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The present study was aimed to elucidate the effect of antiplatelet therapy on patency of saphenous vein graft after aorto-coronary bypass surgery. We divided the 96 patients who underwent aorto-coronary bypass surgery into two groups: GATS (Graft Aspirin Ticlopidine Study) group and control group. And the occlusion rate was assessed both at the time of one month and 12 months after bypass surgery. All patients received warfarin, and the patients in GATS group received aspirin (10～50mg) and ticlopidine (100～200mg). The patients in control group received only warfarin. In GATS group, the early occlusion rate was 14.6% and the late occlusion rate was 28.8%. On the other hand, the early occlusion rate was 19.2% and the late occlusion rate was 28.8% in control group. There was no significant difference in the occlusion rate between GATS group and control group. In patients whose graft flow was under 50ml/min, the occlusion rate in GATS group was 10.8%, but in control group was 32.1% at the time of one month. These results indicate that antiplatelet therapy after A-C bypass surgery may have no effect on whole occlusion rate, but may have a little effect on the occlusion rate in low graft flow group. It may be important that when we should start the antiplatelet therapy after aortocoronary bypass surgery.

As compared with advances in the treatment of acute leukemia, we have made little progress in chronic myelogenous leukemia （CML）. Recentcy we have attempted some new treatment for chronic phass of CML, and confirmed those effectireness. We report the experiences of new therapy in CML.

A review was made on 68 patients with primary thrombocythemia in Niigata prefecture in recent 20 years. The newly diagnosed patients increased from 0.04 to 0.38/10^5 persons/year. The male/female ratio was 0.66. The total survival was estimated to be 167 months with an average period of observation of 54.8 months. Nine died of disease-related events (acute transformation, bleeding or thrombosis etc.) and six died of unrelated disorders such as gastric cancer etc. Survival was longer in patients without thrombo (T)-hemorrhage (H) than those with T and those with T and H. The antiplatelet (AP) or myelosuppression (MS) therapy selected at the diagnosis did not affect the prognosis, but thrapy by AP plus MS for longer than half of the observation period elongated the survival in comparison with that by either of them. Seven cases with low leukocyte alkaline phosphatase. 4 cases developing prominent thrombocytosis from normal or mildly elevated level, and 4 cases (2 in preganacy) showing normalization of the platelet count were presented., 68例について検討し次の結果をえた. 年度別, 新潟県在住の新患数は昭和44～63年にかけて増加した（0.04→0.38/人口10万）. 男/女比0.66と女性に多い. 観察期間54.8ヵ月で死亡15例, 本症と関連した死は9（急性転化1, 骨髄無（低）形成2, 出血血栓6）, 疑い2（出血1, 夜間の不明死1）であった. 50％survivalは非関連死4を入れても, 除いても, 167ヵ月であった. 診断時症状別生存期間は, 出血や血栓症状群が非出血血栓群より, また血栓群が非出血血栓群より有意に短く, 女性より男性が短かった. 治療期間を考慮にいれた治療群間の比較で, 抗血小板剤と骨髄抑制剤の併用群は単独使用群より予後が良好であった. しかし無治療群とは差はなかった. NAP低値7例では特に慢性骨髄性白血病への移行及び近縁性は見られなかった. 血小板数のほぼ正常化した4例中2例は妊娠が契機となった. 診断前, 血小板数が正常かやや増加していた4例をまとめた. 骨髄抑制剤の血小板数維持量を明らかにした.

We have studied antiplatelet therapy by low-dose aspirin combined with ticlopidine under the control of platelet aggregation individually for secondary prevention of cerebral infarction (CI) and a preliminary results were reported. Eighty six patients (9 with TIA, 2 with RIND or 75 with CI) were treated by our protocol (Niigata Med. J. 101;642, 1987) for an average of 22 months. The doses of drugs were for aspirin at 10-75 (median 30) mg/day and for ticlopidine at 50-300 (median 200) mg/day. Cerebrovascular reattacks in all and recurrence of CI were 3.18% and 2.08% (patient x year), respectively. Mild non-fatal bleeding occurred in 4 patients. None of patients died during this study. In conclusion our method is turned out, at least, as effective as those reported by others, and seems safe in clinical application.

Most results on platelet activation during exercise in normal subjects and patients have recently been criticized as artificial activation ex vivo. The present study examined the shape changes of circulating platelets together with some other parameters in healthy subjects during a bicycle ergometer exercise. Striking shape changes revealed were spherification (decrease in the discoidness index) and pseudopod formation (increase in population of platelets with pseudopods). These changes in platelet shape persisted for 30 min after the exercise and after haemodynamic parameters returned to the pre-exercise level. The changes in the discoidness index and pseudopod formation during the exercise were found to be identical with our previous findings on platelets activated in vitro by ADP or thrombin. Trapidil (600 mg daily for 2 weeks per os), a modulator of platelets activity and vascular functions, significantly suppressed the shape change, suggesting a possible clinical benefit.

Most results on platelet activation during exercise in normal subjects and patients have recently been criticized as artificial activation ex vivo. The present study examined the shape changes of circulating platelets together with some other parameters in healthy subjects during a bicycle ergometer exercise. Striking shape changes revealed were spherification (decrease in the discoidness index) and pseudopod formation (increase in population of platelets with pseudopods). These changes in platelet shape persisted for 30 min after the exercise and after haemodynamic parameters returned to the pre-exercise level. The changes in the discoidness index and pseudopod formation during the exercise were found to be identical with our previous findings on platelets activated in vitro by ADP or thrombin. Trapidil (600 mg daily for 2 weeks per os), a modulator of platelets activity and vascular functions, significantly suppressed the shape change, suggesting a possible clinical benefit., departmental bulletin paper

In this present work we describe in detail the trends of both vocal and phonemic confusion in response to distortions of band-eliminating nature. For tracing the finest phases and modes of confusion-characteristics as functions of distortion, it is important above all to have a full knowledge of the referential state of timbre-confusion in the normal condidion (no-cutting) and we take this as the point of beginning for our study.

In the present report we deal with the confusion problem of vocalic timbre. Guided by the dual aspect of quality in timbre, we developed our study along an original line of inquiry treating not only phonemic confusion but also vocal confusion. The subject of vocal-confusion is novel and, because it stands in close relationship to transmission of the voice-quality in speech-communication engineering, is of inexhaustible interest. Complicated and divergent as the phenomena of confusion are, they are none-the-less quite available for, first, the interpretation of quality-loss, such as articulation- and naturalness-loss, and second, they give precious clues for perfect understanding of vocalic timbres themselves for the simple reason that the problem of confusion is but a problem of timbre-discrimination, and for the further fact that an experimental study of confusion also supplies us with an effective system of methods of inquiry on timbre sensitivity which is of vital importance. On the other hand, we must sharpen our observations on confusion phenomena by introducing incoming confusion as well as employing outgoing confusion by the help of which our description of the phenomena is animated and our treatment systematized.