Nihon rinsho. Japanese journal of clinical medicine
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Renal involvement is well recognized extraglandular manifestation of primary Sjögren's syndrome (SS). The most common histopathological lesion is an interstitial lymphocytic infiltrate with tubular atrophy and fibrosis. The clinical presentation may be hyposthenuria, overt or latent distal renal tubular acidosis and less commonly Fanconi's syndrome. ⋯ Immunoregulatory alterations consisting of impaired T-cell function and B-cell hyperactivity probably play a pathogenetic role in the development of interstitial nephritis in SS. Glomerulonephritis in SS has been described in a limited number of case reports. Variant modes of pathogenesis have been proposed in these cases where glomerulonephritis has been associated with immune complex deposition and cryoglobulinemia.
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Examination was made of sclerodermoid changes in porphyria cutanea tarda (PCT) and PCT in association with true scleroderma. Although sclerodermoid change in PCT is rare in Japan, it is important in the diagnosis of PCT when there are few other clinical signs characteristic of PCT. ⋯ Elevated uroporphyrin due to PCT may possibly increase cutaneous sclerosis in PSS. A diagnosis of PCT should be considered for patients presenting scleroderma, since it is difficult to distinguish sclerodermoid changes from true scleroderma.
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Review
[A non-invasive portable blood-glucose monitoring system: sampling of suction effusion fluid].
We developed a new portable transcutaneous blood glucose monitoring system using non-invasive collection of suction effusion fluid (SEF) from human skin. A ion sensitive field effect transistor (ISFET) sensor was employed to measure glucose concentration in a very small quantity of the SEF. The system was composed of a couple of portions. ⋯ The main frame contained a dilution solution reservoir, a liquid waste reservoir, a fluid pump, a vacuum pump, a micro processor, batteries, and a user interface. The system is self-contained for portable usage during up to 6 hrs monitoring. This system may be the first blood glucose monitoring equipment which does not use blood sampling.
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The quality of life, as well as the length of survival, in patients with myeloma has improved since the introduction of melphalan chemotherapy. Although myeloma is a radio-responsive disease, radiotherapy should be chosen for relapsed and refractory myeloma, because prolongation of overall survival is not improved. The aim of radiotherapy for solitary plasmacytomas is to mainly relieve pain, rather than the curative local therapy. ⋯ The hemibody irradiation and whole bone marrow irradiation developed to decrease radiation pneumonitis and hematologic toxicity. On the other hand, the results of radiotherapy in combination with chemotherapy shows no better survival than that of chemotherapy alone. Radiotherapy should be used for severe intractable bone pain and should be employed, using a limited field in lytic lesions.