A homologous radioimmunoassay specific for amino-terminal portion of human parathyroid hormone (PTH) was developed in order to study the clearance of biologically active species of the hormone in the circulation in man. Characterization of the assay system with synthetic analogues of human PTH(1-34) in dicated that the carboxyl-terminal region of human PTH (1-34) is an important recognition site.Plasma amino-terminal PTH levels were less than 0.3 ng/ml in all of 35 normal subjects. The levels were elevated above 0.3 ng/ml in 15 of 24 patients with primary hyperparathyroidism. In 5 patients in whom the levels were determined before and after parathyroidectomy, the elevated levels were all normalized within 60 minutes after the removal of adenomata. The disappearance of exogenous human PTH(1-34) was studied after intravenous administration in 1 7 patients with hypoparathyroidism. A graphical analysis of the data disclosed two major componentsof the disappearance curve with estimated half-disappearance time of 3 and 28 munites respectively, suggesting that multiple mechanisms are involved in the clearance of the peptide from the circulation. These results demonstrate usefulness of homologousradioimmunoassay for human PTH (1-34) in diagnosis and management of hyperparathyroidism, as well as in studying the clearance of amino-terminal portion of PTHwhich is known to represent biological activity.

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The changes in plasma lipoproteins after plasmapheresis were estimated in a case of heterozygous familial hypercholesterolemia. Twoand a half liters of plasma were exchanged with the same volume of Plasmanate. The effects of cholestyramine on the changes in plasma lipoproteins were also studied after the second plasmapheresis. Fasting plasma was collected serially, and plasma VLDL, IDL, LDL₁ (1.019<d<1.045), LDL² (1.045<d<1.063), HDL² (1.063<d<1.125)and HDL³ (d>1.125) were separated by ultracentrifugation. The cholesterol and apoprotein contents in these lipoprotein fractions were analyzed. Apoprotein AI, AH, B, CII and E were measured by single radial immunodiffusion. VLDLC and plasma apoprotein CII and E increased very rapidly. The IDL-C increase was slightly slower than that of VLDL-C.LDL¹-C continued to increase for three weeks, but LDL²-C reached a plateau around a week after plasmpheresis and declined thereafter. The change of apoprotein B was similar to that of cholesterol in VLDL, IDL, LDLi and LDL². Cholesterol amounts in HDL² and HDL³ changed in a parallel manner, as did apoprotein AI and AIL HDL² and HDL³ reached their preplasmapheresis levels in a week. Cholestyramine did not inhibit the increase of VLDL, IDL, LDL₁ or LDL² in this case.

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Effects of aging on the in vitro responses of human peripheral blood lymphocytes (PBL) to interleukin-2 (IL-2, T-cell growth factor) were studied. Aged PBL showed a significantly lower response to phytohemagglutinin (PHA) than young PBL. On the other hand, proliferative responses to exogenous IL-2 showed by aged PBLwere found to be in same extent as those of youngPBL.In addition, cultured lymphoid cells propagated in IL-2 (CLC-IL-2) derived from both young and aged PBL showed a strong cytotoxic reactivity against the natural killer (NK) sensitive target K562.

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A 17-year-old woman with hereditary spherocytosis was found to be heterozygous for an unusual variant of the band 3 protein in erythrocyte membranes. The variant had a molecular weight of 95, 000 daltons which was larger by about 3, 000 daltons than the 92, 000 m.w. normal band 3, and was phosphorylated less efficiently when intact cells were incubated with ³²P-inorganic phosphate. It is discussed that this variant mayaffect the integrity of the membrane skeltons.

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Flow cytometrie analysis of the bone marrowcellular DNA content was performed in 40 adult patients with acute leukemia. Twenty-eight had AML (29 previously untreated and 9 relapse) and 12 ALL (8 previously untreated and 4 relapse). For the whole series, the mean G_1/0-phase compartment was 82±1.3%, the mean S-phase compartment 14±1%, and the mean G₂ +M-phase compartment 4±0.7%. The percentage of cells in the S-phase had a positive correlation with the LDHlevel, but not with other parameters. Patients at relapse had significantly lower percentages of cells in the S-phase in AMLand significantly higher in ALL. The changes of the S-phase size of the same patients at the first and relapse phases varied. Patients who obtained complete remission had significantly higher percent S phase than patients who did not. This difference was more significant in ALL. Percent cytoreduction had no correlation with the remission rate or S-phase size. Therefore, we analyzed changes of cells in the S-phase of patients with untreated AMLduring chemotherapy. The reduction rate of cells in the S-phase of patients who obtained complete remission was significantly higher than that of patients who did not.

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Striatal dopamine availability in connection with the plasma levodopa levels was studied in 12 parkinsonian patients treated with optimal doses of levodopa. Three patients showed the wearing-off phenomenon and the 9 others showed no daily fluctuations in disability. 1) All of the 3 patients with the wearing-off phenomenon showed an up-and-down pattern of dopamine availability index. 2) Out of the 9 patients presenting no fluctuations in disability, 6 showed an ascending pattern of the dopamine availability index and 3 an up-and-down pattern. Of the former 6 patients, 2 received short-term (less than one year) levodopa therapy and the other 4 had the first onset at 42 years or under. In the latter 3 patients, the onset was at over 50 years of age and the duration of levodopa treatment was more than 3 years. In these 3 patients, the mode of action of dopamine in the striatum was considered to be insufficient despite the absence of fluctuations in disability. Thus, the dopamine availability index was considered to be very significant from the viewpoint of prognosis of levodopa therapy.

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A case of pseudohypoparathyroidism (PHP) associated with several hormonal abnormalities in addition to parathyroid hormone (PTH) was reported. Several endocrinological examinations before and after treatment with 1α-OH-D₃ revealed abnormal thyroid stimulating hormone and prolactin responses to thyrotropin releasing hormone, abnormal plasma renin activity responses to renin stimulation test, and abnormal calcitonin responses to calcium infusion test. These abnormalities were not corrected when serum calcium levels returned to normal after therapy. From these results, it was suggested that in. PHP resistance to multiple hormones that worked by stimulating adenylate cyclase might be the cause of these hormonal abnormalities, irrespective of serum calcium levels.

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A 47-year-old woman with nephrotic syndrome (membranous glomerulonephropathy) who excreted high, low density lipoproteins (HDL, LDL) which are almost similar to serum HDL and LDL, and small amount of slightly deformed very low density lipoprotein (VLDL) in the urine has been presented.

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A 57-year-old female was diagnosed as having asymptomatic cornstarch granuloma. The disseminated small nodules over the peritoneum were incidentally discovered at operation for cholelithiasis, when she was misdiagnosed as carcinomatosis peritonei. Histological observations revealed a characteristic finding of tuberculoid granuloma with caseous necrosis, a rather rare histological type of cornstarch ganuloma.Polarized light microscopic examination of biopsy specimens is particularly important for the diagnosis.We emphasize that cornstarch granuloma should once be considered when tuberculoid or unknown abdominal granuloma are observed in patients with history of abdominal surgery.

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We report the rare occurrence of sicca syndrome associated with primary amyloidosis. A 63-year-old man with apparent keratoconjunctivitis sicca and xerostomia died of the cardiac failure. Neither sialography nor labial gland biopsy revealed findings compatible with Sjögren's syndrome. Macroglobulinemia and a positive Bence-Jones protein were noted in urine testing. Amyloid deposition was demonstrated by Congo red staining on biopsied rectal tissues, and by typical birefringence under polarized light microscopy. At autopsy, the amyloid deposition was identified histochemically in the submandibular gland and the minor salivary glands of oral cavity.

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A 74 yo female was found to have bullous dermal amyloidosis on the background of systemic amyloidosis with multiple myeloma. There was monoclonal immunoglobulin light chain of kappa type in the serum with no proteinuria (Bence Jones proteinemia without Bence Jones proteinuria), along with proliferations of kappa-producing plasma cells in the marrow.

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The marked conjugated hyperbilirubinemia in a 72-year-old patient with myocardial infarction and sepsis is reported. The serum bilirubin, which was predominantly composed of conjugated bilirubin, was elevated to 21 mg/100 ml, while serum bile acid and alkaline phosphatase levels were normal or slightly elevated. Postmortem examination of the liver revealed slightly proliferated bile ductules and some bile thrombi with little liver cell necrosis.

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Peptostreptococcal empyema occurred in a 54-year-old man who had suffered from diabetes mellitus and had been in akinetic mutism. Ultrasonic tomogram was useful to detect the space of empyema and to identify the decrease in volume of the empyema space with treatment.

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