Two female breast cancer patients who received combined tamoxifen and tegafur as postsurgical adjuvant therapy developed severe hepatotoxicity after being treated for three and eight months, respectively. Shortly after the cessation of the treatment, routine liver tests showed gradual recovery, but liver biopsies revealed chronic active hepatitis in one patient and liver cirrhosis in the other. Four and five years, respectively, after the cessation of the treatment, the results of liver tests were normal and distinct histological improvement was observed in both patients. Because these patients had no viral and immunoserological markers nor any history of alcohol abuse, this study suggested that the tamoxifen and tegafur regimen induced reversible chronic active liver disease.
21Many male animals donate nutritive materials during courtship or mating to their female 22 mates. Donation of large-sized gifts, though costly to prepare, can result in increased 23 sperm transfer during mating and delayed remating of the females, resulting in a higher 24 paternity Nuptial gifting sometimes causes severe female-female competition for 25 obtaining gifts (i.e., sex-role reversal in mate competition) and female polyandry, 26 changing the intensity of sperm competition and the resultant paternity gains. We built a 27 theoretical model to analyze such coevolutionary feedbacks between nuptial gift size 28 (male trait) and propensity for multiple mating (female trait). Our genetically explicit, 29 individual-based computer simulations demonstrate that a positive correlation between 30 donated gift size and the resultant paternity gain is a requisite for the co-occurrence of 31 large-sized gifts and females' competitive multiple mating for the gifts. When donation 32 of gifts imposes monandry, exaggeration in nuptial gift size also occurs under the 33 assumption that the last male monopolizes paternity. We also analyzed the causes and 34 consequences of the evolution of a female persistence trait in trading of nuptial gifts, that 35 is, double receptacles for nuptial gifts known to occur in an insect group with a "female 36 penis" (Neotrogla spp.). 37 38 3 39
Hepatobiliary cystadenoma was suggested to be uncommon and it is often difficult to make a differential diagnosis. We report a case of a 65-year-old woman who presented with changes in the structure of a cyst that had been observed for the previous 10 years. Diagnostic imaging revealed a 7-cm-diameter cystic lesion with internal septations and papillary projections in her liver. All laboratory test results were normal; however, cystic fluid carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 were raised, at 160 ng/ml andover 200,000 U/ml, respectively. Owing to changes in the structure of the cyst and the difficulty of differential diagnosis from cystadenocarcinoma, a complete surgical excision was performed. The histological findings indicated that the tumor consisted of a multilocular cyst lined by glandular cells (with cuboidal or tall columnar cystoplasm), which were immunohistochemically positive for cytokeratin, CEA, epithelial membrane antigen, and CA 19-9. The underlying stroma was composed of proliferating primitive spindle cells which were immunoreactive for vimentin, alpha-smooth muscle actin, muscle-specific actin, and desmin, and resembled ovarian stroma. From these findings, this tumor was diagnosed as hepatobiliary cystadenoma with mesenchymal stroma. Even though the tumor was previously diagnosed as a simple liver cyst, it was necessary to pay special attention to the changes in the structure of the cyst, using ultra sonography and/or computed tomography, bearing in mind hepatobiliary cystadenoma with mesenchymal stroma. The malignant potential of this tumor is stressed, and complete surgical resection is the recommended therapy.
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