Myofibrous organization of the human inferior constrictor of the pharynx was analyzed in order to elucidate the relation between the deglutitive action of the pharyngeal muscles and the aging. The muscles were obtained from 19 adult humans (male 13, female 6) aged 30 to 87 years (average 68 years) . These materials were embedded in celloidin and stained with hematoxylin and eosin. The following results were obtained. 1) On the thickness of the muscular layer, the majority were thicker in the thyreopharyngeal part than in the cricopharyngeal part in males. This tendency was remarkable in aged muscle in males and in all ages in females. 2) On the number of the muscle fibers per sq. mm., the thyreopharyngeal part had more muscle fibers and the cricopharyngeal part had a little difference than the suprahyoid muscles. In the thyreopharyngeal part, the number tended to increase in aged muscles in both sexes. 3) On the muscle fiber size, the thyreopharyngeal part was smaller than the stylohyoid muscle which was the smallest in the suprahyoid muscles and the cricopharyngeal part was almost equal. The fiber size decreased over 70 years old and this tendency was remarkable in the thyreopharyngeal part. 4) On the distribution pattern of the muscle fiber size, the left shifted pattern which had high peak and the normal distribution pattern in the thyreopharyngeal part and the double peak pattern which had the low peak in the cricopharyngeal part were more predominant, respectively. 5) In both parts, the positive correlations between the fiber size and the number per sq. mm. were recognized. These muscles were differentiated into three groups with aging ; namely, the muscles which had the large fiber size comparatively contained a few fibers per sq. mm. and the muscles which had the small size contained many or a few fibers. 6) The density of the muscle fibers was equal to the most low muscle in the hyoid muscles in both sexes. In the cricopharyngeal part, the density was predominant to the thyreopharyngeal part and tended to decrease with aging. The density in some aged muscles was predominant in the thyreopharyngeal part. 7) On the pathological observation, the grouping muscular atrophy of the muscle fibers was found in half case in the thyreopharyngeal part and the scattered muscular atrophy and the appearance of the fatty cells were found in the greater number of muscles in the cricopharyngeal part. The increase of the connective tissue was found in majority of muscles in both parts and was more or stronger in the cricopharyngeal part. In the thyreopharyngeal part, the perivascular cell infiltration was observed in a third.

View full abstract

The purpose of the studies was to evaluate the construction workers' health levels. The studies consist of the mortality from all deaths, including cancer deaths and the morbidity from cerebrovascular diseases. The number of population included in the present studies amounted to 127, 470.5 person-years. The main results are as follows: 1) Malignant neoplasms were 34.3 % of 411 death cases followed by cerebrovascular diseases 18.7 % and heart diseases 12.4 %. 2) Standardized Mortality Ratio (SMR) for this population from malignant neoplasms and cerebrovascular diseases were higher statistically significant. SMRs for plaster, painter and navvy from all causes of death were higher significant. 3) Cerebral hemorrhage showed in 53 cases (25.4 %) of all strokes, cerebral infarction in 135 cases (64.3 %), subarachnoid in 21 cases (10 %) . 4) Standardized Incidence Ratio (SIR) of all strokes and cerebral hemorrhage for scaffolding was significantly higher in comparison with other occupations.

View full abstract

Human skins collected from the inguinal regions were subjected to tension, and temporal changes on their surface were observed by the replica method and scanning electron microscopy. Structural changes in the skin were also observed by light microscopy. The mean tension per unit width was 0.774 kg/mm and the maximum extension rate was 83.5 % on average. On relaxed condition relatively linear principal sulci cross each other vertically or obliquely to form tetragonal or triangular fields. Narrow secondary sulci slightly shorter than prinicipal ones cross the latter in various directions to form small irregular fields. With the application of tension to the skin, the running pattern of these principal sulci change toward the direction of the tension, gradually resulting in parallel lines. The fields become flat or fusiform. The secondary sulci sharpen and clarify, making them difficult to differentiate from the principal ones. On microscopic observation the longitudinal surface shows disappearance of the sulci, fields and dermal papilla. Collagen fibers and elastic fibers of the dermis extend toward the direction of tension and arrange in a row. By contrast, the transectional surface shows clarification of the sulci and dermal papilla in quantity and size. The fiber groups of the dermis show beehive-like patterns. From these findings, the tension applied to the skin seems to induce extension of the fibers of the dermis, leading to deformation of the dermal papilla, and to manifest as changes in the skin surface as a result of the influence of the sulci on the site of adherence between the dermis and epidermis.

View full abstract

Examining the possible usage in diagnosis of malignancies, we measured 7 tumor markers (Carcinoembryonic antigen: CEA, α-fetoprotein: AFP, Tissue polypeptide antigen: TPA, Immunosuppressive acidic protein: IAP, Carbohydrate antigen 19-9: CA19-9, Ferritin: FER, β₂-microglobulin: BMG) in the serum of 357 patients and evaluated these markers singularly and by the combination assay. Several clinical entities were obtained from the following: 146 cases of stomach carcinoma (Ca) ., 97 cases cob-rectal Ca., 6 cases of pancreatic Ca., 10 cases of biliary Ca., 10 cases of hepato-cellular Ca., 43 cases of breast Ca., 14 cases of esophageal Ca., 20 cases of lung Ca., 6 cases of thyroid gland Ca., 25 cases of benign diagestive diseases and 36 cases of hepato-biliary of pancreatic diseases in the Department of Surgery of Showa University Hospital. For the evaluation of the utility of the combination assay, sensitivity and specificity were calculated on each disease, and also the positive index ratio (PI: the balance of sensitivity and false-positive) and the diagnostic effective index ratio (DI: the division of PI and specificity) were examined. The combination assay of CEA, CA19-9 and BMG for stomach Ca., CEA and IAP for cob-rectal Ca., CEA, IAP and BMG for esophageal Ca., CA19-9 and FER for biliary Ca., CEA and TPA for pancreatic Ca., CEA and TAP for lung Ca. were assumed to be useful. There are no utilities for thyroid Ca. and breast Ca. Hepato-cellular Ca. was enough by AFP only. For all malignancies, the combination assay of CEA, TPA and BMG appeared to be useful. For early stage Ca., the combination assay was useless, but CEA and IAP suggested a few possibilities.

View full abstract

The growth of transverse maxilla and cranium after palatoplasty was studied in 10 cases. (Clinical material & Study method) Those cases were performed cheiloplasty at 80-142 days from birth (ave. 114.5 days), and palatoplasty at 361-454 days from birth (ave. 388.4 days) . Immediately after palatoplasty, one year and about three years after operation, the patients had been observed for maxillary and cranial growth by posteroanterior cephalogramm and submentovertical xeroradiographs. Marking points were as follows: (1) Maxilla ; Interval between the bilateral marking point (A) . To the inner alveolar margin, - from cleft side (B₁) . - from non-cleft side (B₂) . To the outer alveolar margin, - from cleft side (C₁), -from non-cleft side (C₂) . Interval between bilateral inner alveolar margins (D₁) . Interval between bilateral outer alveolar margins (D₂) . (2) Cranium ; Interval between wall of piriform recess (E) . Interval between medial wall of orbit (F) . Lateral wall of orbit (G) . Width of cranium in height nasion (H) . Maximum width of cranium (I) . Then the growth of maxilla and cranium had been observed and compared. (Result of the analysis) 1. Interval between the edge of bilateral palatal bone is obviously decreased. 2. There is no difference between growth of the palate both in cleft side and non-cleft side. 3. There is no difference between growth of the maxilla and cranium. This shows that palatoplasty will not disturb the growth of maxilla transverse.

View full abstract

The total protein (TP) in the blood, the albumin (Alb), the prealbumin (PA) and the concentration of retinal binding protein (RBP) were measured at regular intervals in premature infants between time of birth and 34 days of age, and a study was made on the significance of those measurements as nutritional indexes. The sample consisted of 64 newly born premature infants who had a gestational age of 25-42 weeks. The infants were divided into five groups: Group I consisted of 12 extremely immature infants whose birth weight was less than 999g, Group II of 10 very low birth AFD infants whose birth weight was 1, 000-1, 499g, Group III of 29 AFD infants whose birth weight was 1, 500-2, 499g, Group IV of six very low birth SFD infants whose birth weight, was 1, 000-1, 499g, and Group V of seven SFD infants whose birth weight was 1, 500-2, 499g. These infants, with the exception of those in Group I, had neither feeding difficulties nor complications such as respiratory distress, infections, or PDA. Regarding the types of plasma protein at birth, a positive correlation was confirmed between TP and Alb on the one hand and birth weight and gestational age on the other, with a wigh correlation with gestational age. No significant correlation was recognized between PA versus birth weight and gestational age, but the SFD group had a significantly lower PA value than did the AFD group. In addition, a significant correlation was confirmed between fetal growth condition and weight. The RBP value tended to be lower in the SFD group than in the AFD group, but it was not signficant. Regarding the various kinds of plasma protein in the early postpartum period, the AFD group was affected by the influence of a physiological loss of weight leading to an increase in the RBP concentration in the blood, but the SFD group experienced a decline in RPB concentration without showing any decline in body weight. A significant negative correlation was recognized between the changes in ratios of TP and Alb on the one hand and rate of change in body weight on the other. An investigation into subsequent changes in the protein plasma yielded no significant changes, except for a tendency for TP and Alb to decline in Group I, nor was there any relation with the amount of intake of protein calories. With the exception of Group I, in which there was a low intake of protein calories, PA showed a significant increase in all cases when the intake of protein exceeded 2g/kg/day. There was also a significant correlation with the amount of intake of calories. Except for Group I, in which a tendency was recognized for RBP to decline, no significant changes were noted in any other groups, and there was no relation between RBP and the amount of protein calorie intake. This study showed that PA can be regarded as the most sensitive nutritional index for the fetus in the latter stage of pregnancy. There is a possibility that TP and Alb are greatly influenced by non-nutritional factors. In the early postpartum period, there is little significance of the nutritional indexes of the plasma proteins, but after that period a relationship was confirmed only between protein calorie intake and PA, so it can be regarded as a sensitive reflection of the nutritional condition after birth. TP and Alb lack sensitivity as indexes, and there is a possibility that RBP is influenced by nutritional factors other than protein.

View full abstract

Human ductus arteiosus was studied histopathologically in 28 infants who had been diagnosed prolonged patency clinically, and in 70 infants without diagnosis of prolonged patency. The increased amount of elastic fiber in intimal cushion and subendotherial laminer elastosis was observed in almost all cases of persistent patent ductus arteriosus. These seemed more distinctive when the persistent period was elongate. On the other hand, in the seventy infants without prolonged patency, ductus showed slight increase of the elastic tissue in intimal cushion in proportion to gestational age and there was no distinctive subendotherial laminer elastosis. It is suggested that hemodynamic stress to the ductal wall play a singificant effect to increase the elastic fiber in the intimal cushion and development of the subendotherial laminer elastosis.

View full abstract

Functional and clinical roles of collateral (Coll) circulation were studied by exerciseT1-201 myocardial scintigraphy in 52 patients with myocardial infarction in comparison with CAG and LVG. Coil was classified into three types, good, poor and none. LV wall motion was divided into 6 groups according to criteria of AHA. Exercise test was carried out using an upright bicycle ergometer by a continuous multistage protocol. Radionuclide was injected twice, immediately and one hour after exercise, and images were also taken twice and compared each other visually by plural observers. Of 18 patients with good Coll, 9 showed persistent defect (PD) and remainder revealed redistribution (RD) . In patients with poor Coil and none, 20 out of 26 cases associated with dys- and akinetic LV wall motions than those with RD. And in group of PD, any one with poor or no Coil did not show normal wall motion. But in group of RD, one third of cases revealed normal LV wall motion even in patients without Coll. In conclusion, good Coil is suggested to preserve blood flow at rest. If RD is showed in cases of good wall motion with poor or no Coil, heart muscle is conceivable to be viable by small vessels less than 200μm. To estimate clinical significance of Coil and viability of heart muscle in each cases, it is nessesary to compare findings of scintigrams with CAG and LVG.

View full abstract

Effects of electroacupuncture on the EMG activity of the tail muscle (M. extensor caudae medialis, ECM) elicited by noxious heat stimulation of the tail were investigated in lightly anesthetized rats. When electroacupuncture stimulation (EAS) was applied to the Zusanli point, which is one of the meridian points, at 50 Hz for 30 min, the EMG activity rapidly decreased to about 45% of the control during the first 5 min of EAS; this value continued during EAS for 30 min. After cessation of EAS, the decreased EMG activities recovered to the control level after 40-50 min. The EMG activities were statistically significant as compared with the control during EAS for 30 min and until 30 min after its cessation (P<0.05, t-test two-tailed) . EAS at various frequencies resulted in the decrease of the EMG activity with the increase of the pulse frequency. However, the EMG activity was almost equal to the frequency over 25 Hz. These results suggest the following: (1) the EMG activity of ECM muscle is a quantitative and electrophysiological indicator in the estimation of electroacupuncture effect; (2) frequencies over 25 Hz are more effective on electroacupuncture effect.

View full abstract

Platelet function on liver damaged models using a experimental animal was studied by a Lumi-aggregometer. The liver damaged animal was produced by single administration (p.o.) of carbon tetrachloride, CCl₁to the S.D. rat. CCl₄was mixed with equal volume of olive oil and this solution was administered to the rat. Platelet aggregation and secretion of ATP as platelet functions were searched by use of a Lumi-aggregometer which had advantage to determine both of functions in whole blood instead of platelet rich plasma. Platelet aggregation and secretion of ATP were triggered with collagen (final concentration : 2μg/ml, 5, μg/ml) and ADP (final concentration : 5μM, 10μM) . Simultaneously platelet number by Coulter counter and total coagulative process by thromboelastography were measured. 24 hrs after administration of 1.5ml/kg CCl₄, platelet aggregation and secretion of ATP were decreased with 5μg/ml of collagen, but with 2μg/ml of collagen, platelet aggregation was increased 120 hrs after 1.5ml/kg CCl₄ administration. On CCl₄3ml/kg administered rat groups, there was no significant change on platelet aggregation, but 24 hrs after administration of CCl₄3ml/kg, secretions of ATP with both collagen 2μg/ml and 5μg/ml were increased. Platelet number was decreased 24 hrs after administration of olive oil 3ml/kg and 72 hrs after administration of CCl₄3ml/kg. Platelet aggregation with ADP 5μM was decreased 48 hrs after administration of 6ml/kg olive oil, and 120 hrs after administration of 3ml/kg olive oil, ATP secretion with collagen 5μg/ml was decreased. R values on TEG were increased 120 hrs after administrations of 1.5ml/kg CCl₄and 3ml/kg olive oil. K values on TEG were also increased 24 hrs after administrations of 3ml/kg olive oil and 1.5m1/kg CCl₄, and 120 hrs after administrations of CCl₄and olive oil. Ma values on TEG were decreased 24 hrs after administrations of 1.5ml/kg and 3ml/kg CCl₄. There were some changes on CCl₄ administered groups about the platelet aggregation, the secretion of ATP, and the values of TEG, but there were also resembled changes on olive oil administered groups. Effects on CCl₄ administered groups might have been modulated by olive oil as solvent.

View full abstract

Primary small cell carcinoma of the esophagus is rare, and its prognosis is very poor. This report deals with a case, 66 years old female, with primary small cell cacinoma of the esophagus who died of dyspnea and cachexia. She was admitted to Kawasaki co-op. hospital because of dysphagia and diagnosed as esophageal cancer. Histopathological diagnosis of biopsy specimens from the esophagus was oat cell typed small cell carcinoima. Electron microscopical examination revealed the dense-core membrane-bound neurosecretory granules (N.S.G.) in the tumor cytoplasms. Right after the diagnosis, preoperative irradiation was performed and the size of primary tumors was reduced. After the irradiation therapy, surgical excision of legions involving the esophagus and chemotherapy were performed. But she died of dyspnea and cachexia caused by tumor metatases at 11 month after the diagnosis. In sugical materials, the tumor cells increased in size compared with biopsy finding. By electron microscopy, the tumor cells contained some N.S.G.. By microscopical examination of autoptic materials, the tumor cells findings closely resembled those from surgical materials, but no N.S.G. could be found out by electron microscopic examination. It was suggested that these morphological changes were caused by irradiation and chemotherapy. In spite of the small cell carcinoma has a high sensibility to irradiation, complete control of the tumor with only irradiation is very difficult. It will be necessary to make a plan of new treatment for a such case.

View full abstract

During last 10 years, there were 19 cases of submucosal tumor in our sugical department. 2 cases of them were leiomyosarcoma (10.5 %) . Case 1) a 74 yrs male. Bloody stool was the only finding. Subtotal gastrectomy was carried out because there was no metastasis could be found by C.T. scan and angiography. But finally, he died of due to liver metastasis 2 yrs later. Case 2) a 44 yrs male. His finding was a mass at left upper abdomen. Partial gastrectomy and partial resection of liver and pancreas was done. The radical operation could not be done, because of direct infiltration to the peritonium. After the operation, we gave him anti-cancer chemotherapy. But all efforts were in vain, he died at 88 post operative day. Both cases were diagnose by means of endoscopic biopsy of the lesions with the central fistla. The size of both tumor were bigger than 5 cm in diameter.

View full abstract

Though some scholars including Gibbses studied about the variation of sleep spindle, few payed attention to its frequency. On the other hand, until now, many investigations were reported about the EEG abnormality of atypical psychosis, but few of them were studied on its sleep EEG. Recently, we had a chance of recording sleep EEG of a case of atypical psychosis. Her EEG finding was interesting for spindles of disproportionate frequency to its sleep stage during clinical acute period. Then, we present a part of her EEG and some considerations.

View full abstract

In March 1984, a 56-year-old male was admitted to our hospital because of epigastralgia. An esophagofiberscopic examination revealed an erosive lesion about 35 cm distal from the upper incisors and biopsy specimens showed squamous cell carcinoma. By X-ray examination, a small lesion with granular appearance and irregular shaped mucosal relief was demonstrated. Endoscopic findings with Lugol staining method clealy showed non-stained, slightly depressed area indicating a pathological change. Total esophagectomy with gastic tube reconstruction was carried out at Showa University on May 16. Postoperative histological examination showed moderately differentiated squamous cell carcinoma, 22×28 mm in size, ly (-), v (-), and stage 0 (mm, n (-), M₀, Pl₀) . For the detection of early esophageal carcinoma, careful examination using X-ray and repeated panendoscopic examination with aids of Lugol staining and biopsy have strongly practical value.

View full abstract