The relationship between platelet life-span and plasma concentration of β-thromboglobulin (β-TG) or platelet factor 4 (PF-4) was studied in 28 normal subjects and 69 patients with various diseases (9 patients with essential hypertension, 12 patients with diabetes mellitus, 6 patients with malignant tumor, 24 patients with cerebral infarction, 13 patients with ischemic heart disease and 5 patients with peripheral vessel thrombosis). The platelet life-span was measured by means of a non-radioisotopic method using aspirin. The following results were obtained :
1. The mean platelet life-span in each disease group except for essential hypertension was reduced significantly compared with that of the healthy control group.
2. The plasma concentrations of β-TG and PF-4 in the cerebral infarction and ischemic heart disease groups were elevated significantly compared with those of the healthy control group.
3. Among all the patients and normal control individuals subjected to the present study, a significant inverse correlation was confirmed between the platelet life-span and the plasma concentration of β-TG or PF-4. The correlation was also significant in each disease group except for the malignant tumor and peripheral vessel thrombosis groups.
4. The platelet life-span was correlated inversely and significantly with the plasma concentration of fibrinogen, but was not correlated with either the serum concentration of total cholesterol, HDL-cholesterol or triglyceride.
5. In patients with cerebral infarction and ischemic heart disease, the shortened platelet life-span and increased plasma concentration of β-TG or PF-4 tended to be normalized as the time interval between the attack and their respective measurements increased.
From these results, it was concluded that the intravascular platelet consumption in patients with the various diseases described above was increased significantly, and that plasma concentrations of β-TG and PF-4 are reliable indicators of the platelet consumption.

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In order to investigate the genetic basis of schizophrenia, the frequencies of the types of various genetic markers such as ABO, Rh, MNSs, P, Lewis, Duffy, Kidd and Diego blood groups, HLA-A and -B, and Hp, Gm, Km and Gc serum types, were examined in 128 schizophrenic patients diagnosed according to DSM-III.
The following comparisons were made :
1) The frequencies of the above types of genetic markers in schizophrenics were compared with those in the controls.
2) Schizophrenics were divided into 3 groups according to their age at onset, 14-19 (early onset group), 20-29 (middle onset group), 30-45 years (late onset group), and the frequencies of the various types were compared among these groups.
3) Schizophrenics were divided into 2 groups according to the presence or absence of a hereditary predisposition, and the frequencies of types of genetic markers were compared with each other.
The results were as follows :
1) Statistically significant differences were found between schizophrenics and the controls in the frequencies of MNSs, Duffy, Kidd, HLA-A, Hp and Gm types.
2) Statistically significant differences in the frequencies of the Km type were found between the early and late onset groups.
3) Statistically significant differences in the frequencies of MNSs and Gm types were found between the two groups divided according to the presence or absence of a hereditary predisposition.
The results of this study thus indicate that genes located on chromosomes 1, 4, 6, 7, 8 and 16 have some relevance to the etiology of schizophrenia. In addition, they indicate the possibility that schizophrenia can be genetically classified according to genes located on chromosomes 4, 6 or 8.

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The purpose of this study was to investigate the clinical features of prolonged-type depression. The clinical features chosen as variables were sex, age, family history indicating hereditary predisposition, type of treatment (inpatient or outpatient), age at first onset, number of occurrences of depressive phases, length of the period from the first onset, complications, causes, present state and personality traits.
This time, fifty-two patients with major depression were subjected to this study. They were classified into two groups according to the length of their present illness ; a prolonged group (a period of six months or more) and a control group (a period of under six months). The two groups were examined for the prevalence of clinical features. It was found that, there were statistically significant relations between the two groups with regard to the number of occurrences of depressive phases, the length of period from the first onset, the present state, and personality traits.
Therefore, it was shown that these four variables appear to be clinical features related to prolonged depression.

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In an attempt to analyse abnormalities of the lithium transport mechanisms (uptake and efflux) in erythrocytes taken from unipolar depressive patients, schizophrenics and their parents, the effects of psychotropics on these mechanisms were examined in vitro.
The results were as follows :
1) Lithium uptake by erythrocytes from normal subjects and unipolar depressive patients was increased by psychotropics, but in schizophrenics it was not.
2) Lithium efflux, especially Li-Na countertransport in erythrocytes from normal controls and unipolar depressive patients was inhibited dose-dependently by chlorpromazine (1-14.1 μM), but no such inhibition was observed in erythrocytes from schizophrenics.
3) The parents of schizophrenics could be divided into two groups according to the effects of psychotropics on lithium efflux. One group was similar to schizophrenics, and the other group was similar to the normal controls.
It was concluded that :
1) Quantitative abnormalities of the lithium transport mechanisms exist in the membrane of erythrocytes from unipolar depressive patients.
2) Not only quantitative but also qualitative abnormalities of the lithium transport mechanisms exist in the membrane of erythrocytes from schizophrenics.
3) The finding that abnormalities exist in the membrane of erythrocytes from some parents of schizophrenics indicates that these abnormalities are genetically influenced.

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Early 500 cases that underwent MRI examination at Division of diagnostic radiology between April 1980 and June 1981 are reviewed to investigate its clinical application. Anatomical details of brain stem & posterior fossa lesion & pelvic lesion, and pathophysiological changes associated with multiple sclerosis, brain edema & disc degeneration are better assessed.
Future MRI application using surface coil, contrast agent Gd-DTPA & ECG-gated cardiac study are commented.

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Eleven patients with ureteral stone disease were treated transurethrally using a rigid uretero scope and ultrasonic lithotriptor. From this experience, we consider that most ureteral stones can be removed through this procedure alone or in combination with percutaneous nephrolithotripsy.

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Serial treadmill exercise testing (mean 3.3 tests/patient during 14 months) was performed in 61 patients with myocardial infarction in order to assess its value for the prediction of the later course. Unstable angina appeared in 7 patients in whom exercise tolerance was reduced during the follow-up period. On the other hand, serial exercise testing was unable to predict the occurrence of reinfarction and sudden death. Three reinfarctions and 1 sudden death occurred in the absence of obvious reduction of exercise tolerance during follow-up.
The association of coronary risk factors, left ventricular function and the prescribed drugs did not affect the exercise tolerance during follow-up.

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We have experienced 7 cases of renal arteriovenous fistula since 1967. One of them indicated symptoms of heart failure and the others showed urinary tract symptoms (hematuria, colic pain, tamponade of urinary bladder).
With regard to medical treatment, nephrectomy was performed in 4 cases, partial nephrectomy in 2 cases and the others were treated conservatively. Howerer we think that transcatheter embolization would be better than other approaches in future treatment.

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A 54-year-old female was admitted to the hospital for evaluation of heart disease. The patient had had an episode of paroxysmal dyspnea 2 months prior to admission. Echocardiographic and angiocardiographic studies revealed markedly reduced left ventricular wall motion and a large left atrial mass. The histological findings of the biopsied right ventricular specimens were consistent with dilated cardiomyopathy. A large left atrial myxoma measuring 4 × 6 cm in size was successfully resected later.
This is the first reported case of dilated cardiomyopathy associated with a left atrial myxoma, as far as we know.

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Two male patients with hypertrophic obstructive cardiomyopathy succumbed to infective endocarditis. Although a mitral valve replacement during the acute phase transiently relieved the severe congestive heart failure resulting from rupture of the chorda tendinae, the patient died 10 days after the operation. No surgical intervention was attempted in the second case, a 57-year-old male.
Our experiences, although limited, suggest that surgical intervention should be cosidered even in the acute phase when signs of heart failure appear in patients with hypertrophic cardiomyopathy complicated with infective endocarditis.

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