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Partial Seizures Associated with Cisplatin Administration: A Case Report A 49-year-old man was treated with cisplatin and pirarubicin for tongue cancer. After the second course of chemotherapy, partial seizures including transient motor aphasia, tonic finger movement, and loss of consciousness were observed. The EEG showed frequent diffuse (multiple) spike and slow wave discharges. Following the administration of carbamazepine and diazepam, no seizures occurred and no paroxysmal discharges were observed on EEGs. We conclude that carbamazepine and diazepam administration was effective.

Information processing deficits characteristic of remitted major depression, which may be a vulnerability marker for the disease, were examined from two aspects by means of visual event-related potentials (ERPs) obtained during simple and discriminative response tasks: 1. To clarify the difference in cognitive dysfunction between both depressives and schizophrenics in remission, we compared the ERPs in remitted depressive patients (n = 11) and remitted schizophrenic patients (n = 9) with those of age, and sex-matched controls (n = 10). 2. To clarify the influence of aging on information processing in remitted depression, ERPs in young remitted depressives (20-46 years old, n = 11) were compared with those in older remitted depressives (52-75 years old, n = 11) in contrast to young (n = 10) and older (n = 11) controls. The remitted schizophrenics showed a retardation in NA and N2 latencies and a reduction in P3 amplitude. However, P1 increased in amplitude exclusively in the remitted depressives. The effect of stimulus discrimination on N1 seen in the controls was absent in both patient groups. The results suggest that the remitted depressives had an attentional deficit in early information processing reflected on P1 and N1 potentials, while the remitted schizophrenics had an extensive cognitive dysfunction reflected on N1, NA, N2, and P3 potentials. Although the effect of stimulus discrimination on N1 was absent in both young and older remitted depressive patients, older patients showed no effects of normal aging on ERPs such as P1 increase or N1 increase during discrimination tasks. Significant interaction effects between diagnosis and aging were found by ANOVA only in the laterality of the P1 amplitude. Older remitted depressives showed an unbalanced right-predominance in P1 amplitude. These results suggest that older remitted depressives had the same early information-processing deficit seen in the young remitted depressives as well as an overactivation over the right hemisphere in the attentional mechanism, irrespective of normal aging.

The coincidence rate of cancer and PSS has been increasing according to reports from Nippon Byori Boken Shuho (Annual of Pathological Autopsy Cases in Japan), reaching 12.3% in the most recent report. Therefore we reviewed the histories of 67 PSS patients seen at our division over an 18-year period between 1974 and 1992, and found a high coincidence rate (14.6%) of cancer, reflecting the increasing tendency reported in the Nippon Byori Boken Shuho. The most frequent type of cancer was gastrointestinal cancer, including gastric and colon cancer and duodenal carcinoid. There were no significant differences in the clinical and laboratory findings between PSS patients with cancer and those without. Twenty-six of the 67 PSS patients died. Cancer was the cause of death in four, ranking second behind respiratory failure. The reason for the increasing coincidence rate of cancer and PSS is unclear at present. However, it is very important to discover cancer in PSS patients as early as possible, since it has a marked effect on prognosis.

A 55-year-old woman was admitted to our hospital, complaining of general malaise, muscular weakness, anorexia and weight loss. She had a history of ingesting of a certain germanium (Ge) compound over the preceding 19 months, with a total dose of 47 g as Ge element. She was found to have renal failure (blood urea nitrogen, 44 mg/dl; serum creatinine, 2.6 mg/dl) without abnormal findings in urinalysis, and muscular and nervous damage. Initially, polymyositis was diagnosed and prednisolone administered. However, no improvement was seen, and neuromuscular symptoms and signs steadily worsened, ending in death. Microscopic study of the kidney showed that lipofuscin granules increased in the cells of the thick ascending limb of Henle's loop to the distal convoluted tubule accompanying mild tubular atrophy and that some of the tubules of these segments had vacuolar degeneration or desquamation. No apparent glomerular and vascular changes were observed. High Ge content was found in serum, urine and various tissues, e.g., spleen, liver, kidney, adrenal gland and myocardium, while in controls Ge could not be detected in sera, urine or tissues. We also review case reports about Ge toxicity, and discuss the pathogenesis of renal failure induced by Ge compounds.

Two cases of gastric cancer were treated with immunochemotherapy using Tegafur and Schizophyllan. In one case, a marked reduction in the size of metastatic liver tumor and disappearance of most subjective symptoms were observed. The response continued even 8 months after the initial treatment. In the other case, no marked symptoms except occasional dysphagis have been noted for 2 years and 2 months since diagnosis, although the primary tumor size has remained unchanged. Thus, it is presumed that the combined immunochemotherapy regimen may be useful in the treatment of advanced gastric cancer.

This report describes cardiac angiosarcoma in a 62-year-old man. The patient presented with metastatic pulmonary and extradural spinal cord tumors of unknown origin. During the course, he developed hypoxemia, gastrointestinal bleeding, thrombocytopenia, and microangiopathic hemolytic anemia. Anticancer therapy could not be initiated because of his poor general condition, and he died. Autopsy revealed angiosarcoma in the right atrium. Metastases were found in the lungs, liver, adrenals, gingiva and vertebrae. The various hematologic abnormalities were probably the result of aberrant hemodynamics caused by the presence of a large amount of neoplastic vascular tissue.