Fifty six electron-microscopic mammary histology and cytology specimens (40 cases of mammary cancer, 11 cases of fibroadenoma and 5 cases of mastopathy) were observed and evaluated by morphometric analysis of area and longest diameter of nucleoli of mammary epithelial cells with the use of IBAS (interactive bud analyse system) -2000. We classified 3 types of mammary epithelial cells, clear cell type, dark cell type and intermediate cell type. All cases containing more than 25% dark cells were mammary cancer. In benign mammary diseases, dark cells were fewer than 25%. On the electron-microscopic pictures, area and longest diameter of the nucleoli of the mammary epithelial cells were semiautomatically measured by tracing nucleolar outlines. Parts of the diagnostic points of mammary cancer were: (1) mean nucleolar area more than 2.5μ², and (2) mean longest diameter more than 2.5μ. However there were some cases of mammary cancer with smaller nucleoli rather than benign mammary diseases. Excisional biopsy should be required in such cases.

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The aim of the present work was to determine whether any clinical or morphological features of IgA nephropathy, present at the time of biopsy, correlated with creatinine levels which remained within normal range (0.7-1.4 mg/dl) . In total 88 patients (44 males, 44 females) with IgA nephropathy, 33 males and 44 females were within the normal range of creatinine level, whereas 11 males showed more than 1.5mg/dl. The normal range of creatinine level correlated with the levels of systolic blood pressure, the amount of total cholesterol, uric acid, creatinine clearance and PSP, but not with the levels of diastolic blood pressure or with the serum IgA, C₃ or C₄ levels. Quantitative analysis of the pathological areas in kidney sections revealed that the normal range of creatinine level correlated with the widening of glomerular crescentic areas and tubulo-interstitial lesion, but did not correlate with widening of Bowman's capsule, glomerular loop or mesangial area. Thus, even the normal range of creatinine level could be useful for prognosis.

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Computed tomography (CT) scans were made from 100 adult humans (50 males and 50 females) at five transverse sections in the trunk to measure the differences in the body composition relative to plane, sex and age. Planes of CT scans were taken at: midpoint of the sternum (E5), xiphoid (E6), upper abdomen (E7), umbilicus (E8), and lower abdomen (E10) . The body composition was divided into subcutaneous fatty layer, bone and muscle layer and body cavity. The following results were obtained: 1) The total cross-sectional area was largest at E5 and smallest at E8 in both sexes. The total area decreased with age in males. It was largest in the fifties and rapidly decreased in the sixties in females. 2) The proportion of the subcutaneous fatty layer decreased with age in males, was about constant between the thirties and fifties and decreased above the sixties in females. The proportion of subcutaneous fatty layer was largest at E8 in all ages and was larger in females than in males. The proportion of bone and muscle decreased above the sixties and was lowest in the seventies in males, but did not change with age in females. The proportion of the body cavity increased above the forties in both sexes. 3) In the E5, E6, and E7 planes in each age, and in both sexes, the proportion of body cavity was largest, and was followed by the bone and muscle layer. At E8, the proportion of bone and muscle layer was largest, and the subcutaneous fatty layer was smallest in males. In females, the proportion of subcutaneous fatty layer was largest until the fifties, and that of bone and muscle was largest above the sixties. At E10, the proportion of bone and muscle was largest in every age and was followed by subcutaneous fatty layer in the thirties in males and until the seventies in females. 4) The proportion of the subcutaneous fatty layer was greater in females than in males in each plane and every age. The proportion of bone and muscle was highly predominant in males at E5, E8 and E10, and was slightly so at E6 in each age, and was greater to that in females at E7 until the sixties. The proportion of body cavity in males was greater than that of females at E5 at every age, at E6 and E7, above the forties. At E8 and E10, there were no sex differences in body cavity proportions.

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Steroid treatment restored hearing in half of the children's cases of acute hearing decrease due to sensorineural deafness. However, there were cases of recurrent hearing decrease after discontinuance of steroid treatment. Repeat of the steroid treatment again restored hearing. Cortisol concentration of blood in normal children was measured as 7.8±3.2μg/dl. This value was used as an index when steroid treatment was given in children's cases of acute hearing drop in sensorineural deafness. Cortisol concentration of blood was decreased by steroid treatment. If the steroid dose was reduced and the treatment was discontinued when cortisol concentration of blood was restored, there were no further cases of hearing decrease. From the above, it is concluded that steroid treatment with cortisol concentration of blood as an indicator is effective in treatment of hearing decrease in sensorineural deaf children.

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To determine the effects of fetal calf serum (FCS) on the proliferation of, and antibody production by lymphoid cells from immunized mice, cells were incubated with various concentrations of FCS. To assess the effects of FCS we used ³H-thymidine (³H-TdR) uptake and plaque formation. At concentrations of 5-20%, FCS induced a dose-dependent increase in ³H-TdR uptake by T cells, B cells, and spleen cells from sheep red blood cell (SRBC) immunized and nonimmunized ICR and C 57 Bl/6 mice. FCS also enhanced the production of anti-SRBC IgM antibody by spleen cells and splenic B cells from ICR mice immunized 4 days earlier. However, when B lymphocyte prepared 6 days post-immunization were cultured, there was a big difference between IgM- and IgG-producing cells in response to FCS: IgM-antibody responses to no FCS, 5% and 20% FCS were not different, but the IgG-PFC response increased in the presence of FCS. This unexpected finding suggests that lymphocytes of different types and/or at various stages of differentiation were distinctly sensitive in response to xenogeneic serum. Supernatants from FCS-containing cultures of SRBC-primed spleen cells or T cells activated anti-SRBC IgM antibody production, suggesting that this effect could be attributed to T cell-derived soluble factor (s) .

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The value of tumor markers for diagnosis, evaluation of therapeutic effectiveness, and prognosis is attracting considerable attention. There is no easily evaluated and effective marker for bladder tumors, which constitute most of the tumors of the urinary and reproductive tracts. To determine the possibility of their application in the diagnosis of bladder tumors, 6 tumor markers were simultaneously measured at the time of diagnosis of bladder tumors. The subjects were 93 cases of bladder cancer, first diagnosed between the years 1973 and 1988, in whom the degree of invasion was clearly evident. There were 12 pTa, 50 pT₁, 13 pT₂, 10 pT₃ and 8 pT₄ cases. Controls were 22 cases of prostatic hypertrophy treated during the same period. Blood samples were obtained after fasting prior to treatment ; and CEA, ferritin, β₂ microglobulin (β₂Mg), AFP, immunosuppressive acidic protein (IAP) and tissue polypeptide antigen (TPA) were measured. There were no statistically significant differences between ferritin and AFP of any group. The CEA value for the prostatic hyperophy group was 1.4±0.5 ng/ml, which was significantly different from the 2.5±2.1 ng/ml value of the pT₄ group. When the cut-off point was set at 1.0 ng/ml, which was the most efficient point, sensitivity and specificity were both 83%, which were the highest values for any of the markers. There were significant differences in β₂-Mg between the pT₄ group (2.8±0.3 mg/l) and the prostatic hypertrophy, pT₂ and pT₃ groups (2.0±0.7, 1.7±0.4 and 1.6±0.5 mg/l, respectively) . This indicated high values in advanced stages. There was no correlation between β2-Mg and creatinine in pT₄ cases. There were significant differences in TAP (401±109 ug/ml) of prostatic hypertrophy cases, and that in pT₂ (538±212 μg/ml), pT₃ (697±459 μg/ml) and pT₄ (629±192 μg/ml) . There were significant differences between pTa (408±127 μg/ml) and pT₄, between pTl (423±189 μg/ml) and pT₄, and between pT₁ and pT₃, indicating increased values in advanced stages. A significant difference was observation in TPA only between the prostatic hypertrophy group (109±31 U/l) and the pT₄ group (155±71 U/l) . From the above, the sensitivity and specificity of CEA were highest. Thus when abnormally high levels are found, examination must be performed on the suspicion of bladder cancer. If TAP is abnormal, there is a possibility of advanced stage disease ; and if β₂-Mg and TPA are abnormal the possibility of pT₄ disease must be considered.

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Directional hearing ability test is one of the essential methods in diagnosing retrocochlear deafness. A new directional hearing ability test apparatus, Model TD-01, has been used to test patients with unilateral hemicerebrum disorder due to cerebrovascular disorders such as cerebral hemorrhage and cerebral infarction. Testing was by a self-recording method, which is a modification of the manipulatory technique of a previous self-recording method, plus a conventional manual method and another self-recording method. This new apparatus produces time differences at random from a minimum of 2μsec to a maximum of 2 msec, without distortion, from an optional sound source. Compared with the conventional self-recording method, more precise judgement is now possible by the modified method we have devised to simplify the manipulation by the patient. The subjects were patients with hemiplegia in whom the disordered sites were distinguished by CT, etc., and whose symptoms were evident. For testing, they were divided into 27 cases for stage I and 27 for stage II . For comparison, a similar test was performed concurrently on normal subjects. The result: revealed significant differences between the left hemiplegia group, and the normal subjects, The self-recording method and the modified method were closely correlated in the left hemiplegia group, but not in the right hemiplegia group. From the results, the modifiec self-recording method was found to be more useful for judgement of derectional hearing ability in the hemiplegia patients tested, and the superior ability of the right hemicerebrurc to determine hearing direction was suggested by the larger number of cases in the left hemiplegia group in whom directional hearing ability was deteriorated.

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As a result of recent progress endoscopic clips are now used, not only for endoscopic hemostasis, but they also find general use in gastrointestinal disease. However, for intraoperative determination of oral invasion of early gastric cancer, the J type clip alone could sometimes not be manipulated from outside of the gastric serosa during an operation, and the K type clip was difficult to manipulate at the time of endoscopic clipping. We thus devised a combination of J type clips for intraoperative determination of oral invasion in early gastric cancer. In the case of superficial early gastric cancer, especially in indistinct oral invasion, we used the combination J type clips with support diagnosis of dye endoscopy and direct vision biopsy for the preoperative determination of the operative procedure. We were then able to determine the resectable lines more easily and safety than previously at the time of operation. In this report, we demonstrate the efficacy of this endoscopic method in two cases, and emphasize the utility of the preoperative combination clipping for the purpose of the intraoperative determination of oral invasion and operative procedure in early gastric cancer.

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A 55-year-old male visited a neighboring hospital because of right lower abdominal pain with macrohematuria. Roentgenography revealed a passed right ureteral stone. Right hydronephrosis continued after passing the stone. So he was transferred and admitted to our hospital on October 7th, 1987. A retrocaval ureter was diagnosed from the characteristic location of the right ureter by means of inferior venacavography and transpercutaneous pyeloure-terography. He underwent an end-to-end anastomosis of the right ureter. Pathological dia-gnosis of the ureter removed at the operation was chronic ureteritis. Postoperative IVP showed neither ureteral stenosis nor stone, and improved dilation of the calyces and ureter. We report our case, and statistics of 284 cases of retrocaval ureter in Japan.

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A 70 year-old male was hospitalized for a detailed examination of hepatomegaly and a high blood AFP level. The upper GI series and gastric endoscopy revealed a Borrmann Type 3 gastric carcinoma with a histological picture of a moderately differentiated tubular adenocarcinoma. A CT-scan revealed multiple inhomogeneous low density masses in both hepatic lobes, leading to a diagnosis of gastric carcinoma with liver metastasis. The APP pattern was analyzed using double affinity electrophoresis with Con-A LcH, and revealed a metastatic pattern instead of a hepatocellular carcinoma pattern. The localization of APP was evaluated using a PAP method on autopsy specimens, and the staining pattern indicated activity within the carcinoma cells in the lesion and each metastatic lesion, but no normal tissue. Measurement of the APP content in the tissue revealed significantly higher values in the tumor tissue than in normal tissue. APP appeared to be derived from the gastric cancinoma cells in the primary tumor and its metastasis.

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A female, aged 68, with Pick disease exhibited a state of mutism from the initial stage of morbidity and speech rapport was quite difficult. Pick disease has conventionally been classified into 3 types: temporal and frontal type, temporal type, and frontal type depending on the main site of the lesion. The clinical characteristics decline in motion, mutism and leaving behavior, which are found as frontal lobe symptoms were evident in this case ; but triebhafte Enthemmung, which is noticeable in phase I of Pick disease, and stehende Redensarten in phase II, both of which are known to be temporal lobe symptoms, were not observed. The frontal lobe was also the center of the morbid site in the radiological images from cranial X-ray CT, MRI, and ¹²³I-IMP SPECT, and it is thus presumed that this case can be diagnosed as frontal type Pick disease. Occurrence of frontal type Pick disease is rare in Japan and few cases exhibit mutism from the initial morbid stage. A report will therefore be made, with some bibliographical consideration added, on the mode of occurrence of the previously described behavior of leaving, i.e.“running-away”behavior.

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We report a very rare case of renal carcinoma supervention in chronic maintenance hemodialysis. The patient was a 49-year-old male who had received chronic maintenance hemodialysis for 8 years and 5 months. He was hospitalized because of fever of unknown cause. Based on diagnosis of left nephroma after examination, including abdominal echography and CT, nephrectomy was performed. The kindney removed was found to have a solid tumor centered around the hilus renalis, which was diagnosed as a papillary adenocarci-noma with acquired cystic disease of the kindney (ACDK) . Considering that renal insufficiency is complicated by malignant nephroma in a high percentage of patients, and that a high incidence of ACDK in renal insufficiency has been reported in Japan, it is suggested that ACDK may be a major cause of the development of renal carcinoma.

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