Oligodendroglial microtubular tangles (OMTs) were observed in the central nervous system in 10 cases of multiple system atrophy (MSA) including eight cases of sporadic olivopontocerebellar atrophy and one each case of Shy-Drager syndrome and striatonigral degeneration. There were no OMTs in two cases of hereditary olivopontocerebellar atrophy, nor in 36 cases of various neurological and non-neurological diseases. The distribution and number of OMTs respectively correlated with the location and severity of neurodegenerative changes due to MSA. Immunoreactivity with anti-tubulin, ubiquitin and alpha-B-crystalline antibodies was observed by immunohistochemical procedures. The OMT consisted of randomly oriented fibrils with a diameter of 20 to 30 nm. The fibrillar skeins were studded with granular materials along their surface. It is suggested that the OMT is a pathognomonic change of MSA and confirms the validity of the concept of MSA as a disease entity.

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Basic and clinical assessments were made to evaluate the intracavernous pharmacotherapy with a mixture of vasoactive drugs (papaverine, prostaglandin E1 and phentolamine) in low doses for impotent patients. For the basic assessment, relaxation responses of isolated strips of the rabbit corpus cavernosum induced by either papaverine or phentolamine alone were compared with the responses induced by the mixture of the two drugs in lower doses (1/2 dose of papaverine and 1/2 dose of phentolamine). The mixture of the drugs elicited almost the same relaxation responses as each drug alone in higher doses. For the clinical assessment, erectile responses induced by intracavernous injections of a mixture of three drugs, papaverine, prostaglandin E 1 and phentolamine, in low doses were compared with those induced by a single drug alone in higher doses in impotent patients. The mixture of the three drugs in low doses elicited stronger erectile responses than either of these drugs in higher doses. Hardly any side effects or complications of the treatment with this mixture of drugs were observed. It is concluded that intracavernous pharmacotherapy with a mixture of low doses of vasoactive drugs is more effective than that with each drug alone in higher doses for treatment of impotent patients.

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Ten patients with hematologic disorders exhibiting thrombocytopenia were treated with high-dose Cepharanthin. They consisted of six patients with idiopathic thrombocytopenic purpura (ITP) and four patients with aplastic anemia (AA). All six patients with ITP experienced an increase in platelet counts of more than 30, 000/μl. None of the four patients with AA had increases in platelet counts even 11 months after the administration of Cepharanthin. No adverse reactions were observed in the patients treated with Cepharanthin. These results suggest that Cepharanthin is useful in the treatment of patients with ITP.

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The purpose of this study was to evaluate the effect of using cement on blood flow through the femoral marrow cavity of dogs after prosthetic hip replacement. Blood flow was measured by a direct method on the proximal and distal sides. A section was designed around the 1 cm distal part from the stem tip of the prosthesis. Test experiments were carried out on the left side femur : (1) prosthetic hip replacement using cement (cement group, n=15), (2) similar to (1) but without cement (no cement group, n=15). In both experiments, the intact right femur served as a control (control group, n=30). Blood flow was measured immediately postoperatively and 1, 3, 6, and 12 weeks after the operation. In the test experiments, there was no significant difference in blood flow between the weeks, and mean blood flow values for each week were calculated. The blood flow rates on the proximal side were 2.26±0.31g/min/100g (Mean±SE) in the control group, 0.76±0.26g/min/100g (p<0.0002) in the no cement group and 0.02±0.01g/min/100g (p<0.0001) in the cement group. There were significant differences between these values. The blood flow rates on the distal side were 1.40±0.18g/min/100g in the control group, 0.83±0.20g/min/100g in the no cement group and 0.92±0.30g/min/100g in the cement group. It was found that about 2/3 of the blood flow in the femoral marrow cavity was supplied from proximal side and about 1/3 on the distal side. It was noted that blood flow from the proximal side was almost completely suppressed by using cement, whereas about 1/3 of the blood flow in the control group was preserved without using cement. These results indicate that it is better to perform prosthetic hip replacement without using cement.

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A 54-years-old man, who had traveled to Niigata Prefecture, was diagnosed as tsutsugamushi disease based on elevated serum antibody level and a sticked scar in his thigh.
He suffered from prolonged fever and generalized exanthema followed by jaundice and anemia and died two months later.
At autopsy, mild lymphadenopathy and hepatosplenomegaly were found.
Microscopic examination showed focal monocytic infiltration as well as epitheloid cell granuloma in the heart and kidney. Old and recent angiitis were found in the kidney, digestive mucosa and testis. Cytomegalovirus infections and virus-associated hemophagocytosis were also observed.

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A 47-year old man with a 8-year history of primary aldosteronism was admitted to our hospital for reevaluation of diagnosis and interventional treatment, while he had been administered trilostane and nifedipin due to adrenal hyperplasia. Abdominal CT, scintigram and adrenal venous sampling revealed an adenoma in the right adrenal gland. Adrenal digital subtraction angiography showed a tumor staining in the right inferior adrenal artery, representing an adrenal adenoma. The adenoma was ablated by adrenal arterial injection of absolute ethanol (0.5ml) with a coaxial microcatheter. After the interventional therapy, blood pressure and plasma aldosterone levels were significantly decreased without antihypertensive drugs. No serious complications were observed.
Adrenal artery embolization using absolute ethanol is a newly developed safe and effective treatment for adenoma in primary aldosteronism.

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We recently experienced a case of round atelectasis. One round shadow was seen in the subpleural area of the right lower lung, showing the characteristic “comet tail” appearance and thickened pleura on lateral tomography and computed tomography. Percutaneous needle biopsy of the lung revealed thickened pleura. Pleural effusion was seen on the chest X-ray film, but taking the lateral tomography image into consideration, we concluded that shrinkage of the thick pleural fibrotic coating was intimately involvd in the pathogenetic mechanism.

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