Acute increase in food consuming of rats by diazepam was quantitatively analysed by measuring total stomach weight including the weight of food intaken. The Methodological details of stomach weight measurement were described in this paper. Though present method has disadvantage of inevitable sacrifice of the animals, it seemed suitable for the analysis of acute polyphagic effect of diazepam in that future chemical analysis of neurotransmitters in hypothalamus is necessary for the study of mechanism of polyphagic effect of diazepam.

View full abstract

A correlation between leucocyte adherence inhibition index (LAI Index) and degree of macroscopic extension (Stage) which was decided by operation findings and autopsy findings, was studied in patients with pancreatic carcinoma or hepatocellular carcinoma. In the 20 patients with pancreatic carcinoma, as all of the cases belonged to Stage IV, no correlation could be elucidated between LAI Index and Stage. Also, any obvious correlations were not found between LAI Index and lymph nodes metastasis, invasion of pancreas capsule, matastasis to liver, and peritoneal dissemination in pancreas head carcinoma, respectively. In the patients with pancreas body and tail carcinoma, however, LAI Index showed a tendency of parallel increase with the degree of peritoneal dissemination. On the other hand, in 13 patients with hepatocellular carcinoma, 3 cases belonged to Stage I and 10 cases to Stage III. However, there was no difference in LAI Indices between both Stages. Also, no significant difference was found between the number of days from LAI testing to death and LAI Index.

View full abstract

Of 17 cases with renal tumor, 9 cases (53%) with renal cell carcinoma treated from Jan. 1978 to Jun. 1980 were reviewed. The results obtained were as follows. 1) Encounter rates with such patients were 0.14% of outpatients and 1.10% of inpatients. 2) The right kidneys were more affected than left, the ratio being 3 to 1 female patients were more commonly affected, the ratio being 2 to 1, different from other reports. The average age of patients was 57 years old. 3) The most frequent symptom was macroscopic hematuria (66.7%), but only 22.2% had the classic triad, namely macroscopic hematuria, renal mass and flank pain. 4) Raised erythrocyte sedimentation rate, anemia, lymphopenia, dysproteinemia and pyrexia were demonstrated to be factors of significantly poorer prognosis with regard to the disease. 5) Renal angiography was most useful for the diagnosis. 6) Nephrectomy combined with chemotherapy and/or radiotherapy was performed for 7 cases (78%), and other 2 cases received conservative therapy, followed by no effect in the latter. 7) Actual survival rate was 65% for total cases, 85% for nephrectomized cases. 8) The duration of symptom, tumor size, staging, grading, elevated ESR., anemia, lymphopenia, dysproteinemia and fever were important for the judgement of prognosis of the disease.

View full abstract

Pathological findings of a patient with progressive supranuclear palsy (PSP) were reported. The patient was a 77-year-old male, who showed, during about 12 years of his illness, typical symptoms of PSP, such as dysarthria, supranuclear opthalmoplegia to all directions, axial dystonic rigidity with extention of the neck and hyperreflexia. In addition, he showed difficulty in eyelid opening, which was diagnosed as so-called "apraxia of lid opening" by EMG using surface electrodes. CT revealed obvious dilatation of the quadrigeminal and ambient cisterns indicating atrophy of the brain stem. On autopsy, the brain weighed 1220g, and seemed almost normal except for slight atrophy of the brain stem. Microscopic examination demonstrated marked neuronal loss and gliosis especially in the globus pallidus, nucleus subthalamicus and substantia nigra. A lot of neurofibrillary tangles were observed in the superior colliculus, periaqueductal gray matter, substantia nigra and locus caeruleus. Eosinophilic granules were found in the globus pallidus and substantia nigra. In electron microscopic studies, it should be stressed that the neurofibrillary tangles in this case were composed of bundles of 100Å neurofilaments. This finding is different from previous reports in which 130-150Å straight or twisted neurotubules were described as the components.

View full abstract

Seven cases of rapidly progressive glomerulonephritis (RPGN) were reported. The incidence of RPGN in our university hospital between 1970 and 1980 was only 1.6%. RPGN was diagnosed histologically in cases of glomerulonephritis in which circumferential crescents were present over 50% of the observed glomeruli irrespective of the association of endocapillary changes. Three cases were idiopathic and four cases were due to lupus nephritis. Histologically seven cases were divided into two groups, one with extensive extracapillary proliferation (pure idiopathic RPGN-one case), the other with endo-and extracapillary proliferation (six cases). As reported previously, two cases with marked endocapillary proliferation were recovered from rapidly progressive renal failure by steroid pulse therapy. Immunofluorescence study showed granular deposits of IgG and C3 along the capillary walls and fibrinogen in the Bowman's capsule and capillary walls. In three cases (idiopathic 1, lupus nephritis 2), anti-GBM antibody in serum was positive and in two cases of lupus nephritis circulating immune complex (CIC) was positive with remarkable high titer. A case of LN with severe deterioration of renal function showed positive anti-GBM antibody in serum, high CIC titer and clinically and histologically remarkable changes of blood coagulation system. Then some aspects were discussed on the point of CIC, anti-GBM antibody, blood coagulation mechanism and formation of crescents in patients with RPGN.

View full abstract

A 39-year-old female became a habitual drinker 5 years ago. For the last 6 months, the amount of her alcohol intake has been about 1l of SAKE a day, which resulted in an unbalanced diet and the subsequent weight loss and amenorrhea. In August, 1980, symmetrical erythemas appeared on the limbs as well as lancinating pain in the legs. On withdrawal from alcohol, she suffered from temporary delirium and frequent diarrhea, and was admitted to our hospital. At the time of admission, weakening of the tendon reflexes, peripheral hypesthesia, and ataxia in walking were apparent in addition to the erythema and diarrhea. Alcoholic beverages were completely stopped and oral intake of food was increased little by little. Vitamines were also administered and her condition improved rapidly. The symptoms, which included delirium, polyneuropathy, symmetrical erythemas on the limbs and diarrhea. were diagnosed as pellagra associated with chronic alcoholism. This condition can be regarded as polyhypovitaminosis based on chronic alcoholism. Pellagra, a nicotinic acid deficiency disease, is rarely observed clinically nowadays. Present case revealed that various factors such as an absolute lack of Tryptophan intake, malabsorption caused by drinking, and metabolic dysfunction, when concurrent, can precipitate pellagra. The long habit of drinking and almost self-destructive dietary practice are obviously the direct cause and it is also inferred that some sort of disorder in matabolism must have existed as well.

View full abstract

To determine the usefulness of imaging techniques for the diagnosis of obstructive jaundice, ultrasonography (US), computed tomography (CT), hypotonic duodenography (HDG), pancreatoscintigraphy, angiography, percutaneus transhepatic cholangiography (PTC) and endoscopic retrograde cholangiopan-creatography (ERCP) performed in 69 patients were reviewed retrospectively. Dilatations of intrahepatic biliary trees were noted in 72% of cases by US and in 70% by CT. HDG and pancreatoscintigraphy, were useful proceduers in patient with carcinoma of the head of pancreas and the papilla of Vater. However, positive findings were obtained in only 50% of cases by these procedures. Carcinoma of the head of pancreas as diagnosed in 81.1% of cases by PTC and in 55.8% of cases by ERCP. Positive findings of carcinoma of the common bile duct obtained by PTC and ERCP were 72% and 50% respectively. In conclusion, US in recomended to the first choice of examination to be done in patients with obstructive jaundice. Thereafter PTC and/or ERCP should be performed for finding of the localization and natures of stenosis in bile duct. Angiography is valuable procedure for further diagnosis of invasion of carcinoma and to determine the indication for surgical accessibility.

View full abstract