In order to investigate the contribution of fluid shift from the legs to immersion-induced diuresis, 7 normal and 2 legless (both legs disarticulated at the hip) individuals were tested to measure changes in leg volume (normal subjects) and urinary excretion of solutes and water during a 3-h head-out water immersion (HOI) in thermoneutral water (34.5 ± 0.5℃ ) with a 1-h control period before and after immersion. On a separate day, a 5-h time control (TC) experiment on the same subjects was carried out by having them sit in thermoneutral air (29 ± 0.1℃,relative humidity 60%). The leg volume decreased by 192 ± 20 ml during the 3-h HOI, which accounted for 3.5% of the average leg volume of the preimmersion period. During TC, however, the leg volume increased by 110 ml in the same time course. An increase in urine volume and sodium excretion was observed during HOI in both normal (P＜0.05) and legless subjects. Net urine volume induced by HOI (urine volume during HOI minus urine volume during corresponding TC) in normal subjects was 494 ± 89 ml in 3 h, which was close to a calculated volume reduction of the lower extremities during HOI (508 ± 53 ml). The average net urine volume during HOI in the legless subject was 183 ± 48 ml/min. The above results may suggest that the increase in renal water output is largely accounted for by a fluid shift from the lower extremities during HOI, however, the fluid other than that from the extremities should be accounted for as the urine source. Regardless of the above fact, the present result provides a basis for the therapeutic application of HOI to patients with edema in the lower limbs.

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Due to the gradual increase of endometrial cancer, mass screening for this type of cancer began from 1987 in Japan in accordance with the Law of Health for the Elderly. However, a screening system for endometrial cancer has many controversial problems when compared with that for cervix cancer. Criteria for screening, methods of screening, management after screening, and executive systems are all controversial points in the performance of mass screening. The actual condition in the detection of endometrial cancer in Fukuoka Prefecture based on a questionaire is discussed in this paper.

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A high mortality rate due to hepatocellular carcinoma (HCC) associated with a high prevalence of hepatitis B virus (HBV) infection is a big problem in all Asian countries, including Korea and Japan. In this study, a serological survey and a histopathological comparison of HBV-associated liver diseases in Korea and in the western part of Japan were performed. In- and outpatients of Kosin University Hospital (KUH) and of UOEH Hospital were analysed serologically, and the HBsAg-positive rate among the staff of both universities were also compared. Two-hundred consecutive biopsied livers in KUH, 400 autopsied livers in Kitakyushu, and 576 livers of medicolegal autopsies in Osaka were examined histopathologically. Serological positive rates of HBsAg were 14.5% in KUH patients and 7.0% in UOEH ones respectively (P＜0.001). Overall positive rates of HBsAg in liver tissues were 10.5% in KUH, 4.3% in Kitakyushu and 0.5% in Osaka. Primary liver cancers, most of which were HCCs, accounted for 3.4% of all inpatients in KUH and 1.9% in UOEH (P＜0.01). HBsAg-positive rates among liver cirrhosis and HCC patients were higher in Korea than in Japan. Alcohol was thought to be a predominant cause of 36 liver cirrhosis cases out of 576 cases from Osaka, and a low positivity of HBsAg and a low association of HCC in these Osaka case were noted. HCC patients of KUH were eleven years younger than those of UOEH on the average, and Edmondson's grade of the former was higher than the latter. It was concluded that HCCs in Pusan were younger, less associated with cirrhosis and rather poorly differentiated than those in Kitakyushu, Japan, and that they might be related to a higher rate of HBsAg carriers in the former.

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The effects of systemic toxicity including reproductive toxicity of ethylene oxide on female rats were studied. When Wistar female rats were exposed to 250 ppm of ethylene oxide for six hours a day, five days a week for ten weeks, they showed inhibition of body weight gain and paralysis of the hindlegs. Hematological examination revealed macrocytic and normochronic anemia with high reticulocyte counts. The estrus cycle of the exposed group was prolonged and the percentage of the diestrus stage increased. There was no atrophy in the ovary or the uterus. However, the activity of glutathione reductase in the ovary decreased by 18% and that of glutathione －S－ transferase increased by 30%. These results indicate that ethylene oxide has a similar effect on both female and male rats and that the female reproductive system is also affected.

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Clinical breast echography is increasingly being used as it offers a high degree of diagnostic accuracy rate. Internal echoes of usual breast cancer is hypoechoic in the majority of cases, however hyperechoic mass lesion may appear in rare instances. This echo-pattern was seen in a 38-year-old housewife with invasive ductal carcinoma. Also its bio-acoustical mechanism, that is, why hyperechoic pattern appears, was investigated from the viewpoint of ultrasonic tissue characterization and its related papers were reviewed. Tumor heterogeneity in cellularity such as cribriform pattern, tubular structure, solid nests and a scirrhous pattern of cancer cells may play an important role in producing the hyperechoic breast pattern.

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We experienced a case of pitch-acanthoma which had developed on the hand of a coke worker after 15 years from his retirement. The patient was a 75-year-old male, who had worked mainly as a coke-oven worker for 24 years. In the spring of 1988, after 15 years from his retirement, he noticed a small nodule on the dorsal aspect of his right hand. He visited our clinic on June 1988 because the nodule was rapidly growing larger. The diagnosis of pitch-acanthoma was obvious from his occupational history and the characteristic poikilodermatous outlook of his skin. The tumor was removed surgically. Histological examination showed hyperkeratosis and acanthosis with horn-pearl formation. Moreover, a pack of atypical cells was observed within the lesion, suggesting an early malignant change. The patient was heavily exposed to a tar-gas-containing atmosphere in his workplace for quite a long period. As tar or pitch remains within the skin in spite of careful cleansing, workers in this atmosphere have a relatively high risk of developing skin cancer. Our present case shows that such malignant change can occur after long years and we would emphasize the necessity of a long term follow-up, perhaps throughout the lifetime of these workers.

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This opinion survey on sex and bioethics was carried out in March and April of 1988 by the special committee for family planning and sex related problems which the JMCA (President Dr. Yasuro Anno) had drawn up. This study deals with the analysis of 229 responses to the 3 questions concerning contraception, natural family planning and induced abortion respectively. The background factors of the respondents, sex, age, baptismal age, region (by archdiocese), speciality (clinical, fundamental and social medicine), and payment of the membership fees during the past 3 years were investigated by means of the multiple regression analysis. In addition to the age factor which clearly influenced the responses of each question, the regional factor showed significant influences on the responses to the contraception as well as natural family planning questions. The author proposes five operational hypotheses (A－E) to explain these phenomena, and concludes that it is important to undertake interdisciplinary research as well as to conduct continuous education programs concerning biomedical ethics among the catholic physicians in Japan.

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The new historicism and cultural materialism are here discussed in terms of their assumptions and perspective. The "new" historicists' criticism as opposed to the "old" historicists' "monological" approach rejects the notion of culture as a unity: it assumes that literary texts and other cultural productions are not organic wholes but the sites of ideological contestation. The new historicists further reject the literature (text)/history (context) binary opposition: they do not set history against literary texts as a stable and unified background but assume that literature itself is part of history, a context for other cultural and material practices. The politically engaged British cultural materialists pay considerable attention to the ideological appropriations of the Renaissance writers and texts, while the American new historicists tend to repress the political nature of their critical activity although they are much concerned with the representations of power in Renaissance literature. In spite of some methodological difficulties and problems accompanying this new approach, the new historicism is one of the most stimulative forms of modern criticism and has great potentialities.

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[in Japanese]

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