[in Japanese]

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The delayed cutaneous hypersensitivity test with picryl chloride was used to demonstrate the influence of various kinds of antitumor agents on cellular immunity in mice. Each agent was intraperitoneally administered once daily for 5 days before or after the sensitization with picryl chloride. 1) Influence of alkylating agents: Pre-treatment of mice with carboquone or cyclophosphamide proved to enhance the delayed-type hypersensitivity (DTH) . On the other hand, post-treatment suppressed the DTH. 2) Antimetabolites: Although cyclocytidine and cytarabine showed no effect, azathioprine, 5-fluorouracil, 6-mercaptopurine, methotrexate and tegafur suppressed DTH by the post-treatment. The suppressive effect of 5-fluorouracil showed tendency towards recovery by the administration of schizophyllan. 3) Antitumor antibiotics: Among 10 kinds of antitumor antibiotics tested, pre- or post-treatment with anthramycin and pre-treatment with bleomycin were found to suppress DTH. 4) No significant suppression was observed in the cases of vinblastine, vincristine, L-asparaginase and cisplatin. 5) Prednisolone and cyclosporin A inhibited the reaction by the post-treatment. 6) Immunopotentiating agents: Marked enhancement of DTH was recognized by the interaperitoneal injection of schizophyllan and krestin before or after the sensitization with picryl chloride.

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It is well known that dermal tension affects bones. In order to determine the effects of serial excision, the auther examined craniofacial bones in 177 rats grouped by body weight (50, 100, 200 and 400 g) 3 and 6 months after their cheek skin had continuously stitched 3 times for a period of 3 weeks each time. The degree of deviation toward an operation side was seen greater in younger rats undergoing operations on only one side. Lesser deviation was found in the 6-month observation than in the 3-month observation, and this difference was greater in younger rats. These results suggested that tension on the skin would become relaxed even through that tension was strong at first, and that bones tended to return to their original growth patterns. No deviations were observed in rats which were operated on both sides. No changes in bone growth to an anterior or posterior direction were found in either rats operated upon on one or both sides.

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The argon laser has made an important contribution to the treatment of portwine stains (PWS) . Since the initial work of Goldmann et al, in 1968, studies carried out by many reserchers have been limited almost to the clinical effect of laser beam. PWS are common congenital vascular lesions appearing mainly on the face. Therefore, it is difficult to establish histological effect after exposure of the laser beam to the lesion, especially the relationship between the extent of the destuction of the tissue and the power of the leser beam. And there have not been a report of the condition of surface ultrastructure of human skin with PWS after laser treatment. In this study the author tried to assess the influence of laser beam upon the PWS. In the light microscopic study laser beam reached only the superficial layer of the dermis in the biosy specimen which was obtained clinical result and also in the biopsy specimen which was obtained immediately after experimental laser irradiation in several level of power. In the scanning electron microscopic study by Replica preparation, surface of the skin normally reveals, furrows forming triangular or rectangular fields. Such ultrastructure was destroyed after laser treatment, but these normals skin furrows retruns after one to three months. And if th skin revealed much subcutaneous scar or hypertrophic scarring, the skin field or furrows have been destroyed in propotion to the amount of scarring, which describe texture objectively.

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A possible relation between the elongation of the neurite (morphological differentiation) and the electrical maturation of the membrane (functional differentiation) in neuroblastoma clonal NS-20 cells was studied using serum-free medium, and the medium containing dibutyryl cyclic AMP, or aminopterin. The cells displayed round or spindle in shape (undifferentiated cells) in the normal growth medium. However, in the three kinds of experimental media, the neurites elongated rapidly in the early developmental stage, and their lengths increased gradually to a steady level in the late developmental stage. The range of responses to electrical stimulation varied from the passive response and the delayed rectification to the active response. The rapid elongation of the neurites was accompanied with increasing of resting membrane potential and membrane resistance in the early stage, but the cells producing the active response appeared in the late stage. Finally, most of the differentiated cells came to generate the active response. These results suggest that (1) morphological maturation of NS-20 cells was succeeded by electrical maturation of the cell membrane, and acquisition of the membrane excitability was not always coincident with the morphological differentiation, and (2) the developmental sequence of the membrane excitability was in the following order: the passive response, the delayed rectification and the active response.

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A) Using ^99mTc-Human-Serum-Albumin (HSA) accumulation curve we have studied the blood flow in the lower extremities of the hemiplegic patients.
After injection of 5-10 mCi of ^99mTc-HSA into v. mediana cubiti by the Oldendolf method, we recorded the RI count from both knees. We have examined 68 hemiplegic patients (male: 26, female: 42, right: 31, left: 37, average age: 61.7 years, average Brunnstrom stage of the lower extremity: 3.73, average duration post-stroke: 20.2 months) . We counted the accumulation of the isotope in both knees 1 and 30 minutes after injection, and calculated the percentage (partic side/right and left sides), and named them as “1-minute value” and “30-minute value”.
RESULTS
1) During the 15 months period after an attack, the paretic leg had more blood flow than the non-paretic leg.
2) After 15 months after attack, on the contrary, the paretic leg had less blood flow than the non-paretic leg.
3) This tendency is clear in the left-sided hemiplegic patients.
4) There is no relation between the blood flow and age, and the Brunnstrom stage, and the ability to walk.
B) Using digital plethysmography, we have studied the blood flow in the finger and toe, too. We have examined 57 hemiplegic patients.
We have averaged the five hights of the wave (mV/V), and calculated the percentage involved (paretic side/right and left) and labled it “the paretic blood flow value (of the finger and of the toe) ”.
RESULTS
1) During the 12 month period after an attack, the paretic side had more blood flow than the non-paratic side.
2) After 15 month after an attack, on the contrary, the paretic side had less blood flow than the non-paretic side.
3) This tendency is clear in the finger than the toe.
4) There is no correlation between the blood flow and the age, and the Brunnstrom stage, and the ability to walk.

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Using experimental rats, initial stress operation, i.e. excision of the skin was done in buccal region at 50 gr of average body weight, then the stress was released. In the first group, the stress was released at 100 gr of average body weight and in the second group at 200 gr. Three months after the initial stress operation, the rats were sacrificed for gauging. The third and fouth group were the control of the first and second group respectively. The result showed that deviation of craniofacial bones was found to he corrected almost in the normal range. Though this correction was not clinically perfect, but the deviation might be negligible.

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By means of the X-ray CT (computed tomography) images, the body compositions on the cranial border plane of the sternum, the midpoint plane of the sternum and the xiphoid plane of the sternum were studied in 26 adult humans (10 males, 16 females) . On the each plane, the following items were measured; the cross-sectional area of the subcutaneous fatty layer, the muscle and bone layer and the thoracal cavity, the sagittal diameter of the thorax and the thoracal cavity, the transverse diameter of the thorax and the thoracal cavity. And about the each component, the differences in the sexes and in the body types and the changes due to the aging were discussed. The following results were obtained. 1) Total cross-sectional area of the thorax; in both sexes, the total areas were in the order D-type>C-type>A-type on the each plane. On the comparison between the body types, in male D and C-type, the areas were in the order on the xiphoid>on the midpoint>on the cranial border. In male A-type and in all females, the areas were in the order on the midpoint>on the xiphoid>on the cranial border. 2) Ratio of the each component; in the all types, the ratios were in the order the muscle and bone layer>the subcutaneous fatty layer>the thoracal cavity on the cranial border and were in the order the thoracal cavity>the muscle and bone layer>the subcutaneous fatty layer on the midpoint and on the xiphoid in both sexes. The differences between the muscle and bone layer and the subcutaneous fatty layer showed the tendency to decrease in the order A-type, C-type, D-type. 3) Changes due to the aging; in males, on the each plane, the muscle and bone layer reduced apparently and the differences from the subcutaneous fatty layer decreased with aging. In over 60 years of age, on the xiphoid plane of the sternum, the both layers were approximately equal. The difference of the ratio between the thoracal cavity and the subcutaneous fatty layer changes reversely. In females, no differences with aging were observed on the each plane. 4) Comparison of the sagittal and the transverse diameter of the thorax and the thoracal cavity; both diameters of D-type were larger than that of the other types in both sexes. In the D-type, on the cranial border, the sagittal diameter of the posterior part in males and that of the anterior part in females tended to increase. And on the midpoint, the sagittal diameters of the both parts in males and that of the anterior part in females showed the same tendancy. On the xiphoid plane, the sagittal diameters of the both parts were larger in D-type than that of the other types in both sexes. Furthermore, in males the transverse diameter was also larger than that of the other types. 5) Changes of the diameter of the thorax with aging; in males, the tendencies to increase with aging were observed in the sagittal diameters of the both parts but not in the transverse diameter. In females, no changes with aging were observed in the sagittal and the transverse diameter. 6) From the results stated above, for the factors of the increase or decrease of the cross-sectional area in the thorax, the change of the diameter of the thoracal cavity affected rather than that of the thickness of the thoracal wall. In addition, the subcutaneous fatty layer caused by the decrease of the muscle and bone layer with aging affected mostly.

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Using non-invasive procedures the authors tried to determine exercise-induced changes in LDH (EC 1. 1. 1. 27) activities and LDH isozymes in the tissues and blood of marathon runners by urine assay. Urine samples obtained from 5 well-trained male volunteers ranging in age from 22 to 57 were collected before running and at 0, 1/2, 1 and 2hr after completion of a marathon. Urine LDH activity was determined. LDH isozymes were separated by agarose electrophoresis, and the portion of LDH-H activity and percent of LDH-H/LDH were estimated. Immediately after the marathon, total LDH activity was significantly (p<0.001) elevated from 2.23±1.45 to 9.89±5.90μ moles· min^-1· per gram of creatinine (X±SD), while the percent of LDH-H/LDH significantly (p<0.001) decreased from 95.50±8.99 to 74.95±11.38% (X±SD) . These values returned to the baseline level within 2hr.

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The serum and urine of a healthy male adult, before and after a 12-min running test, were fractionated by gel filtration on Sephadex G-200, and the effect of exercise on LDH isozymes was examined. The LDH activity of the urine was fractionated into 2 parts, main and sub-fractions, by gel filtration of the post-exercise urine, pre-exercise serum and post-exercise serum, but gel filtration of the pre-exercise urine yielded only the mainfraction. The Michaelis constant (Km value) for LDH against lactate in mainfraction was 2.1mM for serum and 5.3mM for urine before exercise, and 4.5mM for serum and 8.0mM for urine after exercise. The molecular weights of the mainfraction and subfraction LDH from gel filtration of post-exercise urine, determined from the standardization curve with standard protein, were approximately 123, 000 and 660, 000, respectively.

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The changes in the proteins in the blood and urine after a marathon running were examined in the 5 male athletes, by the precipitin assay, using the ratio of γ-globulin clearance to transferrin clearance, as the selectivity index. Exercise caused a significant increase in transferrin clearance (p<0.05), while inducing only an insignificant increase in γ-globulin clearance.
The selectivity index rose from significantly 0.38±0.15 before exercise to 0.78±0.28 (mean ± standard deviation) after exercise, (p<0.001) . Urinary lactic acid, albumin, β₂-microglobulin and creatinine were simultaneously determined and analyzed.

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A 21 year-old man visited to our hospital on September 28, 1984, with complaints of pyrexia, lower abdominal pain and watery diarrhea for five days. He noticed m elena and was admitted on the next day in spite of the treatment with antidiarrheic agents. Colonscopy revealed edema, friability and multiple erosions on mucosa continuously from the rectum up to the junction of the sigmoid and the descending colon. Barium enema also showed diffuse granularity and spicula formation from the rectum to the transverse colon. As the morphological findings of colonoscopy and Barium enema were similar to those of ulcerative colitis, we couldn't decide the final diagnosis without bacteriological examination of the stool. Campylobacter jj was isolated from the patient's stool on the 4th hosptal day, and he was diagnosed of Campylobacter colitis. The patient's condition steadily improved by oral administration of Nalidixic acid and hewas discharged on August 18, 1984. According to the recent reports of infectious disease, Campylobacter fetus jj is isolated in the highest frequency from human infectious enterocolitis using Skirow's selective medium. Morphologically, campylobacter colitis is reported to show varied endoscopic findings which resemble to ulcerlative colitis or Crohn's disease. Then we must remember the presence of Campylobacter colitis when we find inflamatory lesions which are similar to ulcerative colitis or Crohn's disease. We wish to emphasize the need of bacterial culture in diagnosis of colonic disease.

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A 11-year-old man, suffering from chronic tympanitis, was anesthetized for tympanoplasty using thiamylal, succinylcholine, nitrous oxide and enflurane, but the operation was stopped because he developed malignant hyperthermia (MH) . MH was succesfully cured with intravenous infusion of dantrolene. One year later he was admitted to our hospital again for the reoperation of tympanoplasty. Because of his episode of MH, we had done prophylactic oral administration of dantrolene preoperatively. As for the anesthesia, we avoided the use of succinylcholine and volatile inhalational anesthetics such as halothane enflurene, and as the anesthetic method to prevent MH, we chose neuroleptanesthesia using droperidol, fentanyl, diazepam, pancuronium bromide and nitrous oxide. On this operation we could prevent MH and the operation was uneventful. The mortality rate of MH has raned highest among complication of modern anesthesia. Therefore when the anesthesia was scheduled for the patient who had episode of MH, we must avoid the use of depolarizing muscle relaxant and volatile anesthetics, and we recommend preoperative prophyactic oral administration of dantrolene and neuroleptanesthesia using droperidol, fentanyl, and pancronium bromide.

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We reported a case, 71, years old male, with malignant histiocytosis who died of splenic rupture. He was admitted to our hospital because of fever, anemia and hepatosplenomegaly. Laboratory findings were as follows; Hb 11.7 g/dl, pits 11.7×10⁴/μl, WBC 6200/μl. Bone marrow finding showed 20.2% of tumor cells which morphology revealed characteristics of histiocyte. We treated only with 40 mg/day of prednisolone. On the 21 hospital days, he suddenly developed severe acute abdominal pain with hyprovolemic shock and died soon. Pathological findings were as follows: The spleen was ruptured. Diffuse infiltration of tumor cells which showed erythrophagocytosis were existed in bone marrow, liver, spleen and lymph node.

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A 64-year-old woman was admitted to a hospital because of cerebral infarction and rheumatoid arthritis in June, 1979. The chest X-ray revealed left atrial calcification and examination showed a heart murmur. She was admitted to our hospital for cardiac catheterisation in June, 1984. On admission, blood pressure was 124/66 mmHg, and pulse rate 66 per minute and irregular. Examination showed a diastolic murmur at the cardiac apex, no pulmonary rales and no edema, NYHA class III. E.C.G. showed atrial fibrillation and right bundle branch block. Chest CT scan revealed extensive calcification of left atrial wall. P.C.G. showed a diastolic rumble. U.C.G. showed decrease of mitral DDR, typical wave of mitral stenosis but no dilatation of left atrium. The cardiac catheterisation showed good contraction of left ventricule and an ejection fraction of 0.85, no contraction of left atrium and no motion of mitral valve. Hemodynamic parameters were within normal limits except cardiac index (1.8 l/min/m²) and pulmonary capillary wedge pressure (18 mmHg) . Coronary angiography showed triple vessel disease. It is necessary to discuss the influence of left atrial extensive calcification on hemodynamics.

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