The myofibrous organization of the laryngeal muscles of the dog was investigated and compared with those of macaque and man to elucidate relations between vocalization and laryngeal muscle morphology. In macaque and man, the innervation ratio of each laryngeal muscle was also analyzed. Materials and method : Materials included a male dog, a female dog, a male Japanese macaque and 4 male humans (ages in forties and fifties) . The dog laryngeal muscle fibers were stained with Sudan Black B and classified into three types. The laryngeal muscle fibers of the men and the macaque were stained with hametoxyline eosin and the nerve fibers were stained with toluidine blue. Results : 1. The laryngeal muscles of the dog did not include the musculus epiglotticus or arytenoideus obliquus which were observed in man and chimpanzee, but they did include the musculus ventricularis. 2. The cross sectional area and the total numbers of muscle fibers of the musculus cricothyroideus were the largest of the dog laryngeal muscles. Those of the musculus thyroarytenoideus including the musculus vocalis were the second largest, and those of the musculus ventricularis were smallest. Generally, all values were larger in male than in female. 3. The frequency of the white muscle fiber of each laryngeal muscle of the dog was highest and was followed by the intermediate muscle fiber. The female white muscle fiber frequency was higher than that of the male. Thickness of the muscle fibers decreased in the order of white, intermediate and red muscle fiber. The white muscle fibers of the musculi cricoarytenoideus dorsalis, cricothyroideus and arytenoideus transversus were larger. Although the order of the muscle fiber types in the female dog was same as that in the male, differences between the muscle fiber sizes of the intermediate and red muscle fiber were less than those of the male. The male muscle fibers tended to be larger. 4. Comparison of the laryngeal muscles of the dog with those of man, chimpanzee, Japanese macaque and galago revealed that the muscles of the chimpanzee were most similar to those of the dogs. Most of the laryngeal muscles of the dog were larger, and were more frequently white muscle fiber than those of men. 5. The ratios of muscle fibers per myelinated nerve fiber in man and macaque were compared. The ratios for all of the laryngeal muscles of man were smaller than those of macaques. Thus, a more dense ratio of innervation in man was concluded. The difference in this ratio was remarkable in the musculi thyroarytenoideus and arytenoideus transversus. Though the numbers of laryngeal muscles of man and macaque were similar, those of dog and man were much different, because of the remarkable differences in the numbers of each muscle.

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In the present study, we investigated the changes of serum lipoproteins and apolipoproteins (Apo) in rats with acute liver injury induced by carbon tetrachloride (CCl₄) or a-naphthylisothiocyanate (ANIT) . Rats were 7 week old, male, Sprague-Dawley. CCl₄ or ANIT were dissolved in olive oil, and the final volume given to each animal was adjusted to 2 ml/kg body weight. CCl₄ was given orally at a dose of 0.5 ml/kg/day for 4 days. ANIT was given orally in a single dose of 100 to 200 mg/kg. CCl₄ decreased the very low density serum lipoprotein (VLDL) level, but did not significantly change the low density lipoprotein (LDL) or the subfractions of high density lipoprotein (HDL), HDL₁, HDL₂, and HDL₃. ANIT decreased VLDL and HDL₃, and increased LDL and HDL₁. In addition, abnormal lipoproteins, indicated as VLDL' and HDL₁', were found after ANIT adiministration. The stained band of VLDL' in the disk electrophoretic gel was found between the origin and VLDL, and HDL₁' was found between HDL₁ and HDL₂. Albumin combined nonesterified fatty acid was increased by CCl₄, but decreased by ANIT. CCl₄ decreased Apo E and C-I in VLDL and HDL fractions. ANIT increased Apo A-I in the VLDL fraction, Apo E and C-I in HDL fractions. ANIT caused swelling of hepatocytes, but did not cause the hepatocyte necrosis nor fat deposition. The results suggest that decrease of VLDL, Apo E and Apo C-I by CCl₄ administration was due to the inhibition of apoprotein synthesis in the liver associated with liver injury, and appearance of abnormal lipoproteins after ANIT administration was due to the abnormality of lipoprotein formation in the liver associated with cholestatic liver injury.

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Bone mineral density (BMD) of head and face was investigated in 99 normal Japanese (45 males and 54 females) by dual-energy x-ray absorptiometry. QDR-1000 was used for the study. BMD for females peaked in the forties. The peak was 1, 390 g/cm². The reduction rate was 9.52 % for 10 years. Variance was 0.01902. Standard deviation was 0.1379. BMD for men peaked in the thirties. The peak was 1.336 g/cm². The reduction rate was 1.26 % for 10 years. Variance was 0.01162. Standard deviation was 0.1078. BMD patterns of head, face and spine (L1-L4) were nearly equal, but there was a slight reduction rate. This was accounted for by differences in the bone components.

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The stimulatory effect of soluble antigens extracted from Hymenolepis nana eggs (soluble egg antigens) on tritiated thymidine (³HTdR) incorporation by mesenteric lymph node cells (MLNC) was tested. Nonsensitized MLNC from uninfected BALB/c male mice showed slight increase of ³HTdR incorporation when crude soluble egg antigens were added to cell culture fluids. Sensitized MLNC prepared from mice inoculated orally with 1, 000 H. nana eggs 10 days before were more responsible for the enhanced incorporation of ³HTdR, particularly under stimulation with crude soluble egg antigens. Incorporation by sensitized MLNC in the presence of crude soluble egg antigens increased to approximatelly 360 % of the control value obtained from sensitized MLNC in the absence of the antigens. The stimulatory effect of crude soluble egg antigens on ³HTdR incorporation by sensitized MLNC pretreated with either anti-Thy-1.2 monoclonal antibody or anti-L3T4 monoclonal antibody was also tested. The results indicate that the values of incorporation by the pretreated MLNC were much smaller than those by non-pretreated MLNC. The values were as small as that of sensitized MLNC in the absence of the antigens. Since it became clear that crude soluble egg antigens blotted onto nitrocellulose (NC) filter sheets retained their stimulating ability on sensitized MLNC, the blotting procedure was employed to examine the molecular weights of antigens effective in the enhancement of ³HTdR incorporation by MLNC. Crude soluble egg antigens were separated by sodium dodecyle sulphate polyacrylamide gel electrophoresis (SDS-PAGE) and transferred to NC filters which were then cut into identical discs (5 × 5 mm) . The results obtained by SDS-PAGE showed that crude soluble egg antigens contained components with molecular weights between 20, 100 and 340, 000. Sensitized MLNC showed a greater amount of ³HTdR incorporation when cultured in the presence of discs blotted with components having molecular weights ranging from 200, 000 to 250, 000.

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Hypophysectomy abolished analgesia induced by low frequency non-acupuncture point (abdominal muscle) stimulation (NAA) after lesioning the analgesia inhibitoty system (AIS), including the lateral part of the centromedian nucleus of the thalamus (L-CM), or treatment with the cholecystokinin (CCK) antagonist, proglumide. Relations between the arcuate nucleus (HARN) and the pituitary gland in production of NAA were investigated by change of pain threshold in the tail flick test, and of neuronal activity in the posterior part of the HARN (P-HARN) . Analgesia was produced dose-dependently by ACTH i.p. (ED₅₀=0.25 mg/kg) . Firing rates of P-HARN neurons were increased by non-acupuncture point stimulation (HAPS) after lesioning the L-CM or treatment with 20ug/kg, proglumide i.v. Intravenous ACTH (0.25 mg/kg) increased the firing rates of P-HARN neurons that were also facilitated by NAPS after pretreatment with 20 μg/kg proglumide, i.v. Increment of the firing rates of P-HARN neurons by NAPS was antagonized by 0.6 mg/kg dexamethasone, i.v. The NAPS responsive neurons also responded to 0.1 mM dopamine ultramicroinjected into the neuronal recording site by picospritzer, but did not respond to 0.1 mM ACTH. Analgesia and increment of firing rates of the P-HARN neurons caused by NAPS or 0.25 mg/kg ACTH were abolished by hypophysectomy. Under these conditions, analgesia and increased firing rates were restored by concurrent application of NAPS and ACTH. It was concluded that NAA is produced by dopaminergic transmission between the anterior part of the HARN, which had previously been identified as the final section of the NAA afferent pathway to the pituiary gland, and the P-HARN in the presence of ACTH liberated from the pituitary gland by NAPS.

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Inter-relations between stimulatory mechanisms of CCK on pancreatic protein synthesis and secretion were investigated in vivo with conscious rats using ¹⁴C-leucine and cycloheximide, which is known as a powerful inhibitor of protein synthesis. Continuous intravenous administration of cholecystokinin (250 ng/kg/hour) stimulated pancreatic protein secretion and protein synthesis, but administration of cycloheximide (1 mg/kg) strongly suppressed protein secretion and protein synthesis. Under the condition in which protein synthesis was inhibited by cycloheximide, intravenous infusion of cholecystokinin stimulated protein secretion alone without enhancing protein synthesis. These findings were confirmed by histological examination showing that the number of zymogen granules in acinar cells was lowest in the cycloheximide plus cholecystokinin group. We concluded that cholecystokinin enhanced both pancreatic protein secretion and protein synthesis, and that both mechanisms were closely related, and were simultaneously stimulated by cholecystokinin, but in some parts, independently.

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We report here a technique for side to end anastomosis on colorecal anastomosis (Baker's method) using a PCEEA (PREMIUM C EEA Stapler) . Reconstruction of colorectal anastomosis in the original Baker's method has been by hand suture. The PCEEA, which is improved from the original EEA stapler (end to end anastomosis stapler), has several new functions. Some points of the new design are as follows : The top portion of the shaft and anvil are removed from the instrument, and there is a separate disposable trocar which is inserted into the shaft. The trocar facilitates insertion through the closed lumen. Using the trocar's function, side to end anastomosis by Baker's method can be easily done. Adavantages of the side to end anastomosis using the PCEEA instrument over end to end anastomosis are : 1) greater technical ease, 2) a more secure anastomosis, and 3) a larger anastomotic lumen. The zero anastomotic leak rate of clinical cases undergoing side to end anstomosis on colorectal anastomosis was better than that in other methods using the usual pursestring EEA technique. We recommend this modified Baker's method using PCEEA as adquate surgical intervention for reconstruction in patients with lower sigmoid colon and upper and middle rectal cancer.

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We report here our experience with six rare cases of primary adenosquamous carcinoma of the stomach and colon. Gastric carcinoma appearing as adenosquamous carcinoma was found in two patients. They were type 2 carcinoma of MA, sei ; and type 3 carcinoma of MC, ssjS. Carcinoma of the colon appearing as adenosquamous carcinoma was found in 4 patients. They were type 1 carcinoma of Rs, ss ; type 4 carcinoma of D, s ; type 2 carcinoma of S, ss ; and type 2 carcinoma of D, ss. Clinicohistopathological study was performed on these six patients. With respect to the mechanism of onset of adenosquamous carcinoma, it was presumed that squamous cell carcinoma was induced by squamous epithelial metaplasia in the adenocarcinoma, because histological analysis revealed adenocarcinoma and squamous cell carcinoma collocated in the same glandular epithelial duct, and PASIAIcian-blue stain positive intestinal mucus was observed at the site of the squamous cell carcinoma. These findings indicate that squamous cell carcinoma is a secondary modification of adenocarcinoma.

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157 cases of facial trauma were studied with respect to the age and sex of the patients, causes, diagnosis, classification and treatment in our clinic from January 1987 to December 1988. Nasal bone fracture resulting from falls and traffic accidents were most common. We surmise that female and aged patients will increase in the near future, so treatment of facial trauma must be performed with functional and cosmetic consideration.

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During the period between Dec. 1979 and Oct. 1989, 24 (18 male and 6 female) patients with amyotrophic lateral sclerosis (ALS) were adimitted to our hospital. Of these, 13 died. No patients had a family history of ALS, are all were sporadic cases. Clinical studies of initial symptoms and laboratory findings were carried out in this series and compared with those in prior reports. The results were as follows: 1) The ratio of male to female was 3 : 1 which is slightly higher than that of other reports. The median age of onset was 60.0 years which was slightly older than in recently reported larger samples. 2) In 50 % of all patients, initial symptoms appeared in the upper limb and although the series is small, the number of patients with bulbar symptoms tended to be greater in female than in male. 3) No significant correlation between ALS and risk-factors of past illness was detected, and surprisingly it was relatively difficult to make definite diagnosis by the family physicians. 4) No specifically abnormal laboratory-finding, including blood-chemistry and thyroid hormone were detected. The physical, social and psychiatric problems associated with management of ALS patients are discussed.

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A 57-year-old male with a brief history of fever and right lower quadrant pain was referred to our clinic. He was diagnosed as having acute appendicitis. Laparotomy revealed cecal diverticulitis with local peritonitis. Appendectomy and peritoneal drainage were performed. On the third postoperative day, fecaloid discharge was obtained from the drainage tube. Fistelography confirmed perforation of the sigmoidal diverticulum. The patient had been treated conservatively with general antibiotics and low residual diet. Six weeks later, the diverticular perforation was found to be cured and he was discharged. After 3 months, he was re-admitted because of severe abdominal pain. Emergency celiotomy revealed panperitonitis due to diverticular perforation of the sigmoid colon and leveling transverse colostomy was made. He was treated successfully by a two stage operation, resection of the sigmoid colon and closure of the colostomy. Our experience in this case suggests that conservatively treated perforated diverticulum in the left colon has high risk of re-perforation, so early definitive surgery is indicated.

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We report 62 years old male of pulmonary fibrosis with liver cirrhosis (LC) and hepatocellular carcinoma (HCC) . We performed TAE. Pulmonary fibrosis was progressed remarkbly during the treatments, and he died of respiratory failure. Pathologically defind 7 cases of pulmonary fibrosis with chronic liver disease were found in our hospital. But we could't identify any factor that suggests the relationship between liver and lung fibrosis. However we should follow carefully that sometimes lung fibrosis may progress with chronic liver disease.

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A 73-year-old man was admitted to our hospital with high fever and anergic stupor. After admission, the above symptoms continued, and diaphoresis, tachycardia and muscular rigidity developed. Laboratory data showed leukocytosis (14540/mm), and high serum levels of CPK (2255 IU) and LDH (1018 U) . As he had been taking diltiazem, dipyridamole, indomethacine, and diazepam habitually for about 5 years, and syndrome malin (SM) was suspected. Despite intensive care in administration of dantrolen sodium, bromocriptine mesilate and levodopa, impaired glucose tolerance, DIC and acute renal failure developed, and he died of SM on the 12th hospital day. Since drugs may cause serious side effects, especially in exhausted patients, careful use of drugs in combination with other drugs must be strongly emphasized.

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