The postoperative change in pulmonary vascular disease following complete surgical repair in cases of the complete transposition of the great arteries with severe pulmonary hypertension remains an extremely interesting problem. We have performed complete surgical repair on an 8-month-old boy with severe pulmonary hypertension having a pulmonarysystemic pressure ratio of 1.0 and 14 units of pulmonary vascular resistance, but who suddenly died 9 months postoperatively. The results of a comparison of the histometrical measurements of biopsy lung and autopsy lung showed postoperative hypertrophy of the media of the small pulmonary arteries and progressed pulmonary vascular disease. It is thought that this phenomenon was brought about in the following way: The specific factor in this congenital heart disease which suppresses the hypertrophy of the pulmonary arterial media is removed due to the total correction and the media over-reacts to the postoperative pulmonary arterial pressure, resulting in hypertrophy. Repeated vasoconstriction of the abnormally thick pulmonary arterial walls leads to ischemic change in the peripheral blood vessels and obstructive pulmonary vascular disease is progressively brought about.
To differentiate species-specificity of blood stains, anti-α2-macroglobulin was raised in rabbits against Canavalia lineata DC lectin-serum complex (LSC). Adsorption of anti-LSC with human lipoprotein resulted in antiserum specific for α2-macroglobulin. It was confirmed by Ouchterlony test that the antiserum adsorbed successively with monkey serum or anti-LSC adsorbed directly with monkey serum reacted with only human serum but not with mammalian ones. Immunoelectrosyneresis and anti-LSC consumption test could identify species-specificity of blood stains kept for up to two years and for up to several years, respectively. It is indicated that anti-LSC is quite effective for differentiating species-specificity of blood stains.
Ultrastructural observations were made on human erythroblasts incubated in a vincristine solution. In certain concentrations and at certain incubation time intervals, paracrystals were observed in the erythroblasts. The fine structure of the paracrystals was similar to that described in platelets, leukemic lymphoblasts or cultured fibroblasts. They showed parallel filaments, amorphous mass or honeycomb-like crystalline structure. One paracrystalline form turned into another form when the sections were tilted by the use of goniometer. These paracrystals were often closely related to other organelles, such as lysosome, Golgi apparatus and nucleus. In the mitotic erythroblasts degraded microtubules coexisted with typical paracrystals.
The minimum essential factors which are necessary for random mobility and chemokinesis of human granulocytes in agarose plate induced by E. coli-derived chemotactic factor were studied in order to compare the essential nature of mobility between them. There were no differences in random mobility and chemokinesis among the media of TC-199 containing or not containing heat inactivated fetal calf serum and Hanks solution. On the other hand, granulocytes in PBS showed no random mobility and a reduced chemokinesis was seen. Further precise analysis revealed that the minimum essential factors for random mobility and chemokinesis are phosphate buffered saline, Ca++, Mg++ and glucose. The necessity for exogenous glucose suggested that intracellular glycolysis is the source of energy for chemokinesis as well as for random mobility. On the other hand, actinomycin D, a nucleic acid synthesis inhibitor, failed to show any suppressive effect on both types of mobility. It was also shown that ehemokinesis as well as random mobility was highly sensitive to culture temperature. From these results, we concluded that the nature of mobility in chemokinesis is the same as that in random mobility.
In spite of many reports of arrest reaction in animals, there are very few reports in man. During a therapeutic stereotactic operation we observed peculiar phenomena caused by electrical stimulation to the deep struture of the cerebrum. The electrical stimulation caused an interruption of counting and other motor actions, which could be resumed following release of stimuli. In almost all cases psychic confusion or memory disturbances were not observed. The head of the caudate nucleus and its adjacent white matter caused arrest reaction with the lowest threshold of 5 V; on the other hand, substantia medullaris lobi frontalis, radiatio corporis callosi and nucl. reticularis oralis of the thalamus caused arrest reaction with the highest threshold of 10-15 V. The arrest reaction that we observed is thought to be due to a direct effect on the head of the caudate nucleus, not due to secondary effects on the internal capsule and the motor fiber in the vicinity of the caudate nucleus. However, the possibility that the current spread to the motor fiber cannot be definitely ruled out.
Surface and deep electroencephalograms, electrocardiogram and behavior of 10 male rabbits were studied by infusing fresh water or sea water slowly at a speed of 0.5-2.0ml/min, by means of a dripping apparatus, into the canulated trachea until the death of the animals. From the behavior of the animal and EEG and EGG findings, the course was divided into 4 stages. The let, alert stage; 2nd, adapted or calm stage; 3rd, dyspnea stage; and 4th, covering from the agonal spasm to ECG silence. The course of this drowning death was quite different from that due to a large amount of water aspirated within a short period. The volume of fresh water needed to kill the animals was 7 times larger than that of the sea water in this method, and the latter was less than half of the volume of sea water necessary for the death due to short period aspiration. The mechanism of death seems to be slow and prolonged asphyxia and, among the terminal events in fresh water drowning, there might occur marked pulmonary hypertension that results in a high degree of lung edema. In the ECG at terminal stage, final bradycardia (84.4% of normal pulse rate) at around the time of surface EEG disappearance, and final tachycardia (142.7% of normal pulse rate) about 120 sec later than final bradycardia and 40 min later than deep EEG disappearance were observed consistently. After clinical signs of death ECG still continued to beat slowly for 1-2 hr.
The histopathological examination of the submucosal tumor without surgical intervention has been difficult. The ordinary gastroscopic forceps were thought to be ineffective to obtain the material from the lesion. To cope with these difficulties, the thorny needle biopsy method was invented using adental cleanser needle. Through the built-in channel of the biopsy gastrofiberscope, the needle was inserted into the lesion. The material attached to the needle was removed and either direct smearing or the preparation after membrane filtration was carried out. The Papanicolaou staining was used for cytological examination. The method was applied to 113 cases of submucosal tumor of the stomach. In 19 cases, surgically removed specimen or specimen removed by high frequency current endoscopic polypectomy were available for comparison. In 9 of 12 myogenic tumors (75%) tumor cells were obtained by the method. Three of these 9 cases were leiomyosarcoma and two of them were so diagnosed before surgery. In one case the re-examination after surgery of the previously obtained biopsy material by the thorny needle method revealed presence of the tumor cells. In one case of the aberrant pancreas, the correct pre-surgical diagnosis was made by the method. The method can be applied without significant hazards to the patients with submucosal tumors especially myogenic tumors or aberrant pancreas even in out-patient clinic, and can be used as the new method for the screening of malignant tumor and highly atypical tumor of the submucosal nature.
The constitution of acidic glycosaminoglycans (AGAG) in the normal human esophagi which were obtained at autopsy from 13 female subjects, from 30 to 59 years old, was biochemically analyzed by the procedures such as resin chromatographic separation, electrophoretic characterization in 3 buffer systems and enzymic assay with chondroitinases and hyaluronidase. The main AGAG was hyaluronic acid which amounts to a half of total AGAG, followed by heparan sulfates and dermatan sulfate one fifth of total AGAG each, and small amounts of chondroitin-4- and -6-sulfates and oversulfated chondroitin sulfate. Heparin was not detected. A possible role of the esophageal AGAG was discussed.
Dephosphorylation of nucleotides of 1-β-D-arabinofuranosylcytosine (ara-C) was studied to clarify the intracellular metabolism of ara-C and the mechanism of natural resistance in the rat ascites hepatomas. The apparent rate of phosphorylation of ara-C in the intact cells was the balance of the true phosphorylation and the dephosphorylation of nucleotides formed, which was visible after the cessation of the phosphorylation. Ara-C nucleotides formed in the intact cells degraded upon the addition of iodoacetate as a result of ATP depletion in the cells thereby interfering with the ara-C phosphorylation and some additional mechanisms. Decrease in ara-C nucleotides after the dilution of 3H-ara-C with unlabeled ara-C was similar to that after the washing-out of the substrate, and longer than after the addition of iodoacetate. Half-life of ara-C nucleotides was shorter in the more resistant tumors; i.e., the dephosphorylation of the nucleotides was active in AH109A, AH60C, and AH66F in the decreasing order in accord reciprocally with the intracellular level of ara-C nucleotides and their drug sensitivity. Therefore, the rate of the nucleotide dephosphorylation is important together with the phosphorylation of ara-C in the maintenance of the active form of the drug, ara-C triphosphate.
Two transplantable, one mucus-producing (R-1) and the other tubular but less mucinous (R-2), adenocarcinomas were investigated electron microscopically. The R-1 tumor was composed of a large number of intermediate cells and mucus-producing cells, incompletely differentiated goblet-like cells and absorptive-like cells, and a small number of undifferentiated cells. The electron microscopic features of the mucus-producing cells exhibited distinctive features different from those of the epithelium of normal colon. They had highly electron-dense granules, expanded rER, well-developed mitochondria and Golgi apparatus. The R-1 tumor was found to be a well-differentiated adenocarcinoma in agreement with observations by light microscopy, while the R-2 tumor exhibited more malignant features than R-1.