The serum levels of CEA, AFP, ferritin, TPA and CA 15-3 were determined in patients with breast carcinoma. Of 44 cases of primary breast carcinoma, ferritin and TPA had high levels. In primary breast carcinoma, the positive rates for TPA were: stage I, 21.4 %; stage II, 29.2 %; and stage IIIa, 33.3 %. In histological type, the patients did not have significantly higher evels of TPA. Sensitivity for TPA was 27.2 %. Of 18 cases of recurrent breast carcinoma, CEA, ferritin, TPA and CA 15-3 had significantly higher levels. In recurrent breast carcinoma, the positive rates for CEA was 50 %; ferritin, 27.8 %; TPA, 72.8 %; and CA 15-3, 50 %. In patients with recurrent breast carcinoma, especially in cases of metastasis of liver or bone and in end-stage patients, the levels of ferritin, TPA and CA 15-3 increased. The evaluation of tumor-markers in various combinations is effective in monitoring recurrence of breast carcinoma.

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Effect of scoliosis on spinal structure in Wistar rats was observed to investigate the causes of development of human adult scoliosis and degenerative scoliosis. Bipedal rats were made by Goff-Sakamoto method and trained to walk on their lower extremities by 2 nd〜3 rd week. Then, thoraco-lumbar scoliosis was produced by unilateral costal-iliac cerelage. The changes in spinal structure were examined radiographically and pathologically at 6th and 12th month, respectively, and compared with those in the following control rat groups: (1) quadripedal thoracic scoliosis, (2) quadripedal thoraco-lumbar scoliosis, (3) bipedal without scoliosis, and (4) normal. About 80 % of the bipedal thoraco-lumbar scoliotic rats showed a progressive scoliosis, particularly a progressive kyphosis at the thoraco-lumbar region after 6 th month. Regressive degeneration in the intervertebral disc and zygapophyseal joint, and yellow ligament on the concave side of spine were also observed in the bipedal scoliotic rats. These findings suggest that the increase in load on the thoraco-lumbar region in standing scoliotic posture may cause further development of aggravating kypho-scoliosis. Thus, compression of spinal cord and nerve roots could be produced by these changes.

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Kyphosis, as compared to scoliosis, is usually very likely to complicate spinal paralysis. Its etiology, however, is still unknown. To determine the etiology of the paralysis, we made an experimental kyphosis model by using Wistar bipedal rats. Following microangiography the materials were embedded with polyester resin in order to study the effect of kyphosis on the anterior spinal artery system. A spinal cord with kyphosis was observed to shift anteriorly, compared to the normal spinal condition. The apex of the spinal cord with kyphosis was deformed owing to pressure from the anterior region. Although the anterior spinal artery at and around the apex of the kyphosis was flattened, obstruction was not observed in the intraspinal vascular network of the spinal cords. No correlation was found between the degree of flattening of the anterior spinal artery and the degree of kyphsis. However, the average flattening of the anterior spinal artery was greater in rats with spinal deformity than in those without deformity (p<0.01). No correlation was found between flattening of the anterior spinal artery, and the area of grey matter around the anterior horn, occupied by the blood capillary network. However, a correlation was seen at the vertebral level of L1/2, and at this level, there was a significant difference between the groups with and without spinal cord compression (p<0.05). There was congestion of the blood capillary network in the spinal grey matter at the L1/2 level. These findings demonstrated the presence of disturbances in the anterior spinal artery system due to various degrees of compression in the kyphosis.

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We have reported previously that the intracerebroventricular (i.c.v.) administration of minute amounts of noradrenaline (NA,1 ng) and phenylephrine (1 ng) prior to exposure of rats to immobilization stress inhibited significantly the stress-induced increase in the plasma adrenaline (Ad), but this was not the case with clonidine (1 μg). The inhibitory effect of NA was antagonized by preadministration (i.c.v.) of prazosin (1 μg), but not by yohimbine (1 μg), suggesting that the inhibition of stress-induced increase in plasma Ad by NA (i.c.v.) was due to stimulation of central α_1-adrenoceptor, but not α_2-adrenoceptor. In the present experiment, changes in the stress-induced increase in plasma Ad by administrations of NA and clonidine given (i.c.v.) during stress exposure was examined. When saline was given during stress, plasma Ad did not change 10, 20, and 30 min after administration prior to stress in conscious rats. Administration of NA (1 ng i.c.v.) during the stress did not cause an inhibition of linear rise of plasma Ad to increase linearly by stress. On the contrary, plasma Ad was inhibited by clonidine (1 ng) given (i.c.v.) 3 min after stress exposeure. The inhibitory effect of clonidine was inhibited by i.c.v. preadministration of α_2-antagonist, yohimbine (1 μg, i.c.v.). In addition, i.c.v. administration of yohimbine (1 μg) alone during stress exposure did not inhibit increase in plasma Ad, but it was observed that administration of prazosin (1 μg, i.c.v.) produced significant inhibition. From these observation, it is supposed that the discrepancy between NA and clonidine responses obtained due to administration during stress exposure may reflect acceleration of central catecholamine turnover in stress-condition.

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The present experiment dealt with the cell-growth promoting activity of bovine platelet vascular permeability factor (VPF) on Balb/c 3T3 fibroblasts. The author reconfirmed the previous finding that the α-granule acid extract of bovine platelets purified by means of Superose 12 contains three kinds of VPF with molecular weights of approximately 30,000, 300,000 and of greater than 450,000. In this study, sodium dodecyl sulfate polyacrylamide gel electrophoresis of the low molecular VPF revealed single band for protein of 30,000 molecular weight. The vascular permeability produced by these three VPFs in the dorsal skin of rabbits was also reconfirmed quantitatively using ^<125>I-bovine serum albumin and ultrastructurally. These VPFs stimulated cell growth of the Balb/c 3T3 fibroblasts and promoted incorporation of ^3H-thymidine into the cells. Furthermore, the growth-promoting activity of each VPF was completely inhibited by incubation with protamine sulfate and reduced by trypsin or 2-mercaptoethanol treatment. The growth activity, however, was stable after heat treatment of the factors at 100℃ for 10 min. Accordingly, VPF may play an important role in exudation and migration in acute inflammation and mesenchymal cell growth in chronic inflammation.

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X-ray computed tomography (CT) was performed in 182 cases of untreated cervical carcinoma, and the CT findings were compared with operative findings and pathological specimens in surgically treated 127 cases, and with post-therapeutic CT findings in irradiated 55 cases. The results were as follows: 1) The cervical image was significantly (p<0.01) enlarged in the group in which the diameter of the cancer in the specimen was greater than 2.0 cm. Accordingly, a cervical area exceeding 12.6cm^2 was classified as enlargement of the cervix. 2) With respect to parametrial invasion in surgically proven cases (256 parametria), the diagnostic value of CT was manifested by a sensitivity of 67%, a specificity of 91%, and an accuracy of 86%. 3) In detecting paravaginal and vesical extension, CT was superior to conventional diagnostic methods, and the accurary of CT in detection of vesical involvement was 96% in surgically treated cases. 4) The diagnostic value of CT in evaluating lymph node metastases in surgically confirmed cases was manifested by a specificity of 100%, and an accuracy of 89%, although the sensitivity was only 26%, when lymph node images with maximum diameter exceeding 2.0cm were regarded as metastases. The above findings indicate that CT provides greater accuracy in the staging of cervical carcinoma, when used with conventional methods.

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The case was a male infant, delivered vaginaly at 37 week 4 day gestation and birth weight was 2546gm. His mother developed varicella rush from a day before delivery, and the rash appeared from 11th day after birth. He had high fever and dyspnea for pneumonia, and general condition was poor. Acyclovir was started 5mg/kg every 8hr from 2nd day to 5th day of the illness, then the baby became to improve from 4th day. No side effect of Acyclovir to liver function and platelet was found. Viral antibody titers were measured by the method of FA, ELISA, CF, through the course. Anti-Varicella Zoster (FA) IgM did not elevate, but ELISA IgM elevated significantly. For these findings, we concluded that ELISA is helpful to evaluate specific anti-viral IgM antibody during newborn period. Though zoster immunoglobuline was used, this therapy was evaluated to make little effect on the course of the illness, considering FA IgG titers. The etiology of the disease may have both possibilities, transplacental and genital tract infection, because onset of the disease was 11th day after birth. From experience of the case, we appreciate that Acyclovir is effective and safe for therapy of neonatal varicella or herpes virus infection.

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A 71-year-old male was admitted because of foot drop, numbness in the limbs and difficulty in walking gradually developed for about 1 year. He had no hyperpigmentation, hypertrichosis, edema, or superficial lymphadenopathy. Neurological examination showed a mixed type of polyneuropathy. Laboratory studies revealed marked elevation of IgA in serum (1448mg/dl) with normal levels of IgG and IgM. IgA and IgG were elevated in CSF. IgA and IgG immune complexes were increased in serum (12.1μg/ml, 4.0μg/ml, respectively , and IgG antimyelin antibody was positive (8×). Studies of the cellular immunity showed deficient activity of natural killer cells (12%) with normal T/B cell ratio, OKT4/8 ratio and the number of Ial-antigen positive cells. Bone marrow examination showed plasma cell dyscrasia. Motor nerve conduction velocities of the right median, tibial, and peroneal nerves were slowed. Sensory action potentials of the right median and sural nerves could not be elicited. Biopsy study of sural nerve disclosed a remarkable reduction in the total fiber density, various stages of demyelination and axonal degeneration with marked edoneurial fibrosis. A large number of myelin ovoid and segmental demyelination were observed by the teased fiber method. IgA and IgG deposits were detected on the endoneurial connective tissue by the immunofluorescence technique and the avidin biotin peroxidase complex method. The demonstration of endoneurial deposition of IgA in polyneuropathies associated with nonplasmocytomic paraproteinemia is rare in the literature. The pathogenetic relevance of endoneurial IgA deposition to the polyneuropathy of this patient remains to be clarified.

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We described a case of pneumothorax complicating rheumatoid arthritis. A 69 year female with a 5 year history of rheumatoid arthritis was admitted to our hospital because of infected chest wall ulcer. Antibiotic therapy and reducing the dozes of steroid were performed. Although the ulcer was improved, the activity of rheumatoid arthritis was increased and right pneumothorax with pleural effusion developed one month later. Two nodules shadows were found on her chest tomogram. The findings of pleural fluid such as low glucose, low complements and high LDH, suggested rheumatoid pleuritis. Despite conservative management by watersealed drainage, the lung failed to expand normally and she subsequently underwent thoracotomy. Although the histological examination showed nonspecific pleuritis without rheumatoid nodules, blebs and pulmonary fibrosis, we thought that the pneumothorax was probably related to rheumatoid pleuritis on the lung surface. Although pleuritis is not uncommon feature of rheumatoid lung disease, pneumothorax is rare. Only 30 cases were reported on pneumothorax with rheumatoid arthritis. In these cases, 66% was male, 43% was occurred in both sides, 96% had complication of empyema or pleural effusion, and 56% was poor response to conservative therapy and was required surgery. We need more carefull management of the patient with pneumothorax complicating rheumatoid arthritis.

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