5-FU dry syrup was administered orally to 128 patients with gastric cancer before operation from 1976 to 1979. The purposes of this administration were to inactivate cancer cells liberated from the primary tumor, to prevent them from implanting into other organs and to treat established metastatic lesions.
To judge effectiveness and side effects in the treatment, tissue concentration of 5-FU, histological changes in cancer cells by light microscopy and electronmicroscopy and side effects in clinical and laboratory data were observed.
The following results were obtained :
(1) Blood levels of 5-FU given orally reached to the maximum after 15 minutes and lowered to trace after 2 hours.
(2) Blood levels were influenced under various conditions such as meals and gastrectomy.
(3) Oral administration elevated the tissue concentration especially in the stomach, the duodenum, the small intestine and portal blood. And it was thought to be suitable for the patient with cancer of upper gastrointestinal tract.
(4) In portal blood of pylorus-ligated rats, maximum level of 5-FU injected into the duodenum showed 18 times higher than that in the case of intragastric injection. It suggests that 5-FU is absorbed mainly in the small intestine.
(5) Histological effects in gastric cancer cells were observed in 3 of 128 cases by light microscopy and in 3 of 17 cases by electronmicroscopy.
(6) During 5-FU D.S. administration, side effects such as nausea, anorexia and stomatitis were occurred only in 11% of 128 cases.
(7) Laboratory data such as wbc count, platelet count and liver function test revealed no abnormality by 5-FU administration.
These data suggest that preoperative administration of 5-FU D. S. for gastric cancer is safe and reasonable.

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The pathophysiology of chronic gastritis remains to be determined. Metoclopramide, sulpiride and γ-Oryzanol, drugs which mainly act on the central nervous system, were reported to be effective against various complaints in patients with chronic gastritis. The aim of the present study was to analyze the part of pathophysiology of chronic gastritis. In addition, the effects of these drugs on clinical evaluations were compared.
Nineteen patients with chronic gastritis (aged 25 to 74 years), 21 men and 8 women, were studied. All patients were orally given a therapeutic dose of metoclopramide (30 mg/day), sulpiride (300 mg/ day) and γ-oryzanol (300 mg/day) for 4 weeks. Serum gastrin was determined by radioimmunoassay. The results obtained herein were as follows :
1. Sixty two % of the patients was found to be neurotic, suggested by the method of modification of CMI test.
2. Various kinds of complaints were observed in patients with chronic gastritis. These include nausea, fatigability, and postpradial fullness and discomfort in the upper abdomen.
3. The effective rates of metoclopramide, sulpiride and γ-oryzanol against various complaints were 66.7%, 86.7% and 75.0%, respectively. It was of interest to note that sulpiride was the most effective against psychic complaints.
4. Administration of γ-oryzanol resulted in decreased serum gastrin levels, while no change was observed in metoclopramide or sulpiride-treated groups.
5. No effect by these drugs on the rate of secretion of gastric juice was found.

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γ-Oryzanol, ferulic acid ester of triterpenol extracted from rice-bran oil, has been used against autonomic instability with abdominal symtoms and climacteric complaints. Itaya et al. postulated that monoaminergic neuron system involved in the anti-gastric ulcerogenic action of this agent. In the first report, γ-oryzanol was found to decrease serum gastrin levels in patients with chronic gastritis. These observations have led me design the present study to elucidate the endocrine effects of γ-oryzanol in patients with chronic gastritis. Thirteen patients with chronic gastritis were orally given a daily dose of γ-oryzanol (300mg/day) for 4 weeks. Seven healthy volunteers constituted the control group. The results shown here were as follows :
1. Administration of y-oryzanol to patients with chronic gastritis resulted in decreased serum gastrin levels, which was approximately 75% lower than the initial value. In contrast, there was no significant change in the serum gastrin levels as a group after administration of γ-oryzanol to normal subjects.
2. Arginine (0.5g /kg, drip infusion over 30 min) -induced serum gastrin responses before and after γ-oryzanol treatment were similar.
3. No difference was observed in L-dopa (0.5g, orally) -induced gastrin response with or without γ-oryzanol. However, serum HGH response to L-dopa was significantly suppressed by γ-oryzanol.
4. γ-oryzanol failed to show discernible changes in serum levels of secretin, glucagon, catecholamines and prolactin.
5. Baseline serum cortisol levels following γ-oryzanol treatment were lower in all patients studied than the initial values without γ-oryzanol. In contrast, no significant change was observed in the control group. The cortisol response to ACTH was not altered byγ-oryzanol. Further more, the basal plasma ACTH levels appeared to be lowered by this agent.
The lowering effect of γ-oryzanol on serum gastrin level was clearly demonstrated in patients with chronic gastritis, in a sharp contrast to control subjects.This suggests an increased susceptibility of the patients to γ-oryzanol. The action of γ-oryzanol on serum gastrin level may result from an effect on the hypothalamo-pituitary-adrenal axis. In addition, the present investigation provides evidence that y-oryzanol is antidopaminergic in the serum HGH response, as reported in metoclopramide and sulpiride.

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In our department, ultrasonic echography and aspiration cytology have been used as adjuncts for differential diagnosis of the thyroid tumor. We report the recent eight years' experience with echography and aspiration cytology, and discuss the great value of these techniques.
Echography with B-mode or sensitivity graded method was carried out in 616 operated patients with thyroid disorders, including 157 cases of carcinoma. Echogram pattern was classified into six types (I, Ip, II, IIc, III and IV) and was compared with pathological findings. In benign neoplasms the over-all true positive rate was 336 of 385 patients or 87.2%, while the rate in carcinomas 88 of 155 cases or 56.8% when the type I p, III and IV were regarded tentatively as a malignant pattern. Aspiration cytology using a fine needle was made on 316 patients. It's true positive rate was 178/190 or 93.7% in the benign tumors dnd 72/102 or 70.6% in carcinomas. However, when echography and aspiration cytology were combined with physical and X-ray examination, the diagnostic accuracy of the carcinoma was raised to 87.0%.
The both techniques are considered to offer many advantages to preoperative differential diagnosis of thyroid tumors.

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In order to elucidate the mechanism by which both chloramphenicol (CP) and thiamphenicol (TP) induce reversible erythroid suppression, an inhibitory effect of these drugs on heme synthesis was investigated in the patients having CP and/or TP-induced acute bone marrow failure.
The patients consisted of five TP cases and the case which had been given both drugs. All cases but a case of polycythemia vera had reversible erythroid suppression. The case of polycythemia vera died of cerebral thrombosis. The anemia observed at the occurrence of acute bone marrow failure were normocytic and normochromic in all cases but one of polycythemia vera, which already had low value of MCV, MCH and MCHC prior to TP administration. Among six patients one had pancytopenia, three had only anemia and two had anemia with thrombocytopenia. Normal to slightly elevated level of serum iron was observed in all cases which were measured one to two days after the occurrence of acute bone marrow failure. Morever, the appearance of ringed sideroblasts were noted in two of six cases which bone marrow examination was performed.
Out of five cases examined, two showed a decrease in deltaaminolevulinic acid synthetase (δ-A-LA-s) activity while the other two did the normal values. Out of three cases two showed an increase in both free erythrocyte copro- and protoporphyrin, and the third did the normal value. Neither inhibitory effect of CP succinate nor TP on δ-ALA-s was observed in the in vitro study examined at a concentration of less than 10^-3 mol of CP or TP.

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