Successful salvage treatment of recurrent endometrial cancer with multiple lung and abdominal metastases.

The prognosis of recurrent endometrial carcinoma is generally poor except for isolated vaginal or pelvic relapse without previous radiation. Recurrences associated with infield failure or distant metastasis carry a poor prognosis. We report a case of recurrent endometrial carcinoma treated with cytoreductive surgery, targeted radiation to lung metastasis defined by CT and PET and adjuvant chemo-hormone therapy followed by maintenance progestin therapy with a good outcome. This case implied that chemo-hormone therapy with targeted radiation should be evaluated in recurrent endometrial cancer with positive progesterone receptor for salvage treatment.

The development of a rapid prototyping prosthetic socket coated with a resin layer for transtibial amputees.

This article proposes a type of transtibial socket composed of an inner layer fabricated by a rapid prototyping (RP) machine and an outer layer coated with unsaturated polyester resin. This work integrates contemporary technologies including a handheld scanner and CAD systems, to design a thin primary socket shape and then manufactures the socket using a fused deposition-modeling machine. To prevent breakage caused by the layer-based forming process and to reinforce flexural strength, the current research coats the preliminary RP socket with a layer of unsaturated polyester resin. After shaping the proximal brim of the resin-reinforced RP socket to match the specific stump, this study assembles and aligns a shank and a prosthetic foot to form a prosthesis set. After completing a trial safety walk wearing the prosthesis, which is satisfactory to the amputee and a registered prosthetist, this research measures interface pressures between the stump and the resin-reinforced RP socket. Experiment results demonstrate that the resin-reinforced RP socket is applicable for transtibial amputees. In addition to strengthening the FDM socket and producing consistent socket fit, this study also demonstrates a feasible procedure that employs current technologies to design and manufacture transtibial sockets without plaster moulds.

Chromium speciation in residues after sequential extraction of a thermally treated sludge analog.

XANES fitting indicates that non-Cr2O3 form of Cr(III), transformed from CrO3 by four-hour heat application at 1100 degrees C, is the key species sorbed onto or lattice-diffused into kaolin matrices that exhibits strong leaching resistance to sequential extraction using various combined solutions including HNO3, H2O2, and HF. The EXAFS spectra are all in agreement with the XANES results. It is suggested that some Cr2O3 might have reacted with kaolin to form new compounds such as Cr2O3 x Al2O3 x 2SiO2 to account for the slight dissimilarity between the EXAFS spectra of samples and that of Cr2O3.

Thymic hyperplasia in a patient with Graves' disease.

Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 32-year old woman with Graves' disease and hyperthyroidism. During medical evaluation and treatment for her hyperthyroidism, a large anterior mediastinal mass was incidentally discovered. A cytological study of the lesion via computed tomogram-guided fine needle biopsy could not make a definitive diagnosis and suggested the possibility of a thymoma, which led to a surgical exploration. However, the final pathological diagnosis of the surgically removed tissue was thymic hyperplasia. The relationship between Graves' disease and thymic changes is discussed.

Well-differentiated fetal adenocarcinoma of the lung.

We describe the case of a 43-year-old woman with a tumor shadow in the upper lobe of the left lung. The tumor was initially suspected to be a carcinoid tumor, following percutaneous needle biopsy. Subsequently, a left upper lobectomy was performed, and a well-differentiated fetal adenocarcinoma was diagnosed histologically. Unlike the biphasic epithelial and stromal features of pulmonary blastoma, it was composed solely of malignant glands of embryonal appearance.

Chylothorax: a complication of internal jugular vein catheterization.

Thoracic duct injury is a potential problem from central venous catheter insertion that has rarely been reported. A case in which a left chylothorax developed 2 days after internal jugular vein catheterization is presented here. This complication was managed successfully by continuous drainage of the pleural space, oral administration of a low-fat, high-carbohydrate and high-protein diet, and application of positive end-expiratory pressure. The etiology, pathogenesis, clinical presentation and recommended management of such iatrogenic chylothorax are discussed on the basis of this clinical report and of a review of the literature.

Treatment of carbon monoxide poisoning with hyperbaric oxygen.

BACKGROUND: Carbon monoxide poisoning is a major cause of accidental morbidity and mortality in Taiwan. Utilization of hyperbaric oxygen in severely carbon monoxide intoxicated patients has been investigated widely. The object of this study was to determine the nature of carbon monoxide poisoning and to evaluate the effect of hyperbaric oxygen therapy for such patients. METHODS: Retrospective analysis of 34 consecutive carbon monoxide intoxicated patients by review of medical records and clinical follow-up for the past three years. RESULTS: Subjects were 10 males and 24 females, aged 12 to 82 years. The source of the poisoning in 25 cases was faulty-operating heating systems; in 4, incomplete combustion of automobile engine; in 3, use of alternative sources of energy for indoor cooking and heating; in 2, smoke inhalation in fire accidents. All had neurologic symptoms; five also had cardiovascular symptoms and one developed delayed neurologic sequelae. The group with poor outcome after hyperbaric oxygen therapy (n = 10) had higher serum CK values, lower Glasgow coma scale, longer delay in the first aid at emergency service and longer delay in provision of hyperbaric oxygen therapy. CONCLUSIONS: It was concluded that hyperbaric oxygen therapy is an effective method in treating carbon monoxide intoxicated patients. Understanding the pathogenesis of carbon monoxide poisoning and indications for hyperbaric oxygen therapy will help physicians manage such patients earlier and more adequately. Information on currently available hyperbaric facilities in Taiwan is necessary for timely transfer.

Further evidence that the failure to cleave the aminopropeptide of type I procollagen is the cause of Ehlers-Danlos syndrome type VII.

Dermal fibroblasts from a Chinese Ehlers-Danlos syndrome type VII patient synthesized approximately equal amounts of normal pro-alpha 2(I) chains of type I procollagen and abnormal ones with electrophoretic mobility of pN alpha 2(I) chains, in which the amino-propeptide (N-propeptide) was retained. Reverse-transcriptase PCR analysis of the proband's RNA showed outsplicing of the 54 base exon 6 in half of the pro-alpha 2(I) mRNAs. Exon 6 encodes 18 amino acids of the N-telopeptide which contains the procollagen N-proteinase cleavage site and a cross-link precursor lysine. Loss of these sequences would result in failure to cleave the amino-propeptide of pro-alpha 2(I) and the accumulation of pN-alpha 2(I) chains. Nucleotide sequencing analyses of the proband's COL1A2 gene showed the presence of a T to C transition at position +2 of intron 6 in one allele and the proband is heterozygous for the defect. This mutation which destroyed the consensus GT dinucleotide at the 5' splice donor site of the intron is responsible for the loss of exon 6 by exon skipping. Electron microscopic analysis of the patient's dermis showed the presence of abnormal collagen I fibrils of irregular diameter and circularity. This mutation in COL1A2 in an EDS VII patient is the first reported case in the Chinese population and is identical to one reported for another EDS-VII (Libyan) patient. The occurrence of an identical mutation in two probands of different ethnic origin is direct evidence that the mutant genotype is the cause of the EDS VII phenotype.(ABSTRACT TRUNCATED AT 250 WORDS)

[A study of ambulatory treatment for pulmonary tuberculosis in foreigners residing in Japan].

We studied 130 cases of pulmonary tuberculosis in foreigners residing in Japan to obtain the results as follows; 1. Of the cases of pulmonary tuberculosis in foreigners who are registered and receiving treatment in Japan, 20.3% were treated at three dispensaries of the Japan Antituberculosis Association in Tokyo. 2. The nationality of the cases treated was China in more than half of them, followed by the Republic of Korea. 3. The number of days taken from entry into Japan to the start of treatment was about 11.4 months; 0.9% of the total number of cases examined by chest radiophotography required medical treatment. 4. Their living conditions in Japan according to questionnairing are: 56.2% have jobs in Japan; working hour, 4.99 +/- 1.19 hours a day; 64.4% take night work; 57.6% work in food/drink service industry; living space is 12.5 m2; 52.4% share the same house with other persons, living together with 1.6 persons. 5. As for the type of illness at the start of treatment, GAKKAI classification type III accounted for 90% and spread 1 83.8%. GAKKAI classification type II accounted for 10%, consisting of many relatively mild cases. 6. The defaulter rate was high at 40.8%. The reason for defaulting was broken down to discontinuation on his own 68%, repatriation 15% and side-effects 19%. The time to default was average 3.2 +/- 3.1 months after the start of treatment. They defaulted 1.2 +/- 0.4 times on the average. 7. To reduce the defaulter rate to the minimum in treating the foreigners residing in Japan, the following may be needed. a. To give guidance on the regimen including the need of treatment and risk associated with discontinuation of treatment at the first visit. b. Measures to reduce the amount to be born by the individual in the medical expenses. c. Preparation of a pamphlet for therapeutic guidance in foreign languages.

Functional size of the thylakoid phosphatases determined by radiation inactivation.

Radiation inactivation technique was employed to determine the functional size of phosphatases from thylakoid membrane. The enzymatic activities of phosphatases decayed in a simple function with the increase of radiation dosage. D37 values of 18.8 +/- 2.4-14.1 +/- 1.5 Mrad were obtained, using phosphoserine, phosphothreonine, p-nitrophenol phosphate, and phospho-histone V-S, respectively, as substrates. The molecular masses of 48.2 +/- 6.3-61 +/- 5.7 kDa were yielded by target theory analysis. We thus speculate that the thylakoid alkaline phosphatase is probably a monomer while acid phosphatase is functionally a dimer in situ.

Inhibition of tonoplast ATPase from etiolated mung bean seedlings by fluorescein 5'-isothiocyanate.

Fluorescein 5'-isothiocyanate (FITC) was used to modify the lysine residue in the active site of tonoplast H(+)-ATPase from etiolated mung-bean (Vigna radiata L.) seedlings. FITC caused marked inactivation of the enzyme activities of both membrane-bound and soluble ATPase and its associated H+ translocation. The SDS/PAGE pattern revealed that the FITC-binding site was in the large (A) subunit of ATPase. Inhibition could be substantially prevented by its physiological substrate ATP, pyrophosphate and nucleotides in the decreasing order: ATP greater than pyrophosphate greater than ADP greater than AMP greater than GTP greater than CTP greater than UTP. The mode of inhibition by FITC was competitive with respect to ATP. Loss of ATPase activity followed pseudo-first-order kinetics with a Ki of 0.33 mM, a minimum inactivation half-time of 110 s, and a first-order rate constant of 0.244 s-1. A double-logarithmic plot of apparent rate constant versus FITC concentration gave a slope of 0.913, indicating that inactivation results from reaction of at least one lysine residue at the catalytic site of the large subunit. Labelling studies indicated that the incorporation of approx. 1 mol of FITC/mol of ATPase is sufficient to inhibit ATPase completely. The enhancement and blue shift of emission maxima of FITC after modification of ATPase indicated that the labelled lysine residue was located in a relatively hydrophobic domain.

Expression of natural killer (NK) cell-specific alloantigens on a mouse NK-like cell line.

As part of the strategy for screening for natural killer (NK) cell-specific monoclonal antibodies (MoAb) we have raised a number of murine NK-like cell lines in media containing interleukin-2 (IL-2). The detection of specific NK cell alloantigens on a C57BL/6 cell line in long-term culture in IL-2 is the subject of this paper. The C57BL/6 cell line has the morphology of large granular lymphocytes (LGL) and exhibits strong cytolytic activity against the archetype NK cell target, YAC-1. Absorption of three anti-NK antiserum, NZB anti-BALB/c (anti-NK-2.1), BALB/c anti-DBA/2 (anti-NK-3.1) and CE anti-CBA (anti-NK-4.1), with the C57BL/6 cell line removed the anti-NK activity from these antisera. Flow cytometric studies of the C57BL/6 cell line demonstrated significant binding of the anti-NK-1.1 MoAb produced by hybridoma PK136. Our results suggest that the C57BL/6 NK-like cell line exhibits some of the properties of naive NK cells and expresses all the known NK cell-specific alloantigens, NK-1.1, NK-2.1, NK-3.1 and NK-4.1 and therefore is potentially useful in selecting NK specific hybridomas and in studying the biology of NK cells.

Studies of the biosynthesis and metabolism of rat testicular galactoglycerolipids.

1-O-Alkyl-2-O-acyl-3-O-beta-D-(3'-sulfatoxygalactopyranosyl)-sn- glcerol (SGG) and its nonsulfated analog (GG) are the major glycolipids of rat testis. Aspects of the biosynthesis and metabolism of these two lipids have been investigated by determining their specific activities at various times after injection of [16-14C]palmitic acid, [1-14C]cetyl alcohol, and D-[1-14C]galactose into the testes of the adult rats. Evidence was obtained from studies with each of these three radioactive compounds that is consistent with the interpretation that GG exhibits a precursor relationship to SGG in vivo. The turnover time of GG, as estimated from the use of each of the three precursors, ranged between 21 and 69 h. In contrast, a slow increase of radioactivity in SGG was observed following injection of each of the three precursors, a plateau value being reached between 72 and 168 h. The radioactivity in the acyl, alkyl, and galactosyl moieties of SGG thereafter remained quite constant for another 21 days. Small amounts of monoalkylmonoacylglycerol were detected in rat testis. Radioactive studies indicated that this compound could be a precursor of GG and (or) monoalkyldiacylglycerol, another lipid that was also detected in rat testis. The results are consistent with the concept that the synthesis of SGG occurs primarily at an early stage of spermatogenesis and that the various moieties of this lipid exhibit almost complete metabolic stability during the subsequent complex stages of this process.

[Experimental investigation on intrapulmonary and tracheobronchial distribution of ampicillin after administration of a beta-lactam antibiotic, bacampicillin].

Bacampicillin (BAPC) is a esterified derivative of ampicillin (ABPC) developed recently by the Swedish company. In present investigation we measured the concentration of ABPC in plasma, lung and tracheobronchial tissues from normal, pleuritis and pneumonitis male albino rabbits after an oral administration of BAPC. In these 3 groups plasma level of ABPC reached the maximum at 30-50 minutes after oral administration, then showed a gradual decrease. The decaying curves of pleuritis and pneumonitis groups were steeper than that of control group. Plasma level of ABPC in pneumonitis group at the maximum value was about 1/2 comparing with that in control and pleuritis groups. ABPC levels of tracheobronchial tissues in pleuritis and pneumonitis groups were higher than that in control group at 60 minutes after oral administration of BAPC. On the other hand, tissue level of ABPC in control group was higher than that in pleuritis and pneumonitis groups at 120 minutes after oral administration of BAPC. ABPC level of lung tissues (L1 and L5) in control group was higher than that in pleuritis and pneumonitis groups at 60 minutes after oral administration of BAPC, on the other hand ABPC level of L3 in control group was lower than that in pleuritis and pneumonitis groups. ABPC levels of lung tissues (L1 - L5) at 120 minutes after oral administration of BAPC were higher in control group comparing with that in pleuritis and pneumonitis groups.