Successful antidepressant treatment for five terminally ill cancer patients with major depression, suicidal ideation and a desire for death

In the debate on euthanasia and physician-assisted suicide, we have to exclude terminally ill patients in whom the desire for death is caused by major depression. However, it is still not clear to what degree major depression can be treated by psychiatric intervention in this setting. We evaluated the effect of antidepressant treatment in terminally ill cancer patients. Six cancer patients with suicidal ideas thought to be due to major depression were treated with tricyclic antidepressants. Three had requested terminal sedation to relieve them from their suffering. The median survival of five of these patients was 4 weeks after diagnosis; one was lost to follow-up. The efficacy of the antidepressant treatment was assessed using the Hamilton Rating Scale for Depression (HRSD). One week after the start of treatment with antidepressants, five of the six patients showed a marked improvement in their mood and showed no further suicidal thoughts or requests for terminal sedation. The average reduction in the HRSD score was 23.4 points (14-38; SD = 9. 9). Antidepressant treatment can be effective in alleviating the desire for death due to major depression, even in terminally ill cancer patients.     

Carcinogenicity of naturally occurring 1-hydroxyanthraquinone in rats: induction of large bowel, liver and stomach neoplasms

The carcinogenic potential of 1-hydroxyanthraquinone (HA), anaturally occurring compound, was examined. A total of 60 maleACI/IN rats, 1.5 months old at the commencement were dividedinto two groups. Group 1 (30 rats) were fed the diet containingHA at a concentration of 1% throughout the experIment (480 days).Group 2(30 rats) served as the control given a basal diet alone.Twenty-five of 29 effective animals in group 1 developed adenomasor adenocarcinomas in the cecum or upper portion of the colon,the mean number of large bowel tumors/tumor bearing rat being2.3. In addition to these intestinal tumors, liver neoplasms(neoplastic nodules and hepatocellular carcinomas) were observedin 12 rats and benign stomach tumors were obtained in five animals;no rats of group 2 demonstrating development of any of thesetumor types. The incidences of the large bowel, liver and stomachneoplasms in group 1 were all significant as compared with group2 (P < 2 x 10^–13, P < 5 x 10^–5 and P <3 x 10^–2 respectively) clearly indicating that HA is carcinogenicin rats.     

INHIBITION OF CYCLIC GMP PHOSPHODIESTERASE BY XANTHINE DERIVATIVES RELAXES GUINEA-PIG TRACHEALIS SMOOTH MUSCLE

1. For the purpose of clarifying the mechanism of the airways smooth muscle relaxant action of xanthines, cyclic guanosine monophosphate (GMP) phosphodiesterase (PDE) from guinea-pig trachealis muscle was purified with diethylaminoethyl ether (DEAE) cellulose column chromatography. 2. Five 3-alkylxanthines (3-methylxanthine, 3-ethylxanthine, 3-n-propylxanthine (enprofylline), 3-n-butylxanthine, and 3-iso-butylxanthine), and five 1-methyl-3-alkylxanthines (1-methyl-3-methyl-xanthine (theophylline), 1-methyl-3-ethylxanthine, 1-methyl-3-n-propylxanthine, 1-methyl-3-n-butylxanthine, and 1-methyl-3-iso-butylxanthine (IBMX] were compared in terms of purified cyclic GMP PDE inhibition. The relationship between the structure and inhibition of cyclic GMP PDE was studied. 3. The -log EC50 values for relaxation of spontaneous tone of isolated guinea-pig trachealis preparations by the 3-alkylxanthines and 1-methyl-3-alkylxanthines were determined. 4. The five 1-methyl-3-alkylxanthines were each more potent in relaxing isolated trachealis smooth muscle than the corresponding 3-alkylxanthines. The 1-methyl-3-alkylxanthines were also more potent than the corresponding 3-alkylxanthines in their cyclic GMP PDE inhibitory effect. There was a strong positive correlation between the concentration of inhibitor which inhibited hydrolysis by 50% (IC50) values for cyclic GMP PDE inhibition by the xanthine derivatives and their EC50 values for trachealis muscle relaxation. 5. It is suggested that the mechanism by which xanthine derivatives relax trachealis smooth muscle involves inhibition of cyclic GMP PDE in addition to inhibition of cyclic adenosine monophosphate PDE.     

Linear Enhancement After Radio-Frequency Ablation for Hepatocellular Carcinoma: Is It a Sign of Recurrence?

This prospective study was performed in 179 hepatocellular carcinoma (HCC) lesions treated by radio-frequency ablation (RFA) to explore the clinical outcome of “linear enhancement” on contrast-enhanced sonogram. Thirty-three lesions (18.4%) showed linear enhancement, a linear-shaped positive enhancement in the RFA-treated area. Seventeen of them were followed up with no treatment (remaining 16; dropout in eight, additional RFA in six and ineffective treatment in two) and three lesions (3/17, 17.6%) showed local tumor progression corresponding to linear enhancement at 7, 14, 19 months after RFA. Although there was no significant difference in local recurrence rate between the lesions with (3/17) and without linear enhancement (10/35), local tumor progression inside the ablation zone occurred only in the lesions with linear enhancement. In conclusion, linear enhancement inside the RFA-treated area should be followed up within 7 months because it has a risk of local tumor progression. Histology of linear enhancement and its influence on distant recurrence remain to be solved.     

An improved Internet-based melanoma screening system with dermatologist-like tumor area extraction algorithm

In this paper, we present an Internet-based melanoma screening system. Our web server is accessible from all over the world and performs the following procedures when a remote user uploads a dermoscopy image: separates the tumor area from the surrounding skin using highly accurate dermatologist-like tumor area extraction algorithm, calculates a total of 428 features for the characterization of the tumor, classifies the tumor as melanoma or nevus using a neural network classifier, and presents the diagnosis. Our system achieves a sensitivity of 85.9% and a specificity of 86.0% on a set of 1258 dermoscopy images using cross-validation.