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1. With a view to grasp more simply and clearly the characteristics of this disease and in order to find a clue for prompt discovery of cases when encountered in future, the authors undertook a statistical study of the cases already reported by various authors. 2. The cases reported so far amount to 17 familial groups which consisted of 38 acatalasemic cases. These groups were distributed widely throughout Japan. The disease seemed to be prevalent in the rural communities where adherence to the custom of consanguineous marriage occurs. As yet, we have not heard of the occurrence of this disease in other countries. 3. The disease has equal distribution in both sexes. About one half of patients showed a peculiar oral gangrene (Takahara's disease). The great majority of these were noted in those less than 10 years of age. 4. The great majority of them were children whose parents were united in consanguineous marriage and have siblings with acatalasemia. 5. As for the treatment of oral lesions in this disease, extraction of tooth at the site of the lesions, removal of the diseased tissues en masse by resection, and penicillin treatment given concomitantly are effective. The course and the length of time required in healing of the wound due to the operation are about the same as in the case of normal persons. 6. The authors wish to call special attention to the phenomenon peculiar to the acatalasemic blood. The blood of acatalasemic individuals changes to brownish-black color in the absence of foaming or bubble formation upon the application of hydrogen peroxide to blood.

In Japan, laryngofissure technique applied for the larynx cancer made its debut comparatively late, as compared with that in Europe and America. Namely, the laryngofissure was first used in the treatment of larynx cancer in 1931 by Prof. F. Tanaka and that was the first time this technique had ever been used in Japan, as far as in author's knowledge. This author had a good fortune to witness that first operation as his assistant.

Experiment on the animals proved that in the case of the death by drowning planktons always immigrate into the bone marrow and some kinds of them can be detected in the bone marrow even after a long period of time, suggesting that the detection of these planktons in the bone marrow of the dead person will give the important clue for the determination of the cause of death by drowning. Actually applying this method in a decayed corpse, we could successfully show the cause of death is due to drowning in which the cause of death was long argued in the court.

Papanicolaou's smear test is a method based upon the morphological study of the cancer cells exfoliated from the epithelium, whereas T.P.T. is a method for examining the intracellular metabolism, the glycolysis, by a supravital staining of the cancer cells. The latter, therefore, can be called as a cytochemical diagnosis. Since, by the T.P.T. method, even a beginner can obtain the result of approximately 80% in correct and the skilled ones as high as 95%, the clinical diagnosis can be made all the more accurate by using Papanicolaou's test in combination with T.P.T. method. As for the entity of these granular cells, there remains a room for discussion, but Misonou feels that Cell Type A arises from necrobiosis of the carcinomatous tissues while Type B would be a certain wandering cell. This reaction, however, should not be employed to the cases in the puerperium, because the similar cells are exfoliated from the puerperal uterus. Thus, I can say that the T.P.T. is not a specific reaction to cancer. From this study, I wuld recommend T.P.T. as a method that is quite simple and is servicable for saving a great deal of effort and time on the part of clinicians, and I would like to encourage you to use it as one of tools for the diagnosis of carcinoma of the uterus, especially for an early diagnosis.

The author studied the hematopoietic disturbances of rabbit induced by saponin injection and drew the following conclusions: 1) By saponin injection, the structure of bone marrow is disintegrated and hematopoietic cells are released into the circulating blood forming extramedullary hematopietic foci mainly in liver and spleen. The main attacking point of saponin should be RES. Recovery of hematopoietic foci is associated with the recovery of RES. The most marked extramedullary hematopoiesis is found three days after the injection. Thereafter, bone-marrow hematopoiesis proceeds to recovery stage, during which hematopoietic foci in liver and spleen are preserved, especially those in spleen persist fairly for a long time. 2) Daily injections of India ink kept up over a long period of time after the treatment with saponin, prevent the recovery of anemia and bone-marrow hematopoiesis. The lymph nodes, whose RES escaped from the severe damage by India ink, keep the hematopoietic foci for a long time. 3) As far as hematopoiesis is concerned, there seems to be no functional differentiation among RE cells, though they seem to have a special function according to the organs to which they belong, e. g. antibody formation in lymph apparatus, hematopoiesis in bone marrow and red cell destruction in spleen.

For the purpose to clarify the control mechanism of erythroid cell differentiation, the author observed morphologic changes in bone-marrow cells and circulating red cells in phenylhydrazine anemia of rabbits by introducing a mass of red cells into vein at one time and reached the following conclusions. 1. After red cell transfusion in a mass to animal showing a marked hematopoietic activity, anisocytosis or macrocytosis becomes distinct with the appearance of big reticulocytes and red cells as large as four times the normal in volume. This suggests, judging from their volume, the accelerated denucleation of erythroblast as early as at the late basophilic stage. 2. Observations on bone marrow at this stage revealed the reduction in the number of erythroblasts of undifferentiated type with the increase of rather differentiated ones. In erythroid islet, undifferentiated cells are found surrounding a reticulum cell located in the center, while well differentiated ones in the outskirt area are situated near the sinusoid. Such a cell arrangement suggests that the erythroid cell requires a high oxygen tension for its differentiation. 3. From these observations and other results obtained from the studies on reticulocyte maturation and RNA synthesis of erythroblast, the author stresses that erythroid cells can differentiate as long as it is provided with a certain level of oxygen, even though it may develop m-RNA for differentiation. In other words, there should be two steps in the differentiation of erythroblast, the first is m-RNA synthesis induced by the information and the second is the somatic protein synthesis with oxygen supply. This seems to be directly connected to the control mechanism of hematopoiesis by oxygen.

The bony labyrinth obtained at necropsy in four cases was studied by a new computer-generated three-dimensional (3-D) system. One case was normal (control) and the other three were histopathologically confirmed cases of Mondini's dysplasia. In case 1, the cochlea had only 2 turns and the lateral semicircular canal did not make a circle but appeared as a spherical mass projecting from the utricle even though the posterior semicircular canal made a normal circle. In case 2, there were no turns in the cochlea even though the semicircular canals and the vestibule appeared normal. In case 3, the cochlea showed 1 to 1 and 1/2 turns and the semicircular canals were premature showing only bud-like projections. This 3-D imaging system, which utilizes the toggling method, provides a way of obtaining satisfactory images without markers, and the time required to obtain these 3-D images was reduced by using a video camera instead of a digitizer. One of the problems associated with the use of 3-D imaging is the long processing time. We resolved this by inputting the section images with a video camera and by picking up structures using density segmentation instead of tracing with a digitizer.

A non-invasive method for measuring portal blood flow by magnetic resonance (MR) phase contrast was evaluated in a flow phantom and 20 healthy volunteers. In a flow phantom study, the flow volumes and mean flow velocities measured by MR phase contrast showed close correlations with those measured by electromagnetic flowmetry. In 20 healthy volunteers, the cross-sectional areas, flow volumes and mean flow velocities measured by MR phase contrast correlated well with those measured by the Doppler ultrasound method. Portal blood flow averaged during the imaging time could be measured under natural breathing conditions by using a large number of acquisitions without the limitations imposed on the Doppler ultrasound method. MR phase contrast is considered to be useful for the non-invasive measurement of portal blood flow.

P-glycoprotein is a transmembrane protein which acts as an energy-dependent drug efflux pump for a variety of anti-cancer drugs. The mdr-1 gene which encodes P-glycoprotein was successfully cloned in 1986. To investigate P-glycoprotein expression in diverse ovarian tumors, including benign, low malignant potential and malignant, immunohistochemical study was done using a monoclonal antibody (C 219). Overall, 8 out of the 59 epithelial ovarian tumors (13.6%) expressed P-glycoprotein. It was noted that 5 of the 12 mucinous tumors were found to express P-glycoprotein, while none of the 31 serous tumors were immunohistochemically positive. In 10 malignant ovarian tumors, P-glycoprotein immunostaining was examined both prior to and after chemotherapy. Nine of them did not express any P-glycoprotein before or after chemotherapy. However, one tumor expressed P-glycoprotein after six courses of multidrug resistance-related drug administration. These findings indicate that P-glycoprotein expression is not so common in ovarian tumors, regardless of their malignant potential. Nevertheless, the results suggest a strong association between P-glycoprotein expression and certain histological cell types in epithelial ovarian tumors. It is also possible that P-glycoprotein appears as a result of chemotherapy, but such a phenomenon can not occur unless chemotherapy is administered at high doses for a long period of time.

Stress is a proximal interphalangeal (PIP) joint model was analyzed by the two-dimensional and three-dimensional finite element methods (FEM) to study the onset mechanisms of the middle phalangeal base fracture. The structural shapes were obtained from sagittally sectioned specimens of the PIP joint for making FEM models. In those models, four different material properties were given corresponding to cortical bone, subchondral bone, cancellous bone and cartilage. Loading conditions were determined by estimating the amount and position of axial pressure added to the middle phalanx. A general finite element program (MARC) was used for computer simulation analysis. The results of the fracture experiments compared with the clinical manifestation of the fractures justify the applicability of the computer simulation models using FEM analysis. The stress distribution changed as the angle of the PIP joint changed. Concentrated stress was found on the volar side of the middle phalangeal base in the hyperextension position, and was found on the dorsal side in the flexion position. In the neutral position, the stress was found on both sides. Axial stress on the middle phalanx causes three different types of fractures (volar, dorsal and both) depending upon the angle of the PIP joint. These results demonstrate that the type of PIP joint fracture dislocation depends on the angle of the joint at the time of injury. The finite element method is one of the most useful methods for analyzing the onset mechanism of fractures.

The aim of this study was to investigate the usefulness of magnetic resonance (MR) imaging in the evaluation of renal function, with particular attention to the effects of water load. Ten healthy volunteers underwent dynamic MR imaging after an injection of gadolinium diethylene-triaminepenta-acetic acid (Gd-DTPA) as a contrast agent to evaluate renal function by the following four methods: the positive method [longitudinal relaxation time (T1) shortening is the dominant effect], the negative method [transverse relaxation time (T2) shortening is the dominant effect] and two intermediate methods by switching the Gd-DTPA concentrations used in the positive and negative methods. A prolonged cortical peak time and a reduced medullary peak level were observed by the positive method under a dehydrated condition, suggesting that these variables were slightly influenced by Gd-DTPA concentrated in the medulla. By the negative method, low signals due to T2* (T2* is the effective transverse relaxation time, typically shorter than T2) shortening appeared in the medulla under normal conditions, but these signals were unclear when the subject was under an overhydrated condition. These results indicate that water metabolism, in addition to imaging parameters and Gd-DTPA dose levels, should be considered when renal function is evaluated by dynamic MR imaging. Analysis of both the pattern of MR images and the time-signal intensity curves may be useful in the evaluation of renal function. The results also indicate that the positive method is preferred when the patient is overhydrated as it allows the evaluation of the local renal kinetic function by recording changes in the regional contrast agent levels.

The sensitivity and specificity of single cell polymerase chain reaction (PCR) were studied. Its high sensitivity enabled detection of a single-copy gene, such as human T-lymphotropic virus type I genome in paraffin sections. The rate of obtaining positive signals with this method was affected by the number of copies of the gene in the target cell. Specificity was satisfactory if the procedure was properly and carefully followed. Since the single cell PCR is a time-consuming method which requires skill and experience to pick up the target cells accurately, the applicability of this method is limited. It works best when it is used to analyze a single or a few copy genes in histologically identified cells.

To clarify the influence of the introduction of metal bats on the physique and batting records of the players in the National Summer High School Baseball Tournaments, a comparative analysis was conducted between height, body weight, body-weight ratio (body weight/height), batting average and home run average of the best four teams' players (n = 493) and those of the other teams' players (n = 4,590) in three periods: the period of the use of wooden bats, that of the use of both wooden and metal bats and that of the use of metal bats. In the period of metal bat use, the mean values of physique of the best four teams' players were significantly larger (P < 0.05) and their average number of home runs was significantly higher than those of the other teams' players (P < 0.01). The only significant differences between the two groups in those indices for each time period were for height in the wood and metal/wood periods. This study demonstrated that the differences between the home run average and physique, including height, body weight and body-weight ratio of the best four teams and the rest of the teams were the greatest after the use of metal bats. These findings suggest that the importance of the home run average increased and was associated with large-size of physique after the use of metal bats in the National Summer High School Baseball Tournaments.

Effects of ischemia and nitroglycerin on systolic time intervals in the segmental myocardial length were studied in anesthetized open-chest dogs. Two strain-gauges were sutured on the surface of the left ventricular wall; one was in the central area perfused by the left circumflex coronary artery (LCX) and the other was in the area perfused by the left anterior descending coronary artery. LCX was partially occluded with a screw type constrictor to the degree at which reactive hyperemia after the transient total coronary occlusion almost disappeared. After the hemodynamics stabilized nitroglycerin (20 microgram/kg) was injected into the femoral vein. In the ischemic area, contraction time was shortened and precontraction time was prolonged in association with an elongation of end-systolic and early systolic segment-length, respectively. The systolic time intervals in the ischemic segment were improved as a result of the recovery in the segment-length toward the control. The results suggest the usefulness of analyzing the segmental myocardial systolic time intervals for verifying the asynchronous contraction of the ventricle and the favourable effects of nitroglycerin on segmental myocardial function in the ischemic area.

A blood coagulation deficiency was found at the contact phase in identical Japanese female twins. Of the four possible factors involved, Factor XI or XII can be ruled out according to cross-correction studies. The problem factor was probably not Fletcher factor, because the abnormal partial thromboplastin time was not significantly shortened by increasing the incubation period of plasma with kaolin. The deficiency is most likely due to the lack of Fitzgerald factor.

The intestinal mucosal barrier of rabbits was damaged by carrageenan-induced ulceration of the colon, superior mesenteric artery occlusion (SMAO) and hemorrhagic shock and the values of Endotoxin (lipopolysaccharide, LPS) were determined by radioimmunoassay and the concentration of lysozyme (LZM) by the turbidimetric method. As a result, endotoxemia was observed in 13 out of 15 carrageenan rabbits, and in all of the SMAO and hemorrhagic shocked rabbits. Serum LZM concentration rose with time in all cases. As to the correlation of LPS and LZM, they changed almost in parallel in carrageenan rabbits, SMAO and hemorrhagic shock. LPS value and LZM concentration in blood were also determined in LPS injected rabbits. It was confirmed that injected LPS increased the LZM concentration of blood. On the basis of these results, it can be concluded that destruction of intestinal mucosal barrier permits an invasion of LPS into blood and then releases LZM into the blood stream.,/p>

The incidences, distribution and histopathological findings of N, N'-dimethylnitrosourea (DMNU)-induced brain microtumors in Sprague-Dawley rats were studied. Subcutaneous injections of DMNU in young adult rats one a week resulted in the induction of 122 gliomas in 38 animals with an incidence of 69% after a time lapse of between 157 and 246 days from the first injection. Of these tumors, 66 were classified as microtumors (diameter less than about 1 mm) by detailed light microscopy observation of serial sections. The microtumors were of 3 types: 55 oligodendrogliomas, 8 astrocytomas and 3 mixed gliomas. As the tumors became larger in size, anaplasia appeared, especially in the central part of the tumors. The microtumors developed randomly throughout the brain. It was concluded that, in adult rat brains, the target cells of DMNU were well differentiated glial cells which had already migrated from the matrix layer.

The correlation between the systolic time interval and abnormal contraction in ischemic myocardium was studied in anesthetized open-chest dogs. A strain-gauge was sutured on the surface of the left ventricular wall perfused by the left anterior descending coronary artery (LAD) for measuring segment-length. The left ventricular stroke volume decreased progressively after occlusion of LAD. The left ventricular ejection time (LVET) was progressively shortened in close correlation with the elongation of segment-length at the onset of isometric relaxation in 20 seconds after LAD occlusion when early systolic myocardial contraction and isometric contraction time (ICT) were not affected. ICT was gradually prolonged and closely related with the lengthening of the early systolic segment-length, while LVET recovered toward the control level in spite of further decrease in stroke volume. A close relationship was observed between ICT/LVET and stroke volume (gamma = 0.76, P less than 0.01). The results suggested the possibility that LVET was normalized even when the left ventricular function was impaired, and ICT/LVET ratio was the most sensitive index of LV dysfunction.

Using in vivo and in vitro experimental models, the uptake and excretion of 67Ga-citrate in tumor cells and normal cells were studied. The time-lapse accumulation of 67Ga in the tumor of rats bearing Yoshida sarcoma reached its peak 24 h after the administration of 67Ga and gradually decreased thereafter. However, the excretion of 67Ga from the tumor was less than that from normal lung. For culture cells in vitro, the uptake of 67Ga increased with lapse of contact time between 67Ga and the cells, but there was no distinct difference between the results of tumor cells and normal skin fibroblasts. The excretion of 67Ga from the cells tended to decrease with prolongation of the contact time, the excretion from tumor cell being only about 10% after a contact time of 24 h. This indicated a significant delay in excretion in comparison with that of normal skin fibroblasts. This delay in the excretion of 67Ga may be an important factor in the tumor accumulation of 67Ga.

Patients with multiple myeloma were treated chemotherapeutically with a combination of melphalan, ifosfamide, prednisolone, nitrosourea and vincristine (MIP-NV therapy). The M-protein kinetics during the course of MIP-NV therapy was studied. The kinetics of serum and urinary M-protein in the first cycle of the chemotherapy was classified into four patterns, and the mode of change in the M-protein level over the entire course of chemotherapy was classified into four prototypes. There were intimate relationships among M-protein kinetics patterns in the first cycle of the chemotherapy, the effect of the chemotherapy on M-protein reduction, maturity of myeloma cells, pretreatment labeling index and clinical stage of the disease. Moreover, analyzing the prototypes, it was found that both the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction affected the survival time. To predict the effect of the chemotherapy on M-protein reduction and survival time, it was useful to analyze subgroups, which were classified according to the M-protein kinetics pattern in the first cycle, the time for maximum M-protein reduction and the rate of increase in the M-protein level after maximum M-protein reduction.