Stereotactic radiosurgery using a gamma knife obtains good results for small intracranial disease, arteriovenous malformation (AVM) and acoustic neurinoma. In this study, accuracy of the radiation method of stereotactic radiosurgery using a LINAC was investigated and preliminary treatment results were also evaluated. The deviation of rotation center of the LINAC gantry was within 0.5mm. However, the deviation of rotation center of the LINAC table was more than 0.5mm. To apply the LINAC target positioner manipulator, the deviation of rotation center of the LINAC table was improved to within 0.5mm. Between July 1992 and November 1994, 25 patients recieved stereotactic radiosurgery using a LINAC. All patients had a small intracranial lesion, AVM ; 6, primary brain tumor ; 9 (acoustic neurinoma ; 4, meningioma ; 2, astrocytoma ; 2 and pineal tumor ; 1) and metastatic brain tumor ; 10. Two of 6 AVMs and one of 4 acoustic neurinomas decreased in size. Seven of 10 metastatic brain tumors either shrunk or disappeared. It is suggested that stereotactic radiosurgery is more effective than whole brain irradiation for metastatic brain tumor. In only one patient who had AVM, post irradiation brain edema appeared. Optimal dose to control tumors remains to be determined by accumulation of further clinical experiences.

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Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder that frequently results in renal failure due to progressive cyst development. The prevalence is approximately 1 in 1000 individuals among all races. At least two loci have been reported: PKD1 gene is mapped to 16p13.3 and PKD2 gene is mapped to 4q13-q23. Although a part of the PKD1 gene has recently (1994) been cloned, genetic linkage analysis is still important for presymptomatic diagnosis. In this study, we attempted to establish an indirect DNA diagnosis by PCR using microsatellite markers and buccal cell DNA which is the most convenient and rapid method. 1-20μg of DNA were isolated from 200 streaks of cheeks by successive treatment of proteinase K, phenol, chloroform, and ethanol. Markers SM7 and 16AC2.5 revealed clear polymorphisms among six microsatellite markers (SM7, 16AC 2.5, SM5B, MS7, KG8 and SM6) and were most informative. Two families each including two affected persons were studied by using these two markers. PKD1 gene seemed not to inherit to an elder son in one family and to inherit to one boy in the other family from his affected grandfather through his affected father This simple method is being used for the presymptomatic diagnosis.

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We have examined whether CD11b, CD15 and CD35 on human granulocytes as adhesion molecules, related to both rolling along and attachment to endothelium, were increased by treatment with bamboo-leaf extract (BE), in vitro. The BE was partially purified by gel filtration with Sephadex G-75 columun and was separated into two fractions : large molecular weight polysaccharide (Fr. -a, M.W.>50,000) and small molecular weight polysaccharide (Fr. -b, M.W. <50,000). The cells from healthy volunteers were treated with Fr. -a or Fr. -b for 30min at 37℃. The amount of each adhesion molecule on these cells was measured by flow cytometry and was represented as fluorescence intensities. The fluorescence intensities of CD11b, CD15 and CD35 on cells treated with Fr. -a or Fr. -b showed about twofold increase compared to untreatment cells. The Fr. -a and Fr. -b concentrations at which the value of these adhesion molecules reached a maximum flurorescence intensity were as followed : CD11b, 0.067mg/ml and 0.33mg/ml; CD15, 0.33mg/ml and 2.0mg/ml; CD35, 0.013mg/ml and 0.067mg/ml, respectively. CD35 positive granulocytes by treatment with low concentration (0.013mg/ml and 0.067mg/ml) of Fr. -a or Fr. -b increased about 12 percent compared to untreatment cells. These results suggest that human granulocytes were stimulated directly or indirectly by BE, in vitro and were induced by BE the expressions of adhesion molecules on the cells.

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Hypercalcemia is frequently associated with the certain types of malignancy such as lung cancer and most cases are due to humoral substances produced by tumor tissue (humoral hypercalcemia of malignancy: HHM). Among those substances PTH related protein (PTHrP) was identified recently as a major factor to cause hypercalcemia. We described two cases of HHM associated with squamous cell lung carcinoma, the first patient was 51-year-old man and the second was 84-year-old woman. In both cases, the results of parathyroid function tests including serum concentrations of Ca and P were compatible with those of primary hyperparathyroidism. However, the serum concentrations of PTH were suppressed and those of PTHrP were remakably elevated. Tumor was removed by right radical pneumonectomy in the first patient. In this case, all of the hypercalcemia related laboratoly findings were normalized after operation and the concentration of PTHrP in serum decreased to normal level. The second patient could not be treated surgically and died of pneumonia on the 58th hospital day. The determination of serum PTHrP concentration is useful for differential diagnosis of hypercalcemia and also valuable to estimate the effect of treatment for the patient with HHM.

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