Significance of radiotherapy in the multidisciplinary treatment of gynecological malignant tumor

Effectiveness of radiotherapy and measures for improvement of treatment were examined with regard to cervical cancer, endometrial cancer and ovarian cancer, for (1) adenocarcinoma, (2) metastatic cancer, and (3) cancer in persons of advanced age. I. (1) The prognosis of cervical adenocarcinoma is poor, but radiotherapy in combination with chemotherapy can be expected to be effective for the poorly differentiated type, metastasis to the lymph node, and deep cervical invasion. (2) Radiotherapy has limited effectiveness for endometrial cancer and needs to be employed in combination with chemotherapy for the poorly differentiated type adenocarcinoma, serous adenocarcinoma, deep uterine wall invasion, vascular invasion, and metastasis to the lymph nodes. (3) In regard to cervical cancer and endometrial cancer, identification and computation of the labeling index of S-phase cells by BrdU and examination of the localization and the changes in the appearance of tumor markers and oncogenic products showed radiosensitivity of adenocarcinoma to be poor. (4) For ovarian cancer, whole pelvic irradiation by the moving strip (MS) method in combination with chemotherapy showed satisfactory results for stage I and stage II cancers. For stage III cancers, the results was not satisfactory when the residual tumor was 2 cm or larger in size. Whole pelvic irradiation of 50-TDF or more is necessary in such cases. II. The prognosis in cases of metastasis to multiple pelvic lymph nodes is poor. For such cases, it is desirable to employ paraaortic irradiation in combination with chemotherapy, with consideration of the histologic type and progress of the cancer. III. The prognosis is poor in persons of advanced age of 70 or over.(ABSTRACT TRUNCATED AT 250 WORDS)     

Acute occlusion of the iliac arteries due to blunt trauma

Two cases of acute iliac occlusion due to blunt trauma are presented. The cause of injuries were a fall from bicycle in case 1 and a compression between an automobile and a wall in case 2. The end-to-end anastomosis was possible in case 2, but an interposition of an artificial prosthesis was necessary because of the length of damaged artery in case 1. Both cases were associated with the pelvic fracture, adding the perforation of small bowels and the bladder in case 2. Postoperative course was almost uneventful except fasciotomy was needed for the compartment syndrome of the right lower extremity in case 2.     

Influence of age and severity of hypertension on blood pressure response to isometric handgrip exercise.

The influence of age and severity of hypertension on the blood pressure response to isometric handgrip exercise (IHG) was studied in essential hypertensive patients (n = 122). The change in blood pressure during IHG in elderly patients with isolated systolic hypertension (ISH) (n = 12) was also studied. Left ventricular hypertrophy due to hypertension was used as an index of the severity of hypertension. The change in systolic blood pressure (SBP) during IHG was markedly greater in essential hypertensives than in normotensive subjects (n = 36). Among hypertensive patients, the change in SBP increased with increasing severity of hypertension. This change in SBP was not influenced by age. The change in SBP during IHG in patients with ISH was significantly smaller than that in essential hypertensive patients and was similar to that in normotensive subjects in the elderly. These results demonstrate that age does not affect the increased blood pressure response to IHG in essential hypertensive patients but the greater the severity of hypertension, the greater the increase in SBP during IHG. Elderly patients with ISH do not have an enhanced blood pressure response to IHG.     

Trigeminal trophic syndrome--a report of three patients.

Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in Japan, were reported. Cutaneous lesions were a long-standing ulcer and destruction of the right ala nasi in case 1, a persistent deep ulceration on the forehead after a small trauma in case 2, and development of small, discrete ulcers on the right forehead during the treatment of a postherpetic neuralgia in case 3. A protective device was very effective in one patient.     

The enhancement of the hypomotility induced by small doses of haloperidol in the phase of dopaminergic supersensitivity in mice

Dopaminergic supersensitivity in mice was induced by pretreatment with a single injection of haloperidol (4.8 mg/kg). After the pretreatment, further treatment with haloperidol (0.6 or 0.01 mg/kg) was made at varying intervals, and catalepsy, locomotor activity and homovanillic acid (HVA) were measured. The intensity of the supersensitivity was evaluated by enhanced apomorphine (1 mg/kg)-induced climbing behavior. Supersensitivity was displayed on the 2nd and the 4th day. The cataleptogenic effect of haloperidol (0.6 mg/kg) was significantly weakened on the 1st, 2nd and 4th days. The motor inhibitory effect of haloperidol (0.01 mg/kg) increased on the 1st, 2nd and 4th days. Homovanillic acid was measured in the striatum and the prefrontal cortex on the 2nd day. Haloperidol (0.6 mg/kg) increased the concentrations of HVA in both regions of the brain. The increase in the concentrations of HVA in the striatum was blunted after the pretreatment, but such tolerance did not develop in the prefrontal cortex. Haloperidol (0.01 mg/kg) did not influence the concentration of HVA in both regions. These results suggest that the behavioral effect of a small dose of haloperidol may be enhanced, rather than reduced, in the phase of supersensitivity.     

Study of factors related to the surgical prognosis of cervical compression myelopathy

The purpose of this study was to determine whether or not surgical results of cervical compression myelopathy can be predicted morphometrically using computed tomographic myelography (CTM). Results; Through an autopsy study, the area and compression ratio in cross-section of the spinal cord were in good correlation with severity of the pathological changes. Morphometric study of fifty patients with this condition showed that the spinal cord area at the maximum compression segment in CTM was significantly correlated with surgical results. In most patients with less than 40 mm2 of the spinal cord area, postoperative score and recovery rate (Hirabayashi) were poor. Thus, 40 mm2 is the critical point of viability of the spinal cord. Several factors such as chronicity of the disease, age at surgery and multiplicity of involvement have been validated as predictive factors; however, the spinal cord area on CTM image proved to be the most comprehensive parameter for the prediction of surgical results through an analysis of covariance.     

A prospective, randomized trial of early versus late administration of a single dose of surfactant-TA.

Thirty-two neonates weighing 500-1500 g with documented surfactant deficiency and without evidence of severe birth asphyxia, infection, prolonged rupture of membranes greater than or equal to 72 h, or oligohydramnios were randomly assigned to receive a single intratracheal dose of surfactant-TA (100 mg/kg) either within 30 min of birth (n = 16, early group) or at 6 h of age (n = 16, late group). By 6 h of age, all neonates of the late group had moderate/severe RDS, while none of the neonates of the early group had either clinical or radiological respiratory distress syndrome. The incidence of bronchopulmonary dysplasia was significantly lower in survivors of the early group than those of the late group (1/15 versus 7/14, a 43% reduction with a 95% confidence interval of 14-72%, P = 0.025). These beneficial effects of early surfactant treatment remained after controlling for the various confounding factors in the logistic models.     

静脉穿刺比足跟切开更适用于采集足月新生儿血样

研究背景:口服蔗糖可减轻新生儿手术时的疼痛反应,这种观点已经得到人们的广泛认可。一些研究证实,血样采集过程中,静脉穿刺(V P)造成的疼痛反应低于足跟切开(H L)。目的:在口服蔗糖或不用蔗糖的情况下,采用VP法或H L法采集血样,确定疼痛最轻微且效果最佳的血样采集方法。设计: