The importance of premedication in paediatric anaesthesia is well known, and induction is associated with a risk of hypoxaemia. Therefore, the aim of this study was to measure changes of oxygen saturation during induction in children given narcotics. Arterial oxygen saturation was measured by a pulse oximeter during induction of anaesthesia in children aged 1-15 years. W e gave four kind of premedication (1. nil, 2. narcotics, 3. sedative, 4. narcotics and sedative) to children undergoing selective surgery. Age classification was as follows : 1, 1-5 years ; 2, 6-10 years ; 3, 11-15 years. Children were induced with thiopenton and muscle relaxant during air breathing. Among the children in the narcotics group and the narcotics and sedative group, 70% were sufficiently satisfied (cooperative or sleeping) . Immediately before induction, SpO₂was 95.87±1.16% (mean±SEM) in the sleeping group, 97.51±0.87% in the cooperative group, and 96.69±1.00% in the screaming group. The lowest SpO₂in the sleeping group was 93% and none were transferred to hypoxaemia (SpO₂<90%) . Of the children in the screaming group, 70% showed hypoxaemia, which was signi-ficantly different from the other groups (p<0.01) . Few chidren in the cooperative and sleeping groups were hypoxaemic. In the screaming group, the desaturation time tended to be very short (16 sec.), the time to recover from hypoxaemia was much longer than that of the other groups. Premedication in paediatric anaesthesia is very important, partly because it can keep children in good psychological condition and avoid psychological trauma, and partly because it can help to avoid hypoxaemia. The doses of narcotics given to the children in our study were adequate but safe considering pulse oximetry. W e recommend that children should be given enough narcotic premedication to avoid hypoxaemia during induction.

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Myofibrous composition of the pharyngeal constrictor muscle from man was investigated for functional analysis of its 3 parts, superior, middle and inferior. The muscles were obtained from 40 humans (23 males and 17 females ; average, 71 years) . Muscle slices of three parts of the muscle belly were embedded in celloidin, and the thin sections were stained with H.E. Results : 1) The thickness of the muscle layer was greatest in the inferior part and least in the middle part. Tendency of thickness to decrease with age was evident in all parts, and this was greatest in the middle part. 2) The numbers of muscle fibers per square millimeter decreased in the order of superior, middle and inferior parts ; and decreased in old men in all three parts. 3) The mean size of the muscle fibers was greater in the order of inferior, middle and superior. Size was greatest at age 60, and least at age 90 in males ; it was greatest at age 90, and least at age 60 in females. 4) The density of muscle fibers was about 60% in all 3 parts ; it was lowest at age 90 in males and highest at age 90 in females. 5) Pathological changes of muscle fibers were most frequent in the inferior part, and more frequent in old men than in younger. 6) Compared to laryngeal muscles, the muscle fibers of pharyngeal constrictor muscles were greater in number per square millimeter, lower in density and had more connective tissue in esch layer.

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A total of 1031 breast carcinomas (ca) were collected from surgical and resected specimend during the last ten years. They were classified into histological types according to the General Rules For Clinical And Pathological Recording of Breast Cancer. I. Had undergone Clinico-pathological study of special types. These cases were : Mucinous ca, 31 (3.0 %) : Squamous cell ca, 4 (0.4%) : Apocrine ca, 2 (0.2%) : Paget's disease, 4 (0.4%) : Secretory ca, 1 (0.1%) : Ca with cartilaginous and/or osserous metaplasia, 1 (0.1%) : and non invasive ca, 10 (1.0%) . The ages of mucinous ca, squamous ca, and Paget's disease were higher than those of the more common types. The prognoses for mucinous ca and Paget's disease were better than those for the more common types. II. Operations were perforated on 63 cases of locally advansed primmary breast cancer. There were 16 infusion group cases (intra-arterial infusion chemotherapy, ADM 90-160mg), and 47 non-infusion group cases. There was no difference between the survival rates of these groups. Clinical response was noted in 14 cases (87.5%), and histological response according to Shimosato's Criteria appeared in 14 cases (87.5 %) . Intra-arterial infusion chemotherapy was effective against locally advanced breast cancer.

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Whole homogenates of rat islets of Langerhans were incubated with [γ-³²P] ATP to investigate endogenous substrate proteins for three major protein kinases, cAMP-dependent (CAMP-PK-A), Ca²⁺-calmodulin-dependent (CaM kinase), and Ca²⁺-phospholipid-dependent protein kinases (PK-C) . Phosphorylated proteins were separated by SDS-polyacrylamide gel electrophoresis and assesed by autoradiography. Endogenous substrates for Ca²⁺-dependent calmodulin-stimulated protein phosphatase were also studied. Substrates of cAMP-PK-A were 15 proteins of 15 kDa et al. CaM kinase substrates were 13 proteins of 16 kDa et al. PK-C substrates were seven proteins of 16 kDa et al. Three proteins, 21, 30 and 31 kDa, were also common substrates for cAMP-PK-A, CaM kinase and PK-C. In addition, common substrates for cAMP-PK-A and CaM kinase were four 17, 20, 32 and 60 kDa proteins, and those for CaM kinase and PK-C were four 16, 22, 42 and 70 kDa proteins. The Ca²⁺-dependent calmodulin-stimulated protein phosphatase substrates were proteins that included most of the CAMP-PK-A substrates, and two 38 and 47 kDa proteins. Multiple interactions between the cAMP and Ca²⁺ second messenger systems, and the phosphorylation and dephosphoylation of islet proteins may be important to the release of insulin.

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A total of 752 soft tissue tumors were collected from surgical cases during the last ten years (348 males, 404 females) . They were classified into histological types according to the WHO International Classification. Of these materials, 380 lipoms comprised about 50 % of the entire series. Other common types were : neurinoma (68), ganglion (54), hemangioma (51), fibroma (23), giant cell tumor of the tendon sheath and P.V.S (23) . Malignant tumors included 31 cases of soft tissue tumors, 6 liposarcomas, 5 malignant fibrous histiocytomas, 4 leiomysar-comas, 4 rhabdomyosarcomas and 2 malignant schwannomas, among others. Soft tissue sarcomas were difficult to clasify. Electron microscopical and immuno-histological examination were considered to be significant for differential diagnosis of soft tissue sarcomas.

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Characteristics of solute removal and biocompatibility were clinically compared among three kinds of membrane hemodialyzers with minimum activating capacity for complement, and comparable in vitro clearance of urea. Ten patients with chronic renal failure who had undergone hemodialysis (HD) three times a week for more than one year were enrolled in this study. These patients were dialyzed using three kinds of dialyzer membranes, Hemophan (H), cellulose di-acetate (CA), and polymethylmethacrylate (PMMA) in a crossover method under HD conditions that were similer except for dialyzer membrane. Testing of HD included evaluation of clearance and reduction rate of small molecular substances (urea nitrogen, UN; creatinine, Cr ; uric acid, UA ; and phosphate, iP) ; and changes of blood cell counts ; beta-thromboglobulin (β-TG) ; thromboxane B₂; 6-keto-prostaglandin F1α; granulocyte elastase-α_l proteinase inhibitor complex (G-elastase) ; celite activated coagulation time (CCT) ; and fibrinopeptide A (FPA) . Although the clearance and reduction rates of UN, Cr and UA did not differ among the three membranes, those of iP were significantly lower with PMMA than with CA or H, and the clearance of iP was maximum with H. HD with H induced a greater decrease of leucocytes, than with CA and a higher venous/arterial ratio of β-TG than CA or PMMA. HD with H prolonged CCT less than HD with PMMA, and increased FPA more than CA or PMMA. The largest increase in G-elastase was observed in HD with PMMA. Strongly negative, and relatively positive membrane charges were reported in PMMA and H, respectively. It is well known that positive membrane charge is an activating stimulus for platelets. The results thus suggest that elimination of negatively charged iP decreased in HD with PMMA and increased with H membrane because of membrane charges, and that coagulation cascade was stimulated during HD with H, possibly because its positive membrane charge activated platelets and adsorbed negatively charged heparin.

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A morphological study of hemiblock affecting the left bundle branch was performed by three-dimensional imaging to obtain a clear description of the pathological changes in both branches. The preparations were autopsied hearts of 27 patients shown electrocardiographically to have suffered from bifascicular block (20 men and 7 women, ranging from 64 to 88 years) . The controls were six autopsied electrocardiographically normal hearts. Serial sections of 70μm, were prepared from the autopsied hearts by the method of Lev. The samples were imaged at 420μm intervals, by a personal computer and a digitizer. The remaining conduction cells were color-sorted at 4 levels. In the left bundle branch, a residual area of less than 25% was treated as significantly losing area. Left bundle branch disturbances varied, ranging from those limited to the origin to extentive lesions affecting the peripheral portion. Lesions affecting the His bundle were noted in some. Loss patterns of conduction systems in three-dimensional images were divided into three groups : localized, scattered, and extensive types. Of the 27 cases observed, finding of 21 corresponded to the electrocardiographic data. By additional factors of location, three-dimensional images were grouped into 6 subgroups. Scattered type lesions throughout the conduction system were characteristic of chronic myocarditis. It is suggested that damage of chronic myocarditis increased by scattering from localized injury, and then fused into single extensive lesions.

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One hundred and fifty ddy-mice (6 weeks old, male) were prepared for the examination, and divided into four groups. Mice in groups A and B were fed vitamin E (VE) deficient food with mean serum VE-levels of 0.18±0.04mg/dl. Groups C and D were fed normal food with serum VE-levels of 0.29±0.06 mg/dl. Mice in groups A and C were also given 0.2 to 0.4 ml of 38 % ethanol fluid per-orally, 4 to 5 times per week by stomach tube. Serum amylase levels were remarkably elevated in group A (13610±4000 IU/1) after alcohol administration. Histopathology of pancreata showed vacuolar degeneration of acinar cells and protein plugs in ducts, and liver, vacuolar changes of nuclei, and fatty changes. These were more frequently observed in groups A, B and C. Acute pancreatitis with hemorrhagic and necrotic changes and hepatic necrosis were most frequently observed in group A. It was very interesting that many cases (incidence 50 %) of acute pancreatitis occurred in mice with short-term alcohol administration (group As), but there was no acute pancreatitis after long-term alcohol administration (group Al) . Pancreatic fibrosis, suggesting chronic pancreatitis, was totally recognized in only three cases in groups As and Al with no great difference in their incidence. From this examination, it is suggested that alcohol administration may initially induce, not chronic pancreatitis but acute pancreatitis, and recurrence of this may later progress to chronic pancreatitis.

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Nasal cavity volume was studied in 69 healthy volunteers (from 8 to 23 years old) by MRI. The right and left nasal cavity areas were measured on horizontal images displayed directly on the MRI console. The nasal cavity volume was obtained by integrated volume calculation. The nasal cavity volume was positively correlated with age, body height and weight up to age 16. The body height and weight reached a plateau at 16 years, but the nasal cavity volume continued to increase. There was no significant difference in the volumes of the right and left cavities.

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We investigated age-related changes of aqueous humor protein in male, W istar-strain and Ihara cataract f-strain (ICR) rats, using two dimensional electrophoresis with silver staining. In this study we took a system using capillary isoelectric focusing for first dimension separation and polyacrylamide gradient slab gel for second dimension electrophoresis. A 5pl sample of aqueous humor was analyzed. The staining patterns of aqueous humor proteins were almost the same in the two strains. Albumin and Immunoglobulin G (IgG) in aqueous humor were detected by immunoblotting and transferrin (TF) was separated by electrophoresis with purified TF. Albumin was the major aqueous humor protein. Albumin and IgG levels increased with aging, but no increase of TF was observed. In ICR rats, protein concentration in aqueous humor was greater than in W istar strain rats, and larger molecular weight proteins, such as IgG and TF, appeared earlier. This suggests that IgG and TF are actively transported into the aqueous humor and may also be produced around the anterior chamber. It seems likely that IgG and TF are important to changes of the blood-aqueous barrier with aging and cataractogenesis.

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Rupture of the long head of the biceps tendon is relatively rare. Most of the patients are middle-aged manual laborers, who have a history of trauma. The patients visit a hospital usually with a chief complaint of asthenia, and abnormal or well-developed biceps. Rupture has been diagnosed by clinical findings, xeroradiograms and scapulohumeral X-ray findings. This report presents correlation between the surgical and MRI findings along with some bibliographical consideration. Out patient was a 68 year old male who visited our hospital with a chief complaint about the right brachial tumor and underwent an operation for rupture of the long head of the biceps tendon, a cystic mass filled with retained synovial fluid and the shortened stump of the long head of the biceps tendon were ruvealed by MRI.

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We report a case of vertebral dissecting aneurysm appearing in Wallenberg's syndrome, complicated with headache. The patient was a 48-year-old woman. About 4 months after the first attack of headache in Wallenberg's syndrome, an infarcted lesion was detected outside of the medulla oblongata on an MRI T2 weighted image, and a thrombus was depicted inside the right vertebral artery on an MRI T1 weighted image. Cerebral angiography revealed occlusion and aneurysm dilation of the right vertebral artery. Operation was performed under the diagnosis of a dissecting aneurysm of the right vertebral artery. After treatment, consisting of proximal clipping of the right vertebral artery and anticoagulation therapy, a favorable prognosis was obtained. Although several authors have recently reported dissecting aneurysm of the vertebral artery as a case of W allenberg's syndrome accompanying headache, the onset mode of the headache varied case by case. Twenty cases of this type of dissecting aneurysm found in the literature are also discussed.

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We report rare twin babies with Osteogenesis imperfecta (OI) . Only 10 other cases of twins with OI have reported. One twin died within 1 h and the other within 12 h after birth ; both were autopsied. Autosomal recessive inheritance was comfirmed by their pedigree chart. These cases were classified into type II of Scillence's classification. They showed characteristic physical features : short and round extrimities and soft skull with diastasis of the sutures. Autopsy of the babies revealed membranous skull bone, bone fractures and thin cortex of tubular bones. Pulmonary hypoplasia and congestive edema with massive aspiration syndrome became the cause of death. Microscopically, the skull bone were fibrous tissue with scattered ossification centers, and the metaphysis and diaphyseal cortex of the femoral bone were insufficiently ossified. An ultrastructure study has revealed that collagenous fibers do not make up the bundles, although controls show so called interweaving fibrous bundles.

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