Myocardial ischemia usually is evaluated by echocardiography, ultrasound crystals, ATP activity, etc. Also, epicardial ECG still is one of the more important methods of myocardial function evaluation. The aims of this study were (1) easy production of a small injury current mapping electrode with low electric resistance, and (2) a means of analyzing the resulting signals using a personal computer. The tip of the electrode is made using Fujikura Chemical's Dotide D-753 and shaped like a cylinder 2 mm in diameter. It is connected to a wire 0.5 mm in diameter and isolated with epoxy resins. The signals are amplified and the mean electromotive force measured with a 12-bit A/D converter. The electrodes produced were electrically stable, and their injury currents were below 2 mV.

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To assess the significance of menstruation leave, basic epidemiological data was obtained by having 626 female college level students fill out a questionnaire in which they were asked which of 37 selected common subjective symptoms appeared in each premenstrual phase, menstrual phase, and phase other than these two. The menstrual status of each subject, including age at menarche and body mass index, also was ascertained. On the basis of these data, the correlations among the three phases of each individual of the number of symptoms and the correspondence rate of each symptom's occurrence, and the interrelationships of the 37 subjective symptoms were statistically analyzed. The conclusions were as follow 1. The subjective symptoms can be found much more abundantly in the premenstrual phase and the menstrual phase of an individual than in the third phase. Furthermore, there may be a close relationship between the number of subjective symptoms in the premenstrual phase of an individual and that in the menstrual phase. 2. Late menarche may be related to oligomenorrhea, thinness and an irregular menstrual cycle. 3. In healthy young females, many common subjective symptoms, such as abdominal symptoms, psychiatric symptoms, lumbago, etc., originate in the premenstrual phase. From the viewpoint of medical background, however, most of these premenstrual symptoms can be considered not largely different from those in the menstrual phase. 4. For young females, it is necessary to control work-shifts in accordance with the characteristics of the symptoms of each individual because there are considerable differences in premenstrual and menstrual syndromes among various individuals. Furthermore, the application of menstruation leave to the premenstrual phase also should be considered.

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A case of bladder cancer with lung metastases in which TUR-Bt was performed following M-VAC (methotrexate, vinblastine, doxorubicin, cisplatin) chemotherapy is presented. There has been a partial response of the patient. Histopathologic diagnosis and flow cytometric (FCM) analysis of cell cycle were performed before and after chemotherapy and at the time of rceurrence. Lung metastases disappeared, and the bladder cancer markedly decreaseed in size after M-VAC chemotherapy, but histopathologic diagnosis indicated the same grade. However, cell cycle analysis of FCM indicated a decrease in the phase of DNA synthesis (S phase), which suggested a decrease in biological potential. The possibility that transitional cell carcinoma of the bladder is transformed to squamous cell carcinoma following M-VAC chemotherapy is advanced.

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Heat shock response originally was described in relation to thermal stress, but it subsequently has been shown that some heat shock proteins can be induced by a wide variety of other forms of stress. A study was conducted to examine whether substances used in chemotherapy induce stress proteins such as heat shock proteins. Penicillin G, imipenem/cilastatin, streptomycin, polymyxin B, and nalidixic acid were tested in Escherichia coli B 178 for their ability to induce stress proteins. All chemotherapeutic substances demonstrated strong induction of stress proteins. It also was demonstrated, by using Escherichia coli B 178/PBR^+ which was transformed plasmid pRB 322, that the antimicrobial action of β-lactam antibiotics has a direct effect on the inducement of stress proteins.

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In order to elucidate the immunosuppression induced by infection with Mycoplasma pneumoniae (M. pn), the effects of M. pn antigen on the humoral and cell-mediated immunity of mice were studied. Changes in humoral and cell-mediated immune response against diphtheria toxoid (DT) and sheep red blood cells (SRBC) in mice immunized with a mixture of M. pn and DT or a mixture of M. pn and SRBC were analyzed by enzyme-linked immunosorbent assay (ELISA), plaque-forming cell assay (PFCA), footpad reaction (FPR) and flow cytometric analysis. The titer of antibody against DT in mice immunized with the mixture of M. pn and DT were significantly lower, compared with that of mice immunized with DT alone. In mice immunized with the mixture of M. pn and SRBC, the number of antibody-producing cells in the spleen against SRBC were lower, and the reaction of delayed-type hypersensitivity also decreased than that of mice immunized with SRBC alone. However, the levels of the immune response directed against M. pn were not changed. Flow cytometric analysis demonstrated that the population of immunologically competent cells significantly changed in a mouse after infection with M. pn, suggesting that the fluctuation of these cell populations are involved in the immunosuppression in mice infected and immunized with M. pn.

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An analysis was performed of HCV antibody (C100-3, ELISA) and HCV-RNA in the sera of patients with either liver cirrhosis (LC) or hepatocellular carcinoma (HCC) which probably were caused by the non-A, non-B hepatitis virus (NANBV) or the consumption of alcohol. The patients were categorized in accordance with their history of alcohol consumption: moderate drinkers consuming the equivalent of more than 3 go/day of Japanese sake (containing 75.6 ml of ethanol) for more than 5 years, and heavy drinkers consuming more than 5 go/day of sake (containing 126.0 ml of ethanol) for more than 10 years. Affirmation of the hepatitis C virus (HCV) was 79.2 % for moderate drinkers and 80 % for nonalcoholics, or almost equal percentages. It therefore was presumed that LC and HCC among moderate drinkers mainly are caused by HCV. In HCV-positive cases of HCC, the time lapse between blood transfusion and the diagnosis of HCC was shorter among alcoholics. This finding suggested the probable role of alcohol as a factor in the development of HCV-positive HCC. Cases of HCV-Ab-negative and HCV-RNA-positive liver cirrhosis included many elderly persons and those with severe clinical conditions. It was suggested that there may be a reduction in HCV during the progression from LC to HCC. RNA often was positive among patients with a negative cut off index for HCV antibody when the indices were relatively high.

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The present study was undertaken to evaluate the efficacy of daily intranasal administration of a luteinizing hormone-releasing hormone agonist (LHRHa) for 16 weeks in the treatment of uterine leiomyomata. The possibility of employing medicinal therapy that would eliminate the need for surgery in the treatment of leiomyoma and symptoms associated with leiomyoma is described. Thirty-nine patients, aged 45 to 54, were divided into two groups in accordance with responsiveness to LHRHa: 13 patients reached menopause after the LHRHa treatment (menopausal group), whereas resumption of menstruation occurred in 26 patients after cessation of the treatment (menstrual group). The mean age in the menopausal group (50.9±0.7 years) was significantly greater than in the menstrual group (48.3±0.4 years). Although there was no significant difference in the levels of serum LH and estradiol (E_2) and uterine volume before treatment between the two groups, the levels of serum FSH before treatment were significantly higher in the menopausal group than in the menstrual group. The levels of serum LH, FSH and E_2, and uterine volume were suppressed during LHRHa treatment, except for a transient increase in serum LH and E_2 one to two weeks after the treatment. After completion of therapy, serum LH and FSH concentrations returned to pretreatment levels in the menstrual group, whereas those gonadotropins increased significantly in the menopausal group. The serum levels of E2 and uterine volume returned to pretreatment values concomitant with the return of normal ovulation in the menstrual group. In conclusion, intranasal administration of LHRHa was successful in significantly decreasing uterine volume and relieving symptoms in perimenopausal women with leiomyoma. One-third of perimenopausal patients reached menopause after 16 weeks of treatment, thus avoiding the need for surgery.

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The effect of administration of desipramine and mianserin on monoamine and their metabolites were estimated in the forced swimming rat by in vivo brain dialysis in the anterior hypothalamus. A significant reduction of immobility time was found during the first 5 min and second 5 min in desipramine-treated and mianserin-treated groups (p<0.01). A significant increase in DA and 5-HT turnover in the anterior hypothalamus was found in control group following forced swimming stress (p<0.05). Pretreatment with desipramine and minaserin significantly suppressed these stress-induced increases in DA and 5-HT turnover. Contrary to previous reports, these results suggest that DA and 5-HT turnover may be increased in 'behavioral despair' and such an increase may be reversed by antidepressants.

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Nutrient arteries of the bilateral coracobrachialis muscles in 10 Japanese adult cadavers were examined and the study is summarized herein. The coracobrachialis muscles were divided into four classifications in accordance with the origin and pattern of distribution of the supplying arteries. The coracoid process artery (Sato・Takafuji 1985) supplied the Type 1 muscle but was absent in Type 2. The profunda brachii artery supplied the Type a muscle but was absent in Type b. The Type 2-a coracobrachialis muscle was most frequently observed, being found in seven cases in which the upper portion of the muscle was supplied by the coracobrachialis artery (Sato, 1980), the central portion by the coracobrachialis branch (supplying this muscle alone) arising from the axillary artery and the profunda brachii artery, and the lower portion by the coracobrachialis branch and the common stem of muscular branches (supplying this and other muscles), both originating from the brachial artery. Calculation of the distribution ratios of arteries in the four types of muscle revealed that the coracobrachialis artery existed in all specimens, supplying 38.3 % of the entire muscle. On the basis of this finding, the coracobrachialis artery was considered the main artery of the coracobrachialis muscle. In two specimens demonstrating the superficial brachial artery, the coracobrachialis artery arose from the deep brachial artery and supplied both the coracobrachialis and biceps brachii muscles. The total numbers of arteries ranged from 4 to 7, with five (in 11 cases) being most common.

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The author studied the effects of fluorescein sodium and miotic solutions, such as carbachol and/or acetylcholine, on endothelial function of rabbit cornea by monitoring the transendothelial electrical potential difference (TEPD). As controls for fluorescein, a balanced salts and glucose (BSG) solution was used. The TEPD in a BSG solution increased for the first 30 min and then decreased slowly, reaching about 60 % of its initial value after 5 h. W hen a BSG solution containing 5 μg/ml of fluorescein sodium was used, the TEPD time course was similar to that of the control solution. With a fluorescein sodium concentration of 500 μg/ml, the TEPD decreased below control value after 4 h of exposure. In the case of a miotic solution, a balanced salts solution was used for control. A solution containing 55 mM acetylcholine and minimal amounts of salts maintained a transendothelial electrical potential difference 30 % above control levels for up to four hours. Two other solutions including either balanced salts and 0.55 mM carbachol or a mixture of 0.19 mM carbachol and 55 mM acetylcholine plus minimal salts were adequate to maintain the TEPD at control levels. A solution with acetylcholine without any salts decreased the TEPD to 30 % of the control level in 100 minutes.

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The effects of systemic administration of IL-1 on bone mineral metabolism were investigated in normal rats which received daily intraperitoneal injections of recombinant human interleukin-1-alpha (rhIL-1α) either 4 μg for 7 days, 2 μg for 7 days or 2 μg for 10 days. Tibial bone histomorphometry revealed significantly increased bone resorption and formation with the loss of bone volume (high turnover bone remodeling) in rhIL-1α 4 μg for 7 days group. In rhIL-1α 2 μg groups, tibial bone histomorphometry revealed significantly increased bone resorption and formation for 10 days, not for 7 days. There were no significant changes in blood ionized calcium levels, serum bone Gla protein and 1,25 dihydroxyvitamin D levels. Serum parathyroid hormone levels in rhIL-1α 4 μg for 7 days group were significantly decreased. These results indicate that IL-1 may affect bone tissue in vivo as well as in vitro so as to cause high turnover bone remodeling.

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There are many preoperative complications with regard to morbid obesity, and such patients tend to develop hypoxemia during surgery. They are therefore considered as high risk patients in anesthetic management. We have experienced two obese patients whose body weights exceeded 250 % of the standard value. One patient, a 17-year-old male 178 cm in height and 178 kg in weight, underwent removal of a lipoma from his right buttock in the left lateral position and under general anesthesia. The other patient was a 30-year-old male 180 cm in height and 195 kg in weight. He underwent extraction of the pilonidal sinus in the prone position and under spinal anesthesia. The courses of anesthesia were uneventful in both cases. The two cases are described and the implications of morbid obesity in regard to anesthesia are discussed.

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