急性骨髄性白血病(AML)の寛解導入療法において，海外の基礎および臨床研究では，IDRの有用性が数多く報告され，IDRとシタラビン(Ara-C)の組み合わせが治療戦略の主体となっている。われわれは1995年5月から1998年10月までの当科におけるIDRを寛解導入療法に用いた初発AML41例について，その臨床経過，寛解率，再発率，予後について検討した。その成績は当科での92年から95年に行った，寛解導入にDNRを用いたJALSG-AML92登録26例の成績とほぼ同等であった。なお前者では，従来予後良好因子とされているt(8;)(q;q)を有する症例5例が全例再発し，IDRによる寛解導入療法ではこの染色体異常は予後を反映しないことが示唆されたが，CD56陽性など予後不良因子が加味していたことも疑われる。今後長期予後を期待するためには，寛解導入後の地固め療法をより強化することが必要と考えられた。

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帯状疱疹に対するRo-8181の有効性, 安全性および有用性を検討するため, ヒト血清アルブミンを対照薬として, 二重盲検比較試験を行つた。皮膚症状の観察項目別の改善率では, 水疱·膿疱において投与開始後5日目でRo-8181群70%, placebo群50%で, 両群間に差(p<0.05)が認められた。皮膚症状改善度の推移を著明改善以上の症例についてみると, 投与開始後4日目の著明改善率はRo-8181群8%, placebo群0%であり, Fisherの直接計算法で両群間に差(p<0.05)が認められた。また, 投与開始後5日目の著明改善率はRo-8181群15%, placebo群3%であり, κ² 検定で両群間に差(p<0.05)が認められた。主治医による有効性の判定ではU検定でRo-8181群が優れている傾向が認められた。主治医による安全性の判定では副作用発現率がRo-8181群83%, placebo群14%であり, U検定で両群間に差(p<0.001)が認められた。主治医による有用性の判定ではU検定で両群間に差は認められなかつた。以上の結果より, 帯状疱疹に対し, Ro-8181は皮疹のうち水疱·膿疱に対して有効であり, 主治医判定でも有効性が認められたが, 安全性については本薬剤の耐薬性が示されたものの副作用の発現率が高かつたため, 有用性は高くないと考えられた。

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CTAの行政上の取り扱い、歴史、投資戦略等をまず簡単に説明する。CTAとは金融先物、オプション、スワップを対象とした取り引きに関する投資のアドバイスやサービスを個人、ファンドに提供する個人、または組織に対する金融行政上の用語で、正式名はCommodity trading advisorである。CTAという用語は投資信託、ETFを含むヘッジファンド、プライベートファンドへの投資アドバイスにも適応される。CTAs は米国連邦政府による規制対象であり Commodity Futures Trading Commission (CFTC) への登録と National Futures Association (NFA) のメンバーになることが義務付けられている。また、CTAはヘッジファンドの投資スタイルのひとつ (Global Macro) でもある。

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[Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4–0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (

), 2-min step test (2mST), and 6-min test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for , >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except had moderate accuracy according to the area under the curve of 0.76–0.88 (70–93%). [Conclusion] Clinical measures (except ) have moderate validity in predicting the level of community ambulation of stroke survivors.

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Fat embolism syndrome (

) is a serious complication of orthopedic surgery. We describe a woman in her 30s, who experienced cerebral after extensive femoral tumor resection and intercalary endoprosthesis for a malignant soft tissue tumor of the thigh. Before the surgery, the patient was able to with a single axillary crutch, capable of independent self-care and had no cognitive problems. After the surgery, the patient developed respiratory and central nervous system symptoms, which are characteristic of . After critical care, we provided rehabilitation treatment, which included getting out of bed, basic motion training, cognitive rehabilitation treatment, and Activity of Daily Living (ADL) training. At the time of commencement of the rehabilitation treatment, the patient presented with higher brain dysfunctions, such as cognitive dysfunction (Mini Mental State Examination：MMSE score points), attentional dysfunction and left unilateral spatial neglect (USN). However, apparent motor paralysis of the extremities was not detected. On the 95^th day after the surgery, the patient's MMSE score was 29 points, and the attentional dysfunction and USN were resolved. Additionally, the patient was again able to with axillary crutch. Six months after the surgery, the patient could independently without the aid of a crutch. One year after the surgery, the patient's reinstated to work. Cerebral may be accompanied with higher brain dysfunction；present a variety of higher brain dysfunctions；however, the symptoms may be reversible and resolved with rehabilitation treatment.

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[Purpose] The purpose of this study was to determine the effects of the Otago exercise program on fall efficacy, activities of daily living, and quality of life in elderly stroke patients. [Subjects and Methods] Eight subjects performed the Otago exercise program three times per week, for 8 weeks. The outcome measures were the Fall Efficacy Scale score for fall efficacy, modified Barthel index for activities of daily living, and EQ-5D for quality of life. [Results] In our comparison of the results before and after the intervention, we found that the Otago exercise program improved fall efficacy significantly as well as the score for activities of daily living and quality of life, though not significantly. [Conclusion] We consider that the Otago exercise program is an effective method for improving fall efficacy in elderly stroke patients.

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Falls are a major public health problem for older people. Recent research suggests that fear of falling may be a more pervasive and serious problem than falls among the elderly. The present study was conducted to determine whether frail elderly persons with fear of falling have lower physical function. A total of 47 subjects (aged 73 to 95) were recruited from a geriatric health services facility in Osaka. Physical function including balance, mobility, and muscular strength were measured using the following tests: Timed up & go test (TUG), functional reach test, single limb stance with eyes open, ten-meter , and knee extensor strength. Twenty-nine subjects (62%) had fear of falling and 18 (38%) had no fear of falling. There was no significant difference in age, sex, or the proportion using assistive devices. Results from the statistical tests showed that there were no differences in physical function, except in the functional reach test. The ratio of TUG to 10 m was used to determine the association between balance and mobility. In frail elderly persons with fear of falling and in those without fear of falling, the means of the ratios were 1.20 (SD=0.27) and 1.03 (SD=0.16), respectively. The ratios for frail elderly persons with fear of falling were higher (p=0.024) than the frail elderly without fear of falling. Our study suggests that even if frail elderly individuals slowly, they are not afraid of falling if there is a feasible balance function. We conclude that, in low-functioning frail elderly, fear of falling is associated with a combination of balance function and gait speed.

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The Japan Society for Occupational Health (JSOH) recommends the Occupational Exposure Limits (OELs) as reference values for preventing adverse health effects on workers caused by occupational exposure to chemical substances, continuous or intermittent noise, impulsive or impact noise, heat stress, cold stress, whole-body vibration, hand-arm vibration and time-varying electric, magnetic and electromagnetic fields and ultraviolet and ionizing radiation.

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（誤）fa'cility
（正）facility

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t(16;)(p11;q)の染色体異常を有する急性骨髄性白血病症例を経験した。症例は24歳，女性で1992年4月に発熱と出血傾向のため当科に紹介された。白血球18,700/μl（芽球83%），Hb 5.1 g/dl, 血小板1.7万/μlで，骨髄検査では有核細胞数75,500/μlで単芽球が86%を占め，急性白血病(M5a)と診断した。Micromegakaryocyte, 小型で多核の巨核球も散見されたが，他の異形成は明らかでなかった。染色体分析ではt(16;)の核型異常が認められた。BHAC-DMP療法により完全寛解が得られたが，dysmegakaryocytopoiesisは継続して認められた。1988年Yaoらの報告後，本症例を含め，文献上8例のt(16;)の報告があり，好酸球・単球・巨核球など，多系統にわたる異常が指摘されている。t(16;)をt(8;)(q;q)のsimple variantとする考え方もあるが，形態学的特徴および予後が異なっており，t(16;)を伴う急性白血病は独立した亜群を形成すると考えられる。

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Intracerebral injection of vegetative myxamoebae of strains of Polysphondylium pallidum caused 80 to 100% mortality in mice, whereas a 30 to 50% mortality occurred with strains of Dictyostelium giganteum and D. mucoroides. Death is attributable to an unidentified toxic factor. Histopathologically a giant cell formation was seen in the spleen of mice. This cell was different from Langerhan's or foreign body giant cell. Rats injected intracerebrally behaved similarly. Intranasal instillation of myxamoebae in guinea pigs caused transient pneumonia. Myxamoebae do not multiply in the brain tissues of mice or rats, or in the lungs of guinea pigs.
Intranasal instillation of vegetative myxamoebae is less pathogenic than free living amoebae like Hartmanella culbertsoni, H. rhysodes, Naegleria sp. (Culbertson strain HB-1), or Naegleria aerobia.

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[Purpose] The purpose of this study was to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis in patients with hemiplegic stroke. [Subjects] Fifty-five community-dwelling hemiplegic stroke patients were selected as participants. [Methods] Data were analyzed using the Winsteps program (version 3.62) with the Rasch model to confirm the unidimensionality through item fit, reliability, and appropriateness of the rating scale. [Results] There were no misfit persons or items. Furthermore, infit and outfit statistics appeared adjacent. The person separation value was 3.07, and the reliability coefficient was 0.90. The reliability of all items was at an acceptable level for patients with hemiplegic stroke. [Conclusion] This was the first study to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis. The results of this study suggest that the 6-point Falls Efficacy Scale is an appropriate tool for measuring the self-perceived fear of falling in patients with hemiplegic stroke.

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[Purpose] This study investigated the effects of a multifactorial fall prevention program on balance, gait, and fear of falling in stroke patients. [Subjects] Twenty-five stroke patients were divided randomly into multifactorial fall prevention program group (n=15) and control treadmill group (n=10). [Methods] All interventions were applied for 30 min, five times per week, for five weeks. The fall prevention program included interventions based on the “Step Up to Stop Falls” initiative and educational interventions based on the Department of Health guidelines. For those in the treadmill group, the speed was increased gradually. The Korean falls efficacy scale and Korean activities-specific balance confidence scale were used to assess fear of falling. To assess balance and walking ability, the Korean performance-oriented mobility assessment scale and the 10-m and 6-minute tests were used. [Results] The fall prevention program interventions were found to be very effective at improving gait, balance, and fear of falling compared with the treadmill intervention and therefore seem appropriate for stroke patients. [Conclusion] A multifactorial fall prevention program is effective at improving balance, gait ability, and fear of falling. It is a more specific and broad intervention for reducing falls among inpatients in facilities and hospitals.

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[Purpose] The purpose of this study was to determine whether a multidirectional stepping training improves balance, gait ability, and falls efficacy in stroke patients. [Subjects] Firty patients who met the selection criteria and agreed to participate in research at hospital N were randomly allocated and enrolled in this study. Twenty of the subjects were assigned to an experimental group that participated in combined stepping exercise, and the other twenty subjects were assigned to a control group that received general physical therapy. [Methods] In the two groups, balance was measured using the Berg Balance Scale, gait ability was measured using the 10-m Test, and falls efficacy was measured using the Falls Efficacy Scale before training and after 6 weeks of training. [Results] Comparative analysis of the experimental group’s pretest and post-test results showed statistically significant differences in the Berg Balance Scale, 10-m Test, and Falls Efficacy Scale scores. There were significant between-group differences in the Berg Balance Scale, 10-m Test, and Falls Efficacy Scale scores. [Conclusion] The results suggest that a combined stepping exercise can be an effective intervention to improve the balance, gait ability, and falls efficacy in stroke patients.

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[Purpose] The purpose of this study was to determine the effects of brain-computer interface (BCI)-based functional electrical stimulation () on balance and gait function in patients with stroke. [Subjects] Subjects were randomly allocated to a BCI- group (n=5) and a group (n=5). [Methods] The BCI- group received ankle dorsiflexion training with according to a BCI-based program for 30 minutes per day for 5 days. The group received ankle dorsiflexion training with for the same duration. [Results] Following the intervention, the BCI- group showed significant differences in Timed Up and Go test value, cadence, and step length on the affected side. The group showed no significant differences after the intervention. However, there were no significant differences between the 2 groups after the intervention. [Conclusion] The results of this study suggest that BCI-based training is a more effective exercise for balance and gait function than training alone in patients with stroke.

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