From August, 1979 to June, 1990, 226 cases of primary lung cancer were treated surgically at our Department. Of these, 176 cases, excluding hospital deaths from lung cancer and other diseases, were analyzed according to prognosis. The 5-year survival rate of the 176 cases was 40.2% and the 5-year survival rates according to sex were, male, 36.1%; female, 53.2%. The 5-year survival rates according to postoperative stage were, stage Ⅰ, 64.1%; stage Ⅱ, 44.1%; stage ⅢA, 22.1%; stage ⅢB & Ⅳ, 0% and the 5-year survival rates according to histologic type were, adenocarcinoma, 40.5%; squamous cell carcinoma, 49.7%; large cell carcinoma, 18.9%; small cell carcinoma, 0%. The 5-year survival rates according to primary site were, right side, 43.8%; left side, 34.6%; right upper lobe, 39.7%; right middle lobe, 60.0%; right lower lobe, 44.4%; left upper lobe, 41.7%; left lower lobe, 18.1%. The prognosis of squamous cell carcinoma, and the early stage, female group, right side group, right middle & lower lobe group, were all fairly good.

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To obtain normative data on the sural nerve for clincal evaluation of the pathologic process and severity of the various peripheral nerve disorders, a morphometric analysis was made on 30 control sural nerves from normal volunteers, and from patients and cadavers with no evidence of peripheral nerve involvement. The ages of volunteers, patients and cadavers ranged from 13 to 83 years. The data obtained included 1) the mean frequency of abnormal teased myelinated fibers and its upper limit value of 95% confidence interval, and 2) the mean densities of total, large and small myelinated fibers and of unmyelinated fibers and their lower limit value of 95% confidence interval for each decade. The linear correlation between the age and each of the frequencies of abnormal teased myelinated fibers and the densities of total, large and small myelinated fibers and of unmyelinated fibers were statistically significant (P< 0.01). Therefore, the morphometric data obtained from the disease nerve should be compared with the normative data adjusted for the age of the subject described in this study.

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The morphologic effects of the toxicity of high doses of pyridoxine hydrochloride (vitamin B₆) on the lumbar primary sensory neurons in rats were studied. The test rats were treated with 1,200 mg/kg of pyridoxine hydrochloride by intraperitoneal injection once a day, and were sacrificed by perfusion at periods ranging from one to seven days after the injection, together with the control rats. Initial lesions consisted of eccentricity and crenation of the nucleus and vacuole formation in the cytoplasm of large dorsal root ganglion neurons, 2 days after the injection. These lesions were followed by segregation of the nucleolus, axon reaction-like changes in the cytoplasm and axonal degeneration of both peripheral axons in the sural nerve and central axons in the fasciculus gracilis. The frequency of teased myelinated fibers showing axonal degeneration during tests was significantly greater than in control 3 to 7 days after the injection. No significant difference of such frequency was found between the proximal and distal sural nerve during tests. The number of large myelinated fibers per nerve in the sural nerve, when compared with control, was preferentially decreased during tests. In the fasciculus gracilis, the decrease of the density of myelinated fibers was more pronounced in the third cervical segment than in the fifth thoracic segment. Because both peripheral and central axons were similarly affected and the initial lesions were found in the neuronal cell body, the mode of degeneration of axons in this study was regarded as "neuronopathy". By both light and electron microscopy, accumulation of mitochondria, vesicles, multilamellar and dense bodies were found in the nodal and distal paranodal axons of myelinated fibers in the sixth dorsal root ganglion on the 2nd day after the injection, which preceeded the degeneration of both peripheral and central axons. Such accumulation, revealed for the first time in this study, may reflect the presence of a blockade of the axoplasmic transport in the proximal axon and cell body of the lumbar primary sensory neuron and subsequently give rise to the degeneration of both peripheral and central axons of the lumbar primary sensory neuron. The pathologic alterations at the different sites of the lumbar primary sensory neuron revealed in this study should be taken into consideration for the better understanding not only of the pathogenesis of human pyridoxine-induced sensory neuropathy, but also of other human and experimental neuropathies.

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Giant cell carinomas of the lung have been notorious in fulminant clinical courses. Thus, this report describes two exceptionally favorable cases among six cases of giant cell carcinoma of the lung. Their histopathological features are a sharply-demarcated tumor of Stage Ⅰ, absence of vascular permeation of the cancer cells, prominent lymphoid and plasma cell infiltration in the tumor tissue, and lymph follicle formation in the surrounding tissues. Another case with a Stage Ⅱ tumor showed the same histopathological findings as the above two cases with the exception of lymphatic permeation of the cancer cells. This patient expired about one year after undergoing an operation. As conventional controls, the remaining three cases with Stage Ⅲ tumors showed an alveolar extension of tumor cells and vascular permeation. There was a fulminant course after the operation. Notwithstanding similar intervals from their clinical onset to operation in the 4 cases other than Cases 4 and 6, their stages showed considerable variations. Hence, each histopathological feature might have substantiated the different clinical courses following the operation. Electron microscopy of three of the cases indicated double-membrane-bound blisters with intermediate junctions in the bizarre giant cells, and cancer cell differentiation toward both glandular and squamous directions.

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Malignant fibrous histiocytoma (MFH) can be classified as a pleomorphic mesenchymal sarcoma which occurs most commonly in the extremities and retroperitoneum. We report a very rare case of MFH presumably originating in the pulmonary artery and resembling recurrent pulmonary thromboembolism. MFH was suggested by transbronchial biopsy and confirmed by open lung biopsy. Obstruction of the right main pulmonary artery and stenosis of the left main pulmonary artery was confirmed by pulmonary angiography.

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Hyperbaric chamber dives at 19 ATA with helium-oxygen were performed at the Japan Marine Science Technology Center, Yokosuka, from January 31 to February 2 in 1990. During simulated underwater experiments, event-related potentials were recorded in 2 divers for assessment of the cognitive function. Although the P300 amplitude of the potentials did not show any significant change, its latency was clearly prolongated and this prolongation continued to when the decompression reached to 70 m below sea level. These findings indicated that the hyperbaric environment corresponding to 180 m below sea level or less must cause some cognitive dysfunctions and that P300 is useful for early detection of those dysfunctions or HPNS.

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One of the aims of the University of Occupational and Environmental Health, Japan, is to educate students to become occupational health physicians. However, the number of students who enter the university without an understanding of this aim is large. Therefore, the course titled 'Introductory Lectures on Occupational and Environmental Health' was planned for the 2nd-year students with the purpose of giving them the motivation to become occupational health physicians. Surveys of students' images of the term "occupational health physician" before and after taking the course were accomplished using the method of 'Monju card', that is, three students, in turn, write their ideas of an occupational health physician on a card. Moreover, after the series of lectures, students were assigned a self-evaluation regarding the improvement of their images. The results of these surveys show that favorable images increased after the course, that classes offering information regarding the occupational health physician had an influence on the improvement of the images, and that students desire more such information. However, as some students indicated a strong rejection to becoming occupational health physicians throughout the course, a different type of course, and a new philosophy regarding the training of medical students may be necessary.

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