Treatment modalities and risk factors associated with refractory neurosensory disturbances of the inferior alveolar nerve following oral surgery: a multicentre retrospective study.

Little research has been conducted into hypoesthesia, and no studies have elucidated the risk factors for refractory hypoesthesia and compared treatment modalities. The purpose of this multicentre retrospective cohort study was to investigate the relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Risk factors for refractory hypoesthesia after oral surgery were evaluated using univariate and multivariate analysis. To minimize the selection bias associated with a retrospective data analysis, a propensity score analysis was performed between the medication and non-medication groups (65 sites in each group). Moderate or severe hypoesthesia (odds ratio 13.42) and no or late administration of ATP/vitamin B12 (odds ratio 2.28) were significantly associated with refractory hypoesthesia. In the propensity score analysis, the incidence rate of refractory hypoesthesia in the medication group was lower than that in the non-medication group (P<0.001). This study demonstrated the multivariate relationships between various risk factors, treatment modalities, and refractory hypoesthesia. Moderate or severe hypoesthesia and no or late administration of ATP/vitamin B12 were significantly associated with refractory hypoesthesia. Therefore, clinicians should consider these risk factors and initiate early oral administration of ATP/vitamin B12 in cases of hypoesthesia.

Spontaneously complete regression of pseudolymphoma of the remnant pancreas after pancreaticoduodenectomy.

BACKGROUND: Pancreatic pseudolymphoma is extremely rare. METHOD: We present multiple pseudolymphomas in the head and body of the pancreas. The hypoechoic lesions observed by endoscopic ultrasound were enhanced in late-phase angio-computed tomography and homogeneously hypointensive in T1-weighted magnetic resonance imaging (MRI). (18)F-fluorodeoxyglucose positron emission tomography showed strong accumulation in the lesions. The lesions were suspected to be non-functioning islet cell carcinoma. The intraoperative pathological diagnosis for the specimen obtained by a pylorus-preserving pancreaticoduodenectomy was non-neoplastic lymphoid cells. The remnant lesion in the pancreatic body was preserved. RESULTS: Macroscopically, the mass was well-circumscribed gray-white colored lesion. The pathological diagnosis was pancreatic pseudolymphoma. The lesion in the remnant pancreas spontaneously disappeared within one year after the operation. CONCLUSION: The differential diagnosis of pancreatic pseudolymphoma from malignant tumor is very difficult, however, the image findings demonstrated here may be informative. The spontaneous disappearance of pancreatic pseudolymphoma was firstly observed in the present case.

Improving the quality of miniature pig somatic cell nuclear transfer blastocysts: aggregation of SCNT embryos at the four-cell stage.

Miniature pigs share many similar characteristics such as anatomy, physiology and body size with humans and are expected to become important animal models for therapeutic cloning using embryonic stem cells (ESCs) derived by somatic cell nuclear transfer (SCNT). In the present study, we observed that miniature pig SCNT blastocysts possessed a lower total number of nuclei and a lower percentage of POU5F1-positive cells than those possessed by in vitro fertilized (IVF) blastocysts. To overcome these problems, we evaluated the applicability of aggregating miniature pig SCNT embryos at the four-cell stage. We showed that (i) aggregation of two or three miniature pig SCNT embryos at the four-cell stage improves the total number of nuclei and the percentage of POU5F1-positive cells in blastocysts, and (ii) IVF blastocysts with low cell numbers induced by the removal of two blastomeres at the four-cell stage did not exhibit a decrease in the percentage of POU5F1-positive cells. These results suggest that the aggregation of miniature pig SCNT embryos at the four-cell stage can be a useful technique for improving the quality of miniature pig SCNT blastocysts and indicating that improvement in the percentage of POU5F1-positive cells in aggregated SCNT embryos is not simply the consequence of increased cell numbers.

Comparison of clinicopathological characteristics of curatively resected pancreatic head and body/tail ductal cancers.

Few studies exist comparing the clinicopathological features between resectable pancreatic head (Ph) and body/tail ductal cancer (Pbt). Eighty consecutive patients with resectable tumors (Ph-56, Pbt-24) were analyzed. Tumor size was the only significant difference in clinicopathological factors between Ph and Pbt (Ph

Biodistribution of trace elements in normal, aluminum-overloaded and cadmium-overloaded mice. An application of the radioactive multitracer technique.

The radioactive multitracer technique was applied to simultaneous evaluation of biobehavior of many trace elements in normal, Al-overloaded and Cd-overloaded mice. The tissue and subcellular distributions of Be, Sc, V, Mn, Fe, Co, Zn, As, Se, Rb, Sr, Y, Zr, Ru, and Rh were examined by using a multitracer solution, prepared from an Ag target irradiated with heavy ions, in 9 organs (brain, cardiac muscle, lung, liver, spleen, pancreas, kidney, skeletal muscle, and bone) and blood. Their tissue and subcellular distributions were evaluated by gamma-ray spectrometry in terms of tissue uptake rate (the radioactivity percentage of injected dose per gram of tissue, percent of dose/g) and fractionation percentage (the radioactivity percentage of nuclear fraction, mitochondrial fraction, microsomal fraction or supernatant fraction, percent), respectively. Comparative biobehavior of these elements in brain and liver is reported. Aluminium- and Cd-induced synergistic interactions were observed among these trace elements in their liver uptake behavior.

Monozygotic twin patients with congenital ichthyosis, microcephalus, spastic quadriplegia, myoclonus, and EEG abnormalities.

A pair of monozygotic twins manifested widespread ichthyosis on the trunk and extremities, mainly on the extensor surface of the lower legs. Both patients had severe developmental retardation, microcephalus, spastic quadriplegia, myoclonus, and hearing impairment. Cranial computed tomography and magnetic resonance imaging revealed diffuse cortical atrophy. Electroencephalography documented diffuse slow wave dysrhythmia and marked epileptic discharges, namely bilateral occipital dominant, and low-voltage multifocal spikes which appeared asynchronously as a burst, mainly during sleep. Skin biopsy revealed hyperkeratosis with parakeratosis. Granular cell layer was not thickened and diminished. Papillomatosis was absent. Electron microscopy did not reveal any distinctive abnormalities. Sjögren-Larsson syndrome and other known ichthyosis syndromes were excluded because of the difference in localization of skin lesions, skin manifestations, lack of papillomatosis, the nature and severity of neurologic symptoms and marked electroencephalographic abnormalities.

Bilateral intrahepatic lithiasis without extrahepatic bile duct stones.

Bilateral intrahepatic lithiasis is a rare condition, and for this reason a nationwide survey was conducted. Reports on 675 patients with bilateral intrahepatic lithiasis over a 10-year-period were collected. Among these, 258 patients with bilateral intrahepatic lithiasis having no extrahepatic bile duct stones were analyzed. The peak incidence was seen in the fourth to sixth decades. Males and females were equally effected. The stones removed were mainly calcium bilirubinate stones (75.6%). The main clinical symptoms were abdominal pain, fever and jaundice. Charcot's triad was seen in 29.7%, while 12.4% of the patients had no symptoms. Visualization of each segmental duct of the liver by direct cholangiography was excellent in this survey and ranged from 88 to 97.3% of the patients. The most frequent site of stones was the left hepatic duct (60.1%). The site of bile duct dilatation coincided with the location of stones. The most common sites of stenosis were the central part of the lateral segmental duct (32.5%) and the left hepatic duct (37.6%). Hepatic resection was employed in 49.2% of the patients, and drainage procedures were added in 95.6%. Follow-up studies of 236 patients treated by surgery revealed good results in 67.4%, fair in 13.6%, and poor in 7.6%. In these patients, however, endoscopic lithotomy was often employed intra- and/or post-operatively. Conducting hepatic resection, with adequate biliary drainage procedure and cholangiofiberscopic lithotomy may help to improve the therapeutic results of bilateral intrahepatic lithiasis.

Rational treatment of refractory epilepsy in childhood.

A multifaceted study on childhood refractory epilepsy disclosed an insufficient classification of epilepsies and epileptic seizures, and inappropriate polypharmacy as the most important factors preventing appropriate therapy. By means of an adjustment of AEDs based on the accurate classification of epilepsies and epileptic seizures, the number of AEDs could be reduced in 37.5% and monotherapy was successful in 13.8% of refractory cases. Most of the latter were those of partial epilepsy and generalized epilepsy with the monoseizure type. The exacerbation of seizures due to AEDs was also mentioned as one of the important side effects of AEDs.

[Clinical evaluation of a new tumor marker, CA 15-3, in breast cancer; a comparative study with CEA].

Recently, a new RIA method has been developed by Centocor Co., utilizing the monoclonal antibody CA 15-3. We performed a clinical trial to evaluate its utility as a tumor marker for breast cancer in comparison with CEA. We set 15 U/ml as the cut-off value of serum CA 15-3 level from results acquired from controls; 10 volunteers and 17 patients with non-malignant diseases. The CA 15-3 positive rate among the cases of primary breast cancer was 13.3%, which was of poor diagnostic value. In the recurrent cases the positive rate of CA 15-3 was 72.0%, which was valuable compared with that of serum CEA, 52.0%. In the cases of primary cancers other than breast cancer, the positive rate of CA 15-3 was 6.9%.

[A case of remission of metastatic gastric cancer lesions in the chest and abdominal wall by 5'-DFUR administration].

52-year-old female was weakened and bed-ridden by metastasis of gastric cancer to the chest and abdominal wall, and peritonitis carcinomatosa 2 years after gastrectomy. One week after administration of 5'-DFUR, 1200 mg/d, p.o., a clinical effect was seen. In 3 weeks metastatic lesions had diminished in size, ascites had decreased and the patient had regained her appetite and put on weight. She recovered sufficiently to be able to do some daily work. Pathological degeneration and necrosis of cancer cells were observed. Although she died 8 months after remission, 5'-DFUR was effective in improving her condition and prolonging her life.

[Clinical study of preoperative chemotherapy of primary breast cancer. 1. Efficacy of a combined use of CPA (endoxan) and FT-207 (or 5-FU dry syrup)].

In twenty-nine cases of primary breast cancer preoperative treatment using CPA and FT-207 (or 5-FUDS) was performed to determine their efficacy. Daily dose of each anticancer drugs was as follows: CPA 50-200 mg, FT-207 200-600 mg, 5-FUDS 200 mg, p.o.. The total doses were CPA 1.8 g, FT-207 5.0g, 5-FUDS 3.4 g in average. In 11 cases (37.9%) reduction in tumor size was obtained. According to Ohboshi's criteria, over Grade II a effect was seen in 5 cases (17.2%), while Grade III effect was not seen in any of the cases. Effective cases were more frequently observed among those which received CPA at 25 mg/kg or more, or FT-207 (5-FUDS) at 80 mg/kg or more. Main side effects were G. I tract symptoms such as anorexia and nausea. To obtain definitive conclusion on the clinical significance of use of CPA and FT-207 (5-FUDS) as preoperative chemotherapy for breast cancer, further studies are required.

[Whole-body retention studies of 167Tm-citrate.--Estimation of radiation dose to human from 167Tm-citrate--(author's transl)].

For the purpose of calculating absorbed dose to humans from 167Tm-citrate, the whole-body retention studies using 5 rats were carried out. Up to 40 days following intravenous injection of 167Tm-citrate, the whole-body counts were monitored with a animal counter. The whole-body retention curve was obtained with three exponentaial components. Namely, the 26% of the injected 167 Tm-citrate had a biological half-time of 3.4 hours, 12.5% had a biological half-time of 99 hours and 61.5% had a biological half-time of 106 days. These results indicate, that three components consist of the rapid clearance from the kidneys, the retention in the liver and other soft tissues with relatively long half-time and the retention in the bones with long half-time. Based on these biological data and the MIRD Committee method, the average dose estimates to the bone and whole-body from intravenous administration of 1 mCi 167Tm-citrate were 7.08 rads and 1.28 rads, respectively.