It is known that neonatal development of vision is based on neuronal activity in the visual cortex, and influenced by closing the eyelids during a certain period in neonatal cats. It is obvious that development of vision depends not only on the visual cortex but also upon the perception process of vision. When the visual evoked potentials (VEP) are used to indicate the visual sensation, the primary and secondary evoked potentials are those of the visual cortex and the whole cortex, respectively. In the present experiments, neonatal development of visual sensation was examined by recording both primary and secondary evoked potentials. VEP were recorded through cranial surface plate bipolar electrodes between Pz and Inion, corresponding to regions of the ten-twenty Recording Methods for electroencephalogram. A flash of light was applied through a hole in the top of the box. Unanesthized and unrestricted animals were put into the box. The secondary VEP was identified from the primary VEP with a latency of about 100 msec. It is well known that primary and secondary VEPs reach the visual cortex via a specific projection system and of the whole cortex via a non-specific projection system, respectively. Since it was reported that development of visual cortex neuronal activity was profoundly influenced by eyelid closure during the critical period, a few days in the begining of the fourth week after birth, three kinds of the eyelids closure were performed in the present experiments. Eyelids were closed 1) at 2 weeks after birth for 2 weeks, 2) at 4 weeks after birth for 3 or 7 weeks, and 3) at 2 weeks after birth for 4 weeks. Primary VEP appeared 2.5 weeks after birth, developed gradually, reached the maximum 5 weeks after birth and then remained stable. The secondary VEP was unstable, depending on the state of the animal, during the 12 weeks of the experimental period. Development of the primary VEP was transiently depressed, but it was evoked during eyelid closure and gradually developed to the control level after the eyelids were opened. On the other hand, the secondary VEP was not induced during eyelid closure. In eyelid closures 1) and 2), the reappearing of the secondary VEP after the eyelids were opened was very slow, but it recovered to control level 50-120 days later. In eyelid closure 3) the secondary VEP never recovered after the eyelids were opened. It was concluded that secondary VEP was strongly influenced and did not recover after eyelids closure at 2 weeks after birth for 4 weeks. It was estimated that the perception process was more influenced by eyelid closure than the visual cortex process.

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It is well known that periaticular and systemic osteoporosis are found in patients with rheumatoid arthritis (RA) associated with disease progression. We have studied the therapeutic effect of 1 a-OH-vitamin D₃ (VD₃) on osteoporosis observed in twenty patients with RA and other arthritides. These patients were given 1 μg VD₃ per day for one year. The degree of osteoporotic change was assessed by microdensitometry (MD) using MCI, GSmin, GSmax and XGS/D. Serum calcium (Ca), phosphorus (P), alkalin phosphatase (ALP) and parathyroid hormone (PTH) were measured simultaneously during this period. The clinical effects of VD₃ on disease activity of RA patients were evaluated by Lansbury's index. Microdensitography of the patients revealed improvement of osteoporosis in RA patients with scant bone change and early stage or no corticosteroid therapy (P<0.01-0.05) . No significant changes of serum levels of Ca, P, ALP or PTH were found. It has been observed clinical improvement in certain patients, although no significant alteration of Lansbury's index was evident. The results suggest that VD₃ is beneficial for osteoporosis in RA patients, especially in the patients with scant bone change and early stage or no corticosteroid therapy.

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On the basis that choline, produced from cholinester by cholinesterase (ChE), is oxidized by choline oxidase to hydrogen peroxide, the blood plasma ChE activity was determined by advancing the 2 succesive reactions in a single reaction cell, and electrochemically measuring the hydrogen peroxide of the final product. The enzyme electrode, consisting of an immobilized choline oxidase membrane and a hydrogen peroxide probe, was employed for the second reaction and the assay of hydrogen peroxide. The most suitable ChE analysis included addition of 10μl of 4 mM ACh and 10μl of plasma in 1 ml of 1/15 M phosphate buffer (pH 8.0) in the reaction cell, incubating the mixture for 2 min at 37°C and recording the hydrogen peroxide yield during the incubation. The ChE activity was expressed as mM of choline formed/ml of plasma/min of reaction, calibrated from the amount of hydrogen peroxide produced. The ChE activity from normal human- or MEP-treated rabbit blood, determined by the present method, had good correlation with that of the DTNB method or the ΔpH method. The reaction was 4.5 to 7.5 %, compared to 12 to 14 % by the DTNB method, and the enzyme electrode was stable for up to 25 repeated examinations. The enzyme electrode method could thus be available for the rapid and simplified determination of blood plasma ChE activity.

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We classified 270 cases of gall stones treated surgicaly in our hospital into three groups as cases of cholecystolithiasis, cholecysto-choledocholithiasis, and choledocholithiasis. We then added 12 cases as a control group. Referring to the front view of the ERC findings as pre-operative examinations, we measured and analyzed the angle formed by the extra-hepatic left and right bile ducts (X angle), the angle formed by the extra-hepatic left bile duct and the common bile duct (Y angle), the angle of bend of the common bile duct (Z angle), the largest diameters of the extra-hepatic left and right bile ducts (Bl diameter and Br diameter) and the largest diameter of the common bile duct (CBD diameter) . In the groups with gall stones, the Z angle is sharper than in the control group. The largest bile duct diameter of the group with choledocal stones was much larger than that of the group with cholecystolithiasis and the controls. Moreover, study of the relation between the angle of bend and the largest diameter of the common bile duct indicated that the larger the common bile duct, the more it is apt to bend.

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Current studies of cross-sectional observation of live body using computed tomography (CT) have progressed from observation of subcutaneous adipose tissue to that of all body composition. Recently, the emphasis of CT study has been on each muscle belly. To clarify basic movement of the upper limb, I used CT to measure cross-sectional area of each muscle belly in the proximal third of the forearm of 104 humans (49 males, 55 females) and analyzed the muscles according to body type, size of total forearm cross-sectional area and age. The following results were obtained: (1) The muscles having the largest cross-sectional area are M. flexor carpi radialis, M. flexor digitorum superficialis and M. pronator teres. There is no difference between the sexes in this order of cross-sectional area. (2) Analysis by body type showed that each muscle area increases in size in the order of A-C-D, but the ratios of the areas are larger for M. flexor carpi radialis and M. extensor carpi radialis brevis. (3) Increase of each muscle area follows the increase of the total forearm cross-sectional area. It appears that in males development of muscles relating flexion-extension, and radial abduction of the wrist and extension of the digits is more marked, and in females development of muscles related to wrist flexion and elbow flexion is more marked. (4) In analysis by age, the decade in which muscle cross-section area is maximed for most persons is 30-39 years in males and 50-59 years in females. There are no difference between males and females in tendency of muscles to atrophy. (5) There seems to be differences between the two sexes in functions of the forearm muscles.

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The purpose of this study was to determine the effects of superimposed, jet oscillated ventilation (SOV) on 4 types of experimental acute lung injury, such as pulmonary edema, RDS, methacholine induced bronchial constriction, and histamine induced bronchial constriction. The PaO₂ increased significantly only in the group with bronchoconstriction by methacholine when the ventilation support was changed from conventional mechanical ventiation (CMV) to superimposed 10 Hz-jet oscillation (SOV) during expiration. There was no significant difference in PaO₂ between CMV and SOV in the three remaining subjects. Though Pa CO₂ decreased easily under SOV in all injured lung groups compared to CMV, the respiratory phase in which jet oscillation decrease PaCO₂ was not the same in injured lungs. There was no significant change in circulation between CMV and SOV in all subjects. The author conclude that SOV is better for gas exchange when pulmonary failure is the result of bronchoconstriction (induced by methacholine) .

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Four isoenzymes of creatine kinase (CK) are present in human serum. Three isoenzymes, CK-MM, CK-MB and CK-BB, were found in the cytoplasmic fraction, and the other, mitochondrial CK (m-CK), was located in the mitochondrial fraction. We describe here the abnormal fractions detected by electrophoresis for CK isoenzyme analysis. Creatine kinase-linked immunoglobulin (Macro-CK type 1), high molecular weight m-CK (Macro-CK type 2), m-CK, adenylate kinase (AK), and abnormal CK-MM subbands were detected by electrophoresis as abnormal CK zymogram. Macro-CK type 1 could be detected in the serum of the patients who suffered from hereditary muscular disorders and malignant tumors, and the globulins that bound to the CK could be identified by immunological techniques. The physico-chemical properties of the Macro-CK type 1 were : activation energy was below 75 kJ/mol, it was stable under heat treatment, and its biological activity was not inhibited by CK-M antibodies. On the other hand, Macro-CK type 2 was a polymer of m-CK, and was detected in the sera of the patients who suffered from malignant tumors. The physico-chemical properties of the Macro-CK type 2 were: activation energy was above 75 kJ/mol, it remained heat stable, and there was no inhibition by the CK-M antibodies. Abnormal zymogram created by AK could be discriminated by the exclusion of creatine phosphate in the substrate solution. CK-MM had 3 subbands detected in human serum by extension of electrophoresis, we classified the abnormal CK-subbands into 2 groups.

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Acupuncture analgesia caused by low frequency electrical stimulation of the anterior tibial muscle corresponding to the Tsusanli point was abolished by hypophysectomy in rats. The pathway from the acupuncture point to the hypophysis is defined as the acupuncture afferent pathway, and the final region of this pathway has been found in the anterior hypothalamus (AH) . However, in our previous studies, it was proved that, besides finding that the posterior part of the hypothalamic arcuate nucleus (P-HARN) was the initial region of the acupuncture efferent pathway, the medial part of the hypothalamic arcuate nucleus (M-HARN) also displayed acupuncture afferent characteristics. The present study was undertaken to examine relations between the AH and M-HARN in the acupuncture afferent pathway. Acupuncture responding male Wistar rats were used in the experiments discussed here. The pain threshold was estimated from the percent change of tail flick latency. Electrodes were implanted in the brain for electrical stimulation and for fine lesion according to the stereotaxic atlas of König and Klippel. The destruction of restricted regions in both the AH and the M-HARN abolished acupuncture analgesia. Focal electrical stimulation of the AH produced the analgesia that lasted after termination of the stimulation. This is characteristic of the acupuncture afferent pathway stimulation-produced analgesia. Similar analgesia was produced by stimulation of the M-HARN. The analgesia produced by stimulation of the AH was abolished after restricted lesion of the M-HARN. Furthermore, potential was evoked in the M-HARN by stimulation of the AH. From these result, it was concluded that the M-HARN was more rostrally located than the AH in the acupuncture afferent pathway.

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Traditionally there have been two types of muscular exercise, isometric and isotonic. Recently, isokinetic exercise, developed to incorporate the advantages of the previous two types of exercise and overcome their disadvantages, has found application in sport and rehabilitation medicine, although it still has many aspects to be clarified clinically. We measured muscular strength of top-ranking athletes, and used an isokinetic machine to study characterisitics of their muscular strength in various events. W e also used isokinetic exercise for rehabilitation of top-ranking professional and amateur athletes who had injured knee joints, and observed their muscular strength for certain elements, such as muscle power, work volume and peak torque acceleration energy, to assess the possibility of using these elements for objective evaluation of progress in muscle strength recovery and on return to sport and ADL. Studies were carried out on : (1) 39 top-ranking track and field athletes engaged in various events, (2) five amateur athletes with knee joint injuries, and (3) 9 top-ranking skiers with knee joint injuries. Results were as follows : (1) Measurement and analysis of the track and field athletes revealed maximum muscle strength differences for knee extension and power endurance depending on the characteristics of their events. This necessitated grouping them into two types : Quick muscle fiber dominance was found in athletes such as throwers, short-distance runners and jumpers, who had strong explosive power but poor endurance. Slow muscle fiber dominance was found in athletes such as long- and middle-distance runners, who showed poor explosive power, but strong endurance. These results encouraged application of isokinetic exercise to sports medicine. (2) Application of isokinetic exercise for rehabilitation of amateurs with knee joint injuries increased the maximum absolute values of muscular strength for knee extension and flexion with increasing exercise duration. Muscular strength elements, such as muscle power, work volume and power endurance also increased with increasing muscle volume. In addition, results of the study suggested that recovery of the maximum muscle strength of the affected side to 30 to 50 % of that of the unaffected side could indicate possible return to ADL. (3) Application of isokinetic exercise for rehabilitation of atheletes with knee joint injuries also revealed that recovery of muscle strength on the affected side compared to that on the unaffected side is a more effective indicator than the absolute value of muscular strength for return to sport and ADL. It is important for skiers to recover muscle strength to 70 % of normal before returning to sking, and increase in muscle strength recovery should be more marked in muscular strength for knee extension than that for knee flexion.

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In the present study, pathology of the pancreas and other organs, and interrelations between organs, were investigated during autopsy and in cases of acute pancreatitis. This pathological investigation revealed close relations between acute pancreatitis, particularly acute severe pancreatitis, and MOF similar to those between infection and MOF. It is thus urgent to establish treatment against shock, renal failure, respiratory disorder, or respiratory failure-pleural effusion, pulmonary atelectasis, ARDS and so on-that might cause early death.

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We extracted a lipopolysaccharide-like substance (LPS) from Legionella pneumophila (Philadelphia serogroup 1), and examined its chemical properties, and biological and immunological activity. The results obtained were : (1) About 70 mg of LPS was extracted from 10 g of freeze-dried L. pneumophila cultured in B-CYE-agar medium. (2) SDS-polyacrylamide gel electrophoresis yielded PAS positive bands at approximate molecular witghts of 32K and 62K dalton. These bands were also weakly stained by coomassie brilliant blue stain. (3) L. pneumophila LPS consisted mainly of penta- and hexadecanoic acid, with only slight hydroxyfatty acid. The main saccharide components were rhamnose and mannose. (4) When biological activity was compared with various LPS prepared from other sources (E. coli, S. enteritidis, and C. jejuni), the activity of L. pneumophila LSP was higher in Limulus reaction, slightly lower in pyrogenicity and comparable in both Shwartzman reaction and lethality. (5) In immunological examination, L. pneumophila LPS inhibited antibody production and showed no TNF inducing ability in mice. It had no effect on the L. pneumophila-phagocytosis of polymorphonuclear neutrophils but suppressed bactericidal action. Actions of this LPS also differed from those of other LPS in infected mice, for example, the immunological state was depressed and the lethality was increased. Since it is suspected that Legionnaires' pneumonitis is related to cellular immunity, there is a possibility that L. pneumophila LPS may give rise to the so-called immunocompromised state in which lethal infection by this strain is easily provoked.

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A statistical analysis was made of 133 patients who visited our clinic complaining of vertigo and dizziness between August 1987 and July 1988. They were classified into 3 groups by etiology as otological, central and other. The origins were : 53.4 % otological, 31.6 % central and 15.0 % other. The number of patients complaining of vertigo and dizziness increased during the period reported here.

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Fifteen years ago, when patient was 22 years old, she underwent aortic valve replacement with 9A model 2320 Starr-Edwards ball valve, because of aortic insufficiency. We report here, reoperation about fifteen years after the primary operation, because of hemolysis anemia, brain embolism, mitral stenosis and insufficiency, and tricuspid insufficiency. The operation included aortic valve rereplacement, mitral valve replacement by St. Jude Medical valve prosthesis, and tricuspid annuroplasty with Capentier ring. Operation was indicated because of hemolysis anemia and brain embolism diagnosed as due to cloth wear in Starr-Edwards ball valve. Details are reported here.

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Subungual exostosis is a relatively rare disease, with 155 cases having been reported in Japan. Pathologically, there are two types of this disease, osteochondroma type and exostosis type. The authors have experienced six cases of osteochondroma type subungual exostosis. They discuss these cases with some review from the literature.

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