As a background of Health Promotion, which was advocated by World Health Organization in 1986, it could be pointed out that there was serious health problem resulted from chronic and non-infectious diseases. The purpose of this article was to describe the multidimensional structure of the semi-health status, which indicated transitional health condition based on natural history of disease on chronic disease, among elderly persons, adolescent persons, and school-aged children in Japan. The data derived from the self-reported questionnaire, which consisted of 47 items regarding physical and mental conditions based on subjective symptoms by self-estimation, was used for the analysis. Then the principal component analysis was applied to the data in order to extract indices that represented the characteristics of the multidimensional structure on the semi-health status. As the result, four principal components, which were interpreted as the synthetic component, physical-mental component, slight-severe symptoms component, and medical component on the semi-health status, were extracted. It was pointed out that the semi-health status among Japanese people was composed of four-dimensional scales. Furthermore, the first principal component was a beneficial scaling to evaluate the level of the semi-health condition from a quantity aspect.

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This study examined clinical findings, treatment and outcome of the patients with oral metastatic tumors. Six patients who were admitted to our department between April 1984 and March 2004 were examined. Four of the 6 patients were male and 2 were female. Age of patients ranged from 50 to 83 years (average 61. 8). Three of 6 patients had metastatic tumors at the upper gingival, 2 had at the lower gingival and 1 had at the mandibular bone. The most common site of the primary tumors was the lung (3 cases), followed by the liver (2 cases) and the mammary gland (1 case). The histological types were small cell carcinoma (2 cases), hepatocellular carcinoma (2 cases), squamous cell carcinoma (1 case) and adenocarcinoma (1 case). Oral metastatic tumors were diagnosed 1-96 months after revelation of the primary tumors in 4 patients and metastatic tumors were diagnosed before revelation of the primary tumors in 2 patients. Four cases were treated palliatively, but 2 cases did not received treatment. In 4 cases who received treatment, pain was reduced and temporal improvement of the oral function was recognized.

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Follicular lymphoma in a 31 years-old female was refractory to repeated conventional chemotherapies. She had cardiac dysfunction due to the regimen related toxicity of chemotherapy. She received allogeneic peripheral blood stem cell transplantation following the reduced intensity conditioning regimen with melphalan and cladribine. Hematopoietic recovery after transplantation was prompt, and complete chimerism was obtained. The patient had not acute or chronic graft versus host disease. Lymphoma was in complte remission for a year until the swelling of neck lymphnode which disappeared after the withdrawal of cyclosporine. The patient enjoyed good quality of life after transplantation.

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Twenty seven years old female complained of pleural fluid, neck lymph node swelling and mediastinal mass. The cytologic examination of pleural fluid and neck lymph nodse biopsy revealed malignant lymphoma. However immature blasts, which were peroxidase and PAS negative and morphologically diagnosed as M0 by FAB classification, and were CD7, CD19, CD13, CD33, CD34, HLA-DR, CD56 positive by flow cytometry analysis, were observed in the bone marrow. Myeloid/natural killer cell precursor acute leukemia was diagnosed. The remission induction chemotherapy for acute myeloblastic leukemia (AML) was performed, and complete remission was obtained. However, the size of mediastinal mass was unchanged. For attempting hematopoietic stem cell transplantation, irradiation to the mediastinal mass was performed, however, the mass did not became smaller than a half. The leukemia relapsed after 3 months, and the leukemic cells were refractory to the repeated chemotherapies, and the patient died 6 months. The autopsy findings demonstrated leukemic cells infiltration into the various organs, mediastinal mass and pulmonary alveolar proteinosis.

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We report a patient having gastric cancer with peritoneal dissemination, who has survived over 11 years after the several chemotherapies and 3 times bowel reconstructions. The patient is a 67-year-old female. In 1994, she was hospitalized for pneumonia. By further examination, she was diagnosed as gastric cancer. She underwent non-curative resection with total gastrectomy and pancreaticosplenectomy in August 1994. Although some disseminated nodules couldn't be resected, we performed postoperative chemotherapy with (1) tegafur + lentinan, (2) methotrexate / 5-FU, (3) docetaxel + 5'-DFUR and (4) TS-1 one after another. During a follow-up period, cholecystectomy was performed to cholecystitis in February 2000. No cancer recurrence was found. In July 2001, she underwent a bypass operation due to the cancerous stenosis of reconstructed jejunum. For the following 30 months, she recovered to be able to run a social life with chemotherapy (2)(3). Since March 2004, she started to have the symptom of ileus repeatedly. 8 months later, duodenojejunostomy was performed to the dilatation of duodenum caused by the cancerous stenosis of jejunum and we performed chemotherapy (4) afterward. In September 2005, the patient underwent ileostomy to the stenosis of ileum. At present, she is able to consume a meal and run a social life.

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