Pressor responses to vasoconstrictors are increased in both clinical and experimental hypertension. Previous studies from our laboratory showed exaggerated pressor responses to vasoconstrictors in prehypertensive rabbits of renal hypertension. Although these results have revealed important roles of several humoral factors such as renin-angiotensin system and prostaglandin systems, many other humoral factors and neurological mechanisms may be involved in enhanced pressor responses. Furthermore, humoral factors could modulate vascular reactivity via neurogenic system, e.g. baroreflex. The present study examined 1) a role of angiotensin II in enhanced pressor responses in early stage of one-kidney, one clip renal hypertension in rats (2 days after renal artery stenosis : 2-day clipped rats), using [1-Sar, 8-Ile] angiotensin II, specific antagonist of angiotensin II ; 2) a role of serotonin, one of the other humoral factors, in the enhanced pressor responses in this model, using ketanserin, a specific antagonist of 5-HT₂ ; and 3) changes in baroreflex sensitivity to determine whether baroreflex causally relates to this pressor hyperresponsiveness. Mean arterial pressure was slightly higher in the 2-day clipped rats than in sham-operated rats. Pressor responses to norepinephrine, arginin vasopressin and serotonin were exaggerated in the 2-day clipped rats than in the sham-operated rats. This hyperresponsiveness was attenuated by administering [1 -Sar, 8 -Ile] angiotensin II and ketanserin either of which did not alter mean arterial pressure. Baroreflex sensitivity was studied by measuring changes in arterial pressure and pulse interval in responses to bolus injections of phenylephrine. Baroref ex sensitivity was not decreased but markedly increased in the 2-day clipped rats and was unaffected by the infusion of [1-Sar, 8-Il] angiotensin II. These results provide evidence that 1) in the 2-day clipped rats there are exaggerated pressor responses to norepinephrine, arginin vasopressin and serotonin ; 2) angiotensin II and serotonin play significant roles in these increased pressor responses ; and 3) the changes in baroreflex sensitivity do not participate in the pressor hyperresponsiveness in the 2-day clipped rats, because the increased sensitivity should have attenuated this response, not exaggerated it.

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The role of the brain renin-angiotensin system (RAS) in pressor responses to norepinephrine (NE) and angiotensin II (AII) and in baroreflex sensitivity was examined in two-kidney, one-clip rats with renal artery stenosis of 2 days' duration (2K1C) and sham-operated controls by intraventricular and intravenous administration of an AII antagonist, [1-Sar, 8-Ala] angiotensin II (saralasin).
In 2K1C rats, mean arterial pressure (MAP) was increased as compared with controls and an exaggerated pressor response to NE was observed. The intraventricular infusion of saralasin (0.5 μg/kg/min for 30 min), which did not change MAP in either group of rats, abolished the hyperresponse in 2K1C rats. After obtaining the pressor response to NE, the same dose of saralasin used intraventricularly was infused intravenously for 30 min. The MAP in 2K1C rats was decreased, but that in controls was not changed ; the pressor response to NE was not altered in either of the two groups. Baroreflex sensitivity was decreased in 2K1C rats. The intraventricular infusion of saralasin restored the decreased baroreflex sensitivity in 2K1C rats. Plasma renin activity (PRA) was elevated in 2K1C rats as compared with controls. Plasma NE concentrations were not different in the two groups and they were not altered by the intraventricular infusion of saralasin. The intraventricular infusion of saralasin decreased PRA in 2K1C rats, whereas it increased PRA in controls. The pressor response to AII in the two groups was inversely related to the level of PRA, both before and during the intraventricular infusion of saralasin.
These results suggest that 1) the brain RAS is involved in the enhanced pressor response to NE in 2K1C rats, but not in the response to AII ; 2) the exaggerated response to NE is not mediated through either the peripheral RAS or the plasma NE levels, but induced in part by decreased baroreflex sensitivity, and 3) the brain RAS may have a role in modulating the peripheral PRA.

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Growth hormone (GH) secretion is mainly regulated by growth hormone releasing factor (GRF) and somatostatin (SRIF). Their chemical structures have already been determined and the distributions of immunoreactive GRF and somatostatin neurons in the central nervous system have been revealed. At this time, however, the neural mechanisms which regulate these two peptidergic neurons in the central nervous system are not fully understood. To clarify the neural circuitries responsible for the regulation of growth hormone secretion, electrical stimulation was delivered to the basolateral amygdala (ABL) and several brainstem nuclei in pentobarbital anesthetized rats.
Electrical stimulation of the ABL caused an increase in the plasma GH level 10 min after the onset of stimulation. This increase in plasma GH level was not affected by prior lesioning of the hypothalamic periventricular nucleus (Pe), from which the major SRIF immunoreactive fibers in the median eminence originate. These results indicate that the increase in plasma GH level caused by electrical stimulation of the ABL is not caused by reducing SRIF secretion. This indicates that the ABL stimulation causes the excitation of GRF neurons and consequently induces GH secretion.
Stimulation of the central gray matter in the midbrain and the pons, the locus ceruleus, the solitary tract nucleus and the lateral reticular nucleus suppressed exogenous GRF-induced GH secretion, but prior lesioning the Pe abolished the suppression of the GH secretion. These results indicate that electrical stimulation of several brainstem nuclei suppressed GH secretion through the excitation of SRIF neurons in the Pe.

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A new self-administered questionnaire, named the THI (Todai Health Index) for juniors, was developed in order to assess the mental health of adolescents. The development process and some aspects of its validity and reliability evaluation are reported.
Initially a preliminary questionnaire consisting of 195 items for assessing the physical and mental status of adolescents was prepared. It was then distributed to 1, 215 junior high school students in Gunma Prefecture.
By factor analysis methods, 103 of the 195 items were used to construct 8 scales : Vague Complaints, Extraversion, Neuroticism, Deviation from Routine Life, Irritability, Lie Scale, Depression, and Psychoticism.
The reliability of internal consistency was satisfactory, since Cronbach's alpha coefficient was over 0.8 in 6 of the scales.
To confirm the content validity of the scales, interviews with the teachers in the subject school were carried out. Through cluster analysis (Ward) of the scale scores, some typical patterns between the scale-scored profiles and actual status of the students were found.
For the assessment of predictive validity, discriminant analysis (Fisher) using all eight scale scores was applied to the results of the diagnostic interview by Rutter's method. Correct identification ratios were rather high at 83.33% (conduct disorder group vs. control), 62.86% (emotional disorder group vs. control), and 85.71% (mixed disorder group vs. control).

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Monoamine oxidase (MAO) activity in whole blood measured by the fluorescence method was examined in 44 chronic schizophrenics meeting the DSM-III criteria (26 males, 18 females) and 27 normal controls (13 males, 14 females).
In both groups the MAO activity in females was significantly higher than that in males. The MAO activity in schizophrenics was significantly reduced than that in controls. This was true even when sex differences were taken into consideration. This suggests that the reduction of MAO activity is related to the etiology of schizophrenia.
Although the reduction of MAO activity in the schizophrenic group as a whole or in the female schizophrenics had no significant correlation with the clinical background factors, in the male schizophrenics it was significantly correlated with the length of their present illness, the Brief psychiatric rating scale (BPRS) total score and the BPRS negative symptoms score, suggesting that it could be an index of the chronicity of schizophrenia.

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In order to elucidate the psychophysiological aspects of depression, the latency (LAT) and amplitude (AMP) of auditory event-related potentials (ERPs; N100, P200, N200, P300) recorded from F3, F4, C3, C4, P3 and P4, the reaction time (RT) and number of errors in binaural target detection tasks were studied in 31 depressives and 31 agematched normal controls. The depressives, meeting the DSM-III criteria for major depression, were divided into two groups : remitted (17 patients) and depressed (22 patients). The degree of depression was determined using the Hamilton depression rating scale.
In the depressed group, RT, RT variance and number of errors were larger than in normal controls. In the remitted group, the errors decreased to the normal level, but the RT and RT variance remained larger to some extent. There was a significant correlation between the reaction time and the Hamilton scores.
Analysis of mean values of ERP variables revealed shortened N100 LAT, reduced N100 and P200 AMP, prolonged N200 LAT and reduced P300 AMP in the depressed group reduced N100 AMP, prolonged P200, N200 and P300 LAT and reduced P300 AMP in the remitted group. There was a significant negative correlation between P300 AMP and the Hamilton scores.
Shortened N100 LAT in both hemispheres and reduced P300 AMP in the right hemisphere as well as prolonged RT observed in the depressed patients were considered to be state-dependent abnormalities. On the other hand, reduced N100 AMP in both hemispheres and prolonged N200 LAT in the right hemisphere were considered to be probably trait-dependent.
In examining the hemispheric regions that showed abnormal ERP variables, the following characteristics with regard to hemispheric laterality were observed : 1) More abnormalities were distributed in the right hemisphere in the depressed group, whereas there were more in the left hemisphere in the remitted group. 2) Abnormalities mostly common to both groups were found bilaterally. 3) Abnormalities partly common or characteristic to one group were found either bilaterally or in the right hemisphere in the depressed group, but only in the left hemisphere in the remitted group. Also the following characteristics with regard to hemispheric longitudinality were observed : 1) Abnormalities common to both groups were distributed in the frontal regions. 2) Abnormalities characteristic to one group were distributed in the central or parietal region.

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A case of stenosis after esophagogastric anastomosis in a 64-year-old male was repaired using free jejunal grafts revascularized by vascularanastomoses. The patient has previously undergone the curative resection for advanced esophageal carcinoma in September, 1987. Unfortunately, leakage at the esophagogastric anastomotic site resulted in stricture of the cervical anastomosis. He was initially treated by balloon dilation method several times, but he failed to eat satisfactorily.
So, operative method for the lesion was choiced. The cervical skin incision was extended downward and midsternal incision was added, and the right common cervical artery and internal jugular vein were exposed. Then, the stenotic lesion was removed.
A free jejunal segment with mesenteric vessels was removed, then the mesenteric vessels were anastomosed in order of the vein to the artery. On completion of the arterial anastomosis, the graft became pink and displayed peristalsis. Reconstruction of the digestive tract itself was performed in order of esophagojejunal and jejunogastric anastomoses.
Postoperatively, the patient was able to eat a regular diet and was discharged

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From February 1984 to December 1986, twenty-five patients with renal cell carcinoma were treated with interferon (INF) -α. The patients were divided into two groups. Group I (therapeutic group), with advanced renal cell carcinoma, was administered INF-α, 5×10⁶ IU daily for at least 8 weeks. Group II (prophylactic chemotherapy), at stage IIII, was administered 5×10⁶ IU of INF-α once in the first week, twice in the second week and three times in the third week for at least 6 months.
Twenty-two of the 25 patients underwent the whole schedule, only three dropping out.Fever (<39°C) was observed in 19 of the 25 patients, appetite loss in 16, depression in 2 and irritability in another 2. Myelosuppression was also seen. Fatal complications in two patients, one of whom had acute myocardial infarction and the other severe liver dysfunction. It thus seems important to stipulate discontinuation or reduction of the dosage of INF-α when side effects appear.

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The ability of genital Chlamydia trachomatis organisms to infect the human Fallopian tubes in organ culture was investigated by means of transmission and scanning electron microscopy.
Fimbriae or ampullar portions of the Fallopian tubes, obtained from 6 women who had been undergone hysterosalpingotomy, were cut into 1-mm cubes immediately after the operations, and were infected with freshly prepared chlamydial stocks which contained more than 5×10⁷ infective unities per ml. They were incubated for 5 days in an incubator at 37°C after an adsorption time allowed for 6 hours.
At various time intervals after the inoculation, infected organ-cultures were taken and fixed immediately and prepared for transmission and scanning electron microscopy. In every infected organ cultures mature inclusions were observed in approximately 9 % of the ciliated and 6 % of the non-ciliated epithelial cells, but not in the connective tissue cells of the Fallopian tubes.
The life cycle of the chlamydia organisms in the Fallopian cells was almost the same as those described with culture cell lines. It included three steps : initial conversion from the invaded elementary bodies (EB) to the vegetative reticulate bodies (RB) through an intermediate forms (IF), multiplication of the RB by binary fission and final maturation process producing the infective EB. The whole growth cycle was completed in 48 to 72 hours.
A characteristic “ladder-like” structure was found in the growing RB at the binding site to the limiting membrane of the inclusion cavity, which is thought to have a beneficial role for their intracellular metabolism.

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Since the original report by Dieulafoy, there have been over 200 cases of Dieulafoy's ulcer reported in Japan.
Now we report a case of Dieulafoy's ulcer that necessitated gastrectomy due to unsuccessful endoscopic hemostasis.
A 49-year-old man was admitted to the National Numata Hospital because of sudden hematemesis during having lunch. Successful endoscopic hemostasis was performed by 95% ethanol injection. Three days later, rebleeding occurred, for which endoscopic hemostasis was unsuccessful. Then he got an emergency operation totalgastrectomy and ρ-Roux-en-Y reconstruction.
The resected specimen showed an ulcer measuring 10 × 8 mm with an exposed vessel measuring 2 mm in diameter. Microscopic examination disclosed an abnormally thick vessel in the submucosal layer, which had an inflammatory intima without microaneurysm or arteriolitis.

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