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We report a 69-yr-old female with a liver mass which, when surgically resected, was believed to be the spontaneous complete necrosis of hepatocellular carcinoma. The preoperative level of alpha-fetoprotein was high at 1050 ng/ml, and the mass was grossly an encapsulated nodular lesion with septa. Histologically, no viable tumor cells were demonstrated. The alpha-fetoprotein level decreased to a normal range. The postoperative course was uneventful, and the patient is alive and well 1 yr after surgery.

To help determine whether preoperative perfusion and inhalation SPECT imagings are useful in predicting postoperative lung function, Tc-99m MAA perfusion SPECT imaging, CT scans, and pulmonary function tests were prospectively performed in 33 patients with primary lung cancer before and after lobectomy or pneumonectomy. Tc-99m Technegas inhalation SPECT imaging was performed in 6 of 33 patients as well. The authors also studied changes in radioactivity on the operated and nonoperated sides before and after surgery, examined the lowest limit value for adaptability to the operation, and made a comparison of both perfusion and inhalation SPECT imaging. The predicted postoperative values obtained from the preoperative Tc-99m MAA SPECT images correlated more closely with the measured 6-month postoperative values than with the measured 3-month postoperative values. The highest correlation coefficient (r = 0.86) was observed between the predicted forced vital capacity (FVC) value and the measured 6-month postoperative FVC value. In many cases, there was not a great difference between the 6-month and 3-month radioactivity on the operated side obtained from Tc-99m MAA SPECT images. This appears to indicate that pulmonary blood flow on the operated side has completely recovered by 3 months after surgery. However, radioactivity in both the upper and lower lobes of the nonoperated side increased soon after surgery compared with that before the operation, and had not returned to preoperative levels 6 months after surgery. The radioactivity in the right middle lobe did not change before and after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

Insulin-like growth factor I (IGF-I) is a useful therapeutic agent in insulin resistant diabetes mellitus due to insulin receptor disease because of its hypoglycaemic effects through the IGF-I receptor. A girl with typical type A insulin resistant syndrome was treated with IGF-I for two years and the treatment was effective in ameliorating hyperglycaemia. Overproduction of testosterone in polycystic ovaries was aggravated with this treatment, however. Therefore, IGF-I treatment may be used for glycaemic control but with caution because of its possible side effect of aggravating hyperandrogenism in these patients.

Respiratory syncytial virus (RSV) plays an important role in acute bronchiolitis, which is life threatening in some infants. We investigated the epidemiology of RSV acute bronchiolitis in children less than 3 years old in northern Japan. From April 1991 to March 1993, 162 infants with acute bronchiolitis were hospitalized in our pediatric wards. The diagnosis of RSV acute bronchiolitis was based on the typical clinical manifestations and the presence of RSV antigen in their nasopharyngeal specimens or the rise of the RSV antibody titer. 124 out of 162 patients (76.5%) were diagnosed as having RSV acute bronchiolitis. 43.5% of patients with RSV acute bronchiolitis were 6 months old or less. The epidemic of RSV acute bronchiolitis commenced in October, peaked in December and ended in summer. RSV is quite prevalent in infants with acute bronchiolitis in northern Japan.

7-Substituted 5-methyl-2-isopropylamino-4H-3,1-benzoxazin-4-ones (BOZNs) were prepared and tested as inhibitors of human sputum elastase (HSE). The BOZNs with certain amino acid residues at the 7-position proved to be potent inhibitors of HSE. Some of the compounds also showed a high selectivity for HSE versus chymotrypsin. In a hamster model in which acute injury was induced by intratracheal administration of HSE (1.0 mg/kg), these compounds, when administered intratracheally (1.0 mg/kg) either 30 or even 240 min before challenge with HSE, significantly suppressed pulmonary hemorrhage. These findings suggest that 7-substitution of BOZN by amino acid residues can produce strong and HSE-specific inhibitors, with potential use in elastase-mediated disorders.

There are few reports on the assessment of left ventricular contraction during cardiopulmonary bypass (CPB) in open heart surgery. LV Emax is thought to be a load-independent index of left ventricular function. We used a left ventricular conductance catheter to measure LV Emax from "non-working beating heart" during CPB in 16 patients who underwent open heart surgery. During CPB, at 45 minutes after aortic declamping, changes of heart rate with atrial pacing (120/min) did not change LV Emax, but after intravenous dobutamine administration (DOB, 10 micrograms/kg/min) LV Emax increased by 26% (p < 0.01). DOB increased LV Emax in 14 of 16 patients during CPB. These 14 patients were weaned from CPB without difficulty. But in 2 other patients DOB didn't increase LV Emax during CPB. In order to be weaned from CPB, the two patients needed epinephrine and intraaortic balloon pumping. We concluded that change of LV Emax made by intravenous administration of dobutamine is one of useful indexes to assess left ventricular contractility during cardiopulmonary bypass.

The serum 4-O-methylpyridoxine (MPN) levels in a 21 months-old patient with gin-nan food poisoning were determined by HPLC. The blood of the patient was taken at 8.5 and 15.5 h after taking about 50 ginkgo albumens. After deproteinization of the serum, the supernatant was pretreated with Sep-pak C18 cartridge and was applied to HPLC. HPLC was performed with a Hibar LiChrosorb RP-18 (4.0 mm i.d. x 250 mm, 7 microns) using a fluorescence detector (wave length of excitation and fluorescence; 290 and 400 nm, respectively). The serum MPN level was determined by the absolute calibration method. The determination limit of MPN in the serum was 0.05 micrograms/ml. The serum MPN concentration was 0.09 micrograms/ml at 8.5 h after taking ginkgo seeds, and was less than the determination limit of MPN (0.05 micrograms/ml) at 15.5 h. MPN, isolated from the seed of Ginkgo biloba L., is responsible for "gin-nan food poisoning," and its cardinal symptoms are mainly tonic and/or clonic convulsions and loss of consciousness. Infants are particularly vulnerable. This method may be available for proving the gin-nan food poisoning, chemically.

Respiratory syncytial virus (RSV) infection is severe and life-threatening in some infants. To investigate the epidemiology of RSV infection in hospitalized children in North Hokkaido, Japan, we tried to detect RSV antigen in nasopharyngeal aspirates (NPA) from those children with lower respiratory tract infection (LRTI) and asthma attack. From April 1991 to March 1992, 317 patients were hospitalized in our pediatric ward for the treatment of LRTI and asthma attack. The presence of RSV antigen in NPA taken from 283 patients (89.3%) were examined by enzyme immunoassay. RSV antigen was detected in 88 patients (31.1%). RSV LRTI were noted throughout the year, and the epidemic peak was observed in November and December. There was no significant correlation between the RSV antigen positive rate and mean temperature. RSV played an important role in LTRI in children in North Hokkaido, Japan. RSV LRTI in North Hokkaido was not rare in summer, indicating that RSV was transmitted commonly among children throughout the year.

The aim of this prospective study is to evaluate the availability of preoperative perfusion SPECT in predicting postoperative pulmonary function following resection. Twenty-three patients with lung cancer who were candidates for lobectomy were investigated preoperatively with spirometry, x-ray computed tomography and 99mTc macroaggregated albumin SPECT. Their postoperative pulmonary functions were predicted with these examinations. The forced vital capacity and the forced expiratory volume in one second were selected as parameters for overall pulmonary function. The postoperative pulmonary function was predicted by the following formula: Predicted postoperative value = observed preoperative value x percent perfusion of the lung not to be resected. The patients were reinvestigated with spirometry at 3 months and 6 months after lobectomy, and the values obtained were statistically compared with the predicted values. Close relationships were found between predicted and observed forced vital capacity (r = 0.87, p < 0.001), and predicted and observed forced expiratory volume in one second (r = 0.90, p < 0.001). The accurate prediction pulmonary function after lobectomy could be achieved by means of lung perfusion SPECT.

Inhibitors of human leukocyte elastase (HLE) may exert potent therapeutic effects on pulmonary emphysema, adult respiratory distress syndrome and other diseases involving tissue degradation. 7-(4-Chlorophenylsulfonyl-L-glutanyl)amino-5-methyl-2-isopro pylamino-4H-3,1- benzoxazin-4-one (TEI-5624) and 7-(4-chlorophenylsulfonyl-L-lysyl)amino-5-methyl-2- isopropylamino-4H-3,1-benzoxazin-4-one (TEI-6344), two derivatives of 5-methyl-4H-3,1-benzoxazin-4-one, showed strong and highly specific inhibition of human sputum elastase (HSE), which is equivalent to HLE, with Ki values of 6.91 and 16.3 nM, respectively. The selectivity of TEI-5624 for HSE vs. several proteinases ranged from 300-fold to 45,000-fold in favor of HSE. TEI-5624 and TEI-6344 also efficiently prevented degradation of insoluble elastin by stimulated polymorphonuclear leukocytes. The elastase inhibitory capacity of these compounds was not affected by treatment with stimulated polymorphonuclear leukocytes or Pseudomonas aeruginosa-origin elastase. When administered intratracheally to hamsters. TEI-5624 and TEI-6344 were eliminated from the lung with half-times of 85 and 240 min, respectively. In acute injury induced by intratracheal administration of HSE in hamsters, these compounds significantly suppressed pulmonary hemorrhage when administered intratracheally (1 mg/kg) either 30 or 240 min before challenge with HSE (1 mg/kg). HSE-induced emphysema in hamsters was also prevented by TEI-5624 (1 mg/kg) administered intratracheally 7 hr after HSE administration (1 mg/kg). These results suggest that TEI-5624 and TEI-6344 may be useful therapeutic agents for the treatment of HLE-mediated diseases.

A series of 241 consecutive autogenous vein bypasses for chronic lower-limb ischaemia performed by two surgeons since 1980 was reviewed. After 1985, in situ vein bypass was employed preferentially and was compared with reversed vein bypass. The two groups of patients had similar risk factors, indications and outflow. Of the 241 bypasses, 157 were to the below-knee popliteal artery and 84 to infrapopliteal arteries. The utilization rates of a single ipsilateral saphenous vein were 57.5% for reversed and 71.9% for in situ vein bypass. However, in situ vein bypass was impossible in 43 procedures and these were changed to the reversed operation with contralateral vein. The primary 5-year patency rates of reversed and in situ vein bypass grafts to the popliteal artery were 82.5 versus 74.5%, and the primary 4-year patency rates for infrapopliteal bypass 68.5 versus 80.0%. The respective secondary patency rates were 94.2 versus 92.1% and 85.7 versus 91.1%. The main cause of graft failure was vein graft stenosis (reversed vein bypass, 13.0%; in situ, 11.1%), which usually occurred in the first 2 years after surgery. Of 23 grafts revised for stenosis, 21 were salvaged and restenosis rarely occurred. Both reversed and in situ vein bypass grafts were equally effective, but careful surveillance for 2 years and aggressive revision were extremely important after either type of reconstruction.

A successful experience of a case with chronic traumatic thoracic aneurysm is reported. A 51-year-old male patient had a history of a blunt chest trauma in a traffic accident one and a half year ago. He developed gradual hoarseness because of the recurrence nerve paralysis. Computed tomography and angiography revealed a saccular aneurysm at thoracic descending aorta. It was treated with direct closure of the tear under partial clamp of the aorta. His postoperative course was excellent. He is doing well two years after operation.

A 43-year-old man was pointed out an abnormal shadow on chest X-ray film. Chest CT showed a solid mass and a cyst at anterior superior mediastinum. Operation revealed a capsulated thymoma and a multilocular thymic cyst. PTH and CA19-9 level in the cystic fluid was elevated. Histological examination demonstrated the clear separation of the mixed type thymoma and the thymic cyst. There were few reports for cases of thymoma with a thymic cyst.

A 66-year-old male was referred to our department with mediastinal tumor. The chest X-ray and the chest CT showed a large tumor adjacent to pulmonary artery and descending aorta. Cavogram revealed a filling defect of the SVC. He underwent complete resection of the tumor, resection of the SVC and reconstruction of the SVC with ringed PTFE. The main tumor was 12 x 7 cm in size and the tumor in the SVC was 20 x 15 mm in size. Histopathological findings showed a lymphocytic thymoma. Compact invaded nest of tumor cell was found in the innominate vein. The tumor in the SVC was invasive to the intima of the SVC, but its media and adventure were intact. This case is rare among patients with invasive thymoma as far as the growth is concerned.

University of Wisconsin (UW) solution has been reported to extend the safe cold ischemic time in the preservation of the liver, kidney and pancreas. However, there have been few reports of safe cold ischemic time in heart preservation with UW solution. The purpose of this study was to find whether UW solution can extend the safe cold ischemic time in cardiac transplantation in dogs. Heterotopic cardiac transplantation was performed in mongrel dogs after cold ischemic preservation of the hearts with UW solution, ischemic time 8, 16 and 24 hours (Gr.UW8, Gr.UW16 and Gr.UW24, respectively) and with GIK solution, ischemic time 4 hours (Gr.G4) which is considered the safe cold ischemic time in clinical cardiac transplantation. The following was studied: 1) Emax of the LV, myocardial contraction, by pressure-volume curve with the volume measured conductance catheter method, 2) myocardial tissue blood flow of the LV (MTBF), with laser doppler tissue flow meter, 3) serum CPK and electron microscopical evaluation. Emax and MTBF were measured before transplantation and after reperfusion. Their results were expressed as percentage of the values before transplantation. As results, after 120 minutes from reperfusion, Emax was recovered to 94 +/- 13% in Gr.G4, 104 +/- 11% in Gr.UW8, 67 +/- 22% in Gr.UW16 and 66 +/- 16% in Gr.UW24. Emax in Gr.G4 and Gr.UW8 were significantly (p less than 0.01) higher than that in Gr.UW16 and Gr.UW24. After 120 minutes from reperfusion, MTBF was recovered to 90 +/- 19% in Gr.G4, 98 +/- 9% in Gr.UW8, 63 +/- 19% in Gr.UW16 and 61 +/- 6% in Gr.UW24.(ABSTRACT TRUNCATED AT 250 WORDS)

A 38-year-old male was admitted with edema of the neck and face. Chest X-ray revealed a mediastinal tumor. On chest CT and MRI, a tumor infiltrating the superior vena cava and bilateral brachiocephalic veins in the upper mediastinum was observed. Venography revealed obstruction of bilateral brachiocephalic veins. The tumor was diagnosed as thymoma by percutaneous biopsy, but since it was of stage III according to Masaoka's classification, complete extirpation was considered to be impossible. Preoperative chemotherapy with multiple drugs (CDDP, ADM, VCR, CPA) was administered. The superior vena cava syndrome resolved and the tumor diminished in size. Because of leukopenia, rhG-CSF was also used. The tumor infiltrated the left brachiocephalic vein; therefore, total resection and left brachiocephalic vein reconstruction were performed. Histopathological examination showed extensive, necrosis and fibrosis containing residual thymoma. Postoperatively, similar chemotherapy and cobalt irradiation (40 Gy) to the superior mediastinum were performed. We thus present a case of invasive thymoma which responded to preoperative chemotherapy.

A case of invasive thymoma with retroperitoneal recurrence is reported. A 55-year-old man with invasive thymoma (Masaokas classification, Stage IVa) underwent thymo-thymectomy, partial resection of left upper lobe, resection of phrenic nerve and partial resection of parietal pleura on March 14, 1989. Histological findings revealed thymoma with predominantly lymphocytic type. Two years after the operation, the tumor of retroperitoneal recurrence was discovered in abdominal CT. This retroperitoneal tumor was huge in size (16 x 12 cm) and extended into posterior mediastinum via aortic hiatus. The patient underwent resection of tumor through thoracotomy and laparotomy on April 23, 1991, after two cycles of chemotherapy. Histological findings revealed thymoma with predominantly lymphocytic type. This case was rare among patients with recurrence of thymoma as far as the site of recurrence is concerned.

This study examined the incidence of downhill esophageal varices due to SVC syndrome. The presence of downhill esophageal varices was examined by esophagoscopy or autopsy. Downhill esophageal varices were detected in two of nine (22%) patients with SVC syndrome. One case was a 66-year-old male case who and underwent upper lobectomy for lung cancer in September 1985. He developed SVC syndrome due to recurrence in 1986 and died in 1987. Downhill esophageal varices wer in the upper esophagus by esophagoscopy and confirmed by autopsy. The another case was a 61-year-old female who developed carcinoma of the tongue in 1986 and lymph node metastasis to the mediastinum in 1987. Autopsy revealed downhill esophageal varices in the upper and middle esophagus. Eleven cases of downhill esophageal varices due to SVC syndrome reported in Japan were reviewed and discussed.

A 67-year-old man was referred to our surgical clinic for evaluation of an abnormal shadow on the chest X-ray examination. CT scan and MRI revealed a tumor in the posterior mediastinum and destruction of the pedicle and intraspinal invagination by the tumor. The tumor in a paravertebral area are linked with a vertebral canal through a destructed intervertebral foramen. MRI showed that the tumor was a cyst which contained fluid. On thoracotomy a hen's egg sized cyst was found in the posterior mediastinum, the cyst was excised. Pathological diagnosis was a perineurial cyst. This case was clearly differentiated from an intrathoracic meningocele and a neurilemmoma microscopically. This case is the first intrathoracic perineurial cyst in Japan.

A very rare case of perianeurysmal fibrosis was presented. A 65-year old man was admitted with the complaint of abdominal pulsatile mass and intermittent claudication of right lower limb. Aortography revealed fusiform, calcified aneurysm of the infrarenal abdominal aorta and severe stenosis of right common iliac artery. CT scan demonstrated a soft tissue density structure around the aortic aneurysm which was enhanced after contrast medium injection. At surgery, the aneurysm had a thick, firm, smooth wall which was shiny white in appearance and adherent perianeurysmal fibrosis was marked. In order to avoid injury to surrounding tissue such as the duodenum or vena cava, thrombo-exclusion method was chosen. Histological examination of the aneurysmal wall showed fibrous tissue infiltrated with mononuclear cells such as lymphocytes and plasma cells. The postcontrast enhancement of aortic wall and perianeurysmal sheet disappeared on CT on the post-operative 57th day and no recurrence has been observed.

We experienced a case of the ruptured pseudoaneurysm of the aortic arch. Patient complained left anterior chest pain, back pain and hoarseness. Considering the past history of pulmonary tuberculosis, emergency operation was performed median sternotomy approach and using aortic occlusion balloon catheter method and selective cerebral perfusion. Woven dacron graft was anastomosis intraluminal aneurysm. Postoperative course was good. Median sternotomy approach and AOBC method were better than intercostal approach method, because of a little bleeding, short operative time and method.

Premature rabbit neonates (gestational age 27 days) were treated at birth with natural surfactant purified from chloroform extracts of porcine lung lipids either by acetone precipitation (Surfactant CK, n = 10) or liquid gel chromatography (Curosurf, n = 22). Another group of animals received artificial surfactant "reconstituted" from isolated low molecular weight (less than or equal to 15 K) apoproteins and synthetic dipalmitoylphosphatidylcholine (DPPC) and dipalmitoylphosphatidylglycerol (DPPG) (Aposurf, n = 10). The phospholipid concentrations of the preparations were adjusted to provide the same individual dose of DPPC for each group of treated animals (3 or 4 mg). In comparison with untreated controls from the same litters, there was a 4-7-fold enhancement of lung-thorax compliance in all groups of surfactant-treated animals during a 3-h period of artificial ventilation. The average initial (20 min) compliance value was lower in the Aposurf-treated group than in animals receiving natural surfactant preparations, but the difference between the groups gradually diminished and was no longer statistically significant during the 2nd and 3rd h of artificial ventilation. Judged from the fall in tidal volume during ventilation with a short expiration phase (0.17 instead of 0.75 s), the apoprotein-based artificial surfactant was also less effective in stabilizing the lungs. A similar conclusion could be drawn from data on alveolar expansion in histological sections, evaluated by automated image analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

The present report is a detailed, prospective analysis of 29 pregnancies in 19 patients with systemic lupus erythematosus (SLE). The clinical pregnant status was correlated with maternal serologic patterns. Poor obstetrical prognosis was associated with low or declining complement (C3 and C4) levels and rising antinuclear and anti-DNA antibody titers. Complement levels reflected clinical changes more accurately than either antinuclear factor. A smooth antepartum course and successful delivery occurred when complement values remained normal. Immunohistochemical studies showed granular or linear depositions of immunoglobulin and complement on syncytial trophoblast and stromal tissue in placenta with SLE. Slight deposits of IgG were observed on the stromal tissue in normal placenta. Immune complex deposition on the trophoblast correlated to both serologic evaluation and course of SLE pregnancy. Obstetrical prognosis can be evaluated by serial determinations of serologic status. These data suggest that declining levels of maternal complements in SLE may be partly due to immune complex deposition in the placenta, resulting in the increased placental dysfunction.

Dextromethorphan and its analogues (DM 16, DM 34, DM 72, DM 75 and DM 96) were examined for their effect on Ehrlich ascites carcinoma or ascites sarcoma-180 in female mice of the ddY strain. The suspension of Ehrlich carcinoma cells or sarcoma-180 cells was prepared from mice at 10 days after i.p. inoculation of the cells, using Hanks' balanced salt solution, and the cell suspension was inoculated i.p. into mice (2 X 10(6) viable cells/mouse). The chemicals dissolved in physiological saline containing 5% HCO-60 were then injected i.p. into the mice once daily for 5 successive days (5-40 mg/kg/day). In addition, mice given the tumor cells were treated with the saline containing 5% HCO-60 alone for 5 days (untreated mice). In groups of mice bearing Ehrlich ascites carcinoma or ascites sarcoma-180, the mean survival time of mice treated with 20-40 mg/kg/day of DM 96 was more than twice that of the corresponding untreated mice. The mean survival time of mice treated with 20 mg/kg/day of DM 96 was also longer than that of mice treated with 40 mg/kg/day of the other chemicals, irrespective of the ascites tumors. Concerning these survival times, the LD50 (i.p.) of DM 96 in mice differed slightly from that of other chemicals (88 mg/kg and 77-106 mg/kg). These results indicate that DM 96 is more active than the other chemicals against the ascites tumors in mice.

By using adult rabbits in which the lung surfactant had been reduced by repeated whole-lung lavage, we examined the effects of surfactant supplement and positive end-expiratory pressure (PEEP). The rabbits were anesthetized with pentobarbital sodium and mechanically ventilated with pure O2. Surfactant that was extracted from pigs' lungs was supplemented to the rabbits through the trachea. The PEEP was set at 4 cmH2O. The seven rabbits that were ventilated without the supplement and without the PEEP all died of hypoxia, hypercapnia, and reduction of lung compliance within 2 h. The 18 rabbits that were ventilated with either the supplement or the PEEP showed some elevations of arterial O2 tension, but 9 of them died within 4 h. After application of both the surfactant supplement and the PEEP, six out of the eight rabbits survived for more than 11 h with nearly normal values of blood gases and compliance. We concluded that the combination of the transtracheal surfactant supplement and ventilation with PEEP has favorable therapeutic effects on surfactant deficiency.

Experimental and clinical studies were made of the localization and morphology of anastomotic intimal hyperplasia (AIH) at the end-to-side anastomosis in relation to flow disturbances. In vitro experimental findings showed that boundary layer separation (BLS) became prominent as proximal outflow segment (POS) flow increased. An aorto-right iliac bypass was performed on 30 dogs using 22 Biografts, 3 EPTFES and 5 Dacron grafts. Distal end-to-side anastomoses were made at 3 different angles, i.e., 30 degrees (Group I), 90 degrees (Group II) and 150 degrees (Group III). BLS was likely to occur at the toe in Group I because POS flow exceeded 50%, while not in Group III. Up to 35 months observation, AIH was noted to develop at the toe 36% in Group I, 25% in Group II but in none in Group III. Thirty five reconstructions using Biograft in which angiography was performed later than 6 months postoperatively were chosen for clinical study. Invariably in all cases of AIH occurring following a femoropopliteal bypass, severe stenosis was noted to occur at the toe and heel of the distal end-to-side anastomosis. In conclusion, a disproportionate increase in POS flow was considered a likely cause of marked BLS and, consequently, an important precipitating cause of AIH. When POS flow exceeds 50%, a distal anastomosis dividing flow distribution should be considered as a salvage operation of potential usefulness.

Dextromethorphan, dimemorfan, dihydrocodeine and oxymethebanol, centrally acting antitussives, were examined for their effect on Ehrlich carcinoma cells and sarcoma-180 cells in vitro or in vivo. The tumor cells were suspended in Hanks balanced salt solution (pH 7.4) supplemented with 2% bovine albumin, and they were incubated with and without 1 mM drugs at 37 degrees C for 120 min. The incubation of the tumor cells with dextromethorphan or dimemorfan resulted in a decrease in the proportion of the viable cells (less than 25% after 120 min). However, no significant change was observed in the proportion of the viable tumor cells during the incubation with and without the other drugs (80-83% after 120 min). In addition, mice given the tumor cells i.p. were injected intraperitoneally with drugs (20-80 mg/kg/day) once daily for 5 successive days, and their survival time was observed. There was a slight difference in the survival time between mice treated with and without dextromethorphan or dimemorfan. However, a significant difference was found in the survival time between mice treated with and without dextromethorphan when mice given Ehrlich carcinoma cells were injected with the drug (40 mg/kg/time) twice a day for 5 days (about 18 days and 29 days). These results indicate that dextromethorphan and dimemorfan are cytotoxic to the tumor cells in vitro and in vivo.

Immunohistochemical localization of ornithine aminotransferase (L-ornithine: 2-oxo-acid aminotransferase, EC 2.6.1.13), a mitochondrial enzyme whose hereditary absence induces gyrate atrophy of the choroid and retina, was elucidated by a direct immunoperoxidase method using Fab'-horseradish peroxidase conjugates. In immunodiffusion studies, the antibodies raised with the re-crystallized enzyme were highly specific to ornithine aminotransferase. To show localization of ornithine aminotransferase in normal rat tissues, clear immunohistochemical staining of this enzyme through the inner mitochondrial membrane in paraffin sections was achieved with Fab'-horseradish peroxidase conjugates. Strong immunoreactivity was present in cerebral neurons, hepatocytes, and epithelial cells of renal tubuli, gut mucous membranes, and ocular tissues. Specific distribution of ornithine aminotransferase was found in ependymal cell groups: namely, epithelial cells of the choroid plexus, pigmented and nonpigmented epithelial cells of the ciliary body. and Müller cells and pigment epithelium of the retina.

Oosponol (4-hydroxymethylketone-8-hydroxyisocoumarin) is a metabolic product isolated from Oospora astringens which originated from house dust in a room of an asthmatic patient. The compound and the structurally related isocoumarins were studied to determine the inhibition of histamine release induced by compound 48/80 from isolated rat peritoneal mast cells. The released histamine was assayed by fluorometry. The compounds tested were not observed to release histamine. Some of 4-acyl-isocoumarins inhibited the histamine release at doses less than 10 micrometers, whereas the 3-acyl- and the 4-alkyl-compounds were not effective at doses over 100 microns. The pretreatment of mast cell with the compound for 15 min before the application of compound 48/80 was more effective than the simultaneous administration. The mode of inhibitory action of KIT-302, 4-(4'-carboxy-benzoyl)-isocoumarin, was non-competitive antagonism to compound 48/80 on the mast cells.

Preparations 60F and 50F isolated from the cell-free extract of anticancer hemolytic streptococci possessed not only anticancer activity but hemolytic activity. Thus, the experiment to separate hemolytic substances from 60F and 50F were carried out. Three kinds of fractions were obtained from 60F or 50F by dissolving them in ammonium sulfate solutions of various concentrations. These fractions were named 60F-I, 60F-II and 60F-III, and 50F-I, 50F-II and 50F-III, respectively. 60F-I and 50F-I possessed neither anticancer activity nor hemolytic activity. 60F-II and 50F-II possessed only anticancer activity, and 60F-III and 50F-III possessed only hemolytic activity. Thus, hemolytic substances were separated from 60F and 50F, and it was demonstrated that the anticancer activity of hemolytic streptococci was not due to their hemolysins or hemolytic activity.

A 45-year-old male with incomplete type of Behçet's disease was operated on because of abdominal aortic aneurysm. The post-operative course was uneventful. On twenty-one months after discharge, the patient noticed left leg pain and tarry stool, and was referred to our hospital. Computed tomography and angiography showed aorto-enteric fistula at the proximal aortic anastomotic site. Aortic reconstruction was performed, but the patient died on 36th post-operative day. We analysed the reports of 95 cases of aneurysm associated with vasculo-Behçet's disease in Japan. This series comprised 82 men, 9 women and 4 unknowns. The cases were classified to four groups, which were incomplete type (48 cases), complete type (27 cases), suspected type (12 cases) and unknown (8 cases). They had 46 aortic aneurysms and 108 peripheral aneurysms. Operation was performed on 29 aortic aneurysms and 73 peripheral aneurysms. Eleven aortic aneurysms and twelve peripheral aneurysms had anastomotic complication post-operatively. Four cases after reconstruction of abdominal aortic aneurysm was complicated with aorto-enteric fistula. They were all dead post-operatively. Vasculo-Behçet's disease with aortic aneurysm is comparatively a rare entity and morbidity and mortality is high because of its etiological characteristics.