In this study the effects of joint moment and alignment of the lower extremity with osteoarthritis of the knee (OA) were investigated. We used a three-dimensional analysis system to measure the hip and knee moment of subjects standing on one leg. Pelvic obliquity was also calculated. Motion analysis system (VICON) and two force plates as measurement devices were used in the study. Thirteen markers were placed on each subject. Radiographically F.T.A., ∠TDK, ∠CFK, ∠LGA, FD/TD, FG/AG and grade of progress of OA were assessed. We learned that FTA, ∠LGA, FD/TD, and FG/AG became indices of hip abduction moment and the knee valgus moment of a dynamic factor by radiography. Knee valgus moment was shown to increase with progress of the disease. This dynamically corresponds to parting of the body center of the gravity line from the knee joint. Moreover, hip abduction moment was shown to decrease with progress of the disease. The pelvic obliquity angle in all OA groups reduced on the side of the swing leg. It seems varus deformity of the knee joint caused progressive movement of the upper part of the body to the side of the standing leg. Therefore, it was supposed that there were two joint muscles which adhered to the pelvis, especially the participation of the tensor fascia lata, contributed to compensate for the progress of the knee OA. While standing, the tensor fascia lata is important realignment of the lower body. We suggest that biarticular muscle dysfunction, especially of the tensor facia lata, correlated with the progress of OA. Advancement of varus deformity, strain of the tensor facia lata, muscle imbalance between the abductor and adductor muscles of the hip joint caused pelvic obliquity and medial shift of the gravity line.

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Analysis of tumor DNA provides useful information for regarding malignancy and disease progression. Such data have been used increasingly for therapeutic purposes. Mutation of the p53tumor suppressor gene (p53abnormalities) is considered one of the most important factors in the development of many types of cancers which might predict responsiveness to therapeutic response or prognosis. Currently, analysis of DNA content by propidium iodide (PI) staining and assessment of p53 abnormalities by immunohistochemical staining (p53-immunostaining) are used succerrf ully. However, there have been no studies of the relation between DNA ploidy and p53 abnormalities in the same cells. In the present study, we prepared thinlayer cytologic specimens of 18 cases of ovarian surface epithelial-stromal tumors from 26 ovarian tumors. Patients had undergone intraoperative rapid diagnosis between April 2002 and April 2003 at our hospital. Specimens were fluorescently stained for both DNA and p53 protein, and analyzed by Laser Scanning Cytometer (LSC) . DNA ploidy analysis revealed that all seven malignant tumors were aneuploid, whereas all five benign tumors were diploid, and three borderline tumors were either aneuploid or diploid. p53-immunostaining revealed that the p53-positive rate was significantly higher in malignant tumors than in benign tumors, and the rate in borderline tumors was intermediate. In malignant tumors, including borderline tumors, cells with more DNA tended to contain more p53 protein even in the same cells. We considered that dysfunction of cell cycle regulation caused by p53 abnormalities increased genetic instability, resulting in the predominance of aneuploidy in tumor cells. Both DNA ploidy analysis by LSC and p53-immunostaining might be useful for diagnostic, therapeutic and prognostic analyses of ovarian surface epithelial-stromal tumors.

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We report a fatal case of a 71-year-old man who had Churg-Strauss syndrome with recurrence of vasculitis symptoms during corticosteroid tapering. Because the patient had bronchial asthma, eosinophilia, and vasculitis symptoms, a diagnosis of Churg-Strauss syndrome was made. We commenced the administration of 1 mg/ kg / day of prednisone. The oral corticosteroid treatment was continued for 1 month. Subsequently, the treatment was tapered because no evidence of disease was present. The patient, however, died of recurrence and exacerbation of vasculitis symptoms during a gradual taper of prednisone. Thus, we believe that physicians who treat patients with Churg-Strauss syndrome should always guard against a severe relapse of vasculitis and prepare to commence methylprednisolone pulse treatment or additional therapy of immunosuppressive agents during a taper of corticosteroid.

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Patient: 74-year-old. Male. A patient of amyotrophic lateral sclerosis (ALS) underwent brain surgery due to traumatic brain injury. The patient atc meals after undergoing the operation, but complications with pneumonia resulted in feeding with a nasal tube. The patient suffered ftom dementia in addition to weakness of the proximal limb muscles. Videof luoroscopic examination of swallowing showed food remained in the pharynx and food had gone into the larynx. However, if it was a small amount, it was possible for him to eat from the mouth. There was no desire to eat meal from the mouth at all though it was able to eat food for oneself for the hospitalization period. Therefore, we did percutaneous endoscopic gastrostomy (PEG) to him. His feeding desire improved after his discharge from the hospital, and the intake for oneself became possible partially. However, the intake for oneself became difficult again as his upper extremity function decreased. Afterwards, he died for pneumonia. In this case, the bulbar palsy caused by ALS was a comparatively light symptom. However, because he had had the decrease in the feeding desire, it was difficult for us to forecast the prognosis concerning his swallowing difficulty. In progressive diseases of the nervous system such as ALS, when some disabilities in addition to the swallowing difficulty overlapped, the necessity for doing gastrostomy at the early stage was suggested.

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