We reported three cases of tick bite (Ixodes ovatus) which affected right chest of 47-year-old male, left clavicular region of 49-year-old female and right shoulder of 6-year-old boy. In addition, we observed the insert site of 49-year-old female using scanning electron microscopy. In all cases, erythema around the insert site was found. Histologically, degeneration of dermal collagen fiber, dense inflmmatory cell infiltration, dominantly composed of lymphocytes and histiocytes, were found. Scanning electron microscopically, hypostome in dermis and degeneration of adjacent collagen fiber were seen. Reported cases about tick bite have been increasing year after year, and complications have been focused. In order to treat tick bite, excision of affected skin with tick is most recommended.

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Central endogenous opioid peptides are generally known to play an important role in the feeding behavior of rats. Several experimental hyperphagia rats were pretreated with naloxone, an opioid peptide receptor antagonist, to observe the changes in the feeding behavior. The intracerebroventricular (i.c. v.) administration of naloxone suppressed the hyperphagia caused by fasting, the subcutaneous injection of diazepam (a benzodiazepine antianxietic drug), and the i.c.v. administration of muscimol (a GABA agonist), clonodine (an co-adrenaline agonist) and 2-deoxy-D-glucose (a glucose metabolite). The i.c.v. administration of thiorphan, an enkephalinase inhibitor, on the other hand, increased the food intake of satiated rats. These results suggested that the central endogenous opioid peptides would control the activity of the central a2-adrenergic and GABAergic systems on the feeding behavior of rats. The central opioid peptidergic system would play a significant role in the central regulation of the physiological feeding behavior of rats.

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Although mechanical stimuli such as atrial muscle stretch induced by atrial pressure increase or volume overload release atrial natriuretic polypeptide (ANP), transmembrane and intracellular mechanisms of production and release of ANP are not yet clear. To define biochemical mechanisms of regulation of ANP release, the direct effects of biochemical stimuli, such as acetylcholine, isoproterenol, methoxamine, vasopressin and high osmolalities, were evaluated on isolated adult rat atrial myocytes maintained on tissue culture. ANP release from adult rat atrial myocytes was enhanced by acetylcholine or methoxamine with reciprocal intracellular ANP reduction. Block of muscarinic receptors by atropine and of alpha-1 adrenergic receptors by bunazosin attenuated transmembrane ANP release. These results suggest that phosphatidylinositol response, which is a common pathway for muscarinic and alpha-1 adrenergic receptor stimulation, may play an important role to regulate ANP release.

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In the hypoendemic malarious area, classical malariometric measures such as spleen rate and parasite rate are not enough sensitive to detect latent malaria foci or to get the epidemiological feature in the population. A seroepidemiological study was carried out at a hypoendemic Amazonian colony Tome-Acu in Path, Brazil. In the area, malaria parasite was not detected in the surveyed inhabitants, nor splenomegary was reported at all. The malaria indirect fluorescent antibody test (IFAT) was applied to find the epidemiological picture of the area. In August, 1988, 148 Japanese settlers at Tome-Acu were comparatively studied with 162 migrant labourers and their families stayed in the same area. The frequency distribution curves of falciparum indirect fluorescent antibody titers showed bimodal pattern in a collection of sera from the migrants, however, the pattern was unimodal in the sera of settlers. The results suggested that the malaria was endemic among the migrants, but not among the Japanese settiers. IFAT positive rates by age group of the migrants showed a particular peak in the age range from 0 to 14 year. The peak like this was not shown in the distribution obtained from Japanese settlers. The findings were thought to support it that endemic malaria existed among the migrants but not among the settlers. IFAT positive rate of the migrants was decreased according to the elongation of their residence period in Tome-Avu. Interviews were performed from house to house to ask their past malaria histories, and answers were compared with the IFAT results respectively. The agreement rate of both questionnaire and serological test was 77.7 % in the settlers, while 56.8 % was obtained in the migrants. This survey presented the importance of application of IFAT in the hypoendemic area to obtain detailed epidemiological picture which was not obtained by classical malariometric measures. Application of IFAT together with the history questionnaire was useful to obtain the real state of the epidemic and inhabtants' knowledge on malaria.

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The distribution and the dynamics of cell surface negative charge were studied in rat liver sinusoidal cells and hepatocytes by perfusion of cationized ferritin (CF) through the portal vein. When CF was perfused at 4℃, CF bound onto the membrane of the endothelial cells especially on their sinusoidal side. In hepatocytes, CF binding was restricted to the surface of the microvilli facing the Disse's space. Its population was larger along their tip portion. Thus, a cellular polarity is to be indicated in terms of the distribution of anionic sites on the surface membrane of both the endothelial cells and hepatocytes. When CF was perfused at 37℃, CF particle were found in clusters on the surface of endothelial cells especially on their sinusoidal side. In addition, the bound CF was taken up actively into endothelial cells and Kupffer cells. After 30 min of perfusion at 37℃, these incorporated CF was localized in coated and uncoated pits and vesicles. After 60 min at 37℃, uncoated and coated vesicles and multivesicular bodies appeared heavily labeled with CF. On the contrary, hepatocytes and Ito cells revealed only a small amount of incorporated CF even after 60 min of perfusion. When compared among the different regions in the hepatic lobules, the binding and the endocytosis of CF were more prominent in the perilobular sinusoid than in the centrolobular one. Thus, regional differences and the differences in cellular dynamics of hepatic tissues have been clarified in terms of the distribution and incorporation of anionic sites by use of the in situ perfusion of CF.

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Esophageal carcinoma in rats was experimentally induced with the oral administration of N-methylbenzylamine and sodium nitrate. In addition to the conventional morphological findings, lectin binding patterns were examined by light and transmission electron microscopy employing horseradish peroxidase (HRP)-labeling methods, and compared among the normal esophageal epithelium, papilloma, dysplasia, carcinoma in situ and invasive carcinoma. Lectins used were concanavalin A (Con A), wheat germ agglutinin (WGA), Ricinous comnaunis agglutinin (RCA), peanut agglutinin (PNA), soybean agglutinin (SBA), Dolichos biflorus agglutinin (DBA), Ulex europeus agglutinin-1 (UEA-1). By light microscopy, ConA, W GA and RCA stained positively the cells of all layers of the normal esophageal epithelium, and those of papilloma, dysplasia, carcinoma in situ and invasive carcinoma as well. PNA stained positively the cells in the middle layer of the normal esophageal epithelium and papilloma. However, PNA stained positively all the cells of dysplasia and part of the cells of carcinoma in situ and invasive carcinoma. SBA and UEA-1 stained positively the cells in the middle and superficial layers of the normal epophageal epithelium and papilloma. In dysplasia and carcinoma in situ but not in invasive carcinoma, SBA and UEA-1 appeared to lose their bindings. DBA binding was negative in all the tissues. By electron microscopy, lectin bindings were proved to be positive mainly in the plasma membrane and Golgi membranes. In addition, ConA binding was positive also in nuclear membranes and endoplasmic reticulum. By comparing the progression of carcinoma with the change in lectin binding patterns, especially when stained with PNA, SBA and UEA-1, it is possible to estimate that dysplasia is a precancerous condition in the esophageal epithelium. Therefore, PNA seems to be especially useful for diagnosing the esophageal carcinoma.

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We made an epidemic study in a total of 131 cases with nasal complaints considered to be in needed of pshychosomatic care becuase of "discrepancy between subjective symptons and diagnosis", "too much concern to nose", and "Psychic complaints". There were 32 cases of psycosis-like condition (psychosis group), 52 cases of nerosis-like condition (neurosis group), and 47 almost normal cases (normal group). Clinical diagnosis were chronic sinusitis and deviation of nasal septum in most of cases. However, there were some normal cases also. Findings of Y・G test and CMI apparent difference was seen among groups. Pshychological background factor was "nasal operation" in most of cases. This finding suggested that some of cases were condidered iatrogenic cases. From these findings the importance of taking approaches from both somatic side and mental side in patients with nasal disease was confirmed.

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We measured systolic time intervals (STI) on mechanocardiograms in 95 patients with myocardial infarction 1 month after its onset and compared them with findings of cardiac catheterization and nuclear cardiological examination. 1) Prolongation of the Q-I interval reflected a decrease in cardiac output, and an increase in the PEP/ET ratio reflected an increase in pulmonary capillary wedge pressure. The Q-I interval and PEP/ET can be used instead of Forrester's classification mapping obtained by invasive cardiac catheterization. 2) PEP/ET was significantly higher in the group with multivessel disease than in that with one-vessel disease. 3) The left ventricular ejection fraction at rest was not reflected by STI, but that after exercise in nucler cardiological examination was higher in the group with a higher PEP/ET. These findings show that a high PEP/ET indicates latent decrease in cardiac function even when left ventriclar funcion at rest is normal. In long-term follow up for cardiac function in patients with myocardial infarction, non-invasively obtained STI is a very useful subsitute for findings of cardiac catheterization or nuclear cardiological examination.

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In 51 cases with anterior myocardial infarction, diagnostic probabilities of elecrtrocardiography (ECG) and two-dimensional echocardiography (2-ED) were evaluatated in regards to site of lesion in left anterior descending coronary artery (LAD), and its distribution in the apex. Sites of responsive coronary arterial lesion were assessed in relation to first diagonal (D1) and first septal (S1) branches, and LAD extension in the apex. Upon comparison of two methods, 2-DE demonstrated the site of lesion in LAD to differentiate the proximal and distal from Sl, with more accurate diagnosteic probability. ECG demonstrated the site of lesion in LAD to differentiate the proximal and distal from D1, with little better diagnostic probability. Development and extension of the LAD in the apex was well evaluated with 2-DE. No significant difference was seen in left ventricular ejection fraction by the site of lesion in distal and proximal to S1 or D1, however, significant difference was seen in LADs with and without favorable growth. Although location of the lesion in LAD, development of LAD in the apex, and related cardiac function were able to evaluate using 2-ED alone, better diagnostic accuracy could be obtained with combined use of 2-DE and ECG.

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A 72-year-old male with 35 years history of rheumatoid arthritis was admitted to our hospital because of the left leg ulcer. Depite of various treatments, the ulcer was not improved. After days of admission leg purpura and rapidly progressive glomerulonephritis with massive proteinuria developed. Although anticoagulant therapy was dose for his rapidly progressive glomerulonephritis, renal function declined rapidly in about two weeks. Hemodialysis was eventually instituted, but he died of massive intestinal hemorrhage. Postmortem histopathological examination of the kidney was performed and revealed mild mesangial proliferative glomerulonephritis with partial and circumferential crescent formation. Although vasculitis was not detected in his renal specimen, leg ulcer, purpura, subcutaneous nodules, intestinal hemorrhage, high titer of RAHA, low level of complements and positive anti-neutrophil cytoplasmic antibodies suggested the existence of vasculitis. We, therefore, thought that the rapidly progressive glomerulonehritis was probably related to vasculitis associated with rheumatoid arthritis. As far as we examined in the literatures, only 15 cases were reported on rheumatoid arthritis complicated by rapidly progressive glomerulonephritis, the pathogenesis of which was not considered related to drugs, amyloidosis or other collagen diseases. In these cases, 47 % was associated with the clinical signs of vasculitis, 20 % was detected to have vasculitis by histological examination. 42 % was required hemodialysis and 42 % was died. Although rapidly progressive glomerulonephritis is uncommon feature among extra-articular lesions of rheumatoid artrhitis, specific carefull attention should be made in patients with rheumatoid arthritis associated with vasculitis.

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