Twenty percent of cultured carp and their pond water in Gunma and Saitama Prefecture were contaminated with Salmonella. The major isolates were S. typhimurium (30%), 82% of which were drug-resistant. Six kinds of R plasmids, five IncH and one IncK, were isolated from five multiply resistant S. typhimurium. No Salmonella could be isolated when the carp was washed thoroughly with clean fresh water.
Each of five kinds of fresh water fish, -carp, ayu, eel, rainbow trout, and yamame-, carried drug-resistant bacteria, the majorioy of which were Aeromonas hydrophila, ranging from 70% (Carp) to 29% (Eel) in the isolates. All of these A. hydrophila were drug-resistant, and 44 R plasmids were isolated. They all belonged to the IncC group. As for 17 standard R plasmids belonging to different incompatibilities, seven kinds of R plasmids (IncFII, FV, C, O, P, T, X) were transferable to A. hydrophila, but only IncC R plasmid was stable in the new host. The results paralleled the epidemiologdcal studies. The IncC plasmid was also characteristic in its high transferability at relatively high salt concentration.

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Enhancement of the antitumor effects of vincristine (VCR), vindesine (VDS), mitomycin C (MMC) and adriamycin (ADM) by the calcium antagonist, verapamil was investigated using human xenografts serially transplanted into nude mice.
Neuroblastoma, rhabdomyosarcoma, and gastric and colonic carscinomas were subcutaneously transplanted into the backs of BALB/C nude mice. VCR, VDS, MMC and ADM with verapamil were administered to the tumor bearing nude mice. The effects of chemotherapy were evaluated by the growth rate curve of the tumor, doubling time, the ratio of mean weight of the treated tumor to that of the control tumor, histological findings and flow cytometric study.
Verapamil remarkably enhanced the antitumor activity of VCR in neuroblastoma, VDS in rhabdomyosarcoma and MMC in gastric cancer. Verapamil slightly enhanced the antitumor effect of ADM in gastric cancer and MMC in colonic cancer. In nude mice, the nontoxic and effective dose of verapamil was from 25 mg/kg to 50 mg/kg. This combined chemotherapy of an anticancer drug and verapamil seemed to be effective for tumors transplanted into nude mice, suggesting its clinical applicability.

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Seven patients with supravesical obstruction due to pelvic malignancies were treated with percutaneous nephrostomy. There were five women (three : carcinoma colli ; two : gastric cancer) and two men (one : rectal cancer ; one : prostatic cancer and bladder cancer). Percutaneous nephrostomy is easier than surgical nephrostomy, and it can be under taken safely without fatal complication. Postoperatively, BUN and creatinin were normalized or lowered. No patient has died because of renal failure. Considering the prognosis of advanced pelvic malignancies, our conclusion is that percutaneous nephrostomy is better for urinary diversion than surgical nephrostomy.

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Percutaneous nephrolithotomy was performed in eight patients with renal calculi over the past year.
The procedure is that an approximate 26Fr. size of nephrostomy was performed under fluoroscpic control and echo guidance. The calculi was then removed through the nephrostomy, by grasp forceps, or disintegrated by ultrasonic lithotripsy, or the electrohydraulic lithotripsy.
Judging from our clinical experience, it was concluded that percutaneous nephrolithotomy is an excellent procedure for the lithotomy of the upper urinary tract.

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Eight hundred thirty-five patients with acute appendicitis operated on at Tone Central Hospital during the eight-year period from January 1977 to February 1985 were reviewed. The clinico-pathological types of acute appendicitis were
1 appendicitis without peritonitis
1) catarrhalis
2) phlegmonas
3) gangrenous
2 appendicitis with peritonitis
In children (under 16 years old), the white blood cell count usually increased remarkably in those with gangrenous appendicitis or appendicitis with peritonitis. On the other hand, in older people (65 or more), the white blood cell count didn't usually increase and physical signs weren't usually remarkable, even in patients with gangrenous appendicitis or appendicitis with peritonitis.

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Tissue levels of CEA were elevated in some histological types of colonic carcinomas. Recently, it has been shown that tissue levels of N¹-acetylspermidine (N¹-Aspd) were elevated selectively in colonic adenocarcinomas. In the present study, attempts were made to correlate N¹-Aspd levels and CEA levels in human colonic adenocarcinomas, seventy-thee patients with colorectal carcinomas were studied. As a control, mucosae were taken at 3 cm distant from the margins of the adenocarcinomas. Tissue CEA levels were measured using high-performance ion-exchange chromatography. The carcinomas studied included a well-, moderately and poorly differentiated adenocarcinomas. Both N¹-Aspd and CEA levels were significantly higher in adenocarcinomas than in control mucosae. There was no significant correlation between the two tumor markers in the colonic adenocarcinomas. These findings indicate that these two markers are of a different nature.

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The balance-study method in the assessment of the fat-absorbing ability of patients after gastric surgery was reappraised. As a test meal, Caloriemate and Hinex-R, obtained from commertial sources, in which the content of fat and all other nutritional elements was well known, was newly introduced to the present study. The results obtained were in good paralel with those of the D-xylose excretion test. The feasibility and the value of the balance-study method in the assessment of fat-absorbing ability was stressed.

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A fifty-year-old man was admitted to the hospital because of nocturnal dyspnea. Physical examination showed moist rales, an enlarged liver and edema in lower extremities. X-ray films of the chest revealed lung edema, cardiomegaly and bilateral hilar lymphadenopathy. An electrocardiogram showed right bundle branch block and multiple ventricular premature beats. An echocardiogram and a left ventriculography disclosed decreased ejection fraction and cardiac output. The serum calcium level, angiotensin converting enzyme and serum 1, 25 dihydroxyvitamin D were elevated. An ultra-sound examination and a urogram revealed renal and ureteral calculus. The diagnosis was made on the evidence of epiteloid cell granulomas and giant cells in the biopsy specimen of the lung. Although the sarcoidosis has been known to be associated with hypercalcemia and urinary calculus, this association has been reported only in eight cases in Japan.

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Five renal transplantations were performed in Tomioka Kousei Hospital from November 1982 through April 1985. Four were living donors and one was a cadaver. All patients were tested for HLA-A·B·C·DR and direct crossmatch. All patients had previously received blood transfusions and cases 3 and 5 had received donor-specific blood transfusion before transplantation. The survival and graft survival rate are 100% at present. ATN was observed in four patients (80%) who were maintained with hemodialysis. All cases recoverd. Serum creatinine levels in recipients are 0.61.6mg/dl and no patient is treated with HD.

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This is a report of a 62-year-old man with a history of asthmatic attack following therapy for bronchial asthma with intravenous injection of hydrocortisone sodium succinate (Saxizon^®, Solu-Cortef^®).He had had episodes of dyspnea since 1979 and was treated with oral bronchodilators and intermittent cortimosteroids (prednisolone), and at the exacerbation of asthmatic symptoms he was treated with intravenous drip infusion containing aminophylline and Saxizon^®. On June 15, 1983, he complained of dyspnea. As a result, he was given 200mg of Saxizon^® intravenously. After then, his asthmatic attack worsened. To confirm the suspected relationship between the drugs and asthmatic attack, intravenous provocative challenge tests were performed, and 100mg of Saxizon^® and Solu-Cortef^® revealed positive results, but intravenous challenge tests with 100mg of hydrocortisone disodium phosphate (Hydrocortone^®) and 20mg of prednisolone sodium succinate (Predonine^®, Shionogi) and oral challenge with 100mg of hydrocortisone (Hydrocortone^®, Japan Merck-Banyu) were negative. Skin and P-K tests with hydrocortisone sodium succinate were positive. Although this type of adverse reaction to steroidal products is rare, it is very important in allergy practice.

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Renal osteodystrophy (ROD) with secondary hyperparathyroidism (2°HPT) is a serious complication in patients who have received long term maintenance hemodialysis. In patients whose bone pain, bone fracture and bone deformity are resistant to medical treatment with aluminium hydrochloride, 1α-OH D₃, etc, and whose serum parathyroid hormone (c-PTH) is elevated, parathyroidectomy is generally performed.
We report herein two patients who underwent total parathyroidectomy and autoplantation of the parathyroid graft in the left forearm, and subsequently showed amelioration of clinical signs and laboratory data..
Case 1 is 29-year-old man. He was diagnosed as chronic proliferative glomerulonephritis with nephrotic syndrome in 1972 and received some medications, but his renal function gradually deteriorated. Hemodialysis was started in 1975. In May 1982, facial change and pain in the lumbar region and the chest were noted. He received 1α-OH D₃, but without any effects. Therefore he was admitted to the hospital in December 1982. On laboratory examination, serum alkali-phosphatase (Al-ptase) and c-PTH were found to be elevated to 97.5 K.A.units, and 25.5ng/ml, respectivdly. He received total parathyroidectomy and autoplantation of the parathyroid graft in the left forearm.
Three days after the operation, his bone pain disappeared, and he remained free from pain until 1985.
Case 2 is 33-year-old woman.She was diagnosed as chronic proliferative glomerulonephritis in 1971, and hemodialysis was started in 1979. In March 1982, she complainted pain in the bilateral knee joints and heels. In November 1983, laboratory examination revealed that serum Al-ptase and c-PTC were elvated to 69 K.A. units and 34.2ng/ml, respectively. She was diagnosed as ROD with 2°HPT and underwent total parathyroidectomy and heterotopic autoplantation. Two days after the operation, her complaint disappeared.

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