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The analgesic effect of porcine calcitonin (PCT) was studied in 32 patients with cancer-induced bone destruction. Twenty patients (62.5%) showed some response among them 10 of 13 patients who had suffered from uncontrollable pain despite other treatment methods such as radiotherapy, and or the administration of other analgesics. The effect was observed about 10 days after the administration of the drug. Combined therapy with PCT and other modalities such as radiotherapy, chemotherapy and hormone therapy had a marked effect in controlling the pain.

A 54-year-old Japanese woman with primary adenocarcinoma of the appendix was treated. The diagnosis was established before surgery by means of barium studies and ultrasound examination. Histologically, the tumor was a mucinous cystadenocarcinoma. The patient was treated by ileocecal resection, and a 10-month follow-up has revealed neither evidence of recurrence nor of metastases. The preoperative investigations, pathologic features and surgical management in this case are briefly discussed.

A case of brain metastasis from urachal carcinoma is reported. Originally the source of the tumor was unknown. Histologic diagnosis of resected specimen was adenocarcinoma. Later removal of urachal carcinoma with partial resection of the bladder revealed adenocarcinoma identical to that of the brain tumor.

This study was carried out to determine whether the ovulatory response with clomiphene citrate and bromocriptine in 20 amenorrheic women with normoprolactinemia and gestagen withdrawal bleeding is influenced by the pretreatment pattern of pulsatile luteinizing hormone (LH) secretion. Two patients who had no LH pulse for 3-5 h failed to respond to clomiphene. One of them was treated with bromocriptine, but ovulation did not occur. Eleven of 12 patients who had one or more LH pulses and LH pulse/h ratios of less than 1 for 3-5 h ovulated with clomiphene. One clomiphene nonresponsive patient ovulated with combined therapy of bromocriptine and clomiphene. All 6 patients who had LH pulse/h ratios of greater than or equal to 1 for 3-5 h failed to ovulate with clomiphene. Three of them were treated with bromocriptine. Two of 3 patients ovulated with bromocriptine alone and 1 ovulated with combined therapy of bromocriptine and clomiphene. These results suggest that the pretreatment pattern of pulsatile LH secretion may predict the clinical response to clomiphene and bromocriptine treatment in amenorrheic women with normoprolactinemia and gestagen withdrawal bleeding.

A histopathologic study was done on tissues from 117 patients with colorectal carcinoma, and we compared data on 57 patients who died of a recurrence within 2 years (group I) with 60 others who survived for over 10 years (group II). All patients were surgically treated and followed for over 10 years. Particular attention was directed to the very advancing margin of the tumor, and we examined invading modes of sprouting tumor cells, reactive fibrosis, and inflammatory infiltration around the tumor, in addition to the other clinicopathologic features. In group II, extensive sprouting of individual tumor cells occurred less often, and intense reactive fibrosis and marked inflammatory infiltration around the tumor were more frequent than in group I in which conspicuous lymphatic and vascular permeations were often present. We propose that the invading mode of sprouting tumor cells and the presence or absence of reactive fibrosis and inflammatory infiltration at the advancing margin of the colorectal tumor are of prognostic value.

In cycling rats exposed to a controlled light schedule of 12 h of light daily from 22.00 to 10.00 h the concentration of estradiol in the anterior hypothalamus at 5.00-6.00 h on the day of proestrus was significantly higher than those at 0.00-1.00 h on day 1 of diestrus and estrus, and was about twofold higher than serum estradiol concentration, which reached a peak at 5.00-6.00 h on the same day. Autoradiographically, the uptake of tritiated estradiol by the nuclei of neurons in the nucleus (n.) preopticus, pars suprachiasmatica (POSC), n. preopticus periventricularis (POP), and anterior part of n. anterior hypothalami (AAH) was significantly higher at 1.00 h on the day of diestrus 1 than at 6.00 h on the day of proestrus and at 1.00 h on the day of estrus. These results suggest that the POSC, POP and AAH may be target sites in the anterior hypothalamus of estradiol for its feedback action.

The effects of glycine on serum gonadotropins and estradiol (E2) and on concentrations of free amino acids in the middle hypothalamus have been studied in diestrus-1 rats. 20 min after intraperitoneal administration, glycine in doses of 50 and 100 mg had no significant effect on serum luteinizing hormone (LH) levels, but 200 mg significantly elevated serum LH levels. Glycine in doses of 50-200 mg had no effect on serum follicle-stimulating hormone levels at 20 min after intraperitoneal injection. 200 mg of glycine significantly elevated serum LH levels at 20 and 50 min and serum E2 levels at 50 and 80 min after intraperitoneal injection. The effects were maximal at 20 min after injection for LH and at 50 min after injection for E2. 20 min after intraperitoneal injection, 200 mg of glycine significantly increased the concentration of glycine in the middle hypothalamus, but had no effect on the concentrations of the other free acidic and neutral amino acids in the middle hypothalamus. These results suggest that glycine may play a role in the neural regulation of LH secretion.

We report herein a case of poorly differentiated adenocarcinoma of the rectum occurring in a nephrotic patient with focal segmental glomerulosclerosis. The neoplasm which first appeared to be a submucosal tumor occurred in a 29-year old Japanese man with a nephrotic syndrome for 2 years and 6 months. Autopsy disclosed a large tumor located between the rectum and urinary bladder. Renal specimens showed changes consistent with focal segmental glomerulosclerosis.

A revised group classification of histology in gastric biopsy specimens was recently proposed by the Japanese Research Society For Gastric Cancer. The specimens judged as Group III by the revised classification contained; adenoma that used to be judged as Group III by the former classification, lesions difficult to distinguish between adenoma and carcinoma, lesions difficult to distinguish between atypical regenerative epithelium and carcinoma, and so on. Pathologists are requested to describe whether the lesion is adenoma or not and to consult with clinicians about the lesion in order to reduce the possibility that a case of well-differentiated adenocarcinoma is misdiagnosed as Group III by the revised classification.

The patient, a man aged 57, was admitted to our clinic on May 1, 1987, because of severe vertigo and unsteadiness in standing. Since the age of 55 he had been suffered from hypertension and atrial fibrillation. In September, 1986, he experienced vertigo but recovered soon without therapy. On April 25, 1987, while working, he noticed severe vertigo, nausea and vomiting. He was admitted to a hospital, and then transferred to our clinic. On admission, he was alert and the mentality was normal. Slight ptosis abducent nerve paresis, hypalgesia on the forehead, nose and cheek, facial paresis of peripheral type and hypacusis were detected on the left side. No anisocoria was observed. Sweating was impaired over the left side of the face. Elevation of the soft palate was limited on the left side and the tongue deviated to the left on protrusion. Dysarthria was detected. Though there was no muscular weakness in the extremities, incoordination and dysmetria were noted in the left arm and leg. He could not stand up because of vertigo and unsteadiness. There was no sensory disturbance in the trunk and extremities. Deep tendon reflexes were well elicited and no pathological reflex was observed. These clinical manifestations, except for the ipsilateral palatal and lingual disturbances, were typical of the lateral inferior pontine syndrome caused by occlusion of anterior inferior cerebellar artery, and the lesion was clearly demonstrated by horizontal and coronal MRI. The palatal and lingual disturbances might be due to the involvements of the corticobulbar tracts of the 10th and 12th nerves after the fibers had decussated.

Hypothalamic function during pregnancy and hypothalamic-pituitary function during the first month after abortion or premature labor have been studied. The plasma LH-RH level in pregnant women was significantly lower between 18 and 23 weeks' gestation than that in eumenorrheic women on day 8 or 9 of the normal cycle, and thereafter decreased until term. Serum FSH showed normal response to LH-RH on day 10 after pregnancy termination between 5 and 23 weeks' gestation, but no FSH response to LH-RH was found on day 10 after premature labor at 33 weeks' gestation. Serum FSH responded normally to LH-RH on day 30 after pregnancy termination at 18 weeks' gestation, but serum FSH responded excessively to LH-RH on day 30 after premature labor at 30 weeks' gestation. The positive feedback effect of estrogen on LH release was not operative on day 30 after pregnancy termination beyond 18 weeks' gestation, though it was operative on day 30 after pregnancy termination between 6 and 11 weeks' gestation. These results indicate that the duration of pregnancy has an influence on the recovery of hypothalamic-pituitary function after pregnancy termination and that the recovery of hypothalamic-pituitary function during the first month after premature labor beyond 30 weeks' gestation is similar to that after normal labor.