[Clinical nursing conference: lessons in clinical training. Nursing of a patient in the terminal stage of tongue cancer].
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Biomedical subjects
Publications and source records attributed to T Tashiro.
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A 49-year-old female complaining of hematemesis was examined by emergency endoscopy. Multiple gastric erosions and ulcers which had healed after 6 weeks, except for one ulcer, were found. A biopsy of this unhealed ulcer revealed gastric carcinoma. Enucleation of the tumor was performed because of multiple metastases to the liver, lung and the lymph nodes. The high serum alpha-fetoprotein level (800 ng/ml) and the size of a coin lesion in an X-ray film of the chest before the enucleation decreased post- operatively.
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Sugar alcohols, such as mannitol, sorbitol, galactitol, and inositol, selectively reduced the acute lethal toxicity of 1-(2-chloroethyl)-3-(methyl alpha-D-glucopyranos-6-yl)-1-nitrosourea (MCNU) without reducing its antitumor activity. Fifty mg MCNU/kg killed all CD2F1 mice within about 10 days, while the administration of 3,000 mg sugar alcohols/kg immediately prior to MCNU protected mice from the lethal toxicity and all survived. The amelioration of MCNU toxicity by sugar alcohols was dose-dependent. Pretreatment with mannitol 1 day before MCNU administration was effective. In addition, a series of five daily treatments with lower doses of mannitol was also effective. This protection was accompanied by the reduction of both body weight loss and myelosuppression. The antitumor effects of MCNU on P388 leukemia and Lewis lung carcinoma were not significantly altered by mannitol treatment. These phenomena were not limited to MCNU, the lethal toxicity of GANU, ACNU, Me-CCNU, and mitomycin C also being reduced by mannitol treatment.
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Nemaline myopathy was first reported in 1963 and has been considered to be a congenital, non-progressive myopathy with weakness since birth. However, severe forms leading to death in infancy have been rarely reported. Recently we necropsied a female infant with fatal neonatal nemaline myopathy who required mechanical ventilatory support immediately following delivery. She had suffered from recurrent pneumonia and died at five months of age. Light and electron microscopic studies on both muscle biopsy and autopsy specimens were diagnostic of nemaline myopathy. Characteristic rod-like structures were demonstrated within skeletal muscles, and accumulations of thin filaments were seen in numerous muscle fibers. The origin of these structures in the Z-disks and other morphologic features were the same as those of the rods occurring in congenital cases of rod myopathy. No involvement was observed in the cardiac muscle or in the smooth muscle of the gastrointestinal tract. It is likely that involvement of the skeletal muscles of the pharyngeal areas, intercostal spaces, and diaphragm might have contributed to the difficulty in swallowing and respiratory distress.
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