Adenosquamous carcinoma of unknown primary origin: a case report and literature review.

BACKGROUND: Adenosquamous carcinoma is a rare variant of semicircular canal that can affect various regions, including the head and neck. Adenosquamous carcinoma is characterised pathologically by the simultaneous presence of distinct areas of semicircular canal and adenocarcinoma, and usually takes an aggressive course with local recurrences, early lymph node metastases and distant disseminations. CASE: We report a rare case of neck adenosquamous carcinoma of unknown primary origin, which was well-controlled by thorough resection without any other additional therapy. CONCLUSION: We discuss the diagnosis and treatment of adenosquamous carcinoma along with a review of pertinent literature. We also consider the potential differential diagnosis of branchiogenic carcinoma.

[A case of AIDS complicated with isosporiosis as initial manifestation].

We reported a Thailander patient with isosporiasis accompanied by AIDS. The 34-year-old male, who had been living in Japan for six years, was admitted to our hospital complaining of diarrhea and body weight loss. After admission the patient developed acute renal failure due to dehydration resulting from diarrhea. Laboratory findings on admission showed neither significant microorganisms nor parasite ova in the stool. The patients was given both an intestinal drug and an antibacterial agent, but is vain. Frequent stool examinations disclosed Isospora oocyst in the feaces. Co-trimoxazole was administered resulting in remarkable diarrheal improvement. Renal function was also improved without dialysis. Although isosporiasis is rarely found in Japan, it is stressed that in the AIDS patient with persistent diarrhea who may develop a parasitic disease as did in this case, frequent fecal examinations should be conducted.

[A case of imported paratyphoid fever associated with Giardia lamblia and Isospora belli infection].

We report a case of imported paratyphoid fever associated with Giardia lamblia and Isospora belli infection. The patient was a 23-year-old Japanese female with complaints of high grade fever and diarrhea after 10 days traveling to Nepal. Salmonella Paratyphi A was isolated from the blood and fecal cultures on admission and Ciprofloxacin of 200 mg tid was administered for 14 days. Fecal examination revealed cysts of G. lamblia at the same time and metronidazole of 250 mg tid for 7 days was effective for their eradication. During the follow-up studies oocysts of I. belli were found and cotrimoxazole of 960 mg bid for 10 days was effective for their eradication. Fecal examinations on parasites which is rare in Japan such as I. belli are recommended to the cases returning from tropical areas.

Signaling through CD40 rescues IgE but not IgG or IgA secretion in X-linked immunodeficiency with hyper-IgM.

The ligand for CD40 (CD40L) is a membrane protein on activated T cells that induces B cell proliferation and differentiation. Several mutations of the CD40L gene were reported responsible for defective class switching of B cells in an X-linked immunodeficiency with hyper IgM (X-HIM). We studied four affected males from three families and found three independent mutations including new mutations of CD40L gene. In every X-HIM patient tested, however, anti-CD40 plus IL-10 did not induce class switching from IgM to IgG or IgA, even in the presence of Staphylococcus aureus Cowan I strain (SAC). CD4+ T cell clones, expressing CD40L on their surface, also did not rescue IgG or IgA induction by X-HIM peripheral blood B cells in vitro. But signaling through CD40 induced both B cell proliferation and IgE secretion when IL-4 was added to the culture. Taken together, these results show that in vitro signaling through CD40 rescues IgE but not IgG or IgA secretion by peripheral blood X-HIM B cells and suggest that in vivo CD40 and CD40L interaction might be necessary for IgG and IgA differentiation in X-HIM.

[Basic and clinical examinations of CS-1170 in pediatrics (author's transl)].

1. CS-1170 was administered for the purpose of prophylaxis during cardiac catheterization in patients with heart disease, and its blood levels were measured. 2. The mean blood level (Moni-Trol I standard) after one intravenous shot of 20 mg/kg was 53.6 mcg/ml in catheterized children aged below 6 and 66.9 mcg/ml in catheterized children aged above 10 at 30 minutes, and 1.95 mcg/ml and 5.2 mcg/ml respectively at 6 hours. 3. The mean half life of the blood level was 1.09 hours in catheterized children aged below 6, 1.37 hours in catheterized children aged above 10, and 0.71 hours in infections children. 4. The urinary excretion seemed satisfactorily high although there was a great variation. 5. The clinical efficacy was 88.9%. 6. The bacteriological efficacy was 100% for E. coli, Klebsiella, Proteus mirabilis and Staphylococcus aureus and was 0% for Staphylococcus epidermidis. 7. Although GOT and GPT were elevated in one case as a side effect, they rapidly returned to normal after discontinuation of administration.

[Fundamental and clinical studies of PC-904 in pediatrics (author's transl)].

The following studies were carried out in pediatric patients. 1. Serum levels of PC-904 were examined in 3 patients by 1 hour intravenous infusion of 20 mg/kg, reaching the peak of 22.5 approximately 25.5 microgram/ml at the end of infusion. Half life was 37 approximately 48 minutes. 2. Investigated in only 1 patient, the urinary excretion rate was 12.9% (0 approximately 6 hours). 3. The effect of PC-904 on blood pressure was examined in 1 patient, and no effect was observed. 4. Clinical effects of PC-904 were examined in 9 patients; urinary tract infection (6 cases) and Salmonella enteritis (3 cases). The daily dose was 32.6 approximately 93.0 mg/kg. The overall clinical effectiveness was 66.7%. As to causative organisms E. coli, Klebsiella and Salmonella were isolated. The clinical effects by the organisms were 100%, 0%, and 66.7%, respectively. 5. Slight elevation of GOT and GPT and eosinophilia were observed in each one case but these abnormalities rapidly returned to pre-treatment levels when the administration was discontinued. No other side effects were noticed.