The Keio Journal of Medicine
Online ISSN : 1880-1293
Print ISSN : 0022-9717
ISSN-L : 0022-9717
Volume 40, Issue 2
Displaying 1-7 of 7 articles from this issue
  • Liu Tai-fu
    1991 Volume 40 Issue 2 Pages 59-62
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Nasopharyngeal carcinoma (NPC) is one of the major cancers that Chinese radiotherapists have to treat, because of its high incidence which shows a tendency to increase. Although results of radiotherapy in NPC have improved markedly during the last decade, treatment at an early stage of the disease is the most effective. It is therefore important to make the diagnosis early, and recently serological surveys by IgA/VCA show its efficacy in high risk populations. Histological diagnosis so far has not correlated to prognosis, and new histological classifications have been proposed by many authors. The importance of CT scans in diagnosis and treatment is stressed. Criteriae for clinical staging of NPC will have to be reconsidered, especialy the T staging, as 80% of cases formerly classified as Tl may already have paranasopharyngeal extension, as shown on CT scans. The technique of radiotherapy has not changed much essentially since the advent of telecobaltherapy. However, various institutions have their own special variations. The most striking advance is the use of high-dose rate afterloading brachytherapy as boost for residual disease or as main treatment for nasopharyngeal recurrences. Finally, the role of chemotherapy in the radiation treatment of NPC is discussed, and the paper concludes with some remarks on the future outlook in the diangosis and treatment of NPC.
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  • James A Garrity
    1991 Volume 40 Issue 2 Pages 63-71
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    In summary, the first step in managing Graves' orbit-opathy rests with establishing a correct diagnosis. The evaluation does not stop at this point, however. A thorough ophthalmic examination to identify the patient's areas of concern and to evaluate the status of the visual acuity, eyelids, cornea, ocular motility and optic nerve is done. A general medical evaluation determines the status of the thyroid gland and any other medical problems which threaten the patient's health.
    The surgical management of Graves' orbitopathy as described above at first glance might seem to be ag-gressive therapy. In many patients, especially those with severe or sight threatening orbitopathy, this type of therapy may prove to represent conservative therapy in the long-term as patients generally tend to be rehabi-litated sooner and can be spared untoward effects of prolonged high dose corticosteroids. It has been our belief that surgical management of severe orbitopathy is more predictable than medical management and that surgery is associated with an acceptable rate of compli-cations. While long-term follow-up has been provided for some patients treated by transantral orbital decom-pression, 37 a larger group with longer follow-up is cur-rently being evaluated at our institution in order to further assess late results, detail any late complications, assess patient satisfaction and to review the status of thyroid function before and after decompression.
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  • Thomas T Provost
    1991 Volume 40 Issue 2 Pages 72-77
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Anti-Ro(SSA) and La(SSB) antibody determinations have become important serologic tests in the evaluation of lupus erythematosus and Sjögren's syndrome patients. These antibodies appear to identify a group of lupus patients with prominent skin diseases. Although much of the initial investigations regarding the value of these antibodies has been performed in the United States and Europe, preliminary studies suggest that the frequency of these antibodies in Japanese and other Oriental patients may be double that seen in American patients. This article will briefly review our knowledge of the molecular, immunogenetic and clinical features of the anti-Ro(SSA) and anti-La(SSB) antibody responses.
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  • Yuzuru Takemura, Takao Ohnuma, Susumu Sekiguchi
    1991 Volume 40 Issue 2 Pages 78-81
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    The influence of tumor cell density on the antitumor effect of doxorubicin (DXR) in combination with cisplatin (CDDP) was studied in vitro using DND-39A lymphoma cells. DXR was progressively less effective on colony formation inhibition when cell density was increased from 105 to 108 viable cells/ml (positive inoculum effect), whereas the effect of CDDP was not influenced by cell densities. At a density of 105 cells/ml, inhibition of colony formation was virtually identical irrespective of cells being exposed to DXR and CDDP either simultaneously or sequentially. When cell density was increased to 107 and 108 cells/ml, sequential exposure to CDDP followed by DXR was more active than simultaneous or reversed order of exposure to the two drugs. These results indicate that for DXR-CDDP combination chemotherapy against the cells at high density, the proper sequence of the treatment should be the administration of CDDP followed by DXR, rather than simultaneous or reversed order of exposure. Inoculum effect may be an additional determinant for the rational development of combination chemotherapy.
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  • Mikio Mikami
    1991 Volume 40 Issue 2 Pages 82-89
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Uterus is an organ in which cellular proliferation and differentiation are strictly controlled by sex steroid hormones. Since we found a characteristic expression of sulfatide (I3 SO3-GalCer) in the human endometrium during its secretory phase, we decided to analyze developmental changes of glycolipids in murine uteri with special reference to the estrous cycle. Moreover, we analyzed sulfotransferase activity for the synthesis of sulfatide in the endometria in the proliferative and secretory phases and that in the epithelial and stromal cells derived from the human uterine endometrium. In the murine uterus, contents of GlcCer, LacCer, and Gb4Cer were relatively constant both during estrus and diestrus, but those of Gb3Cer and Gg4Cer during estrus were significantly greater than those during diestrus. In contrast, GM3 and sulfatide contents during diestrus were higher than those during estrus. This increase in GM3 and sulfatide during diestrus was characteristically observed in the uterus after sexual maturity. In human uterine endometrium, sulfotransferase activity for the synthesis of sulfatide was found only in the epithelial cells, but not in the stromal cells. Furthermore, the synthetic potential of sulfatide in the human endometrium was higher in the secretory phase than in the proliferative phase. Thus, sulfatide metabolism in human endometrial epithelial cells as well as in the murine uterus is supposed to be well controlled under hormonal regulation, and sulfatide may participate in several reproductive functions of the uterus.
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  • Masao Hagihara, Hiroyuki Kobayashi, Hayato Miyachi, Tetsuhei Ogawa
    1991 Volume 40 Issue 2 Pages 90-93
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    Nine acute myelogenous leukemia(AML) patients with a translocation 8;21, who were treated at Keio University Hospital between 1983 and August 1990, were reviewed. All of them were classified into AML-M2 subtype of the French-American-British classification. It formed 43% of all M2 cases. The patients' mean age was 47 years. Neutrophil alkaline phosphatase score was lower than normal and complete remision (CR) was achieved in all cases. In statistical analysis, patients with the t (8;21) showed a longer CR duration and a higher percentage of eosinophils than the other AML-M2 patients without this karyotype (p<0.05, p<0.01, respectively). As an additional chromosomal abberation, two patients showed a loss of Y chromosome at first diagnosis and another patient did a deletion of 12p- at the 3rd relapse and an elongation of 20q in addition to the 12p at the 4th relapse. Although patients with the t (8;21) are regarded as a favorable group in respect of survival, we found a subset of patients who had poor prognosis. Some of them were accompanied with solid tumor formation. Only one patient has lived longer than 5 years. These findings suggest that AML with the t (8;21) is clinically heterogenous.
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  • Tohru Ogihara, Hiroyuki Miyao, Hiroshi Katoh, Hideki Ikenaga, Naohiko ...
    1991 Volume 40 Issue 2 Pages 94-96
    Published: 1991
    Released on J-STAGE: March 27, 2009
    JOURNAL FREE ACCESS
    A 25-year-old Japanese woman experienced pulmonary edema, shock, encephalopathy and silent pancreatitis after hysterosalpingography using lipiodol ultra fluid, because the contrast media flowed directly into the blood stream from endometrium injured by several curettages for termination of pregnancy. Total iodine concentrations in plasma and urine decreased exponentially and their half-life was 16.12 and 13.04 days, respectively. Clear correlations were observed between the iodine concentration in plasma and the amelioration of both electroencephalogram and neuropsychic abnormalities. Adverse reactions of oil-soluble contrast media are also discussed.
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