Urinary arylsulfatase A (ASA) activity was measured with an aim of elucidating the clinical usefulness as a parameter for predicting the early relapse of acute leukemia. ASA activity expressed as units per mg creatinine showed considerable difference among individuals, as well as diurnal variation. However, the activity in the partial urine obtained early afternoon was significantly elevated above normal values in patients with untreated acute leukemia, while it returned to normal range when complete remission was attained.
The change of ASA activity was followed every 1-2 weeks until relapse or the end of the study in 33 patients with acute leukemia in remission. The observation period was 1-28 months with average of 9 months. The relapse occurred in 11 patients during study period. The pattern of ASA activity and clinical course was classified into the following 5 groups. Group I : 18 patients without relapse in whom ASA activity remained stable within normal range. Group II : 4 patients in whom ASA activity fluctuated significantly despite continued remission. Group III : 3 patients whose activity did not elevate above normal in face of relapse. Group IV : 3 patients in whom ASA activity increased to abnormally high values simultaneously with clinical judgement of relapse. Group V : 5 patients who showed elevated ASA activity 213 weeks in advance of the clinical diagnosis of eventual relapse. Thus, from the viewpoint of usefulness for the judgement of relapse, ASA activity measurement was found to be effective in 79% of patients, while a significant proportion showed either false positivity (12%) or false negativity (9%).
It was concluded that with more detailed informations regarding various factors affecting urinary ASA activity, it may be one of the parameters useful for the better clinical management of patients with acute leukemia.

抄録全体を表示

TSH secretory dynamics under continuous TRH stimulation for two or three hours was studied in euthyroid and hypothyroid rats.
In euthyroid, plasma TSH level induced by continuous TRH stimulation was the biphasic pattern, which had two peakes of response around 15 minutes (min) and between 90 to 120min, and the nadir at 60min after TRH stimulation. Changing the dose of TRH at 45min, bigger TSH response was observed after 60min in higher TRH dose than in ordinary TRH dose. Thyroxine (T₄) pretreatment had no effect on the biphasic TSH response.
In hypothyroid made by methylmercaptoimidasole treatment (MMI), plasma TSH level induced by TRH was the monophasic, which had one single peak around 30min and then kept the pre-experimental basal level. In MMI rats maintained with T₄ (MMI+T₄), the biphasic TSH response to TRH was seen again.
Pituitary TSH content of euthyroid was almost same as of MMI+T₄, and they both were higher than that of hypothyroid, significantly.
Conclusion : In euthyroid, continuous TRH stimulation induced the biphasic TSH response. The nadir of TSH response was likely due to the transient desensitization of TRH receptor. In hypothyroid, TSH response to TRH was monophasic. Pituitary TSH content seemed to make the difference of TSH response between in euthyroid and hypothyroid.

抄録全体を表示

From 1981 to 1985, a mass screening for prostatic diseases among men over 50 years old was carried out in 3 cities, 8 towns and 7 villages in Gunma Prefecture, Japan. The total number of persons examined was 5, 770. Digital rectal examination and measurement of serum prostatic acid phosphatase activity were performed for 5, 770 men. About 40% of the total persons examined was diagnosed as benign prostatic hypertrophy. Prostatic biopsy was recommended to men who were found of abnormalities by digital rectal examination or measurement of serum prostatic acid phosphatase activity. Prostatic cancer was detected in 54 men (0.94%). Out of 54 men, 28 men (52%) were found by clinical or pathological methods to have stage B condition of the disease. Serum prostatic acid phosphatase is not useful to detect early stage of prostatic cancer, but is useful to find out metastatic advanced prostatic cancer which should not be overlooked. The cost of detecting one cancerous prostate tumor was approximately ¥700, 000. These results apparently indicate the importance and the necessity of mass screening examination which include digital rectal examination and serum prostatic acid phosphatase activity measurement in order to detect prostatic cancer.

抄録全体を表示

Two-dimensional echocardiography (2DE) was used to study left ventricular wall motion in 10 normal subjects and 55 patients with Kawasaki Disease. These 65 cases could be divided into four groups by the findings of ECG, 2DE, Thallium 201 myocardial imaging and coronary angiography : group A (10 normal subjects) had normal findings in ECG and 2DE. group B (6 patients) had infarction and regional wall motion abnormalities in those examinations. group C (19 patients) had coronary aneurysms. group D (30 patients) had no infarction and coronary aneurysmal changes.
Echocardiographic studies were performed in short and long axes of ventricle, which was divided into nine segments for analysis. Wall motion in each segment was classified as normal, hyperkinetic, hypokinetic, akinetic or dyskinetic. Based on this analysis a wall motion index was derived as an overall assessment of left ventricular asynergy. In group B, the wall motion index was 10.3±3.1, which was significantly higher that in group A (p < 0.001). In group C, the wall motion index was 2. 2 ± 2.3, which was also significantly higher than that in group A (p < 0.01). Between in group D and group A, the wall motion index had no significance.
Therefore, two-dimensional echocardiography may be a useful method for detecting the presence of regional asynergy associated with myocardial ischemia and infarction in Kawasaki Disease.

抄録全体を表示

Observations of the routine chest X -ray films of the patients between the age of 40 and 59 years revealed a high incidence of calcification of aortic arch in the presence of significant coronary stenosis as compared with those without significant coronary lesions and those without arteriosclerotic disease. The incidence of aortic arch calcification of zero, one and multivessel coronary disease was 15%, 29% and 38%, respectively. The difference was not obvious in the patients above the age of 60 years.

抄録全体を表示

This report describes five bronchial asthmatic patients who had asthmatic attacks following administrations of steroidal products. Case 1 was 62 years-old male with asthmatic attack provocated by hydrocortisone disodium phosphate (Hydrocortone Phosphate Injection®). Case 2 was 62 years-old male with asthmatic attack provocated by hydrocortisone sodium succinate (Saxizon®). Case 3, 4 and 5 were 55 years-old male, 47 years-old female and 35 years-old male with asthmatic attacks provocated by steroidal products (Solu-Cortef®) These three cases were aspirin-induced asthma. Although these types of adverse reactions to steroidal products are rare, it is very important in allergy practice.

抄録全体を表示

15 severe cervical spinal cord injury patients were treated actively in Isesaki City Hospital from eight years ago. Injured cord levels were C₂ 1 case, C₄ 6 cases, C₆ 6 cases, C₆ 2 cases. The age distribution of the patients ranged from 16 to 74, with an average of 46 years. Thirteen were males, two females.
In acute stage, all patients were of the abdominal respiratory type and slight hypoxia (PaO₂ ranged from 38 to 80mmHg) in blood gas analysis. In pulmonary function test, the majority of patients showed restrictive pattern and four cases occurring pulmonary complications were of the mixed pattern. We were able to set up the critical level predicting the occurrence of pneumonia and atelectasis as follows : PaO₂, % vital capacity and % forced expiratory volume were under 66mmHg, 50% and 70%, respectively.
At the follow up time, two cases died and thirteen cases still remained to be the abdominal respiratory type and the restrictive pulmonary pattern. Five walking cases were capable of using intercostal muscles when doing deep breathing exercises and were nearing normal pulmonary function.
We have concluded that the pulmonary function test was essential to the management of acute severe cervical spinal cord injury adding blood gas analysis and one of the quantitative analyses of muscle strength of extremities in chronic state.

抄録全体を表示

Left ventricular systolic time intervals (STI) at rest was examined by carotid pulse tracing in 37 patients with hypertrophic cardiomyopathy (HCM) consisting of 13 patients with hypertrophic obstructive cardiomyopathy (HOCM) and 24 patients with hypertrophic nonobstructive cardiomyopathy (HNOCM).
These values were compared to peak systolic pressure gradient (pSPG) and mean systolic pressure gradient (mSPG) determined by cardiac catheterization at rest.
In patients with HOCM, Q-II c (corrected Q-II time) and LVETc (corrected left ventricular ejection time) were elongated, PEPc (corrected preejection period) was shortened and PEP/LVET (preejection period/left ventricular ejection time) was low compared to those in patients with HNOCM and in normal subjects.
In patients with NHOCM, LVETc was shortened, PEPc was elongated and PEP/LVET was high compared to those in patients with HOCM and in normal subjects.
In patients with HOCM, Q-II c and LVETc were positively correlated with pSPG (r = 0.714, r= 0.810, respectively) and mSPG (r = 0.884, r =0.930 respectively).
Furthermore, PEP/LVET was negatively correlated with pSPG (r= 0.865) and mSPG (r= 0. 851).
It is concluded that STI determined by carotid pulse tracing is an useful diagnostic method in differentiating HOCM from HNOCM, moreover it may be possible to assess noninvasively the degree of systolic pressure gradient in patients with HOCM.

抄録全体を表示

In 100 patients with hepatocellular carcinoma (HCC), 79 cases were accompanied by liver cirrhosis and 21 cases were not. In the accompanied (A) and unaccompanied (B) groups by liver cirrhosis, there was no differences about sex, alcohol intake, the serum level of alpha-fetoprotein. B group was widely distributed from 20 to 80 years old in age and more rarely had the history of blood transfusion than A group. The family history of liver disease and the rate of positive HBsAg were frequently observed in B group than A group. Though B group was found in advanced state with subjective and objective symptoms, there was no difference in prognosis between the two groups. The histology of the non-cancerous lesions of the B group included 2 cases of portal fibrosis, 7 cases of chronic active hepatitis, one case of non specific changes. Two young patients under 40 years old of B group were both HBsAg positive, so it seemed to be necessary for HBsAg carriers without liver cirrhosis to be screened as high risk group of HCC.

抄録全体を表示

A case of unilateral aneurysm of the renal artery is reported. The patient is a 21 old young man who has been suffering from rheumatic fever since eleven years. A renal aneurysm was found accidentally during autopsy. The aneurysm is considered to be formed due to rheumatic arteritis.

抄録全体を表示