Climatic influence on the reproductive characteristics of Japanese males.

We previously performed a survey of the sperm characteristics of the partners of pregnant women in four cities in Japan. In the present study, we analyzed the sperm characteristics of these subjects and the correlations between these sperm characteristics and climatic changes or Y chromosome haplogroups. Our results showed that more haplogroup D2a1 males than O2b1 males were born in the first half of the year (January to June), whereas more O2b1 males were born in the last half of the year (July to December) (P<0.05). This was agreed and correlated with the seasonal variations in their mean sperm concentrations. The haplogroup C, D* and D2a1 males displayed lower sperm concentrations from March to May, followed by an increase in their sperm concentrations starting in June or July, while the O2b1 males displayed higher sperm concentrations in the first half of the year followed by a sudden decrease from July to August (P<0.05). We hypothesize that the Japanese climate has different effects on the sperm characteristics and reproductive seasonality of males from different lineages; and therefore, has influenced the modern population of Japan.

[Pulmonary adenocarcinoma with multiloculated cystic change].

A 63-year-old man was admitted to our hospital for evaluation of an abnormal chest X-ray film finding. He was asymptomatic. The chest HRCT showed a ground-glass attenuation with multiloculated cystic change in the left lower lobe. There were no cystic lesions in the other lung fields except a ground-glass attenuation in the left lower lobe. The pathological examination of trans-bronchial lung biopsy specimen revealed adenocarcinoma. Therefore, primary lung cancer was diagnosed, and he underwent left lower lobectomy and mediastinal lymph node resection. Macroscopic examination of the resected lung specimen revealed multiloculated cystic lesions associated with a poorly demarcated white-gray tumor. The histological examination showed that papillary adenocarcinoma proliferated along the alveolar walls and that the walls of the multiloculated cystic lesions were composed of cancer cells. We speculated that adenocarcinoma cells extended along the alveolar walls and destroyed the alveoli without disrupting the overall lung architecture, resulting in enlarged multiloculated cystic lesions.

[A case of chronic bird fancier's lung in which VATS biopsy was diagnostically useful].

A 72-year-old woman was admitted to our hospital complaining of dry cough and dyspnea on effort for 9 months. Her chest HRCT findings showed diffuse reticular opacities, ground-glass opacities, and interlobular septal thickening with subpleural and peribronchovascular distribution, not typical of IPF/UIP. BAL revealed mild lymphocytosis and elevated CD4/CD8 ratio. Since TBLB was not diagnostic, we performed VATS biopsy. The pathological finding by VATS biopsy revealed collapse, fibrosis, and scar formation in both subpleural and intralobular regions with small granuloma, consistent with chronic hypersensitivity pneumonitis. Both antibodies in serum to pigeon dropping extract and inhalation provocation test using avian dropping extracts were positive. and therefore we diagnosed chronic bird fancier's lung. We should suspect chronic hypersensitivity pneumonitis in cases with HRCT findings atypical of IPF/UIP. and examine antibodies against specific antigens and perform VATS biopsy.

[A case of primary lung cancer complicated with hypothyroidism by diffuse thyroid metastasis].

A 56-year-old woman with hypothyroidism was admitted to our hospital because of an abnormal chest X-ray film. The chest CT showed a 3-cm spiculated tumor in the left lingual branch, and multiple nodular shadows with random distribution. Cervical CT showed diffuse enlargement of the thyroid gland with low density. The cytology of the tumor in the left lingular branch revealed adenocarcinoma, and ultrasound-guided fine needle aspiration cytology of the thyroid gland revealed adenocarcinoma, cytologically identical to the cells from bronchoscopic examination. Immunochemically, specimens obtained from both bronchoscopy and the thyroid gland were negative for thyroglobulin. Therefore, we diagnosed this case as primary lung cancer complicated with hypothyroidism by diffuse metastasis of the thyroid gland. Metastatic thyroid tumor is rarely diagnosed clinically. Furthermore, metastatic thyroid tumor complicated with thyroid dysfunction is extremely rare. We conclude that in patients with both diffuse thyroid swelling and thyroid dysfunction, the possibility of metastatic thyroid tumor should be considered.

High-dose chemotherapy with peripheral blood stem cell transplantation for advanced testicular cancer.

BACKGROUND: The aim of this study was to investigate the efficacy and safety of high-dose chemotherapy (HDCT) for the treatment of patients with advanced testicular cancer. METHODS: Fourteen patients were treated with high-dose carboplatin, etoposide and cyclophosphamide (with or without THP-adriamycin) followed by peripheral blood stem cell transplantation. The treatment was used for two refractory cases, a second relapse, and for consolidation after the first relapse in one case each. It was also used for nine cases as part of the first-line treatment following primary conventional-dose chemotherapy, and for one case as the first salvage for a late recurrent tumor of teratoma with malignant transformation. RESULTS: The first two patients who received intensive pretreatment with cisplatin-based chemotherapy did not respond to HDCT. The two patients who were treated with HDCT as the first or second salvage therapy achieved successful outcomes. The results for the subsequent nine patients (consisting of two with stage IIIC, five with IIIB2, one with IIB, and one extragonadal seminoma) were two progressive disease, three no change and four partial remission. Only three are alive with NED following salvage surgery. Finally, a case of teratoma with malignant transformation did not respond well to two cycles of HDCT. There were no marked adverse reactions except one episode of severe neutropenic colitis. CONCLUSIONS: The results demonstrated the limited efficacy of HDCT even in cases with a good to intermediate risk rating according to classification by the International Germ Cell Cancer Collaborative Group. Because treatment for relapse after HDCT is extremely difficult, new HDCT regimens consisting of drugs that are not used in induction chemotherapy need to be established.