The appearance time of abnormal Q waves in standard 12 leads ECG may differ individually in acute myocardial infarction. We noticed its appearance time and devided 107 cases with acute transmural infarction, who were admitted within four hours of the onset of attack, into an early appearance group (group E: less than four hours after the onset of anterior infarction and less than seven hours after inferior infarction) and a late appearance group (group L: four hours or more after anterior infarction and seven hours or more after inferior infarction) . The incidence of prior angina pectoris persisted for one month or longer showed a significant higher rate in group L. Of the types showing an unstable angina, the rate of changing patterns were significantly higher in group L. The degree of chest pain tended to be severe in group E. The maximal degree of ST elevations in 12 leads was significantly higher in group E. Cases with multiple coronary vessel disease showed a high rate in group L. The peak GOT and CK were significantly low in group L. For the hemodynamic findings on admission, CI and SWI in group L were significantly high and PCWP showed a low level. The complication of VT, VF and Af, AF, PSVT were highly seen in group E. In conclusion, the development of myocardial defense mechanism such as the formation of collateral circulation was suspected a one of participating factor in delays with abnormal Q waves appear, and the evolution process of abnormal Q waves was considered a useful indicator reflecting the infarction clinical state.

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Out of 481 patients with acute myocardial infarction, 50 patients complicated with cardiogenic shock were divided into two groups from the response to therapy: in 31 responders and 19 poor responders, and their clinical findings were comparatively evaluated. Age of the responder-and poor responder-group was 63.7±10.6 and 70.2±11.5 years old, respectively. No difference in the frequencies of myocardial infarction attacks was observed between two groups. In 12 leads ECG, the patterns of widespread infarction including anterior wall were seen in the poor responder group. On admission to the CCU, 27 of 50 patients (54%) were already in the shocked state, and the patients hospitalized within 3 hours from the incidence of myocardial infarction were observed in the poor responder group (25.0% vs., 63.6%, p<0.05) . For the degree of pulmonary congestion in shock, patients in the poor responder group were severe. There were no difference of heart rates and systolic blood pressure states between both groups, whereas lower hourly urinary output was observed in the poor responder group. For the comparison of hemodynamic indices obtained in the shocked states, CI, SVI and LVSWI in the poor responder group were significantly low, whereas PCWP showed significantly high values. There was no difference between both groups in the initial thera-peutic dosages of dopamine (DOA) or dobutamine (DOB), and the effective dosages of DOA or DOB used for 21 patients of the responder group, who were survived from the shocked states without IABP, were 10.6±6.2μg/kg/min. Therefore, it is considered the necessity of an immediate IABP, when the shocked state was not reversed by the administration of DOA or DOB at dosage of 10μg/kg/min.

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For the purpose of exploring the method of pre-operative chemotherapy before delayed primary operation for hepatoblastoma in children, one-shot hepatic arterial and intraportal infusion with high-dose of Adriamycin (ADM) were examined experimentally by following method. 15 mongrel dogs were divided into 3-groups according to the infusion route as below: Group 1; hepatic arterial infusion in 5 dogs, Group 2; intra-portal infusion in 5 dogs, Group 3; peripheral i.v. infusion in 5 dogs. To each groups, ADM high-dose infusion (1.5mg/kg) was performed, and ADM concentration of blood (peripheral and in right atrium), cardiac muscle, hepatic tissue and bone marrow were measured. The data can be summarized as follows: 1. ADM concentration of hepatic tissue of group 1 and 2 is extremely high. 2. ADM concentration of cardiac muscle (right atrium and ventricle) and bone marrow of group 3 is higher than that of the two other groups. 3. The peak of serum ADM level of group 3 is high level compared with other two groups. In summary we concluded that in high-dose ADM hepatic arterial and intra-portal infusion, ADM concentration of hepatic tissue is extremely high and the cardiotoxicity and the concentration of bone marrow is lower than i.v. infusion. Therefore it is suggested that these method is very effective as pre-operative short-term chemotherapy to perform delayed primary operation.

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The aromatic amino acid (AAA) did not change after the treatment of both CHP and PE, however the branched-chain amino acid (BCAA) increased significantly. In the cases that recovered consciousness, AAA decreased, BCAA returned to normal range, molar ratio (MR, BCAA/AAA) and EEG showed the improvement after the treatment of CHP and PE.
It was considered that there were some degrees of interrelation between MR and coma grade and between coma grade and EEG, however, there was no difference between MR and EEG.
Thus, it was suggested that hepatic coma was related to the improvement of BCAA metabolism in the muscle after the treatment of both CHP and PE, and the function of remaining hepatic cells.
It was usefull to use CHP and/or PE together with the special amino acid for the improvement of consciousness in hepatic coma, however, the function of the remaining hepatic cells was the most important.

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Primary hypothyroidism, untreated from a neurological viewpoint, was studied in 61 cases. 1) Of the patients, 89% complained of muscle weakness. Sluggishness was evident in 80%, muscular weakness in 51% and hypertrophy of muscles in 89%. There were symptoms of dysesthesia in 46% of the patients, and 25% had objective sensory disturbance. 2) In 21 cases, histopathological examination was performed on biopsy specimens from m. quadriceps f emoris without regard to the degree of muscular symptoms. Myogenic changes were recognized in all cases (Table 3) . Small angulated fibers or small group atrophy was seen in 12 out of 21 cases (57%), whereas definite findings of neuromyopathy were observed in 3 cases (14%) . 3) Histopathological changes in muscle were correlated not with thyroid functions (T₄, TSH), but with the duration of illness. 4) The numbers of type II fibers were higher than, or equal to those of type I fibers in 16 out of 17 cases (94%) . Atrophy of type II fibers was noted in 8 cases (47%), and atrophy of type I fibers was found in 2 cases (12%) . When lesion of muscular tissue was high, both types of atrophy were seen in 3 cases (18%) . Hypertrophy of type I fibers was noted in 2 cases, and hypertrophy of both types was recognized in one case. 5) Sural nerve biopsy performed on 6 cases reveald reduction in the number of myelinated fibers, segmental demyelination and endoneurial fibrosis. 6) The protein content of CSF was elevated in 10 of 21 cases (48%) studied, and was not correlated with neurogenic changes in muscular tissue. 7) 15 out of 23 cases (65%) showed positive EMG findings which included myogenic pattern in 87%, polyphasic potentials in 53% and high amplitude NMU in 20% of cases. The incidence of neurogenic patterns tended to be high in EMG studies of patients with long histories of hypothyroidism.

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We have previously reported that hot water extract of pine cone of Pinus parviflora Sieb et Zucc. (PCE) contained substance (s) which induced differentiation of human myeloblastic leukemic cell line ML-1 into macrophage-like cells. In this study, we purified this substance approximately 327-fold with an overall yield of 11%, by Sephadex G-200 gel filtration and DEAE-Sepharose CL-6B ion exchange chromatography. The purified substance migrated as a single brownish band on 7.5% polyacrylamide gel electrophoresis and the major differentiation-inducing activity was recovered from the gel slice corresponding to this band, which was PAS-stainable. These findings suggest that the differentiation-inducing substance of PCE contained acidic roun (s) and sugar moiety in the molecule.

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The effects of clinofibrate on hyperlipidemia and atherosclerosis were studied in rabbits fed a 1 % cholesterol diet (HCD) . The plasma content of total lipids, total cholesterol (TC), free cholesterol, phospholipid (PL) and triglyceride was increased more by treatment with clinofibrate than by HCD. The content of TC and PL in plasma high density lipoprotein (HDL-C and HDL-PL) in clinofibrate-treated animals was not significantly different than that in the HCD-fed group. Both atherogenic indices, TC-HDL-C/HDL-C and PL-HDL-PL/HDL-PL, were increased by clinofibrate. The deposition of fatty plaques on the lumen surface of the thoracic aorta in clinofibrate-treated rabbits was greater than that due to HCD. Scanning electron microscopy of the lumen surface of the aortic arch did not indicated that clinofibrate prevented fatty plaques or decrease of the endothelial fissures produced by HCD. The results suggested that clinofibrate did not improve the hyperlipidemia or atherosclerosis in cholesterol-fed rabbits.

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The effects of dexamethasone (DM) and prednisolone (PS) on the lipid metabolism and thyroid-stimulating hormone (TSH) concentration in the pituitary gland, thyroid and serum were examined in rats. Five week old male Sprague-Dawley rats, weighing about 150 g, were used in the experiment. DM and PS were subcutaneously administered at doses of 0.2 and 2.0 mg/kg, respectively, once a day for 7 days. Gain in body weight was suppressed by administration of DM at 0.2mg/kg and PS at 2.0mg/kg. The body weight of 2.0mg/kg DM-administered rats decreased below the initial weight in this experiment. The pituitary gland and thyroid weight were decreased by 2.0mg/kg of DM, while PS at 0.2mg/kg increased pituitary gland weigh. Serum lipids (total cholesterol, free cholesterol, phospholipid, triglyceride) and transaminase (GOT, GPT) were increased by administration of DM at 2.0mg/kg, but there levels were not changed by PS administration. Administration of DM and PS did not affect the transaminase levels in the pituitary gland or thyroid. In histological findings in liver, 0.2mg/kg DM caused the swelling of hepatocytes, and 2.0mg/kg DM caused cytoplasma loss and nucleus leakage. The TSH level in serum and the thyroid were slightly increased by administration of DM, but the increases were not significant. DM at 2.0mg/kg decreased TSH level in the pituitary gland. The results suggest that abnormality of lipid metabolism by DM is related to histological liver injury. Furthremore, DM affects the function of the pituitary gland-thyroid system. The side effects of DM on lipid metabolism and functions in the pituitary gland, thyroid and liver were found to be greater than those of PS.

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To examine the muscle pathology of obstructive vascular disorders, ischemic muscles were produced experimentally by arterial clamping, and changes in the muscle spindles were observed histochemically. The subjects were 9 male cats for ischemic muscle pathology, and 4 normal controls. The abdominal aorta, right common iliac artery and right femoral artery were clamped simultaneously for 8 hours, and the animals were sacrificed 3 days after the surgery. The right anterior tibial muscles were then isolated immediately and each was divided into 4 blocks. Each block was frozen by liquid nitrogen, and serial transverse sections were made by cryostat. Muscle spindles in each segment through the central, equatorial to the peripheral polar regions were confirmed microscopically. Histochemical staining was then carried out using NADH-Tetrazolium reductase stain and myosin ATPase stain (pH 4.6) . Results: 1) Muscle spindles of normal control: The average numbers of muscle spindles in each block from the rostral to the caudal side in the anterior tibial muscles were 4.5, 4.8, 6.3, 3.5, respectively. Many muscle spindles were situated along the anterior tibial artery and beside the major branches of the artery. The average diameter of each muscle spindle in the equatorial region was 100-180 μm. Capsule thickness was 3-7 μm. Each intrafusal muscle fiber consisted of 2 bag fibers, and 4 to 6 chain fibers. Hypoactivity was evident in the equatorial region in both NADH-TR and ATPase (pH 4.6) histochemical staining. In the paraequatorial and polar regions, however, bag 1, bag 2 and chain fibers were clearly evident from the enzymatic activity of both NADH-TR and ATPase. Regional differences in ATPase staining (pH 4.6) occurred along the bag 1 fiber but not along the bag 2 and chain fibers. The microvasculature of the muscle spindle and its relations to the extrafusal muscle were also observed. Capillaries in muscle spindle were larger than those in extrafusal muscle. 2) Ischemic changes in muscle spindles: From comparison of changes in muscle spindles and extrafusal muscle, muscle spindles were well preserved histochemically in the group without any lesions at the extrafusal muscle. NADH-TR activity of type I fiber was selectively reduced in the group in which the extrafusal muscle was affected slightly, whereas NADH-TR activity of intrafusal muscle fibers was well preserved. Both NADH-TR and ATPase activities in intrafusal and extrafusal muscle fibers were reduced markedly in the group in which the extrafusal muscle was affected severely. No regional sensitivity of ischemic muscle spindles was observed histochemically. Conclusion : Ischemic changes of muscle spindle were clearly less than those of extrafusal muscle. Capillaries in muscle spindles that were larger than those in extrafusal muscle might be a factor in determining ischemic resistance of intrafusal muscle.

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A poll of chronic MCLS children and their mothers was conducted by the authors. Of 113 mothers questional, 75.3% answered the questionaire. We describe anxiety and life style of the mothers and children. The main findings were:
1) A total of 89.4% of the mothers worried about their children. The main worries were: relapse 62.8% ; aneurysm, 59.3%; deficiency in sports, 26.5%.
2) There were 7 characteristics common to children, and mothers who worried a lot about them. The children a) went to the hospital frequently, b) took medicine. The mothers c) hoped that long term follow-up for MCLS could be conducted periodically, d) asked many people to help them deal with their child's disease, e) had some other family members to help with the care, f) felt that their daily lives were more stressful than those of other women of the same age, g) had more complaints of mental and physical condition.
3) Although all mothers were evaluated by the catell anxiety scales, only 6.2% received counselling.
4) 28.3% of the mothers restricted the daily activity of their children. Main subjects of restriction were vaccination (12.4%), playing sports (10.6%), and sitting up late at night (10.6%) .

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Glomerular alterations in autopsy of chronic alcoholic liver disease (fatty liver 42 cases, fatty liver cirrhosis 28 cases) were examined by light microscope and immunohistochemical methods. Pathological manifestation was increased amounts of mesangial matrix. This lesion was present in 73.2% of the fatty liver and 100% of the fatty liver cirrhosis cases. In 29.3% of the fatty liver and 67.9% of the fatty liver cirrhosis changes were more than moderate. In 46.7% of the fatty liver and 57.1% of the fatty liver cirrhosis cases, IgA immunoglobulin rate was positive by immunohistology. The results inferred that glomerular lesion is associated with IgA immunoglobulin. The glomerular scar rate was higher in alcoholic liver diseases than in contrast cases and non-alcohol cirrhotic cases. This scar was considered to be a hypertentional change. These studies confirmed that glomerular lesion of alcoholic liver diseases (fatty liver and fatty liver cirrhosis) are similar to non-alcoholic liver cirrhosis, and that glomerular scars are due to the effect of alcohol.

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A reflection and penetration problem of photons from a plane monodirectional beam normally incident on semi-infinite medium of water has been solved by Monte Carlo method. Secondary radiation spectra and their integrating resultant number fluence, energy fluence, and dose (exposure) buildup factors as well as depth doses of a variety of field size are presented for the source energy from 200 to 25 keV at the depth up to 5 mean-free-paths. Photoelectric effect, coherent scattering, and incoherent scattering were taken into account as an important process for these energies photons in water. A comparison of the present results with those published in literature shows generally good agreement except for the source energy of 100 keV, though it deteriorates at deep penetration.

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We investigated here quantitative changes of T cell and B cell in granulomatous lymphadenitis including 5 cases of tuberculosis, 2 cases of syphilis and 1 case of sarcoidosis. Lymph node imprints of these diseases were examined by the both ANAE and ATPase stains. Comparing with recent reports used by monoclonal antibodies, following results were obtained. 1. In granulomatous lymphadenitis, T cells were prominent population in the examined materials, but some cases were not shown an obvious increase in ANAE-droplet positive cell. 2. The result mentioned above might suggest that ANAE-negative and/or ATPase-positive cell could be included, at least in part, T8 cell and/or activated B cell. 3. Even at early stage of syphilis, T cells were more prominent than B cells. In luetic lesion as well as tuberculosis cellular immunity may play an important role from the onset of granuloma formation. In addition, each 1 cases of Piringer's lymphadenitis and Morbus Pfeiffer were investigated, in order to compare with the granulomatous lymphadenitis. T cells were prominent in the both diseases, but especially in Morbus Pfeiffer T cells (ANAE-droplet positive cells) showed a remarkable increase.

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Seven cases of relatively rare lymph node diseases were investigated by using ANAE and ATPase stains, in order to count the ratio of T and B cells. These diseases were consisted of 2 cases of T zone lymphoma, 1 case of hemangioma cavernosum, 3 cases of prolymphocytic leukemia and 1 case of Castleman's lymphoma. All materials used lymph node imprints. In T zone lymphomas there was seen a relative predominant T cell population, which showed as ANAE-droplet positive cells. In prolymphocytic leukemias and Castleman's lymphoma, B cell and plasma cell which reacted as ATPase-diffuse or ANAE-granular positive cells were estimated 70% or more. Various classifications of non-Hodgkin's lymphoma have been attempted by many investigators, but T zone lymphoma is not yet given a distinct entity, differing from other lymphomas. Moreover, prolymphocytic leukemia and Castleman's lymphoma are not clarified their cell origin, then recently discussed from many points of view because of their various histological changes case by case. Our report in this time showed that T cell was predominant in T zone lymphomas and B cell was a chief component in prolymphocytic leukemias and Castleman's lymphoma.

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