Search

To investigate the response of glucocorticoid (GC) therapy for patients with polymyalgia rheumatica (PMR) and predictive factors which correspond to the long-term GC.We reviewed 93 patients with PMR who were treated with GC for more than 6 months. We compared the clinical findings between patients who achieved remission within 24 months (early-remission group,Among 93 patients, 49 have achieved a remission, 35 were undergoing treatment, and 9 have transferred to other hospitals or died. Rate of remission of patients treated for one year GC therapy was in 12% and 53% after 2 years. Serum CRP of long-therapy group was significantly higher than those of the early-remission group. The ratio of patients who experienced more than one relapse within 6 months was 37.5% of long-therapy group and 7.5% of early-remission group. Multivariate logistic regression analysis showed that the history of relapse until 6 months was a significant predictor of long therapy.Some patients need the long-term therapy for more than 4 years. The history of relapse till 6 months is a significant predictor of the long-term GC therapy.

Previous reports have shown the benefits of intradialytic exercise to patients undergoing hemodialysis. However, most of those studies assessed the effects of exercise in middle-aged patients and little is known about advanced-age patients undergoing hemodialysis. Therefore, the present randomized controlled trial was performed to determine the effectiveness of exercise therapy in advanced-age patients undergoing hemodialysis. This non-blinded, randomized controlled parallel trial enrolled a total of 101 patients who were randomly assigned to intradialytic exercise (n = 51) or usual care (n = 50) groups. The training program included both resistance and aerobic exercises and was performed three times per week for 6 months. The aerobic exercise intensity was adjusted to a target Borg score of 13 for 20 minutes. Four types of resistance exercises were performed using elastic tubing, with three sets of 10 exercises performed at moderate intensity (13/20 on the Borg scale). The usual care group received standard care. Lower extremity muscle strength, Short Physical Performance Battery score, and 10-m walking speed were the outcomes and were evaluated before the hemodialysis session and after 6 months of training. There were statistically significant improvements in Short Physical Performance Battery score (effect size, 0.57; 95% confidence interval, 0.15‒1.95) in the exercise group relative to the control group. There were no statistically significant differences in lower extremity muscle strength or in the 10-m walking speed between the two groups. These findings suggest that 6 months of intradialytic training could improve physical function in older patients undergoing hemodialysis.

Recently, several types of nursing care equipment to aid the lifting and transfer of aged persons have been developed. Especially, rotational boom-type care lifts are used widely because of their simplicity and usefulness. However, such lifts sometimes provide a feeling of uneasiness because during lift-up, the center of the human body moves backward relative to the position of the heel. Hence, in this paper, we first propose a telescopic boom-type care lift to approximate the trajectory of the lift-up motion of a human standing up naturally. By using a multibody dynamics approach, we show that the proposed mechanism can achieve nearly natural standing-up motion and requires a smaller force for lift-up than that required by the conventional-type lift. Next, we develop a prototype telescopic boom-type care lift and verify experimentally that the proposed lift can reduce mental and physical burden compared with the conventional lift. To compare mental burden, we conduct a sensory evaluation by administering a questionnaire. To compare physical burden, we estimate muscle activation based on users' electromyographic signals. These results show the effectiveness of the proposed telescopic boom-type lift. Finally, we consider the optimal design of the proposed care lift structure. We propose an algorithm to seek optimal design parameters that minimize the error between the tip trajectory of the lift and the human chest trajectory measured using a motion capture system.

Aim: the purpose of this study was to examine whether home care nurses consider that fulfilling a family role makes a positive difference on nursing performance, and to identify associated factors. Methods: a self-report questionnaire was used to survey 236 home care nurses working in Japan. We asked each respondent to identify his/her family-related and work-related variables. We then measured their level of work-family conflict, and the degree to which fulfilling their family role had a positive effect on nursing performance. Descriptive statistics and a hierarchical regression analysis were conducted (p < .05). Results: a total of 201 participants (85.2%) indicated that fulfilling a family role had a positive effect on nursing performance. This perception was positively associated with having a child (β = .248, p = .02) and training in a home healthcare office (β = .154, p = .018). However, age (β = -.225, p = .003), on-call duty (β = -.300, p = .006), and work-family conflict (family interference with work; β = -.206, p = .01) were negatively related to it. Conclusion: the majority of home care nurses perceived that fulfilling a family role had a positive effect on nursing performance. Home care nurses recognized that their experience in childrearing fosters their nursing ability. Future research should explore the skills home care nurses acquire by fulfilling a family role. Article DOI: https://dx.doi.org/10.20319/lijhls.2017.31.0113 This work is licensed under the Creative Commons Attribution-Non-commercial 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-nc/4.0/ or send a letter to Creative Commons, PO Box 1866, Mountain View, CA 94042, USA.

We report the first case of cerebral cyst infection by Helicobacter cinaedi, a fastidious spiral-shaped gram-negative rod bacterium. A 70-year-old man visited Tokyo Medical University Hospital with persisting fever since 2 weeks. He underwent surgery and radiotherapy for parapharyngeal space squamous cell carcinoma 10 years ago. The radiotherapy resulted in a cerebral cyst as a side effect, and an Ommaya reservoir was inserted into the cyst. Blood culture and analysis of the brain cyst fluid revealed the presence of spiral-shaped gram-negative rod bacteria, which were identified as H. cinaedi by polymerase chain reaction. Initially, we administered clarithromycin (400 mg per day). After H. cinaedi infection was confirmed, the treatment was changed to meropenem (MEPM 6 g per day). The patient was treated for 43 days in the hospital with intravenous meropenem, and his clinical course was satisfactory. On the 44th day, he was discharged and prescribed oral minocycline (MINO 200 mg per day). After discharge, the patient's H. cinaedi infection did not recur. Our case illustrated the wide clinical spectrum of H. cinaedi as well as the effectiveness of antibiotic therapy comprising MERM and MINO for treating central nervous system infection by this organism.

We report a case of malignant melanoma of unknown primary origin presenting metastasis in various organs as well as intraluminal gallbladder bleeding due to gallbladder metastasis. A 58-year-old woman was diagnosed with stage IV metastatic malignant melanoma. Because she exhibited acute cholecystitis and hemobilia due to malignant melanoma of the gallbladder, laparoscopic cholecystectomy was performed to relieve the symptoms. The resected gallbladder specimen showed a pedunculated black mass indicating malignant melanoma. Pathologic examination and immunohistochemical analysis revealed malignant melanoma of the gallbladder. Only a few cases of gallbladder malignant melanoma presenting hemobilia have been reported; here we present our case, including the experience of multidisciplinary treatment.

The purpose is to investigate the 90-min sleep-related rhythm of intestinal motility in constipated women by spectral analysis of electrogastrograms (EGG). Constipation is classified into two types, spastic and flaccid. The study was performed on 51 subjects who slept for 300 min. We evaluated the amplitude of 90-min cycle and maximal time (lag-time) of the 6 cpm (cycles per minute) power on the EGG by cosinor analysis. We introduced a power analysis by calculating the sample effect size and statistical power. The 6 cpm power increased at the beginning of the time span in flaccid and non-constipation groups, but not in the spastic group. The amplitude of the 90-min cycle showed a significant difference between flaccid and non-constipation groups, but no difference between spastic and flaccid groups. We conclude that the 6 cpm power is affected by parasympathetic activity during sleep and the sleep-related rhythm of the power is higher in constipated subjects.

Recent widespread use of screening mammography has led to increased detection rates of non-palpable breast cancer. This study aimed to evaluate the clinicopathological features of non-palpable ductal carcinomas in situ of the breast that were detected by screening mammography of patients with a family history of breast cancer.We selected 6 Japanese patients diagnosed with non-palpable breast cancer with self-reported family history of breast cancer. Mutations in BRCA1 and BRCA2 were evaluated with germ line genetic testing and immunohistochemistry (IHC) using resected specimens. Pathological features, such as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2, were also evaluated.The patients (ages 41-67 years; mean 53.5) had 7 tumors with one patient having synchronous bilateral breast cancer. Breast cancer was suspected from the microcalcification in 5 tumors and the distortion in 2 tumors by mammography and diagnosed by biopsy. Breast-conserving surgery was performed in 2 patients and mastectomy was performed in 4 patients. Genetic testing revealed BRCA2 gene germ line mutation in three patients. IHC of BRCA was consistent with BRCA2 mutation status.The family history of breast cancer patients may lead one to suspect familial breast cancer and screening mammography is useful for the early detection of these cancers. IHC of BRCA showed staining results that were consistent with BRCA genetic testing, suggesting that it has the potential to be a useful tool in clinical practice.

目的：教育と臨床の専門家が合意する看護基礎教育卒業時の看護技術の到達目標と到達度を明らかにする．方法：デルファイ法により，看護の教育者91名および看護実践者98名の専門家の協力を得て158項目の看護技術の到達目標に関する質問紙調査を3回実施した．結果：到達目標は143項目に絞られ，うち138項目は教育者・看護実践者合わせて80%以上の同意率，残り5項目も74～79%であり，ほぼ合意が得られた．それらは，到達度Ⅰ（ひとりで実施できる）が33項目，到達度Ⅱ（指導のもとで実施できる）が53項目であり，日常生活行動援助の看護技術が多く含まれた．また到達度Ⅲ（学内演習で実施できる）が20項目，到達度Ⅳ（知識としてわかる）が37項目であり診療に伴う看護技術が多く含まれた．結論：明らかになった到達目標と到達度は，看護基礎教育と継続教育のギャップを埋め，看護技術教育の充実をはかる上で有用な基礎資料になると考える．

Aneurysm of the ductus diverticulum in the adult is rare and its rupture is fatal. A 75-year-old man presented with congestive heart failure that suddenly occurred with a continuous murmur. Angiography showed a left-to-right shunt through a large thrombosed aneurysm of the ductus diverticulum (6 cm), and the pulmonary-to-systemic flow ratio was 2.6. Patch closure of the orifice (3x4 cm) of the aneurysm and repair of the perforated pulmonary artery were done emergently under hypothermic cardiopulmonary bypass with selective cerebral perfusion. He recovered uneventfully. Early recognition and early intervention should be indicated in this otherwise fatal condition.

悪性胸膜中皮腫の進展再発形式は原発巣からの直接浸潤が主であり，遠隔転移はまれである．今回，我々は多発消化管転移を来した悪性胸膜中皮腫を経験したので報告する．症例は53歳の男性で，2005年に悪性骨肉腫の診断で左胸壁切除術をうけていた．術後1年6か月目の2007年に貧血が出現し，上部消化管内視鏡検査で胃に多発する粘膜下腫瘍あり，生検にて転移性悪性腫瘍と診断された．止血目的に開腹手術を行ったところ，小腸にも多発腫瘍を認め，小腸バイパス術および小腸腫瘍生検を行った．免疫組織染色検査にて，calretinin陽性，WT1陽性の小腸腫瘍であった．初回胸壁腫瘍および胃腫瘍生検組織も追加免疫組織染色検査で，同様に中皮腫細胞マーカーに陽性を示した．以上より，悪性胸膜中皮腫の多発消化管転移と判断した．術後化学療法を開始し，術後7か月より他臓器転移を認めているが，12か月経過した現在ペメトレキセドによる化学療法を継続中である．

Background The shortage of nurses is a problem in many countries. In Japan, the distribution of nurses across different care settings is uneven: the shortage of nurses in home healthcare and nursing homes is more serious than in hospitals. Earlier research has identified numerous factors affecting nurses' intention to leave work (e.g., job control, family-related variables, work-family conflict); however, these factors' levels and effect size may vary between nurses in hospitals, home healthcare, and nursing homes. Objectives This study measured job control, family-related variables, and work-family conflict among nurses in hospitals, home healthcare, and nursing homes, and compared these variables' levels and effect size on nurses' intention to leave their organization or profession between these care settings. Design The research design was cross-sectional. Methods Participating nurses from hospitals, home healthcare facilities, and nursing homes self-administered an anonymous questionnaire survey; nurses were recruited from the Kyushu district of Japan. Nurses from nine hospitals, 86 home healthcare offices, and 107 nursing homes participated. We measured nurses' intention to leave nursing or their organization, perceived job control, family variables and work-family conflict. We analyzed 1461 participants (response rate: 81.7%). Results The level of job control, family variables, and work-family conflict affecting nurses varied between hospitals, home healthcare, and nursing homes; additionally, these variables' effect on nurses' intention to leave their organization or profession varied between these care settings. Work-family conflict, family variables, and job control most strongly predicted nurses' intention to leave their organization or profession in hospitals, home healthcare, and nursing homes, respectively. Conclusions Interventions aiming to increase nurse retention should distinguish between care settings. Regarding hospitals, reducing nurses' work-family conflict will increase nurse retention. Regarding home healthcare, allowing nurses to fulfill family responsibilities will increase nurse retention. Regarding nursing home nurses, increasing nurses' job control will increase nurse retention.

Pneumatosis cystoides intestinalis (PCI), which is characterized by the presence of multiple gas-filled mucosal, submucosal, or subserosal cysts located throughout the colon and/or small intestine, is an unusual complication of systemic lupus erythematosus (SLE). We report a case of a 33-year-old woman with a 5-year history of SLE with PCI. Her symptoms improved with conservative management. Although PCI is a rare manifestation of SLE, clinicians should be alert to the differential diagnosis of this complication.

Breast cancer with cartilaginous and/or osseous metaplasia is considered a rare disease, but several cases have been reported recently. We report a case of breast cancer with cartilaginous and/or osseous metaplasia that was Stage IV, (T4bN0Mlb (PUL)), on the basis of the Japanese General Rules for Clinical and Pathological Recording of Breast Cancer, which responded well to chemotherapy. A 58-year-old women visited our hospital with a chief complaint of a palpable breast mass that had increased in size in March 2002. It was 20 x 15 x 14 cm and occupied the entire right breast. Chest computed tomography (CT) demonstrated multiple lung metastases. Histology of the biopsy specimens revealed a spindleshaped cell carcinoma. It was ER (−), PgR (−), and HER2/neu Score 0. CAF was given to the patient as preoperative chemotherapy. Five cycles of treatment yielded improvement at the primary site and improvement of the metastatic lung lesions, which was judged as a partial response. Subsequently, one cycle of weekly paclitaxel 80 mg/m2 and oral administration of 5’-DFUR 800 mg/day were given. In November 2002, the patient underwent a right simple mastectomy with whole-layer skin grafting from the abdomen. The final pathological diagnosis was a rare type of breast cancer with cartilaginous and/or osseous metaplasia. Preoperative chemotherapy had caused necrosis in most of the tumor cells, and the efficacy was judged as Grade 2. From the third week postoperatively, weekly paclitaxel (80 mg/m2) was given. Six months after the operation, the multiple lung metastases were completely eliminated and new metastasis to liver or bone or local recurrence have not been observed.

Three-dimensional direct observation of fluid dynamics in microchannels was performed by confocal fluorescence microscopy and three-dimensional computational fluid dynamics simulation to examine the fluid interface in curved microchannels. Results revealed that the interface of the two laminar flows is heavily distorted and increases the interfacial area because of its curved structure. The combined effect of flow velocity, curvature radius of the microchannel, density, and viscosity on the interface configuration was simulated. Increasing flow velocity and density complicated the interface configuration more. In contrast, increasing curvature radius and viscosity simplified it. Interface distortion is emphasized in a microchannel whose depth is five times its width. The interface configuration is important because it affects diffusion and chemical reactions that occur at the interface. Results herein emphasize the importance of microchannel design based on a three-dimensional comprehension of fluids and their associated mixing behavior.

The mixing efficiency of a simple, 32-layered micromixer was evaluated. Two liquids are each divided into 16 streams, and converged into 32 laminar flows by merging five times transversely, in turn. Miscible fluids can be mixed rapidly; and, 31 stable interfaces of fluid layers can be produced for immiscible fluids. This process is expected to increase the scope of high-speed chemical reactions and material syntheses. The micromixer used in this study was fabricated using PMMA plates which are easily processed. Mixing efficiency was evaluated by confocal fluorescence microscopy and computational fluid dynamics simulation. The results indicate that about 90% mixing was achieved within 1 s after the streams had been merged at a flow rate of 150 μl/min.

骨・軟骨化生を伴う乳癌の中の特殊亜型であるmatrix-producing carcinoma (MPC)の1例を経験した.症例は55歳の女性で1999年1月に乳房切除術が施行され,病理組織診断は軟骨粘液化生を伴う充実腺管癌であった. 1年10カ月後に肺転移が出現したため他院で転移巣の楔状切除を受け, MPCの肺転移と診断された.原発巣の病理組織像を再検討したところ, Wargotzらの提唱したMPCの組織像に合致した.本症例の軟骨基質を産生する細胞の由来は,免疫組織化学的検討の結果から上皮細胞由来であると考えられ,さらにCD10が軟骨基質に直接接する腫瘍細胞の一部に陽性であることから,この細胞は筋上皮細胞様の形質を持つと推定される.

人間の感覚機能の加齢による衰えは, 嗅覚でも見られることが報告されている. 加齢による嗅覚機能の衰えを補い, 生活における危険臭の危険度を感知するための代行システムとして, ガスセンサの利用が考えられる. ガス洩れや火災といった危険を検知するためのガスセンサシステムは, これまでいくつか報告されているが, 食品の腐敗という危険に対するものはほとんど見られない. 本研究では食品の腐敗臭を取り上げ, 複数のガスセンサの応答と心理量との対応によって, 食品の腐敗度判定を行うセンサシステムの構築を試みた. 心理実験は19名の主婦により行い, そこで得たニオイに対する心理量および腐敗度判定値と, 脂質二分子膜被覆水晶振動子センサおよび金属酸化物半導体ガスセンサで測定したデータとをニューラルネットワークにより対応させた. これらの対応関係を利用することによって, ガスセンサで食品の腐敗度判定を行うシステムを構築する可能性を示す.

分娩後数日から1か月後までの褥婦の不安の程度と変動の実態を明らかにする目的で, 681名の褥婦に対し, 入院中, 退院1週後, 分娩1か月後の継続的な調査を行った。不安の測定尺度は, STAIを用いた。532名の褥婦から3回連続の調査協力が得られ, 有効回答数は528であった。状態不安得点は, 入院中37.5点, 退院1週後39.5点, 分娩1か月後392点であり, 初産婦のほうが高かった。特性不安得点は, 入院中39.2点, 退院1週後39.3点, 分娩1か月後39.7点であった。褥婦の背景と不安得点は, 学歴や月経時, 悪阻時に自覚する症状, 分娩の認識において有意な関連があった。状態不安得点を高中低の3群に分け, 1か月までの変動を追跡した。入院中に中等度不安群だった褥婦も, 1週後に高不安群へ移行していれば1か月後に低不安群へ移行することは少なく, 1週後に低不安群に移行していれば1か月後に高不安群へ移行することはまれであった。

We report an extremely rare case of familial breast cancer with deleterious germline mutations in both BRCA1 and BRCA2 genes, of which, to date, no such case has been reported among Japanese breast/ovarian cancer patients. Genetic testing of the family members indicated that the same double heterozygosity for BRCA1 and BRCA2 genes was transmitted to the paternal cousin, and the same BRCA2 mutation to the younger sister with bilateral breast cancer, younger brother with stomach cancer, and proband’s son and daughter without cancer. Immunohistochemical analysis of BRCA protein expression was performed using breast cancer tissues from the proband with double heterozygosity for BRCA1 and BRCA2 genes and from her sibling without BRCA1 mutation but with BRCA2 mutation. There was no staining of either BRCA in the proband and no staining of BRCA2 in the sibling.

The patient was a 50-year-old woman with a palpable tumor and pain in the right breast in May of 2008. The tumor was then diagnosed as an atheroma. The tumor enlarged rapidly in June, and the pain and the redness had worsened. The patient was then referred to our hospital. The tumor was in the upper inner quadrant of the right breast with surface redness, measuring about 3 cm. In the mammographic (MMG) findings, the tumor shadow was in the upper inner quadrant of the right breast and was observed to be circular and have a high density with a plain boundary and slightly roughed edges. In the ultrasonographic (US) findings, an oval-shaped high echoic region was found subcutaneously in the right breast. Because the high echoic area was subdivided in the partition of the low echoic string, it looked like a pebbled wall. Upon core needle biopsy, this case was diagnosed as malignant lymphoma. After comparing the histopathology and the US image, it was determined that the pebbled wall-shaped image was due to lymphocyte infiltration of the tissue. The US image was peculiar and we report this case as a peculiar example of malignant lymphoma.

A case of primary splenic histiocytic sarcoma is reported.A 29-year-old man was admitted to Fukushima Medical College Hospital for pretibial edema. Physical examination showed splenomegaly without lymphadenopathy and hepatomegaly. Laboratory findings revealed thrombocytopenia and hypoproteinemia, and bone marrow aspirate and biopsy were normal. Clinically, splenic malignant lymphoma was suspected and surgical splenectomy was performed. His symptoms resolved after the treatment.The spleen weighed 730g and a well-defined reddish-colored tumor was observed on cut surface. The tumor was composed of an intense infiltration of variable sized histiocytic cells, from 8μm to 20μm in diameter, containing abundant eosinophilic cytoplasm and large round to oval nuclei.Mitotic figures were a few and multinuclated giant cells were occasionally seen. The tumor cells were considered as monocyte/histiocyte series based on cellular morphology and immunological charactaristics for monocytic markers and germline of immunogloblin heavy chain (JH) and T-cell recepter beta chain (Cβ1) genes. Flow-cytometric DNA analysis showed a hypodiploidy pattern. These findings indicate that the present case is primary splenic histiocytic sarcoma with low grade malignancy.

Experimental animal pain models involving peripheral nerve lesions have expanded the understanding of the pathological changes caused by nerve damage. However models for the pathogenesis of chronic pain patients lacking obvious nerve injuries have not been developed to the same extent. Guided by clinical observations, we focused on the initiating noxious event, the context when applying nociceptive stimulation targeting long-lasting pain elicited by muscle insult. The administration of a nociceptive agent (6% hypertonic saline: HS; 5-time repeated-injection: HS5) after pretreatment with an immuno-inflammatory agent (lipopolysaccharide: LPS, 2 μg/kg) into one gastrocnemius muscle produced markedly long-persisting biphasic sustained mechanical hypersensitivity on the plantar surface of both hindpaws. In the acute phase, the blockade of afferent inputs from the injected-site was effective in returning the contralateral enhanced-responses to baseline levels. In contrast, similar blockade during the chronic phase did not affect the contralateral enhanced-responses, indicating that the hypersensitivity in the two phases was probably induced by different mechanisms. However, increasing the dose of LPS (20 μg/kg) before applying HS5 eliminated the development of mechanical hypersensitivity in the chronic phase, while the hypersensitivity in the acute phase was significantly more severe than with low-dose LPS-pretreatment. In this model, the development of hypersensitivity could be modulated by manipulating LPS-doses prior to noxious stimulation. This novel chronic pain model based on a preceding ‘priming’ myalgic stimulus provides an intriguing means for studying the pathogenesis of chronic pain.

TSUCHIYA, S., MINEGISHI, M., FUJIE, H., MINEGISHI, N., OHASHI, Y., ITANO, M., MORITA, S., YAMAGUCHI, Y., SATO, T. and KONNO, T. Allogeneic Bone Marrow Transplantation for Malignant Hematologic Disorders in Children. Tohoku J. Exp. Med., 1992, 168 (2), 345-350- In the present study we carried out allogeneic bone marrow transplantation (BMT) in 14 leukemia children with high risk prognostic factors. Six patients with acute nonlymphocytic leukemia (ANLL), four with acute lymphocytic leukemia (ALL), two with chronic myelogenous leukemia (CML), and two with myelodysplastic syndrome (MDS). Among these patients, six with ANLL, two with ALL, one with CML and one with MDS were alive in complete remission 8 to 58 months post-BMT. Four patients died of relapse (one with ALL, and one with MDS), and chronic GVHD (one with ALL and one with CML). In six patients recombinant granulocyte colony stimulating factor (rG-CSF)was used to shorten the period of granulocytopenia. The mean time of recovery to granulocyte count of 500/mm3 was 13.2 days in the rG-CSF+group, being 15.9 days faster than that in the rG-CSF-group. In light of these results, allogeneic BMT is shown to be a choice of treatment for leukemia children with high risk prognostic factors and rG-CSF may be an effective reagent to prevent infectious episodes in BMT.- allogeneic bone marrow transplantation; leukemia; high risk prognostic factors; recombinant granulocyte colony stimulating factor

An analytical cross-sectional study was conducted with 812 subjects aged 35-74 years in Prek Russey commune, Cambodia to detect some factors associated with severe periodontitis. Four calibrated examiners employed Community Periodontal Index (CPI) to ascertain periodontal pocket depth (PD) and loss of epithelial attachment (LA). A questionnaire was used to obtain tobacco and alcohol consumption habits. One hundred (12.3%) subjects had one or more sextants with ≥ 4mm PD and ≥ 6mm LA (severe periodontitis). Smoking, tobacco chewing and age were significantly associated with severe periodontitis in bivariate analysis while only age and quantified smoking remained significant in a logistic regression analysis. The impact of quantified smoking on severe periodontitis was almost negligible [OR: 1.0006 (95% CI: 1.0001, 1.001)] compared to that of age [OR ranged from 8.3 at 45-54 years to 22 at 65-74 years (95% CI: 3.1, 62.3)]. Nevertheless, both age and quantified smoking can be considered as factors associated with severe periodontitis in rural Cambodians. Asia Pac J Public Health 2004; 16(1): 50-53.

A case of breast cancer that metastasized to the cervix 10 years and 8 months after mastectomy is reported. The patient had undergone pancreaticoduodenectomy due to solitary metastasis to the head of the pancreas 4 years previously. The cervical metastasis was associated with abnormal genital bleeding. After pancreaticoduodenectomy the serum levels of CEA, CA15-3 and NCC-ST-439, which are markers of breast cancer, were within normal limits, but the serum level of CA15-3 had increased month by month. The patient had abnormal genital bleeding and presented to the department of gynecology at our hospital. The tumor was in the cervix, bled easily and 2.5 × 2.0 cm in size on ultrasonography. It was thought to be carcinoma of the cervix, but biopsy revealed the tumor to be an adenocarcinoma pathologically and CA15-3 was immunohistochemically demonstrated in the resected specimen, similar to lobular carcinoma of the breast. Abdominal CT scan revealed involvement of the ovaries and uterus, prompting hysterectomy with bilateral oophorectomy. After discharge, she received chemoendocrine therapy. However, she subsequently died due to peritoneal carcinomatosis.

There is a paucity of information pertaining to oral disease patterns including periodontal disease in Cambodia, which is just emerging from a 20-year ruin. A house-to-house survey was conducted to assess the periodontal status of 1948 subjects aged 15-74 years in a rural commune in Cambodia using Community Periodontal Index (CPI) and measuring Attachment Loss (LA). The periodontal status of Cambodians increased with age as indicated by both CPI and LA. Calculus was the most common finding among Cambodians pointing to overall poor oral hygiene levels. Notwithstanding the poor oral hygiene, however, the severe periodontitis as denoted by ≥ 6mm periodontal pockets was rare even in the elderly while edentulousness was not frequently observed until 65 years. Preventive programmes targeting periodontal disease in Cambodia should focus on oral health education and simple oral hygiene instructions while the ubiquitous calculus could be dealt with oral prophylaxis. Asia Pac J Public Health 2002; 14(2): 105-109.

ITANO, M., MORITA, S., FUJIE, H., OHASHI, Y., MINEGISHI, N., MINEGISHI, M., YAMAGUCHI, Y., SATO, T., TSUCHIYA, S., KONNO, T., HAYASHI, Y., OHI, R. and SHIRAISHI, H. Mass Screening for Neuroblastoma in Miyagi Prefecture. Tohoku J. Exp. Med., 1992, 168 (2), 137-139 - In Japan, aiming at early and preclinical detection of neuroblastoma in infancy a mass screening program for the tumor has been implemented nationwide using urinary tests for catecholamine metabolites, vanillylmandelic acid (VMA) and homovanillic acid (HVA) (Sawada 1990; Sawada et al. 1991). In this report, the results obtained from the screening program in Miyagi Prefecture for the last 6 years are described. The detection rate of neuroblastoma by mass screening was 1:8, 377 among 125, 652 infants tested in Miyagi Prefecture. All but one patients survived after removal of the primary tumor and none or minimal chemotherapy. - neuroblastoma; mass screening; urine VMA; urine HVA

Okinawa Prefecture has been promoting dental treatment and oral health care in places where there are no dentists. The Ministry of Health and Welfare has been cooperating with eight dental colleges, including Tokyo Medical and Dental University, for promotion thereof since 1961. The 155th promotion was held on Tokashiki Island. The caries prevalence rate of the students on Tokashiki Island was relatively high compared with the average caries prevalence rate of the same age group throughout Japan, and most of the caries were thought to be due to too many soft drinks. Resin filling was the most popular treatment during this promotion. Severe periodontal disease was observed in middle-aged persons, but we could only perform initial periodontal treatment because of the limited treatment period. Complete or partial dentures were made or repaired for many elderly. The questionnaire study showed most of the denture wearers on Tokashiki Island were satisfied with their dentures, although many dentures did not fit, and the prescription was improved. The period of this promotion was too short to perform complete dental treatment and to prevent caries and periodontal disease, and primary prevention and higher dental hygiene education should be strengthened in no dentist areas like Tokashiki Island.

We report a case of fibroadenoma of the supernumerary breast of axilla, diagnosed by fine-needle aspiration. A 31-yearold pregnant woman reported a left. axillar mass. Cytological examination and fine-needle aspiration from the mass showed many clusters of cohesive epithelial cells with single, stripped nuclei and bipolar cells in the background. Histopathological examination of the surgical excisional sample showed a well-defined, capsulated pericanalicular type of fibroadenoma. The diagnosis of supernumerary breast is important because it can be a marker for urological and caldiovascular malformation.

Differences in the dental arch and palate among Taiwan Aboriginals were investigated and compared with Taiwanese and Japanese. Plaster models were taken from 315 Taiwan Aboriginal adults, 185 Taiwanese and 426 Japanese between 1979 and 1989, and various dimensions were measured. There were no clear differences in the characteristics of the dental arch and palate between Taiwan Aboriginal tribes. However, they were found to differ from those of Taiwanese and Japanese. In a dendrogram constructed from a cluster analysis, two major clusters were found. Among males, the first cluster contained Paiwan and Rukai, the second contained Japanese, Taiwanese, Ami and Bunun. Among females, the first contained Japanese, Taiwanese, Rukai and Paiwan, the second contained Ami and Bunun. The Ami were close to Bunun and the Paiwan were close to Rukai among both males and females. These results indicate that Ami and Bunun, and Paiwan and Rukai, respectively, have close affinities.

In this study, after confirming the suppression of autonomic nervous function by isoflurane anesthesia using autonomic antagonists, we pharmacologically investigated the involvement of vasomotor and cardiac sympathetic functions in systolic blood pressure variability (SBPV) frequency components in conscious rats at rest and during exposure to low-ambient temperature (LT-exposure, 9°C for 90 min). Under unanesthesia, phentolamine administration (α-adrenoceptor antagonist, 10 mg/kg) decreased the mid-frequency component (MF 0.33–0.73 Hz) and inversely increased the high-frequency component (HF 1.3–2.5 Hz). The increased HF was suppressed by subsequent treatment with atenolol (β-adrenoceptor antagonist, 10 mg/kg), but not with atropine (muscarinic receptor antagonist, 10 mg/kg). Moreover, phentolamine administration after atenolol decreased MF, but did not increase HF. LT-exposure increased MF and HF; however, phentolamine pretreatment suppressed the increased MF during LT-exposure, and atenolol pretreatment dose-dependently decreased the increased HF. These results suggest that MF and HF of SBPV may reflect α-adrenoceptor-mediated vasomotor function and β-adrenoceptor-mediated cardiac sympathetic function, respectively, in the conscious state.

The proportion of T-cell subsets was normal in all patients with X-linked agammaglobulinemia except for an 8-month patient who showed a decrease in OKT8+ T-cell population. In two patients with hypogammaglobulinemia with IgM production, T-cell subsets were normal in distribution and the patients' B cells produced only IgM in culture with autologous T cells. A patient with common variable immunodeficiency showed no imbalance in distribution of T-cell subsets. Imbalance of regulatory T-cell subsets was found in a patient with DiGeorge syndrome and severe combined immunodeficiency.

A successful transplantation of soybean agglutinin (SBA) and sheep red blood cell (SRBC)-fractionated, maternal marrow in a patient with severe combined immunodeficiency (SCID) is reported. The engraftment of HLA-haplotype mismatched marrow cells was obtained without apparent graft versus host disease (GVHD). With immunological reconstitution the patient recovered from a BCG infection, which might have been caused by a BCG inoculation before his bone marrow transplantation.