Antigen-specific immunotherapy cannot be applied to cancer immunotherapy. At the present time, immunotherapy has to depend on non-specific activation or restoration of protective mechanisms followed by augmentation of resistance against tumor. Although the mechanism of the action of immunotherapeutic agents, including BCG, OK-432, Coryne-bacterium parvum, levamisole, PSK and lentinan, is not fully understood, antitumor effect of these agents has been observed to be mediated by some defense mechanisms of the host, mainly consisting of immune response. Agents such as BCG and OK-432 may activate primarily macrophages followed by T cell activation, and agents such as PSK and lentinan appears to have a potency to restore depressed functions of T cells or macrophages in tumor-bearing hosts. These agents seem to deserve further investigation.

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Literatures on the infections due to Mycobacterium fortuitum which appeared in the related journals until 1981 were reviewed. Some cases of pulmonary infections were related to the history of tuberculosis and pneumoconiosis and/or the presence of mega-esophagus. Abscess formation due to this organism were frequently resulted from iatrogenic causes such as injection and surgical treatment. Infections secondary to trauma were also reported.

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Literatures on the infections due to Mycobacterium chelonei were reviewed. In this country, only 15 cases of pulmonary infection caused by this organism were reported, whereas there were no cases of extrapulmonay infection. However, there are many reports in the world on this subject. Hopefully Japanese surgeons show more interest in this subject.
Notably, M. chelonei infections occur frequently after injection or surgical treatments, and the infections may occur endemically.

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An analysis of the serum and salivary concentration after procainamide (PA) adminis-tration was first carried out and an attempt was made to determine the relationship between pharmacokinetics and anti-arrhythmic effect of the PA in patients with premature ventricular contractions (PVCs). Five hundred mg of PA was given orally to 4 healthy volunteers. In chronic oral administration study, maintenance dose of PA was adminis-tered repeatedly in every half-life of PA. In patients with PVCs, 500 mg of PA was injected intravenously and 1000 mg of PA was administered orally. Blood and salivary samples were collected at regular intervals. Blood and salivary concentration of PA and its active metabolite, N-acetylprocainamide (NAPA), were determined fluorometrically. In oral administration study, blood concentration data was analyzed using adequate compartment models. After single oral administration of PA to normal subjects, the salivary concentrations of PA and NAPA were approximately twice higher than the serum concentration of PA and NAPA. The saliva to serum concentration ratios of PA and NAPA kept at constant values during elimination phase. There was a significant correlation between serum and salivary concentration of PA (r=0.89, p<9.001) and NAPA (1=0.87, p<0.001) in both single and chronic oral administration studies. In patients with PVCs, significant correlation between QTc prolongation induced by PA and its serum concentration was seen. A significant correlation (r=0.69, P<0.001) between the percent decrease of PVCs and serum PA concentration was also observed after intravenous injection of PA.

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During the course of our present study about the effect of sera of cancer patients on the growth of cultured cells, it was found that the serum of one of the patients inhibited the growth of FL-Y, a human amnion cell line, but did not inhibit that of CV-1, an African green monkey kidney cell line. Since the human a-interferon (IFN-α) had been administered to the patients, the identity of IFN-α and the growth inhibitory factor was examined.
1) The patient's serum did not inhibit the growth of CV-1 but did inhibit that of FL-Y.
2) IFN-α inhibited the growth of CV-1 to a higher extent than FL-Y.
3) The growth inhibitory activity of the patient's serum was lost after storage at -85°C for 62 days.
Since the patient had not been treated with drugs which inhibited the cell growth except IFN-α, the presence of unknown factors in the patient's serum was suggested.

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Fibronectin (Fn), one of the glycoprotein, is considered to play a role in various dis-eases, but it was not used clinically until recently. We measured human plasma Fn by using laser nephelometer (Hyland Laboratories) and investigated the standard curve, the reproducibility and compared with the traditional single radial immunodiffusion (SRID) method.
In the standard curve (n=8), the coefficient of variation (CV) was within a range of 1-2%. As to the reproducibility (n=5) for high (x=106.6%), middle (x=52.4%) and low(x=27.7%) concentration, CVs were 5.2%, 2.7% and 4.3% respectively. The corre-lation between this method and SRID method was good (r=0.969, P<0.01).
Thus, we could measure many samples rapidly with high sensitivity using small amount of anti-serum. The present study suggested that the measurement of plasma Fn by this method was useful and should be used as a routine test.

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The major purposes of reconstructive surgery in the head and neck regions are cos-metic repair of a large tissue defect caused by tumor extirpation in patients with ma-lignancies and early come-back to social activity.
Recently the new method of the pectoralis major musculocutaneous flap developed by Ariyan has been frequently used for the surgery of the head and neck regions.
Since July 1980, using this method we have operated nine cases of the tongue and oral cancers, six patients with the cervical esophagus cancers and five other cases.
All cases had complete repair by this technique for a while.
The operative method and its efficiency were described in this paper.

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Sixty-four cases of carcinoma of the tongue treated in Kure National Hospital from 1972 to 1981 were reviewed.
In most cases primary lesions were treated by interstitial irradiation and cervical me-tastsis by surgery.
According to TNM classification, 24 cases were in T₁, 26 in T₂ and 14 in T₃.
Just before the initial treatment, 16 cases showed evidence of cervical metastasis. Late cervical metastasis was found in 13 cases.
Radical neck dissection was performed in 17 cases having cervical metastasis.
The five year crude survival rate of 64 cases was 46.8%. (Stage I : 76.5%, Stage II: 61.5%, Stage III: 23.1%, Stage IV: 0%)
The major cause of death was the failure of the management of cervical metastasis.

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Inspite of the advances of psychopharmacologic therapy for the mental diseases, the administration rate per bed number of our institute had not been enough. Even in the closed male ward for acute therapy, this rate had been under 100% during 7 year-period from 1971 to 1977.
Considering that this had been the result of the prolonged protect from social contact, we attempted to let the patients contact with open society even when they need care in the closed room.
The main program for this attempt was to let all patients in the ward march once a month and camp for 3 days a year. Especially this training camp had the purpose of elliminating the dependence, by setting the situation in order to live spontaneously, such as selfcooking.
This training was rather severe for patients as well as for therapeutic stuffs who must be the model for patients in addition to being the nurses for severe ly ill patients.
This therapeutic activity was started in 1978. In 1979 the administration rate increased over 100%, and reached to 130% in 1980.
Based on the analysis of the patients, this was the result of the increase in number of patients discharged within 2 months in contrast to the previous duration of admission for 6 months.
The possibility of the difference in the severity of the disease was not found to be the cause.

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The status of marriage was investigated among forty-one schizophrenics who had married after the onset of illness.
The results were as follows:
1) Most of male patients married at the age of thirty or older. The marriage age in female patients showed two peaks.
2) The number of arranged marriages was higher in male patients, but the number of arranged marriages and love marriages were almost equal in female patients.
3) Thirteen out of fifteen male patients did not tell their partners about their own illnesses, but fifteen female patients did tell and eight did not tell their partners about the disease.
4) The number of female patients who had their own child or children was lower than that of male patients.
5) Six patients were divorced and all were female patients.
6) Social adjustment and state of employment in female patients were better than those of male patients.

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We reported a case of neurilemmoma arising from the left chest wall seen in a 42-year-old man. This tumor arising from the chest wall is very rare and this case is the 26th one reported in Japan. One of the features of this tumor is benign in nature in spite of large size among the tumors of the chest wall. The figure of rosary in shape seen in this case is very unique because the shape of most of this type of tumor are egg or ellipsoid.
In addition, we described the general aspects of the neurilemmoma arising from the chest wall referring to the literatures.

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We report a case of Addison's disease caused by tuberculosis. Enlarged adrenal glands were demonstrated by a computed tomographic scan (CT scan). An open biopsy of the left adrenal gland was carried out. We also report 20 cases of Addison's disease seen in our hospital during 28 years.
A 61-year-old man was admitted to our hospital because of general fatigue. The patient was well until February in 1981, when general fatigue and loss of appetite developed. After one month, pigmentation of oral cavity and lips, and a decrease in weight were ob-served. The blood pressure was 92/60 mmHg and the pulse rate 76 beats/m. No lymph-adenopathy was found. The hemoglobin was 10.7 g/dl. The erythrocyte sedimentation rate was 40 mm/h. The C-reactive protein was 3+. A skin test for tuberculin was positive. There were persistent elevations of the serum alkaline phosphatase and the serum asparate amninotransferase (SGOT). The serum sodium was 132 mmol and the potassium 5.2 mmol. The urine sodium and potassium were normal. The fasting glucose was 60 mg/100ml. An X-ray film of the chest disclosed the old scar of tuberculosis. The Cooms test, the microsome titer and the anti-adrenal-antibody were all negative. The serum fasting cortisol was 1.8 μg/dl, the aldosterone 50 pg/ml, the ACTH 467 Pg/ml and the β-lipotropine 3259 pg/ml. The rapid ACTH test and the long ACTH test showed no response. Adrenal scinti scan revealed no uptake by adrenal glands. A CT scan of the abdomen revealed enlargement of adrenal glands (no calcification). The anatomical diagnosis was the tuberculoma of the adrenal glands.
Among 20 cases of Addison's disease seen in our hospital, 6 cases were due to tuberculosis. Two cases were due to adrenal atrophy diagnosed by autopsy associated with liver cirrhosis and old scar of pulmonary tuberculosis respectively. Metastasis of the stomach cancer to the adrenals was one case in which the right adrenal gland was completely invaded and the left adrenal gland was invaded almost in two-thirds of the gland. The liver, lungs, kidneys, and the abdominal aortic lymphnodes were also invaded. The long-term steroid therapy caused the adrenal insufficiency in 4 cases. Seven cases were agnogenic.
Recently CT scan was developed. CT scan was capable of displaying the adrenal gland tumor as small as 1 cm in diameter. In cases of Addison's disease due to tuberculosis, adrenal glands were found definitely to be enlarged and the tuberculous process was always progressive until the glands were almost completely destroyed. In this case the adrenal glands were also almost thoroughly destroyed. Although the number of Addison's disease due to tuberculosis is decreased, we should pay attention to adrenal tuberculosis since the long-term steroid therapy, dialysis, and diabetes mellitus are increased.

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A case of leiomyoblastoma of the stomach is reported. A 64-year-old man was re-ferred to our hospital because of abnormal findings in upper GI series. The double contrast of the upper GI series and gastroscope suggested a exogastric mass in the lesser curvature of the antrum. Angiogram and ERCP demonstrated normal appearances of the anatomic situation. CT scan showed a round shape of the low density tumor connecting with the wall of the antrum. A 5×5×4 cm size of the tumor was extirpated from the lesser curvature of the antrum. It was solid combined with partially pseudocystic change. Histologically, it was made up of round or polygonal cells. The nucleus was surrounded by a ring of eosinophilic cytoplasma and by a peripheral clear halo. It is generally accepted that the majority of leiomyoblastomas follow a benign clinical course, but they are not very rare. The clinical and pathophysiological characteristics including 62 cases reported in Japan were reviewed.

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The purpose of this study is to asses the feasibility of the new technique of suction curettage (MR Method) in the diagnosis of endometrial cancers. In the course of our investigation involving 356 patients it was possible to perform the suction curettage without anesthesia on 348 (97.8%) patients. In another 9 patients the material from the corpus were inadequate due to endometrial atrophy. Of 339 patients, endometrial cancer was discovered in 12, and adenomatous hyperplasia in 8 cases. The method was found to be reliable histologically. No serious complications occurred during or after the suction curettage. There were two cases with syncope and recovered spontaneously. The pro-cedure of the MR method without anesthesia was well tolerated by the patients.

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The outcome of coronary cine angiography and surgical treatment of ischemic heart disease was presented at the Cardiovascular Division, Kanagawa-Byoin National Sanatorium during the period of November, 1976 to December, 1981.
1) Coronary cine angiography and surgical treatment:
Coronary cine angiography 848 cases
Surgical treatment 78 cases
The number of cases are increasing every year.
2) Surgical treatment:
Direct revasculization surgery 68 cases
Combined operation 7 cases
Aneurysmectomy 3 cases.
3) Patency of the graft: 81.4% (96/118, LAD>LCX>RCX). Internal mammary artery 100% (9/9), its graft seemed to be more beneficial than saphenous vein graft.
4) Mortality and complications:
Mortality 7 cases (early 3, late 4)
Complications including perioperative
myocaraial infarction 4 cases.
5) NYHA functional class:
Significant improvement after surgery.

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