For the purpose of obtaining some knowledge on the participation of host factors in tumor chemotherapy, studies were designed using original Yoshida sarcoma (YS), which is sensitive to cyclophosphamide (CPM), and a CPM-resistant form of YS (YS-R) established by T. KOKAWA in our department.
1) Effect of CPM on YS- and YS-R-bearing rats: Donryu rats subcutaneously (s.c.)implanted with YS or YS-R (each at 2×10⁷ cells) were treated thereafter with i. p. administrations of CPM at 20,40, or 80 mg/kg. CPM was given in one bolus on the fifth postimplantation day, or divided into eight daily dosages from the same day on. Among the one bolus regimens,40 mg CPM was found to be most effective for survival of the YS-bearing rats; 80 mg CPM often caused death by intoxication. The same regimens enhanced tumoral growth in the YS-R bearing rats to yield an adverse effect. The divided dosage schedules exerted influences on the growths of the YS and the YS-R similar to those effected by the one bolus regimens, but the adverse effect on YS-R was not observed.
2) PH A response of spleen cells from tumor-bearing rats treated with CPM: After counting the total number of cells obtained from the spleen, each unit of 15×10⁶ cells was cultivated with PHA, and examined for its 3HTdR uptake. The total response of each spleen was found by multiplying the reactivity of each culture by the total cell count.
Spleens of YS-bearing rats showed elevations in response during the early stage after tumor implantation, followed by a consistent descent in concomitance with tumor growth; such changes were not significant in rats bearing YS-R, which grew much more slowly than did the YS.
Normal rats administered with CPM 40 mg/kg showed suppression of their spleen responsiveness, being most remarkable on the 7th day after CPM administration, and recovering rapidly thereafter. This temporary depression was seen to be similar in all the CPM dosage schedules.
YS-bearing rats treated with CPM 40 mg/kg, both in one bolus and dividedly, showed, after a rapid and temporary depression in spleen responsiveness, recovery proportionate to tumor regression. On the contrary, YS-R bearing rats, in whom the tumor grew regardless of CPM administration, continued to lose spleen responsiveness without recovery.
These changes in spleen responsiveness were attributable not only to the increased or decreased number of spleen cells, but also to the changes in the mean reactivity of each spleen cell.
These obtained results show that, even after the administration of CPM, which is a potent immuno-depressant, the immunological activity of a tumor-bearing host can be restored in concomitance with tumoral regression, when the tumor is sensitive to the drug they may also make evident the rationality of immuno-chemotherapy, i. e. chem otherapy combined with immuno-stimulants.

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For the purpose of obtaining some basic knowledge on the immuno-chemotherapy of cancer, studies were made on the effects of BCG on tumor growth and on the cellular immune response in rats, with special reference to its influence on the effects of cyclophosphamide (CPM) administration in Yoshida sarcoma (YS) bearing rats. Th e results obtained were as follows
1) Determination of t he optimum day for BCG administration after subcutaneous (s.c.) YS inoculation combined with CPM treatment on the fifth post-inoculation day: BCG (1mg s.c.) administration on the third day caused early but temporary suppression of tumor growth which was followed by a regrowth, while BCG given on any other day yielded no remarkable influence on tumor growth following CPM administration.
2) Determination of BCG dose: Experiments with various do sages of BCG (O.5 to 4mg) on the 3rd post-inoculation day revealed that a 4mg administration was the most effective by showing remarkable tumoral regression as well as a 100% survival rate.
3) Comparative studies on the effects of immunotherapy (BCG 4mg on the third day), chemotherapy (CPM 40mg/kg on the fifth day), and immuno-chemotherapy (BCG combined with CPM): Immunotherapy alone enabled survival rate of 92.3% and a complete regression rate of 84.6% on the 24th day; the respective immuno-chemotherapy rates were 84.6% and 46.2%, and chemotherapy alone led to tumoral growth of the tumor after an early temporary regression, its rates being 80% and 20% respectively, Tumor implanted rats receiving no treatment, showed progressive tumoral growth, the survival rate being 28.6% without any instance of complete tumoral regression.
So far as this experiment is concerned, the immunotherap y was the most effective, followed by immuno-chemotherapy, the chemotherapy being the least effective.
4) Estimation of in vitro PHA responsiveness of rat spleen cells in various condition (³HTd Ruptake method); BCG (4mg s.c.) administration in normal rats brought about persistent spleen cell increases, both in count and in reactivity to PHA.
Spleen cells from tumor-bearing rats showed a persistent desce nt in their responsiveness to PHA proportionate to ineffective treatment: In all of the treated animals the responsiveness descended on the 7th to 12th post-implantation day (2th to 7th day after CPM administration), most remarkably in the immuno-chemotherapy group, followed by the chemotherapy group, while the immunotherapy group showed only a slight depression; nevertheless, the responsiveness recovered in concomitance with t umor regression.
These obtained findings, showing the effectiveness of BCG with or without chemotherapy, may prove useful in the practice of immuno- or immuno-chemotherapy against malignant tumors.

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Plain abdominal roentgenography and barium meal study or barium enema have been the roentgenographic diagnostic means chiefly employed for ileus, yet these diagnostic technics have not always proved capable of getting its pathologic features in details. For this reason, even if the diagnosis of "ileus" may be made by such technics, information necessary about the measures that should then be taken has not been available.
In an attempt to diagnose not only the severity of intestinal ischemia which is the core of the most important pathophysiologic change in this disease but also its cause and the location and area of its pathologic change as quickly as possible, the author has lately applied emergency abdominal angiography in ileus, and achieved the useful findings clinically. The findings are discussed, and their clinical significance described hereunder.
The materials comprised a series of 32 mechanical ileus cases of 20 men and 12 women who were admitted under the diagnosis of acute abdomen in an emergency and whose plain abdominal x-ray films were noted the formation of fluid levels. For the angiography,15-35 ml of 76% urograf in was injected automatically under pressure selectively into either or both of the superior and inferior mesenteric arteries by Seldinger's method. The angiograms were, as a rule, taken with the patient in the supine position, and of in a case which was difficult for the patient to take the supine position because of abdominal pain, etc., the arterial puncture was made with the patient in the left lateral position, and the dorsoventral angiograms were taken by the use of a lateral x-ray apparatus. In order to accomplish this angiographic examination, it required 15-30minites.

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1. When thiamine tetrahydrofurfuryldisulfide (TTFD) was added to the medium in which an isolated rat atrium was spontaneously contracting, the toxic action of Nethylmaleimide (NEM) to affect the contractions was suppressed by TTFD with increasing the TTFD concentration.
2. The above effect of TTFD was observed even after TTFD had been removed from the medium before the NEM addition.
3. The amount of thiamine in the atrial tissue was chemically estimated. A large amount of thiamine was found in the tissue which had been incubated in the TTFD containing medium, but also in the other tissue which had been incubated in TTFD-free medium after the pre-incubation in TTFD containing medium.
4. The preparation was incubated in TTFD contain ing medium, and then in TTFDfree but L-cysteine containing medium. When the preparation was thereafter placed in drug-free medium and then NEM was added, the effect of TTFD to decrease the toxic action of NEM was reduced by the treatment with the L-cysteine.
5. The treatment with L-cysteine did not influence the amount of thiamine in the preparation pretreated with TTFD.
6. The results may sugg est that the protective effect of TTFD against the toxic action of NEM in isolated rat atria might be caused by some other moiety rather than thiamine radical in the chemical structure of TTFD.

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Measurements were obtained for the purpose of calculating cardiac volume with frontal and lateral chest X-rays (FFD: 200cm) from 792 subjects (611 males,131 females),20-70 years of age in human dock. Measurements of their height, weight, circumference of the chest and abdomen, ECG examinations, blood chemical analyses, and anamneses were completed within three days. With measurements obtained from biplane chest films, the author investigated the factors of sex, age, weight, height, and body-type which would possibly affect the size and shape of the cardiac silhouette. The subjects were separated into two groups (enlarged hearts and unenlarged or “normal hearts”) according to the diagnosis of the radiologist. Using measurements taken from the biplane chest films, six formulas (Vol/kg, Vol/m², (Mr+Ml) / ID, (Mr+Ml)/2⋅√kg/m, L⋅B⋅d/ID⋅D, L⋅B/ID⋅CTR)were derived to obtain index values with which determinations could be made as to the extent of cardiac enlargement. With the index values obtained from these six formulas, quantitative evaluations of the cardiac silhouette were made.
A. Factors in Radiological Diagnosis

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Despite of recent progress in neurosurgical techniques and managements, cerebral arterial spasm has been a difficult problem, which has great influence on prognosis for life as well as for function of patients with the ruptured aneurysm. Mechanisms of vasospasm after subarachnoid hemorrhage (SAH) have been intensively studied and elucidated to a certain extent in experimental models, however, once cerebral vasospasm has occurred in patients after subarachnoid hemorrhage, restoration of vascular caliber is extremely difficult. Moreover, it has been recently found that prolonged constriction of the vascular lumen in so-called vasospasm was partly due to organic changes of the arterial wall, such as myonecrosis and intimal thickenings. Since only a part of patients with prolonged vasospasm develops ischemic symptoms of the brain, intimal changes such as endothelial degeneration and desquamation with possible mural thrombosis might play an additional part to narrowness of the vascular lumen for manifestation of cerebral ischemia.
From this point of view, the author studied the luminal surface of cerebral arteries of experimental vasospasm as well as human autopsy materials using a scanning electron microscope.
1) Experimental studies:
Prolonged spasm was induced in dogs by introducing fresh blood into the cisterna magna or by puncturing the intracranial internal carotid artery with a fine needle.
On the luminal surface of the arteries four days after SAH, there were segmental longitudinal folds covered with undisrupted flat endothelial lining. The segmental presence of longitudinal folds in the specimen perfusion-fixed under pressure was interpreted that constriction of the arterial wall in vasospasm was not equally intense throughout the whole spastic portion, although narrowing of the arteries appeared diffuse on the angiomas, and that segments in severer spasm were not completely extended out at the time of fixation under pressure. The folds of the luminal surface were no more present in the specimens 10 days after SAH.
Apparent degeneration and/or desquamation of the endothelial cells in the spastic segments were not recognized.
2) Studies with h uman materials:
Four fatal cases of severe subarach noid hemorrhage were studied. The arterial segments at the base of the brain were dissected at autopsy and examined on SEM.
There were patches of area which was covered with fibrin network in three cases. In the remaining case the mural thrombus with fibrin and red blood cells were noted in a segment prepared for a light microscope. There was no endothelial lining beneath or around a fibrin net on the luminal surfaces. As a control study, proximal middle cerebral arteries were obtained at either medico-legal or pathological autopsy from 17cases died from other than intracranial diseases.
There was frequent patchy desquamati on of the endothelial lining, showing flat and smooth surface, however, fibrin nets as well as fibrous structures alike were never encountered in a control study.
It was assumed that in a severe prolonged spasm the endothelial cells underwent degeneration by prolonged compression, and that subsequent mural deposit of fibrin net could take place if increased coagulability of some kind and/or stasis of blood stream favoured it.
3) Expe rimental studies could not supply any evidence supporting the assumption derived from findings obtained in human materials. The failure was undoubtedly due to great difficulty to reproduce prolonged spasm in dogs so severe as seen in clinical cases manifesting ischemic symptoms.
It would be important for further experiments to establish experimental models, in which long-lasting severe spasm could be induced and yet no threatening to life of animals would exist.

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