Eighty-one patients with stomach cancer in 4 different stages were randomly divided into 2 groups and one group of patients was given the immunomodulator levamisole (LMS) preoperatively for 3 days. The effects observed on cellular immunity are as follows.
1) In general, a greater response was observed in stage III and IV patients in the group given LMS and the effect persisted until two weeks after surgery.
2) LMS was found to have positive effects on peripheral blood lymphocyte blastogenesis induced by PHA with or without the addition of autologous sera, similar to those observed in the PHA skin test.
3) With respect to regional lymph node lymphocyte, total T-cell traction and active T-cell traction in the group given LMS increased more than in the group not given LMS. The effect of LMS on lymphocyte blastogenesis induced by PHA and PHA plus autologous sera was more marked in proximal than in distal lymph node.

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We often encounter patients who have uncertain complaints in the upper abdominal quadrant characteristic of back pain and epigastralgia. Some of these patients show only hyperamylasuria, expressed as hourly amylase secretion for seven consecutive days, without abnormality in upper gastroendoscopy, abdominal ultrasound examination and other diagnostic imaging tests. We studied the clinical features of these patients and endoscopic manometry of the pancreatic duct and the papillary zone to elucidate the mechanism of these complaints and the hyperamylasuria.
The subjects were 62 patients (male 37, female 25, mean age 43.7) who visited the Isesaki Municipal Hospital. All these patients with uncertain complaints in the upper abdominal quadrant showed only hyperamylasuria and no abnormality of the upper gastrointestinal tract, liver, biliary tract and pancreas on the diagnostic imaging. No cases underwent abdominal surgery. Back pain and epigastralgia were experienced in 59.7% and 58.1% respectively. The C. M. I. (Cornell Medical Index) test was given in 19 of the patients. Class III and IV, which indicate of neurotic tendency, were found in 4 and 5 patients respectively.
Manometric study of the pancreatic duct and papillary zone was performed endoscopically, using a 4 Fr microtransducer (Gaeltec Ltd.).
In the patients, pancreatic duct pressure, peak pressure, basal pressure, frequency and duration were 10.17±4.84mmHg, 118.80±40.95mmHg, 10.65±4.31mmHg, 5.35±3.15/min, and 5.13 ± 1. 09sec, comparing with 4.75±2.00mmHg, 70.00±16.60mmHg, 6.24±2.82mmHg, 6.28 ± 2.88/min, and 4.75 ± 1.27sec, respectively, in the control group. Pancreatic duct pressure, peak pressure and basal pressure were significantly different (P <0.01, Student's t-test) from the control.
From these results, we suspected that the uncertain complaints in the upper abdominal quadrant and hyperamylasuria of these patients may be related to abnormal function of the papillary zone and high pressure in the pancreatic duct.

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In order to clarify glomerular permeability factors in minimal change nephrotic syndrome (MCNS), T cell-rich fractions were obtained from the peripheral blood of nine patients with MCNS and six healthy donors as controls. Each T cell-rich fraction was co-cultured with Concanavalin A, and the supernatants, which were rich in glomerular permeability factors, were collected after 48 hours of cultivation.
Then, 2 ml of the supernatant was perfused into left renal artery of the anesthetized adult male Wistar rats for 30min. Urine samples were serially collected and their protein concentration were analyzed. This experiment revealed that urine protein excretion in the experimental animals increased during 12 hours after the renal perfusion of culture supernatants derived from MCNS patients. However, urine protein excretion was not increased in the control experiment. To determine the cause of increased glomerular permeability in experimental animals perfused with culture supernatants derived from MCNS, the animals were injected with polyethyleneimine (PEI) solution into the tail vein after the perfusion of supernatants. Electron microscopically, PEI-binding particles were counted in glomerular basement membrane (GBM). Compared with the control, PEI-binding particles were decreased in the lamina rara interna of glomeruli perfused with the supernatant derived from MCNS. The experimental result that supernatants derived from the T lymphocytes of MCNS patients decreased the negative charge of the GBM, resulting increased glomerular permeability, may suggest the pathogenesis of MCNS.

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The cord serum concentration of N-terminal procollagen III peptide (PIIIP) was measured in 149 neonates, consisting of 22 who were small for gestational age (SGA), 95 appropriate for gestational age (AGA), 21 large for gestational age (LGA), and 11 of less than 24 weeks' gestation. A significant negative correlation was found between PIIIP levels and gestational age. No significant difference, however, was found in PIIIP levels between SGA and LGA neonates, suggesting that cord serum PIIIP level can be a useful parameter in assessing newborn maturity.
Serum PIIIP levels were also determined longitudinally during treatment in children with Graves' disease or chronic thyroiditis. Individual changes in serum PIIIP varied with thyroid status. Administration of T₃ for seven days for the T₃ suppression test to six euthyroid patients treated with antithyroid drugs resulted in a 25-75% increase above basal values in serum PIII P. In contrast, the same treatment given to three patients with generalized thyroid hormone resistance produced small rises in serum PIIIP levels of 9.5%, 10.5%, and 10.1%, respectively. Therefore, measurement of serum PIIIP before and after T3 therapy seems to be useful for the diagnosis of thyroid hormone resistance.
In addition, longitudinal observations of serum PIIIP levels in 3 girls with anorexia nervosa showed that the levels were very closely correlated with changes in their body weight.
These findings, which were based on repeated determinations of serum PIIIP levels, indicate peripheral action of thyroid hormone and nutritional status.
Thus, the measurement of serum PIIIP concentration can provide useful information with which to assess hormone action and metabolism in the fetus and in children.

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I have investigated the ability of peripheral polymorphonuclear leukocytes (PMN) from children with bronchial asthma and control subjects to generate superoxide anion (O^-₂) and other active oxygen species using 2-methyl-6- (p-methoxyphenyl) -3, 7-dihydroimidazo [1, 2-a] pyrazin-3-one (MCLA), a sensitive and specific chemiluminescence (CL) probe for O^-₂, and luminol-dependent CL methods. The ability of PMN from subjects with asthma to generate O^-₂ and other active oxygen species was significantly greater than that of PMN from control subjects when stimulated with opsonized zymosan (OZ), phorbol myristate acetate (PMA) or N-formyl-methionyl-leucyl-phenylalanine (FMLP).
Furthermore, in the same asthmatic children, the generation of O^-₂ and other active oxygen species was significantly higher with attacks than without attacks when PMN were stimulated with OZ. I also demonstrated that O^-₂ generation correlated with the degree of bronchial hyperresponsiveness (BHR) to inhaled histamine. These results suggest that PMN from asthmatic children, especially those with attacks, generate more active oxygen species than those from control subjects and that airway inflammation caused by O^-₂ may be closely related to BHR in subjects with bronchial asthma.

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Thirteen cases with unresectable primary hepatocellular carcinoma were treated by administering SMANCS/LIPIODOL into the common or proper hepatic artery and followed for over three years. Results were as follows ;
1) Changes in liver function after the administration of SMANCS/LIPIODOL were milder than those after the administration of TAE.
2) The survival rates at one year, two years and three years were 53.8%, 15.4% and 7.6%, respectively.

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Remnant-like particles (RLP) were studied in 139 diabetic patients. RLP were those lipoproteins that did not bind to an immunoaffinity gel mixture using anti-apo B-100 and apo A-1 monoclonal antibodies, and were shown to provide a useful index for atherogenic chylomicron and very low density lipoprotein remnants. RLP-positive findings (RLP≥ 5 mg/dl) in diabetics (42%) were significantly higher in prevalence than those in controls (12%) (p<0.001). RLP-positive findings were more frequently observed in diabetics with lower levels of serum total cholesterol (T-ch) and serum triglyceride (TG) than in controls. In general, the higher the T-ch or TG level, the more frequent RLP-positive results were observed both in diabetics and in controls. In particular, all controls were RLP positive when their TG level was greater than 300mg/dl, as were all diabetics whose level was more than 200mg/dl. No relationship was detected between RLP and serum fasting plasma glucose, Hb-A_1c, method of intervention or complications of diabetes mellitus. The determination of RLP could be a useful index to evaluate abnormal lipoprotein metabolism in diabetes mellitus.

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In the past 12 years, we have encountered five cases of chylothorax following intrapericardial cardiac surgery.
Four of the patients were successfully treated by conservative therapy, namely, chest drainage, low fat diet, MCT (medium chain triglyceride) and cardiac diuretic. In these patients, the amount of chylus was reduced within two weeks.
Only one case needed ligation of the thoracic duct ligation after two months of conservative therapy.
The above results indicate that, patients with chylothorax after intrapericardial operation should be treated with a non fat diet from the beginning. When conservative treatment is not effective within two weeks, surgical ligation of the thoracic duct should be chosen.

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