The ovarian hilus cells from a female patient, 77 years of age, have been observed by light and transmission electron microscopy. The ovarian hilus contains some collagenous fibers, blood vessels and nerve fibers. Hilus cells with a polygonal shape are found in clusters or scattered in the ovarian hilus. The nuclei are nearly round and contain dominant nucleoli. The most prominent cytoplasmic organelle of the hilus cell is an extensively developed smooth endoplasmic reticulum (ER) which is characteristic of steroid secreting cells. The form of the smooth ER is either a network of randomly interconnected tubules or parallel, concentric lamella. A large number of mitochondria with tubular cristae, well-developed Golgi complexes, lipid droplets and lipofuscin granules are in this cell. In addition, rod-shaped crystalline structures, similar to Reenke's crystal, are frequently observed. This fine structure indicates that the ovarian hilus cells are quite similar to steroid producing cells, especially mature Leydig cells in the human testis. The hilus cells are located near myelinated or unmyelinated nerve fibers. The ovarian hilus cells and myelinated nerve fibers may have an intimate relationship. In the interstitial tissue there are abundant capillaries with fenestrated endothelial cells. This observation indicates that the ovarian hilus cell has an important endocrine function even at an old age.

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The relationships between sensory nerve fibers and odontoblast processes in the human dental pulp were investigated primarily with the scanning electron microscope. The nerve fibers in the pulpodentinal border zone ramified from the nerve plexus which formed a dense interlacing network beneath the odontoblast layer. They run along the processes of odontoblasts in the predentin and dentin. In the odontoblast layer, a few nerve fibers were observed along one odontoblast body and some of them had branches which extended to the neighboring body. Axonal varicosities of various sizes were observed not only in the odontoblast layer but also in the predentin and dentin. The diameters of the nerve fibers and varicosities were smaller in the deeper regions of the dentin. The axoplasm of the varicosities contained many mitochondria, vesicles which were 30-150 nm in diameter and glycogen granules. The number of varicosities in the deeper portion of the dentin was greater but the diameters of the varicosities were smaller about 2μm. Thus small beaded varicosities were frequently seen in close apposition to the odontoblast processes in the dentin. The function of the varicosities for sensory perception in the dentin is discussed.

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Two hundred eighty-two subjects were inoculated with influenza whole particle vaccines or hemagglutinin (HA) vaccines during the winter of 1978-1979. Antineuraminidase antibody (ANAb) responses to both vaccines were compared. Hemagglutinin-inhibiting antibody responses to the HA vaccines were as large as the responses to whole particle vaccines. ANAb responses to the whole particle vaccines were large for all strains in the vaccine. ANAb responses to the HA vaccines were not always large. Seroconversion (3×or more rise in ANAb titer) rates for A/USSR/92/77 one month after vaccination with HA vaccines varied from 32 to 40 % . They were as large as the rates after whole particle vaccines. The seroconversion rate for A/Yamanashi/2/77 was low (6 %) for the HA vaccine, although it was high (52 %) for the whole particle vaccine. The elevated ANAb titer after the vaccination with HA vaccines decreased to pre-vaccination levels earlier than with the whole particle vaccines.

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Meningeal signs and CSF findings in 10 patients with Vogt-Koyanagi-Harada disease were studied. The distribution of T and B lymphocytes n CSF and also blood from 6 of them were analyzed. A moderate pleacytosis in the CSF was found in most of them, though they hardly revealed meningeal signs. The mean cell count was 131 per mm³, the protein and sugar contents 49.4 mg and 62.2 mg per 100 ml, respectively. The cytogram was almost completely occupied by lymphocytes. In the analysis of T and B cells, increased T cell and decreased B cell values were observed in CSF compared with blood. These findings were discussed in relationship to those of viral meningitis and the pathogenesis of VKH.

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As an approach to the mechanism of myalgia and myositis observed frequently in human influenza, virological and morphological studies were carried out on experimental influenza in mice. Influenza virus A/PR8/34 (H_oN₁) was inoculated by the intranasal or intramuscular route. Muscle was examined histologically, by electron microscopic and immunofluorescent techniques. Virus isolation was also carried out from muscle, lung, spleen and blood. Myositis was induced predominantly when virus was inoculated into the hamstring muscles of young mice (three-week-old, DDy strain). In mice inoculated intranasally, myositis was not observed. Significant changes in muscle were observed neither in congenitally athymic nude mice inoculated with active virus nor in DDy mice inoculated with inactivated virus. On the other hand, the degree of myositis in adult mice (seven-week-old) was milder than that in younger mice. Myositis developed from the epimydium surrouding muscle cells, and healed approximately 14th days after inoculation. In spite of obvious myositis, no evidence for multiplication of virus in muscle was obtained by virus isolation and immunofluorescent studies. The virus was stained by fluorescent antibody method mainly in fibroblasts and adipose tissues near muscle cells. A similar outcome was seen in the muscle of nude mice. Thus, host factors such as age, species and immune system might play a role in the susceptibility of muscle to influenza virus. The results obtained from these studies suggest that viral toxicity and T cell function, rather than the virus itself, may induce inf luenzal myositis.

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One hundred and twenty-eight cases with chronic recurrent headaches were studied in Japanese children with regard to classification, the detailed clinical features, genetic data, and electroencephalographic and computed tomographic findings. The 128 children were classified into the following classes: 1) vascular headaches of migraine type, 46 %, 2) muscle-contraction headaches, 21 %, 3) psychogenic headaches, 14 %, 4) traction headaches, 2 %, 5) unclassifiable, 17 %. Clinical characteristics of migraine in children is summarized as unilateral (60 %) paroxysmal headaches localized in the frontal or temporal areas (76 %), sometimes with preceding symptoms (28 %) and almost all with nausea and/or vomitings (80 %). The frequency of headaches in 128 children was more than once a week (67 %) but the duration was shorter (77 %, less than a few hours) than those in adults. Appropriate classification of recurrent headaches in children and differentiation from epileptic headaches are also described.

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We present a case history of a patient with angina of effort associated with hypothyroidism on whom was performed successfully an aortocoronary bypass operation. A 59-year old man was admitted because of dull retrosternal chest pain. Examination of thyroid function demonstrated hypofunction of thyroid gland; EMR, -30 % ; T₃<10 ng/dl ; T₄<1 μg/dl; and TSH, 306 μU/ml. Electrocardiogram examined after an exercise tolerance test showed ischemic depression of ST segment in leads I, ll, aVL and V 4-6. Coronary angiogram showed 90 % stenosis in the main trunk of left coronary artery and proximal regions of the left anterior descending branch and circumflex branch. Left ventriculogram showed reduced wall motion of the anterolateral segment; however, neither akinesis nor dyskinesis was seen. Effort angina with hypothyroidism was diagnosed and aorto-coronary bypass operation was recommended. 76 days after commencement of treatment for thyroid hormone deficiency, aorto-coronary bypass grafts were placed on both the anterior descending branch and circumflex branch using major saphenous vein. After the operation, 50μg dailly of L-thyroxine was given intravenously and from the first postoperative day, 75μg daily of thyroxine was given orally. There was no onset of perioperative myocardial infarction and no angina episodes after operation. Postoperative course was uneventful.

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The coincidence of various brain tumors and a cerebral arterial aneurysm is unusual. A case of meningioma of the planum sphenoidale associated with an aneurysm of anterior communicating artery is presented. The pertinent literature is reviewed, and the etiological factors contributing to the development of the aneurysm and symptomatology in patients with a brain tumor are discussed briefly.

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Intracranial pressure (ICP) is one of the most important parameters for evaluating intracranial conditons. The skulls of newborns and infants, unlike the tightly sutured skull of adults, provide non-invasive access for measurement of ICPs via the anterior fontanelle. A new transducer has been developed which is convenient for non-invasive, continuous measurement of intracranial pressure through the anterior fontanelle. The new transducer is thinner and lighter than the APT-16 type transducer (Hewlett-Packard). The principles of measurement of ICP with this new transducer, the results of basic experiments, and results obtained from clinical applications are deseribed in this report.

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The advantages of the P-50 Transducer for monitoring intracranial pressure are easy attachment, simplified zero point determination and easy calibration similar to recording methods for electrocardiograms and respiration. The P-50 transducer is a semiconductor strain gauge transducer which was originally developed for determining blood pressure. By attaching a foot plate, the applanation principle could be applied and pressure determinations from the anterior fontanelle were feasible. The accuracy of this device was confirmed in several experiments. As a semiconductor strain gauge, it was extremely light, which is necessary for continuous measurement. Although some problems remain to be solved in regard to its fixation on the subject, this device should be clinically acceptable as a system for monitoring intracranial pressure.

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A follow up study on ICP was carried out in 6 cases of hydrocephalus within normal head circumference during the period 8-9 months after birth. There were no shunting operations. An, abnormal plateau like wave recorded in 2 cases with myelomeningocele during the follow-up period. In other cases, almost normal baseline pressure was recorded without abnormal pressure wave and all these cases showed favorable morbity (function). These results indicate that the importance of a follow-up study on ICP for months after birth in such cases as hydrocephalus without large head circumference: Furthermore, shunting operation should be recommended in cases showing abnormal pressure wave during the follow-up period.

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From the results of ICP determination in 6 cases of macrocrania, it has become evident that Lundberg's pressure wave (plateau wave, B wave) can be applied satisfactorily in the evaluation or abnormality under semi-closed conditions such as occur in infants. ICP dermination in cases of macrocrania with moderately enlargement of the ventricles is important for the recognition of pathologic changes. In paticular, the pressure variation and the amplitude changes during REM period seem to be an interesting index of the extent of the involvement of the venous function. An increased ICP during REM period was also observed in a patient with holoprosencephaly, having only brain stem formation morphologically, suggesting an important relationship between the brain stem and the increased ICP during REM period.

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