Histopathological examinations were made on the irradiated central nervous system tumors from 43 cases of autopsy, performed during 10 years period from 1970 to 1977, in order to investigate the effect of intensive radiotherapy on various histological types of intracranial and intraspinal tumors.
1. Of these 43cases, 30 (70%) were found with unusual histological findings such as extensive necrosis or disappearance of the neoplasm, which were considered to be attributable to radiation treatment.
2. Extensive necrosis of the tumor in areas exposed to radiation was found in 16 treated cases (37.2%) ; 11gliomas, 2 malignant lymphomas, 1 pineal teratocarcinoma and 2 metastatic brain tumors. Histopathology of the massive necrosis was that of simple coagulative necrosis sometimes with marked vascular alterations and extravasation of fibrinoid materials into the necrotic tissue. The necrosis appeared almost always incomplete and foci of residual tumor were found at the periphery of the tumor. It seems that space-taking effect of the primary tumor remained unchanged regardless of the presence of massive necrosis. The terminal picture of these cases with massive necrosis was often that of widespread intra-and extra-cranial metastases. Foci of necrosis of the brain with the histology typical of delayed radionecrosis were found in 3 other cases without residual tumor cells.
3. Pineal germinoma and malignant lymphoma, both primary and secondary, appeared radiosensitive. Almost complete disappearance of the tumor was observed in some such examples with subsequent diffuse degenerative changes in the brain parenchyma exposed to radiation.
4. In 5 cases of irradiated tumors autopsy findings gave the impression that the growth of the primary tumor might have been restricted. In 5 cases the tumor cytology was marked by the presence of a large number of multinucleated bizarre giant cells with evidences of degeneration both in the cytoplasm and the nucleus. In two irradiated temporal lobe gliomas fibrosarcoma developed later at the site of previous craniotomy. It is considered that these findings might be also related in some ways to radiation.
5. Disseminated necrotizing lesions of the white matter of the brain have been reported in cases treated with combined radiation and chemotherapy for malignancies of the brain. Multifocal necrosis of the brain with axonal swelling and sponginess of the tissue was observed in two examined cases following combined radiation and antineoplastic chemotherapy.
6. Diffuse loss and degeneration of nerve cells of the cerebral cortex in pseudolaminar fashion was observed in 7 cases with or without bilateral necrosis of the globus pallidus. The histology was that of typical anoxic encephalopathy. It is to be emphasized that the nervous system is liable to be involved by various anoxic factors during the course of therapy for brain tumors.

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The measurements of systolic time intervals and echocardiographic parameters were performed on 36 cases of mitral stenosis and the results were correlated with the hemodynamic observations.
Increase in left ventricular ejection time (LVET), decrease in preejection period (PEP) and decrease in PEP/LVET were observed in about two thirds of the patients. The diastolic descent rate of the mitral valve (DDR) tended to be low, while the pulmonary artery wedge pressure (PAWP) tended to be high in the cases with increased PEP/LVET. However, there was no significant correlation between the systolic time intervals and the cardiac index or the calculated mitral valve area (MVA).
A significant negative correlation was demonstrated between the DDR and the PAWP (r=-0.62, P<0.01), while a significant positive correlation was demonstrated between the DDR and the MVA (r+0.57, P<0.01). However, the correlation of the DDR with the cardiac index was not statistically significant.
The above observations indicate that the measurements of systolic time intervals and the echocardiographic studies are of limited value for the assessment of hemodynamic status and the cardiac performance in mitral stenosis when used alone. A thorough analysis of all available clinical and laboratory informations is neccessary for the precise evaluation of the patients.

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The present study was undertaken to clarify the effects of lysosomal hydrolases on mitochondria in vitro. Lysosomal enzymes extracted from canine liver were applied on intact rat hepatic mitochondria, and the changes in mitochondrial respiration and in swelling rate were observed. The hydrolases caused a significant suppresion of oxidative phosphorylation of mitochondria, exhibiting decreases in respiratory control ratio and ADP oxygen ratio. The degree of respiratory suppresion was paralled to the concentration of β-glucuronidase as a marker enzyme. The enzymes came forth a rapid swelling of mitochondrial pellets as determined by the decrease of absorbance of light at 540 nM in a spectrophotometer. The results suggest that lysosomal enzymes released into cytoplasm could be responsible for the mitochondrial impairment in the ischemic region during shock.

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A 21-year-old female and a 23-year-old female with advanced atrioventricular block in the course of hyperthyroidism were reported.
In the latter case, the febrile illness was associated immediately preceding the onset of the heart-block. The sore throat, polyarthralgia, pericarditis, leukocytosis, high erythrocyte sedimentation rate and ASO titre are compatible with a diagnosis of acute rheumatic fever, but a typical cardiac murmur was absent.
In the former case, an unexplained inflammation was suspected by elevated sedimentation rate, positive C-reactive protein, increased γ-globulin and subsequent course, although she was apyrexial.
In both our cases, therefore, the development of advanced A-V block might be due to the summation of delayed conduction induced by hyperthyroidism and infection or inflammation, as most previous reports suggested.

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One case of interstitial pneumonitis developed during gold therapy for rheumatoid arthritis was reported.
A 44year-old female with rheumatoid arthritis developed dry cough and exertional dyspnea after receiving injection of 445mg gold sodium thiomalate in total dose. Chest roentgenogram showed diffuse reticular and nodular shadow in the both middle and upper lung fields giving a partial ground glass appearance. Pulmonary function tests revealed restrictive change and impairment of diffusing capacity. As respiratory symptoms appeared in a period of remission of symptoms of rheumatoid arthritis with gold therapy and accompanied by development of stomatitis, skin rash and alopetia with eosinophilia, which commonly occur in gold therapy as side effect. Abnormal shadows in the chest xray film was dominant in the both middle and upper lung fields, the interstitial pneumonitis was diagnosed to be caused by gold therapy.
After administration of corticosteroids (Prednisolone), her subjective symptoms, respiratory functions and chest roentgenograms improved except for remaining of mild reduction of diffusing capacity (after 9 months of follow up).
Comparison of reported 14 cases of gold pneumonitis including this case from 1971 Japan was also disscussed.

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