.0%) and almost complete pain relief (559 cases, 30.8%)., Conclusion: Chronic pain could occurred in any age group. The kinds of chronic pain syndrome were prone to different age groups. Chronic pain patients could get good therapeutic effect if they cooperated with the doctor.(ABSTRACT TRUNCATED AT 250 WORDS)

A total of 65 resected cases with primary lung cancer were examined on correlation between nuclear DNA content by flow cytometry and other prognostic factors, including tumor doubling time (DT). 1) DNA diploidy was found in 18 cases (28%) and DNA aneuploidy in 47 cases (72%). Percent aneuploidy was 79.5% in cases with adenocarcinoma, which tended to be higher than that in cases with squamous cell carcinoma (57.1%). 2) Percent aneuploidy in cases with advanced carcinomas tended to be higher than that in cases with earlier carcinomas, and percent aneuploidy in cases with rapid growing carcinomas tended to be higher than that in cases with slow growing carcinomas. 3) The geometric mean of DT of DNA aneuploid tumor was 130.0 day, which tended to be shorter than that of DNA diploid tumor (171.9 days), but the difference was not significant. There was not a significant correlation between DT and DNA Index. 4) The five-year survival rate of 47 patients with DNA aneuploid tumor was 45%, which was significantly lower than that of 18 patients with DNA diploid tumor (78%).

When regenerating from an injury, fluid containing nerve growth-promoting components such as the nerve growth factor (NGF) will accumulate around the stump of a cut nerve within 24 hours. It has been found that this fluid also contains fibrin. To evaluate the effect of fibrin on nerve regeneration, we cut both facial nerves of 40 guinea pigs and sutured both ends of the nerve stumps to silicone tubes. The distance between the stumps were kept at around 8 mm in the silicone chamber. Autogenous fibrin isolated from the blood of each guinea pig was injected into the silicone chamber on the left side, while lactate Ringer's solution was injected into the silicone chamber on the right side as a control. The status of nerve regeneration in both sides of the silicone chambers were later evaluated at 3 and 5 weeks. Histological study revealed that after regeneration for 3 weeks, the total axon number and the fascicular number increased significantly in the fibrin-filled chamber. However, after 5 weeks, there was no significant difference in nerve regeneration between the two groups.

"The mortality rates and causes of death among elderly people aged sixty five and over were compared between China and Japan. The data used for comparison was China's 1990 and Japan's 1990 vital statistics. It appears that the mortality rate in China was higher than Japan. Comparing the causes of death, it was found that the death rates involving cerebrovascular diseases, malignant neoplasms and heart diseases in urban districts of China [were] higher than those in Japan. Also the death rate of people with bronchitis in rural districts was significantly higher in China.... The differences in the medical systems and life styles in China and Japan were suspected as the reasons for the differences of death rates and causes of death...." (SUMMARY IN ENG), (excerpt)

Biological activities of the 50% ethanolic extract of Kijitsu, dried immature Citrus fruits prepared from C. hassaku Hort. ex Tanaka (H), C. natsudaidai Hayata (N) or allied plants (T, A) were observed. Weak toxicities, weak intestine or uterine relaxant activities, beta-adrenergic activities were shown by in vitro experiments and antiasthmatic activity by intraperitoneal administration. These activities among each extract did not differ. The content of flavonoids (narirutin, naringin hesperidin, neohesperidin) or synephrine did not show much difference among the four dried immature Citrus fruits. These results suggest that H can be used for medicine as the substitute for N, T or A which has been commonly used as Kijitsu. This method is generally applicable to the proof of the biological equivalency of the crude drug and its substitutes.

Neonatal mice within 24 h of birth were highly susceptible to infection of Listeria monocytogenes. The 50% lethal dose of bacterial cells for neonates and adult mice was 6.3 X 10(1) CFU and 3.2 x 10(6) CFU, respectively. A single intraperitoneal injection of recombinant murine interferon-gamma (rMuIFN-gamma) protected neonates from the simultaneous challenge with a lethal dose of L. monocytogenes. The protection of rMuIFN-gamma was consistently observed in neonates at doses more than 4 X 10(2) IU (0.1 micrograms protein) per mouse. The bacterial growth in the spleens and livers of neonates treated with rMuIFN-gamma was significantly suppressed in comparison with that in the untreated neonates. Furthermore, survived neonates from the infection with L. monocytogenes showed an acquired resistance against the intravenous injection of lethal dose of L. monocytogenes 4 weeks after the primary infection, and this resistance significantly increased in mice that had been treated with rMuIFN-gamma. In addition to rMuIFN-gamma, recombinant human interleukin-1 beta and recombinant human tumor necrosis factor -alpha were also effective on rescue from the lethal infection with Listeria monocytogenes in neonatal mice, but the effect was seen only in the limited doses. On the other hand, recombinant murine IFN-beta and recombinant human IL-2 were not effective at all. These results suggest that rMuIFN-gamma rather than other cytokines might endow neonatal mice with the enhanced antilisterial resistance involving macrophages and T lymphocytes.

The in vitro and in vivo cultivation of horseshoe crab amebocytes is studied. Partial bleeding promotes the proliferation of horseshoe crab amebocytes, and could be a useful method for amebocyte production in vivo. The optimal conditions of in vitro cultivation of amebocytes were incubation at 15 degrees C and pH delta 6.8-7.2. The best medium was the hemolymph of the horseshoe crab. Measuring DNA synthesis of amebocytes by 3H-thymidine uptake showed that no proliferation of amebocytes occurs during in vitro cultivation. Because some protozoa were found in the hemolymph, primaquine, quinine, pyrimethamine and metronidazole were used in the culture medium. Primaquine and metronidazole have a protozoacidal effect on the protozoa parasitising in the horseshoe crab.