The effect on the HBeAg/anti-HBe system of SSM (specific substance Maruyama), an extract from human tubercle bacilli, was evaluated in patients with HBeAg positive type B chronic hepatitis.
Subjects and Methods: Twenty-five (25) HBeAg positive patients with biopsy-proven chronic hepatitis were injected subcutaneously with SSM solution twice a week for twoyears. Fifteen (15) comparable patients served as untreated controls for one year. HBeAg and anti-HBe were measured by the MA method.
Results: (1) In the group receiving SSM injections, HBeAg disappeared in 8 out of 25 patients (32.0%) one year after the treatment and in 15 out of 23 (65.2%) within two years. Seroconversion from HBeAg to anti-HBe occurred in 5 of the 25 patients (20.0%) after one year and in 7 out of 23 (30.4%) within two years. Of the 15 untreated controls, HBeAg disappeared in 3 patients (20%), and seroconversion from HBeAg to anti-HBe occurred in 1 (6.7%) within one year. (2) In the SSM group, the HBeAg cut off index decreased significantly (p<0.01), from 5.2±1.9 during the pretreatment period to 2.7±2.3 twelve months after the treatment. (3) In the SSM group, a transient rise in sGOT and sGPT was observed in some patients three to nine months after starting the treatment. HBeAg disappeared in all these patients. (4) No notable side effects were observed in any of the patients treated with SSM.
Conclusion: These results indicate that SSM treatment improves the HBeAg/anti-HBe system in patients with HBeAg positive chronic hepatitis.

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Preoperative diagnostic accuracy was significantly improved following a recent development of diagnostic imaging techniques. However, the incidence of retained biliary tract stones is far from satisfactory low. Retrospective studies on operative and postoperative cholangiography, and choledochoscopy were carried out to determine the limitation of each modality in preventing the retained biliary tract stones.
The effectiveness of postoperative stone extraction technique for retained biliary tract stones was reevaluated by a follow up study of 213 cases with retained biliarytract stones in which complete removal of the stones was considered to be successful. Finally, a radiologicalexperimental study concerning stone detectability was carried out using phamtom system.
Conclusion: 1) In the retrospective study of operative cholangiography, stones were not demonstrated on cholangiograms in 78 out of 167 cases, although they were detected and extracted by postoperative choledochoscopy. The main causes of the failure of cholangiography were the administration of highly concentrated contrast material (47.4%) and incomplete filling of whole ducts (26.9%). Therefore, the further development for the detection of these stones by operative cholangiography should be desired.
2) In the experimental study, it was clarified that complete filling of the ducts with 30% or 20% contrast materials was essential in normal size or dilated ducts respectively in order to detect small size stones. Moreover, the author emphasized that it is important to take two photographs, one is taken at proper voltage and the other at voltage 10 kVp. Higher in order to demonstrate whole stones whose sizes are varied.
3) Stone detectability was improved to 87.1% by using both operative cholangiogram and choledochoscopy.
4) Routine use of postoperative choledochoscopy at the time of 1-tube removal is essential, because stone not detected by T-tube cholangiography were found endoscopically in2.2% of cases with retained stones.
5) In the follow-up study, a good result was obtained in the cases in which complete stone extraction was considered to be successful by postoperative choledochoscopy. However, reoperation was found to have been performed in 13 cases, because of recurrent or retained stones. Of them three cases were judged to be recurrence. In the other 10 cases, the stones were defined as overlooked stones by postoperative choledochoscopy. Therefore, the final stone detectability of postoperative choledochoscopy was estimated at 93.3%. 6) Retained biliary tract stones can be readily managed with this endoscopic stone extraction technique in the majority of cases, but we should note that some stones will be left behind in the duct no matter how carefully the duct is explored. It is important that postoperative choledochoscopy should be repeatedly carried out if any doubts exist on roentgenological examination.

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An improved method for the purification of human placental transferrin receptor (Tf-R) was developed. Fresh human placenta was homogenized in cold acetone and the acetone powder was prepared. After the acetone powder had been washed with HEPES buffer, the insoluble proteins containing Tf-R were separated by centrifugation and dissolved in Emulgen 109P-containing buffer. Tf-R was collected by affinity binding to Tf-Sepharose and extracted by consecutive treatment with 4 different kinds of buffers. Tf-R was eluted by buffer C (2 M KC1) and buffer D (0.5 M NaSCN). Tf-R was characterized as a 90-kDa monomer on gradient SDS-PAGE (4-20%) in the presence of 2-mercaptoethanol. Though there were several minor bands of 180- and above 205-kDa, all these bands were confirmed as Tf-R by Western blotting using an anti-Tf-R monoclonal antibody (OKT 9). The apparent molecular weights, measured by HPLC using a TSK-G 3, 000 SW column, demonstrated that Tf-Rs eluted with buffer C were approximately 370-, 500- and above 500-kDa, but only a peak of above 500-kDa was found in Tf-R eluted with buffer D. Although the polymers of Tf-R with moleculer weight of above 500-kDa were resistant to trypsin digestion, the Tf-R of 370-kDa was resistantto the enzyme only when it conjugated to the diferric Tf. The stability of the polymers of above 500-kDa to trypsin digestion suggested an advantage for the repeated use of Tf-R in the endocytosis of diferric Tf, which was performed by the translocation of Tf-R between cell surface and intracellular vesicles.

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In order to know the role of the lens fiber processes and there surface morphology, scanning electron microscopic examination was performed with the lens from the normal rabbits and naphthalene cataract affected rabbit and a normal human lens.
The results are as follows:
1) Normal rabbit lens: The edge processes and lateral large processes were well developed within the areas 20 to 40 μm from the suture line and 600 μm in an extended direction from the end of the suture line. Ball and socket junctions were noted in the cortex, and globular surfaces were noted in the nucleus.
2) Naphthalene cataract: Both the edge processes and the lateral large processes were partially swollen, and the lens surface changed into the microplicae-like structure.
3) Human lens: Ball and socket junctions, edge processes and microplicae were observed. However, neither lateral large processes nor globular surfaces were observed in a human lens. In conclusion, the lateral large processes and the edge processes were the main processes for fiber-to-fiber binding attachment. Ball and socket junctions were processes for the dynamic accomodation. Microplicae and globular surfaces were degenerative changes of the lens surface.

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In this study, vascular dementia (VD, 31 cases), senile dementia of Alzheimer type (DAT, 36 cases) and mixed type dementia (14 cases) were studied by means of magnetic resonance imaging (MRI). Diagnosis of dementia was made according to DSM-III and Hachinski's ischemic score. The areas of periventricular high intensity lesions (PVH) and those of brain parenphyma were measured by digitizer which was connected to a computer.
The PVH score was obtained by dividing the areas of PVH by those of brain parenchyma at the level of the body of the lateral ventricule. A multiple variable analysis was applied to the PVH scores and risk factors for dementia using Hayashi's quantification method I.
The multiple correlation coefficient between the PVH and the risk factors was 0.685. The most significant correlation was found between Hachinski's ischemic score and the PVH score (partial correlation coefficient: 0.58). Significant correlations were also found between ADL and the PVH score (0.25), as well as between the Hasegawa dementia score and the PVH score (0.24). Using the student T test, it was shown that the large PVH group was significantly correlated to poor ADL, whereas the small PVH group was not. The large PVH group in VD showed lower Hasegawa score than the small PVH group. On the other hand, there was no such correlation in DAT.
PVH with prolongation of T2 could exist in various pathological states irrespective of their causes. Diffuse PVH tended to be frequently observed in VD together with poor ADL. It was therefore thought that brain ischemia was the main cause of PVH.

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The role of arachidonic acid in patients with acute myocardial infarction (AMI) was investigated. Plasma levels of thromboxane (TX) B₂, 6-keto-prostaglandin F₁0 (6KPG), leukotriene (LT) B₄, LTC₄, peptideLTs (LTC₄ + LTD₄ + LTE₄) were evaluated in 19 AMI patients, 2 unstable angina (UA) patients and 12 normal controls. Blood samples were obtained from the femoral and pulmonary arteries. Further, plasma levels of LTC₄ from the antecubital vein were determined in 14 AMI patients on admission and 10 healthy volunteers.
Plasma levels of TXB₂, LTB₄, LTC₄, peptideLTs from arterial blood significantly increased in AMI patients at the acute stage and one day after an attack of AMI compared with those of normal controls. TXB₂, LTB₄, LTC₄, peptideLTs levels in UA patients were higher than those of normal controls. TXB₂, LTC₄ and peptideLTs levels on week after an attack of AMI significantly decreased compared with those at the acute stage, and these values decreased to normal control levels one month after an attack of AMI. LTB₄ levels did not decrease one week after an attack of AMI but they significantly decreased one month after an attack compared with those at the acute stage. These values from the pulmonary artery were not significantly different from the values from the femoral artery obtained at the equivalent phases. Plasma levels of 6KPG did not show significant serial changes either. But the patients showing high levels of 6KPG in the acute stage showed lower levels of CPK and lower Wanger's QRS score than the patients showing low levels of 6KPG. Plasma LTC4 levels in the venous blood of 14 AMI patients were also significantly higher than those of healthy volunteers. Serum levels of lipid peroxide, α-tocopherol and superoxide dismutase activity were also measured but did not show significant serial changes in AMI patients.
These results in AMI patients suggest that LTB₄, LTC₄ and peptideLTs, which are lipoxygenase metabolites of arachidonic acid, play an important role in the pathogenesis of AMI attacks as well as TXB₂ and 6KPG, which are cyclooxygenase metabolites of arachidonic acid.

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The present study was designed to determine the superoxide production of polymorphonuclear leukocytes (PMN) in endotoxin shock and the antioxidative effect of coenzyme Q₁₀. PMN were collected from rats before and after the intravenous administration of endotoxin. PMN were also collected from healthy humans. Superoxide production of PMN was measured by the cytochrome C method. Lipidperoxide in the liver was examined by the TBA method.
Twelve hours after the intravenous administration of 5 mg/kg endotoxin, superoxide production of PMN was 13 times higher than that in the control rats, and the amount of lipidperoxide in the liver was increased. In coenzyme Q₁₀ treated endotoxin shock rats, superoxide productionwas significantly decreased, and lipidperoxide production in the liver was also inhibited. These findings suggest that endotoxin has a priming effect on the superoxide production of PMN and induces lipid peroxidation.
Furthermore coenzyme Q₁₀ has an anti-endotoxin shock effect by inhibiting the superoxide production of PMN and lipidperoxidation in the liver.

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