Parathyroid hormone (PTH) /PTH-related peptide receptor (PTH/PTHrPR) mRNA is widely distributed in rat tissues. In order to quantify PTH/PTHrPR in various tissues and to elucidate the effect of estrogen on PTH/PTHrPR mRNA transcription, a simple and reliable polymerase chain reaction (PCR) -based method for quantifying rat PTH/PTHrPR mRNA was developed. This method involves co-amplification of cDNA transcribed from sample RNA with the internal standard synthesized by insertion of a DNA fragment near the midportion of the rat target PTH/PTHrPR cDNA to reduce tube-to-tube amplification variations. The reverse transcription rate and the coefficient of variation of this assay were 22% and 12.0%, respectively. PTH/PTHrPR mRNA levels in the kidney removed from 12 week old rats were 165.8± 20.7 × 10^-19mol/g total RNA (n=4) and was higher than those in any other tissues. The chronic administration of estrogen significantly increased PTH/PTHrPR mRNA levels in the uterus, but had no significant effects on those in the kidney, heart, lung or brain. However, in the in vitro experiment using rat osteosarcoma ROS 17/2.8 cells, the administration of estrogen at a dose of 10^-8M significantly decreased PTH/PTHrPR mRNA levels. These findings suggest that the expression of PTH/PTHrPR is under the control of estrogen in certain tissues.

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We report the clinical statistics for new outpatients in our department in 1996.
The total number of new outpatients was 878, 629 males and 249 females, with a sex ratio of 2.52 : 1. The majority of patients both male and female were in the 7 th decade of life. 378 of the patients (43. 1 %) were referred to our department by other sources.
There were 149 malignant tumors, consisting of prostate cancer in 51 patients, renal cell carcinoma in 41, testicular tumors in 25, and bladder tumors in 19. Benign prostatic hypertrophy, in 100 patients, accounted for a large number of the benign tumors. Other major categories of patients were urinary tract stone patients (60 cases), renal transplantation and dialysis patients (54 cases), and cystitis patients (35 cases). Compared with other hospitals, the percentages of patients of prostatic cancer, renal cell carcinoma, testicular tumor, and renal transplantation, dialysis were higher. The percentages of cases of cystitis, bladder tumors, sexually transmitted diseases, phimosis, balanoposthitis, and injury were rare.

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Drug therapy was performed on 16 patients with nasal polyps who visited the hospital with major complaints of severe unilateral nasal obstruction and the therapeutic efficacy was investigated. Steroids and an anti-allergy drug with an anti-histaminic effect were administered orally and steroids were sprayed in the nasal cavity. Antibiotics and anti-inflammatory drugs were administered optionally. Six weeks after initiation of therapy, remarkably good therapeutic effects were obtained with respect to nasal obstruction, subjective symptoms, and the actual size of nasal polyps. Drug therapy for nasal polyps is considered necessary, though not sufficient, and could also prevent recurrence of nasal polyps after resection.

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Investigation of the elderly citizens over 65 years of age living alone in S town, Gunma on PGC (Philadelphia Geriatric Center Morale Scale), living status, financial status as well as psychological and health status revealed the following :
1. Average PGC score was 13.09 ± 3.26 and average age of the subjects was 75.97 ± 5.85. The PGC score of those under 75 was significantly higher than those over 76.
2. Average monthly income was ¥133.1 ± 85 thousand. Those whose expenses exceeded ¥130 thousand showed higher PGC score than those who spent less than ¥120 thousand. Those who lived in their own house showed significantly higher monthly income and PGC score than those who rent a house/apartment.
3. Sixty two percent of the responders felt that they were rather healthy. However, 83% of the subjects suffer from some kinds of diseases. Average PGC score of those responders believing that they were rather healthy was 13.82 ± 2.80.
4. Those who had something to live for had higher PGC score than those who didn't. Those who had no concerns about their future presented higher PGC than those who had some.
5. PGC score of those who wanted to live alone was higher than that of those who were forced to.

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The patient was a 90-year-old man, who was admitted to our hospital with complaint of dysphagia. The results of gastrointestinal fiberscopy revealed malignant obstruction in lower part of esophagus. To improve quality of life, Wall stent was inserted. By insertion of Wall stent in a patient of 90 years old with malignant esophageal obstruction, satisfactory improvement in quality of life was achieved.

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A 7-year-old girl with type I truncus arteriosus successfully underwent a Rastelli-type operation. Pulmonary artery banding had been performed for severe congestive heart failure refractory to medical treatment at 3 months of age. Two years later, she underwent a right modified Blalock-Taussig shunt for hypoxemia associated with decreasing pulmonary blood flow resulting from her continued growth. A longer than normal distance between the right ventricle and the pulmonary arteries and dilation of the common trunk prevented alternative reconstruction of the pulmonary trunk using autologous tissue. We reported our experience of a radical operation for type I truncus arteriosus and discussed the timing of definitive repair after palliation for this congenital cardiac anomaly.

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A 3-year-old boy with double-chambered right ventricle (DCRV), ventricular septal defect (VSD) and pulmonary stenosis underwent successfully surgical correction without a right ventriculotomy. This surgical approach consisted of a combined right atriotomy and pulmonary arteriotomy. A perimenbranous VSD was closed through the tricuspid valve, and the anomalous muscle bands of right ventricular outflow obstruction were resected through both the tricuspid valve and pulmonary valve. The pressure gradient between the right ventricle and pulmonary artery decreased from 70mmHg to 20mmHg. No major complications occurred after the repair. The transatrial approach with pulmonary arteriotomy is an appropriate and effective method to correct a DCRV.

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43-year-old woman was admitted to our hospital with lumbago and anemia. A diagnosis of multiple myeloma (IgG, χtype, stage III a) was made and was treated with 4 courses of MCNU-VMP therapy and 3OGy irradiation to the 12th thoracic vertebra. Treatment was followed by a decrease in M-protein and the percentage of myeloma cells in the bone marrow. After the 4th MCNU-VMP treatments, peripheral blood stem cells were mobilized with granulocyte-colony stimulating factor (G-CSF), and autoperipheral blood stem cells (PBSCS) were collected. However, the number of PBSCS collected was indeguate peripheral blood stem cell transplantation (PBSCT), and a 2 nd PBSCS collection was performed after high-dose for cyclophosphamide therapy. The total number of PBSC was CFU-GM 1.06 × 10⁵/kg, and the CD34 count 2.06 × 10⁶/kg. Auto-PBSCT was performed following the conditioning regimen of L-PAM 140mg/m² and TBI (11Gy).
Although hematological recovery after the PBSCT was delayed, complete response of the multiple myeloma was achieved. Six months later, no M-protein was not detected, and the plasma cell count in the bone marrow was 0.6% in the absence of any treatment for multiple myeloma. Auto-PBSCT may be useful for the treatment of multiple myeloma.

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