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A urinary iron excretion test was carried out in 22 patients with iron deficiency anemia. The iron excretion index was significantly higher in patients with intractable iron deficiency anemia compared with normal subjects and anemic patients who were responsive to iron therapy. The findings suggest that iron excretion may be a factor that modulates the response of patients to iron therapy.

Cytogenetic studies were performed on a biopsy specimen of a jaw tumor and on a bone marrow aspirate from a Japanese patient with Epstein-Barr virus-negative Burkitt's lymphoma. A 14q + chromosome was found in cells from either source, although each contained a different clone. Other karyotypic abnormalities present in common included 2dir dup (1q) (q21 leads to q32), 3q+, 6p--, +12, +mar.

Function of pituitary-thyroid axis was studied in rats with experimentally induced thyroiditisWistar strain female rats were immunized with homologous thyroid extract in Freund's complete adjuvant and with simultaneous intradermal injection of pertussis vaccine concentrate. They received booster shots at the first and third week after the initial immunization. Serum thyroid hormones and TSH were measured just before, and at weekly intervals after, the initial immunization. Histological examination of the thyroid gland at the second week after immunization showed slight infiltration of macrophages in the thyroid follicles. From the third to the fourth week, massive lymphoid cell infiltration and destruction of follicular architecture developed in all immunized rats. Serum R3 levels slightly decreased during the second week, increased transiently during the third week, then decreased again thereafter. Serum T4 levels decreased slightly durinf the fourth week. Serum TSH levels were not elevated significantly during the third week, but the response to TRH was significantly increased at this time. Basal TSH levels were increased during the fourth week. The TRH test was a sensitive method capable of detecting minimal failure of thyroid function undetected by other routine measuremens of thyroid hormones and TSH.

A recently modified method using peroxidase labeled antibodies for light and electron microscopic demonstration of hepatitis B virus (HBV) was applied to the evaluation of hepatitis B surface antigen (HBsAg) on the surface of liver cells in biopsy specimens from 24HBsAg chronic carriers. Membranous distribution of HBsAg was demonstrated in diffuse or scattered hepatocytes in all 4 asymptomatic carriers and in 3 of the 20 patients with HBsAg-positive chronic active hepatitis or liver cirrhosis. In these patients with membranous expression of HBsAg, hepatitis B e antigen, Dane particles and DNA polymerase were often detected in sera, and large amounts of hepatitis B core antigen appeared in the liver. These results suggest that membrane-bound HBsAg may be expressed by the HBV genome. The ultrastructural study of liver cells showing membranous expression disclosed dense deposits of reaction product indicative of HBsAg on the cell membrane and/or on assembled particles within the extracellular space. In some hepatocytes showing both diffuse cytoplasmic and membranous expression of HBsAg, HBsAg-positive membrane of cisternae open to the intercellular space was connected with the liver cell membrane. These findings supported the conjecture that HBV associated antigens are integrated into the liver cell membrane.

In electron microscopic observation of a liver biopsy obtained from a hepatitis B surface antigen-positive patient, noncoated core particles were occasionally seen budding into the hepatocytic cisterni and many Dane particles were found in the pericanalicular vesicles of hepatocytes. Noncoated core particles were also localized in clusters within the bleb of microvilli. There were some core particles being protruded from microvilli into the lumen of bile canaliculi by budding. These findings suggest hepatitis B virus being released from the hepatocyte to the bile canaliculi by two different modes; through vesicle by reversed phagocytosis and from the microvilli by budding.

Basilar arteries with experimental vasospasm were studies histochemically using a catecholamine fluorescence technique in 15 cats. Fluorescence microscopy of normal vessels revealed abundant catecholamine fluorescence in the adventitia and in close contact with the media, but none within the media. Experimental subarachnoid hemorrhage resulted in depletion of catecholamine fluorescence in the adventitia and in its appearance in the media. In vessels with vasospasm which lasted for 2 or 5 h and responded to vasodilators, fluorescence was scarce in the adventitia, but abundant in the media. In vessels with vasospasm unresponsive to spasmolytic agents, fluorescence was observed neither in the adventitia nor in the media. The results suggest that noradrenaline in the media of spastic arteries plays an important role in the development of cerebral vasospams.

A near diploid clone derived from a rat liver cell line was continuously treated with various concentrations of 3'-methyl-4-dimethylaminoazobenzene (3'-Me-DAB) in culture. By treatment with 2.8 micrograms/ml, cells with 41 chromosomes formed a mode and which then shifted to 39. The chromosome numbers of cells treated with 5.4 micrograms/ml were widely distributed at early stages, but later the mode shifted to hypotetraploid region. Untreated control cells were confirmed as near diploid. Increased plating efficiency by 3'-Me-DAB as well as the appearance of large sized colonies was obtained. The production of alpha-fetoprotein (AFP) by the cells was slightly enhanced by treatment with 3'-Me-DAB. The cells treated with and without 3'-Me-DAB did not produce any tumor in rats 6 months after their intraperitoneal injection.

Immune complexes in liver specimens from 10 patients with chronic liver diseases [2 with chronic persistent hepatitis (CPH), 3 with chronic aggressive hepatitis (CAH) of moderate activity, 3 with CAH of severe activity, and 2 with liver cirrhosis] were examined by a technique of direct immunofluorescence using FITC-labelled human purified Clq (FITC-Clq). FITC-Clq bound to the nuclei of all cells in liver tissue. After DNase treatment, positive nuclei were absent, but positive staining with FITC-Clq remained in amorphous deposits and hepatic cell membranes in the areas of piecemeal necrosis of four CAH patients. Since FITC-Clq could not be demonstrated in the liver tissue of CPH and liver cirrhosis which contained no piecemeal necrosis, positive fluorescence in the liver of CAH patients was thought to indicate immune complexes bound to FITC-Clq. The fact that these positive substances, however, were few in number, may be the result of physiological mechanisms of immune clearance which rapidly eliminate immune complexes from the body.

A papillary (villous) adenoma of the duodenum was found in a 67-year-old male. Radiographic barium studies of the upper gastrointestinal tract revealed a tumor in the second portion of the duodenum. Biopsied specimens taken through a duodenofiberscope showed papillary adenoma. A partial duodenectomy with duodenojejunostomy was performed. The specimen was a pedunculated tumor measuring 3 X 2 X 1.5 cm. Histologically, the tumor was composed of villous and tubular arrangements of mucus-secreting columnar epithelial cells. A moderate number of entero-endocrine cells and a few Paneth cells were also noted. Forty-two other cases reported in Japan are briefly reviewed.

In the aortic stenosis group, the left ventricular (LV) muscle mass index was a good parameter for predicting the prognosis. Associated mitral valve disease had no influence on long term survival after aortic valve replacement. In the aortic insufficiency group, associated mitral valve disease had a marked influence on the results of aortic valve replacement. In general, the aortic insufficiency group had less clinical improvement postoperatively than the aortic stenosis group. In the annuloaortic ectasia group, left ventricular enddiastolic pressure (LVEDP) might be the predictor to the prognosis. This group had the worst prognosis, of the three groups. Early operation should be considered for patients who have no, or only mild symptoms of, aortic valve disease.

The precise distribution of thyrotropin releasing hormone (TRH) in 23 discrete brain nuclei and areas of Wistar strain male rats was determined by specific radioimmunoassay. TRH was detected in most of these areas. The highest concentration was found in the median eminence (27.52 +/- 2.84 ng/mg protein). The arcuate nucleus (4.92 +/- 0.58 ng/mg protein), dorsomedial nucleus (4.77 +/- 0.59 ng/mg protein) and medial preoptic area (3.94 +/- 0.15 ng/mg protein) also contained a considerable concentration of TRH. However, no TRH was detected in cerebral cortex, cerebellar hemisphere, anterior pituitary or pineal body. The data indicated that TRH was widely distributed throughout the hypothalamus; in particular, high concentrations occure in relatively restricted areas: in the median eminence, arcuate nucleus, dorsomedial nucleus and medial preoptic area. These areas coincide well with the so-called "thyrotropic" area of the hypothalamus.

<p>The levels of HDL-cholesterol and gamma-glutamyltransferase in the sera of 17 patients with alcoholic liver injury were followed after abstinence and compared with those of 11 patients with acute non-alcoholic hepatitis. The activity of gamma-glutamyltransferase decreased in all cases irrespective of the type of liver injuries. The level of HDL-cholesterol also decreased in 11 of 17 cases with alcoholic liver injury. The other alcoholics, in whom HDL-cholesterol level increased or showed no definite change after withdrawal of alcohol, had severe and advanced liver injuries. In non-alcoholic hepatitis, the HDL-cholesterol level increased as normal liver functions were restored except for one case with cholestatic features. It was concluded that alcohol intake can increase HDL-cholesterol level even in the presence of a concomitantly induced hepatic lesion.</p>

<P>A 73-year-old man with a left testicular tumor is presented. Orchiectomy was performed and the tumor was diagnosed as a plasmacytoma. There has been no bone lesion or immunoglobulin abnormality during a follow-up period more than one year. For several reasons, the tumor was regarded as a primary plasmacytoma of the testicle. The literature concerning testicular plasmacytoma is reviewed briefly.

The three-dimensional architecture of the collagen framework of human lumbar intervertebral discs was studied with scanning electron microscopy and polarized light microscopy concentrating on the fibrillar interconnection between the intervertebral disc and the vertebral bodies. The fibrillar framework of the annulus fibrosus and the cartilage end-plates encircled the nucleus pulposus as a closed-pack system in the adult. This closed-pack system developed in the seventh embryonic month and was completed by the tenth month. In general, fibrils composing the framework in the fetus were thinner than in the adult. There was no fibrillar interconnection between the cartilage end-plate and subchondral bone. In the inner one-third of the annulus, obliquely oriented fibrillar lamellae interconnected with the cartilage end-plate. In the outer two-thirds, the fibrillar bundles of the lamellae were firmly anchored into the vertebral bodies. This fibrillar anchoring system was already present in the full-term fetus although the vertebral rim was not ossified.

Twelve patients with refractory acute leukemia (7 patients with acute myelocytic leukemia and 5 patients with acute lymphocytic leukemia) were treated with a new anthracycline antibiotic, aclacinomycin-A (ACM). ACM was administrated by intravenous drip infusion at a dose of 20 mg/day for 7 or 14 days and this was repeated after at least 7 days. Four of 12 patients (33.3%) achieved a complete remission; 3 of 7 acute myelocytic leukemia (42.8%) and 1 of 5 acute lymphocytic leukemia (20.0%). The days required for achieving the complete remission ranged from 23 to 78 days (median: 61) and the total doses of ACM used from 180 to 500 mg (median: 310), and the durations of complete remission from 11 to 28+ weeks (median: 21+). The untoward effects on digestive organs, such as nausea, vomiting and anorexia, and hematological toxicities were frequently seen; however, they were controlled by supportive treatment. Alopecia was not observed. Arrythmia was recognized in one patient at the initiation of ACM infusion with complete remission without withdrawal of ACM. These results suggest that ACM is a potentially effective anthracycline antibiotic in the clinical management of acute leukemia.

A rare case of bilateral fat necrosis of the breast is reported. The patient was a 50-year-old unmarried woman having no history of trauma, disease or surgery of the breast. In the bilateral breasts, ill-defined, firm masses with skin retraction were noted. Bilateral breast cancer was diagnosed clinically. However, both lesions showed histologically chronic granulomatous inflammation with foci of fatty necrosis, infiltration of lymphocytes, plasma cells, lipid containing foamy cells, foreign body giant cells engurfing choresterol-crystals, and calcification. "Paraffinoma" was thus suspected, but there was no history of cosmetic mammoplasty and histochemical studies failed to demonstrate saturated lipid indicating paraffin or other mineral oils