Femoral head cyst formation and repair in coxarthrosis was studied by histopathology and histomorphometry. Femoral heads of 33 patients with coxarthrosis were examined. Examinations were by soft x-ray, contact-microradiogram, histology, osteomorphometry, and tetracycline double labelling. The bone cysts in the femoral heads were classified into two types, superficial cysts and deep cysts. Deep cysts were further classified into four types, medial nonweight-bearing area, weight-bearing area, lateral nonweight-bearing area and intermediate. Trabecular bone around superficial cysts had the most active formation surface with thick osteoid matrix and active osteoblasts. Trabecular bone around deep cysts in weight-bearing areas had active formation and resorption surfaces with active osteoclasts. Trabecular bone around deep cysts in lateral nonweight-bearing areas had inactive formation and resorption surfaces. Primary, secondary, and dynamic parameters of the trabecular bone were measured in the zones around the cysts in each area, and in corresponding zones in normal femoral heads. The fractional formation surface (FrFS) and the fractional resorption surface (FrRS) around a cyst differed with the cyst type. The activity of remodeling trabecular bone around a cyst was related to the site of the cyst. Osteotomy could improve the remodeling activity of trabecular bone around a cyst, and could repair a cyst in a femoral head in coxarthrosis.

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The skin prick test (SPT) is a useful examination to detect the antigen in a pediatric allergic disease. Its disadvantages are non-specific response due to vasoactive substances such as histamine, choline and monoamine included in the allergen extract. In this study, the histamine and choline concentrations in 49 allergen extracts were measured. Additionally, histamine concentrations in 26 raw food items and choline concentrations in 33 raw food items were determined. The subjects were 30 atopic patients on whom the SPTs were performed. A SPT was performed according to the guidelines of the Scratch test Study Group. It has been suggested that histamine solution (1 mg/ml, 10 mg/ml) should be tested as a positive control in the SPT. The Radioallergosorbent tast (RAST) was also performed in these patients. Histamine concentrations of the house dust, mite, egg white and milk extracts were low, and high correlation was seen between SPT and RAST. However the histamine concentration in fruit, vegetable and fish extracts were higher. Positive SPT result did not correlate well with the patients' history nor with RAST. Choline concentrations of vegetable and fish extracts were also high, but in the SPT, the wheal and flare reactions were absent or small by choline. This study indicates that vasoactive substances, especially histamine, should be useful in positive control tests for the SPT, but choline is not.

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Microvascularization of the human cruciate ligaments was studied by means of microangiography. The cruciate ligaments were nourished by branches of the middle genicular artery running in the loose connective tissue and synovial membrane covering the ligaments. The small vessels entered in the ligaments via the synovial membrane. The surfaces of the ligaments were well vascularized by a network of small vessels. The core of the mid part of the ligaments was relatively hypovascular. The femoral and tibial attachments of the ligaments were poorly vascularized.

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The histology of the anterior cruciate ligament was studied by a modified technique of the Gairns gold chloride stain for neural elements. Three morphological types of mechanoreceptors and free nerve endings were identified. Most of these mechanoreceptors were found at the surface of the ligament beneath the synovial membrane. Also most of these mechanoreceptors were found in the distal portion of the ligament, especially in the tibial side. Degeneration of the ligament by aging or rupture decreased the number of mechnoreceptors. There were no mechanoreceptors in the reconstructed ligaments replaced by either artificial ligaments or ilio-tibial tract grafts.

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The purpose of this study was to prove some of the benefits of axial dynamization in the fracture healing process. Midfemoral transvese osteotomies were performed on 22 mongrel canines. The femur of each animal was fixed with a dynamic axial fixation system that had a telescoping mechanism to provide axial dynamization at the osteotomy site. On the 21st day, one group of 11 was subjected to axial dynamization by weight bearing (dynamization group), while the other group was maintained relatively rigid throughout the study control group. At 7, 10, and 13 weeks after osteotomy, histological investigation and bone morphometric analysis of intracortical new bone formation were performed. The dynamization group showed early abundant intercortical new bone formation at 7 weeks, Haversian remodeling at 10 weeks, and evidence of bone union at 13 weeks. However, these were absent or negligible in the control group at the same times. In torsional testing, at 7 and 10 weeks of healing, the dynamization group was stronger than the control group. But at 13 weeks, the mechanical properties of the bones of the two groups were simillar to those of intact bone. The results suggest that axial dynamization stimulates intracortical new bone formation in early stages, and Haversian remodeling in later stages to promote fracture union.

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An important factor affecting the prognosis of colon cancer, metastasis through blood circulation. Particularly, hepatic metastasis greatly affects prognosis, and predicting the risk of hepatic metastasis by observing the amount of venous invasion seems to be possible venous invasion of resected advanced colon cancer was observed using Victoria blue-H.E. Stain to examine the veins. The grade and location of venous invasion, the diameter of the invading veins, and the involvement and the involvement pathological significance of those factors in hepatic metastasis were evaluated. The subjects were 220 cases of curativly resected solitary advanced colon cancer from among 378 resected cases of primary advanced colon cancer treated at our hospital in the past 8 years (January, 1981-December, 1988) . Positive venous invasion was found in 141 cases (64.1 %) . The invasion was divided into 3 groups : v₁, 1-2; v₂, 3-6; and v₃, more then 7. The diameters of the invading veins were classifed into S, M and L groups according to their diameters. By incidence of invasion, there were 80 cases (56.7 %) of v₁, 48 cases (34.0 %) of v₂, and 13 cases (9.3 %) of v3. By diameter, there were 18 cases (12.8 %) of group S, 95 cases (67.4 %) of group M, and 28 cases (19.9 %) of group L. There was correlation between the two ; the higher the incidence of invasion, the largely the diameter of the invading veins. Among the v (+) group, moderately differentiated adenocarcinoma and a₂+s cases were seen significantly more often, and ly₀, n₀ were seen less often. There was no correlation between the grade of invasion, the diameter of the invading vein or the location of the cancerous lesion, histological type, depth of invasion, or lymph node metastasis. Only lymph invasio (ly₃) showed correlation between grades. The cumulative survival rates for the v (-) cases and v (+) cases were 84.2 % and 58.6 %, respectively, and the 5-year survival rates had poor prognosis with the v (+) cases being significantly poor. The greater the venous invasion, and the larger the diameter of the invading veins, the poorer the prognosis was. There were 17 cases (7.7 %) of postoperative recurrence in the liver, and 16 of those were v (+) . The incidence of venous invasion by grade was v₀, 1.2% ; v₁, 5.0% ; v₂, 12.5 % ; and v₃, 46.2%. The diameters of the invading vein, were group S, 5.6 % ; group M, 7.4 % ; and group L, 28.6 %. Comparison of ssv presence was ssv (+), 14 out of 86 cases (16.3 %) ; and ssv (-), 2 of 55 cases (3.6 %) . The difference was significant (p<0.005) . The state of venous invasion in colon cancer is thus very important in predicting postoprative recurrence of cancer to the liver. In cases at high risk for these factors, observation of the clinical course, with consideration for the risk of recurrence to the liver are needed, even in curatively resected cases.

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The effects of hydrocortisone on human non-AFP-producing immature hepatoblastoma cells were studied in the cell-line, OHR, which was established from a human non-AFP producing hepatoblastoma. The OHR cell-line used for this study had been grown in culture and transferred for 3 years. To prove the cell character had not changed during culture, a₁-AT, keratin, EMA, vimentin, type I, III, N and V collagen, type I, III pro-collagen, and human albumin were all compared with those of the original tumor cells and the OHR cell-line by the ABC method. This comparison revealed no functional difference between the original tumor and the OHR cell-line. The effect of hydrocortisone (HC) on the cell differentiation was : Cells were seeded at 4×10⁶ per 10 cm diameter tissue culture dish, and covered with 10 ml of Eagle's minimum essential medium containing fetal calf serum (MEM), or the same medium but with 500 μg/ml added (MEM+HC) . Albumin value was measured by a turbidimetric immunoassay kit (TIA : Orion Diagnostica) . The albumin value in MEM+HC accumulated to 2 μg/ml on the 15th day, and 5 μg/ml on the 33rd day, although the albumin in MEM was less than 2 μg/ml either day. The production of albumin was enhanced by HC. The results suggest that glucocorticoid may be an inducer of differentiating OHR cells.

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Cross-sectional areas (CSA) of skeletal muscles observed in the CT image at the E12 level of Erdheim's grid (the level on the upper margin of pubic symphysis) were measured as part of a series of studies to elucidate the development of skeletal muscle in situ. The subjects included 99 healthy adults (50 males, 49 females), grouped into five age groups and three body types. The shape of each muscle on the CT image was traced, and the CSAs were measured. The results were analyzed against sex, age and body type, and functional differences were considered. Results : 1) The CSA of m. gluteus maximus, which was largest, occupied about 47.8 % of the whole CSA (7349.2 mm²) of the skeletal muscles. The CSAs of iliopsoas, obturatorius internus, gemellus and gluteus medius followed gluteus maximus and occupied about 9.0 %. Those of pectineus and tensor fasciae latae occupied approximately 4.0 %, and rectus femoris and sartorius occupied approxi-mately 3.0 %. The CSA of pyramidalis was smallest, about 1.2 %. 2) In general, the CSAs of male skeletal muscle were larger than those of females and this tendency was remarkable for muscles of the gluteal region. The gluteus maximus and obturatorius internus were relatively superior in females compared to males. 3) The whole CSA of the skeletal muscles decreased from ages in the forties in males and fifties in females and was smallest in the seventies in both sexes. CSAs of the muscles of the iliac and the gluteal region, and extensor in femoris decreased with age in males, and this tendency was remarkable in obturatorius internus. In females, CSAs of obturatorius internus and gluteus maximus decreased with age. 4) Remarkable differences among body types were observed in the muscles of the gluteal region. In body type D, gluteus medius in males and gluteus maximus in females and obturatorius internus in body type C in males were larger than other muscles.

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The incidence and the pathogenesis of gastritis cystica polyposa (GCP), which occurred at a site of gastric anastomosis, were investigated. The subjects were 112 patients with partial gastrectomy by Billroth- I (Bill- I) or Billroth- II (Bill- II) for benign gastric diseases or duodenal ulcers. GCP was observed in patients operated by either Bill-I or Bill-II. Although there was no correlation between the incidence of GCP and postoperative period in the patients operated for benign gastric diseases, its incidence increased with elongation of the postoperative period in the patients operated for duodenal ulcer. The duodenal ulcer patients were younger than the patients with gastric diseases, so aging of the stomach or atrophic change may contribute to the development of GCP. There were no significant differences in trypsin concentration in the gastric juice or mucosal content of hexosamine between the patients with and without GCP. CDCA and CA concentrations in the gastric juice were significantly higher and glycine/taurine conjugation ratio was significantly lower in the patients with GCP. This suggests the bile acid influences on the development of GCP. However, CDCA and CA concentrations in the patients without GCP operated by Bill- II was much higher than that in patients with GCP operated by Bill- I, so it is suggested that changes of bile acids must be a factor in the development of GCP and other factors were involved in the patients operated by Bill-II.

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A clathrate of cycloartenol ferulic acid ester (CAF) with 19-cyclodextrin (β-CyD) has been developed to improve the intestinal absorption of CAF, the major component of γ-oryzanol which is clinically used for autonomic imbalance. We studied the effect of CAF-β-CyD in rat fed with high cholesterol diet (HCD) and compared the result with that of CAF. Male SD rats (130-150 g) received 300 mg/kg CAF, 180, 600, or 1800 mg/kg CAF-β-CyD or 1500 mg/kg β-CyD once a day for 12 days during HCD feeding. Blood levels of total cholesterol (TC), phospholipids (PL), free cholesterol (PC), and triglyceride (TG) were examined on days 6 and 12. In animals fed HCD only, serum TC, PL, PC, and TG were markedly increased on both days 6 and 12, whereas cholesterol in high density lipoprotein (HDL-C) tended to decrease on day 6 but increase on day 12. Administ-ration of 600 or 1800 mg/kg CAF-β-CyD inhibited inreased TC, FC, PL, and TG, and decreased HDL-C. Administration of CAF alone inhibited the increases of TC and PL. The antihyperlipidemic action of CAF-β-CyD tended to appear from 600 mg/kg, which is equivalent to 100 mg/kg CAF : this suggests that CAF-β-CyD is more potent than CAF. Also, CAF-β-CyD seemed to have an effect on lipid metabolism in the liver ; antagonizing the decrease in PL induced by HCD feeding.

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The role of the reactive oxygen species (ROS) in the induction of tissue injury has been reported. The process of tissue injury by ROS depends on the reaction of ROS with unsaturated bonds in the membrane lipids of the cells followed by initiation of a chain reaction of lipid peroxidation. In this experiment, as a model of glomerular disease induced by ROS, puromycin of aminonucleoside was given to rats and the reducing effect of proteinuria was examined by giving the anti-oxidant which prevents peroxidation of the membrane lipids. In addition, to detect the injurious reaction of a hydroxyl radical generated from hydrogen peroxide catalyzed by ferrous iron, deferoxamine was injected into the rats. The rats were fed chow that contained alpha-tocopherol as an anti-oxidant ; proteinuria decreased compared to the rats bred without treatment with alpha-tocopherol. The amount of lipid peroxide of the kidney, measured by the TBA method, was higher in rats not fed alpha-tocopherol, and was also higher in rats that had proteinuria. Rats injected with deferoxamine showed heavy proteinuria compared to other proteinuric rats that had not received deferoxamine. The results suggest that the amount of peroxidation of lipids of the kidney generated by the reaction of ROS, is related to increased proteinuria, and reducing peroxidation of the membrane lipids was induced in the rats by giving an anti-oxidant in the chow. To evaluate the function of a hydroxyl radical of this model, additional detailed studies are needed.

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Dipyridamole (Persentin), a vasodilatory drug with antiplatelet activity, has been recently reported to inhibit lipid peroxidation and scavenge oxygen radicals. The radioprotective effects of dipyridamole were studied in ddy mice. When the mice were irradiated to 8.0 Gy, 30 days-lethality was reduced from 89 % (control group) to 56 % (0.5mg/mouse and 1.0 mg/mouse i, p. injection of dipyridamole), and to 33 % (2.0 mg/mouse and 4.0 mg/ mouse i, p. injection) . The dose required to kill 50 % of the dipyridamole-tested mice within 30 days (LD_50/30) was 7.56 Gy compared to 6.63 Gy for the control mice. The results suggested that dipyridamole has significant radioprotective effect, so we clinically studied on its radioprotective effects using white-cell counts and platelet counts of 12 patients with breast cancer. Dipyridamole (150 mg/day) was administered to 6 of 12 patients during radiation therapy. There was no statistically significant difference between these two groups. These results suggest the other factor than radioprotective effects on bone marrow.

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A case of duodenal leiomyosarcoma was reported. A 41 year old woman was admitted with complaints of abdominal tumor. Abdominal US, CT and angiography revealed a cystic tumor measuring 7×3 cm in the pancreas head. Under clinical diagnosis of cystadenoma of the pancreas, pancreatico-duodenectomy was performed. Macroscopically, a cystic tumor was located in the head of the pancreas arising from the duodenal muscle. Microscopically, there were tumor cells interlaced with bizarre atypical cells, and focal invasion to the pancreas was observed. Electron-microscopically, actin filament with focal density, well developed rER and mitochondria were seen. From these findings, this tumor was diagnosed as duodenal leiomyosarcoma.

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The malposition twist of cuff site of size 2 laryngeal mask airway (LMA) in a 10 month old female is described. In this case the obstruction produced a slight sound at expiration, and elevation of end tidal CO₂. W e examined the airway condition by X-ray in a lateral view of the cervical spine, and found the cuff site of the LMA to be twisted. The airway obstruction by the twisted cuff was reduced in the head down position. We concluded that size 2 LMA was too big for the patient.

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This case report describes a patient with the Klippel-Trenaunay-Weber syndrome associated with a severe hemangioma-like lesion of the rectum. A 20-year-old male visited our hospital for a complete examination. In infancy, vascular nevus, varicosities, hypertrophy of the right hand and hypertrophy of left foot had appeared. At the age of fifteen, this syndrome was diagnosed. Because of occult blood, a colonoscopic examination was performed by which a hemangioma-like lesion of the rectum was found. These findings were considered to be complications of the alimentary tract associated with this syndrome. Further examination is certain to reveal more vascular lesions.

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Relations between herpes zoster and gastrointestinal lesions were studied in 1989 and 1990. During this period, 25 cases of herpes zoster were observed by upper gastrointestinal endoscopic examinations, because of symptoms of epigastralgia etc. Abnormal endoscopic findings were noted in 10 of these cases. All cases had benign lesions of gastric ulcer and gastric erosion. Of the 25 cases, 12 were studied by colonoscopic examinations, because of complaints of occult blood stool, etc. Among these 12 cases, 2 abnormal endoscopic findings, ulcerative lesion and erosion, were noted. The shallow ulcerative lesions in the stomach and colon were very similar.

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