The quantitative changes of T cell and Plasma cell Series were investigated in 70 cases of chronic nonspecific lymphadenitis. 7 groups according to the age were classified as follows; 1) 0-9, 2) 10-19, 3) 20-29, 4) 30-39, 5) 40-49, 6) 50-59, 7) 60 or more aged. Materials were lymph node imprints which had been done ANAE staining. According to ageing, the gradual diminution of T cell was seen. 40-49 aged group was shown a sudden and remarkable T cell decrease. Both various reports of peripheral blood and this investigation using ANAE staining of lymph node imprints might suggest the dysfunction of cellular immunity of the aged. On the contrary, Plasma cell Series had no distinct correlation to the ageing.

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ANAE and ATPase stains were done in 16 cases of chronic nonspecific lymphadenitis. The cases which contain many ANAE-droplet positive cells were shown low percentage of ATPase positive cells. On the contrary, the cases which predominate ATPase positive cells were decreased ANAE-droplet positive cells. In addition, there were seen the correlation of reactive pattern in lymph nodes between quantitative change of ATPase positive cells and that of ANAE-droplet positive cells, that is, ATPase activities and follicular hyperplasia, as well as ANAE activities and enlargement of paracortical area (T zone) . In order to investigate quantitative change of T and B cell in lymph node diseases, it is necessary to use the combined method, that is, specific stains for T and B cell.

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Lymph node imprints in 12 cases of CLL of B cell type were examined by using ANAE and ATPase stains. In all cases it was shown diminution of ANAE activity, whereas ATPase activity was remarkably increased. It was suggested that ANAE activity might be served as T cell marker, in the same way, ATPase stain could be helpful as a B cell marker. Further investigation should be needed to estimate whether ATPase stain might be available as B cell marker in the other cases of lymph node disease.

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Amitriptyline (AMT) and Imipramine (IMP), representative anti-depressants, were given singly or combinedly to 38 outpatients showing the depressive states. By the use of subjective test (DRS-S78) and objective test (HRS), review was made on the related changes of symptoms and concentration of the drugs. For the mesurement of serum level, reference was made for the full and exact also simple methods even in combination of many agents by the use of HPLC. In application of these methods, these cases were checked at the time initial examination, 1 st, 2 nd, 4 th week, then, the change in timecourse was pursed, therby, several conclusions obtained were as follows: AMT showed dose-dependent effect, and its clinical effect was seen after the second week of administration, and judgement was possible for the therapeutic efficacy at the 4 th week. IMP did not show any dose-dependent efficacy, but its clinical effect was observed when serum level reached 100 ng/ml, and also, it took over 2 weeks until a constant state was obtained. In combinned use of AMT with IMP, AMT was hardly affected by the effect of IMP, and similar tendency to that of single administration was observed, while IMP showed some differrences in the reactivity and single administration. Thus it is necessary to select the suitable cases. Also, in case of single administration of IMP, it is meaningless to increase the dosage recklessly, and it is necessary to establish rational plan for administration. It is very effective to evaluate the change in time course of the symptoms in order to evaluate the drug by the use of DRS-S78 and HRS. By the combined use of RS with the mesurement of serum level, earlier estimation of therapeutic effect can be obtained as compared with the conventional method. Accordingly, the mesurement of serum level of the therapeutic drug for treating the depressive state can be a powerful index for therapy.

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To investigate three-dimentional ultrastructures of the muscle and tendon junction, the rectus femoris muscle, vastus lateralis and gastrocnemius muscle, rabbits's muscles were observed by scanning electronic microscopy (SEM) . The changes in this junction were observed during muscle contraction and relaxation. The observation by an optical microscopy were also made to obtain additional information. 1. The muscle tissue could be relatively clearly distinguished from the tendon tissue. They did not overlap each other. 2. The tendon appeared to form a plate-like shape at the junctional area and a unilateral site (boundary surface) of the tendon connected with the tip of the muscle. At the binding site, the tip of the muscle fiber and myofibril connected aslant with the boundary surface of the tendon. 3. The binding status between the muscle and the tendon was observed only at the sagittal surface and a frontal surface of the muscle. A transverse section of the binding site was unable to observe. 4. The connective tissues of the muscle such as endomysium and perimysium were transferred to collagen fibers of the boundary surface, and the muscle and the tendon were cennected through collagen fibers. 5. The tip of the muscle fiber runnel aslant to the boundary surface of the tendon, where each myofibril connected with the boundary surface of the tendon by a fine collagen fiber. Myofibrils were bound to each other with T-system. 6. The terminal end of the myofibril was Z-membrane. A fine collagen fiber connected with the terminal sarcomere, and thereby connected the boundary surface of the tendon with myofibril. 7. On the observation of the sagittal surface of the muscle, an angle of the incidence of the muscle to the tendon increased during muscle contraction and decreased during relaxation.

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A noise induced reaction of peripheral vasoconstriction was made an indicator as one of influences of noise to cardiovascular system. This reaction have be studied with plethysmography by many reserchers. In our reserch, we carried out experiments concerning with 2 groups, one consists of 42 women living in a quiet residential section and the other consists of 86 women living in a big road side. As for noise used in the experiments, a sound with a trapesoid envelope appears 6 times with about one minute cycle. The trapesoid noises are 65, 75, and 85 dBA of peak levels, about 10 dB/s of rising and decay speed, and about 10 seconds of a duration time. The plethysmography as the indicator of a peripheral vasoconstriction was continuously observed and recorded to a data recorder. Results are: 1) This reaction becomes more stronger as the noise level is more higer. 2) This reaction to a white noise is more stronger than one to a pink noise. 3) This reaction to a big road side inhabitant was more stronger than that to a quiet residential section inhabitant under conditions of a noise level and kind of noise. These results agree with the results of other reserchers. With this results, a reaction appeared obviously under the conditions of the noise levels among 65 and 85 dBA. And this reaction may be a proper index that examines an influence of road side inhabitant by a road traffic noise.

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Carboquone (CQ) and Cytosine Arabinoside (ara-C) were instillated intravesically in 35 patients with superficial bladder tumors. The combination of these drugs were clinically effective in 12, moderately effective in 13, slightly effective in 1, and ineffective in 9. The bladder tissues from these patients taken at surgery or biopsy were studied using light and electron microscopy. The findings were compared between the specimens taken before and after the instillation. In the instillation-effective cases, main findings after the treatment were deciduation or necrosis of tumor cells, swollen nuclei, swelling of mitochondria, and a decrease in chromatin, Golgi apparatus and free ribosomes, with a stronger tendency in the layers nearest the superficial layers of tumors. In the instillation-ineffective cases, these cytological changes after the treatment were only occasionally observed in the superficial layers of tumors. Most of the tumor cells, especially in deep layers, were unchanged. In 4 of the instillation-ineffective cases, the grade of tumor malignancy was exacerbated after the treatment. We consider that the intravesical administration of carcinostatics is, as is the ordinary cancer chemotherapy, more effective when combined with several agents, and when the proper patients were selected, i.e., in cases of the instillation therapy, those patients with well differentiated and small tumors with diameters of 1 cm or less.

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Concerning the changes of primary necropsy diagnosis, pathological studies were done on 144 very low birth weight infants. And 104 cases, after NICU induction, were examinaed for pathological findings correlating with the causes of death. 1; The necropsy cases of very low birth weight infants were increasing in the neonatal necropsy cases. 2; After the NICU induction, HMD, BPD, SEH/IVH, infections had increased, whereas aterectasis and massive pulmonary hemorrhage had decreased, in primary necropsy diagnosis. 3; In pathological findings, respiratory disease is still found frequently, and which might suggest on difficulties in respiratory care. SEH/IVH is a significant disease, and increase in numbers. Infections, chiefly sepsis, are increasing rapidly and 90% of them are late onset type. And they are less complicated with SEH/IVH, and have a good possibility of being survived without sequlea unless they are infected. 4; Infections are often find SFD rather than AFD, but HMD and SEH/IVH do not have that of tendency. Anomaly is the significant cause of death for SFD, those birth weights are between 1250-1499 g. 5; The correlation of primary necropsy diagnosis and secondary pathological findings reveals as follows. Pulmonary aterectasis, HMD are primary anoxic pulmonary lesions, which often complicate SEH/IVH, secondary. Severe SEH/IVH as primary necropsy diagnosis often complicate hyaline membrane formation and other hemorrhagic lesions. Infections often complicate pneumonia, BPD, and adrenal hemorrhage.

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Considered from the viewpoint that gastric cancer has late recurrence, the late recurrence, i.e. recurrence from 5 years after resection of gastric cancer, means that gastric cancer cells are in an advantageous situation allowing 5 years of survival at the time of surgical operation and that they have concurrently risk factors developing recurrence. Elucidating the factors which are considered to affect late recurrence is important in establishing the surgical procedure and adjuvant immuno- and chemotherapy for improving the prognosis after resection of gastric cancer. Using 740 cases with curative resection of gastric cancer at this department (March, 1956-December, 1981), we compared cases of late recurrence with the control cases, that is, cases of early recurrence that had the recurrence not more than 2 years after resection and cases of middle-period recurrence, 2-5 years after resection, and made a clinicopathological study. Recurrence after curative resection was found in 261 cases, the breakdown of which: 157 cases (60.1%) of early recurrence, 74 cases (28.4%) of middle-period recurrence and 30 (11.5%) of late recurrence. Late recurrence corresponded to 4.1% of the cases with curative resection. The number of cases of recurrence by the number of years elapsed after curative resection reached 60% of all cases of recurrence up to 2 years after resection, gradually decrease thereafter and was only 1 from 10 years after resection. Cases of recurrence up to 2 years were found many in cases with relative curative resection and cases of recurrence from 3 years were found many in cases with absolute curative resection. As to 10 factors condidered to aftect prognosis after resection [location of cancerous lesion, macroscopic type, size (major diameter), depth of invasion, histologic type, lymph invasion, vascular invasion, lymph node metastasis, infiltrative growth (INF), histologic stage], statistical analyses and comparative studies were made in 3 groups, namely, the early recurrence case, the middle-period recurrence case and late recurrence case. The results showed the incidence of late recurrence to be high in M and A of location of cancerous lesion, 0 and 5 type of macroscopic type, m, sm and pm of depth of invasion, v (-), n (-), INFα, and stage I . These characteristics were similar to those of cases with 10-year survival after curative resection of progressive gastric cancer at this department. Cases of late recurrence are in an advantageous situation that allows a relatively good prognosis. However, they have a slightly disadvantageous risk factor compared with cases with 10-year survival. Presumably, that is why they has recurrence from 5 years after resection. Furthermore, a difference in the time of recurrence as viewed by the absolute curative resection and relative curative resection was studied in relation to 3 factors, namely, depth of invasion [ps (-), ps (+) ], lymph node metastasis (n₀+n₁, n₂+n₃) and stage [I + II, III+IV] . As a result, it was made clear that is a tendency for the frequency of absolute curative resection to increase and for the frequency of relative curative curative resection to decrease with a shift from early recurrence to late recurrence in each factor and that s-factor more influences on the prognosis (recurrence) than n-factor. As for the site of recurrence (total number inclusive of main and sub-site of recurrence) in late recurrence, the recurrence was found the most in the peritoneum 12 cases (24.5 %) and lymph nodes 11 (22.4 %), followed by the liver 8 cases, bones 6 cases, subhepatic space 4 cases, remnant stomach 3 cases and lungs 2 cases. In any case, late recurrence is characterized mainly by the low resicual rate of cancer at the time that surgical operation has been performed.

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For evaluating the influence of air pollution on health, a monitoring system was adopted by the regional Medical Association in K city. By the monitoring physicians, the number of patients with asthmatic bronchitis (AB), chronic bronchitis (CB) and bronchial asthma (BA) and also the total number of patients reported on one fixed day every month. The ratio of the patients mentioned above to the total number of patients (RPT) was calculated for 10 years. The relationships between these ratios and air pollution concentrations were evaluated by statistical methods. The results were as follows: 1) By correlation analysis, statistically significant relationships were found between AB and SO_x, NO₂, SO₂and the total sulfur oxide emmission. Furthermore, significant relationships were observed between BA and NO₂, SO₂. 2) In the multiple regression analysis using the monthly average concentrations of SO_x, NO₂, O_xand suspended particulate matters (SPM) as predicator variables, the PRT regression equations of AB and CB were statistically significant. 3) In the canonical correlation analysis, in which the monthly average RPTs of AB, CB and BA were used as health indicators and the monthly average concentrations of SO_x, NO₂, O_xand SPM as environment indicators, a statistically significant correlation was observed between the two indicator groups. The scattergram of canonical scores also showed corresponding changes in both groups. These findings demonstrate that the monitoring system was useful and informative in evaluating the influence of air pollution on the health condition of residents.

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This study was undertaken to identify factors predisposing to cartilaginous degeneration in the patella. The test samples used were 67 patellae from males and 48 from females, totalling 115, their ages ranging from 39 to 93, averaging 65, 59 pieces from right legs and 56 pieces from left legs. The degeneration of cartilage was classified into rough surface, velvet formation, cartilage defect and peripheral hypertrophy. The cartilage surface was divided into 7 sections. The findings were classified according to sex, age, laterality and patellar morphology. 20 patellae were embedded in polyester resin and sliced. Then, the maximum thickness of cartilage on the medial and lateral facets was measured and the thickness of cartilage measured were contoured. The thickness of cartilage was studied for a relationship with the morphology of the subcartilaginous bone, and the findings were classified on this relationship. The following results were obtained; 1) In the macroscopic study, rough surface accounted for 97% of specimens, velvet formation 22%, cartilage defect 32% and peripheral hypertrophy 26%. The incidence of cartilaginous degeneration was not correlated with sex or laterality, but showed a correlation with aging. The frequency of cartilaginous degeneration was low for patellae which had little difference in size between the medial facet and lateral facet. 2) The mean maximum thickness of cartilage was 3.24±0.67mm on the medial facets and 3.68+ 0.38mm on the lateral facets. Based on the relationship between the thickness of cartilage and the morphology of the subcartilaginous bone, the patellae were classified into central, lateral and peripheral types. 3) With respect to classification by the thickness of cartilage and subcartilaginous morphology, the frequency of cartilaginous degeneration was low for the central type specimens, velvet formation and catilage defect accounted for 48% of the lateral type specimens and peripheral hypertrophy 41% of the peripheral type specimens. Of the factors which were examined in this study, aging, patellar morphology, thickness of cartilage and subcartilaginous morphology were considered responsible for cartilaginous degeneration in the patella.

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A-73-year-old male patient has been suffering attacks of TIA caused by the left internal carotid atherosis. The left carotid endarterectomy was performed under the type of general anesthesia whose induction and intubation were facilitated by thiopental and succinylcholine chloride and whose maintenance was nitrous oxide, oxygen and halothane. During the operation, ECG and EEG were monitored and arterial blood gas sampled. ECG and EEG did not show any change nor deterioration during the left carotid arterial clamp. The postoperative condition was uneventful.

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A 55-year-old male was crushed by a car and admitted to a local hospital in a slightly dyspneic state. Due to complaint of increasing dyspnea and chest pain the patient was transferred to the Fujigaoka Hospital on the next morning. A chest roentgenogram revealed sternal and multiple rib fractures. As closed reduction of the sternum could not be accomplished, open reduction was performed immediately. Under endotracheal anesthesia, the fracture site was exposed through a vertical median skin incision which extended well above and below the fracture site. The sternal fracture was just beneath the sternal angle showing posterior overriding of the distal fragment, but bilateral internal thoracic vessels were not injured. Reduction and fixation were done easily using two sternal wires.

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A 75-year-old woman with refractory corneal ulcer, iritis, scleromalacia and polyclonal gammopathy was admitted to examine the relationship between systemic diseases and those ophthalmological symptoms. After admission, polyuria and polydipsia developed. Although the primary diabetes insipidus was strongly suggested by the positive results of water deprivation test, Carter-Robbins test and DDAVP test without pathological findings on skull X-ray film and brain CT scan, the definite diagnosis could not be made due to various clinical manifestations, such as polyclonal gammopathy, trigeminal neuralgia, diabetes mellitus and positive serum reaction with TPHA. The problems whether these clinical symptoms were related to the cause of diabetes insipidus or they were observed as complications of the disease would be clarified by intensive follow up study.

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A 56-year-old woman with solitary liver cyst was reported. Without any complaints, she consulted our hospital for further examination of slight elevation of serum LDH level, which was noticed by conventional screening tests. Physical examination revealed abdorr final tumor which moved easily and showed cystic appearance on abdominal echogram and CT scanning. However we could not clarify the origin of this cystic tumor, cystectomy was performed to avoid the possible complications, such as infection, bleeding, rupture or torsion. Postoperatively it was explained that the cyst was originated from liver and was peduculated and therefore this tumor would easily moved on palpation. Elevation of serum LDH level has been continuing after cystectomy and the elevation of LDH level seems to be not related to the solitary liver cyst.

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As we experienced Eosinophilic lymphofolliculosis of the skin (so-called Kimura's disease) which resisted treatments, a report is made with some bibliographic consideration. The case was a male aged 44. The patient is undergoing dialysis at our hospital since August, 1979, due to amyloidosis and chronic renal failure, and a tumescence developed in the left frontauricular region. Excision of the legion was made under general anesthesia at our surgical department on May 25 of the same year. As a result, diagnosis of Kimura's disease was made. Development of the tumescence recurred in the left front auricular region around from August, 1982. The patient visited our department to have Sialography on January 11, 1983. Treatment was made with oral administration of steroid and Tranilast. Tranilast is a condensed agent consisting of a derivative of cinamic acid contained in nandin and anthranilic acid which is a protein metabolite. The drug has been developed in Japan as an agent which can be administered orally to inhibit release of chemical mediator. The drug is known to have inhibitory activities not only on type I reaction but on type II and III reactions. Administration of Tranilast was continued for more than 2 years as we judged this disease as that caused by type I allergy, but no control was possible against the tumescence. Even from the aspect of the pharmacological actions peculiar to Tranilast, the disease can be considered as a mixed type allergic reaction participated not only by types I, II and i but also byIV (delayed type) .

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