Two hundred and three subjects with non-insulin dependent diabetes mellitus (NIDDM) Were divided into six groups according to difference in the apo E phenotype (E 2/2, E 2/3, E 2/4, E 3/3, E 3/4 and E4/4). Plasma glucose, body weight, plasma lipids and apolipoproteins Were measured in subjects with the apo E phenotypes E 2/3, E 3/3 and 3/4 before and after d et therapy. The frequency of the apo E alleles in NIDDM were the same as in normal subjects. The values of LDL-choresterol (LDL-C) on the 2nd day of hospitalization (before diet therapy) were significantly higher in the E 3/4 than in the E 2/3 group (P <0.05), though there were on differences in the total serum cholesterol (TC) among the three groups. On the 9th day of hospitalization (after therapy). TC and LDL-C were still significantly higher in the E 3/4 than in the E 2/3 group (P <0.05). The percentage changes in plasma glucose and body weight did not differ among these 3 groups (E 2/3, E 3/3, E 3/4) before and after diet therapy. The percentage improvement in TC with diet therapy was most remarkable in the E2/3 group, followed by the E3/3 and E3/4 groups in that order. Thus, the hereditary apo E phenotype could be one of the factors relevant to the improvement of serum TC or LDL-C with diet therapy in NIDDM.

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Acute gastric mucosal lesion (AGML) is well known as a pathology induced in animals by the injection of sodium cinchophen.
The morphological changes in AGML have not been fully elucidated.
The author attempted to examine the pathogenesis of AGML from the morphological standpoint of the microcirculation in the rat gastric mucosa through the vascular casting method and the ultrathin section method. Both types of specimens were examined with scanning type or transmission type electron microscopes.
In the casting specimens, observation revealed narrowing and cessation of capillary blood flow in AGML areas indicating that alteration of microcirculation in the gastric mucosa was evoked.
The morphological patterns of microcirculatory alterations in various AGML areas were conspicuously different. The author classified them into five types as follows ; 1) contracted capillary type, 2) apical mucosal type, 3) extensive mucosal type, 4) transmucosal type without affected collecting venule and 5) transmucosal type with affected collecting venule.
These findings indicated that the microcirculatory changes occurred initially at the superficial region of the mucosa and that they gradually spread out in both vertical and horizontal directions in the mucous membrane. In some areas, a small amount of casting material leaked from the capillary lumens, though it was uncertain whether or not vascular ruptures actually occurred.
In ultrathin sections, two different types of endothelial cells were identified in the capillary walls of the mucous membrane of rats, namely a continuous type and a fenestrated type. The distribution pattern of both types of cells was different, that is, the continuous type cells were more numerous in deeper area of the mucous membrane, while they gradually decreased in number toward the luminal surface.
These results indicated that AGML was initially evoked and spread due to progress of the disturbance of microcirculation of the gastric mucosa in rats.

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A trial in standardizing the measured values of serum electrolytes (Na, K, Cl) was carried out in 22 clinical laboratories in Gunma prefecture. First, precision was evaluated, then confirmation of maintenance of precision and quantative analysis of factors changing determination were performed, and finally, accuracy of electolyte measurement was evaluated.
Twenty-one laboratories conducted the studies of precision. Six, 16, and 13 of these met the allowable targets for Na, K, and Cl, respectively. The precision was particularly poor for Na. Many laboratories did not meet the allowable targets for intercepts or slopes of regression equations, or for the mean differences between 1 st and 2 nd determinations. Seventeen laboratories carried out the confirmation of maintenance of precision study. All of these met the allowable targets for K, but 3 of these did not meet the allowable targets for Na and Cl. These findings indicate that more extensive control of assays is needed to obtain precision of Na and Cl measurement that is as good as that of K. The quantitative analysis of factors changing precision revealed that factors changing day-to-day assay measurements were greater than those changing within-day assay measurenents of Na, though in the case of K and Cl, factors changing within-day assay measurenents were greater than those changing day-to-day assay measurenents. Of factors changing within-day assay measurenents and factors changing day-to-day assay measurenents, factors changing in the short-term were regarded as relatively important compared to factors changing in the long-term. The existence of considerable bias was revealed from measursment of working certified reference sera. By using equations for correction derived from the certified values and the values determined in the laboratories, the magnitude of the bias decreased by about one severalth. However, in some laboratories, the correction did not seem to work well owing to poor precision. Also, the studies of pooled sera indicate that the above-mentioned procedures were effective in decreasing the differences between laboratory data.
These results suggest that the means used in this trial are useful in unifying measured values of serum electrolytes.

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A 65-year-old woman with renal cell carcinoma extending to the suprahepatic vena cava was successfully operated upon by the total hepatic vascular exclusion (THVE) technique. It was difficult to expose and tape the inferior vena cava, because of the enlarged right and left lobes of the liver due to tumor thrombus in the inferior vena cava. Good exposure of the inferior vena cava was obtained with resection of the left caudate lobe of the liver. Then, the inferior vena cava was incised and the tumor thrombus was resected safely and constitutively using the THVE technique.

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Gallium-67 citrate scintigraphy (⁶⁷Ga scintigraphy) was evaluated in 305 patients with lung cancer. The positive rate among 135 patients, in whon the radiation doses were less than 10Gy when ⁶⁷Ga scintigraphies were performed, was 76% ; positive rates for small cell carcinomas, poorly differentiated epidermoid carcinomas and large cell carcinomas were higher (>90%), while positive rate for well differentiated adenocarcinomas was the lowest (57%).The positive rates for poorly differentiated types of epidermoid carcinomas and adenocarcinomas were higher than those of well differentiated types. No relation between ⁶⁷Ga accumulation and tumor diameter was recognized within the range of tumor diameter from 30 mm to 100mm. In small cell carcinomas and well differentiated adenocarcinomas, the cases that showed high ⁶⁷Ga accumulation tended to decrease according to increase of radiation dose. But there were many cases that showed high ⁶⁷Ga accumulation when radiation dose increased in other histologic types. In 86% of cases with atelectasis or pleural effusion or inflammatory change, ⁶⁷Ga scintigraphy was useful for differentiating the extent of tumor from these changes. ⁶⁷Ga scintigraphy appeared to assist the differential diagnosis of histologic types of lung cancer, and to be useful for evaluation of the extent of tumor.

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Thirty-four patients with benign tumors and tumor-like lesions of the lung were operated during 1976 and 1990. Nineteen patients had the operative diagnosis of benign tumor including 11 hamartomas, 3 sclerosing hemangiomas, 2 leiomyomas, 2 bronchogenic cysts and 1 adenoma. Meanwhile, 15 patients were diagnosed as tumor-like lesions, including 8 tuberculosis, 5 organizing pneumonias, 1 lung abscess and 1 cryptococcosis. If the differentiation between benign and malignant tumors is not obtained preoperatively, open biopsy is necessary. Wedge resection should be selected to preserve respiratory function for benign tumors or tumor-like lesions.

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