STUDY ON CLINICAL REFERENCE RANGE CALCULATED FROM ROUTINE CHEMICAL LABORATORY DATA

We studied sex-linked differences and aging-dependent changes of the clinical reference range (CCR) calculated from routine chemical laboratory data with analyzing histogram of data. CCR of γ-GTP, UA and Cr was higher in males than in females. CCR of ALP was about three-fold higher in adolescents than in adults. Aging-dependent increase was found on CCR of AMY, LDH and BUN. CCR of GPT, ChE and AMY, LDH and BUN. CCR of GPT, ChE and UA was elevated in males in the age group of 30-60. CCR of γ-GTP was elevated in males in the age group of 50-60. Frequency curve of the data in TP, Alb, A/G ratio, Na, Cl, Ca, IP and Mg showed normal distribution, and that of the data in T-Bil, I-Bil, ALP, AMY, LDH, ChE, TC, TG, PL, BUN, UA, Cr and K showed log-normal distribution. We discuss these results and establish the CCR for clinical use

上腕骨近位端骨折による上腕動脈損傷・術中大量出血・ショック状態に対し緊急で腋窩動脈 -上腕動脈バイパスを実施し，救命救肢した一例

症例は80歳女性．パーキンソン病にて外来通院中であった．自宅にて転倒し，近医にて右上腕骨近位端骨折の診断となり，手術目的に当院紹介予定となった．術前，発熱意識障害みとめ，菌血症，尿路感染，誤嚥性肺炎合併の診断にて，抗生剤治療が開始された．全身状態改善を得て，血液培養陰性を確認し，骨折受傷後28日に上腕骨近位端骨折に対する右人工関節置換術を予定した．術中骨周囲の癒着は著明であった．剥離操作中に，上腕動脈損傷を認め，大量出血ショック状態となった．そのため，緊急止血，右腋窩動脈-右上腕動脈人工血管バイパス術を実施した．術後造影CT検査にて，グラフト開存を確認し，状態改善を見て，リハビリ目的に転院となった．今回上腕動脈近位端骨折の際に上腕動脈損傷，大量出血に際し，緊急で腋窩動脈-上腕動脈バイパスを実施し，救命，救肢しえた 1 例を経験したため報告する

A Case of Primary Central Nervous System Lymphoma that Developed during the Treatment of Castration-Resistant Prostate Cancer

A 64-year-old man was diagnosed with metastatic prostate cancer (cT3bN0M1b) and treated with combined androgen blockade. After two years and three months, he developed castration-resistant prostate cancer. Multiple lung metastases appeared after the administration of five courses of docetaxel and four courses of cabazitaxel therapy. Pulmonary metastases disappeared following rechallenge with docetaxel. Enzalutamide administration was initiated because docetaxel had to be discontinued due to adverse events. Although enzalutamide lowered the prostate specific antigen value, the patient staggered while walking and developed homonymous hemianopsia. Magnetic resonance imaging revealed a brain tumor. Although the brain tumor was considered to have metastasized from the prostate cancer, it was diagnosed as a primary central nervous system lymphoma using open-ended tumor biopsy. The brain tumor was eliminated with whole-brain irradiation. Thereafter, he has been treated with enzalutamide for 3 years without clinical progression of either disease

BACKGROUND OF CLINICAL LABORATORY DATA : WITH SPECIAL REFERENCES TO GPT, GOT AND γ-GTP

Background clinical laboratory data such as GOT, GPT and γ-GTP were studied in 19,167 outpatients and 62 normal subjects identified with medical screenings. The results are as follows : 1) GPT increased with aging and showed a peak in male patients in their forties and in female patients in their sixties. No difference in GPT between male and female patients in their forties was found with normal subjects in the same range of body weight, 2) GOT decreased in patients till their twenties and increased in male patients thereafter. An abrupt increase in GOT was found in female patients in their fifties. No difference in GOT between male and female patients in their forties was found with normal subjects. 3) γ-GTP showed a similar mode of change with aging to GPT. But no sex-linked difference was found between male and female normal subjects who were non-drinkers. It is suggested that sex-linked difference in GPT, GOT and γ-GTP are mainly associated with body weight, pathological variation and alcohol-intake, respectively

STUDIES ON DETERMINATION OF APOLIPOPROTEINS BY TURBIDIMETRIC IMMUNOASSAY AND THEIR DIAGNOSTIC SIGNIFICANCE

Serum levels of apolipoproteins were determined in 386 outpatients without obvious metabolic disorder by turbidimetric immunoassay. By studies on linearity, repeatability, reproducibility and interference, this assay was confirmed to be applicable for routine laboratory tests. Clinical reference ranges in serum levels of apolipoprotein (apo) A-Ⅰ, A-Ⅱ, B, C-Ⅱ, C-Ⅲ, and E were 92. 56-173. 79, 22. 11-40. 34, 52. 53-110. 37, 1. 39-5. 44, 4. 27-12. 94 and 2. 87-6. 38 mg/dl, respectively. Also, comparative studies on skewness and coefficient of variation in distribution of values were done with apo A-1 and high-density lipoprotein (HDL) cholesterol, and apo B and low-density lipoprotein (LDL) cholesterol. The findings suggested that levels of apolipoproteins such as A-Ⅰ and B are related to particle numbers of lipoproteins such as HDL and LDL, while cholesterol content in lipoproteins is affected by qualitative changes in particles as well. In coronary heart diseases, apo B and apo B/A-Ⅰ ratios were significantly elevated and are suggested to be sensitive indicators for these diseases

カキ新品種 \u27早秋\u27

Soshu\u27 is a pollination constant non-astringent (PCNA) type of Japanese persimmon (Diospyros kaki Thunb.) cultivar released by the Persimmon and Grape Research Center (presently the Department of Grape and Persimmon Research) of the National Institute of Fruit Tree Science (NIFTS), Akitsu, Hiroshima, Japan, in the year 2000. The fruit is distinguished by its very early ripening time, no cracking habit at calyx end, red skin color and excellent eating quality. \u27Soshu\u27 resulted from the cross \u27Izu\u27×\u27109-27\u27 made in 1988. \u27109-27\u27 is a PCNA selection from the cross \u27Okitsu-2\u27×\u27Okitsu-17\u27. \u27Okitsu-2\u27 and \u27Okitsu-17\u27 are PCNA selections from crossing \u27Fuyu\u27×\u27Okugosho\u27 and \u27Okugosho\u27×\u27Fukurogosho\u27, respectively. \u27Soshu\u27 was primarily selected at NIFTS, Akitsu in 1994, designated as \u27Kaki Akitsu-13\u27, and had been tested at 29 locations in 28 prefectures under the Fifth Persimmon Regional Trial initiated in 1996. The \u27Soshu\u27 fruit ripens in late September to early October (the same time as that of \u27Nishimurawase\u27), and is flat-shaped, weighing on an average of 250 g (slightly less than the fruit of \u27Matsumotowase-Fuyu\u27) at NIFTS, Akitsu. The fruit shape is unlikely to be uniform. The skin is reddish-orange at harvest time, having a value of 6 to 7 on the color chart for \u27Fuyu\u27 (Yamazaki and Suzuki, 1980, Bull. Fruit Tree Res. Stn. A7:19-44), more reddish than that of \u27Tonewase\u27, a leading early-ripening astringent cultivar. The flesh is moderately fine and juicy. Soluble solids content in juice averages 15.9% and is comparable to that of \u27Izu\u27. The fruit is PCNA, in which the deastringency in fruit occurs naturally and stably on the tree, irrespectively of the number of seeds contained in fruit when the tree is grown in warm areas. \u27Soshu\u27 can be commercially grown in \u27Fuyu\u27 and \u27Matsumotowase-Fuyu\u27 production area. Fruit cracking at the calyx end, which is a serious physiological disorder in \u27Izu\u27 and \u27Matsumotowase-Fuyu\u27, does not occur in \u27Soshu\u27. Fruit cracking at the stylar end occurs rarely, except for very small size of cracking that does not affect its marketablity. The occurrence of skin blackening, a physiological disorder, averaged 20% in the regional trial, which was comparable to that of \u27Nishimurawase\u27. The shelf life of \u27Soshu\u27 averaged 12 days at ambient temperature in the regional trial, which was longer than that of \u27Izu\u27 and shorter than that of \u27Matsumotowase-Fuyu\u27. The tree is moderately vigorous but less vigorous than \u27Fuyu\u27. It is intermediate between upright and spreading in shape. It produces no male flower but easily produces many female flowers every year. The trees treated with flower thinning show slight physiological fruit dropping in early fruit-developmental stage in June and July, which is higher than that of \u27Fuyu\u27. Planting pollinizer trees is needed to promote pollination for stable fruit production. \u27Zenjimaru\u27 is suitable as the pollinizer in terms of flowering time, male flower quantity, pollen quantity, and pollen activity. Fruit dropping in late fruit-developmental stage in August and September is very rare in \u27Soshu\u27. Anthracnose resistance in \u27Soshu\u27 is less than that of \u27Fuyu\u27. Thrips attacks are rare