The prognosis of metastatic angiosarcoma of the scalp is extremely unfavorable. No effective chemotherapeutic protocol for metastatic angiosarcomas has yet to be established. We herein report a case of metastatic angiosarcoma, a 67-year-old Japanese female, who received a combined chemotherapy with peplomycin, cis-platin, adriamycin and vindesine (P-CAV). After 2 course of P-CAV therapy, primary lesion, regional lymphnode metastases and bone metastases were disappeared dramatically. But a few months later, another metastases of brain and lung were developed instead of adding 2 course of CIV (CBDCA, IFM, VDS) chemotherapy, and the patient died of 5 months clinical course. Although the chemotherapy might not prolong the survival of this case, P-CAV chemotherapy may be useful for angiosarcoma of the scalp.

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The questionaire about truth telling to skin cancer patients and informed consentwas underwent at the 8th annual meeting of the Japanese society for skin cancer, 1992. Ninety physicians replied the questionaire. Main results; only 17% (15/90) of subjectshad a policy of informing the correct diagnosis to the patients, while 93% (85/90) of subjects have informed the diagnosis to the family of the patients. 76% (68/90) agreedthe necessity of informed consent and truth telling theoretically but 49% (44/90) feltthe difficulty to do it practically. 29% (26/90) of the subjects approved the promotinof informed consent to the skin cancer patients, while 63% (57/90) took a prudentattitude to this problem. There were a variety of opinions concerned with informedconsent and additional problems. We may need a further discussion about theseproblems.

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症例1，67歳，男性．平成12年6月頃より，頭頂部にドーム状に隆起した暗紫紅色の腫瘤が出現したため受診した．病理組織学的に血管肉腫と診断し，IL-2局所注射，腫瘍切除，放射線照射による治療を行った．これらの治療の後paclitaxel 180 mg/m²を1日投与3週間休薬の形で2回行った．投与後，白血球の減少，筋肉痛，関節痛が出現した．その後，定期的に外来通院中であるが腫瘍切除後22カ月経過した現在まで再発，転移は認められない．症例2，72歳，男性．平成13年8月より頭頂部に直径1.5 cm×1.5 cm大のドーム状の腫瘤が出現してきた．平成13年9月6日当科を受診した．生検組織より血管肉腫の診断を確認した．その後2週間程で左側頭部に皮膚転移を認めたため，原発巣と一緒に切除した．術後放射線による治療と同時にpaclitaxel 60 mg/m²を1日投与6日間休薬の形で合計12回行った．格別副作用はなく12カ月経過した現在まで再発，転移は認められない．このように2症例とも，少なくとも12カ月以上再発，転移が認められないことよりpaclitaxelを加えた集学的治療は血管肉腫に対する有用な治療法として期待できる．

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A statistical investigation was conducted of Japanese angiosarcoma patients who had been registered by the Prognosis and Statistical Investigation Committee of the Japanese Skin Cancer Society. Data were obtained from 44 major medical institutions in Japan during the period from 1985 to 1995, and 162 patients were registered.
The data analyzed included the age, sex, anatomical distribution, clinical features, immunohistochemical staining patterns and treatment of the primary lesions. The survival rate was assessed by the Kaplan-Meier method and the log-rank test.
The commonest sites for angiosarcoma in both sexes were the head and face, and the prognosis was worse than that of tumors at other sites.
To improve the prognosis, treatment including rIL-2 seems superior to treatment without rIL-2 at the present time. [Skin Cancer (Japan) 2001; 16: 281-288]

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In recent years, there have been focus on environmental pollution issue resulting from consumption of fuel, e.g., coal and oil. Thus, introduction of an alternative energy source such as solar energy is expected. However, insolation is not constant and output of photovoltaic (PV) system is influenced by meteorological conditions. In order to predict the power output for PV system as accurate as possible, it requires method of insolation estimation. In this paper, the authors take the insolation of each month into consideration, and confirm the validity of using neural network to predict insolation by computer simulations. The proposed method in this paper does not require complicated calculation and mathematical model with only meteorological data.

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A 76-year-old female patient with Merkel cell carcinoma was reported. The tumor presented at the left neck and chest wall. Tumor cells were stained by antibodies to neuron specific enolase and keratin. Electron microscopy revealed dense core granules. Thirty cases reported sine 1988 were reviewed.

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Between May 1986 and September 1991, 104 patients of advanced or recurrent cancer were treated with combination therapy of hyperthermia and irradiation at UOEH hospital. Twenty seven patients had superficial tumors and 77 patients had deep seated tumors. They were irradiated with conventional fractionation. Hyperthermia was performed within 30 minutes after each irradiation once or twice a week using RF capacitive heating equipment, Thermotron RF-8. Total number of heating was 791 times. The most frequent side effect was pain under the electrode. It was observed in 444/791 (56 %) but most of them were mild and severe pain was seen only in 2 %. Burn due to heating was observed in 13 patiens (13 %). Severe side effect was observed in 9 patients consisting of 4 cases of ileus needing hospitalization, 3 cases of bleeding from intestine and tumor and 2 cases of intestinal fistula. It was not clear whether those damages were due to the heating itself or tumor growth. No patients had cardiovascular side effects.

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癌化学療法において最大のdose limiting factorである骨髄機能抑制に対処する方法として, ここ数年自家骨髄移植 (ABMT) が脚光を浴びつつある。今回, 我々はstage IIIのメラノーマ3例 (37歳, 女。45歳, 男。45歳, 男。) に術後補助療法として, ABMTを併用したDTICとACNUの大量化学療法を試みた。症例1ではABMTの効果が充分でなかったが, 症例2, 3では末梢白血球の回復は速やかで感染症に対するリスクは軽減された。しかし, 副作用として, 長期にわたる悪心, 食思不振と血小板減少症の遷延化が認められ, 症例3はDICを併発して死亡した。症例を供覧し, 本法の適応, 薬剤の選択, 投与量などにつき考察を加えた。

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　ビンカアルカロイド系抗がん剤の一種である硫酸ビンクリスチンは, 血管外に漏出した際, 対処方法として ｢温めること｣ が推奨されている. 薬剤の血管外漏出時の対処方法の一つである罨法は, その効果についての科学的確証が不足しているため, 看護師の間で統一した見解が得られていないのが現状である. そこで本研究では, ビンカアルカロイド系抗がん剤が血管外に漏出した際の対処方法として勧められている温罨法の作用について明らかにすることを目的に, 実験動物 (ラット) を用いて研究を行った. その結果, ビンカアルカロイド系抗がん剤が漏出した際, それに伴う皮膚傷害は漏出直後ではなく, 数日をおいて出現することが明らかとなった. また, 本実験条件下では, ビンカアルカロイド系抗がん剤漏出後, 温罨法を施行したラット皮膚に潰瘍形成という重篤な傷害を認めた. このことから, ビンカアルカロイド系抗がん剤が血管外に漏出した場合の温罨法適用の有効性は示されず, むしろ皮膚傷害を増悪させる危険性があると考えられた.

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A large-scale installation of a photovoltaic power generation system (PV system) may cause some diculties in the operation of electric power systems. Taking into account a smoothing effect of power outputs of PV systems by dispersed installation, this paper discusses the LFC (Load Frequency Control) capacity for power output fluctuation of PV systems based on the insolation data simultaneously observed at 5 points around Nagoya, Japan. The main results are (1) the frequency deviation might not exceed the tolerance (0.05Hz)when the installed PV system is 2% of system capacity, which is Japan’s target value toward 2010, (2) when the larger capacity of PV system is installed, the frequency deviation would be larger than 0.05Hz, and the capacity of LFC generator must be increased, (3) the frequency deviation due to the installation of PV system might be larger in holiday with smaller electricity demand than in weekday.

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Photovoltaic (PV) systems are rapidly gaining acceptance as some of the best alternative energy sources. Usually the power output of PV system fluctuates depending on weather conditions. In order to control the fluctuating power output for PV system, it requires control method of energy storage system. This paper proposes an optimization approach to determine the operational planning of power output for PV system with battery energy storage system (BESS). This approach aims to obtain more benefit for electrical power selling and to smooth the fluctuating power output for PV system. The optimization method applies genetic algorithm (GA) considering PV power output forecast error. The forecast error is based on our previous works with the insolation forecasting at one day ahead by using weather reported data, fuzzy theory and neural network(NN). The validity of the proposed method is confirmed by the computer simulations.

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We have proposed a method which can smooth a short-term change in PV system's output by suppressing a response of MPPT against a rapid insolation change. Because our proposed method does not convert insolation to electricity when insolation changes rapidly, it might increase energy conversion loss and decrease economy of a PV system. Comparative assessment on economics was made for two PV systems equipped with an output smoothing function, i.e. our proposed system adjusting MPPT and a battery system. By using the data on insolation for a year, we evaluated the energy conversion loss of PV system, which utilizes the proposed MPPT for smoothing the output. Then, taking into account the required capacity of battery, we compared the annual cost for smoothing PV system's output. The result suggests that the proposed method could be more economical relative to the smoothing method using a battery with future target cost.

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67歳男性の上腕に生じた有棘細胞癌の再発例に対し, CAV療法 (CDDP, ADM, VDS) を試みた。同療法6クールを施行し, 転移巣の著明な縮小を得た。CAV療法は, 有棘細胞癌の進行例の治療に有効であると思われた。

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The largest output fluctuation is an index used to quantify disturbance against a power grid caused by wind power plants and photovoltaic power generation systems connected to it. To develop its estimation method, we investigate the relationship between the largest output fluctuation and the standard deviation of a newly proposed stochastic variable derived from the output variation of photovoltaic power generation systems. Output fluctuation coefficients are defined and estimated using the measured data of photovoltaic power generation systems located at 52 places. An approximation formula is presented to predict correlation factors between the stochastic variables corresponding to photovoltaic power generation systems using distances between their locations. Finally it is shown that the largest output fluctuation of many photovoltaic power generation systems dispersed in a wide area is predictable by using the output fluctuation coefficients and the formula to approximate the correlation factors.

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A PV system’s output is not stable and fluctuates depending on a weather condition. Using a battery is one of the feasible ways to stabilize a PV system’s output, although it requires an additional cost and provides an additional waste of the used battery. In this paper, we propose tuning a characteristic of Maxiumum Power Point Tracking (MPPT) control for smoothing a short term change of PV system’s output during a sharp insolation fluctuation, as an approach without additional equipments. In our proposed method, when an insolation increases rapidly, the operation point of MPPT control changes to the new point where the maximum power is not generated with present insolation, so that the speed of PV system’s output increase is limited to a certain value, i. e. 1%/min. In order to evaluate the effect of our proposed method in terms of reducing the additional operation task of the electric power system, we evaluated the additional LFC capacity for a large-scale installation of PV systems. As a result, it was revealed that the additional LFC capacity is not required even if a PV system is installed by 5% of utility system, when our proposed method is applied to all PV systems.

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We reported 30 cases of genitary Paget's disease which were admitted to Saitama Cancer Center from 1983 to 1997. The male and female ratio was 3:1. The average age of 30 cases was 69.4 years old. Skin manifestation of 23 cases were erosive erythematous lesions, 4 cases had nodular lesions, 2 cases had vitiligo-like lesions. We categorized 30 cases into stages in according to Oohara TNM classifications. The number of cases in each stages were Stage I: 16 cases, Stage II: 8 cases, Stage III: 2 cases, Stage IV: 4 cases. All stage I-III patients were alive by surgery alone, instead all stage IV patients died. The necessity of prophylactic lymphonode dissection of T3 patients was discussed. Also, we suggested the efficacy of 2cm surgical margins of genitary Paget's disease.

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It becomes serious problem to control a large number of milk bottles in hospital.
In this report dealing with washing and sterilization of milk bottles in the central system, the experimental data shows ultra-sonic washing is more effective and less loading than brush washing, and prewashing by a automatic bottle washing machine is recommended. On the sterilization, using of a chemical disinfectant-for instance “Milton”-is more economical and simpler than boiling.

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Balloon cell melanoma, a rare variant of malignant melanoma, was firstly described by Gardner & Vazquez at 1970. We report a case of 56-year-old female with SSM type balloon cell melanoma on the skin. The tumor was mainly composed of atypical balloon cell nests involving into the deep dermis. Tumor thickness was 4mm. lmmunohistochemically, the tumor cells war strongly positive for S-100 and HMB-45, positive for NSE, and weakly positive for CEA. Wide local excision and therapeutic neck dissection were performed (pT₄N₁M₀, stage III b). Until now the patient has been free of disease. We analyzed 7 cases in Japanese literature and 7+34 cases in English literature, and discussed the prognosis of balloon cell melanoma.

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