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Radiological findings on the fate of grafted Kiel bone implants for the treatment of bone tumors were evaluated in 25 lesions. The mean follow-up period was 14.8 years, ranging from 5 to 21.8 years. We classified the radiological findings into 4 grades; Excellent (4 lesions), Good (14 lesions), Fair (2 lesions), and Poor (5 lesions). All cases of the Poor grade were polyostotic fibrous dysplasia. The younger the patient at the time of the operation, the more rapidly Kiel bone grafts tended to be incorporated. The grafted bone can become enmeshed in the structure of the recipient bed (Good or Excellent grades) within 10 years in most cases, except in polyostotic fibrous dysplasia.

A new model of status epilepticus (SE), which was induced by intermittent electrical stimulation (20 Hz for 20 sec every min for 180 min) of the deep prepyriform cortex, has been developed in the conscious rat. SE was induced in 9 of 16 rats in the drug-free group. The number of stimulation trains required to induce SE in this status subgroup was 125.6 +/- 12.7 (mean +/- SEM) and the mean duration of self-sustained seizure activity (SSSA) occurring after cessation of the stimulation session was 295.4 +/- 111.4 min. Some animals showed secondary generalized seizures. Significant cell loss was observed in the hippocampal CA3 pyramidal cell layer ipsilateral to the stimulation site and bilateral CA1 areas in the status subgroup compared with the group subjected to sham operation. In addition, there was a significant negative correlation between the duration of SSSA subsequent to the stimulation session and the total number of intact pyramidal neurons observed in the bilateral CA1 and ipsilateral CA3 subfields of the status subgroup. There were significant differences between the status and non-status subgroups with respect to the number of afterdischarges (ADs) and the total AD duration during the stimulation session. Pretreatment with phenobarbital (30 mg/kg) prevented the development of SE and hippocampal cell loss completely. Pretreatment with MK-801, a non-competitive N-methyl-D-aspartate (NMDA) receptor antagonist (0.25 or 1 mg/kg), also prevented hippocampal cell loss, although it did not block SE generation completely, which suggests dissociation of the mechanisms underlying the development of SE and hippocampal damage. These results indicate that prolonged SSSA actually causes hippocampal damage and it is critically dependent upon NMDA receptor participation.

Indocyanine green (ICG) was injected into rat liver nodules induced by 2-acetylaminofluorene (2-AAF) via portal vein. The relationship between ICG staining and cell atypism of liver nodules was examined by means of histology and DNA flow cytometry. After 2-AAF administration, many small nodules appeared on the liver surface. All hyperplastic nodules were ICG stained until 10 weeks after the administration, but some nodules were not stained after 14 weeks. ICG-stained nodules histologically consisted of benign tissues and borderline lesions, and many of them showed "diploidy" in DNA cytometry. ICG-unstained nodules consisted of hepatocellular carcinoma (HCCs) and borderline lesions, and many of them showed "aneuploidy". In this way, it has been suggested that HCC could derive from hyperplastic nodules and that they might lose an ability to take up ICG in the process of hepatocarcinogenesis. Immunohistochemical staining for glutathione-S-transferase alpha (GST-alpha), a carrier protein of ICG in hepatocytes, was well correlated with ICG staining in the nodules, suggesting that the loss of ICG uptake in HCC was partly due to the decrease of GST-alpha. Moreover, the appearance of ICG unstained and aneuploid nodules was significantly inhibited in rats which were fed on diet containing Syosaiko-to after the administration of 2-AAF. Chemopreventive effect of Syo-saiko-to on hepatocarcinogenesis was identified.

Since December 1988, a centrifugal ventricular assist device (VAD) was used to support the circulation in 5 patients who could not be weaned from cardiopulmonary bypass (CPB) or developed cardiogenic shock after removal from CPB. Three patients required a left VAD, one needed a right VAD. One patient had biventricular support using a centrifugal left VAD and a diaphragm type right VAD. The duration of the centrifugal VAD support ranged from 6 to 136 (mean 72)h. All patients were weaned from the VAD, but only 2 patients were discharged from the hospital. Two patients died of multiple organ failure, and one died of cardiogenic shock caused by intractable arrhythmia. Infection occurred in all non-survivors, and 2 of them developed renal failure. We conclude that the centrifugal VAD is effective to recover a failing ventricle. The factors related to the unsuccessful recovery were delayed start of the VAD support and major complications such as infection as infection and renal failure.

Patients with mitral regurgitation (MR) due to mitral valve prolapse operated at the Second Department of Surgery, Okayama University Medical School, between 1976 and 1986 were divided into two groups. The first consisted of 20 patients who had mitral valve replacement (MVR) and the second 15 patients who had mitral annuloplasty (MAP). Long-term results of surgery, cardiac function, hemodynamic status, and surgical findings were compared between the two groups. Before surgery, there were no significant differences in patient's clinical status and cardiac function between the two groups. However, after surgery statistically significant differences emerged between the two groups in ejection fraction (EF), cardiac index (CI) and mean circumferential fiber shortening velocity (mVcf). Left ventricular pumping function and myocardial contractile force tended to decrease after surgery in the MVR group and to remain unchanged or even increase in the MAP group indicating that valve preservation procedures should be selected as often as possible for the patients involved in mitral valve prolapse.

Our initial experience with laparoscopic cholecystectomy for cholecystitis and cholelithiasis was reviewed in 42 patients and the data were compared with those of 21 patients who underwent conventional open cholecystectomy previously. Only one patient required conversion to an open operation. Three of the 42 patients had minor complications without death in laparoscopic cholecystectomy. The mean time for the laparoscopic cholecystectomy was 100 +/- 40 min, as compared with 79 +/- 21 min for the open cholecystectomy. The average postoperative hospital stay was 11.4 +/- 7.1 days for the laparoscopic procedure and 35.5 +/- 15.4 days for the conventional procedure. The laparoscopic cholecystectomy offers the patients shortened hospitalization and lower complications and can replace the conventional open cholecystectomy in large degree, at least in the uncomplicated cases.

We evaluated the surgical problems encountered during treatment of 14 patients with malignant tumors originating in the pelvic region at our department. The tumor involved the iliac bone in 6 patients, the ischial bone in 2, the pubic bone in 2, and the gluteal region in 4. Invasion to the sacrum was observed in 7 patients. Twelve patients underwent surgical procedures consisting of intralesional resection in 6, marginal resection in 3, and wide margin resection in 3. Six of the 7 patients with sacral invasion developed local recurrence. Two patients with chondrosarcoma and one with parosteal osteosarcoma survived for 4 or more years, but the mean survival period in those with high grade malignant tumors was 11 months. These findings indicate the difficulties encountered in the treatment of malignant pelvic tumors.

1. When chicken sarcoma virus is serially inoculated on the mouse brain, it loses its carcinogenecity, but when it is inoculated on young chicken, granuloma develops in the liver and lung. When this granuloma is transplanted on adult chicken, a transplantable fibrosarcoma is obtained. 2. According to literature, the originaltumor of the Brown-Pearce cancer is a basal cell cancer, but that imported to Japan in 1953 presented a histological picture of carcinosarcoma. The metastasized tumor of the eye presents a purely cancer tissue, but when this is inoculated on the testis, carcinosarcoma is reproduced. It is therefore considered that the mother cell of the sarcoma is of host origin. 3. MY sarcoma is not a sarcoma, but is a spindle cell cancer. It might be a sarcoma which transformed into a cancer during serial transplantation, but perhaps it was originally a cancer but had been erroneously diagnosed as sarcoma. 4. The tumors we obtained by means of the feeding tests of Yoshida tumor all developed at organs other than those of the digestive tract. They are chiefly reticulo-sarcoma, but others which develop are malignant granuloma in the liver and lung, malignant adenoma in the kidney, papilloma of pelvis, and ependymoma in the cerebral ventricle. Since the discovery of the Yoshida tumor in 1943, serial transplantation has been conducted for 19 years with this tumor not only in Japan but also in foreign countries, but there has been no report to this date that a transformed strain has developed by cell transplantation. It therefore must be considered that the carcinogenesis observed in our feeding tests is a carcinogenesis due to a mechanism completely unlike that of cell transplantation. It has been confirmed by electron microscopy that in the early stage of transplantation of this tumor into the abdominal cavity there was an additional tumor growth due to the anaplastic proliferation of serous cells. 5. During the serial transplantation of viral tumors and/or virus dependent tumors, the tumor sometimes undergoes a morphological change. Though the cause of this is not yet sufficiently elucidated, it is suspected that there is some relationship with virus in the wide sense.

As has been well established, reticulocytes (RC) synthesize the species specific protein, globin, actively for about 24 hours or more till the time of their complete maturation1,2,3. This will be possible only in the presence of messenger RNA (m-RNA)4,5. Since the splendid hypothesis of m-RNA proposed by JACOB and MONOD6 for explaining the mechanism of the transfer of genetic information from nucleus to cytoplasm, it has largely been accepted through the numerous observations that followed7,8,9,10. However, the m-RNA hypothesis, which has been deduced by observing the protein synthesis in E. Coli, includes the meaning of labile RNA which is incessantly decomposed and newly synthesized to compensate the rapid degradation. As m-RNA cannot be synthesized in RC which have no detectable DNA, it has been supposed that the m-RNA of RC should be considerably stablell,12,13. Even in the denucleated cells, however, the RNA synthesis might be possible because Borsook reported the positive RNA synthesis of RC14, and this result has recently been reconfirmed by BURNY15.

With the purpose to elucidate the cause and difference of blood fluidity in sudden death and natural one, we have observed the fibrinolysis of the blood in medico-legal and pathological autopsies by means of Fibrin Plate Method, a routine method devised in our laboratory. As the result it has been found that in the blood serum of sudden death and in some of natural deaths from tumors, leukemias, etc., the decrease in fibrinolytic activity is equivalent to the amount of proactivator that combined with the SK-like substance liberated into blood. On the other hand, in the blood of most of natural deaths, and in that bled from vessels and stored in body cavities, no natural fibrinolysis is observable and the same fibrinolytic activity with SK as normal one is demonstrated. Thus it is concluded that the cause of blood fluidity in sudden death is due to the fibrinolysis.

Following Fibrin Plate Method of SZOLLOSY and RENGEI² , and ASTRUP and MULLERTZ³, the author conducted a series of experiments in an attempt to identify human blood by detecting the proactivator believed to be one of the enzyme proteins contained abundantly in human blood. As the results it has been found that with 0.1 mg. % SK-solution human blood alone responds to the reaction, showing almost absolute species-specificity within 4 hours but not with blood of monkey. In addition, the sensitivity is so high that it responds positively up to the dilution of 1: 8,000 to 1: 10,000 (human blood: physiological saline solution). By means of this method using 0.1 mg% SK-solution it has been clearly demonstated that the identification of human blood is possible in a variety of conditions and states as may be encountered in practical legal medicine such as with blood stains in cloth, wood, stone, leaves of tree even with a trace of blood stain, old human blood stain left standing for 20 to 30 years, old blood mixed with iron rust, blood stains soaked in various oils, and even the blood stained cloth washed thoroughly and left standing in room temperature for 6 months. Therefore, this Fibrin Plate Method seems to be the excellent one for the identification of human blood.

When the lymph node cells sensitized by Ehrlich ascites tumor were mixed and cultured with JTC-ll cells derived from Ehrlich ascites tumor, the interaction of the two cell groups exhibited a contactual phenomenon accompanied by the destruction of JTC-ll cells. These two cell groups in contact were fixed with OsO4, solution and the ultra-thin sections were observed in the electron microscope. As a result the following findings were obtained. In the interaction where lymph node cells become attached to JTC-ll cells, resulting in the destruction of JTC-ll cells, lymphnode cells were also destroyed. Effector cells seem to be a kind of cells in the lymph nodes, and from their morphological characteristics they are considered to be lymphocytes. Electron microscopic observations of the surface of contact revealed the following: some cells are adhered to one another at the surfaces of the cell membranes that run in parallel; some are in contact by means of filamentous projection of lymhocytes; the cell membranes of the two cells form interdigitation; and both surfaces of two cell membranes are disrupted at the point of contact and the cytoplasm of the two cells appears to be directly connected with one another.

By means of the thin layer chromatography (TLC) a study was carried out on the decomposition of methyl parathion, ethyl parathion and sumithion when exposed to heat or ultra-violet irradiation. The results are briefly summarized as follows. 1. Parathions, when exposed to heat, form hydrolysates and such 0-analog as paraoxon as well as S-alky1 isomers. 2. When parathions are exposed to ultra-violet rays at 365 mμ and 254 mμ, the rate of decomposition is extremely slow. For example, when exposed to such rays in Petri dish for 5 hours, only a small amount of S-alkyl isomer is formed. 3. After heating parathions in a small test tube and conducting TLC, when each 0-analog and S-alkyl isomer above mentioned is confirmed, it is possible to identify a minute amount of each parathion by this method, and thus this method is feasible to apply to practical poison examination as a rapid and simple qualitative examination method.

In the present experiments attempts were made to identify semen from various specimens such as the semen itself, spots of semen on clothes, putrefied semen or semen contaminated with blood, menstrual blood, vaginal fluid, according to the techniques of LEVONEN. As the result it has been clarified that in every instance it is possible to isolate and detect the spots of choline by spraying Dragehdorff's reagent.

As a link in a series of studies on the effects of blood constituents on the brain function by means of brain perfusion, we used four kinds of artificial blood; namely, the blood containing a low molecular dextran, one containing glutamic acid, one containing essential amino acid group and the one containing both essential amino acid group and glutamic acid. During the perfusion experiments we observed the effects of blood constituents on the function and metabolism of the perfused brain and obtained the following results. 1. When a low molecular dextran is used as the colloid osmotic pressure agent instead of hydrodextran, the amount of the blood flow in the brain is maintained roughly at a certain fixed level throughout the experiment, showing no gradual decreasing tendency. 2. When using the artificial blood supplemented with glutamic acid, EEG of the perfused brain shows an increase in the appearance rate of β32 and β33 bands, approaching closely to the pattern of EEG of unrestrained controls at arousal state. 3. In the case of the blood added with essential amino acids similar to the case using the blood with glutamic acid, EEG approaches towards the alert pattern of the controls. 4. When the perfusion is done with the artificial blood lacking in amino acids, about one hour after the start of the perfusion the amount of glutamic acid and its related compounds in the brain can no longer be maintained at normal level and the decrease, being so marked, brings about a marked decrease also in total amino acid content. 5. When the perfusion blood contains glutamic acid, essential amino acid group or both, the concentrations of amino acids of the brain glutamic acid group and the total amino acid can be maintained approximately at normal level for the duration of over one hour.

Intestinal absorption tests with the use of D-xylose were conducted on 12 healthy Japanese subjects and the following results were obtained. 1) The mean value of the urinary xylose excretion within five hours after an oral administration of 25 g of D-xylose was 8.07 g and standard error of the mean was 0.11. The mean of urinary excretion was higher than most of previous reports. 2) The 5 hr urinary excretion after intravenous administration of 25 g D-xylose in normal subjects was almost equal to that reported by BUTTERWORTH et al. 3) The rate of D-xylose absorption from the intestine of normal Japanese subjects was higher than that in Europe, Canada and U. S. A. 4) The differences in the pattern of the intestinal absorption of D-xylose in normal individuals seemed to originate from different dietary habit continued over the period of many years, especially of carbohydrate contents.

An anatomical study was made to follow the degeneration of fibers by means of Marchi technique in cat after making experimentally lesion in Forel H field. As the results the following conclusions were reached. 1) The ipsilateral distribution of the degenerated granules was in the anterior sigmoid gyrus, caudate nucleus, putamen and globus pallidus, thalamic nuclei medial to the internal medullary lamina, substantia nigra, rubrocerebellar system, medial longitudinal fascicle system, mesencephalic and pontine reticular formation and medial lemniscus. 2) There was also contralateral distribution to the interpositus and dentatus nuclei of the cerebellum via brachium conjunctivum, to globus pallidus via supraoptic commissure, to subthalamic region and substantia nigra via supramammilary commissure, and to red nucleus via tegmental decussaion. 3) The degeneration is so extensive that the Forel H-field seems to be the cross road of the extrapyramidal system in association with brainstem activating system.

Maximal expiratory volume-time and flow-volume (MEVT and MEFV) curves were constructed from the measurements of young male nonsmoking, mild and moderate asthmatic patients (mean age, 29.7 yrs.). Eleven parameters of the pulmonary function tests, two MEVT, six MEFV, and three mean time constant (MTC) parameters, were calculated from the curves. These parameters were used in 15 analyses through the all possible selection procedure (APAP) discriminating between mild and moderate asthmatics. The probability of misclassification was computed with each of the eleven parameters, and all eleven probabilities thus obtained were compared with each other. This procedure showed us that the probability of misclassification ranged from 30.83% to 45.40% and that the most useful parameter was MTC50-25. The probability of misclassification computed using all eleven parameters (total parameter group) was 15.90%. The discriminant analysis indicated that the flow-volume patterns varied according the severity of bronchial asthma, thus, the flow-volume curve was considered to be important in analyzing the severity of bronchial asthma.

Levels of gamma-aminobutyric acid (GABA) in cerebrospinal fluid (CSF) were measured by radioreceptor assay (RRA) in 25 normal controls and in 121 patients with various central nervous system disorders. CSF-GABA levels could be measured down to 5 pmoles/ml reliably by this assay. In normal controls, the mean (+/- SEM) GABA level in CSF was 127 +/- 5.2 pmoles/ml. There was no correlation between age, sex and the CSF-GABA level in normal controls. The lowest CSF-GABA level, which was 60 +/- 6.0 pmoles/ml, was observed in alcoholic patients suffering from cerebellar ataxia. The CSF-GABA levels were quite low in patients with Alzheimer's disease, late cortical cerebellar atrophy, neuro-Behcet's syndrome, olivopontocerebellar atrophy, Huntington's chorea, Parkinson's disease and cerebral hemorrhage. On the other hand, the CSF-GABA levels of meningitis patients were significantly increased. These findings suggest that measuring the CSF-GABA level is quite beneficial in the diagnosis and pathophysiological determinations of some diseases.

Active enhancement was induced in inbred rats with cardiac allografts using semisoluble antigens. The optimal time of antigen pretreatment and optimal dose of semisoluble antigens were examined. The presence of serum blocking factors in the sera of rats having had allografts for a long time was examined with a macrophage migration inhibition test and lymphocyte microcytotoxicity assay. Since the blocking factors of macrophage migration inhibition were increasing on the 7th day, that day was determined to be the optimal time of antigen pretreatment. The mean survival time (MST) of cardiac allografts in untreated rats was 17.2 +/- 7.5 days. Semisoluble antigens were administered at 2 mg/kg body weight 7 days before the graft, 4 mg/kg 7 days before the graft and 2 mg/kg divided over three days, 15, 8 and 1 day before the graft, and the MSTs of cardiac allografts of rats receiving these treatments were 71.2 +/- 39.9, 62.6 +/- 42.2 and 79.3 +/- 31.0 days, respectively. The MST in each group of the treated rats was significantly longer than that of the control group (p less than 0.01). Rejection of the allograft, however, was accelerated in a group treated with 8 mg/kg 7 days before the graft (MST: 8.4 +/- 3.2 days). Serum blocking factors were detected in the sera of approximately half of the rats having cardiac allografts which survived a long time.