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A number of Farmer-type ionization chambers were tested against storage humidity to confirm whether they satisfied the criteria for the long-term stability of reference-class ionization chambers.The ionization chambers were stored for several months in an environment with relative humidity adjustable from 20% to 80%. The ionization chambers were removed from the storage environment at variable intervals ranging from 1 to 70 days and irradiated in a Co-60 radiation beam. The responses for each ionization chamber were evaluated from the measured currents corrected for the atmospheric air density, and were compared with those predicted by the Co-60 half-life.Certain ionization chambers gave a constant relative response regardless of the storage humidity, while the relative responses of two types of ionization chambers changed as a function of the storage humidity. The difference between the relative responses for the low (20-30%) and high (70-80%) storage relative humidity wasThe present results and previous reports by other authors indicate that the magnitude of the change depends on the magnitude of the water absorption of the plastic used for the outer wall and/or the electrode of the ionization chamber. Thus, it is important in the selection of the reference-class ionization chamber to note the material and structure of the outer wall and electrode of the ionization chamber. If the ionization chamber has a hygroscopic wall and electrode and it is used as a reference ionization chamber, it is necessary to pay additional attention to the humidity difference for the storage, daily irradiation, and yearly calibration especially in regions with large seasonal humidity fluctuations.

PURPOSE We experimentally determined the radiophotoluminescent glass dosimeter (RPLD) dose responses for TomoTherapy, CyberKnife, and flattening-filter-free (FFF) linear accelerator (linac) outputs for dosimetry audits in Japan. METHODS A custom-made solid phantom with a narrow central-axis spacing of three RPLD elements was used for output measurement to minimise the dose-gradient effect of the non-flattening filter beams. For RPLD dose estimation, we used the ISO 22127 formalism. Additional unit-specific correction factors were introduced and determined via the measured data. For TomoTherapy (7 units) and CyberKnife (4 units), the doses were measured under machine-specific reference fields. For FFF linac (5 units), in addition to the reference condition, we obtained the field-size effects for the range from 5×5 cm to 25×25 cm. RESULTS The correction factors were estimated as 1.008 and 0.999 for TomoTherapy and CyberKnife, respectively. For FFF linac, they ranged from 1.011 to 0.988 for 6 MV and from 1.011 to 0.997 for 10 MV as a function of the side length of the square field from 5 to 25 cm. The estimated uncertainties of the absorbed dose to water measured by RPLD for the units were 1.32%, 1.35%, and 1.30% for TomoTherapy, CyberKnife, and FFF linac, respectively. A summary of the dosimetry audits of these treatment units using the obtained correction factors is also presented. The average percentage differences between the measured and hospital-stated doses were

Summary: Highly ordered brain architectures in vertebrates consist of multiple neuron subtypes with specific neuronal connections. However, the origin of and evolutionary changes in neuron specification mechanisms remain unclear. Here, we report that regulatory mechanisms of neuron subtype specification are divergent in developing amniote brains. In the mammalian neocortex, the transcription factors (TFs) Ctip2 and Satb2 are differentially expressed in layer-specific neurons. In contrast, these TFs are co-localized in reptilian and avian dorsal pallial neurons. Multi-potential progenitors that produce distinct neuronal subtypes commonly exist in the reptilian and avian dorsal pallium, whereas a cis-regulatory element of avian Ctip2 exhibits attenuated transcription suppressive activity. Furthermore, the neuronal subtypes distinguished by these TFs are not tightly associated with conserved neuronal connections among amniotes. Our findings reveal the evolutionary plasticity of regulatory gene functions that contribute to species differences in neuronal heterogeneity and connectivity in developing amniote brains. : Neuronal heterogeneity is essential for assembling intricate neuronal circuits. Nomura et al. find that species-specific transcriptional mechanisms underlie diversities of excitatory neuron subtypes in mammalian and non-mammalian brains. Species differences in neuronal subtypes and connections suggest functional plasticity of regulatory genes for neuronal specification during amniote brain evolution. Keywords: Ctip2, Satb2, multi-potential progenitors, transcriptional regulation, neuronal connectivity

To clarify typical diagnostic computed tomography (CT) findings of Petersen’s hernia for differentiation from other causes of internal hernia observed in patients having undergone gastrectomy with Roux-en-Y gastric bypass. We retrospectively reviewed CT findings of internal hernia in patients who had undergone both gastrectomy and Roux-en-Y reconstruction and a second surgery for bowel obstruction. Thirteen patients with Petersen’s hernia and 6 with internal hernia other than Petersen’s hernia were investigated. Six CT findings, viz. whirl sign, mesenteric fat haziness, intestinal distension in the upper abdomen, herniated intestinal loop above the gastric level, middle/distal ileum courses downwards from the left hypochondrium, and hooking intestine sign, which means two or more intestines pass through the inner side of J-shaped vessels consisting of mesenteric vessels of the elevated jejunum, were scored and evaluated regarding their diagnostic performance. The hooking intestine sign showed the highest sensitivity, specificity and accuracy (100%, 100% and 100%). We could detect J-shaped vessels in all Petersen’s hernia patients. Inside the J-shaped vessels there were two or more intestinal tracts passing through in the Petersen’s hernia group. There was only transverse colon inside the J-shaped vessels in the control group. The hooking intestine sign may be useful for diagnosing Petersen’s hernia on CT.

Complete visceral inversion occurs in 1/5,000 individuals. In 64%of cases, complete visceral inversion is complicated by the malformation of other organs. Careful attention is required when performing surgeries. In recent years, with the development of laparoscopic surgery, some cases of laparoscopic surgery with complete visceral inversion have been reported. Herein, we report a case of safely performed laparoscopic surgery for sigmoid colon cancer with complete visceral inversion along with a relevant discussion.

Adult newts can regenerate large parts of their brain from adult neural stem cells (NSCs), but how adult NSCs reorganize brain structures during regeneration remains unclear. In development, elaborate brain structures are produced under broadly coordinated regulations of embryonic NSCs in the neural tube, whereas brain regeneration entails exquisite control of the re-establishment of certain brain parts, suggesting that a yet-unknown mechanism directs NSCs upon partial brain excision. Here we report that upon excision of a quarter of the adult newt (Pleurodeles waltl) mesencephalon, active participation of local NSCs around specific brain subregions’ boundaries leads to some imperfect and some perfect brain regeneration along an individual's rostrocaudal axis. Regeneration phenotypes depend on how wound closing occurs using local NSCs, and perfect regeneration replicates development-like processes, but takes more than 1 year. Our findings indicate that newt brain regeneration is supported by modularity of boundary-domain NSCs with self-organizing ability in neighboring fields. This article has an associated First Person interview with the first author of the paper., Summary: Upon large-scale brain excision in adult newts, the outcome of structural regeneration of the brain cytoarchitecture depends on ways of closing the wound by NSCs residing between brain subregions.

The evolution of unique organ structures is associated with changes in conserved developmental programs. However, characterizing the functional conservation and variation of homologous transcription factors (TFs) that dictate species-specific cellular dynamics has remained elusive. Here, we dissect shared and divergent functions of Pax6 during amniote brain development. Comparative functional analyses revealed that the neurogenic function of Pax6 is highly conserved in the developing mouse and chick pallium, whereas stage-specific binary functions of Pax6 in neurogenesis are unique to mouse neuronal progenitors, consistent with Pax6-dependent temporal regulation of Notch signaling. Furthermore, we identified that Pax6-dependent enhancer activity of Dbx1 is extensively conserved between mammals and chick, although Dbx1 expression in the developing pallium is highly divergent in these species. Our results suggest that spatiotemporal changes in Pax6-dependent regulatory programs contributed to species-specific neurogenic patterns in mammalian and avian lineages, which underlie the morphological divergence of the amniote pallial architectures., Highlighted Article: Pax6 promotes neuronal differentiation in the developing chick and mouse telencephalon via Notch inhibition, whereas its stage-specific function in RGC maintenance in the VZ is unique to mammalian neocortical progenitors.

The amplification of distinct neural stem/progenitor cell subtypes during embryogenesis is essential for the intricate brain structures present in various vertebrate species. For example, in both mammals and birds, proliferative neuronal progenitors transiently appear on the basal side of the ventricular zone of the telencephalon (basal progenitors), where they contribute to the enlargement of the neocortex and its homologous structures. In placental mammals, this proliferative cell population can be subdivided into several groups that include Tbr2+ intermediate progenitors and basal radial glial cells (bRGs). Here, we report that basal progenitors in the developing avian pallium show unique morphological and molecular characteristics that resemble the characteristics of bRGs, a progenitor population that is abundant in gyrencephalic mammalian neocortex. Manipulation of LGN (Leu-Gly-Asn repeat-enriched protein) and Cdk4/cyclin D1, both essential regulators of neural progenitor dynamics, revealed that basal progenitors and Tbr2+ cells are distinct cell lineages in the developing avian telencephalon. Furthermore, we identified a small population of subapical mitotic cells in the developing brains of a wide variety of amniotes and amphibians. Our results suggest that unique progenitor subtypes are amplified in mammalian and avian lineages by modifying common mechanisms of neural stem/progenitor regulation during amniote brain evolution., Highlighted article: In the developing chick pallium, a basal progenitor population resembles mammalian cortical basal radial glia, suggesting a more ancient evolutionary origin for this cell type.

Although chemotherapy is the main treatment for recurrent colorectal cancer, the utility of radiotherapy as a local treatment has been widely reported. We performed chemoradiotherapy with S-1 for cases with recurrence after surgery, and the outcomes are reported herein.Chemoradiotherapy with S-1 was performed in 4 cases. S-1 was administered for 2 weeks during the irradiation period, and the off period provided was 1 week.X-ray irradiation was performed in 2 cases and proton beam irradiation in the other 2. The progression free periods of the 2 cases receiving proton beam irradiation were 31 months and 36 months. In contrast, the progression free periods of the 2 cases given X-ray irradiation were 24 months and 21 months.It is known that S-1 not only achieves a high anticancer effect via dihydropyrimidine dehydrogenase(DPD)inhibition, which is a major metabolic pathway of 5-FU, but also increases the radiation susceptibility of malignancies. S-1 is regarded as an ideal anticancer agent when used in combination with radiation therapy. Since the local control achieved in our 4 cases was good, chemoradiotherapy with S-1 was considered to be a useful treatment.

Reptiles and birds have been highlighted as excellent experimental models for the study of developmental biology; however, due to technical limitations in cellular analysis, dynamics of neural stem/progenitor cells of these animals remain unclear. In this chapter, we introduce the protocols for neurosphere culture and ex ovo embryonic culture of developing reptilian and avian embryos, which are modified from the method originally established for rodent embryos. Applications of these techniques provide powerful strategies for the study of comparative neural development of amniotes.

A facile and robust method to prepare 2-methyl- and 2,6-dimethyltetrahydropyrans, most useful Nicolaou intermediates for the synthesis of ladder-shaped polyethers, is disclosed. The established highly practical recipe, adopting chemo- and stereoselective catalytic oxidations and one-pot reactions with few chromatographic purifications, would significantly facilitate the large-scale supply of pivotal monocyclic building blocks, which is a rate-determining process of gigantic tetrahydropyran-containing natural products synthesis.

Extensive radiation of extant amniotes could have been achieved by the innovation of several unique characteristics in the body plans of their ancestors. In particular, distinct brain regions were enlarged independently to acquire similar functional properties in different amniote lineages. The neocortex and dorsal ventricular ridge (DVR) are a typical case of such parallel brain evolution in mammalian and reptilian lineages. Although these structures have distinct developmental origins, striking functional similarities in the neocortex and DVR have led to long-lasting arguments regarding their evolutionary development from ancestral amniotes. Here, we introduce morphological, neuroanatomical, and developmental aspects of the convergent and divergent features of the neocortex and DVR in amniotes. Furthermore, we discuss possible genetic changes that provided these remarkable brain structures, with special interest in the role of the Pax6 gene, an essential regulator of neural stem/progenitor cell dynamics. Comparative functional analyses of the regulatory genes required for pallial development will provide significant insights into the evolutionary origin of the hallmarks of mammalian and reptilian brains.

Reptiles and birds have been highlighted as excellent experimental models for the study of developmental biology; however, due to technical limitations in cellular analysis, dynamics of neural stem/progenitor cells of these animals remain unclear. In this chapter, we introduce the protocols for neurosphere culture and ex ovo embryonic culture of developing reptilian and avian embryos, which are modified from the method originally established for rodent embryos. Applications of these techniques provide powerful strategies for the study of comparative neural development of amniotes.

One-dimensional symmetrical explosive loadings are applied to expand structural components: tubular cylinders, spherical shells and rings of 304 stainless steel and double and single walled cylinders of an aluminum alloy, A5052 to fragmentation, and the effects of wall thicknesses, explosive driver diameters and the constant proportionality of the in-plane biaxial stretching rates are investigated on the deformation and fracture behavior of three types of single walled structures and shatterproof behavior for double walled cylinders experimentally and numerically. In the cylinder tests, the driver is a column of high explosive PETN, inserted coaxially into the bore of a cylinder and initiated by exploding a fine wire bundle at the column axis using a discharge current. In case of the ring tests, ring specimens are placed onto a cylinder charged with the PETN as an expansion driver, and for sphere tests, a specimen filled with the PETN is also initiated by exploding a fine copper wire line with small length located at the central point. Observation results of deformation have shown the final maximum in-plane stretching rate order of , and fracture evaluations on recovered fragments are discussed indicating the need of modified fragmentation model for the structural components. In the double walled cylinder tests, only for lowermost amount of the explosive the outer cylinder has almost caught the fragments of inner cylinder, revealing that the damage phenomena are much different from those for single walled ones.

Purpose: Successful results in carbon-ion and protonradiotherapies can extend patients’ lives and thus present a treatment option for younger patients; however, the undesired exposure to normal tissues outside the treatment volume is a concern. Organ-specific information on the absorbed dose and the biological effectiveness in the patient is essential for assessing the risk, but experimental dose assessment has seldom been done. In this study, absorbed doses, quality factors, and dose equivalents in water phantom outside of the irradiation field were determined based on lineal energy distributions measured with a commercial tissue equivalent proportional counter (TEPC) at passive carbon-ion and protonradiotherapy facilities. Methods: Measurements at eight positions in the water phantom were carried out at the Heavy-Ion Medical Accelerator in Chiba of the National Institute of Radiological Sciences for 400 and 290 MeV/u carbon beams and at the National Cancer Center Hospital East for a 235 MeV proton beam. Results: The dose equivalent per treatment absorbed dose at the center of the range-modulated region H / D t decreased as the position became farther from the beam axis and farther from the phantom surface. The values of H / D t ranged from 6.7 to 0.16 mSv/Gy for the 400 MeV/u carbon beam, from 1.3 to 0.055 mSv/Gy for the 290 MeV/u carbon beam, and from 4.7 to 0.24 mSv/Gy for the 235 MeV proton beam. The values of the dose-averaged quality factor Q D ranged from 2.4 to 4.6 for the 400 MeV/u beam, from 2.8 to 5.3 for the 290 MeV/u beam, and from 5.1 to 8.2 for the proton beam. The authors also observed differences in the distributions of H / D t and Q D between the carbon and proton beams. Conclusions: The authors experimentally obtained absorbed doses,dose-averaged quality factors, and dose equivalents in water phantom outside of the irradiation field in passive carbon-ion and protonradiotherapies with TEPC. These data are very useful for estimating the risk of secondary cancer after receiving passive radiotherapies and for verifying Monte Carlo calculations.

The purpose of this study was to obtain a set of correction factors of the radiophotoluminescent glass dosimeter (RGD) output for field size changes and wedge insertions.Several linear accelerators were used for irradiation of the RGDs. The field sizes were changed from 5 × 5 cm to 25 × 25 cm for 4, 6, 10, and 15 MV x-ray beams. The wedge angles were 15°, 30°, 45°, and 60°. In addition to physical wedge irradiation, nonphysical (dynamic/virtual) wedge irradiations were performed.The obtained data were fitted with a single line for each energy, and correction factors were determined. Compared with ionization chamber outputs, the RGD outputs gradually increased with increasing field size, because of the higher RGD response to scattered low-energy photons. The output increase was about 1% per 10 cm increase in field size, with a slight difference dependent on the beam energy. For both physical and nonphysical wedged beam irradiation, there were no systematic trends in the RGD outputs, such as monotonic increase or decrease depending on the wedge angle change if the authors consider the uncertainty, which is approximately 0.6% for each set of measured points. Therefore, no correction factor was needed for all inserted wedges. Based on this work, postal dose audits using RGDs for the nonreference condition were initiated in 2010. The postal dose audit results between 2010 and 2012 were analyzed. The mean difference between the measured and stated doses was within 0.5% for all fields with field sizes between 5 × 5 cm and 25 × 25 cm and with wedge angles from 15° to 60°. The standard deviations (SDs) of the difference distribution were within the estimated uncertainty (1SD) except for the 25 × 25 cm field size data, which were not reliable because of poor statistics (n = 16).A set of RGD output correction factors was determined for field size changes and wedge insertions. The results obtained from recent postal dose audits were analyzed, and the mean differences between the measured and stated doses were within 0.5% for every field size and wedge angle. The SDs of the distribution were within the estimated uncertainty, except for one condition that was not reliable because of poor statistics.

A rapid access to tetrahydropyrans (I) in only seven and eight steps starting from 2-deoxy-D-ribose is described.

Leptospira interrogans serovar hebdomadis感染例でWeil病重症型と同様に重篤な経過を辿ったが, 血液透析を行い救命し得た症例を経験したので報告する. 症例は69歳男性, 発症6日目紹介入院, 急性腎不全, 心不全, 心房細動, 鬱血肺, 黄疸, 消化管出血, 腸管麻痺, 高血糖, 精神障害, 全身痙攣, 無呼吸発作, 筋障害など多彩な臨床症状を呈した. 入院後streptomycinの投与, 水・電解質バランスの補正ならびに血液透析を行い軽快, 第55病日元気に退院した. Leptospira症の発症は, 近年, 公衆衛生の向上に伴って減少傾向にあり, 忘れられつつある疾患である. しかし, 重症例の死亡率は高く, 医療技術の進歩した今日でも早期診断, 治療開始の遅れによって重篤となる可能性の高い最も危険な感染症の一つである.

Successful results in carbon-ion and proton radiotherapies can extend patients' lives and thus present a treatment option for younger patients; however, the undesired exposure to normal tissues outside the treatment volume is a concern. Organ-specific information on the absorbed dose and the biological effectiveness in the patient is essential for assessing the risk, but experimental dose assessment has seldom been done. In this study, absorbed doses, quality factors, and dose equivalents in water phantom outside of the irradiation field were determined based on lineal energy distributions measured with a commercial tissue equivalent proportional counter (TEPC) at passive carbon-ion and proton radiotherapy facilities.Measurements at eight positions in the water phantom were carried out at the Heavy-Ion Medical Accelerator in Chiba of the National Institute of Radiological Sciences for 400 and 290 MeV/u carbon beams and at the National Cancer Center Hospital East for a 235 MeV proton beam.The dose equivalent per treatment absorbed dose at the center of the range-modulated region H/Dt, decreased as the position became farther from the beam axis and farther from the phantom surface. The values of H/Dt ranged from 6.7 to 0.16 mSv/Gy for the 400 MeV/u carbon beam, from 1.3 to 0.055 mSv/Gy for the 290 MeV/u carbon beam, and from 4.7 to 0.24 mSv/GV for the 235 MeV proton beam. The values of the dose-averaged quality factor QD ranged from 2.4 to 4.6 for the 400 MeV/u beam, from 2.8 to 5.3 for the 290 MeV/u beam, and from 5.1 to 8.2 for the proton beam. The authors also observed differences in the distributions of H/Dt and QD between the carbon and proton beams.The authors experimentally obtained absorbed doses, dose-averaged quality factors, and dose equivalents in water phantom outside of the irradiation field in passive carbon-ion and proton radiotherapies with TEPC. These data are very useful for estimating the risk of secondary cancer after receiving passive radiotherapies and for verifying Monte Carlo calculations.

慢性腎不全 (CRF) 患者における末梢血単球interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α) の産生能について検討した. CRF保存期患者5例, 透析患者6例, 健常人3例を対象とした. ヘパリン加末梢血からFicoll-Conrayを用いた比重遠心法で末梢血単球を分離した. IL-1βについてはlipopolysaccharide (LPS) 20μg/ml, TNF-αについてはLPS 20μg/ml+4β-phorbol 12β-myristate 13α-acetate (PMA) 10μg/mlで刺激し, 16時間培養後各上清中のIL-1βをELISA法で, TNF-αをRIA法で測定した. CRF保存期患者の末梢血単球IL-1β, TNF-αの産生能は, 健常人と比べて低下していた. また透析患者ではCRF保存期患者よりIL-1β, TNF-α産生能がやや高い傾向にあった. これらのことよりCRF保存期患者の末梢血単球IL-1β, TNF-α産生能は透析療法導入後に改善傾向を示すと思われた.

アミロイド骨関節症は長期透析患者にとって重篤な合併症である. 一方インターロイキンー1β (IL-1β) は炎症反応に重要な役割を果していると考えられており, 今回我々は, アミロイド骨関節症を有する血液透析 (HD) 患者の, 末梢血単球IL-1β産生能および末梢血単球細胞内IL-1β濃度について検討した. 対象は, 骨嚢胞性病変または手根管症候群 (CTS) を認め, 骨関節痛を有するHD患者 (A群) 12例, 骨嚢胞性病変, CTSを認めず, 骨関節痛のないHD患者 (B群) 22例, 健常人13例である. HD開始時の患者末梢血および健常人末梢血から, 単球分離用特殊プレートで単球を分離し, 培養液中に1×106 cell/mlとなるように調整, LPSを10μg/ml添加し48時間培養後, 培養上清のIL-1β濃度を酵素抗体法 (ELISA) にて測定した. さらに単球細胞内IL-1β濃度は, 単球を1×106 cell/mlとなるよう調整後, 直ちに凍結, 溶解を3回繰り返し, 遠沈後上清をELISAにて測定した. 結果は, 48時間培養上清のIL-1β濃度は, 健常人では5.01±3.34ng/mlであったのに対し, HD患者群では6.11±2.35ng/mlと有意差を認めなかった. A群, B群間にも有意差を認めなかった. 単球細胞内IL-1β濃度は, 健常人では, 49.58±47.90pg/mlであったのに対し, HD患者群では194.72±179.30pg/mlと有意に高値を示していた. またB群は130.02±125.30pg/mlであり, 健常人と有意差を認めなかったが, A群は251.80±202.90pg/mlと健常人より有意に高値であった. 以上より, アミロイド骨関節症を有する患者の末梢血単球が何らかの形で活性化されていて, このことが, 骨関節病変, 痛みの発現に関与している可能性もあり, 今後さらに検討が必要と考えられた.

Purpose: The purpose of this study was to obtain a set of correction factors of the radiophotoluminescent glass dosimeter (RGD) output for field size changes and wedge insertions. Methods: Several linear accelerators were used for irradiation of the RGDs. The field sizes were changed from 5 × 5 cm to 25 × 25 cm for 4, 6, 10, and 15 MV x-ray beams. The wedge angles were 15°, 30°, 45°, and 60°. In addition to physical wedge irradiation, nonphysical (dynamic/virtual) wedge irradiations were performed. Results: The obtained data were fitted with a single line for each energy, and correction factors were determined. Compared with ionization chamber outputs, the RGD outputs gradually increased with increasing field size, because of the higher RGD response to scattered low-energy photons. The output increase was about 1% per 10 cm increase in field size, with a slight difference dependent on the beam energy. For both physical and nonphysical wedged beam irradiation, there were no systematic trends in the RGD outputs, such as monotonic increase or decrease depending on the wedge angle change if the authors consider the uncertainty, which is approximately 0.6% for each set of measured points. Therefore, no correction factor was needed for all inserted wedges. Based on this work, postal dose audits using RGDs for the nonreference condition were initiated in 2010. The postal dose audit results between 2010 and 2012 were analyzed. The mean difference between the measured and stated doses was within 0.5% for all fields with field sizes between 5 × 5 cm and 25 × 25 cm and with wedge angles from 15° to 60°. The standard deviations (SDs) of the difference distribution were within the estimated uncertainty (1SD) except for the 25 × 25 cm field size data, which were not reliable because of poor statistics (n = 16). Conclusions: A set of RGD output correction factors was determined for field size changes and wedge insertions. The results obtained from recent postal dose audits were analyzed, and the mean differences between the measured and stated doses were within 0.5% for every field size and wedge angle. The SDs of the distribution were within the estimated uncertainty, except for one condition that was not reliable because of poor statistics.

IgD multiple myeloma is a unique type of multiple myeloma which is characterized by increased serum IgD and IgD type M-component in immunoelectrophoresis. It frequently shows renal involvement but it is a rare form of myeloma. The distinctive features of IgD myeloma are the dominance in males, high frequency in younger persons, and the uncertain appearance of M-component in serum electrophoresis. We experienced 3 cases of IgD multiple myeloma with renal failure which required hemodialysis before IgD myeloma was diagnosed. It is important to consider IgD myeloma when treating the patients with renal involvement of unknown origin.

A 64-year-old Japanese male patient with lupus nephritis associated with adult T cell leukemia (ATL) is described. Percutaneous renal biopsy demonstrated findings consistent with membranous lupus nephritis. To our knowledge, this is the first case of lupus nephritis complicated by ATL, suggesting that human T cell leukemia virus type I may be correlated not only to outbreaks of ATL but also to lupus nephritis/systemic lupus erythematosus.

血液透析患者の胃粘膜病変の発生機序解明のため血液透析患者の胃粘膜血流量を内視鏡下で測定した. 対象は, 血液透析患者28名 (男性14名, 女性14名, 年齢27-81歳) で, コントロール群として胃粘膜病変を認めなかった健康者25名 (男性12名, 女性13名, 年齢39-78歳) の胃粘膜血流量を測定した. 血液透析患者の胃粘膜血流量は, 胃体上部大弯19.8±6.4ml/min/100g, 胃体下部小弯18.7±5.9ml/min/100g, 前庭部小弯20.4±6.8ml/min/100g, 前庭部大弯19.0±8.3ml/min/100gであった. これに対してコントロール群では, 胃体上部大弯26.2±8.5ml/min/100g, 胃体下部小弯24.4±8.1ml/min/100g, 前庭部小弯23.0±7.1ml/min/100g, 前庭部大弯19.2±5.9ml/min/100gであった. すなわち血液透析患者ではコントロール群に比して胃体部で胃粘膜血流量の低下がみられ (胃体上部大弯p

A thromboxane synthetase antagonist ameliorates progressive renal disease of Dahl-S rats. Recent studies have suggested a role for thromboxane in the progression of renal disease. The current study evaluated the role of this arachidonic acid metabolite in a model of renal disease which bears many biologic similarities to that in the kidneys of patients with chronic progressive renal failure. The model is that induced by ferritin-anti-ferritin immune complex nephritis in Dahl-salt sensitive rats rendered hypertensive by a high salt intake. Rats with this model of renal disease were chronically given a thromboxane synthetase antagonist OKY-046 or a placebo treatment from 16 to 29 weeks of age. Sequential observations of serum creatinine and 24-hour urinary protein excretion showed an ameliorating effect of OKY-046 on these renal parameters. Histologic examination of the kidneys also showed significantly less glomerular sclerosis in OKY-046 treated animals. The efficacy of OKY-046 was monitored by measurements of serum TXB 2 levels and of glomerular production of TXB 2 (and other prostaglandins); amounts of TXB 2 were significantly reduced in the OKY-046 group. It is concluded that blockade of thromboxane generation has been successful in ameliorating the functional and structural lesions in this model of renal disease, providing further support to the thesis that thromboxane is an important mediator in events leading to eventual chronic renal failure and sclerosis.

The effects of fish oil on serum lipids, eicosanoid production, fibrinolysis, and renal disease of nephrotic rats were studied. Three groups of rats were given adriamycin to induce nephrotic syndrome. They were pair-fed diets containing 14% beef fat, 3%, and 14% fish oil, and killed at 4 weeks. Marked beneficial effects of the fish oil on plasma triglycerides, total cholesterol, and LDL cholesterol were observed. Fish oil suppressed dienoic eicosanoid production. Protection of renal function and morphology was achieved in the fish oil fed groups, as evidenced by lower serum creatinine levels and lesser degrees of tubular dilatation and intraluminal protein in the kidney tubules. We conclude that fish oil, rich in n-3 fatty acids, is beneficial to the plasma lipids and may prevent progression of renal disease in this model of nephrotic syndrome. These two events may be interrelated.

Three isocaloric diets with different fat composition were fed to rats for seven weeks after the production of nephrotic syndrome by adriamycin. The effects of feeding 3% and 14% fish oil were compared with those of feeding beef fat. At the fourth week of feeding the levels of triglycerides and cholesterol were lower in both fish oil fed groups. At the seventh week these levels, and the LDL cholesterol, were lower only in the 14% fish oil group. In rats fed beef fat, but not in those fed fish oil, there was a striking positive correlation of the four-week serum triglycerides and cholesterol with the seven-week serum creatinine level and with the degree of glomerular hyalinosis and endothelial swelling. The favorable effects of fish oil feeding on serum lipids may have a protective effect on the development of glomerular damage.

患者は46才の女性.昭和59年頃に皮膚筋炎と診断され,プレドニゾロン30mg/日にて治療開始.昭和62年10月頃初めて蛋白尿が出現し,腎生検を施行.蛍光抗体法および電顕から糸球体基底膜にimmune-complexの沈着が認められたため,皮膚筋炎にimmune-complex型糸球体腎炎の合併が考えられた.皮膚筋炎に合併する糸球体病変は少ないとされ,本症例はまれな症例と考えられたため,文献的考察を加えて報告する.

Renal function deteriorates progressively in partially nephrectomized rats. This deterioration of renal function may be ameliorated by a diet either low in protein or high in linoleic acid. In the present experiment, partially nephrectomized rats were pair fed diets low in protein, high in linoleic acid or both low in protein and high in linoleic acid. Survival of renal function was most prolonged in rats fed a diet with both a low protein and high linoleic acid content; glomeruli from these animals demonstrated increased glomerular PGE2 production. This additive effect may be mediated by increased production of the vasodilatory PGE2 by glomeruli.

症例は24才,女性. SLEの診断にて,昭和61年よりステロイド薬投与を行っていた.同年12月,妊娠2カ月を確認.本人の希望強く, SLEの経過も良好であったため,妊娠を継続した.妊娠36週, SLE増悪を認め入院.直ちにdouble filtration plasmapheresis (DFPP)および大量γ-globulin療法を行った.治療により症状改善を認め,妊娠38週めに健康な女児を無事娩出した.上記治療法は妊娠中のSLE悪に対し有効と考えられた.