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The characteristics of 59 chest roentgenograms of patients with primary pulmonary hypertension were investigated and compared with roentgenograms of 100 healthy control subjects. The relationship with pulmonary hemodynamics was also examined. In primary pulmonary hypertension, there was remarkable protrusion of the main pulmonary artery; the DPA (T/2) and the PL/T index (see text) had high values. These indices depend mainly on pulmonary hypertension, but are partially determined physically by the size of the individual heart. The width of the descending branch of the right pulmonary artery (dPA) was about double the control value (P less than 0.001). The cardiothoracic ratio was significantly increased in primary pulmonary hypertension and there was a positive correlation between the ratio and the mean right atrial pressure (r = 0.37, P less than 0.01). However, there was no correlation with pulmonary arterial pressure or other pulmonary hemodynamic parameters. These results indicate that the increase in the cardiothoracic ratio in primary pulmonary hypertension is caused mainly by right heart failure.

In Sprague-Dawley rats kept under 14L:10D (lights on 05:00-19:00 h), parturition occurred during the light phase on Day 23, and the pre-partum decrease in progesterone concentrations was observed between 07:00 and 15:00 h during the light period on Day 22. When the rats were transferred to reversed light-dark regimen (lights on 17:00-07:00 h) on Day 7, the progesterone decrease and parturition still occurred during the light period on Day 21 and 22-23, respectively. However, when rats were kept in constant darkness from Day 7, parturition occurred independently of the time of day between Day 22 and 24. A gradual decline of progesterone concentrations was randomly observed in individual rats. In Wistar rats kept under the usual light-dark regimen, parturitions were biphasic, occurring during the light periods on Day 22 and 23. The progesterone decrease occurred at the usual time even when the lighting regimen was changed only on the day of the expected progesterone decrease. However, treatment with pentobarbitone sodium at 15:00, 19:00 or 21:00 h, but not at 12:00 or 23:00 h, on Day 21 resulted in a delay of progesterone decrease and of parturition. Complete lesion of the suprachiasmatic nucleus on Day 13 or 14 led to advancement and random distribution of the time of birth. These results suggest that the time of parturition and of pre-partum progesterone decrease may be closely associated with an endogenous circadian system, and a luteolytic factor involving the nervous system may be present during a limited period before parturition.

Two cases of moderately retarded adolescents with affective disorders have been treated for nine and five years, respectively. Rapid cycling episodes were seen in early adolescence and a long duration of episodes appeared in late adolescence. A two-year lithium therapy was able to control them fairly well but did not work as a prophylaxis. Lithium carbonate induced polydipsia or personality change.

APA is a common cause of constipation, and is the mild case of the imperforated anus. On diagnosing APA, anterior displacement of the anus and normal distribution of the external anal sphincter to the anus are essential. To determine the location of the anus in the perineum simple clinical technique was developed. In 61 normal cases, the result of measurement was almost same in each sex, but in 3 APA cases the location were anteriorly dislocated than normal cases. Distribution of the external anal sphincter was evaluated with electromyographic technique, and location map of the sphincter was made. In 3 APA cases, the anus was totally surrounded by the external anal sphincter, but in 17 ano-cutaneous fistula cases, the opening was anteriorly dislocated to the sphincter distribution map. As a conclusion, newly proposed simple clinical technique to determine anal location and electromyographic examination of the external and sphincter distribution are very useful in objective diagnosis of APA.

To clarify the effect of a cholinergic agent on free-running period of circadian rhythm, locomotor activities were continuously recorded in the rat implanted with a paraffin pellet mixed with or without carbachol near the suprachiasmatic nucleus. Implantation of carbachol, but not paraffin alone, resulted in shortening of the free-running period under constant darkness.

Hepatitis B virus (HBV), transmitted by hepatitis B e antigen (HBeAg)-positive mothers by intrauterine infection, infecting newborns, is closely related to signs and symptoms associated with miscarriage. However, no correlation was observed between intrauterine infection of infants and the presence of antibodies of immunoglobulin M (IgM) class antibodies against hepatitis B core antigen (anti-HBc) in maternal blood, nor was HBeAg found in maternal or cord sera. These results indicate that contamination by the mother's blood, through placental leakage, plays an important role in HBV infection in utero. Without placental leakage, maternal blood could not pass through the placenta and enter fetal circulation, and so intrauterine infection would not occur, even if very high titers of hepatitis B surface antigen (HBsAg) and HBeAg were present in maternal blood.

Delayed primary operation has been started since 1982 in our department and 19 cases of solid tumor in childhood were treated with this method. They included 11 cases of advanced neuroblastoma, 5 cases of hepatoblastoma and 3 cases of yolk sac tumor in sacrococcygeal area. We discussed effectiveness of preoperative chemotherapy to the primary tumor and metastatic lesions, the best timing of operation after chemotherapy and the operative technique in delayed primary operation. Preoperative chemotherapy were useful in almost all cases of delayed primary operation, so the primary lesion and lymph nodes metastases were removed easily. We recommended it was the best timing of operation when 2 or 3 courses of preoperative chemotherapy were finished. CUSA (Cavitron Ultrasonic Surgical Aspirator) was the useful instrument to remove the primary tumor and lymph node metastases completely in advanced neuroblastoma preserving both kidneys.

The kinetics of cytotoxic T lymphocytes (CTL) in a patient with stage IV-S neuroblastoma were examined for 2 months. CTL were detectable during the preoperative and postoperative periods in this stage IV-S neuroblastoma patient, in spite of the tumor-bearing condition. Furthermore, the patient's mother showed the same level of CTL. This experiment suggests that patients with stage IV-S neuroblastoma have a constantly high level of CTL, and that this immunologic response is predominantly hereditary.

The Antineuroblastoma monoclonal antibody CNM-5 was submitted to preclinical studies and then used for tumor imaging with following results. 1. CNM-5 is an antibody which belongs to the IgM fraction and has a molecular weight of 900 kilodaltons. Its protein concentration was found to be 17.99 mg/dl. 2. The 131I-labeled antibody was injected into nude mice transplanted with human neuroblastoma, and imaging was performed by a gamma camera. Accumulation of 131I in the tumor was relatively clearly seen. Various organs were removed and examined for 131I uptake. Radioactivity was easily detected in the tumor, suggesting that CNM-5 is effective for use in imaging diagnosis of neuroblastoma.

A quantitative analysis of episodes and symptom-free intervals in the course of manic-depressive psychosis was attempted. 1,066 patients who visited Tohoku University Hospital between 1955 and 1965 were investigated by a mail questionnaire and subsequent review of records in their care hospitals. There was no difference between the reply group and non-reply group in terms of demographic status. About 6.2% of patients were chronically ill. Eighteen percent of patients were dead at the time of study. The number of episodes was about three in depression and about seven in bipolar type during twelve years of observation. The length of symptom-free interval between episodes was about five years in depression and two years in bipolar type. There was no difference in the number of episodes or in the length of interval between 1955-1959 group and 1960-1965 group. The change of length was not confirmed between early and late intervals.