検索

Antibody activity, especially that involved in the reaction of antibody-dependent cell-mediated cytotoxicity (ADCC), of five commercially available human gammaglobulin preparations (standard, pepsin-treated, plasmin-treated, polyethylene glycol-fractionated and S-sulfonated gammaglobulin) was measured. All these gammaglobulin preparations had high titers of hemagglutination inhibition and neutralizing antibody against measles virus. In ADCC reaction, the pepsin-treated gammaglobulin preparation showed no antibody activity. The standard gammaglobulin preparation showed weak activity only when highly diluted. The remaining three preparations showed high activity. Though the S-sulfonated gammaglobulin preparation showed no activity in ADCC reaction, it showed high activity after reconversion by means of oxidation and reduction in vitro. The plasmin-treated gammaglobulin preparation showed greater activity than the polyethylene glycol-fractionated preparation of the optimal concentration. In ADCC tests using the plasmin-treated gammaglobulin preparation, K cell activity was strongly inhibited by Hg (thimerosal), while, in those using the standard gammaglobulin preparation, the activity was hardly influenced by Hg, suggesting that the low ADCC activity of the standard gammaglobulin preparation of high concentrations was due to the inhibitory effect of aggregated immunoglobulin G molecules.

The role of the lumbar sympathetic nerves and supraspinal mechanism in the defecation reflex was investigated in 30 adult cats and 6 kittens. One or two propulsive contractions, whose mean pressure evoked was more than about 90 cmH2O (adult cats) and 50 cmH2O (kittens), were induced in the rectum of all animals by rectal distension. These propulsive contractions could be generated at the descending and the transverse colons. The removal of the supraspinal influence by spinal transection at T13 or removal of pelvic afferents to the supraspinal center by spinal transection at L abolished the propulsive contractions. Successive lumbar sympathectomy restored the contractions. Lumbar sympathectomy and the successive removal of the supraspinal influence did not affect the propulsive contractions. In both cases, the final exclusion of the sacral segments by pithing of the spinal cord abolished the propulsive contractions. These results suggest that the sacral excitatory reflex mediated via pelvic nerves and the lumbar inhibitory reflex mediated via lumbar sympathetic nerves can function during rectal distension in spinal cats and that the lumbar inhibitory reflex is suppressed by the supraspinal sympathetic inhibitory reflex activated by pelvic afferents in intact cats, as in guinea pigs, resulting in propulsive contractions.

We performed laparoscopic prostatectomy in seven cases with organ-confined prostate cancer. In 6 cases, the surgery was completed successfully and the mean operative time was 424 min. Volume of blood loss was 200 to 3,200 ml and catheterization lasted 6 to 37 days. No major complications were observed in 6 of the cases. In one case, open surgical conversion was necessary mainly due to a bladder injury. Although these were the first cases of laparoscopic prostatectomy in our institution, the technical difficulty and complexity of the surgery were moderate. We believe that laparoscopic radical prostatectomy will become a standard option for the treatment of organ-confined prostate cancer.

Postoperative hip alignment was studied on radiographs in cases of total hip arthroplasty (THA) and of Bipolar Head Prosthesis(BHP), both with MX-1. Postoperative anteroposterior-view radiographs of hip joints of patients with a normal hip joint on the unoperated side and without pelvic tilt were used. Thirty-nine THA patients (femoral neck fracture), 26 THA patients (osteonecrosis of the femoral head and osteoarthritis of the hip joint), and 34 BHP patients were selected for this study. Lines and points for measurement of 9 parameters were established on radiographs. The position of the greater trochanter upper edge is 6.5 mm (mean) superior to the femoral head center in the normal hip joint of Japanese, unlike in Caucasians. A femoral head prosthesis should be inserted so that its center and the greater trochanter upper edge are level in order to equalize leg lengths. In BHP cases, the insertion is made so that the greater trochanter upper edge is approximately 4-mm superior to the center of the prosthesis. For further securing of the stem and to equalize leg lengths, stems should be available in 11 diameters from 5-15 mm in 1-mm increments. Postoperative hip alignment in MX-1 THA cases was found to be satisfactory.

In 1955 SANO found mitochondria by the supravital stain with Janus green B in the basophilic stippled cells from the circulating blood of the lead intoxicated rabbitsl , and in 1956 by means of electronmicroscope VALLEJO-FREIRE, BRUNNER et al. found mitochondria in the reticulocytes2,3, and later at the end of 1956 BRAUNSTEINER et al. also succeeded in revealing mitochondria and the vesicular structure by electron microscope in the ultra thin section of young red cells4. We also have found the mitochondria and the endoplasmic reticulum in young red cells. It has been discussed long whether the reticulum of reticulocytes is a preexistent structure or an artifact. The fact that the mitochondria exist in the reticulocyte seems to support strongly the preexistence theory of the reticulum, substantia reticulo filamentosa. However, the fact that the reticulum has several characteristics different from the general mitochondria5,6 can not be ignored. In this paper we should like to demonstrate the photos of mitochondria and the endoplasmic reticulum in the denucleated red cells revealed by electron microscope comparing to the picture of reticuluocyte appeared by supravital stain.

The purpose of the present study is to reveal the precise mechanism of nervous and humoral regulations of lipid and carbohydrate metabolisms in the adipose tissues. Histochemical and biochemical observations were made on the innervated and denervated interscapular brown adipose tissues and partly on the liver and adrenal cortex of male mice during starvation with or without carbohydrate introduction with special consideration to the changes of the lipid and glycogen contents and to the activities of several important enzymes as well as to pH values in the tissues. In a state of absolute starvation, the animals died in a few days showing a gradual discharge of stored lipids from the innervated brown adipose tissues, while in the denervated tissues the stored lipids increased gradually even in a state of slight or moderate starvation as well as in the cases of normally fed animals. The increase of lipids continued before the stage of severe starvation and the stored lipids being rapidly discharged became nil at the terminal stage of life. Introduction of glucose into starved animals caused also a more marked deposition of glycogen in the denervated than in the innervated tissues in proportion to the degree of starvation, although it did not cause the deposition in both tissues at the terminal stage of life. These facts represent that the nervous regulation is essential for the mobilization of lipids and carbohydrates from this tissue. Adrenalectomy also caused the death of animals within a few days with a gradual decrease of depot lipids. In this case denervation likewise caused a marked depositon of lipids in the brown adipose tissues, showing a sudden escape of lipids at the end of life. Experiments on transplanted adipose tissues taken from the animals at the terminal stage of starvation, proved that the tissue cells retain the ability to deposit lipids until the end of life. Chemical estimation elucidated that the serum glucose and lipids fall markedly at the terminal stage of life. The innervated tissues showed increased activities of succinic dehydrogenase, alkaline phosphatase, ATPase and lipase during starvation with a gradual discharge of lipids. Glucose injection increased the degree of the activities of all these enzymes, though in the terminal stage of starvation the ATPase activity declined again. The activity of total cholinesterase declined slightly in severe starvation. The pH value fell gradually with the progress of starvation. On the other hand, in the denervated tissues the activity of succinic dehydrogenase fell with an increased deposition of lipids, though in the final stage of starvation the activity rose with the discharge of lipids; while the activities of phosphatase, ATPase and lipase rose during starvation and total, unspecific and specific cholinesterase activities declined slightly. The pH value in the denervated tissues rose slightly during mild starvation and fell markedly in severe starvation. Observations proved that the activities Df these enzymes and pH, which are under the control of the autonomic nervous system, have close relationships to the deposition and the discharge of lipids and glycogen from the adipose tissues, and that the rapid discharge of lipids from the denervated tissue at the terminal stage of life is an expression of the onesided progress of oxidative process which may mean a complete loss of regulation of metabolism.

The aim of this study was to determine suitable image parameters and an analytical method for phase-contrast magnetic resonance imaging (PC-MRI) as a means of measuring cerebral blood flow volume. This was done by constructing an experimental model and applying the results to a clinical application. The experimental model was constructed from the aorta of a bull and circulating isotonic saline. The image parameters of PC-MRI (repetition time, flip angle, matrix, velocity rate encoding, and the use of square pixels) were studied with percent flow volume (the ratio of actual flow volume to measured flow volume). The most suitable image parameters for accurate blood flow measurement were as follows: repetition time, 50 msec; flip angle, 20 degrees; and a 512 x 256 matrix without square pixels. Furthermore, velocity rate encoding should be set ranging from the maximum flow velocity in the vessel to five times this value. The correction in measuring blood flow was done with the intensity of the region of interest established in the background. With these parameters for PC-MRI, percent flow volume was greater than 90%. Using the image parameters for PC-MRI and the analytical method described above, we evaluated cerebral blood flow volume in 12 patients with occlusive disease of the major cervical arteries. The results were compared with conventional xenon computed tomography. The values found with both methods showed good correlation. Thus, we concluded that PC-MRI was a noninvasive method for evaluating cerebral blood flow in patients with occlusive disease of the major cervical arteries.

Serum levels of total amylase, pancreatic type (P-type) isoamylase, and salivary type (S-type) isoamylase were measured in obese children (153 subjects; mean age, 10.1 years old; 86 boys and 67 girls) before and after weight reduction therapy. Serum amylase activities were determined using p-nitrophenylmaltoheptaoside as a substrate, with or without an antibody added to inhibit the S-type isoamylase. Serum levels of total amylase, P-type isoamylase and S-type isoamylase activities were significantly decreased in obese children with an obesity index more than 50%. S-type and P-type isoamylases showed negative correlation with the obesity index, the correlation coefficient being slightly larger in S-type than in P-type isoamylase. Analysis of the serum amylase activities in obese children who underwent weight reduction treatments showed a negative correlation only between the differences in S-type isoamylase activity and the differences in the obesity index. It may be concluded that the S-type isoamylase activity in serum of obese children is decreased and that it can be increased by reducing their body weight.

The relationship between past and present lifestyle and urinary excretion of type I collagen cross-linked N-telopeptides (NTx) was studied in 61 Japanese females aged 34-59, with a view toward using NTx excretion rates as a predictor of future osteoporosis. Bone mineral density (BMD) of the lumbar spine, the speed of sound (SOS) and broadband ultrasound attenuation (BUA) of the os calcis, urinary NTx, serum osteocalcin (BGP) and bone-specific alkaline phosphatase (BAP) were measured. Stiffness index (stiffness) was calculated from SOS and BUA. The subjects were asked whether they took regular exercise in their childhood and teen years (in elementary, junior-high, senior-high school and college), the past (20-40 years of age) and present adulthood. Regular calcium intake, smoking habits, alcohol and other beverage consumption and milk consumption were also covered in the questionnaire. The mean NTx values of premenopausal and postmenopausal group were 22.2 and 56.0 nM bone collagen equivalents (BCE)/mM urinary creatinine (Cr), respectively. The group which did not exercise regularly between the ages of 20 and 40 had a higher mean NTx value (40.9 nMBCE/mMCr) than the group which did exercise regularly (22.7 nMBCE/mMCr). In multiple regression analyses, age, stiffness and exercise in past adulthood could explain 43.5% of the NTx variance. For prevention of bone metabolic increases around menopause, habitual exercise in early adulthood seems to be effective.

In order to assess short-term exposures to ethylene oxide, formaldehyde and glutaraldehyde in a sterilization process, the authors conducted continuous environmental monitoring of these chemicals in the breathing zone of workers in 2 hospitals. The arithmetic mean of ethylene oxide was 1.2 ppm near unventilated cabinets housing sterilizing materials, and environmental concentrations of ethylene oxide could not be reduced under threshold limit values time weighted average by only managing general ventilation. Environmental concentration of formaldehyde was lower in a properly ventilated pathology division in which no large specimens were stored (0.3 ppm) than in the pathology division where large specimens were stored (2.3 ppm). Although environmental concentrations of glutaraldehyde in an endoscopy unit with proper general ventilation were not detectable, environmental concentration levels in an endoscopy unit without general ventilation system were 0.2 and 0.5 ppm. According to the results of environmental monitoring in the breathing zone of workers, extremely high concentrations were observed in some work practices (ethylene oxide, 300 ppm; formaldehyde, 8.6 ppm; glutaraldehyde, 2.6 ppm). In order to avoid occupational exposures to these chemicals and prevent potential chronic and acute health hazards, good communications with these chemicals, good work practices, appropriate personal protective equipment, and engineering controls should be required.

We established a drug sensitivity panel consisting of 24 human lung cancer cell lines. Using this panel, we evaluated 26 anti-cancer agents: three alkylators, three platinum compounds, four antimetabolites, one topoisomerase I inhibitor, five topoisomerase II inhibitors, seven antimitotic agents and three tyrosine kinase inhibitors. This panel showed the following: a) Drug sensitivity patterns reflected their clinically-established patterns of action. For example, doxorubicin and etoposide were shown to be active against small cell lung cancer cell lines and mitomycin-C and 5-fluorouracil were active against non-small cell lung cancer cell lines, in agreement with clinical data. b) Correlation analysis of the mean graphs derived from the logarithm of IC50 values of the drugs gave insight into the mechanism of each drug's action. Thus, two drug combinations with reverse or no correlation, such as the combination of cisplatin and vinorelbine, might be good candidates for the ideal two drug combination in the treatment of lung cancer, as is being confirmed in clinical trials. c) Using cluster analysis of the cell lines in the panel with their drug sensitivity patterns, we could classify the cell lines into four groups depending on the drug sensitivity similarity. This classification will be useful to elucidate the cellular mechanism of action and drug resistance. Thus, our drug sensitivity panel will be helpful to explore new drugs or to develop a new combination of anti-cancer agents for the treatment of lung cancer.

<P>Measurements of the cerebrospinal fluid (CSF) flow using phase contrast cine magnetic resonance (MR) imaging were performed on a phantom, 12 normal subjects and 20 patients with normal pressure hydrocephalus (NPH). The phantom study demonstrated the applicability of phase contrast in quantitative measurement of the slow flow. The CSF flows of the normal subjects showed a consistent pattern with a to-and-fro movement of the flow in the anterior subarachnoid space at the C2/3 level, and they were dependent on the cardiac cycle in all subjects. However, the patients with NPH showed variable patterns of the CSF pulsatile flow and these patterns could be divided into four types according to velocity and amplitude. The amplitudes of each type were as follows: type 0 (n = 1), 87.6mm; type I (n = 2), 58.2mm (mean); type II (n = 6), 48.0 +/- 5.0mm (mean +/- SEM); and type III (n = 11), 19.9 +/- 1.8mm (mean +/- SEM). The decrease of the amplitudes correlated to a worsening of the clinical symptoms. After the shunting operation, the amplitude of to-and-fro movement of the CSF increased again in the patients with NPH who improved clinically. Some of the type III cases were reclassified type II, I and 0 and also one of the type II cases changed type I after the shunting operation. We conclude that the phase contrast cine MR imaging is a practically and clinically applicable technique for the quantitative measurement of the CSF flow.</P>

Immunoallergological studies were carried out to clarify the differences between 24 patients with drug-induced asthma (DIA) and 240 with non-drug-induced asthma (non-DIA). The mean values of age, skin reaction to Candida albicans (C. albicans), serum IgE levels, specific IgE antibodies to house dust (HD) and C. albicans, bronchial sensitivity and leukotriene B4 (LTB4) synthesis from peripheral venous blood in patients with DIA were not significantly different from those in patients with non-DIA. In contrast, the frequency of positive skin reaction to HD and histamine release from peripheral basophils by anti-IgE were significantly lower in DIA than in non-DIA. These results agree with the reports that DIA was often observed in non-atopic asthma. But, the mean value of serum IgE was very high in DIA as well as in non-DIA. This result suggests that IgE mediated reaction in DIA is important. Furthermore, the proportion of neutrophils in bronchoalveolar lavage fluid (BALF) was significantly lower in DIA than in non-DIA. Our findings suggest that a decrease of intrapulmonary neutrophils might play an important role in the pathophysiology of DIA.

A total of 124 lesions from 1 to 6cm in diameter, including 31 cavernous hemangiomas, 32 metastases and 61 hepatocellular carcinomas (HCC) were analyzed to study the usefulness of magnetic resonance imaging (MRI) at 0.5 Tesla to differentiate focal hepatic lesions on the basis of qualitative criteria. Each focal hepatic lesion was assessed for shape, internal architecture and signal intensity relative to normal liver parenchyma. While all cavernous hemangiomas and metastases except one lesion could be detected, detection rate of HCC was significantly inferior to that of the other two diseases. A tumor capsule and a hyperintense focus on T1-weighted images were demonstrated in only HCC lesions in strong contrast with the other two diseases; however, metastases with slow-growing characteristics or subacute hematoma may appear as similar images. Cavernous hemangiomas appeared markedly hyperintense on T2-weighted images in 23 of 31 lesions, but one metastasis and one HCC had similar images. A multivariate analysis of several MRI resulted in the following mean discriminant scores: cavernous hemangioma, -1.2652; metastasis, 0.1830; and HCC, 0.7138. It appeared to be possible to differentiate the three diseases with 84.4 percent accuracy.

The relationship between MR configuration and pathological grade was studied in 41 histologically verified supratentorial astrocytic gliomas with a 0.5T superconductive MR system. The gliomas included 13 low-grade astrocytomas (LGAs), 14 anaplastic astrocytomas (AAs) and 14 glioblastoma multiformes (GBMs). MRI configurations were classified into nine criteria which were scored and statistically analyzed. The mean values of LGAs, AAs and GBMs were 0.45 +/- 0.31, 1.18 +/- 0.20 and 1.47 +/- 0.22. In each grade, MRI score increased as pathological grades increased (p < 0.01-0.001). LGAs had significantly lower values than AAs in five of the nine criteria (55.6%); heterogeneity, cyst or necrosis, edema or mass effect, border definition, and the degree of contrast enhancement, and lower values than GBMs in eight criteria (88.9%) except for hemorrhage. Three criteria (33.3%), heterogeneity, cyst or necrosis, and flow void sign were significantly higher in GBMs than AAs. The four variables, heterogeneity, cyst or necrosis, edema or mass effect and border definition, proved to be important factors related to the pathological grade in a multiple regression analysis.

Stump problems in amputations resulting from employment related injuries were investigated in 397 cases in the Chugoku and Shikoku districts of Japan between 1987 and 1991. Ninety-seven patients (24%) had stump problems which interfered the prosthetic fitting. Stump problems of the upper extremity were seen in about 9% (17 amputees), two thirds of which were skin troubles. Stump problems of the lower extremity were seen in about 37% (80 amputees). Certain complaints were associated with specific methods of amputation; abnormal keratosis in Syme's amputation, equinus deformity in Chopart's amputation, reduced muscle power in above the knee (A/K) amputation and joint dysfunction in below the knee (B/K) amputation. Adequate prosthetic fitting was achieved by the modification of the socket and alignment in almost all amputees with stump problems. In only two cases, Chopart's amputation required subsequent Syme's amputation due to equinus deformity with abnormal keratosis. In almost every case, stump problems are avoidable by means of surgeons' deliberate evaluation of the affected limb and adequate choice of the amputation level.

Between November 1984 and August 1992 we used hyperthermotherapy in six cases of local recurrence of rectal cancer. Hyperthermotherapy was performed on the average 8.7 times (range: 3-18) for each patient for 60 min each. All patients underwent combined radiotherapy and received a mean radiation dose of 42.5 Gy (range: 9-60 Gy). Five patients underwent heating within 1 h after irradiation and one patient simultaneously with the irradiation. Four patients underwent combined chemotherapy and two patients immunotherapy. Before the treatment all patients had painful lesions, but pain decreased posttherapeutically in five patients. Performance status improved in two patients. High carcinoembryonic antigen levels prior to the therapy in four patients decreased in all cases after treatment. Posttherapeutical computed tomograms revealed only minor response or no changes. After the treatment, four patients died of exacerbations of recurrent tumors and one patient of distant metastases. The patient who underwent simultaneous radiohyperthermotherapy is presently alive, in August 1992, 38 months after initiation of the treatment. The 50% survival time after initiation of the treatment was 25 months (range: 10-38 months). Hyperthermotherapy combined with radiotherapy, chemotherapy and/or immunotherapy was useful for the alleviation of pain in patients who developed local recurrence after surgery, and improved survival after recurrences can be expected.

Polyamines are closely related to many aspects of cell growth. Since increased amounts of polyamines in the urine of human cancer patients were reported in 1971, polyamines have been studied from the standpoint of tumor markers. In this study, polyamines in erythrocytes, plasma and urine were determined in 42 controls and 105 patients with gynecologic malignant tumors. The changes in polyamine levels were investigated before and after treatment. With advances in the stage of uterine cervical cancer, the frequency of abnormal levels of polyamines (concentrations greater than two standard deviations above the mean control level) became greater, and reached nearly 80% in recurrent and ovarian cancer. In the early stage of cancer, the diagnostic value was low. Comparison with carcinoembryonic antigen (CEA) was also performed. The polyamines lack specificity for malignant diseases, but they can be used to some extent as a tumor marker in the gynecologic field.

The onset of beta-methyl-digoxin action was investigated by the potentiation of the adenosine response in guinea pigs and rats, and compared with that of digoxin and dipyridamole. A number of i.v. infusions of adenosine were given to determine the mean control adenosine response and its 95% confidence limits. After oral administration of the drugs, successive infusions of adenosine were continued until a drug-induced potentiation of the adenosine response was observed. The time of appearance of the potentiated adenosine response was marked as the onset of action of the drugs. The onset of action in guinea pigs was 9 to 12 min for 0.2 to 0.4 mg/kg of beta-methyl-digoxin, 90 to 100 min for 0.2 mg/kg of digoxin and 25 min for 5 mg/kg of dipyridamole. The maximal potentiation was 48.8 to 53.8% at 18 to 21 min for beta-methyl-digoxin, 74.5% at 130 min for digoxin and 74.8% at 80 min for dipyridamole. Adenosine infused i.v. into rats produced heart block, as in guinea pigs. However, in rats, the adenosine response was not potentiated by beta-methyl-digoxin and digoxin. Dipyridamole at a dose as high as 200 mg/kg produced 25.8% potentiation at 36 min after oral administration to rats.