After chemical digestion of the isolated speicimen of the hypophysis of the rat, external surface of the hypophyseal portal vessel in the mature rat was investigated with scanning electron microscope (SEM). The portal vessel lacked smooth muscle fibers, it was accompanied by many pericytes with highly ramifying processes along its whole course. Transmission electron microscopic (TEM) study revealed that the endothelium of this vessel has many fenestrations and channels. These findings suggest that the hypophyseal portal vessel in the mature rat is a capillary sinus with pericytes rather than a vein as sugested previously.

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The effect of cimetidine on survival was investigated in mice infected with herpes simplex virus type 2 (HSV-2), murine encephalomyelitis virus (GD-VII), and vesicular stomatitis virus (VSV). BALB/c mice, 5 weeks of age, were injected intraperitoneally (i, p.) with 5.5 ×10⁵ plaque-forming units (PFU) of virus/0.5 ml, and cimetidine (1 mg/0.5 ml) was administered simultaneously. The survival rates of 80% and 85% in the cimetidine groups were significantly greater than the 10% and 23% for the control groups. The GD-VII-and VSV-infected control mice were dead at 3 days after virus inoculation. However, more cimetidine-treated mice survived than control mice. When anti-mouse T-cell serum or cyclosporine, which is a helper T-cell suppressor, was administered to BALB/c mice; the effect of cimetidine against the HSV-2 infection could be observed. When injected with anti-asialo GM₁, BALB/c mice or beige mice with low natural killer (NK) cell activity were not affected by cimetidine. Lastly, cimetidine was shown to activate the cytotoxic action on NK cells. The above results indicate that the antiviral effects of cimetidine depend on NK cell activation.

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With special attention to intraepithelial nerve supply, the distribution of peripheral nerve fibers in the ejaculatory duct of the monkey (Macacus fuscatus) was examined by histochemical and immunohistochemical methods and conventional transmission electron microscopic (TEM) method. The conventional TEM study has suggested that there are two types of intraepithelial nerve fibers, i. e. cholinergic and peptidergic. Acetylcholinesterase (AChE)-positive nerve fibers which were seen by means of light microscopy (LM) as surrounding the epithelium were revealed to be present intraepithelially by means of TEM examination. Neuropeptide Y (NPY)-like immunoreactive nerve fibers were richly distributed in the ejaculatory duct with a dense plexus spreading just beneath the epithelium. The immunoreactive nerves appeared, in part, to enter the epithelium. Substance P (SP)-and calcitonin gene-related peptide (CGRP)-like immunoreactive nerve fibers were found to be present to a moderate extent in the ejaculatory duct; some of them entered the interior of the epithelium to extend their nerve terminals to its free surface. Neural elements clearly immunoreactive for tyrosine hydroxylase (TH) and vasoactive intestinal peptide (VIP) could not be found in the ejaculatory duct, except for the surroundings of the blood vessels. Possible functional roles of these intraepithelial nerves were discussed on the basis of their distribution pattern.

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A case involving a 34-year-old female with a progressive hemiparesis is described. She had a history of repeated spontaneous abortions. The CT and magnetic resonance imaging (MRI) showed a multiple cerebral infarction. A ^99mTc perfusion lung scintigram demonstrated diffuse bilateral perfusion defects in the lungs. The presence of lupus anticoagulant (LA) was detected from the laboratory data and the thrombosis in the genital organ. The repeated abortions were probably due to thrombosis in the placental vessels caused by LA. High dose steroid therapy was effective in suppressing the LA activity and in preventing progression of the clinical symptoms.

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The shedding of herpes simplex virus type-1 (HSV-1) into the saliva was compared in 28 patients with oral cancer and 26 patients with genital or urological cancer. All subjects tested positive for HSV-1 specific antibody. A statistically significant (p<0.001) difference was found: infectious viruses were isolated from 12 (39.8%) of the oral cancer patients versus only 2 (7.6%) of the genital or urological patients. This indicates that direct stimulation of peripheral nerves during surgery was responsible for the greater reactivation of HSV-1.

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Balloon pulmonary valvuloplasty (BPV) was attempted in 38 cases of congenital pulmonary valve stenosis. It was effective and was done without complication in 36 cases, however it was not effective in two cases of pulmonary valve dysplasia. The balloon used was 20-50% larger in diameter than the pulmonary valve annulus. In the seven cases in which the transvalvular pressure gradient was above 100 mmHg on cardiac catheterization, right ventriculography demonstrated that the functional obstruction of the right ventricular outflow tract increased immediately after BPV, however it subsequently improved at one year after the procedure. At between one and three months after BPV, two-dimensional echocardiography demonstrated that the morphological obstruction to the right ventricular outflow tract had diminished. In two cases, localized right ventricular septal hypertrophy with severe pulmonary valve stenosis was observed by two-dimensional echocardiography and right ventriculography, and persisted at one year. In all cases, two-dimensional echocardiography and angiography demonstrated doming pulmonary valves with valve stenosis, which was diminished by BPV. The pulmonary valve morphology was observed by two-dimensional echocardiography in three cases following BPV. In one case, partial relief of pulmonary valve obstruction was seen to be due to commissural splitting and in the other two, to tearing of cusp tissue. Inspection of the pulmonary valve at operation was made in one case who underwent elective surgery for repair of an atrial septal defect which was associated with pulmonary valve stenosis. It demonstrated partial relief of pulmonary valve stenosis by tearing of cusp tissue. In conclusion, BPV is as effective a treatment for congenital pulmonary valve stenosis as open valvulotomy. In our follow-up study, it has shown no apparent complications. The transient obstruction in the right ventricular outflow tract immediately after BPV improved within one month and improved further after three months and one year. However, in the more long-standing cases the localized right yen tricular septal hypertrophy persisted and these cases will require, a long term follow-up.

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It has been reported that Kawasaki syndrome is accompanied with mitral regurgitation or aortic regurgitation in some cases. To elucidate the incidence and the natural history of valvular heart disease in Kawasaki syndrome, we analyzed the patients who were detected to have a new heart murmur after the onset of Kawasaki syndrome. From 1973 to 1988, we have experienced 13 cases with valvular heart disease in 1215 cases of Kawasaki syndrome, 12 cases with mitral regurgitation (1.0%) and one with aortic regurgitation (0.1%). Valvular lesions were confirmed by angiography or pulsed Doppler echocardiography. The age at onset of Kawasaki syndrome, the duration of fever, the maximum erythrocyte sedimentation rate, and the incidence of coronary artery lesions in these cases were compared with the same variables in 30 cases of without valvular lesion in Kawasaki syndrome. There were no statistical difference between the cases with valvular heart disease and without valvular heart disease about the age of onset (mean±SD 10.2±12.7 months vs 20.8±18.4 months; N. S.) and the maximum erythrocyte sedimentation rate (87.7±29.0 mm/h vs 87.2±35.6 mm/h; N. S.). Whereas the duration of fever in cases of valvular heart disease was more extended than those without valvular heart disease (20.3±8.1 days vs 10.3±4.3 days ; p<0. 001), and the incidence of coronary artery lesions in the cases of valvular heart disease was significantly higher than those without valvular heart disease (12/13 cases vs 7/30 cases; p<0.001), thus suggesting that the cases of valvular heart disease were subject to a severe case of Kawasaki syndrome. All valvular heart disease appeared within 1 month after the onset of Kawasaki syndrome, except in one case whose heart murmur was noticed 5 years after the onset. The heart murmur disappeared within 2 months after the onset of valvular heart disease in 5 cases, however in another 7 cases, the heart murmur persisted more than 2 years (mean; 5.3 years to date) or one has died of acute congestive heart failure due to mitral regurgitation. All cases with persistent valvular disease revealed mitral or aortic valve prolapse. Our data suggest that the cause of valvular heart disease might be different by the time of onset and duration of valvular heart disease. Valvular heart disease of the early onset and short duration may be caused mainly by pancarditis —especially valvulits—, valvular heart disease of early onset and persistence may possibly develop dysfunction in the valve and papillary muscle due to the sequelae of valvulitis, and valvular heart disease in late onset may be caused by ischemia. We suggest that valvular heart disease in Kawasaki syndrome may be an important cause of acquired valvular disease in children, whereas rheumatic fever has become quite rare condition now.

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