Invited Review Articles
Use of Granulocyte Colony-stimulating Factor for Treatment of Aplastic Anemia
SEIJI KOJIMA
pg(s) 77- 82
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Over the last ten years, recombinant human granulocyte colony-stimulating factor (rh G-CSF) has been widely used in the treatment of aplastic anemia (AA). It has been shown to facilitate the recovery of neutrophil count and useful for complicated bacterial or fungal infections. However, recent randomized clinical trials showed that the addition of rh G-CSF to immunosuppressive therapy had no clinical benefit for the prophylaxis of severe infections. These results suggested that rh G-CSF should be used for the treatment of infectious complications, not for the prophylaxis of infections in patients with AA.
Progress in Diagnosing Herpesvirus Infections
TSUNEO MORISHIMA
pg(s) 83- 97
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As molecular biology has developed, several new diagnostic techniques have found application in the clinical setting. The use of the polymerase chain reaction (PCR) assay to study the molecular biology of microbial organisms has led to unparalleled advances, largely due to the rapidity with which results can be obtained. The sensitivity and specificity of PCR detection of viral DNA for diagnostic purposes are remarkable. With such excellent sensitivity, PCR is destined to become a useful diagnostic tool in herpesvirus infections. However, it is well known that herpesviruses establish latency after primary infections and that they can often be reactivated under various conditions. Because of the high sensitivity of PCR, detection of virus sequences by this method does not necessarily imply a disease state. We must be careful not to overdiagnose conditions in a clinical setting based on a PCR assay.
NK and NK-related Neoplasms
NAOYOSHI MORI
pg(s) 99-106
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Owing to the immunological progress in recent years, differentiation and maturation process of NK cells or NK-related cells has been made clear. Also, their neoplastic counterparts, namely NK cell related lymphoma/leukemia have been characterized. In this paper, we will report NK cell neoplasms based on the new classification of malignant lymphomas. Among these, nasal lymphoma is one of the most cleary defined entities, followed by NK cell leukemia/lymphoma, and blastic/blastoid NK cell leukemia/lymphoma.
A New Operation for Noncorrectable Biliary Atresia
HISAMI ANDO
pg(s)107-114
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An improved operative technique to transect the fibrous cord by dividing the ligamentum venosum (Arantius’ canal) is described for noncorrectable biliary atresia. The Arantius’ canal is situated cranial and posterior side to the bifurcation of the umbilical portion and the portal branch of the Quinous’ segment 3. The portal vein is fully mobile and the porta hepatis can be widely exposed by dividing the Arantius' canal. The fibrous cord of the porta hepatis can easily be dissected posteriorly and laterally where there is an extensive number of bile ducts. Eight patients with biliary atresia underwent this procedure. Jaundice resolved completely (serum total bilirubin concentration: ≤1 mg/dl) in 7 patients within 40 days. Postoperative cholangitis did not occur. By dividing the Arantius’ canal, the portal vein comes free from the portal fissure to make the hepatic hilum wider, and surgeons are able to work within a larger porta hepatic space without causing portal vein compression. Free drainage of the bile from the porta hepatis may prevent postoperative cholangitis and promote resolution of jaundice.
Original Papers
Effects of Sodium Hyaluronate on Experimental Osteoarthritis in Rabbit Knee Joints
FEI HAN, NAOKI ISHIGURO, TAKAYASU ITO, TADAHIRO SAKAI and HISASHI IWATA
pg(s)115-126
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The aim of this study was to examine the effects of intraarticular administration of hyaluronan (HA) on cartilage degradation. Using a partial menisectomy model of osteoarthritis (OA) in the rabbit knee, the authors investigated the catabolic and anabolic changes induced by intraarticular injection of HA. To analyze anabolic changes, the authors assessed cell proliferation by measuring [3H] thymidine uptake, and proteoglycan biosynthesis by noting [35S] sulfate incorporation. For catabolic changes, messenger ribonucleic acid (mRNA) expression of interstitial collagenase (MMP-1), stromelysin-1 (MMP-3), and tissue inhibitor of metalloproteinase-1 (TIMP-1) in cartilage and synovium were detected with reverse transcriptase polymerase chain reaction (RT-PCR). Of significance for blocking the development of early OA in chondrocytes was the finding that total proteoglycan synthesis in the HA treatment group was significantly higher than in the controls. At the mRNA level in cartilage and synovium, HA inhibited MMP-3 and TIMP-1 production in the same way in the HA treatment group, while not affecting MMP-1 production. Thus it can be concluded that HA affects cartilage catabolism and anabolism to prevent the progress of OA.
Empirische und mechanistische Auswertungsmodelle für Laktatkonzentrationszeitkurven im Dauerleistungstest
HORST JOSEF KOCH and CHRISTOPH RASCHKA
pg(s)127-134
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Der Dauerleistungstest hat sich neben dem Stufentest in der sportmedizinischen Leistungsdiagnostik als Methode etabliert. Bisher konzentrierte sich die Auswertung auf die maximalen Laktatkonzentrationen im steady state. Die Autoren schlagen verschiedene Modelle vor, sowohl empirische als auch mechanistische, um die Laktatkonzentrationszeitkurve zu beschreiben. Neben der maximalen Konzentration können nach Berechung der Modellkurven via nichtlinearer Regression Konzentrationen zu definierten Zeitpunkten (z. B. LT20 = Laktat nach 20 Minuten, EC50 im Emax-Modell) oder die Steigung der Kurve beurteilt werden. Darüber hinaus läßt sich die AUC (Area under the curve) als Ausmaß für die Laktatbildung während des Dauerleistungstests mit der Trapezregel bestimmen.
Acute Myeloid Leukemia in the Elderly: – 159 Nagoya Case Studies –
EIICHI NAGURA, SABURO MINAMI, KOICHIRO NAGATA, YOSHIHISA MORISHITA, HIDEO TAKEYAMA, HIROSHI SAO, HISAMITSU SUZUKI, TOMOKI NAOE, SHOZO YOKOMAKU, HARUMITSU MIZUNO, TAKUHEI MURASE, NORIYUKI HIRABAYASHI, TAKAAKI TAKEO, MITSUNE TANIMOTO, KOHEI KAWASHIMA and HIDEHIKO SAITO comprising the Nagoya Cooperative Study Group for Elderly Leukemia
pg(s)135-144
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To obtain background information on elderly acute myeloid leukemia (AML), unselected data covering 159 patients aged 60 years or over with AML from 14 hospitals in Nagoya, Japan was analyzed retrospectively. Among these patients, 119 had de novo acute AML, 32 had AML which evolved from myelodysplastic syndrome (MDS-AML), and 8 had other types of leukemia.
The survey showed that MDS-AML tended to be more prevalent in patients aged 70 years and older and that MDS-AML showed a significantly more severe degree of leukopenia and anemia than de novo AML. MDS-AML also showed a significantly lower complete remission (CR) rate than that of de novo AML [6.9% (2/29) vs 58.3% (67/11), P < 0.01] and significantly shorter survival times than those of de novo AML [median: 3.6 months vs 9.6 months, P < 0.01 (generalized Wilcoxon test; GW].
In de novo AML, the proportion of patients treated with conventional therapy (CT group) decreased significantly, and that of those with attenuated therapy (AT group) increased significantly as age elevated (P < 0.01). The CT group showed a significantly higher CR rate (65.4% vs 41.2%, P < 0.05) and a significantly longer survival period than those of the AT group [median: 11.6 months vs 4.8 months, P < 0.05 (GW)]. Overall survival rates of the older age groups became significantly shorter with aging [P < 0.01 (GW)].
Abstracts
Annual Research Meeting for Graduate Students: Nagoya, December 1998
pg(s)145-172
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