In 12, 505 patients who received barium enemas during the past 14 days, 979 cases (7.8%) of diverticular disease of the colon (DDC) were found. The incidence of DDCincreased with age; 2.2% of the patients were below age 29 and 14.3% were over 70 years old. The sex distribution was 584 males and 395 females. 76.1% had diverticula in the right-side colon, 12.9% in the left-side colon, and ll.0% in both sides. All patients below age 29 had the right-side colon type, while 44% of those aged 70 or moredid. On the other hand, the left-side colon type and both-sides colon type were found only in patients over 30 years old, and constituted a majority in those of 70 years old or more. The main symptoms and signs were: disturbances in bowel habits 50.7%, abdominal pain 48.1%, abdominal distension and/or discomfort 41.5%, occult blood 25.2% and melena 5.8%. Therefore, DDCis clinically becoming an important disease in recent years in Japan as well as in Western countries.

抄録全体を表示

A comparative study was made of ventilatory and airway occlusion pressure (P_0.1 ; a parameter reflecting respiratory center output) responses to carbon dioxide between ll patients with bronchial asthma and 10 chronic obstructive lung disease (COLD). Increments in ventilatory volume (VE) produced by a rise in end-tidal CO₂pressure (PETCO₂), i. e. Δ Ve/BSA/APETCO₂, were smaller in 4 patients with hypercapnic COLDthan in 6 normal subjects. On the other hand, increments in P_0.1 produced by an elevation of PETCO₂ (i. e. ΔP_0.1/Δ PETCO₂) tended to be diminished in patients with hypercapnic COLD. Higher values for both VE/BSA and P_0.1 were observed in 6 patients with normocapnic COLD, but the differences from corresponding control values failed to achieve statistical significance due to a large varience. In 11 patients with bronchial asthma without attack, VE/BSA elevated significantly at PETCO₂ levels of 50 and 60 torr, but values of ΔVe/BSA/APETCO₂ were virtually same as those in normal subjects.

抄録全体を表示

The effect of aging and sex on natural killer (NK) cell activity in humans was investigated. The results showed that there were no significant differences in both the age- and sex-related NKcell activities with or without polyinosinic acid-polycytidylie acid stimulation. On the other hand, the mitogenic response of peripheral blood lymphocytes in the aged group (aged 70 to 86 years) was found to be significantly depressed in compared with that in the young adult group (aged 20 to 30 years). These data suggest that the NKcell activity of the aged subjects is operative, and may be important in defense against neoplasia since extensive immunodeficiencies are knownto be associated with aging.

抄録全体を表示

1. A new electrophoresis of lipoproteins was examined as a means of defining hyperlipoproteinemia phenotypes. The serum lipoproteins of 1 19 patients with hyperlipoproteinemia whose serum total cholesterol (TC) concentration was more than 250 mg and/or whose triglyceride (TG) concentration exceeded 180 mgper 100 ml were determined by using a method of electrophoretic separation of lipoproteins on agarose and enzymic staining of each lipid component separately. 2. Based on the lipoprotein-lipid profile with the aid of various parameters for distinction, i.e., Type II A, LDL-C ?? 180 mg/dl: Type IV, VLDL-TG ?? 130 mg/dl: Type II B, LDL-C ?? 180 mg/dl and VLDL-TG ?? 130 mg/dl, 119 patients were classified into Fredrickson's phenotypes of hyperlipoproteinemia. The percentages of phenotypes with those hyperlipoproteinemias were: type II A, 31.1%; II B, 33.6; IV, 29.4%; and V, 5.9% respectively. But types I and III were not observed in this survey. 3. The characteristics of the lipoprotein profiles of each phenotype were clearly identified, and they were: type II A, high peak LDL-C and decrease of HDL-C fraction; II B, high peak of LDL-C and VLDL-TG; IV, high peak of VLDL-TG; V, prominence of chylomicrons and high VLDL-TGpeak. 4. The serial observations of the lipoprotein-lipid profiles were very useful for detecting the progressive changes in lipoproteins which occurred during the course of diseases, particularly in cases of secondary hyperlipoproteinemia. In conclusion, the new lipoproteinlipid profile based on the agarose electrophoresis-enzymic staining method not only offers great help in classification of hyperlipoproteinemia but has contributed to therapeutic management.

抄録全体を表示

Electrocardiographic and dectrophysiologic studies were performed in 21 patients with atrioventricular (A-V) nodal reentrant tachycardia (AVNRT).Patients were classified into three types according to the patterns during the tachycardia, i.e., (1) type I; an atrial echo (Ae) occurred simultaneously with a ventricular electrogram (VE) (14 patients), (2) type II; an Ae occurred in front of the next VE (four patients) and (3) type III; an Ae followed immediately after the preceding VE (three patients). All patients with type I AVNRTshowed discontinuous A-V and continuous ventriculoatrial (V-A) conduction curves. "Enhanced V-A conduction" (1:1 V-A conduction at the ventricular paced rate of 200 beats/min) was demonstrated in five of the 14 and after verapamil in two of the five patients. In type II AVNRTthe tachycardia was initiated with a minimal amount of A-Vnodal conduction delay and second degree A-V or V-Ablock was observed in all four patients. V-Aconduction was poor in these patients. In type III AVNRT A-Vconduction curves were discontinuous and retrograde study revealed the presence of retrograde dual A-V nodal pathways. In conclusion, A-Vand V-Aconduction in patients with AVNRTwere variable and this variability seemed to be responsible for different patterns of AVNRT.

抄録全体を表示

The actual state of IgA nephropathy in Japan was surveyed throughout the nation by a questionnaire. Five hundred patients were collected from 26 departments of pediatrics and 2, 1 75 from 27 internal medicine. IgA nephropathy accounted for 19.2% of the children and 30.0% of the adults among primary glomerular diseases. Most of the patients, regardless children and adults, were detected by chance proteinuria and/or hematuria. No significant difference of renal glomerular findings were observed morphologically, between the children and the adults. IgA nephropathy was characterized by relatively benign clinical course, namely, 87.2% of the children and 74.6% of the adults had a favorable outcome. Nephrotic syndrome developed in 4.6% of the children and 3.7% of the adults, and hypertension in 4.6% and 10.6% of the children and the adults, respectively. While, the fact should not be neglected that 1.8% of the children and 8.0% of the adults developed renal failure or died.

抄録全体を表示

A patient with hypopituitarism which is believed to have developed immediately after birth had been treated with thyroid hormones alone for a prolonged year of seven years until the time of the initial examination by the author. The subject has severe emaciation and lack of secondary sexual characteristics, but no past history of adrenocortical crisis was present, and, in fact, she manifested hyperthyroidism. It is questionable whether the preceding administration of thyroid hormoneson the case with hypopituitarism should have been contraindicated. The two major complaints were improved through proper supplementary hormone treatment.

抄録全体を表示

In a patient with an uncomplicated pheochromocytoma, we observed high basal value of plasma renin activity (PRA), 16.2 ng/ml/h, and a remarkable elevation in PRA from 18.2 to 90.4 ng/ml/h and concomitant blood pressure reduction following a single oral administration of 25 mg of captopril. The response was same as that observed in renovascular hypertensives, and disappeared during the period of α-, β-blocker administration or after the surgery. Basal PRAalso returned to low normal level. The reninangiotensin (R-A) system probably had a role in the maintenance of high blood pressure. The mechanism of the activation of the R-Asystem was thought to be renal vasoconstriction due to excessive circulating catech olamines.

抄録全体を表示

The clinical and pathophysiological features of a case of abetalipoproteinemia in a 34-year-old patient are described. This patient is the first case reported in Japan. The patient was diagnosed as abetalipoproteinemia by confirming the Apo-B deficiency in the patient's serum and the slightly high cholesterol level in his mother's and borderline normal level in his father's. The patient had remarkably low lipid levels, acanthocytosis, and lipid malabsorption. Anunusual feature of this case was that the patient had no neuromuscular or ocular manifestations. This was possibly related to his normal plasma vitamin A and E levels.

抄録全体を表示

In a Japanese family several members in three generations had, on hemoglobin analysis, typical findings of heterozygous β-thalassemia. However, hemoglobin concentrations, red cell morphology, splenic size and clinical histories indicated that the disorder was more severe than in the usual β-thalassemia trait. From the previous and the present studies folic acid supplements appeared to be beneficial in ameliorating the anemia. The findings may provide an apparent pathophysiologic and genetic explanations for the more severe anemia and red-cell abnormalities present in a small proportion of families with β-thalassemia trait.

抄録全体を表示

An autopsy case of primary rhabdomyosarcoma of the liver in a 70-year-old man is described. The case could not be clinically differentiated from hepatocellular carcinoma. The tumor showed typical features of rhabdomyosarcoma; phosphotungstic acid hematoxylin (PTAH)-positive myofibrils and crossstriations were observed in the cytoplasm of highly plemorphic tumor cells.

抄録全体を表示

A case of plasma cell myelomainitially producing Bence Jones protein of lambda type was presented. BJ protein disappeared within two monthsof cyclophosphamideand betamethasoneadministration. A complete remission continued for the following 2 years and 8 monthswith no medication, although the patient insidiously developed osteolytic lesions. The discrepancy of long-term negative BJP and clinical remission without medicationand progressive bonedestruction was reported.

抄録全体を表示