Kenji Ohmura

Syntheses, antitumor activity, and molecular mechanics studies of cis-PtCl2(pzH)2 (pzH=pyrazole) and related complexes. Crystal structure of a novel Magnus-type double-salt [Pt(pzH)4][PtCl4][cis-PtCl2(pzH)2]2 involving two perpendicularly aligned 1D chains

Abstract A new Magnus-type double-salt cocrystallized with a neutral complex, [Pt(pzH)4][PtCl4][cis-PtCl2(pzH)2]2 (1), has been isolated from a reaction between K2PtCl4 and pyrazole as a result of our reinvestigation of cis-PtCl2(pzH)2 (2). Interestingly, compound 1 involves two types of 1D chains respectively growing along the a- and c-axes, giving a novel intersecting framework. The former is {cis-PtCl2(pzH)2}n (PtPt=4.342(2) and 4.373(2) A), and the latter is a Magnus-type 1D chain {[Pt(pzH)4][PtCl4]}n (PtPt=3.9388(1) A). Each stacking interaction is stabilized with two hydrogen bonds formed between the chloride atoms and the NH units of pyrazoles; Cl⋯N(pyrazole)=3.21(2)–3.49(2) A. The in vitro antitumor activity of 2 toward some human cancer cell lines is found to be comparable to that of cis-PtCl2(NH3)2. Molecular mechanics investigations of some GG-adducts of cis-Pt(pzH)2 reveal the importance of hydrogen-bond formation between the NH(pzH) units and the guanine/phosphate groups for the electrostatic stabilization of the adducts.

Poorly differentiated (‘insular’) carcinoma of the thyroid

Three cases of unusual poorly differentiated (‘insular’) carcinoma of the thyroid gland are presented. These three thyroid carcinomas were large; the tumors from patients 1 and 3 were encapsulated, and that from patient 2 showed invasive growth. Microscopically the tumors were characterized by welldefined solid nests (insulae), which were composed of rather small and uniform tumor cells with round to oval nuclei. Formation of small and colloid‐containing follicles was associated with these nests to varying degrees. The tumors of patients 1 and 3 were composed entirely of insular components, but that of patient 2 was associated with small areas of welldifferentiated follicular carcinoma. The metastatic tumors of patients 1 and 2 were essentially similar to the primary with small foci of follicular carcinoma.

Late bone metastasis from an encapsulated follicular carcinoma of the thyroid without capsular and vascular invasion.

A unique case of encapsulated follicular carcinoma of the thyroid, which lacked histologic evidence of capsular and vascular Invasion but developed a late bone metastasis, is described. The thyroid tumor was found in a 42‐year‐old man. It was relatively small (2.5 cm) and totally encapsulated. Histologically, the thyroid tumor showed a microfollicular growth pattern of follicular cells and revealed no histologic evidence of nuclear atypia, mitotic figures or capsular and vascular invasion. The diagnosis of microfollicular adenoma was made and partial thyroidectomy was performed. Bone (rib) metastasis of the thyroid tumor developed 22 years after the thyroidectomy. The present case suggested that capsular and/or vascular invasion is not always sufficient for the diagnosis of encapsulated follicular carcinoma of the thyroid.

Ternary complex formation and reduced folate in surgical specimens of human adenocarcinoma tissues

Background and Methods. Various factors, including thymidylate synthase, thymidine kinase, 5‐fluorouracil phosphorylation and degradation pathways, folate concentrations, and the stability of ternary complex, which influence thymidylate synthase inhibition rate of fluoropyrimdines, were studied in 87 human adenocarcinoma tissues.

Sarcoidosis of the thyroid gland manifested initially as thyroid tumor.

A rare case of a patients with sarcoidosis of the thyroid gland, who was preoperatively diagnosed as having thyroid carcinoma and who had no other clinical features of sarcoidosis, is reported. Thyroidectomy specimen revealed numerous noncaseating, epithelioid granulomas in the thyroid tissue. Mycobacteria, fungi and foreign body material were not identified. Similar granulomas were also found in the lymph nodes and muscular tissue adjacent to the thyroid gland and parathyroid gland After the diagnosis of sarcoidosis of the thyroid, systemic examination failed to reveal any involvement in other sites, including lung, eye and skin. This case demonstrated that sarcoidosis can manifest initially as a thyroid tumor with no other evidence of disease.

Papillary carcinoma of the thyroid gland with fibromatosis-like stroma

Papillary thyroid carcinoma is the most frequent malignant neoplasm in the thyroid gland. There are several histological variants’: microcarcinoma, follicular variant, encapsulated variant, diffuse sclerosing variant and oxyphilic cell variant. Papillary tumours may be associated with sclerotic changes in various degrees2. Histologically, these sclerotic changes usually involve hyalinized fibrosis and occasional calcium deposition. We have encountered a case of follicular variant type of thyroid papillary carcinoma, in which there was an extensive proliferation of fibroblasts and which resembled a fibrous tissue tumour.

Pharyngoesophageal reconstruction with the use of vascular anastomoses: Operative modifications and long-term prognosis

OBJECTIVE Vascular surgical techniques have contributed to the success of pharyngoesophageal reconstruction. We report our methods and analysis of postoperative complications, quality of life, and long-term prognosis. METHODS Sixty-seven patients who underwent pharyngoesophageal reconstruction with use of vascular anastomoses comprised the study population. The operative procedures performed were free jejunal autograft transplantation in 54 patients, gastric pedicle placement with vascular anastomoses in 2, jejunal pedicle with vascular anastomoses in 4, colonic pedicle with vascular anastomoses in 4, free jejunal graft and gastric pedicle in 2, and free jejunal graft and jejunal pedicle in 1. The common carotid artery and internal jugular vein were primarily used as the recipient vessels. The period of postoperative observation ranged from 3 days to 145 months. RESULTS The postoperative complications noted were dehiscence in 7 patients, graft failure in 1, wound infection in 2, small bowel intussusception in 4, pneumonia in 2, disseminated intravascular coagulation in 1, and pancytopenia in 1. Revascularization was successful in all but 1 patient, and oral intake was achieved in 58. Persistent swallowing dysfunction was recognized in 4%. Speech restoration was achieved in 57% of the patients with esophageal speech in 7% and with an artificial larynx in 50%. In the long-term follow-up, 36% of our patients died of the primary disease, 9% died of other diseases, and 55% are alive. CONCLUSIONS Esophageal reconstruction with the use of vascular anastomoses affords low morbidity and mortality. Postoperative swallowing and speech are satisfactory, and the function of the reconstructed esophagus is well preserved for as long as 10 years.

Reconstruction of jugular and portal blood flows using remodeled great saphenous vein grafts.

Remodeled great saphenous vein grafts were used to reconstruct both jugular and portal veins. The great saphenous vein was split longitudinally and sutured side-to-side to construct a vessel twice the diameter and one half the length of the original vessel. This graft was used with good results for reconstruction of the jugular veins in a patient after a bilateral neck dissection for tongue cancer and for a portal vein in a patient after resection for cancer in the head of the pancreas.

Histologic Changes in Graves' Thyroid Gland after 131I Therapy for Hyperthyroidism

The effect of 131I therapy was examined in 13 thyroid glands affected by Graves’disease 3 to 29 years after irradiation for hyperthyroidism. All of the patients had clinically palpable thyroid nodules. Two patients were in a latent hypothyroid, 6 in a euthyroid and 5 in a hyperthyroid state. The microscopic changes in the thyroids showed a pattern of multiple adenomatous nodules with cystic changes, marked oxyphilic cell changes with nuclear atypism and various degrees of chronic thyroiditis. Immunohistochemical staining for TG and T4 was negative to mildly positive in these oxyphilic cells and entirely negative for EGF and CEA. The DNA ploidy pattern was diploid pattern in 6 cases. One papillary‐type microcarcinoma occurred, but there was no evidence of a relationship between the tumor and the irradiation. The pathologic findings in Graves’thyroid gland after 131I therapy are not specific, but pathologists should differentiate this lesion from adenomatous goiter, which occurs with no apparent cause, or from thyroid carcinoma because of the marked nuclear atypism of this lesion.

Venous haemangioma of the neck and mediastinum

A case of cervico-mediastinal venous haemangioma with diffuse upper respiratory airway involvement is reported. The lesion was considered to be an ordinary supraglottic haemangioma at first. We recommend that adult cases of laryngeal haemangioma should be carefully examined for extra-laryngeal lesions.