Search

A case of streptococcal toxic shock-like syndrome in a previously healthy, 57 year old Japanese female has been reported. Initially, she had a sore throat and low grade fever for 5 days. Because of sudden severe pain on the extremities and erythema on bilateral forearms, she was hospitalized. On admission, her conciousness was clear. Although profound hypotension, anuria and prolonged blood coagulation were observed. Antibiotics, fluid therapy and dopamine were given. Four hours after admission, she died in spite of resuscitation efforts, by sudden cardiac arrest. Streptococcus pyogenes was isolated in her blood. At the same time as when she died, three of the five people of the patient's family living with her, had pharingitis or pneumonia. From the pharynxs of the three people with pharingitis, Streptococcus pyogenes was also isolated. The serotype of all organisms was T11, and they produced exotoxintype B in vitro. This case suggests that infection of Streptococcus pyogenes is not essential for the development of toxic shock-like syndrome.

We performed transcatheter fibrolytic therapy using a coaxial microcatheter in two cases of acute superior mesenteric artery occlusion in the early stage. The tip of the microcatheter was introduced into the clot of the superior mesenteric artery. Urokinase was infused at a rate of 10,000 IU/min. The clots dissolved immediately after the infusion of 240,000 IU and 480,000 IU, respectively, without any complications. This infusion technique is promising for the treatment of acute superior mesenteric artery occlusion.

From August, 1979 to June, 1990, 226 cases of primary lung cancer were treated surgically at our Department. Of these, 176 cases, excluding hospital deaths from lung cancer and other diseases, were analyzed according to prognosis. The 5-year survival rate of the 176 cases was 40.2% and the 5-year survival rates according to sex were, male, 36.1%; female, 53.2%. The 5-year survival rates according to postoperative stage were, stage I, 64.1%; stage II, 44.1%; stage III A, 22.1%; stage III B & IV, 0% and the 5-year survival rates according to histologic type were, adenocarcinoma, 40.5%; squamous cell carcinoma, 49.7%; large cell carcinoma, 18.9%; small cell carcinoma, 0%. The 5-year survival rates according to primary site were, right side, 43.8%; left side, 34.6%; right upper lobe, 39.7%; right middle lobe, 60.0%; right lower lobe, 44.4%; left upper lobe, 41.7%; left lower lobe, 18.1%. The prognosis of squamous cell carcinoma, and the early stage, female group, right side group, right middle & lower lobe group, were all fairly good.

A 55-year-old woman was diagnosed as having epipharyngeal cancer, characterized by T2N1M0 and poorly differentiated squamous cell carcinoma. She was treated by radiotherapy (primary site: 65 Gy, neck: 75 Gy) and the tumor completely disappeared. However, 4 months later, the tumor recurred in the epipharynx. Tegafur in the form of a suppository (Sunfural Rectal Capsules, 750 mg) was given once a day. During the course of epipharyngoscopic follow-up the tumor almost totally disappeared at a dose of 10,250 mg (15 days). Biopsy failed to reveal any cancer cells and computed tomography showed no tumor masses in the epipharynx. At present, 6 months have already passed since the start of Tegafur administration, there is no recurrence of the cancer, and the chemotherapy is being continued at our outpatient clinic. By the standard for the efficacy of cancer chemotherapy proposed by Koyama and Saito, this case corresponds to a state of complete response.