For the purpose of selecting effective drugs and eliminating side effect of non-effective agents in chemotherapy for pulmonary cancer, I have tried the drug sensitivity test by means of ³H-TdR uptake method for the primarily cultured cells of human pulmonary cancer and have evaluated the effect of clinical application. Moreover, with the intention of remedying a demerit of 3H-TdR uptake method, I have examined various in vitro assay of drug sensitivity test inclusive of ⁵¹Cr labeling method for in vitro cultured cells of Ehrlich ascites carcinoma and for primarily cultured cells of human pulmonary cancer.
The results are as follows:
1. The sensitivity for an t icancer drugs in in vitro assay of cultured human pulmonary cancer cells was different in same histological type group and the drug sensitivity was variable in each case.
2. The survival time prolonged significantly in non-resected stage IV group, in whom the sensitive drugs were administered.
3. As a result of comparative examination of tumor sensitivity for Mitomycin C and histological finding of resected cancer tissue from the patients underwent the preoperative infusion of Mitomycin C into the bronchial artery, the usefulness of the drug sensitivity test was confirmed.
4. In casees with metastatic lung tumor, the clinical effect of administered sensitiv e agents was not demonstrated.
5. As a result of experimental evaluation of various sensitivity test using Ehrlich ascites tumor cell as a target cell, it was demonstrated that ⁵¹Cr labeling method and ³H-leucine uptake technique were useful even for antimetabolites for which 3H-TdR uptake method was inadequate.
6. The result of evaluation of sensitivity test by means of ⁵¹Cr labeling method or 3Hleucine uptake technique on human pulmonary cancer cells was almost same as that of experimental evaluation. Therefore, they may be clinically applicable.

抄録全体を表示

Here introduced a blood transfusion system which has been established and used practically in our hospital for the purpose of ensuring safty in blood transfusion.
This system has been designed on the basis of our studi es on the usefullness and availability of various tests for blood transfusion (ABO, Rh, antibody screening, cross-match, etc. ). Test methods should be chosen on each occasion according to the grade of urgency.
The discrepancies between the results of the blood group tests o btained by doctors in the wards and those by technicians in the blood transfusion unit were also examined.
All staffs engaged in blood transfusion should keep in mind that da nger is always in dwelt in their practice. Nos only red blood cell antigens, but also those of white cells, platelets and sera can produce antibodies, which may cause side effects of blood transfusion. Each staff should discharge his duties obeying the rule established for safer blood transfusion.

抄録全体を表示

The division of critical care medicine at Kansai Medical University was established in March 1979. The emergency patients numbering 665 were admitted to this service during 20 months period since the inauguration. This report is the analytical observation of each of our cases at this division.
The basic physician staff is needed to be on the premises every hour of every day. The division staffed full-time has 9 physicians and patients are served by 18 nurses, laboratory technicians and X-ray depaptment personel.
Approximately 400 cases have be en admitted to this division between the hours of 6 p. m. to 8 a. m.
The classification of emergency cases are internal medcine: 205 (31%); Opthalmology: 120(18%); General Surgery: 107 (16%); Orthopedics: 95 (14%); Neurosurgery: 75 (11%).
The mortality rate is 19.8 % and 156 cases were transferred to other department s. And as with many exellent forms of therapy, the critical care medicine also has its undesired complications. We have encountered the complications of respiratory failure in 101 cases (15.2%)DIC in 75 cases (11.3%), renal failure in 50 cases (7.5%) and others.

抄録全体を表示

The effect of hyperosmolality on the central nervous system following the administration of 7% sodium bicarbonate was studied electrophysiologically by analyzing evoked muscular discharges, afferent evoked potential and M H wave. The results were as follows.
1) The hyperosmo lality induced by the administration of 7 sodium bicarbonate suppressed evoked muscular discharges by 100 Hz electrical stimuli to the cerebral cortex, but temporarily accelerated evoked muscular discharges only on the flexor-fored-limb and extensor-hind-limb when the serum osmolality was 300-330 mOsm/L. The evoked muscular discharges by stimuli to the hippocampus was also suppressed with hyperosmolality. Above 440 mOsm/L in plasma evoked muscular discharges disappeared completely.
2) Considering the form of evoked m uscular discharges, under 350 mOsm/L in plasma only tonic type waves on muscular discharges were suppressed, when the plasma osmolality reached 380 mOsm/L or more, clonic type waves also decreased.
3) As the results of sciatic nerve stimulatio n, the early 3 negative responses (N₁, N₂ and N₃),1 positive response (P) and late 4 negative responses (N₄, N₅, N₆ and N₇) w ere observed in the cerebral cortex. The early components showed no change under 400 mOsm/L in plasma osmolality but exceeding 400 mOsm/L these were suppressed. Late components indicated a tendency to recover temporarily at 320 mOsm/L and were suppressed when hyperosmolality exceeded 320 mOsm/L in plasma.
4) In hippocampus, there are 6 negative responses (HN₁, HN₂, HN₃, HN₄, HN₅ and HN₆) as the result of sciatic nerve stimulation, these responses showed no changes un der plasma osmolality of 415 mOsm/L, but over 415 mOsm/L were suppressed.
5) The amplitude of H wave increased temporarily when the plasma osmolality of 300mOsm/L, and when the plasma osmolality exceeded 310 mOsm/L, H wave was suppressed. The latency of the M wave shortened at 310 mOsm/L in plasma, but increased at over 320mOsm/L.
The conclusions were as follows:
Under the plasma osmolality was 350 mOsm/L mainly the pyramidal pathway was suppressed, and over 380 mOsm/L the extrapyramidal pathway was also suppressed and when the plasma osmolality exceeded 440 mOsm/L efferent pathways were damaged completely.
Above 320 mOsm/L there was unconsciousness but sense of touch and pain was not affected until 440 mOsm/L in plasma, and the dysfunction of anterior horn cells and peripheral nervous system was induced by hyper osmolality directly over 320 mOsm/L, hence the central nervous system including cerebral cortex, hippocampus, midbrain reticular formation, pyramidal pathway, extrapyramidal pathway and anterior horn cells, and peripheral nervous system were damaged by hyperosmolality induced from the administration of sodium bicarbonate.

抄録全体を表示

Four hundred and ninety six families with rare blood phenotypes of the ABO, I, P, Rh, Kell, Duffy, Diego and Jr were detected in Japanese Red Cross Blood Centers, and all these blood samples were re-tested and confirmed in Osaka Red Cross Blood Center. Some of them were reconfirmed by Dr. Ruth Sanger, MRC Blood Group Unit in London.
These rare bloods, except Fy (a-), Di (b-) and Jr (a-), were recognized mostly by ABO groupings and antibody screenings.
Another ninety seven persons with rare bloods were found among the propositi's family members. Consanguinity rate of the Rh11, Rhmod and -D- was 69.2%, and that of the p phenotype 56.5%, the total consanguinity rate being 63.3%.
While most of the -D- (including cD-) propositi experi enced abortion or stillbirth, some of the p female propositi did not suffer from such episodes.
Most of the i propositi had a congenital cata ract, but recently an i adult free from the disorder was found in Hokkaido. We think the co-occurrence of the i phenotype and congenital cataract to be due to linkage rather than to pleiotropism.
Most Jr (a-) female propositi had anti-Jr' in their sera, but none of them had experienced abortion, stillbirth or hemolytic disease of the newborn.

抄録全体を表示

In 1963, Mori developed what we call Mori's capsulectomy and synovectomy for the knee joint using two parapatellar skin incisions, a new type of knee joint synovectomy designed to preserve the quadriceps muscle bellies as completely as possible in order to guarantee postoperative functional restoration. Since then, this surgical procedure has been called under the term “Mori's incision” widely in Scandinavian and other European countries. This paper presen ts a follow-up study by describing long-term results of this surgical method.

抄録全体を表示

At first, lymphocyte subpopulations were examined in the cord blood by using various technics, which were the E-rosette forming cell, EN-rosette forming cell, early-EN-rosette forming cell, EAC-rosette forming cell, IgG-Fc-receptor binding T cell (double rosette forming cell), and immunofluorescent staining assays, and the results were compared with t hose of adults.
In the second study, the possibility of maternofetal transfer of lymphocytes was investigated in the cord blood. Cord lymphocytes were obtained from 15 healthy male newborns and cultured for chromosome analysis. The culture was carried out in many combinations of pH, mitogens, cell numbers and culture time as follows: (1)pH of culture media were 7.2 and 6.8, (2) Mitogens were phytohemagglutinin (PHA), pokeweed mitogen (PWM), and concan avalin A (Con-A),(3) Added cell concentrations (per 5 ml of culture media) were 3×10⁶,2.5×106,⁵×10⁵, and 1 x 105, (4) Culture time were 72 hours and 96 hours.These four groups of conditions were combined each other and all cultures were done at 37°C in environment of 5 % CO₂. Then the cultured cells were prepared for chromosome analysis and karyotyped. (One of them were performed whole blood cultures. )
The following results were obtaind.
1) In the cord blood, E-, E_N-, and early-E_N-rosette forming cells (T lymphocytes) decreased in percentage as compared with those of adults.
2) The absolute numbers of E_N-rosett e forming cells increased in the cord blood compared with those of adults.
3) In the cord blood, neuraminidase-treated E rosette forming cells (E_N- and early-E_N-rosette forming cells) increased in percentage and its standard deviation was smaller than that of the results obtained from neuraminidase-untreated E rosette forming cells (E-rosette forming cells)
4) In the cord blood, there was no difference in percentage between EN-rosette forming cells and early-EN-rosette forming cells, which suggests that these two populations were the same lymphocyte-subset (of T cells).
5) EAC-rosette forming cells sho wed no difference in percentage between the cord lymphocytes and the peripheral blood lymphocytes of adults, but the absolute numbers of EAC-rosette forming cells increased in the cord blood compared to those of adults.
6) The percentage of surface immunoglobulin (SmIg) bearin g lymphocytes (B lymphocytes)were higher in the cord blood than those of adults.
7) Surface IgD bearing lymphocytes in the cord blood showed an increased percentage as compared with those of adults.
8) In the cord blo od, it is likely that “null cells” (lymphocytes which have no surface marker) increased in percentage compared with those of adults.
9) IgG-Fc-receptor binding T lymphocytes examined by double rosette formation showed no significant difference in percentage between cord lymphocytes and adults.
10) Chromosome analysis were performed on 1320 metaphases in PWM culture,196 metaphases in PHA culture, and 126 metaphases in Con-A culture, altogether 1642 metaphases from 15 healthy male cord blood. Among these experiments, only 1 XX-karyotype was found among the PWM-stimulated metaphases, which was cultured for 96 hours in culture media of pH 7.2. The results obtained so far suggest that maternal lymphocytes do not pass across the placental barrier in normal pregnancy.

抄録全体を表示