We produced a new monoclonal antibody (AD117m) raised against a cell line OMC-4 (a human adenocarcinoma cell line obtained from the uterine cervix), applied them to effusion cytology smears. Futhermore, the immunoreactivities were compared with antibodies against CEA and EMA for making clear the availability of AD117m. Of 425 effusion smears stained by the Papanicolaou method, 219 were cytologically diagnosed as benign, 11 as suspicious, and 195 as malignant. After decoloration, these preparations were tested for the presence of AD117 m, CEA and EMA by the immunoperoxidase method. The positivity rates in the cases of malignant effusions were: AD117 m 92.8%, EMA 98.2% and CEA 78.2%. The AD117 m positivity rate was about 15 % higher than that of the CEA. In contrast, the immunopositivity rates for mesothelial cells in the benign cases were low : 4.8% for AD117m and 31.7% for EMA. More over, the immunoreaction for AD117 m was much weaker and only few mesothelial cells were stained. In addition, we formulated criteria for cytochemical diagnosis, and they yielded a satisfactory result in cytologically negative and suspicious cases. From this study, we concluded that the simultaneous obsevation of AD117 m and two antibodies (CEA and EMA), and the application of our immunocytochemical criteria were useful in reaching a correct diagnosis in effusion cytology.

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Twelve cases of human glioblastoma were studied immuno-histochemically using anti-p16 protein antibody. Nine of them did not express the p16 gene product. This suggested that abnormality of the p16 gene in glioblastomas was a frequent event and that exogenous expression of p16 gene as a target of gene therapy might be a clinical possiblity. Therefore, using the method of gene transfection, we studied whether exogenous expressin of p16 gene modulated the biological characteristics of glioblastoma cells. The human glioblastoma cell line U87MG was doubly transfected with the plasmid pVgRXR, and pIND harboring the wild-type p16 gene. The expression of p16 protein in the resulting transfectants was regulated by addition of the ecdysone homologue, muristerine A. When the cells expressed p16 protein, their growth capacity was reduced, and astrocytic differentiation was induced as suggested by the strong expression of GFAP and by morphological changes such as an increase of cell size, cellular flattening and an increase of glial processes. These results suggest that exogenous expression of the p16 gene may be a promising method of gene therapy for human glioblastomas.v

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To clarify the significance of dietary carbohydrates, protein and lipid as determinants of blood pressure, a cross-sectional study was conducted using the individual-based 3-days weighed food records for 157 Japanese men aged 40 to 49 who were mostly randomly selected from five areas in Japan. Among these subjects, the daily intake levels of non-fibrous carbohydrates and vegetable protein were clearly inversely associated with systolic and diastolic blood pressure (SBP, DBP) after adjusting for age, residence, occupation, body mass index, alcohol consumption and total energy intake by the analysis of covariance. However, in any of fibrous carbohydrates, total protein, animal protein, total lipid, animal lipid, vegetable lipid and fish lipid, the associations between the intake amount and the adjusted blood pressure levels were not clear. For non-fibrous carbohydrates and vegetable protein, the linear inverse associations of the intake level with blood pressure were noted even after further adjustment for dietary sodium, potassium and calcium levels and dietary levels of the counterpart of these two macronutrients (For non-fibrous carbohydrates : p for trend=0.063 for SBP and 0.039 for DBP, respectively ; For vegetable protein: p for trend=0.040 for SBP and 0.018 for DBP, respectively). These results suggest that dietary non-fibrous carbohydrates and vegetable protein may have beneficial effects on blood pressure.

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The molecular mechanism of drug-induced red cell transformation from discocyte to stomatocyte was studied. (1) Upon incubation with amphipathic cations, red cells first transformed to stomatocytes characterized by the presence of dimples on their membrane surface (St-D), and then they transformed to stomatocytes of smooth membrane surface (St-S) through a transient discocyte formation. St-D restored discocytic shape by washing in albumin solution, but St-S could not. (2) St-D deformed to the same extent as for discocytes in a shear flow, while the whole-cell deformability of St-S was impaired. (3) St-D transformed to St-S in a Ca-dependent manner : The increase in cellular Ca content accelerated the transformation to St-S at lower drug concentrations but suppressed the transformation at higher drug concentrations, and the St-S formation was prohibited when Ca was chelated with EGTA. The present study suggests that St-D is formed by the molecular rearrangement in the lipid bilayer, while the St-S formation is accompanied with the reorganization of skeletal proteins.

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The interactions between insulin-like growth factor-I (IGF-I) and the renin-angiotensin system (RAS) in follicular growth and ovulation were studied with the use of an isolated perfused rabbit ovary preparation. Ovulation failed to occur in either control ovaries or the experimental ovaries perfused with IGF-1 in a concentration of 1, 10, or 1OOng/ml in the absence of gonadotropin. Exposure to IGF-I stimulated the secretion rate of angiotensin II (Ang II) in perfused rabbit ovaries in a dose-dependent manner. The percent increase in follicle diameter in ovaries perfused with IGF- I for 12 h was significantly correlated with the secretion rate of Ang II at 12 h after exposure to IGF-I. In hCG-treated ovaries, the mean number of ovulations per ovary was significantly reduced in ovaries perfused with 10,10^2, or 10^3ng/ml of IGFBP-3, compared with that in control ovaries. The addition of IGFBP-3 to the perfusate did not induce ovulation in the absence of gonadotropin but exposure to IGFBP-3 inhibited hCG-induced ovulation in a dose-dependent manner. In addition, IGFBP-3 significantly reduced the ovarian secretion rate of Ang II stimulated by hCG administration. Intrafollicular plasminogen activator (PA) activity significantly increased within 4 h after exposure to 100 ng/ml of IGF-I, compared with that in control ovaries perfused with medium alone. The concomitant addition of IGFBP-3 to the perfusate significantly reduced the IGF-I-stimulated PA activity in the preovulatory follicles at 4, 6, and 8 h after exposure to IGF-I. However, IGFBP-3 alone affected neither the ovarian secretion rate of Ang II nor intrafollicular PA activity. Exposure to streptokinase, an exogenous PA, in vitro stimulated both follicular growth and the intrafollicular Ang II content. In conclusion, I GF-I enhances both ovarian Ang II production and follicular development by stimulating intrafollicular PA activity.

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The property of the cauda equina action potential (CEAP) and its evaluation to identify the level of the spinal lesion were examined. In 6 normal subjects, the CEAP and evoked electromyography were recorded simultaneously after stimulation of the tibial nerve. With liminal stimuli to evoke the H-wave, two components (1st and 2nd waves) of the CEAP were observed, while only the 1st wave was induced with the supramaximal strength at which the H-wave disappeared. Peak latencies of 1st or 2nd wave were progressively increased or decreased at more rostral recording sites, respectively. Moreover, high frequency stimulation suppressed the 2nd component with no effect on the 1st one. It was concluded that the 1st wave was produced by action potentials conducted in low threshold afferent fibers, together with antidromic action potentials along the motor axons when the stimulus strength was increased, while the 2nd one was reflex outflow in motor axons. The CEAPs recorded in patients with lumbar disc hariniation (LDH, N=34) and with lumbar spinal canal stenosis (LCS, N=28) were classified into 4 groups on the based of the degree of the wave form abnormalities. The relationship between CEAP grades and the JOA scores was significant. In 74.2 % of the patients, the level showing abnormal CEAP corresponded to the affected level detected by diagnostic imaging methods. These results indicate that measuring the CEAP can be useful in objective and level diagnosis of lumbosacral di sorders.

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The amino acids in 24-hr urinary excretion of ten neurologically normal and five pervasive developmental disordered children were measured by automatic amino acid analyzer. The five autistic children were diagnosed according to the diagnostic criteria of DSM-III-R. In the controls, among 34 amino acids, the levels of free DL-plus allo-δ-hydroxylysine and α-amin oadipic acid in the 24-hr urinary excretion of autistic children were significantly increased. The lysine (DOSE: 242.5 mg) load test was attempted in 24-hr urinary excretion of ten neurologically normal and five pervasive developmental disordered children. All of the normal controls consistently showed increase in 24-hr urinary free hydroxylysine after oral administration. On the other hand, two cases of decrease were observed among PDD children's group. And increase of free α-aminoad ipic acid was observed in nine normal controls of ten. On the other hand, decrease was observed in four cases of five PDD children. Though there appear to be complex mechanisms in the amino acid metabolism of autistic children, from these results, the possibility was suggested that hydroxylysine kinase activity in autistic children as compared with that in neurologically normal controls may be damaged. And free hydroxylysine and free α-aminoadipic acid excreted constantly in 24-hr urine may be derived from a decomposed product of an unknown protein.

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Ohgai's "A view on Euthanasie" opens with the defining line, as is well-known, "Euthana sie means a peaceful repose." The true meaning of this noteworthy medical essay, however, will not, as I am confirmed, but a guiding principle in Euthanasie [painless, happy death] for the clinical medical science of Japan in the earliest period of modern times. This is preferably an instruction for the medical ethics in regard to the great cause of "how to let the patient pass away peacefully." In other words, it is the typical nursing gist which is justified by the most expectantly requested favor of morality and human consideration for the patient in the terminal stage of life. It is not too much to say, therefore, that this is a book of creditable medical decorums in the present times, for the "solemn ceremonial function for man's last moments."

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Torsion of the visual field is a very rare visual illusion characterized by the tilting appearance of all objects within the visual surroundings. A 48-year-old woman who had past history of right tympanoplasty and nonmedicated hypertension was admitted because of dizziness, nausea and vomiting. Neurological examination revealed the right Horner's syndrome, dysphasia, the right cerebellar ataxia, hypalgesia (decreased pinprick) and thermohypesthesia of the right face and the left body. Spontaneous nystagmus of horizontal and rotatory nature was increased when gazed at her left side. Brain MRI of T2-weighted image revealed high intensity area in the right lateral medulla. The torsion of the visual field occurred in her typical clinical course of Wallenberg's syndrome, 17days after the onset, when Horner's syndrome and nystagmus improved. She saw "tilting world with a counterclockwise rotation of 30 degrees and felt like falling down to her left side." This symptom was not changed by eye opening and closing as well as body posture. There are 18 case reports, including our case, of torsion of the visual field. This peculiar symptom was described as "tilt of the visual world", "upside-down reversal of vision", "floor on ceiling phenomenon", "oculogravic illusion", etc. The pathophysiology of this rare symptom is still unknown, but two mechanisms have been considered. Namely, one is the imbalance of vestibular inflow due to otolith or utricular nerve disorder. Another is the dysfunction of vestibulo-ocular integrative control. In our case the former would be more probable.

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