Nihon rinsho. Japanese journal of clinical medicine
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Allogeneic hematopoietic stem cell transplantation (HSCT) has been based on the use of myeloablative chemotherapy and radiotherapy conditioning regimens to eradicate malignancy and to eliminate host hematopoiesis and immune cells, but this approach is associated with a high risk of complications. A number of non-myeloablative or reduced-intensity preparative regimens for HSCT(NST or RIST) have been proposed to reduce regimen-related toxicities. ⋯ NST/RIST have been feasible in elderly patients and in patients with organ dysfunction or other comorbidities precluding standard ablative conditioning, however the long-term impact is not yet established. The indication for NST/RIST and the optimal preparative regimen need to be defined for each malignancy in controlled clinical trials.
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Review Case Reports
[Magnetic resonance spectroscopy and its clinical applications in multiple sclerosis].
Proton magnetic resonance spectroscopy(1H-MRS), which provides biochemical information in not only visible lesions on conventional MR imaging but also normal appearing white matter(NAWM), has extended the genesis of multiple sclerosis(MS) in several important directions. First, serial 1H-MRS studies reveal dynamic regional biochemical alterations in plaques during the course of the illness. ⋯ Fourth, NAWM shows widespread biochemical involvement prior to detection on MRI. Fifth, severities of neuroaxonal involvement significantly correlate with neurological dysfunction. 1H-MRS will provide more detailed information than conventional MRI, and could be beneficial in monitoring effects of therapeutic interventions in MS.
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Although the mechanism of multiple sclerosis (MS) remains elusive, it is generally hypothesized to be an autoimmune disease targeting the central nervous system (CNS) myelin. Extensive epidemiological and genetic surveys indicate that MS is caused by an interplay between the environment and genetic traits determined by normal polymorphisms in multiple genes. ⋯ Conventional MS in Japanese is, like MS in Caucasians, associated with HLA-DRB1*1501 whereas opticospinal MS is associated with HLA-DPB1*0501. The ratio of conventional to opticospinal MS has increased rapidly in Japanese born after 1960s, suggesting that the modernization occurred after 1960s in Japan has modifying effects on MS susceptibility and phenotypes.