Background: It is difficult to distinguish clinically between leiomyoma and leiomyosarcoma. The prognosis of the latter is poor. In patients with uterine leiomyosarcomas, high serum lactate dehydrogenase (LDH) levels have been reported to be elevated. However, little is known about serum LDH levels in patients with benign leiomyomas, or about the relationship between serum LDH levels and ultrasonographic findings. We therefore explored serum LDH levels and degenerative patterns of the tumor in ultrasonography (USG) in patients with various smooth muscle tumors of the uterus.
Methods: Clinical history, serum LDH and alkaline phosphatase (ALP) levels, images produced by USG, and pathological findings were reviewed in 232 patients with uterine leiomyoma, three with uterine leiomyosarcoma, one with lipoleiomyoma, and one with metastasis of the breast cancer into uterine leiomyoma treated, at Kochi Nokyo General Hospital from September 1988 to August 1996. Relationship between serum LDH levels and the presence of degenerative pattern in USG or uterine weight was also analyzed.
Results: Serum LDH levels were abnormally elevated preoperatively in one of 232 patients with uterine leiomyoma, two of three with leiomyosarcoma, one with lipoleiomyoma and one with metastasis of the breast cancer into uterine leiomyoma. A degenerative pattern in USG was found in 15/232 of leiomyomas, 2/3 leiomyosarcomas, 1/1 lipoleiomyoma and 1/1 metastasis of the breast cancer into uterine leiomyoma. All cases with abnormally elevated serum LDH levels showed a degenerative pattern in USG. There was a significant difference in serum LDH levels between leiomyoma with degenerative pattern in USG and without it (p=0.0320). No significant relationship was found between the weight of the uterus and serum LDH levels in patients with leiomyoma.
Conclusion: The uterine tumor associated with both degenerative pattern in USG and elevated LDH levels in the patients' serum is strongly suspected to be leiomyosarcoma. The patients with presumed uterine leiomyoma should be examined for not only degenerative patterns in USG, but also serum LDH levels.

Background: The purpose of this study were to investigate the survival rate of patients with cervical cancer who were treated at our institution and to analyse its prognostic factors.Methods: One hundred twenty-two patients who underwent treatment for primary cervical cancer at Kochi Municipal Hospital between January 1996 and August 2003 (7 years 8 months) were retrospectively reviewed. There were 59 patients (48.4%) with stage 0 disease. Sixty-three patients (51.6%) had stage I-IV cervical cancer. The mean age was 56.7±15.6 years, and the median follow-up period was 31 months.Results: The overall 5-year suvival rate was 96.4% and 77.1% in stage I and II, respectively. The overall 3-year survival rate was 56.3% in stage III, and the 30-month survival rate was 0% in stage IV. Among the risk factors of histologic cell type, clinical parametrial involvement, clinical vaginal involvement and pelvic lymph node metastasis, clinical parametrial involvement had the lowest p value (p=0.0717) in a multivariate Cox proportional hazards regression analysis.;;Multivariate analysis using the Cox proportional hazard regression model showed that among the risk factors of histologic cell type, clinical parametrial involvement, clinical vaginal involvement and pelvic lymph mode metastasts, the lowest p value (p=0.0717) was for clinical parametrial involvement.Conclusion: Although there was no statistical significance comparing the prognostic factors in multivariate analysis, it was presumed that clinical parametrial involvement was the most influential factor among those which were analyzed in this study on the prognosis of patients with stage I-IV cervical cancer.
Clinical ; Diagnostic Neoplasm Staging ; Cervical Cancer ; lower case pea ; Roman Numeral IV

A 67-year-old woman had left lateral chest pain. CT scan and digital subtraction angiography revealed coarctation of the abdominal aorta just distal from the renal artery and a fusiform aneurysm of the descending thoracic aorta with a maximum diameter of 60mm. The meandering mesenteric artery was significantly dilated as a collateral vessel from the superior mesenteric artery to the inferior mesenteric artery. Aortitis syndrome was suspected from the angiographic findings although inflammatory changes in laboratory data were not observed. She underwent aneurysmectomy followed by prosthetic graft replacement of the descending thoracic aorta under femoro-femoral bypass and an extraanatomical bypass grafting from the replaced graft to the abdominal aorta proximal to the aortic bifurcation via the retroperitoneal space. She was discharged on the 42nd day after operation without any complications and in the past year has returned to her usual daily life without any anastomotic site trouble.

AIMThe objective of this study was to analyze the oral health among Japanese adults, with and without diabetes mellitus.

METHODOLOGYThe subjects were 518 community residents aged 20 to 91 years in Japan, who participated in the "Akita health and nutrition survey" and the "Akita dental disease survey", conducted in 2006. The surveys comprised a self-administered questionnaire, along with medical and dental examinations.

RESULTSUsing the community periodontal index (CPI), the mean numbers of sextants presenting codes 0, 1 and 2 were significantly lower in diabetics than non-diabetics among the 59 years or younger age group. Although the mean numbers of sextants with codes 0, 1 and 2 among the 60 to 69 years age group were lower, and sextants with a code X among the 59 years or younger age group were higher in diabetics than non-diabetics, no statistically significant differences were detected. The tendency of lower mean numbers of natural teeth and functional tooth units in diabetics than non-diabetics was observed, however no differences were statistically significant.

CONCLUSIONThe outcome of periodontal disease seemed to be influenced by the diabetic state to some degree, but a clear association between diabetes and oral health status was not found.

Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; complications ; Female ; Humans ; Japan ; Male ; Middle Aged ; Periodontal Index ; Periodontitis ; complications ; Surveys and Questionnaires ; Tooth Loss ; complications ; Young Adult

Based on two years working of “the enlarged working group for the curriculum of chemistry for medical education”, a provisional plan of the curriculum of chemistry for medical students is proposed. The article is consist of four sections; namely A: general problems, B: “chemistry” as a general education, C: purpose and specific problems of the general education for medical students, D: a provisional plan of the curriculum of chemistry for medical students.
The main part D is consist of three subsections: namely (1) a plan of the curriculum of physical and inorganic chemistry, (2) a plan of the curriculum of organic chemistry, (3) a plan of the curriculum of experiments.