Granulysin is a recently characterized cytotoxic granule expressed in cytotoxic T cells and NK cells. Although its cytotoxic effect against a number of tumor cell lines has been demonstrated in vitro, recent study with transgenic mice, and a number of clinical studies, have further established its significance in cancer immunology. Granulysin may offer a useful indicator in the prognosis of cancer, and an understanding of the mechanism by which it destroys target cells would provide vital information in the development of new therapies for the treatment of this disease.
In the present study, a novel system for the hypoxic culture of individual tissues was established for the subculturing of cell lines for research as well as for clinical culture of primary cells. To provide a hypoxic environment throughout the process of tissue handling and culture, we designed a clean bench with CO2 gas circulation and a hypoxic culture incubator containing disposable capsules. The bench top was covered with an acrylic chamber, and an atmosphere of 5.0% CO2-air was maintained using a sensor control. The cleanliness class of the chamber could easily be improved to 1 within 5 min of circulative filtration, even though it was found to be 105 before the unit was operated. Gas buffer solution (220 ml of 20 mM HEPES, 25 mM NaHCO3, pH 7.4) placed in a 500-ml plastic capsule in the unit stabilized the culture environment by functioning as a heat storage and gas pool. The inflow of air that occurred by the cap of the capsule was opened was excluded by the infusion of purging gas (5.0% CO2 and 95% N2); the O2 level returned to 2.0% within 4 min, after which the gas supply automatically switched to the culture gas (2.0% O2, 5.0% CO2, and 93% N2). If this purging process was omitted, restoration of the O2 level required 120 min, even though the inner volume was only 280 ml.
Necrotizing sialometaplasia is a benign and inflammatory lesion, which heals spontaneously. However sometimes this lesion is excised, by reason of confusing clinically and histologically with malignant disease. In this report, we reexamined the cytological findings in three cases of Necrotizing sialometaplasia. In the result, we obtained the common findings of three cases. Finding 1. necrotic tissue with inflammatory cell infiltration. Finding 2. degeneration of the acinar cells and extravasation of mucus. Finding 3. squamous cells with weak dysplasia in a part. In general, Necrotizing sialometaplasia is diagnosed by clinical findings and course. In that situation, we advocated that oral cytology is useful method for diagnosis.
In this report, we describe two cases of small-cell lung cancer (SCLC) presenting with fulminant hepatic failure as the initial manifestation. Neither of the patients had a previous history of liver disease, evidence of viral infection, or exposure to hepatotoxins. Both presented with hepatomegaly and an increase in the serum LDH level. Although they had a history of smoking and respiratory symptoms such as dyspnea on exertion, their most striking initial symptoms were those of hepatic failure, which made it difficult to suspect the underlying primary lung cancer. In one case, contrast-enhanced CT of the abdomen revealed hypovascular nodules that were not visible on plain CT. After a rapidly deteriorating course, both patients died, 8 and 13 days after admission, respectively. Autopsy revealed diffuse infiltration of the hepatic sinusoids and extensive replacement of the liver parenchyma by metastatic small-cell carcinoma. We conclude that metastatic SCLC should be considered in the differential diagnosis in patients of advanced age with a smoking history presenting with rapidly progressive liver failure associated with hepatomegaly and elevation of the serum LDH.
A 74-year-old male was admitted to our hospital in August 2006 because of an exacerbation of the symptom of diabetes mellitus. Abdominal CT showed locally advanced cancer of the head of the pancreas with encasement of the superior mesenteric artery, suggesting that the lesion was unresectable. The patient was scheduled for treatment with gemcitabine at the standard dose of 1000 mg/m2 once a week for 3 consecutive weeks followed by a one week rest, but on day 7 of cycle 1, grade 3 of hematological toxicity was diagnosed, and the schedule was changed to biweekly administration at a dose of 1000 mg/m2. The biweekly low-dose gemcitabine regimen slightly reduced tumor size, and the regimen was continued for 12 months. This case suggests that this new biweekly regimen of gemcitabine can be used as a safe and effective first-line chemotherapy for patients with advanced pancreatic cancer who are unable to tolerate the standard regimen of gemcitabine.
Utility and safety of EMR for colorectal lesions and lesion-lifted condition as an indicator of the tumor invasion were investigated. We investigated 672 cases and 708 lesions treated between 1993 and 2006. We classified the lesion-lifted condition at the time of submucosal fluid injection, using four categories: "completely lifted/soft", "completely lifted/hard", "incompletely lifted", and "non-lifting". The pit patterns and lifted conditions were related to tumor pathology and the extent of tumor invasion, and often corresponded to particular macroscopic types of tumors. Early colorectal cancer was treated in 231 cases by EMR alone, while 29 cases received additional colectomy after EMR because of an unfavorable pathology. Complications after EMR included bleeding in 19 cases (2.8%) and abdominal pain in 3 (0.4%). There were no cases of perforation. Recurrence occurred in 5 cases (2.2%) (4 cases were cured by re-EMR; one case required surgical resection) out of 231 cancer cases.