The seed oil oo Aleurites cordata (tung oil), which contains eleostearic acid (9, 11, C18: 3) at each position of α, β, and a' position of grycerol by 76 %, can work as a substrate of lipases. As the fatty acid possess specific absorbance at 275 nm, the lipase activity can be evaluated by measuring the the optical density of the phase containing fatty acids liberated by the enzyme reaction, after the partition by organic solvents. By application of this procedure, screening test of serum lipase activity, with less than 25μl of serum, can be done for a minor improvemnt; the assay can be made by adding sodium dodecyl sulfate and sodium taurodeoxycholate to the reaction mixture. The procedure and the "BALB method" which is widely employed in clinical screening test of serum lipase were apploximately equal in sensitivity. As a natural oil is used as a substrate in this procedure, it can be excluded the errors which may occur in the BALB method by the contamination of other esterases. It also be possible by the procedure to measure the lipase activities in chylemia and in the high activity region of serum, of wich activities are difficult to measure by the BALB method.

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The seed oil of Impatiens balsamina contains parinaric acid of which maximum absorbance is at 305 nm. The seed oil was confirmed to be a substrate instead of tung oil in the assay system of serum pancreas lipase reported previously. In the assay, the amount of fatty acid released by the lipase from the seed oil was determined by measuring the optical density at 305 nm of alkali aqueous phase which contained the parinaric acid partitioned together with other fatty acids. In case I. balsamina seed oil was used as a substrate, the increase in optical density according to the contamination of protein was small in compare to that in case tung oil was used as a substrate sinec 305 nm is far from the maximum absorbance region of protein. Thus, we could measure the activity with less amount of serum and could shorten assay period. By using the I. balsamina seed oil, it was possible that the ultraviolet spectrophotometrical simple assay for post herarin lipolytic activity (mainly, lipoprotein lipase activity) which needs a preseance of a large amount of protein.

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In tung oil, eleosteraric acid of which maximum absorbance is at 275 nm, equally distributed at α,β,α' positions of grycerol. The oil could be a good substrate of the simple ultraviolet spectrophotometrical lipase assay. The estimation of the enzyme activity was achieved by measuring the optical density at 275 nm of the alkali aqueous phase which includes eleostearic acid together with other fatty acids liberated by the lipase. Since the wave length of the maximum absorbance of eleostearic acid coincides with that of protein, the optical density of the aqueous phase increased by the protein contamination in some cases where an assay medium contained a large amount of protein. The deproteininzation with zinc hydroxide was useful to exclude the protein contamination without complicating the asay procedure. Thus, we could employ tung oil as a substrate for the assay of the rabbit and human post heparin lipoliytic activity, which requires a large amount of proteins in the assay medium.

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The diagnostic rate of respiratory syncytial virus (RSV) infection was 50 % by virus isolation, 47 % by immune adherence hemagglutination (IAHA), 54 % by complement fixation test (CF) and 98 % by enzyme-linked immunosorbent assay (ELISA) IgM antibody detection. Thus the detection of IgM antibodies by ELISA appeared to be more efficient than CF and IAHA for detecting serologic response in infants with RSV infection. RSV was detected in 43 of 282 inpatients with acute middle and lower respiratory tract illness. More than half of the patients (56 %) with RSV infection were diagnosed as having bronchiolitis, and all cases with bronchiolitis were less than 2 years of age. The prevalence of acute middle and lower respiratory tract illness with RSV infection was unrelated to their birthweight and type of feeding. In the control group, high RSV-IgG antibodies passively received from the mother were observed in neonates. RSV-IgG antibodies gradually decreased in infants 1-4 months of age, followed by a secondary increase in the adolescent phase. RSV-IgG antibody levels in acute phase sera from patients with RSV infection showed the same trends. There was no difference between RSV-IgG antibody levels in acute phase sera form patients with RSV infection and those of the control group. These findings indicated that circulating ELISA RSV-IgG antibodies had no direct effect on the clinical features of acute middle and lower respiratory tract RSV infection.

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In order to clarify the pathogenesis of decreased cellular immunity in patients with chronic hemodialysis, lymphocytotoxin (LT) and p2-microglobulin (β_2-MG) in sera of these 31 patients were examined. Immunologic parameters such as the number of lymphocytes, B cells, T cells and T cell subsets as well as routine laboratory examinations including WBCs, serum immunogloblins and serum complements were examined. LT was measured by the microcytotoxicity method and β_2-MG was measured by the RIA assay. Patients were divided into 3 groups according tto duration of hemodialysis treatment: Group A (11 cases); less than 5 months, Group B (10 cases); between 5 months and 5 years, and Group C (10 cases); over than 5 years. In all groups there were lymphopenia. In regard to T cell subsets, a decrease of T4 cell ratios and a low value of T4/T8 cell ratios were noticed especially in Group C. Although LT was found in all three groups, the level was significantly high in Group C compared with Group A and B (P<0.05). Cytotoxicities of LT to T cell subsets was higher in T4 cells than T8 cells and there was a negative correlation between the percentage of T4 cell killings and the T4 cell ratios. The serum level β_2-MG was increased in parallel with duration of hemodialysis. A negative correlation between the level of β_2-MG and the T4 cell ratios and a positive correlation between the level of β_2-MG and the percentage of T4 cell killings were found. Other immunologic parameters did not correlate with the level of LT and β_2-MG. Thus, it was concluded that LT can be detected in patients with chronic hemodialysis, particulary in those having with the high level of β_2-MG and on long term hemodialysis. From these data, the T cell injury by LT seems to play a role in the decrease of cellular immunity in patients with chronic hemodialysis.

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Hallucinations in schizophrenic disorders are one of the major problems encountered in psychopathology. They are found so often in all phases of the clinical course. Therefore these problems have been few statistical studies of schizophenic hallucination by direct interview. In this paper, I investigated the phenomenology of schizophrenic hallucinations (auditory, visual, body sensational, tactile, olfactory, gustative). This study dealt with the schizophrenic hallucinations reported by 130 inpatients and 87 outpatients during an interview with each patient over about 2 months. Seventysix inpatients (58.5 %) and 19 outpatients (21.8 %) had hallucinations. In this phenomenological study, I examined throughly the characteristics of schizophrenic hallucinations through investigation of experiences reported by each patient and by consideration of the frequencies of these hallucinations. This study reveals the psychological viewpoint of each hallucination and the patient's impression of the hallucination. As a result, it was found that auditory hallucinations and abnormal body sensations were of the highest frequency in schizophrenic hallucinations. From this study, it may be concluded that schizophrenic hallucinations are pseudo-hallucinations because they lack perceptual characteristics. Patients in the stage of exacervation experience hallucinations with reality, but they cannot explain their detail. On the other hand, patients in the chronic stages describe hallucinations in detail, but without reality. The characteristic schizophrenic hallucination does not include the perceptive components, but there is delusional conviction.

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[in Japanese]

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A 39-year-old male, who had a history of Osserman type II myasthenia gravis and underwent thymectomy 5 years ago, was admitted to the hospital because of bulbar symptoms. On admission, laboratory data showed remarkable high titer of anti-Ach-R antibody (108 nM/l) and high percentage of CD8 cells and low percentage of CD4 cells in peripheral blood. Further study by two color analysis using various anti-lymphocyte antibodies revealed that the high percentage of CD8 cells was dependent on the increment of CD8(+)CD11(-) cells (cytotoxic T cells) and the low percentage of CD4 cells was dependent of CD4(+)2H4(+) cells (suppressor/inducer T cells). Anti-lymphocyte antibodies in serum detected by the microcytotoxicity test were found and their activities were mainly to CD4 cells rather than to CD8 cells. These antibodies were considered to be associated with the alteration of T cell subsets in this patient. Therefore, the immunoadsorption trial with IM-T was done and the excellent improvement was observed in the clinical symptoms and in the abnormal laboratory data including anti-Ach-R antibody and Tcell subsets. Afterwards, he was in good condition for one year. However, he was attacked again by myasthenic crisis and was maintained on mechanical ventilation. Thus, the second immunoadsorption therapy was instituted and resulted in good response. Accordingly, we presumed that reduced number of peripheral CD4(+)2H4(+) cells in this case might be associated with the destruction of CD4 cells by the anti-lymphocyte antibody in serum, but the pathogenic relevanse of increased number of parpheral CD 8 cells was not clarified. Concerning about the immunoadsorption therapy, it could induce the clinical improvement, but post-immunosuppressive treatment was needed for the prevention of immunological rebound phenomenon.

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Infants who admitted to Neonatal Intensive Care Unit of Kyorin University, Medical Center between 1987 to 1988 were reviwed. Number of infants admitted was 124 in 1987 and 120 in 1988, respectively. 1. The survival rate of extremely immature infants (<1000 gm of birth weight) was 75 % (18/24). All the very low birth weight infants between 1000 to 1499 gm of birth weight were survived (18/18). 2. The major causes of death in the extremely immature infants (6) were respiratory dintress syndrome with pulmonary interstitial emphysema (2), massive intraventricular hemorrhage (3) and sepsis (3). Congenital heart disease was the most frequent cause of death in infants more than 1500 gm of birth weight. 3. The incidence of neurological sequerae in the very low birth weight infants (<1500 gm of birth weight) who were born between Sept., 1985 to Dec., 1987 and had been followed for more than one year was 14 % (4/28). Pneumothorax developed in all four cases. 4. Intrauterine diagnosis was made in the seven patients with Bochodarek hernia, umbilical hernia, intestinal atresia, renal tumor and hydrocephalus. Congenital arrhythmias were also diagnosed in utero in six cases. Intrauterine informations were useful for the determination of the appropriate treatments biginning immediately after birth. 5. Artificial surfactant was used in six cases of respiratory distress syndrome. Symptomatic patent ductus arteriosus developed in three cases and they were managed sucsessfully by mephenamic acid administration. 6. Sepsis due to mechicilline and cephem resistant staphylococcus aureus developed in four cases. Vancomycin was effective for those infants. Determination of the blood levels of Vancomycin was recomended in order to prevent the adverse effects of the drug. 7. The incidence of retinopathy of the prematurity (ROP) between Sept., 1985 to Dec., 1988 was 41 % (20/41) in the very low birth weight infants. ROP developed mainly in patients less than 28 weeks of gestation and/or 1249 gm of birth weight.

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