Invited Review Articles
Molecular Diagnosis of Malignant Lymphoma: Mantle Cell Lymphoma, Anaplastic Large Cell Lymphoma, and Marginal Zone B-Cell Lymphoma of Malt
YOSHIE SHIMOYAMA, AYAKO SAKAKIBARA, KUMI KAWAI, TETSURO NAGASAKA and SHIGEO NAKAMURA
pg(s) 1- 8
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Malignant lymphoma is a heterogeneous category embracing three major types of lymphoid neoplasms: B cell neoplasms, T and NK cell neoplasms, and Hodgkin lymphoma. Within each type, distinct disease entities are defi ned based on a combination of morphology, immunophenotype, genetic features and clinical syndromes, the emphasis on which represents a new paradigm in the lymphoma classifi cation of the World Health Organization (WHO). These lymphoma entities often have distinctive cytogenetic abnormalities, usually involving translocations that place a potential cellular oncogene under the infl uence of the immunoglobulin in some low-grade B-cell lymphomas. Both pathologists and oncologists are now concerned with better understanding each disease entity and its spectrum of morphology, genetic events, and clinical behaviors. Over the last decade, signifi cant progress has been made in the molecular characterizations of mantle cell lymphoma, anaplastic large cell lymphoma, and marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT), which have not only provided insights into the pathogenesis of lymphomas, but also valuable data that could lead to therapies based on their clinical behavior.
Cellular and Systemic Defense System Against Age-Promoting Stimuli
KEN-ICHI ISOBE, SACHIKO ITO, MASATAKA HANEDA and YOSHIYUKI ISHIDA
pg(s) 9- 18
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Although much progress has been achieved in aging research using lower animals, especially yeast and C. elegans, aging in humans remains puzzling. Here I offer my hypothesis of host defense against age-promoting stimuli, which holds that the cell itself has a defense system and multi-organism, an even more sophisticated one against age-promoting stimuli. Here I review recent achievements in aging research and try to explain their fi ndings in the light of my hypothesis. Age-promoting stimuli, including reactive oxygen species, telomere shortening or external stimuli such as UV or radiation induce stress responses in cells. The cellular defense system operates to overcome stimuli or repair damaged cellular components. Stress-induced damaged cells or infectious stimuli activate systemic defense systems, especially the innate immune system. Macrophages in the innate immune system are especially active not only in clearing damaged cells and repairing damaged tissue, but unfortunately, also in inducing age-related diseases.
Advances in Treatment of Epithelial Ovarian Cancer
FUMITAKA KIKKAWA, AKIHIRO NAWA, KAZUHIKO INO, KIYOSUMI SHIBATA, HIROAKI KAJIYAMA and SEIJI NOMURA
pg(s) 19- 26
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Since most cases of epithelial ovarian cancer are advanced at diagnosis, this disease is one of the most lethal malignancies of the female genital tract. In recent years, aggressive cytoreductive surgery and chemotherapy have been employed in an attempt to improve the survival rate in patients with epithelial ovarian cancer. Introduction of platinum anticancer drugs increased survival rate, and several randomized studies have been tried to establish the better combination of anticancer drugs. As a result, the combination of paclitaxel and carboplatin was considered as standard regimen for the fi rst-line treatment of patients with advanced ovarian cancer. Since International Federation of Gynecology and Obstetrics (FIGO) accepted a postoperative staging system in 1988, staging laparotomy needs hysterectomy, bilateral adnexectomy, omentectomy, and pelvic and para-aorta lymphadenectomy. However, the infl uence of lymphadenectomy on survival still remains controversial. Complete resection of the tumor is often diffi cult since the disease has spread to the abdominal cavity. In such cases, interval debulking surgery is performed after chemotherapy to remove tumors completely. The effectiveness of neoadjuvant chemotherapy and interval debulking surgery still remains unclear. This review will describe the advances in surgical procedures and chemotherapy in treatment of ovarian cancer patients.
Original Papers
Characteristics of Processing for Trait Adjectives in Depressive Persons: An Event-Related Potential Study
HIDEKI SHIMIZU, HIROFUMI SAITO and MINORU HOSHIYAMA
pg(s) 27- 33
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Event-related potentials (ERP) following emotive words were investigated in 22 healthy subjects with high (HD) or low (LD) depressive scores. The ERP was recorded following a visual presentation of emotive adjectives. The adjectives presented included words that subjects felt to be fi t or unfi t to their own character or traits, and that they perceived as positive or negative. The latency of P300 (P1) for negative words was signifi cantly longer than that for positive words at Pz in HD subjects. The N400 (N1) in HD subjects showed a longer latency than that in LD subjects (p<0.01) at Cz and Pz. However, there was no difference in amplitude between the fi t and unfi t category, nor in the positive or negative category of words between the LD and HD groups. The present study suggests that an excessive level of cognitive processing in response to passive stimulation by non-specifi c emotive words occurs in normal subjects with a depressive condition.
Cognitive Mechanism for Meaning of Emotive Words in Depressed Personality: An Event-Related Potential Study
MHIDEKI SHIMIZU, HIROFUMI SAITO and MINORU HOSHIYAMA
pg(s) 35- 44
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We investigated the relationship between the ERP modulation of emotive words and the depression score in thirty-fi ve healthy subjects with both high and low Beck Depression Inventory scores. The event-related evoked potentials (ERP) were measured following a visual presentation of emotive adjectives. Each word was classifi ed into two sets of categories by each subject, i.e., positive or negative, and fi t or unfi t to his/her personality. The ERP signals were then separately averaged according to the subject’s classifi cations. After stimulation, positive and negative ERP components at 200 ms (P2) and 400 ms (N2), respectively, were enhanced in amplitude in subjects with a high depression score. The enhancement of the P2 and N2 components was not related to the subject’s categorization of the words. The results suggest that hypersensitivity to non-specifi c emotive words might be a neurophysiological phenomenon in a depressive state in healthy subjects.
Simultaneous Registration with CT-Fluoro Matching for Spinal Navigation Surgery: A Case Report
YOSHIHITO SAKAI, YUKIHIRO MATSUYAMA, HISATAKE YOSHIHARA, HIROSHI NAKAMURA, SHOJIRO NAKASHIMA and NAOKI ISHIGURO
pg(s) 45- 52
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Computer-assisted surgery, which provides simultaneous, multiplanar images of bone structures, has become widely used. However, registration maneuvering remains time consuming. The objective of this paper is to document the usefulness of CT-fl uoro matching for spinal navigation. A spinal navigation system (VECTORVISION® compact; Brain LAB, Germany) and a digital imaging system (OEC9800; CATHEX, Tokyo, Japan) were used for CT-fl uoro matching in cases of L4/5 and L5/S1 posterior lumbar interbody fusion. A reference array was attached to the L4 spinous process. Preoperative CT images and intraoperative fl uoro-shots including L4, L5, and S1 were superimposed on the navigation monitor. Following insertion of L4 screws, a reference array remained to be attached to the L4 spinous process, after which a level defi nition and pre-registration of L5 and S1 vertebrae were performed and the screwing procedure of L5 and S1 was completed without additional fl uro-shots. Registration of three vertebrae was completed without paired-point or surface-matching procedures. The calculation time for the registration in a single vertebra was 30 sec. All pedicle screws were seen to be successfully inserted on postoperative CT images. We performed the navigation surgery by matching the preoperative CT images to the intraoperative fl uoro-shots without manual registration. This technique may prove useful in the future for anterior spinal surgery and percutaneous screwing without the need for total exposure of the bone surface.
Elective Neck Irradiation on Ipsilateral Side in Patients with Early Tongue Cancer for High-Risk Group with Late Cervical Lymph Node Metastasis
YOSHIYUKI ITO, NOBUKAZU FUWA, YUZO KIKUCHI, NORIO YOKOI, NOBUYUKI HAMAJIMA and KOZO MORITA
pg(s) 53- 62
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A prospective study was performed to assess the effi cacy of elective neck irradiation (ENI) on the ipsilateral side in patients with early tongue cancer among a high-risk group with late cervical lymph node metastasis. Patients in the high-risk group had T2-tumors, excluding superfi cials or T1-tumors >=19 mm in maximal diameter with invasion or ulcer. Between February 1989 and October 1997, 70 patients with tongue cancer of Stages I and II were enrolled in the present study (ENI group: 31, non-ENI group: 39). In a combination therapy of external beam irradiation and brachytherapy, the standard dose of interstitial brachytherapy for primary tumors was approximately 60 Gy. Irradiation was initiated with a 9-MeV electron beam at a dose of 50 Gy on the ipsilateral side of the neck only when the day of brachytherapy approached. Three patients (9.7%) in the ENI group had neck lymph node metastasis as did 5 (12.8%) in the non-ENI group (p= 0.684). In patients with ulceration, the incidence of subsequent lymph node metastasis was signifi cantly higher (p=0.029). Neck lymph node metastasis occurred in 2 (16.7%) of 12 patients with ulcers in the ENI group and in 2 (66.7%) of 3 with ulcers in the non-ENI group. Although we could not demonstrate the signifi cant effi cacy of ENI in the high-risk group in this study, ENI decreased the neck lymph node metastasis. In addition, our results suggested that ENI particularly inhibits cervical lymph node metastasis in tongue tumor patients with ulcers.
Short Communication
Gitelman's Syndrome with Silent Thyroiditis
Short Communication
pg(s) 63- 65
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