Predictive factors of cytotoxic damage in radioactive iodine treatment of differentiated thyroid cancer patients.

Radioactive iodine (131I) therapy in patients suffering from differentiated thyroid cancer (DTC) is a targeted treatment commonly used for thyroid ablation and locoregional and distant metastatic spread management. Despite a significant proportion of the 131I dose entering the circulation, there is currently no detailed information regarding its effect on the blood cell system. In order to assess the cytotoxic effects of 131I therapy on the circulatory system, blood cell levels, thyroid-related hormones and CD45+ cell cytotoxicity were estimated in blood collected from patients with DTC. The micronuclei (MN) frequency of the peripheral blood CD45+ cell fraction was significantly increased after 30 days of 131I therapy compared to that prior to treatment, although a strong individual variation was observed. A significantly negative correlation between MN frequency and the level of platelets and plateletcrit was observed; however, there was no such correlation with thyroid-related hormones. These resultS suggest that the correlation between MN frequency and the platelet system may serve as a biomarker of exposure and, possibly, of sensitivity in DTC patients undergoing 131I therapy following thyroid and lymph node surgery.

[Case of advanced gastric cancer successfully treated with chemotherapy of weekly paclitaxel].

We report a case of gastric cancer with ascites treated with chemotherapy. The patient is a 67-year-old male. Combination chemotherapy of S-1 and CDDP was given as the first-line treatment. However, the symptoms did not improve with that regimen, so we decided to change the chemotherapy to paclitaxel as second-line treatment. After 4 cycles, CT scan revealed decreasing ascites and endoscopy a reduction of the primary tumor. The patient has maintained a condition of decreasing ascites with improvement of QOL for 8 months. This regimen is considered effective treatment for unresectable gastric cancer.

Vesiculobullous systemic lupus erythematosus: a case with circulating IgG and IgA autoantibodies to type VII collagen.

We report a case of a 17-year-old Japanese boy with vesiculobullous systemic lupus erythematosus. He had a facial "butterfly" erythema and blistering eruption develop. Antinuclear, RNP, and Sm antibodies were positive. The American Rheumatism Association criteria for a diagnosis of systemic lupus erythematosus were met. A skin biopsy specimen showed papillary microabscesses of neutrophils and subepidermal blisters and deposits of IgG, IgA, IgM, and C3 by direct immunofluorescence. Indirect immunofluorescence on salt-split skin showed linear IgG, IgA, and C3 deposits on the dermal side. IgG and IgA autoantibodies in his serum reacted with the 290-kd proteins of type VII collagen from human dermal extracts and the recombinant fusion proteins from the noncollagenous domain of type VII collagen by Western immunoblot. To our knowledge, this is the first report of vesiculobullous systemic lupus erythematosus with circulating IgG and IgA autoantibodies to type VII collagen.