Considerations and challenges in the ICRP dialogues

'Yes I tried to explain, but residents couldn't understand …' This was the title of my presentation at the first International Commission on Radiological Protection (ICRP) dialogue seminar in November 2011 held at the Fukushima Prefectural Government office. The accident at Fukushima Daiichi nuclear power plant was triggered by the tsunami caused by the Great East Japan Earthquake of March 2011. Initially, it was thought that Date city, 50-60 km away from the accident, would be safe, but unfortunately this was not the case due to the direction of the wind at the time of the accident. I reported on decontamination in the aftermath of the accident at the ICRP dialogue seminar, following an invitation from Dr. Niwa of the University of Kyoto and a member of ICRP. There were many participants from overseas, and it was the first time that I had attended a meeting with simultaneous interpretation. I still remember that I was slightly bewildered.

Prevalence of major depressive disorder in self-referred patients in a late onset hypogonadism clinic

The goal was to clarify the rate of major depressive disorder (MDD) in self-referred patients who visited our late onset hypogonadism (LOH) clinic and the importance of screening of MDD in LOH clinic. Two hundred consecutive self-referred patients who visited our LOH clinic were evaluated. MDD was diagnosed using, the Mini International Neuropsychiatric Interview (MINI) questionnaire. Scores of the Aging Males Symptom (AMS) scale were compared between the MDD and non-MDD groups with and without low testosterone values. Forty-two percent of all patients were categorized into the MDD group. Only 4% of the patients were considered to be LOH. The MDD group had significantly higher scores on the AMS scale than the LOH and non-MDD with normal testosterone groups. In conclusion, significant numbers of undiagnosed MDD patients visited the LOH clinic. Screening for MDD is an essential step in the LOH outpatient clinic.

[A case of Castleman's disease that recurred nine years after initial surgical removal]

Castleman's disease (CD) is a lymphoproliferative disorder with resemblance in histopathology of thymoma. Here we describe a 48-year-old man with bloody sputum and a mass lesion of the right hilum on chest roentgenogram. He had undergone an incomplete surgical removal of a mediastinal tumor nine years earlier, which proved to be CD with characteristics of hyaline-vascular type pathology. The regrown mass lesion as well as the right upper and middle lobes were removed surgically. Histological examination of the tumor specimen revealed characteristics of hyaline-vascular type CD which were nearly identical to those of the tumor removed nine years earlier. Recurrence of CD as observed in the present report is very uncommon, since only 5 cases, including this one, have been reported. We suggest that in CD the primary tumor as well as regional lymph nodes should be completely removed, and the patients should be kept under long-term postoperative observation to check for recurrence.

[Clinical evaluation of a new tumor marker, CA 15-3, in breast cancer; a comparative study with CEA]

Recently, a new RIA method has been developed by Centocor Co., utilizing the monoclonal antibody CA 15-3. We performed a clinical trial to evaluate its utility as a tumor marker for breast cancer in comparison with CEA. We set 15 U/ml as the cut-off value of serum CA 15-3 level from results acquired from controls; 10 volunteers and 17 patients with non-malignant diseases. The CA 15-3 positive rate among the cases of primary breast cancer was 13.3%, which was of poor diagnostic value. In the recurrent cases the positive rate of CA 15-3 was 72.0%, which was valuable compared with that of serum CEA, 52.0%. In the cases of primary cancers other than breast cancer, the positive rate of CA 15-3 was 6.9%.