シュワン細胞と末梢性髄鞘に特異的に反応するSchwann/2E抗体を用いて, 神経鞘腫92例, 悪性神経鞘腫6例, 神経線維腫12例, 外傷性神経腫3例を免疫組織化学的に検索した.神経鞘腫の78%にSchwann/2E陽性細胞が出現しており, 37%の症例では全体の1/3以上の細胞がSchwann/2E陽性であった.悪性神経鞘腫と神経線維腫は全例がSchwann/2E陰性であった.外傷性神経腫では大部分の細胞がSchwann/2E陽性となった.以上の結果から, Schwann/2E抗体のシュワン細胞由来腫瘍における特徴的な染色性ならびにそれら腫瘍の検索におけるSchwann/2E抗体の有用性が示された.

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1987-1996年の10年間に群馬大学草津分院に入院しリハビリテーションを受けた70歳以上の患者222例について, 年齢, 住所, 疾患名, 合併症, 障害期間, 入院期間, 入院理由, 介護者, 家族数を検討した.年齢は70歳代が多く, 患者は地元草津町が45%を占めた.疾患別では脳疾患が最多 (38%) で, 患者の70%が合併症を持っていた.平均入院期間は82日であった.高齢ながら温泉を利用したリハビリを希望して遠方より来院する患者が多いが, 本人の意志による入院が多く, 医師の紹介による入院はわずかであった.介護者は女性が81%を占めた.介護者が妻, 夫, 娘, 息子, 嫁 (息子または兄弟の妻), 無しの症例の平均入院期間はそれぞれ58, 71, 75,114, 86,124日であった.家族数は1, 2人がそれぞれ16, 31%で, 独居老人や老夫婦2人暮らしがほぼ半数を占めた.80歳以上の患者についてみると4人以上の家族が多かった.高齢者のリハビリの動機と目標は漠然としていて, 入院は長期化した.温泉療法を活用することでリハビリの意欲は増加しQOLの向上に寄与したと思われるが, 高齢者のリハビリ適応については慎重な検討を要すると思われた.

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We have clarified that when estrogen is administered to immature castrated rats, the seminal vesicle is more responsive than other accessory sex organs, and we are using this experimental model to study the proliferation of the stroma in the male accessory sex organs. In this study we used this experimental model to investigate the usefulness of the estrogen releasing silastic tubing as an alternative administration method to the continuous injection method. Silastic tubing was filled with 17β-estradiol-3-benzoate (E2). The E2-silastic tubing was then subcutaneously implanted into the backs of immature castrated rats, and treatments were performed for 112 weeks. At 1, 2, 3, 6 and 12 weeks after the administration of estrogen, the rats were sacrificed and the serum estradiol-17β concentration and the weight of the seminal vesicle were determined. As well as histological analysis, comparisons were made with the subcutaneous continuous injection method (5 μg/day). The average serum estradiol-17β concentration was 120.0 ± 89.8pg/ml for weeks 12 with the injection method, and 118.2 ± 64.8pg/ml for weeks 112 with the E2-silastic tubing. As with the injection method, proliferation of stroma, a characteristic effect of estrogen, was seen in the seminal vesicle. The weight of the seminal vesicle increased almost linearly for the first 6 weeks. These results suggest that the silastic tubing method is useful as a continuous administration method for estrogen.

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We examined the antitumor effect of combination therapy consisting of cyclophosphamide and allogeneic lymphocyte transfusion in Meth A-bearing Balb/c, Meth A-bearing T-cell deficient nude and Meth A-bearing T-and B-cell deficient severe combined immunodeficiency (SCID) mice.
Combination therapy induced significant inhibition of tumor growth in the Balb/c mice but not in the nude or severe combined immunodeficiency mice. Cells collected from spleens of the Balb/c mice which regressed tumors showed cytotoxic activity against Meth A cells. The cytotoxicity against labeled Meth A cells was inhibited only by non-labeled Meth A cells and not by non-labeled EL-4 or S-180 cells.
These results suggest that the effector cells induced by combination therapy consisting of cyclophosphamide and allogeneic lymphocyte transfusion are not derived from donor cells but from the recipient mice and that the effector cells are not natural killer (NK) or lymphokine-activated killer (LAK) cells but specific cytotoxic T-lymphocytes.

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Although circulatory disorders in the vertebrobasilar arterial system can be expected to induce vertigo without any other indications, no findings to serve as a definite basis for diagnosis of such circulatory disorders have yet been established. Therefore, if the clinical characteristics of cases in which circulatory disease induces vertigo alone were elucidated, it would contribute to diagnosis.
We performed a diagnostic trial on six patients who presented no findings in audibility tests and balance tests to aid in diagnosis of vertigo. The clinical characteristics of cases in which therapy aiming at improved cerebral circulation was effective were as follows :
1) Vertigo is rotary or floating, lasting for short periods, and not accompanied by cochlear symptoms.
2) Hypacusis in both ears in the low-tone region at a similar level, which the patient is not aware of, is observed.
3) Findings of nystagmus suggesting transient central vestibular disturbance are obtained in some cases.
4) DP (directional preponderance of nystagmus) is found by caloric testing in some cases.
Cases with the above clinical characteristics were considered to be cases of vertigo due to circulatory disorder in the vertebrobasilar arterial system.

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In general, other brainstem symptoms frequently serve as a basis for diagnosis in patients with vertigo due to circulatory disorders of the vertebrobasilar artery. It is thus difficult to diagnose patients who complain only of vertigo. Clarification of clinical features of such patients is important in diagnosis as well as the treatment.
Diagnostic treatment was given to 18 patients complaining only of vertigo with a history of visual disorders, eyes blacking out, periods of unconsciousness or brainstem symptoms including nausea, vomiting and headache. In 17 patients (94.4%), vertigo disappeared within 8 weeks after initiation of treatment for cerebrovascular circulatory disorders. A tendency toward improvement in bilateral reduced hearing in the low-tone region which was detected on audiograms during the initial examination.
The clinical features were as follows :
1) Vertigo is rotatory or floating with a short duration and occurs spontaneously or upon moving.
2) Although patients are not aware of impaired hearing, a reduction in hearing in the low-tone region is observed at a similar level on audiograms of both ears.
3) Tinnitus aurium or congested feeling in the ears, if present, does not appear or disappear accompanying vertigo.
4) Transient nystagmus findings suggesting a central vestibular disorder are occasionally observed in nystagmus tests.
5) Directional preponderance (DP) is occasionally obtained in caloric testing.
A circulatory disorder in the vertebrobasilar artery, for which treatment for improving cerebrovascular circulation is effective, was considered as the pathogenesis of vertigo in patients with the above-mentioned clinical features.

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A diagnostic treatment was given to 18 patients with vertigo accompanied by hypotension. Neither audiometry nor equilibrium tests revealed diagnostic evidence for vertigo in these patients. In 17 patients (94.4%), vertigo disappeared within two weeks after the initiation of treatment for cerebrovascular circulatory disorders. An improvement or a tendency toward improvement was achieved in bilateral reduced hearing in the low-tone region which was detected on audiograms during the initial examination.
The clinical features were as follows :
1) Vertigo is rotatory or floating with short duration and occurs spontaneously or upon moving.
2) Although patients are not aware of impaired hearing, a reduction in hearing in the low-tone region is observed at a similar level on audiograms of both ears.
3) Tinnitus aurium or congested feeling in the ears, if present, dose not appear or disappear accompanying vertigo.
4) Transient nystagmus findings, suggesting a central vestibular disorder, are occasionally observed in nystagmus tests.
5) Directional preponderance (DP) is occasionally obtained in caloric testing.
A circulatory disorder in the vertebrobasilar artery for which treatment for improving cerebrovascular circulation is effective, was considered as the pathogenesis of vertigo in patients with the abovementioned clinical features.

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Although there are many cases of tinnitus aurium due to circulatory disorders in the vertebrobasilar arterial system, a basis for diagnosing of circulatory disorders has not yet been found. Twenty seven ears of twenty patients with tinnitus aurium with no history of middle ear diseases or sensorineural hearing loss but with cerebral infarction and assumed to have circulatory disorders in the vertebrobasilar arterial system were selected for diagnostic therapy in order to elucidate their clinical features.
Curative effects on tinnitus aurium were good twenty ears (74.1%) markedly improved at the eighth week after the first treatment. Hypacusis hearing in the low-tone region observed on audiograms during the initialexamination showed improvement or tendency toward improvement.
Hypacusis hearing in the low-tone region observed at a similar level in audiograms of both ears possibly suggests the existence of circulatory disorders in the vertebrobasilar arterial system and also was a clinical characteristic of patients with tinnitus aurium to where circulation improving agents were effective.

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We report a case of videothoracoscopic surgical treatment of neurofibroma arising from the intrathoracic left vagus nerve associated with Recklinghausen's disease. Tumors that originate in the bilateral vagus nerve are extremely rare. But, as right side, we diagnosed on radiographic identification, not histologically. Only the tumor located near the left vagus nerve was resected due to rapid growth of the tumor. To the best of our knowledge, this is the fourth report of such videothoracoscopic surgical intervention.

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We report the case of a patient with an olfactory neuroblastoma which occupied the sphenoid sinus with nasal and suprasellar extension. Presenting symptoms included diminished visual acuity in the right eye. Computed tomography (CT) and magnetic resonance (MR) imaging demonstrated a tumor that had destroyed most of the sphenoid sinus, extending to the nasal cavity and suprasellar region. The patient underwent surgery via a fronto-temporal approach. An extensive review of the literature revealed approximately 300 cases of olfactory neuroblastoma, however, only two of these cases involved the sphenoidal region. This tumor is not thought to be derived from the olfactory neuroepithelium, but rather from neural crest tissue surrounding the sphenoid sinus.

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Since Japan implemented its national isolation policy in 1639, the Dutch factory on Deshima Island of Nagasaki had been playing a unique role to provide the Japanese with information of the Western world. There, the Japanese foreign policies were put into practice most actively. For both the Japanese government and those who were studying medicine and natural science in Japan, communication with the Dutch was the only way to learn about the latest information and technologies. Soon after his arrival in 1823, Siebold started to conduct medical treatment for patients to whom he had been introduced by the interpreters and doctors visiting Deshima. His reputation as an internist, surgeon, oculist, and gynecologist was especially high because he was very successful with treatments in such areas. Being a specialist in the medical field, Siebold also owned expertise in European studies, which helped to improve the academic standards of the Japanese. Court journey in 1826 was an excellent opportunity for Siebold to learn more. He was very excited about it, but never imagined that his inquiring mind would cause unfavorable conditions to himself. On his way to Edo, he collected specimens of animals and plants with a help of his friends and his students. In Edo, he invited some people to Nagasakiya, the inn where he was staying, in order to obtain important information and objects. Among the articles Siebold had obtained during his court journey, there were numbers of items against the Japanese law, and this became the cause of the Siebold Incident later in 1828. The Siebold Incident still is full of mysteries. To discover the truth hidden in history, it may be helpful to analyze the series of inconsistent actions taken by the government. This would allow us to grasp what their real intention was, and look at the incident from a different point of view. Reviewing the whole story of the Siebold Incident will certainly help us to understand the importance of the newly discovered documents.

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