Postnatal development of gonadotrophs (GTH cells) in the anterior pituitary glands of the rat was examined by immunoelectron microscopy with the colloidal gold antibody method using ovine LHβ antiserum. GTH cells of young rats could be classified into two types, Types I and II, according to the granule size. The former contains large and small secretory granules, while the latter contains exclusively small secretory granules.
Each type was further divided into three subtypes, immature, intermediate and mature, based upon the developmental morphology. The nucleo-cytoplasmic ratio is large in the immature type GTH cells, whose cell organelles are poorly developed.
The intermediate type GTH cells are moderately well developed, as compared with the immature type. The cell organelles of intermediate type are well developed and the secretory granules are increased in number.
The cell organelles of the mature type GTH cells were similar to those of adult rat GTH cells and contained a large number of secretory granules.
In the neonatal stage, most GTH cells in the anterior pituitary are of the immature type, but intermediate type cells appear and those of mature type take the place of the former two, as the animals grow. In the female rats, Type I GTH cells had increased in number 10-20 days after birth and subsequently decreased gradually. In the adult, most GTH cells were Type II. On the contrary, in the male rats, Type I cells increased progressively and in the adults the Type I cells predominated over the Type II cells.

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The synthesis of relatively low molecular weight copoly (D-lactic acid/L-lactic acid) was performed by direct polycondensation in the absence of catalysts. The in vivo degradation of the polymers, for example copoly (D-lactic acid/L-lactic acid, 50 : 50mol-%) with a number-average molecular weight (Mn) of 2, 200, was examined by implanting them subcutaneously into the backs of rats. This polymer led to an “S” type degradation pattern, which is characterized by degradation with initial lag time. An LH-RH agonist, [D-Leu⁶] -des Gly-NH₂¹⁰ LH-RH ethylamide (Leuprolide), was incorporated into a fine cylindrical polymer formulation by a so-called melt-pressing technique. The main purpose of this paper is to explain the effect of drug dispersion in the formulation on drug release and pharmacological activity through the degradation of the polymer. For this purpose, three polymer formulations with different structures of drug dispersion were prepared : (a) sandwich type, (b) blend type, and (c) molecular dispersion type.
The daily amount of drug released in vivo was strongly influenced by the difference in drug dispersion. Constant release for a longer period was maintained in the order of (c) > (b) > (a) formulation. Both (a) and (b) formulations showed an initial burst of drug release. In contrast, (c) formulation maintained constant release over a period of 12 weeks without the initial burst. The pharmacological activity of the drug released in vivo from the three formulations was evaluated by measuring the changes in weight of accessory sex organs of male adult Wistar rats. The organ weights were decreased rapidly after administration of the drug through controlled delivery until they reached up to those of castrate levels. The lost weight of the organ was regained up to the normal level soon after the complete cessation of the drug release. This response can be explained by the mode of drug release.

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In order to elucidate the mechanism of vocal cord paralysis (VCP) in multiple system atrophy, thirty-one patients were studied in terms of clinical symptomatology, the electromyographical approach using surface and needle electrodes, the phoniatric approach to the inspiratory stridor using a sound spectrograph, and the pathological approach to the intrinsic laryngeal muscles and nucleus ambiguus.
Selective neurogenic atrophy of the posterior cricoarytenoid muscle was the primary causative factor of VCP and in addition, in some cases, inspiratory contraction of the vocal cord adductor (thyroarytenoid muscle) also seemed to participate. Our precise morphometric study of the nucleus ambiguus revealed neuronal loss in both of the two autopsied cases. Phoniatric study showed that the mean fundamental frequency of the inspiratory stridor in the six patients was 281+/-55 Hz.
Tracheostomy is, at present, the safest and most reliable method of therapy for VCP. However, a perplexing problem for the clinician is when tracheostomy should be performed. To evaluate the progressive process of VCP, we have tried periodic examination by laryngofiberscopy, including under the condition of forced sleep induced by intravenous administration of diazepam, and phoniatric analysis of the inspiratory stridor during sleep. It remains to be seen whether or not these procedures are useful in evaluating the severity of the VCP quantitatively.

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We studied the effect of a novel immunosuppressive agent, FK506, on two models of experimental glomerulonephritis. The induction of active Heymann nephritis was completely suppressed by FK506 injected simultaneously with the antigen (day 1) and successively daily for 14 days at a dose of 0.64 mg/kg per day or more. With a lower dosage or other treatment schedules (for 1-7 days or for day 8-21 days duration), immune deposits in the glomerular basement membrane (GBM) occurred despite the suppression of proteinuria. Rats that were prevented from developing Heymann nephritis or the autologous phase of Masugi nephritis by FK506 treatment exhibited a suppressed immune response to a second immunization with the same antigen even 4 weeks after cessation of drug administration ; however, they developed antibodies and immune deposits in the GBM when inoculated with other antigens. In vitro, antibody production of lymphocytes from nephritic rats was suppressed when co-cultured with T lymphocytes from FK506-treated Heymann nephritic rats.
These results indicate that FK506 has potent immunosuppressive activity, and suggest that FK506 is able to induce an antigen-specific immunotolerance maintained by suppressor T cells.

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It is well-known that premedication of corticosteroids inhibits the development of late asthmatic responses (LAR) in allergen inhalation tests on asthmatics. This fact suggests that impaired functions in steroid synthesis or metabolism may play a role in the induction of LAR.
In order to clarify these possibilities, the author performed allergen inhalation tests on asthmatic patients. Serial changes in their bronchial responses and plasma cortisol and ACTH levels were observed. Furthermore, to investigate regional level of cortisol in the lung, a new animal LAR model of ovalbumin sensitized guinea-pig was made. Following allergen inhalation tests, serial cortisol levels in serum and broncho-alveolar lavage fluid (BALF) were measured in this animal model for 24 hours.
During LAR phase, blood cortisol levels were markedly decreased in both asthmatics and guinea-pigs with accompanying mirror image of the increase of BALF cortisol level. However, no change in serial plasma ACTH levels was noted.
The results of the present study suggest that decreased serum cortisol levels are involved in the pathogenesis of antigen-induced LAR.

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Respiratory muscle gas exchange as well as respiratory muscle strength has been considered to be an index of respiratory muscle performance. Oxygen consumption was measured continuously in the setting of hyperventilatory exercise.
MGC 2001 and our CO₂ rebreathing device for maintaining Paco₂ were able to measure breath-by-breath gas exchange in sustained maximal voluntary ventilation.
The time course of respiratory oxygen consumption rate yielded new knowledge, i.e. that oxygen consumption increased at the end of hyperventilation without increasing minute volume in the sitting position. On the other hand, no such phenomenon was observed in the supine position. We concluded that the supine position was most appropriates for testing respiratory muscle gas exchange.
The subjects were challenged with a preparative infusion of aminophylline or placebo while in the supine position. Hyperventilation study was also performed in 11 healthy non-athletes.
The results were as follows : Neither oxygen consumption nor minute volume difference significantly between the aminophylline-treated and placebo groups. However, in terms of the duration of hyperventilation (P<0.05) and the serum level of blood lactate (P<0.05) there were significant differences between the aminophylline-treated group and the control group.
We concluded that aminophylline increases the endurance capacity of respiratory muscle without elevating the oxygen consumption, probably as a result of increased anaerobic metabolism.

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The outcome of 124 patients with operated and unoperated abdominal aortic aneurysms (AAA) were reviewed.
Of the 124 patients admitted to the department (from 1973 to 1988), 108 were treated surgically, and 16 were not operated on because of concurrent medical disorders or refusal.
Of the 108 patients who underwent operation, 87 were treated electively, and 21 were done as emergency cases.
The 5 year life table survival of all of operated patients was 68%, 70% for elective cases and 56% for emergency cases. There were no significant differences among these three figures. On the other hand, all of non operated patients died within 4 years.
The three major causes of death in the late phase in the operated group were myocardial infarction, stroke and malignancy, but the major cause in the non operated group was rupture of the AAA.
Therefore, unless general condition contraindicates surgery, all patients, AAA without respect to age, should be considered for elective aneurysmal resection before rupture.

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One hundred seventy-seven patients underwent total gastrectomy for gastric cancer. Rates of complication and death after stapled anastomoses were compared retrospectively with those after sutured anastomoses. In 155 patients esophagojejunostomy was performed with the EEA stapler and in 22 patients hand sutures were employed. No major differences could be noted among the background factors of the two groups. Roux-en-Y anastomosis was the most frequent mode of reconstruction performed in the stapled group. The rate of leakage was 3.8% in the former and 9.0% in the latter with no significant difference. Three patients (1.9%) died within 30 days of stapled anastomosis and in one of them death was caused by anastomotic leakage. There was one case (4.5%) of post-operative death in the sutured group. It seemed that the stapler was able to secure and facilitate esophagojejunostomy after total gastrectomy.

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Two successful retrievals of IVH catheter fragments from the pulmonary artery are reported. We employed the loop snare method for a catheter fragment in the main pulmonary artery and myocardial biopsy forceps in the right descending pulmonary artery. These methods and selection of techniques are described in this report.

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Three hundred and four patients who underwent surgery for primary lung cancer were investigated clinicopathologically.
1) The ratio of females to males was 6 to 4.
2) The average age was 62.7 years (15 to 80 years).
3) Approximately 79% of the patients were initially detected by mass screening.
4) There was a slight predominance of primary lesions in the right lung and the superior lobe.
5) Adenocarcinoma accounted for 60% of the histological types.
6) Pulmonary lobectomies were carried out in approximately 82% of the patients and combined excisions were performed in 11%.
7) Regarding the postoperative disease stage, the majority of patients were in stage I, while one third were in stageIIIA, or beyond, of progressive lung cancer.
8) The overall 5 -year survival rate was 53% ; 73% for stage I, 39% for stage II, 25% for stage IIIA, 0 % for stageIII B and 30% for stageIV : also, interms of histological types, 48% for adenocarcinoma, 59% for squamous cell carcinoma, 36% for large cell carcinoma and 100% for small cell carcinoma.

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A questionnaire on unification of biochemical laboratory data was sent out to 416 persons (286 doctors, 130 medical technologists) living in Gunma prefecture.
Results are as follows ;
1. There was a total recovery rate of 57.2% for the questionnaire ; recovery rates from doctors and medical technologists were 49.0%, 75.4%, respectively.
2. Of the respondents, 38.2% considered difference in ALP data between laboratories to be inconvenient. Other items felt to be inconvenient are as follows ; Che>Amylase>GOT>GPT>γ-GTP.
3. Most of the respondents agreed to [do by all means] and [do if possible] the [unification of laboratory data by adjusting different values to make them the same]. There was no significant difference between doctors and medical technologists. On the other hand, as to the answers to [unification of laboratory data by common scale], the separate and opposite rate of doctors was greater than that of medical technologists.
4. To a question about participating time, each of 25% of the respondents is in favor of [would participate when medical doctor association of Gunma prefecture and medical technologist association of Gunma prefecture agree to unification] and [would participate when medical staff in our facilities agree to], and 8.3% to [would participate when medical staff in our facilities agree to and instruments is updated]. The three answers mentioned above come to 57.7%. There was no significant difference between doctors and medical technologists.
Although the results seem likely to indicate that [unification of laboratory data by adjusting different values to make them the same] is supported, there are some problems to be solved before it can be put into operation. It is necessary that these issues be discussed thoroughly by the organizations involved.

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A 48 year old female with fulminant ulcerative colitis was treated by a 4 -stage operation. Initially, she was managed by conservatively. i. e. with oral sulfasal azine, predonisolone, and imuran. But her condition was not corrected, so predonisolone was given intravenously. Nevertheless her illness became worse and toxic megacolon was suspected, emergency operation was performed by double-barreled ileostomy for intracolonic decompression. In the second stage, total colon and upper rectum resection was performed, and a terminal ileostomy was made. In the third stage, mucosectomy of the residual rectum and an anastomosis between the ileal J-pouch and dented line of the anal canal was performed. At the same time, a safety ileostomy was made. Therefore in the fourth stage, this ileostomy was closed. These operative procedures are safe and give the patient of good quality of life because anal function is completely preserved.

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A case of left carotid-ophthalmic aneurysm with recurrent epistaxis in a 37-year-old female is presented. As the aneurysm was partially in the cavernous sinus, clipping of the aneurysmal neck was impossible. A Selverstone clamp was applied to the internal carotid artery at the neck. A contralateral symmetrical aneurysm of smaller size was also demonstrated, which was followed-up. The patient has since had a normal life, without nasal bleeding, for more than 2 years.

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A 25-year-old man was admitted to our hospital in March, 1990 because of diarrhea, general fatigue and low grade fever. He had a history of severe diarrhea dating from 1985. Physical examination revealed no abnormalities. Hypoproteinemia (5.1g/dl) and normocytic normochromic anemia (11.9g/dl) were noted. X-ray examination revealed skip lesions, stenosis and a cobblestone appearance in the small intestine. Clinically, a diagnosis of Crohn's disease was made in the small intestine. Elementary hyperalimentation using a liquid diet was started in April, 1990. Although no anti-inflammatory drugs were administered, clinical symptoms and abnormal laboratory findings improved within 4 weeks. After establishment of remission, the elementary diet was gradually replaced with a normal diet. There was no subsequent reappearance of symptoms nor abnormal laboratory data. Thus, the effectiveness of elementary diet therapy for Crohn's disease was confirmed.

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One autopsy case of a neonate with herpes simplex virus type 1 (HSV-1) is reported. In this case, isolation from skin lesions and typing of the causative virus were performed virologically, and HSV-1 was identified as the causative virus. At autopsy coagulative necrosis was seen in the liver and adrenal glands. Numerous intranuclear inclusions were found in the vicinity of the necrotic lesions. Immunohistochemical study showed the same result as the virological study. Electron microscopically viral particles were seen in the necrotic tissue of the liver.

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