A case-control study on climacteric symptoms and complaints of Japanese women by symptomatic type for psychosocial variables.

Postal questionnaires about psychosocial factors of climacteric symptoms and complaints were sent to 353 women (subjects) with such symptoms and complaints and to 1024 volunteers without such symptoms and complaints. Controls were selected from the latter. Both subjects and volunteers were inhabitants of Miyagi Prefecture, North-East Japan. Two hundred and eighty-two subjects (79.9%) and 829 volunteers (81.0%) returned completed questionnaires. Two hundred and sixteen of these 282 subjects, 40-59 yr of age, were selected. Each was matched at random with one of 639 volunteers, also 40-59 yr of age and within 1 yr of the subject's age. Thus, 216 matched pairs, each consisting of a case and control, were created. Significantly high relative risks of the following variables as estimated by McNemar's test were shown by this case-control study, and were of two types. Social variables were few intimate friends, low educational level, husband employed in unskilled labor, and subject employed in unskilled labor. Psychic variables were a feeling of poor health, low self-esteem, perceived lack of respect from people surrounding the subject, dissatisfaction with present life, anxiety about the future, and a feeling of being a burden to family and/or community. Moreover, correlations between all possible pairs of variables of the above two groups were examined by means of the chi-square test. Statistically significant correlations were found for the following two pairs of variables: few intimate friends and either low self-esteem or anxiety about the future, and low educational level and either dissatisfaction with present life or a feeling of poor health. These results suggest that climacteric symptoms and complaints are closely associated with a lack of potential social support characterized by few intimate friends, etc., especially in mild symptom-type cases, and also with low socioeconomic status related to low educational level, etc., particularly in severe symptom-type cases.

[A case of complete remission obtained with etoposide in uterine choriocarcinoma].

A 27-year-old female was admitted to Sendai National Hospital complaining of continuous slight genital bleeding for about one and a half year after incomplete abortion. At first visit, urinary hCG was elevated to 32,000 IU/l and ultrasonography revealed a heterogeneous tumor in the uterus body. After abdominal simple total hysterectomy, the sample was diagnosed pathologically as a uterine choriocarcinoma. The patient was treated with 2 courses of MTX, but this regimen was not so effective. Because of persistent elevation of urinary hCG, 2 courses of etoposide were performed and hCG was rapidly reduced to within LH level. Etoposide (25 mg/day per os) was given to the patient for about three months since hospitalization and now complete remission has been obtained.

[Spontaneous subcapsular hemorrhage: a rare clinical presentation of renal cell carcinoma].

We present a case of renal subcapsular hemorrhage caused by a small renal cell carcinoma. The patient was a 52-year-old housewife, presenting abdominal pain and vomiting, of abrupt onset. Modern imaging modalities clearly visualized a perirenal or subcapsular hematoma in her left kidney, but no underlying pathology, was found even on the arteriogram. Relying on the statistics based on more than 100 reported cases with the spontaneous renal rupture, nephrectomy was carried out. The renal carcinoma was of granular cell type (G2), and classified as pT2, pN0 and pM0. Difficulties in making a correct diagnosis as to the pathology and therefore a rational decision for nephrectomy were also stressed.

[Psychosocial backgrounds of climacteric symptoms and complaints].

Postal questionnaires about psychosocial factors related to climacteric symptoms and complaints were sent to women subjects with such symptoms, and to volunteers without such symptoms. Controls were selected from among the volunteers. Each of 216 subjects was matched at random with one of 639 volunteers within one year of the subject's age. Thus, 216 matched-pairs were created, each consisting of a subject and a control. Significantly high relative risks of the following factors as estimated by McNemar's test were shown by a case-control study: social: few intimate friends, low educational level, husband engaged in unskilled labor, employed subject; psychic: feeling of poor health, low self-esteem, perception of lack of respect by people surrounding the subject, dissatisfaction with present life, anxiety about the future, feeling of being a burden to family and/or community. Moreover, correlations between various items listed above were examined by means of the chi-square test. Statistically significant correlations were found for the following pairs of items: low educational level, suggesting low socio-economic status, and either dissatisfaction with present life or feeling of poor health, and few intimate friends, suggesting a lack in potential social support, and either low self-esteem or anxiety about the future. The first mentioned pairs were predominantly associated with severe climacteric symptoms and complaints and the latter with mild symptoms and complaints.

Statistical factor analysis and cluster analysis in the etiology of climacteric symptoms.

Factor analysis and cluster analysis were applied to a set of 17 climacteric symptoms data obtained from 194 premenopausal and postmenopausal women. Six distinct factors were extracted and the women were divided into 7 groups by hierarchical cluster analysis in terms of their factor scores. Only one representative factor was identified in 3 groups out of the 7. These 3 groups including 87 women were tentatively designated as vasomotor symptom, neurotic, and sensory disturbance groups. These results confirmed statistically that at least 3 simple etiological factors exist among climacteric symptoms.

Expression level of the retinoblastoma susceptibility gene is elevated in simian virus 40-transformed cells.

We examined the level of mRNA of the retinoblastoma-susceptibility gene (Rb gene) in simian virus 40 (SV40)-transformed primate cells. The mRNA level of Rb gene was elevated in SV40-transformed cells compared with that in untransformed parental cells. The level of Rb message was also increased by SV40 infection on monkey kidney CV-1 cells. The level of Rb gene mRNA in SV40-transformed or SV40-infected cells was about fourfold higher than that in controls. These observations suggest that Rb gene is one of the cellular genes which can be elevated by SV40 directly or indirectly.

A new method for the screening of unidentified complaints syndrome in pre-, mid- and post-menopausal women.

A new simple test for the screening of pre-, mid- and post-menopausal women with unidentified complaints overlaid by psychiatric disorders has been devised. This test is performed by intravenous injection of conjugated estrogen and by comparing Kupperman's menopausal indices before and after the injection. That is, the discriminant function between groups with and without psychiatric abnormalities was obtained from Kupperman's menopausal indices before and after intravenous injection of conjugated estrogen, and from this function was made a calculative differential diagnosis between the two groups. The calculative diagnosis agreed fairly well with the clinical diagnosis by the psychiatrist.

Clinical and endocrinological features of statistical clusters of women with climacteric symptoms.

Clinical and endocrinological features of women with climacteric symptoms, who were clustered by means of factor analysis and cluster analysis, were evaluated as to serum concentrations of estradiol, progesterone, follicle-stimulating hormone and luteinizing hormone, and also as to mean ages as well as a rate of premenopausal women or that of postmenopausal women against all women in each one of the clusters. Comparison of these parameters among these clusters indicated, with statistical significance, that vasomotor symptoms, neurotic symptoms, and depressive state of the climacteric women are endocrinologically characterized by a depressed level of serum estrogen, relatively high level of serum estrogen, and an elevation of serum gonadotropin, particularly of luteinizing hormone, respectively.

Combination chemotherapy in advanced ovarian cancer.

Among the 95 cases of ovarian cancer treated by us between May, 1975 and August, 1978, only 33 were suitable for complete resection. The remaining 62 cases underwent incomplete resection, followed by F.Q.C. combination chemotherapy (1-(2-tetrahydrofuryl)-5-fluorouracil, carbazilquinone, cytosine arabinoside); 54.8% showed an antitumor response. The median survival time of the responders was 13.2 months, whereas it was 7.4 months for the non-responders. The survival rate after 24 months, however, was 13% and 4%, respectively. Side effects of the drugs, including leucopenia, thrombocytopenia, nausea and vomiting, were found in roughly one half of the cases.