イデンセイ シュヨウ ノ リンショウ

Heredity of malignant diseases has been an inexplicable issue for a long time. Because there was less precise description or undeveloped genetic science, most of those cases were explained as a coincidental accumulation of cancer. Recent advantage of microbiology revealed many of responsible genes for diseases including some malignancies. Familial adenomatous polyposis (FAP) and hereditary non-polyposis colorectal cancer (HNPCC) are well-investigated autosomal dominant diseases among them. In 1992, HNPCC patients in Japan were firstly screened by newly developed Japanese Clinical Criteria. During the study, 777 families were collected from 32470 colorectal cancer patients in 60 institutions in Japan. They showed features as an early age of onset, right colon involvement, and association of many other malignancies. Currently, hereditary tumor syndromes are classified in two categories ; A) Hereditary tumor syndrome including FAP, HNPCC, multiple endocline neoplasia (MEN) I and II etc, and B) Hereditary condition susceptible for cancer including xeroderma pigmentosusm, ataxia pigmentosum etc. Present investigations suggest an incidence of hereditary cancers as high as 5-10% of all cancers. It is not so high but study of these conditions may give a great advantage upon a carcinogenesis and treatment of all other malignancies. However, we have to pay a careful attention to the ethical, legal, and social issue that might be developed by the study

ジョクソウ ニ タイスル ラップ リョウホウ ノ ココロミ : ポリエンカビニリデンセイ ショクヒン ホウソウヨウ フィルム オ モチイタ ジョクソウ チリョウ

A food wrap film was used as a part of therapeutic materials for 34 decubitus ulcers in 29 patients, 15 males and 14 females, who were hospitalized in our departments from June 2000 to May 2001. Basic diseases of the patients consisted of 10 cerebrovascular diseases, 4 cephalic injury sequelae, 3 spinal diseases, 3 femur fractures, and 9 other diseases. Treatment of the decubitus ulcers was done everyday mostly according to Toriyabe’s method. Firstly, the bedsore was rinsed with physiological saline without applying pressure. Then, the ulcer including surrounding skin was covered with plastic food wrap (polyvinylidene chloride food wrapping film). Edge of the film was fixed to the skin with non-woven fabric tape. The results were evaluated by measuring two-dimensional sizes of the ulcers every two to four weeks. Reduction rate of the ulcer was calculated following formula : ((1-present size (maximal diameter×perpendicular size)/original size (maximal diameter×perpendicular size)×100)) (%) in 19 lesions followed more than one month. An average reduction rate was 43.7% at 3 months and 87.9% at 7 months after starting the food wrap film therapy. Moreover, 3 lesions got complete healing during the observation period. We strongly recommend the food wrap film therapy for the treatment of decubitus ulcers because it is simple to handle and extremely inexpensive, as well as effective

Ways of improving three-dimensional CT angiography images of cervical and cerebral vascular lesions

We evaluated various ways of improving the image clarity of three-dimensional CT angiography (3D-CTA) for the diagnosis of cervical and cerebral vascular disease in sixty-seven patients (36 males and 31 females). The mean age was 61.4 years, with a rang of 17 to 89 years. The patients were examined with a helical CT scanner (TCT-X vision GX) after intravenous bolus injection of 90 ml nonionic contrast medium (300 mgI/ml) at the rate of 3ml/sec. Intracranial and cervical 3D-CTA were performed 60 and 12 times, respectively. Our findings were as follows : 1. Reduction of the pre-scanning delay time from 18 to 10 sec after the injection of the contrast medium eliminates much of the cavernous sinus from the image and makes it easier to distinguish the intracavernous internal carotid artery in intracranial 3D-CTA. In cervical 3D-CTA, reduction of the pre-scanning delay time from 15 to 9 sec delays imaging of the jugular vein and makes it easy to distinguish the bifurcation of the common carotid artery. 2. A subtraction image on 3D-CTA is useful for detecting of vascular lesions adjacent to bone, such as lesions on the internal carotid artery. 3. By producing a stereo picture, a closer three-dimensional relationship between the vascular lesion and the vessel circumference organization can be recognized. 4. Vascular lesions can be clearly visualized from inside the artery using a 3D-CT endoscopic image. We were able to obtain a great deal of detailed information from 3D-CTA images with these modifications and we believe they enhance diagnostic accuracy of the technique

Bile-induced DNA strand breaks and biochemical analysis of bile acids in an experimental model of anomalous arrangement of the pancreaticobiliary ducts

A canine experimental model for the anomalous arrangement of the pancreaticobiliary ducts (APBD) was made to investigate the effects of bile acids on carcinogenesis. Seven adult mongrel dogs underwent dorsal pancreatico-cholecystostomy to serve as a functional model for APBD, and six dogs underwent the same procedure with the pancreatic duct ligated as a control group. Bile from the gallbladder was taken 14 months after surgery for bile acid analysis by HPLC. DNA strand breaks in HeLa cells induced by the bile were also investigated in situ by nick translation method. As a result, the fraction of cholic acid tended to be lower, and that of deoxycholic acid slightly higher in APBD-dogs (N.S.). The ursodeoxycholic acid percentage in APBD-dogs significantly decreased compared with that in the control and normal dogs (p<0.05). Extremely high frequency of DNA strand breaks was shown in only two out of seven APBD-dogs. In those two dogs, the cholic acid percentage decreased and that of deoxycholic acid increased extremely. These findings suggest that the alteration of the bile composition in APBD caused frequent DNA strand breaks and repair which might lead to gene mutation and biliary tract carcinoma

Anthropometrics estimates renal function

In recumbent elderly patients, creatinine clearance (eCCr) estimated by the Cockcroft-Gault (CG) equation may not necessarily reflect renal function. We aimed to develop a novel formula to revise the CG equation using anthropometric measurements in bedridden elderly patients and evaluate its clinical utility. The subjects included 77 bedridden Japanese patients aged ≥ 65, hospitalized at Naruto Yamakami Hospital. The actual CCr (mCCr) value was measured using the 24-hour urine collection method. Anthropometric data, such as skeletal muscle mass, body fat mass (BFM), and triceps skinfold thickness (TSF), were collected. We established a novel formula to estimate CCr(BFM) or CCr(TSF) by correcting the eCCr(Enz + 0.2) value with BFM or TSF. The stage of classification of renal dysfunctions in patients with eGFR(BFM) or eGFR(TSF) was equivalent to the GFR(control) based on the mCCr. Notably, the novel equation for eCCr based on TSF (eCCr(TSF)), dubbed the “Naruto” formula, can be useful to evaluate renal function in bedridden elderly patients without expensive equipment or additional costs. In this study, mCCr was considered to be the true renal function of the patient, but whether and to what extent mCCr correlates with inulin clearance is unknown

Inflammatory bowel disease in Tokushima prefecture : A report of questionnaire investigation

To investigate the number of cases and clinical features of inflammatory bowel disease, a questionnaire was sent to 1,271 hospitals or clinics in Tokushima prefecture. A total of 320 cases were collected from 60 institutes for the period from January to December 1997. Eight cases were excluded from this study because of duplicated report (6 cases) and inadequate diagnosis (2 cases). Finally, 312 cases were investigated on their clinical features, treatments, complications, and prognosis. The cases included 195 ulcerative colitis (male 106, female 83, gender unknown 6 cases, age ranged 9-81, mean 39.5± 14.3 (standard deviation (SD) years old), 69 Crohn's disease (male 39, female 24, gender unknown 6 cases, age ranged 17-87, mean 35.1±10.5 (SD) years old), 28 ischemic colitis (male 11, female 17, mean age 65.9±12.6 (SD) years old), 9 intestinal tuberculosis (male 1, female 6, gender unknown 2, age 66.9±6.1 (SD) years old), 4 intestinal Behcet (male 3, female 1, age 39.0±14.2 (SD) years old), 6 simple ulcers (male 3, female 3, age 67.7±11.8 (SD) years old), and a case of aphtous enteritis. Two toxic megacolon cases and 5 colorectal cancer cases were reported among the 195 ulcerative colitis patients. 44 cases out of 69 Crohn's disease patients were received surgical treatment because of severe complications including perforation (12 cases), stenosis (10 cases), internal fistula formation (8 cases) and so on. However, no case died because of the diseases except 3 untraceable patients