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Date Y, Yokoyama Y, Kondo H, Kuroda S, Ohya K, Ota MS, Iseki S, Kasugai S. Restricted expression of chromatin remodeling associated factor Chd3 during tooth root development. J Periodont Res 2012; 47: 180–187. © 2011 John Wiley & Sons A/S Background and Objective: The tooth root is one of the critical parts to maintain tooth function; however, the molecular mechanisms of root development remain unknown. We aimed to identify specific factors for root morphogenesis using a newly developed experimental system. Material and Methods: Tentative cementoblasts and periodontal ligament cells from mouse mandibular molars were isolated using laser capture microdissection. More than 500 cementoblasts and periodontal ligament cells were separately captured. After RNA extraction and amplification, mRNA expression in isolated cementoblasts was compared with that of periodontal ligament cells by cDNA microarray analysis. Then, putative cementoblast-specific genes were subjected to in situ hybridization analysis to confirm the results in mouse mandible. Results: Approximately 2000 genes were differentially expressed between these tissues. Among those genes, zinc finger helicase (ZFH), also termed chromodomain-helicase-DNA-binding protein 3 (Chd3), was one of the highly expressed transcripts in tentative cementoblasts. In situ hybridization revealed that ZFH/Chd3 was strongly expressed in Hertwig’s epithelial root sheath rather than in cementum. Moreover, its expression disappeared when root formation was advanced in the first molar. In contrast, Chd3 was continuously expressed in dental epithelial cells of the cervical loop, in which root extension is never terminated. Conclusion: These results suggest that ZFH/Chd3 might play an important role in tooth root development and subsequent cementogenesis.

Background: Sarcoidosis is a systemic granulomatous disease of unknown aetiology. It has been suggested that T helper type 1 (Th1) polarisation is associated with the pathophysiology of sarcoidosis, but the mechanism of skewing towards Th1 has not been elucidated. Dendritic cells (DCs) are known to regulate immune responses. This study was performed to determine whether DCs are involved in the aetiology of sarcoidosis. Methods: The numbers of peripheral blood DCs in 24 patients with sarcoidosis were analysed and biopsy specimens from four patients were stained immunohistochemically using monoclonal antibodies. Results: The numbers of both myeloid and lymphoid DC subsets were significantly decreased in the blood and mature DCs were found in the granulomas of patients with sarcoidosis. A number of interferon-γ (IFN-γ) producing T cells were also detected in the sarcoid granuloma, as well as many interleukin (IL)-4 producing T cells. Double staining of the biopsy specimen using anti-fascin and anti-CD3 antibodies showed an anatomical interaction between DCs and T cells. Conclusions: These findings suggest that the blood DC subsets may migrate into the affected tissues, contributing to the formation of the granulomas in sarcoidosis. It is hypothesised that the migrating DCs may regulate the T cell response in sarcoidosis, at least in the granulomatous lesions.

Zinc/platinum (Zn/Pt) bimetallic micromotors have been developed. They moved based on the reduction of fuel compounds such as bromine, p-benzoquinone, and methanol at the surface of the Pt and the oxidation (dissolution) of Zn that occur simultaneously. The redox potential of Zn2+/Zn is very negative and was advantageous to cause the redox reactions. The motion of the motor and the reactions that occurred on the surface were investigated. With test motors containing Ni, it was revealed that the Zn/Pt motors showed almost unidirectional motion to the Zn side. Toxicity of Zn2+ is relatively lower than that of other metal ions. Also, the motor features the use of mild compounds such as methanol that are not harmful to tissues or organisms as their fuels.

To investigate how single amino acid substitutions in MHC class I molecules affect differences in peptide repertoires, we eluted and sequenced the naturally processed peptides from three HLA-A2 subtypes (HLA-A*0204, -A*0206, and -A*0207) that differ by a single amino acid residue substitution each with HLA-A*0201 at the floor of the binding groove. Allele-specific peptide motifs for each HLA-A2 subtype substantially differed from that of HLA-A*0201 in the dominant anchor residues. The relative signal intensities for 18 self peptides, determined by mass spectrometry, precisely reflected these peptide motifs. Some overlapping peptides were isolated from both HLA-A*0201 and a single HLA-A2 variant, but no peptide was ubiquitously found across all variants. To rationalize the differences in peptide motifs, possible conformations of each allele were computer modeled by energy minimization calculations based on the reported crystal structure of HLA-A*0201. According to our models, the differences in peptide motifs could be explained by substituted-residue-driven conformational changes for each MHC-peptide complex. These results demonstrate the fine differences between HLA-A2 subtype self peptide repertoires and contribute to the prediction of antigenic peptides.

Human neutrophil peptides (HNPs) 1, 2 and 3, also called defensins, have high antimicrobial activity and are cytotoxic to both normal and transformed human cells. The localization of HNPs 1–3 and their mRNAs in cells of normal human bone marrow and peripheral blood was investigated. Immunoreactivity for HNPs 1–3 appeared in the promyelocyte stage and increased with the maturation of the neutrophil series. HNPs 1–3 were absent from such mononuclear phagocyte systems as peripheral monocytes, alveolar macrophages, and Kupffer cells in the liver. HNP 1–3 mRNAs were detected in bone marrow cells by Northern blot analysis and in peripheral leukocytes by the reverse transcription-polymerase chain reaction (RT-PCR). HNPs 1–3 are restricted to cells of neutrophil lineage and seem to function as microbicidal agents in the neutrophil-mediated defense system.

To report the clinical features of two Japanese brothers with familial leptomeningeal amyloidosis, showing a causative gene abnormality of a transthyretin (TTR) variant Asp18Gly, previously reported only in a Hungarian family.The authors reported on a 42 year old man (patient 1) and his 45 year old brother (patient 2), both suffering from subarachnoid haemorrhage (SAH) without and with hydrocephalus, respectively. DNA sequences of the TTR gene were determined in both patients and the patients' clinical features described. A surgical biopsy of the leptomeninges was performed on patient 1.DNA sequence analyses demonstrated the glycine-for-aspartate substitution at position 18 of the TTR variant. Both patients revealed pyramidal tract signs and cerebellar ataxia. Audiometric studies showed bilateral, mild sensorineural hearing loss in the patients whose cerebrospinal fluid (CSF) protein levels increased. T1 weighted MRI after contrast administration showed diffuse leptomeningeal enhancement along the Sylvian fissures and over the surface of the brainstem, cerebellum, and spinal cord. Gradient echo T2* weighted MRI showed superficial siderosis mainly in the cerebellum. A biopsy of the leptomeninges was obtained from the spinal cord of patient 1. While performing the biopsy, the authors observed the varicose, elongating, and fragile veins on the dorsal surface of the spinal cord. Immunohistochemical study revealed marked deposits of TTR derived amyloid on his leptomeninges.This is the second report of familial leptomeningeal amyloidosis with an Asp18Gly TTR gene mutation, clinically causing only CNS symptoms. Repeated SAH from fragile veins on the dorsal surface of the spinal cord seemed to induce superficial siderosis of the CNS. So far, there have been two reliable hallmarks leading to the diagnosis of leptomeningeal amyloidosis: diffuse leptomeningeal enhancement on contrast MRI and greatly increased CSF protein content. This study has contributed a third hallmark: the presence of superficial siderosis is useful in diagnosing leptomeningeal amyloidosis.

Uroguanylin is a novel natriuretic and diuretic peptide originally isolated from urine.To determine whether uroguanylin has a physiologic role during the perinatal period, uroguanylin levels in umbilical cord plasma obtained at the time of delivery were measured by radioimmunoassay and compared with cord serum osmolality.Mean (+/- SD) cord plasma uroguanylin concentrations (8.8 +/- 2.1 fmol/mL) were higher compared with normal adult values. The extent of maturity, mode of delivery and gender did not appear to influence cord uroguanylin levels. The uroguanylin concentration had a significant positive correlation with cord serum osmolality.These findings support some regulatory role of this peptide in perinatal renal and cardiovascular adaptation.

The hypothalamus is the most important region in the control of food intake and body weight. The ventromedial 'satiety center' and lateral hypothalamic 'feeding center' have been implicated in the regulation of feeding and energy homeostasis by various studies of brain lesions. Orexins(orexin A and orexin B) and melanin-concentrating hormone (MCH), whose intracerebroventricular injections increase food intake, are localized in the lateral hypothalamus and provide diffuse projections throughout the brain. Orexins and MCH neurons have a coextensive distribution, but are not colocalized. Orexins and MCH may affect feeding behavior through distinct neuronal pathways. We here describe the effect of orexins and MCH on feeding behavior from the physiological, neuroanatomical and molecular studies.

Ghrelin, a novel GH-releasing acylated peptide, was recently isolated from rat stomach. It stimulated the release of GH from the anterior pituitary through the GH secretagogue receptor (GHS-R). Ghrelin messenger RNA and the peptide are present in rat stomach, but its cellular source has yet to be determined. Using two different antibodies against the N- and C-terminal regions of rat ghrelin, we identified ghrelin-producing cells in the gastrointestinal tracts of rats and humans by light and electron microscopic immunohistochemistry and in situ hybridization combined with immunohistochemistry. Ghrelin-immunoreactive cells, which are not enterochromaffin-like cells, D cells, or enterochromaffin cells, accounted for about 20% of the endocrine cell population in rat and human oxyntic glands. Rat ghrelin was present in round, compact, electron-dense granules compatible with those of X/A-like cells whose hormonal product and physiological functions have not previously been clarified. The localization, population, and ultrastructural features of ghrelin-producing cells (Gr cells) indicate that they are X/A-like cells. Ghrelin also was found in enteric endocrine cells of rats and humans. Using two RIAs for the N- and C-terminal regions of ghrelin, we determined its content in the rat gastrointestinal tract. Rat ghrelin was present from the stomach to the colon, with the highest content being in the gastric fundus. Messenger RNAs of ghrelin and GHS-R also were found in these organs. Ghrelin probably functions not only in the control of GH secretion, but also in the regulation of diverse processes of the digestive system. Our findings provide clues to additional, as yet undefined, physiological functions of this novel gastrointestinal hormone.

To study polymorphisms in the 5'-flanking promoter/enhancer region of the tumor necrosis factor alpha (TNFalpha) gene and in the coding regions of HLA class I and class II genes, in order to better understand the genetic background of juvenile rheumatoid arthritis (JRA).One hundred eleven Japanese JRA patients (50 with systemic disease, 29 with pauciarticular disease, and 32 with polyarticular disease) and 575 healthy Japanese subjects were examined for the allele frequencies of the TNFalpha, HLA-A, and HLA class II (DRB1, DRB3, DRB4, DRB5, DQA1, DQB1, DPA1, and DPB1) genes, by DNA typing using the polymerase chain reaction-sequence-specific oligonucleotide probe method.The frequencies of the polymorphic allele at positions -1,031 (T to C substitution, termed -1,031C), -863 (C to A, termed -863A), and -857 (C to T, termed -857T) of the TNFalpha gene in patients with systemic JRA, but not in those with polyarticular or pauciarticular JRA, were significantly higher than in the healthy controls. The allele frequencies of DRB1*0405 and DQB1*0401 in systemic JRA, but not in the other JRA types, were significantly higher than in controls. Linkage analysis showed that the presence of both the TNFalpha -857T allele and DRB1*0405 yielded a significantly increased odds ratio (3.84), while the presence of only 1 of them did not yield a high odds ratio (0.87 and 1.58).The -1,031C/-863A allele and the -857T allele of the TNFalpha gene, both of which are related to high production of tumor necrosis factor alpha, are associated with systemic JRA. The -857T allele may enhance the effect of the DRB1*0405/DQB1*0401 haplotype in predisposing to development of systemic JRA.

Polymorphisms in the 5'-flanking promoter/enhancer region of the tumor necrosis factor (TNF)-a gene were examined to study the genetic background of rheumatoid arthritis (RA). Four variant alleles, -1,031C/ -863A, -1,031C/-238A, -857T and -308A, were identified and examined in 387 RA patients and 575 healthy Japanese controls. The frequency of the -857T allele in RA patients was significantly higher than that in the controls. However, the HLA-DRB1 analysis in the same subjects showed that the DRB1*0405 allele, which is in linkage disequilibrium with the -857T, was more strongly associated with the disease susceptibility than the -857T allele. These results suggest that the susceptible gene to RA is more closely linked to the HLA-DRB1 locus than to the TNF-alpha locus.

Uroguanylin, a member of the guanylin peptide family, acts on guanylyl cyclase C (GC-C) to regulate intestinal and renal fluid and electrolyte transport through the second messenger, cGMP. Using an antiserum raised against synthetic rat uroguanylin, we established an RIA and identified three endogenous molecular forms in the intestine and kidney: a 15-amino acid uroguanylin, an 18-amino acid uroguanylin that is a monobasic processing product, and a 9.4-kDa prouroguanylin. Prouroguanylin is the major molecular form in these two tissues, whereas only 15-amino-acid uroguanylin is present in the urine. Rat uroguanylin is most abundant in the proximal small intestine, its content decreasing toward the colon. Uroguanylin is present immunohistochemically in the endocrine cells in the intestine and stomach, B cells in the pancreatic islets, and tubular epithelial cells in the kidney. Uroguanylin has a widespread tissue distribution and is located in cells that function in an endocrine, paracrine, and/or luminocrine (luminal secretion) fashion. Uroguanylin may have physiological functions other than the regulation of fluid and electrolyte transport in the intestine and kidney.

Guanylin and uroguanylin are novel peptides that are first isolated from rat jejunum and opossum urine, respectively. They bind to and activate guanylyl cyclase-C (GC-C) to regulate intestinal and renal fluid and electrolyte transport through the second messenger, cyclic GMP. Heat-stable enterotoxins produced by pathogenic bacteria have close structural similarities to guanylin and uroguanylin, and they use this mimicry to act on GC-C, causing life-threatening secretory diarrhea. Guanylin primarily is restricted to the intestine, whereas uroguanylin is present in the stomach kidney, lung and pancreas in addition to intestine. Guanylin and uroguanylin in the intestine are secreted into the lumen and blood in response to sodium chloride administration. These peptides will function in salt and water transport in the intestine and kidney by luminocrine and/or endocrine actions. Guanylin peptide family links the intestine with the kidney and could play the physiological roles in the control of water and electrolyte balance.

The siblings of Sanfilippo syndrome type A (MPS III A) have been reported. The relationship of their parents was the first cousins. Case 1: A 30-year-old Japanese man was hospitalized because of gait disturbance and mental impairment. His early somatic and mental development was normal until 9 years of age when mental deterioration had developed. Speech and gait disturbances and double incontinence occurred at 18 years of age. He could not walk at 21 years of age. Those symptoms were slowly progressive. Case 2: A 32-year-old Japanese man, the elder brother of case 1, had a similar clinical history to that of case 1. Their neurological findings revealed mental impairment, coarse face, positive forced grasp and sucking reflexes, and pyramidal signs. Lumbar X-ray showed platyspondylitis, compression fracture of L 1 and osteoporotic changes. Brain MRI of both cases showed brain atrophy, ventricular dilatation and abnormal high intensity signals near the posterior horn of the lateral ventricles on T2 weighted image. Low perfusion images of fronto-parietal regions were seen in the early phase of SPECT using 123I-IMP. This siblings were diagnosed as Sanfilippo syndrome type A because of heparan sulfaturia and deficiency of heparan sulfate sulfamidase of the lymphocytes. Average life span of Sanfilippo syndrome type A is not so long but the age of our cases is over 30 years of age.

A 74-year-old female with seropositive rheumatoid arthritis developed severe bone marrow failure after the treatment with very low-dose methotrexate (5 mg/week for 3 weeks). Hematological data showed severe pancytopenia with 0% neutrophils and bone marrow disclosed thoroughly hypocellular marrow. Shortly after the treatment with simultaneous rhG-CSF and methylprednisolone 'pulse' therapy, pancytopenia was ameliorated and bone marrow examination revealed hypercellular marrow with increasing maturation of hematopoietic components. Hematological parameters were maintained within the normal range with a low dose of prednisolone.

Extended thymectomy in conjunction with a collar incision of the neck was performed thoracoscopically for a 64-year-old women with myasthenia gravis. Although this patient had Osserman type II B myasthenia gravis not associated with a thymoma, the clinical symptoms were alleviated after the surgery. Although this surgical procedure has the disadvantage such as of being time-consuming, it also has various advantages such as: 1) extended thymectomy can be performed without a midsternotomy, 2) the wound is small and not prominent, 3) surgical invasiveness is slight, and 4) postoperative pain is mild. This method was considered to be an extremely useful surgical method which should be used in future for cases of myastenia gravis not associated with a thymoma.

We report a long-term survival case of metastatic endometrial stromal sarcoma. A 45-year-old woman with acute abdomen was operated at another hospital. Her uterine histology was endometrial stromal sarcoma. She came to our hospital to treat a metastatic endometrial stromal sarcoma. Endometrial stromal sarcomas were found in liver, spleen and lung. Intra-arterial hypertension chemotherapy was repeatedly performed. After this therapy, metastatic legion in the liver and the spleen disappeared on image studies and metastatic lesions in the lung grew smaller.

The present study evaluated the degree of renal impairment caused by intra-arterial hypertensive chemotherapy (CDDP, PEP). In 11 cases of advanced cancer of the uterine cervix, serum and urinary levels of alpha 1-microglobulin (alpha 1-m) and beta 2-microglobulin (beta 2-m), and urinary albumin (Alb) and lysozyme (LZM) were determined before the chemotherapy and 1,2 and 3 weeks after the therapy. Results are summarized as follows: 1. After intra-arterial chemotherapy, the histological classification was Grade I in 1 case (9.1%), Grade IIa in 2 cases (18.2%), and Grade IIb in 8 cases (72.7%). 2. Serum alpha 1-m and beta 2-m levels remained within the normal range after chemotherapy. 3. Urinary alpha 1-m, beta 2-m and LZM levels exceeded the normal limit between 1 and 2 weeks after the therapy, but thereafter they returned to normal. 4. Urinary Alb was significantly increased (p less than 0.05) between 1 and 2 weeks after therapy, but thereafter it returned to normal. These results suggested that intra-arterial chemotherapy (CDDP 100mg and PEP 40 mg in a dose) was effective for advanced cancer of the cervix and that renal disorders including tubular and glomerular impairment, which are the adverse effects of the therapy, were mild and reversible.

The significance of a halocline for nutrient cycles in a shallow coastal lagoon, Lake Nakanoumi, was investigated. The study was made possible when the northern part of the lagoon was enclosed by polder dikes prior to land reclamation for agricultural purposes. The disappearance of the halocline allowed vertical mixing to extend to the whole depth and vertical gradients in water properties then decreased remarkably. Despite the disappearance of the halocline, dissolved oxygen content of bottom waters decreased considerably during summer months. Summer peaks in inorganic nitrogen and phosphate were still observed after disappearance of the halocline.

Nine patients older than 60 years of age with fracture of the surgical neck of the humerus, treated by percutaneous Kirschner pinning, were reported. Manipulation of the fracture, operative technique and postoperative rehabilitation were described. This method has several advantages; simple technique, little blood loss, eary return to ambulation and good course of bone union. Satisfactory results were obtained in 75% of the cases at follow-up examination assessed by Wolfgang's criteria and Takagishi's criteria.

Several cases with ossification of the posterior longitudinal ligament at the cervical spine have recently been reported to be associated with ossification of either the posterior longitudinal ligament, the yellow ligaments or both at the thoracic spine. The problem that arises from these is which the main lesion for myelopathy is, cervical or thoracic. This is to report our own experiences of 13 cases which were felt somewhat difficult to determine the main lesion. Careful neurological examinations in the upper and the lower limbs were the most valuable for the diagnosis. When the upper limbs are severely affected or nearly same as the lower limbs are, the main lesion is, in high possibility, located at cervical region. If the lower limbs are more severely affected than the upper limbs, thoracic region could be the main lesion.Cervical laminectomy showed satisfactory results. Whereas thoracic laminectomy did not bring good results, anterior body fusion of the thoracic spine brought better results in thoracic myelopathy due to ossified posterior longitudinal ligament. However, good results were obtained by thoracic laminectomy in cases with thoracic myelopathy due to ossified yellow ligaments.

Results and problems of 12 feet in 6 cases operated on by Batchelor's procedure were investigated. At the same time those of 14 feet in 10 cases were compared. The results of Batchelor's procedure by our criteria were as follows; 4 excellent, 3 good and 5 poor. 4n the othr hand those of Grice & Green's procedure were 4 excellent, 7 good and 3 poor. X-ray diagnosis is useful to judge the degree of the correction. This procedure has several advantages such as easy technique, firm fixation and the least influence on the bone growth, and must be indicated for those of reduced ones. It is necessary for us to observe the postoperative course to prevent the fracture of the graft and muscle unbalance.

17 cases with cervical lesions were investigated by cervical Amipaque myelography through cisternal puncture in prone position. Early side effects were observed in 11 cases out of 17 cases (64.7%). No serious complications were seen except one case who developed transient disorientation and speech disturbances. The advantages of this method include low frequency of side effects, high quality myelograms with minimum dilution of the contrast medium, and easy technique. This approach was considered to be useful as Cl-2 lateral puncture for cervical myelography.

A 7-year-old boy with painfull swelling of the left elbow, right forearm and right acromio-clavicular joint. X-ray examinations showed irregular destruction and peiosteal thickening of the left humerus, right radius and ulna, and right clavicle.These findings were very similar to those of osteomyelitis.However, atypical eclls resembling to lymphocyte were seen 22% in peripheral blood and 85.2% in bone marrow.Malignant lymphoma (may be lymphosarcoma type) was diagnosed by the biopsy of the lesion.Chemotherapy was done and 27 months after onset he is now in complete clinical and hematologic remission of his disease.

The author noticed a deformity of the upper femoral region which occurred after the closed treatment of congenital dislocation of the hip joint and attempted to elucidate this cause by clinical observation.Of 6 cases with this deformity, the process of its development was analysed by persuading the course of treatment and radiographic changes.It was found out that most of the cases had been treated before three months of age. They were immobilized in frog-leg plaster cast following closed reduction.On the radiographs all of them showed not only the involvement of epiphysis and physis of the femoral head, but also metaphysis.In comparison with normal cases, all of them showed the growing disturbance of the femoral neck.

Short term and long term follow-up post-operative results were investigated in patients with cervical myelopathy (Spondylotic, due to developmental canal stenosis and due to ossification of the posterior longitudinal ligament).Statistical evaluation was made to find the relation between each signs, each symptoms and general severity the patients had preoperatively, and the clinical postoperative results.There were 208 patients examined at 2 months after surgery and 80 patients examined at more than 3 years after surgery.In short term results no significant relation was found between preoperative general severity and postoperative results, but motor dysfunction of the lower extremities and sphincter disturbance had a close relation between the preoperative clinical factors and postoperative results.In long term follow-up, preopeative general severity had a close relation with the post-operative results. Motor dysfunction of the lower extremities was the only preoperative factor in symptoms and signs with a significant linear association between its presence and postoperative disabilities. Sphincter disturbance had no significant relation with post-operative resuin our investigations.

In our hospital, 375 cases of the legfracture were treated during 1964 to 1968.The legfractures almost were caused by the traffic accident.In the situation of the fractures of tibia, 1/3 distal of tibia was found the greater number.The operation were performed 66% in the fractures of tibia.Pseudarthrosis found 15% in the fractures of tibia.

Results and problems in 14 cases of tibial lengthening were investigated.Patients such as poliomyelitis, congenital dislocation of the hip and osteomyelitis from 10 to 15 years old were operated on by Z or horizontal osteotomy. All but one were lengthened gradually using distraction apparatus (Katayama-Hirakawa). The average gain was 12.2 per cent of the initial length of the tibia. The results were classified as follows; 9 excellent, 2 good and 3 poor, we regarded genu valgum and axial displacement as severe complications.Genu valgum seems to occur by1) descent of the fibular head.2) muscular imbalance.3) adduction contracture of the hip joint.4) medial protrusion of the axis.The prevention of genu valgum is difficult but it'll be possible to avoid the axial displacement by inserting the pins correctly and by device of the pin itself.

55 year-old repairman had feeling of numbness and weakness of flexion in his right fingers. Muscle atrophy on his right thenar eminence and no sensory changes were noticed.EMG findings and subjective symptomes which were made worse with supination of the forearm suspected the pronator syndrome.Surgical exploration was taken because of no relief of 2 months' rest. The median nerve was compressed by tendinous thickening at the lower portion of humeral head of pronation muscle. But we couldn't find macroscopically the abnormal findings of the median nerve.Fortunately feeling of numbness disappered after operation.It seemed difficult case to diagnnsis from other differential diseases.

Seventy-three patients with cervical myelopathy were able to be followed directly more than 3 years up to 16 years and 9 months (mean 6 years and 8 months). There were 57 patients with cervical spondylotic myelopathy (CSM) and 16 with myelopathy due to ossified posterior longitudinal ligament (OPLL).Better results were, generally, obtained at the time of follow-up (excellent+good: 77% in CSM, 69% in OPLL), compared with discharge time (69% in CSM, 62% in OPLL).However, 13 patients had worse results at the time of follow-up. Sensory disturbance increased or appeared in the upper limbs (10 cases) and in the lower limbs (9 cases). Gait disturbance increased or appeared (4 cases).The patients who had late regression showed a tendency of old age, previous history of trauma, appearance or increase of degenerative changes adjacent to the operated level and increased ossification of the posterior longitudinal ligament.

The myelopathy in cervical osteochondrosis was classified into the three types, that is the central type (type I), the posterolateral type (tye II) and the posteroanterolateral type (type III), due to the range and the severity of the cord damage.It was discussed the relation between these types and clinical findings.The posteroanterolateral type shows most sevese type in the subjective and objective symptom.Generally, the first subjective and objective symptom appears on the upper extremities.The type is transitive (type I→type II→type III).Compared the disturbed region of the spinal cord by the clinical view with by myelogram, the former extend to some upper cord.

Selective intra arterial hypertensive infusion of CDDP (100 mg) and PEP (40 mg) with angiotensin II was performed in a 64 year-old housewife with inoperable uterine cervical cancer stage IVa and transitional cell cancer of bladder (grade 1-2). PEP at 5 mg/day was also administered for 20 days (total 100 mg) using an implanted Drug Delivery System through the left internal iliac artery combined with irradiation therapy. There were hardly any side effects due to this treatment except for a slight upper digestive tract disturbance and bone marrow suppression, and the cancerous lesion gradually regressed following this treatment. This case suggested the efficacy of intra-arterial infusion using an implanted Drug Delivery System for advanced uterine cervical cancer. There has been no sign of recurrence six months after this treatment.

One hundred and sixteen patients with cervical intraepithelial neoplasia were treated by CO2 laser excisional conization, from 1985 to 1987. All operations in this series were performed in the outpatient unit. 1) In this series, 83.6% (97 out of 116) were patients with CIN and 44.0% (51 out of 116) were patients under the age 39 who can be pregnant. 2) There was no remaining in the 16 materials out of 44 obtained by hysterectomy due to cervical dysplasia and carcinoma in situ (CIS). 3) In our series, 10.3% (6 out of 58) of the women with dysplasia or CIS (surgical margin negative) required two treatments respectively to eradicate their disease from 9 months to 16 months after laser conization. 4) None of 72 women developed postoperative cervical stenosis and cervical infection. 5) Much of the epithelial cover, although originating from columnar cells, became squamous epithelium by 28 days. 6) There were 5 pregnancies in 72 patients, from 5 months to 13 after laser conization. From our studies, a CO2 laser conization for treating CIN preserved the architecture of the cervix, permitting adequate colposcopic and cytological follow-up, and preserved cervical function, so that fertility is not affected and so that there is no interference with pregnancy.

Physiological studies on the patellar intraosseous pressure gave the following results: The mean value of the intraosseous pressure was 12.5 mmHg (range 7-19.5 mmHg). The effects of femoral vascular occlusion and intravenous infusion of epinephrine or norepinephrine were similar to those reported on long bones. Not only the elevation of intraarticular pressure but also the compression of the infrapatellar fat pad increased intraosseous pressure during extension or flexion of the knee as a result of venous engorgement. The results of efferent nerve stimulation suggested that the femoral nerve carried the vasomotor fibers supplying the vessels of the patellar bone marrow. The afferent nerve responded to more than 20-39 mmHg elevation of the patellar intraosseous pressure.

The immunological effect has been studied of the non-specific immunopotentiator sizofiran (SPG) on patients with advanced uterine cervical cancer treated with radiation. Ten cases (study group: SPG group) were administered weekly 40 mg of SPG throughout the course of radiation and two weekly 40 mg during 12 months after radiotherapy. Nineteen cases (control group) were treated with irradiation alone. The lymphocyte count, the PHA index and the ratio of CD4 cells/CD8 cells were significantly reduced by radiotherapy, being observed the most remarkable decrease at post-radiotherapy. But in SPG group, these decreasing values were significantly smaller than in control group and the values showed a more progressive rise during the 12 month respectively. There was no significant difference in peripheral T lymphocyte; CD3, CD4, CD8. The NK cytotoxic activity showed a progressive rise during the 12 month period following a minimal change after radiotherapy. These results suggest that the SPG have some enhancing effect on the function of the lymphocytes.