Cisplatin (CDDP 100 mg/m2, div), adriamycin (ADR 20 mg/body, iv) and futrafur-uracil conjugate (UFT 200 mg/day, po) were administered on the same day to a 51-year-old housewife with lymphangitis carcinomatosa of the lung. During the CDDP infusion, the patient unexpectedly became highly febrile. On the following day, the patient developed purpura on the upper and lower extremities, and her platelet count was 3.2 x 10(4)/mm3 in spite of being 32.4 x 10(4)/mm3 on the day before chemotherapy. The platelet count recovered to 9.4 x 10(4)/mm3 on day 3, and increased to a maximum of 56.1 x 10(4)/mm3 on day 20. Previously, we had treated several patients with adenocarcinoma by the same protocol, but never experienced such a case that developed a sudden fall in their platelet count. Although the true mechanisms remain to be solved, this case is very interesting from a standpoint of drug-induced thrombocytopenia.

Adenocarcinoma↗

PubMedDate not supplied

Angiogenesis in hepatocellular carcinoma as evaluated by alpha smooth muscle actin immunohistochemistry.

BACKGROUND/AIMS: Angiogenesis has been known to be associated with tumor development. In this study, neovascularization in small hepatocellular carcinoma was investigated by evaluation of intratumoral arteriole counts, using alpha smooth muscle actin antibody immunohistochemistry. METHODOLOGY: Surgical specimens from 38 patients with small hepatocellular carcinoma were immunostained for alpha smooth muscle actin and proliferating cell nuclear antigen. The correlation between intratumoral arteriole density and clinicopathological factors including angiographic findings, proliferative activity, and patient prognosis were analyzed. RESULTS: Significant difference in intratumoral arteriole density were observed between well-differentiated hepatocellular carcinoma and poorly differentiated hepatocellular carcinoma (P = 0.004) or moderately differentiated hepatocellular carcinoma and poorly differentiated hepatocellular carcinoma (P = 0.011). The mean intratumoral arteriole count in the tumors showing angiographic hypervascularity was significantly higher than that in the tumors without angiographic hypervascularity (P = 0.011). A significant and positive correlation was found between proliferating cell nuclear antigen labeling index and intratumoral arteriole density (r = 0.5232, P = 0.001). A high intratumoral arteriole density in tumor was significantly correlated with shorter patients survival (P = 0.018). Cox's multivariate regression analysis showed that the intratumoral arteriole density was independent prognostic factors (P = 0.0306). CONCLUSIONS: Intratumoral arteriole density was found to be significantly associated with histological grade, proliferative activity, and patient survival. It also reflected the angiographic findings. Alpha smooth muscle actin antibody immunohistochemistry would provide a simple and biologically significant method which is usable to screen neovascularization and arterial blood supply in hepatocellular carcinoma, and may have predicting utility for patients outcome. This technique is applicable to routine paraffin sections, and may be useful as an adjunct to surgical pathology of hepatocellular carcinoma.

Actins↗

PubMedDate not supplied

An analysis of intravenous hyperalimentation (IVH) catheter-related infection in a university hospital in Japan over a ten year period (1982-1991).

In order to follow changes in clinical characteristics of IVH catheter-related infections, 183 patients were analyzed in whom microorganisms had been isolated from the tips of IVH catheters over a ten year period (1982-1991) in our university hospital. In 183 patients, the male to female ratio was 2.4, the internal medicine departments (Int. Med. Depts.) to surgical departments (Surg. Depts.) ratio was 0.49, 58% of the patients were over 60 years old, 27% had surgical procedures within 30 days before isolation of organisms, and 44% died before discharge. Malignancies were the highest in number for underlying diseases. The same strains of microorganisms as tip cultures were isolated from blood in around 48% of cases in which blood cultures were employed. In the first 5 years (n = 71) and the latter 5 years (n = 112), the proportion of patients form the Int. Med. Depts. increased from 21 to 40% (p < 0.01), and the proportion of Gram positive bacteria from 44 to 64% (p < 0.01). Their antibiotic sensitivity was, as a whole, slightly lower in the latter 5 years. Among Gram-negative bacteria, P. aeruginosa has shown a tendency to increase (11 to 35%). Clinical features were different depending on the kinds of organisms or types of underlying diseases. Measures against IVH catheter-related infections are discussed.

Adolescent↗