This study was carried out to provide greater precision in the diagnosis of the gestational week by ultrasonic measurement of intrauterine fetal growth.
The subjects for this study consisted of 219 women in a normal pregnancy ranging from 21 to 36 gestational weeks with regular menstrualperiods. Their day of ovulation was estimated and they delivered normal newborns.
The biparietal diameter (BPD), the front-occipital diameter (FOD), the head circumference (HC), the head area (HA), and the fetal femur length (FL), of each fetus were measured by real time ultrasonography. Means ± 3/2 SD of these data were calculated for every gestational week and the developmental curves of these data were prepared.
The following results were obtained: the gestational weeks were estimated until the 28th week by the BPD developmental curve, until the 27th week by the HC developmental curve, until the 26th week by the HA developmental curve, until the 26th week by the (BPD + FOD)/2 developmental curve, and until the 36th week by the fetal femur length developmental curve.
It was suggested that the fetal femur length is the most suitable measurement to estimate gestational weeks in late pregnancy.

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An improved microwave coagulation (MC) method was devised for hemostasis after liver biopsy and puncture of the spleen under laparoscopy. Safety and hemostatic effects of the method were studied with the following results:
1) MC resulted in a wedge-shaped area around the electrode showing necrosis and degeneration of hepatic cells in the liver of five autopsied cases. The area of tissue damage became greater as the output and duration of microwave application were increased. When applied to rabbit livers, repair of the tissue damage caused by MC was almost completed within four weeks, leaving a mild fibrosis. Liver function tests showed no notable changes after application of the MC method in 34 clinical cases.
2) Significant diminution of the bleeding time after liver biopsy was attained by the MC method in com-parison with the time required for spontaneous hemostasis in 50 patients subjected to the test. MC was more effective in shortening the bleeding time after liver biopsy than oppression of the bleeding site by forceps. Hemostasis occurred more rapidly with the MC method than without any treatment irrespective of diagnosis, severity of bleeding, laparoscopic findings, platelet count, or prothrombin time. Complete hemostasis was also achieved by the MC method within short periods of time after puncture of the spleen in 32 patients.
It is concluded that the improved MC method is safe and effective for hemostasis in patients with liver diseases necessitating liver biopsy and /or splenic puncture for diagnosis.

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A new unstable hemoglobin variant, Hb Sendagi (β42Phe→Val), was found in a Japanese male and his daughter both suffering from moderate hemolytic anemia. The structure of the variant was determined and the functional properties were studied. The results obtained are as follows.
1) The variant was electrophoretically silent, but the abnormal β-chain was found to emerge ahead of the normal, 6-chain when the hemolysates from the patients were applied to a reverse-phase HPLC.
2) The tryptic peptides were prepared with the variant β-chain enriched by isopropanol precipitation and column chromatography on CM-cellulose. The abnormal peptide, βT^x-5, was separated by fingerprint mapping or by reverse-phase HPLC of the tryptic peptides.
3) Sequence analyses of the abnormal peptide revealed that the phenylalanine in position 42 (CD1) of the β-chain was replaced by valine. The variant was named as Hb Sendagi according to the place where it was discovered.
4) Hb Sendagi showed a decreased stability upon heat denaturation and isopropanol precipitation tests, and was oxidized faster than Hb A by atmospheric oxygen in the presence and absence of sodium benzoate.
5) The oxygen equilibrium curves of the hemolysates from the propositus also indicated that Hb Sendagi had a lowered oxygen affinity and a normal response to 2, 3-diphosphoglycerate.

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It is generally acknowledged that disorders of calcium metabolism occur in patients with renal diseases. There have been reports of histological changes of the bone in the early stages of renal failure. Bone biopsy is the best method of determining bone disease, but it has a highly invasive effect on the patients. Therefore, microdensitometry (MD), a non-invasive technique, was employed on patients with various renal diseases to check for renal bone disease. The parameters related to calcium metabolism were measured, and the relation between renal bone disease and these parameters was investigated.
Ninety-seven patients with renal disease were classified by grade of renal dysfunction into four groups: 26 patients with chronic glomerulonephritis (CGN) (GFR 103.2±19.5ml/min);20 patients with chronic renal in-sufficiency (CRI) (GFR 39.5±10.2ml/min); 13 patients with chronic renal failure (CRF) (GFR 7.2±2.5ml/min); and 38 patients undergoing maintenance hemodialysis therapy (MHD).
Renal bone disease was investigated using the MD method, and the metacarpal index (MCI) and ΣGS/ D were calculated. Bone disease in the MHD group was followed up for 5 years employing the MD method. The parameters related to calcium metabolism, namely serum calcium, serum phosphate, serum parathyroid hormone (c-PTH), 25-hydroxyvitamin D (25-OH-D), 1, 25-dihydroxyvitamin D (1, 25 (OH)2D) and calcitonin, were measured.
The value of MCI in the CGN group (0.5239±0.0579) was significantly higher than in the CRI (0.4456±0.0626), CRF (0.4070±0.0685) and MHD (0.4366±0.0729) groups. In the CRF group, it was significantly lower than in the others. The value of ΣGS/D in the CGN group (2.633±0.212) was significantly higher than in the CRI (2.285±0.296), CRF (2.106±0.455) and MHD (2.301.±0.347) groups. In the CRF group, it was significantly lower than in the others. The values of MCI and ΣGS/D in the MHD group began to decrease yearly from approximately 3years after initiation of hemodialysis therapy.
In the CRF group, the values of c-PTH and serum phosphate increased significantly whereas the value of serum calcium was extremely low compared with the other groups. The serum level of 1, 25 (OH)2D decreased with degradation of renal function.
These results confirmed that microdensitometry is a useful means of determining renal bone disease in the early stages of renal failure. The cause of bone disease in the CRI group was found to be neither phosphate-retention nor hypocalcemia but the skeletal resistance of parathyroid hormone. Bone disease in the CRF group was due to all three, the skeletal resistance of parathyroid hormone, phosphate-retention and hypocalcemia. Reduction of 1, 25-dihydroxyvitamin D was not found to be a direct cause of renal bone disease in the CRI and CRF groups. Hemodialysis therapy improved bone disease in patients with chronic renal failure in the short term, but in the long-term follow-up study, this therapy by itself was not able to normalize serum calcium and phosphate or suppress the hypersecretion of parathyroid hormone. Hemodialysis therapy was found to be ineffective as a lasting cure against renal bone disease in patients with chronic renal failure.

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NK activity and ADCC of lymphocytes for Oat cells were measured in patients with pulmonary tumors.NK activity was not less in patients with stage III and IV primary lung cancer and with metastatic pulmonary tumors compared with healthy volunteers. Changes in NK activity and ADCC were analyzed according to the performarice status (PS) of tumor-bearing patients. Although NK activity was significantly less in PS 3 and PS 4 patients, ADCC was higher in three groups. It is clear that NK activity in patients with tumors depends on the grade of PS. Furthermore, the effect of chemotherapy on NK activity and ADCC in 15 patients with advanced carcinomas of the lung was examined with regard to the drug, dose, route and timing of administration. The relationship between the effect of chemotherapy on the prognosis for the patients, and the changes in NK activity and ADCC, were also analyzed. NK activity and ADCC were significantly less in patients with poor prognosis, even before treatment. NK activity and ADCC began to decrease 2 weeks after the initiation of treatment, and reached the lowest level during the 3rd or 4th week in all patiens. Thereafter, they returned to the pretreatment level in 8 patients evaluated as no change according to the criteria of WHO. On the other hand, NK activity and ADCC did not return in 7 patients whose disease was progressive and prognosis poor. In 4 patients, it was found that the effect of chemotherapy with Pepleomycin (PLM) and Carbazilquinon (CQ) on NK activity and ADCC differed according to the drug used. Finally, we examined the effect of Cisplatin (CDDP) on NK activity and ADCC, and it was found that CDDP had no effect on their activities. From this study, it is suggested that NK activity and ADCC are valuable prognostic factors in patients with advanced carcinoma of the lung. Detailed analysis of the effect of each anticancer agent on NK activity and ADCC is desirable for the establishment of a better treatment regimen for advanced carcinoma of the lung.

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The author performed skin biopsies on 26 cutaneous lesions from 19 patients with primary or secondary syphilis. The specimens obtained were examined for the existence of Treponema pallidum (T.P.) using silver staining or immunofluorescent complement staining.
The results were as follows:
1) T.P. was observed more frequently under immunofluorescent complement staining than silver staining.
2) Both silver stainingg and immunofluorescent complement staining revealed the presence of numerous T.P. in the epidermis and the dermis in all of the specimens of primary syphilis.
3) In the cases of roseola syphilitica of secondary syphilis, T.P. was not found with silver staining. With immunofluorescent complement staining, however, a small number of T.P. were observed in the perivascular space or in the connective tissue of the superficial dermis.
4) In the cases of syphilis papulosa of secondary syphilis, a small number of Tp. were observed mainly in the lower epidermis in 7 out of 17 cases (41%) with silver staining, while T.P. was observed both in the epidermis and the dermis in 16 out of 18 cases (89%) with immunofluorescent complement staining. In the latter method, the number of T.P. observed in the epidermis was larger than that observed in the dermis in 7 out of 18 cases (39%).
From these results, it seems that the direct observation of T.P. from the lesion using the Indian ink method or the Parker ink method, or the demonstration of T.P. in the tissue with silver staining is highly effective for the diagnosis of syphilis, when the syphilis was in the primary stage.
In contrast, it was rather difficult to demonstrate T.P. in roseola syphilitica of secondary syphilis by the methods of direct observation and silver staining although in syphilis papulosa, those methods were considered to be effective in some cases.

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The prognosis and factors affecting prognosis of 66 putaminal hemorrhage (PH) and 48 thalamic hemorrhage (TH) cases were compared. All patients were diagnosed by CT scan and treated palliatively. They were studied for six months. Functional prognosis was classified into four groups as follows according to activities of daly living (ADL): ADL1 almost full recovery, ADL2 partially dependent, ADL3 almost completely dependent, ADL4 bedridden.
The results were as follows:
1) The mortality rate for PH sufferers, 44.5%, was almost the same as for TH sufferers, 46.8%. 21 (58%) out of PH survivors were classified as ADL1 which was significantly higher than the percentage of ADL1 (23%) in the TH group (p<0.05).
2) Age was one of the major factors affecting prognosis in both the PH and TH groups. For patients in their forties and fifties functional prognosis was favourable. For those in their sixties and seventies ADL was generally poor. Patients in their eighties had an extremely poor prognosis.
3) Deterioration or improvement in consciousness level from admission to the third day of illness occurred more frequently in the PH group than in the TH group. A deterioration in consciousness level indicated a poor prognosis.
4) Anisocoria with a dilated pupil on the same side as hematoma was the worst prognostic ocular sign in both groups. The second worst sign was a non-reactive pupil.
5) None of the TH patients with a severe motor inability on admission advanced to the ADL1 category.
6) In both the PH and TH groups, the patients with bilaterally positive Babinski reflexes had a poor prognosis.
7) A close correlation between CT classification and prognosis was found in both the PH and TH groups. P1 and T1 showed a good prognosis. In patients of P2a and T2a, prognosis depended on their age. However no T2a cases advanced to the ADL1 category. In P2b, T2b, P3 and T3, prognosis was poor.
8) The estimated hematoma volume on CT had a close correlation with the prognosis in PH and TH. The maximum hematoma volume of ADL1 in the PH group was 18 ml and 3 ml in the TH group. Over 80ml was fatal in the PH group, and over 10 ml in the TH group resulted in ADL4 or death.
9) Hematoma rupture into the ventricular system occurred in cases of PH when the hematoma volume was over 25 ml, 4 ml in cases of TH. PH and TH cases with a ventricular rupture generally had a poor prognosis. None of rupture cases in PH became ADL1. A rupture into the 3rd and /or 4th ventricle resulted in an extremely poor prognosis in both the PH and TH groups. However the prognosis of rupture cases was considered to depend more on the degree of brain damage than the ventricular rupture itself.
10) The mean survival time of fatal TH cases was shorter than that of PH (5.4 days vs 9.8 days).

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1) The rabbit hippocampus was kindled through daily electrical stimulation. The rabbit was then anesthetized with Nembutal, and interictal and brain stem-induced potentials, together with fornix-evoked potentials, were studied by observing the depth profiles of field potentials.
2) Interictal field potentials were characterized by the existence of a large slow positivity when recorded in CA1-CA2 apical dendrite layer. On the other hand, brain stem induced field potential having the shortest latency was recorded invariably as a positive deflection in the apical dendrite layer. These positivities were thought to be the extracellular correlates of the Cl-non-dependent hyperpolarization of the pyramidal cell, because they were the largest in magnitude in the apical dendrite layer.
3) The largest interictal field potential and supramaximal fornix-evoked field potential were identical with each other in waveform. Both potentials had one or two population spikes at the onset (CA3-CA4) or at the early part (CA1-CA2). This indicated that the synchronous discharges of pyramidal cells were instrumental in generating the large interictal hyperpolarization through synchronous activation of recurrent inhibitory circuits.

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