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Recent advances in analysis technology have revealed that non-coding RNAs(ncRNA)that are not translated and function as RNA itself. It has been revealed that long ncRNA(lncRNA), which has more than and 200 nucleotides, is involved in the regulation of fate decision in neural stem cells. In this article, we introduce some functional lncRNAs regulating neural stem cells and discuss the future perspective about this field.

The efficacy of cefepime (CFPM) is known to depend on the ratio of the time that the serum levels exceed the minimum inhibitory concentration (MIC) to the dosing interval (%T>MIC). The objective of this study was to clarify the relation between %T>MIC and clinical outcome of CFPM, and to identify the optimal dosage regimen. We investigated the outcome of CFPM treatment for febrile neutropenia (FN) patients with normal renal function. Treatment success was defined as the completion of FN therapy with CFPM only. And we calculated %T>MIC for each case based on population pharmacokinetic parameters. The MIC value for simulation was set as 8 μg/mL. In logistic regression analysis, treatment success was significantly associated with the elevation of %T>MIC in the group with persistent neutropenia, yielding a receiver operating characteristic curve with an optimal cutoff value of 73.1%. Next, we simulated %T>MIC for each case under various dosing regimens. For patients whose creatinine clearance (CLcr) exceeded 100 mL/min, it was found to be difficult to attain the objective under the current regimen. In contrast, it was calculated that treatment with 2 g three times a day (t.i.d.) could attain the objective for most of the patients with 3 h of infusion. These results suggest that CFPM treatment under the current regimen is ineffective for FN patients with normal or augmented renal function, and that 2 g t.i.d. is necessary in quite a lot cases, although such use is off-label.

A 51-year-old man was admitted to our hospital complaining of right upper quadrant abdominal and back pain. Severe hepatomegaly (six fingerbreadths) was detected by liver palpation. Blood test results showed cholestatic liver disease. He was diagnosed with amyloidosis by liver biopsy. Bone marrow aspiration revealed 15% of contents to be plasma cells. BJPκ was detected by urine electrophoresis. Therefore, he was diagnosed with the BJPκ type of multiple myeloma with systemic amyloidosis. The patient was treated with bortezomib, dexamethasone and high-dose melphalan with autologous peripheral blood stem cell transplantation. He achieved VGPR (very good partial response) after transplantation. Hepatomegaly improved but swelling persisted, and he was therefore treated with 1.3 mg/m(2)/day of bortezomib and 20 mg/day of dexamethasone on day 1 and day 15 in 28-day cycles. Upon finishing 22 cycles in June 2014, his liver had returned to normal size. Restoration of normal liver size after treatment is rare in cases with severe hepatomegaly due to systemic amyloidosis. We thus report our case with a review of the relevant literature.

Purpose: To report the ophthalmic relief activities conducted by Iwate Medical University after the Great East Japan Earthquake of March 11, 2011., Subjects and Methods: A retrospective review was conducted of the medical records of patients who visited emergency ophthalmic clinics opened at Yamada-cho, Otsuchi-cho and Rikuzentakada-shi from March 30, 2011 to June 30, 2011., Results: We provided ophthalmic medical care for 14 days at Yamada-cho and Otsuchi-cho, and for 9 days at Rikuzentakada-shi. During this period, 1371 new patients (total of 2015 patients) visited the clinics. The main motives were a desire for prescription of medication, treatment of ocular symptoms and correction of refractive error and presbyopia. The major diseases were cataract, pseudophakia, refractive error, presbyopia and conjunctivitis. Only a few patients had a foreign body in the eye or ocular trauma. Among the 207 patients with contact lenses, 24 patients were wearing them beyond their replacement date, and contact lens care was insufficient in 35 patients. Among 179 patients with glaucoma who were checked for intraocular pressure, 61 patients had an IOP greater than 21 mmHg., Conclusions: Although many patients sought eye drops for chronic eye diseases and correction of refractive error and presbyopia, patients with ocular injuries were few. It is important to prepare for whatever needs patients in emergency circumstances may present.

We report a case of tumefactive demyelinating lesion (TDL) diagnosed using (1)H-magnetic resonance spectroscopy (¹H-MRS) and conventional magnetic resonance imaging (MRI). A 7-year-old girl was admitted to our hospital with complaints of sleepiness and clumsiness of the right limbs. Neurological examination showed somnolence, right-sided apraxia, and hemiparesis with enhanced tendon reflexes and Babinski sign. Conventional brain MRI revealed extensive hyperintensity in the subcortical white matter of the left frontal lobe in both T₂ weighted and fluid attenuated inversion recovery images. Gadolinium-enhanced T₁ weighted images showed a tumor-like lesion in this area with interrupted rim enhancement, termed open ring sign, and a periventricular lesion along the inferior horn of the right lateral ventricle and a juxtacortical lesion under the right motor cortex. In ¹H-MRS, both single voxel spectroscopy (SVS) and chemical shift imaging showed elevation of choline and reduction of N-acetylaspartate in the left frontal lobe lesion. Furthermore, SVS with a short echo time revealed elevated peaks for glutamate/glutamine complex in this lesion. These results suggested the demyelinating nature of this tumor-like lesion, in accordance with the concept of TDL. Based on this diagnosis, we treated the patient with three sets of methylprednisolone pulse therapy, which resulted in the reduction of TDL and neurological improvement. A follow-up study using MRI also demonstrated two more lesions in the corona radiata and internal capsule of the left hemisphere, supporting a diagnosis of multiple sclerosis based on the revised McDonald's criteria (2010). We concluded that ¹H-MRS may be beneficial in the differential diagnosis of TDL.

Purpose: The purpose of this study was to evaluate the effectiveness of endovascular stents placed in the peripheral veins of hemodialysis shunts., Materials and Methods: 156 endovascular stents were placed in the peripheral veins of 155 hemodialysis shunts with 220 stenoses. Among these, 106 stenoses of 93 hemodialysis shunts had been treated by percutaneous transluminal angioplasty (PTA) before stent placement., Results: The initial success rate was 97.7%. Primary radiologic patency rates of the stents at 6 months, 1 year, and 2 years were 69.8%, 49.1%, and 45.8%, respectively. Secondary radiologic patency rates at 1 year, 2 years, and 3 years were 94.0%, 91.8%, and 88.0%, respectively. Primary clinical patency rates at 6 months, 1 year, and 2 years were 64.4%, 43.4%, and 27.3%; while secondary clinical patency rates at 1 year, 2 years, and 3 years were 93.5%, 86.5%, and 73.4%, respectively. Radiologic and clinical primary patency rates of 106 stenoses and 93 hemodialysis shunts were significantly higher than those of PTA that had been performed before stents were placed., Conclusion: Stent placement for stenoses of the peripheral veins of hemodialysis shunts recurring in three months and treated by PTA alone can improve long-term patency.

Purpose: The purpose of this study was to investigate the behavior of the photopic negative response(PhNR) of cone-induced electroretinogram (cone ERG) in patients with normal-tension glaucoma (NTG)., Methods: Cone ERGs were recorded from 30 eyes of 30 patients with NTG according to the recording conditions of the International Society for Clinical Electrophysiology of Vision protocol which is now widely used in clinics. The amplitudes and implicit times of the PhNRs were measured and compared with normal controls. I further attempted to find a correlation between the PhNR amplitude loss and the cupping/disc ratio representing a loss of the nerve fiber layer and severity of visual field defbct., Results: The PhNR amplitudes recorded from patients with NTG were significantly reduced compared with those from normal subjects (p < 0.05). However, the PhNR amplitude loss did not correlate with the cupping/disc ratio or the severity of visual field defect., Conclusions: The Results suggested that the PhNR amplitude qualitatively reflected ganglion cell loss in patients with NTG even under recording conditions which are widely used in the clinical field.

The patient, who is received home enteral nutrition (HEN) for a long time in a day, has problems on moving all days. Now, we tried Portermate, which is new portable devices for HEN, in his clinical care. The patient is chronic pancreatitis, and his clinical problems becomes to be worse after he ate. He was under total enteral nutrition via jejunostomy. His clinical complications were almost controlled after HEN, but he has a few complains receiving enteral nutrition. He would not move easily, for an old HEN system was not compact to move. Portermate made him go everywhere he wanted any time. It extremely improved his QOL under HEN. He continues to use Portermate.

Of 227 esophageal carcinomas treated with a radiation dose of 60 Gy or more, 100 patients had no tumor or ulceration (with or without stenosis) of the esophagus after irradiation. We analyzed local control factors of these 100 patients to determine the need for further treatment. The cumulative local control rate at five years was 40% in all cases, 37% in 21 cases without any stenosis of the esophagus and 40% in 79 cases with stenosis. The presence of stenosis of the esophagus after irradiation was not a critical factor in predicting final local control. Local recurrence of tumors with findings of Borrmann III or Borrmann IV by the pretreatment esophageal barium study, tumors controlled after a total dose of more than 80 Gy, tumors without low dose rate telecobalt therapy (LDRT; 1 Gy/hour, 5 to 7Gy/day, a total dose of 12 to 15 Gy) as boost therapy, and apparently controlled tumors with a stenotic ratio of 60% or more or with 5 cm or more length of stenosis of the esophagus after irradiation was significantly higher than that of the others (p < 0.05). Multivariate analysis revealed that findings of pretreatment barium study, total dose, with or without LDRT, and length of stenosis of the esophagus after irradiation were significantly important factors in local control. Members of the high risk group of apparently controlled tumors should undertake surgical treatment or further intensive chemotherapy.

Forty care-takers providing in-home care of elderly CVD patients were assessed with Zung's depression test and the following results were obtained. 1. Most of the care-takers were female with a mean age of 56 years (41 to 81 years). 2. Scores on Zung's test were higher, but non-significantly, for the care-takers providing longer care compared to those with shorter experience. 3. Higher scores on Zung's test were related to care-takers' perceived burden in managing patient excretory discharges and with being unemployed.

Between April 1975 to March 1991, 17 patients (5 man and 12 women, mean age 49.8 years old) underwent surgical treatment for cardiac myxomas. Fifteen patients had left atrial myxomas, and the other 2 had the ventricular myxomas (left ventricular myxoma 1 and right ventricular myxoma 1). In cases with left atrial myxomas, the tumor was resected through the transatrial approach alone in 12 patients, and the left atriotomy was added in other 3. Left ventriculotomy was required to resect the left ventricular myxoma in addition to the atrial approach. Right ventricular myxoma, which attached the outflow tract, could be removed through the small right vertical ventriculotomy. All patients recovered well, and there was no recurrence in any patient during the follow-up period.

The surgical indications for localized brain stem lesions were evaluated retrospectively through the clinical results of 14 patients: 5 cavernous angiomas and 9 gliomas. Cavernous angiomas were located in fourth ventricle floor (2 cases), in dorsal midbrain (1 case), in right cerebellar peduncle (1 case), and in medulla oblongata (1 case). Those cases had direct surgery because of relapse of clinical symptoms and enlargement of the lesions on follow-up MR imagings. Each lesion was extirpated totally. Consequently, the majority of neurological deficits before operation improved. Therefore, radical extirpation in brain stem cavernous angioma was strongly recommended. Also, total, subtotal resection was performed for gliomas localized in brain stem: 2 low grade astrocytomas, 3 malignant astrocytomas, 3 plexus papillomas, and 1 ependymoma. Most of cases improved without new neurological deficits after surgery. In addition, MR imaging was considered to be essential to accurate diagnosis and surgical strategies for brain stem lesions.

We investigated the effect of nicardipine and diltiazem on adrenal catecholamine releases, and compared it with the effect of nitroglycerin in dogs. A 35% reduction in mean arterial pressure was achieved and maintained for 45 minutes. The dogs were observed until 60 minutes after the discontinuation of drug infusions. Adrenal catecholamine releases increased during hypotension with continuous administration of nicardipine, diltiazem and nitroglycerin, but they showed no significant differences between each drug. There was no more increase in adrenal catecholamine releases in spite of additional nicardipine administration. These results suggest that Ca2+ antagonist such as nicardipine directly inhibits the catecholamine releases from the adrenal glands.

The correlation between somatosensory evoked potential (SEP) and regional cerebral blood flow (rCBF) changes after acetazolamide administration was studied in six patients presented with transient ischemic attack (TIA) or minor completed stroke. All patients had no or only localized low density area on computed tomography, and severe occlusive disease in the ipsilateral common or internal carotid artery on cerebral angiography. In two patients with internal carotid artery occlusion, both marked decrease in ipsilateral N20 amplitude and prolongation of ipsilateral N20 latency were observed from 5-10 minutes after acetazolamide injection. These changes gradually improved and resolved 30-45 minutes after acetazolamide injection. In these cases, stable xenon CT revealed paradoxical rCBF decrease in the territory of the ipsilateral middle cerebral artery after acetazolamide injection. Especially, rCBF in the ipsilateral centrum semiovale fell to less than 20 ml/100 g/min. The other patients showed no change in SEPs and no paradoxical decrease in rCBF after acetazolamide injection. These results suggest that SEP test with acetazolamide loading could be valuable to evaluate a certain group of the patients with severely disturbed cerebral perfusion reserve in the carotid territory and suitable candidate for extracranial-intracranial arterial bypass (EC/IC bypass), although further investigations is needed.

An accurate and simplified method has been developed for determination of residual ethylene oxide (EO) in the endotracheal tube using gas chromatography with a head space sampler. The endotracheal tube made of polyvinyl chloride was sterilized with EO and aerated. Residual EO after aeration was 6630 +/- 1915 ppm (mean +/- SD). It decreased to 72 +/- 46 ppm on 7th day. The endotracheal tube should be left unused for more than 7 days after sterilization and aeration. The safety level of residual EO in the endotracheal tube by U.S.FDA regulation is less than 250 ppm. The concentration of residual EO should be lower than 250 ppm, if this rule is observed.

SEP (somatosensory evoked potential) monitoring was carried out on seven patients with vertebro-basilar aneurysms during balloon occlusion test, during operation, or after operation. In the patient (case 5) with basilar tip aneurysm, the amplitude of N20 remarkably decreased and this finding closely correlated with disturbed consciousness during transient balloon occlusion of the basilar artery. In another patient (case 6) with vertebral dissecting aneurysm, cerebellar retraction caused transient prolongation of N20 latency during operation. In another case, postoperative SEP monitoring revealed marked reduction of N20 amplitude in the patient (case 7) who showed disturbed consciousness and bilateral oculomotor palsy after operation for basilar aneurysms, but who showed no abnormality in postoperative ABR (auditory evoked brainstem response). The other four patients showed no neurological deterioration and no SEP change during transient balloon occlusion of the parent arteries. Because of the high rate of "false-negative" findings, it remains unclear whether SEP monitoring during surgery for vertebrobasilar aneurysms is of value to predict postoperative deficit due to brainstem ischemia. In our study, however, the changes of SEP were well correlated with neurological deterioration and/or the location of postoperative infarction. In conclusion, SEP monitoring during balloon occlusion tests or operations for vertebro-basilar aneurysms is considered to be useful in predicting ischemic complication of the brainstem caused by the occlusion of the parent artery. However other methodologies have to be developed in order to monitor the pyramidal tract and reticular activating system of the brainstem more accurately.

A 73-year-old man complained of pain in his right ear with vesicular lesion for three days. He complained of no weakness of facial musculatures, but muscle test revealed slight weakness in orbital and oral muscles on admission. His hearing acuity of the left ear was intact. Vertigo with spontaneous nystagmus to left was complained. The patient was treated with stellate ganglion block four times a day, prednisolone 80 mg a day p.o. and acyclovir i.v. Mannitol solution 300 ml a day for eight days was given i.v. to reduce edema and to protect facial nerve. On his 3rd hospital day, his paralysis progressed and he could not close his eye or whistle with his mouth. Evoked myogram showed 91% impairment of the nerve. During recovery period there was discrepancy between facial palsy score of clinical signs and degree of nerve impairment by evoked myogram. On his 12th hospital day his facial nerve score improved 9 to 12 (0 complete paralysis, 40 no paralysis) but evoked myogram showed further progress of nerve impairment from 86% to 91% (Evoked wave heights were 14% and 9% of normal site respectively). The discrepancy is probably because facial palsy score reflects also neurapraxia of inflammatory nerve, and stellate ganglion block has no effect on changing course of facial nerve injury.

We compared two methods of respiratory managements during bronchoplasty surgery. In one lung ventilation group (OLV-G), 10 patients were ventilated with Broncho-cath tube or Univent tube. On another 10 patients, ventilation was performed with Univent tube following insertion of bronchial blocker into main bronchus of dependent lung. Dependent lung was then ventilated using high frequency jet ventilation (HFJV) through bronchial blocker superimposed with low tidal volume IPPV (selective HFJV, S-HFJV-G). Oxygenation index (O.I.) of S-HFJV-G was significantly higher than that of OLV-G when bronchus was open. These phenomena might have occurred through prevention of pulmonary blood flow shift to the non-dependent lung when S-HFJV was used.

Hepatitis B virus carriers, a 30-year-old man (case 1) and a 31-year-old man (case 2), associated with nephrotic syndrome were treated with interferon-beta. The nephrotic syndrome did not respond to corticosteroid therapy. Their HBs-Ag, HBe-Ag and HBc-Ab were positive. Renal biopsies revealed membranous glomerulonephritis in case 1 and mixed membranous and proliferative glomerulonephritis in case 2. Direct immunofluorescence studies showed strong granular staining of the GBM with IgG and using sandwich technique with anti-HBe antiserum, granular deposits were seen throughout the GBM. Patients were administrated mainly 3-6 x 10(6) IU/day interferon-beta intravenously for four weeks. After transitory elevation of serum transaminase, HBe-Ag and DNA-polymerase have disappeared with development of HBe-Ab (seroconversion) about six months after the end of interferon-beta administration. Then nephrotic syndrome has recovered in incomplete remission after a year and a half follow-up. The secondary renal biopsy in case 1 showed less intense deposits of HBe-Ag along GBM. These facts suggest that the improvement of proteinuria is associated with the decrease in HBV replication due to interferon therapy.

A 56-year-old man (160 cm, 64 kg) having right visual field defect due to obstruction of the central retinal artery for 6 months was treated with stellate ganglion block and electric acupuncture. His visual field improved slightly immediately after preliminary treatment with stellate ganglion block and electric acupuncture judging from perimeter recording and his complaints. Stellate ganglion block on every day and electric acupuncture on every other day were performed for 10 days and there after these treatments were done two times a week. Twenty days after starting the treatment, his visual field improved on his perimeter examination. We discussed that the cause of improvement was activation of slept cone cells which needed more energy for activation than rod cells by increasing retinal blood flow with stellate ganglion block and electric acupuncture. We recommend vasodilating treatments such as stellate ganglion block and electric acupuncture for visual field defect due to obstruction of central retinal artery even in chronic state.

A 58 year old man had been suffering from intractable left ophthalmic post herpetic neuralgia (PHN) for 7 years. He has also been treated for polyarteritis nodosa for 10 years. For pain relief, he was treated initially with frequent (4 times a day) stellate ganglion block (SGB) and peripheral ophthalmic nerve block for a month without relief. Then supraorbital nerve block with neurolytics, TENS and acupuncture were done with a slight relief of his pain. Recently his pain became worse even with imipramine 75 mg and carbamazepine 100 mg a day which relieved effectively the patient from the pain for the last 3 years. The pain was so severe to disturb his usual daily activity. Gasserian ganglion block with methyl prednisolone acetate 10 mg was done. After the block, his ADL improved markedly. Three months after the block, he had no spontaneous pain and slight pain with light touch on the injured skin did not annoy him. Several days before the block, electric stimulation to control his pain was tested. Stimulation with the electricity (4.5 mA, 10 cycle and 400 microseconds) brought him complete relief from the pain during the stimulation. Trigeminal SEP showed no response to the stimulation of injured skin.

From 40 patients under surgical operation, gastric or bile juice was obtained to determine the possible excretion of free and conjugated catecholamine (CA) into the two kinds of juice. The patients were divided into normal renal function group and chronic renal failure group and former group was further divided into the dopamine (DA)-administered group and the non-DA-administered group. In the non-DA group with normal renal function, the gastric juice contained 0.30 +/- 0.11ng.ml-1 of free and 0.12 +/- 0.06ng.ml-1 of conjugated norepinephrine (NE) and also 0.09 +/- 0.07ng.ml-1 of free and 0.40 +/- 0.10ng.ml-1 of conjugated DA. In DA group, the gastric juice contained 2.01 +/- 0.41ng.ml-1 of free and 3.66 +/- 0.84ng.ml-1 of conjugated DA respectively. Significant differences in DA were observed between two groups. In the bile juice, the conjugated NE increased significantly from 0.15 +/- 0.05 ng.ml-1 to 1.24 +/- 0.34ng.ml-1 and also the conjugated DA increased significantly from 2.17 +/- 0.77ng.ml-1 to 21.33 +/- 5.23ng.ml-1 by infusion of DA at the rate of 2 micrograms.kg-1.min-1 for 197 +/- 48min. In chronic renal failure group, the conjugated NE and DA increased significantly to 1.04 +/- 0.27ng.ml-1 and 1.64 +/- 0.61ng.ml-1 respectively compared to that of normal renal group. It was confirmed that gastric juice and bile juice contain the free and conjugated CA during surgical operation and by the infusion of DA, free and conjugated DA are excreted into gastric juice and bile juice and also conjugated CA in the gastric juice from chronic renal failure group is increased.

Difficulty to determine level of spinal or epidural anesthesia troubles us in the patients who can not communicate well, for example in patients with hearing loss, depressed CNS with or without depressants and in slowly replying patients with various reasons. We know that one can determine spinal or epidural anesthetic level with stroking the skin with finger with which we can detect different touch sensation, feeling as anesthetized smooth and unanesthetized rough. We thought that different touch sensation is due to perspiration at unblocked skin area. If cause of difference of touch sensation was due to perspiration at unanesthetized area as we thought, perspiration may be visible on unblocked area. We found no perspiration but texture change on the anesthetized skin. We photographed the texture of the blocked skin, before and after spinal anesthesia. The skin texture after the block became shallow and widened. These texture changes give us different touch sensation, rough and scratched before and smooth after the block. We can easily differentiate the blocked from the unblocked skin area with finger or by magnifying glass by which the skin texture change is visible.

We evaluated the efficiency of a newly developed cassette EEG recording device and our system for detecting and analyzing ictal EEGs in epileptic children. We got 13 ictal records from 16 epileptic children. We could precisely differentiate and diagnose their classifications of seizures by comparative analyses of ictal records and clinical symptoms. We discussed the characteristics of our system, and described actual analysis methods in 3 cases as examples. It was concluded that our system offered valuable information about ictal events in epileptic children.

A 62-year-old woman complaining of asymptomatic hematuria was hospitalized. Although a cytologic examination of the urine was negative, abnormal findings in the right renal pelvis by DIP, RP and CT led us to suspect a pelvic tumor, and a right nephroureterotomy was performed. Light microscopy revealed deposits of amorphous, eosinophilic material in the pelvis and proximal portion of upper ureter, however tumor cells were not found. Electron microscopy revealed that these materials were aggregates of linear, non-branching fibrils, measuring about 8 nm in diameter. Histochemically, these were seen to be consistent with amyloid, producing an apple-orange birefringence with Congo red staining under a polarized light. Alkali Congo red staining after pretreatment of KMnO4 demonstrate that this amyloid protein was composed largely of AA protein in addition to lesser amounts of non-AA protein, and a primary localized amyloidosis (amyloid tumor) was diagnosed. A clinicopathologic study that was performed on 12 cases of primary localized amyloidosis of the pelvis, including our case, also is reported.

The topical and systemic anti-inflammatory activities of hydrocortisone 17-butyrate 21-propionate (HBP) were studied. The systemic anti-inflammatory activities of HBP and reference steroids were examined for their effects on dinitrochlorobenzene dermatitis, carrageenin edema, cotton pellet granuloma and adjuvant arthritis in rats and by the delayed allergic edema test in mice. The topical anti-inflammatory activities of these steroids were examined for their effects on croton oil dermatitis, croton oil ear edema, carrageenin edema and cotton pellet granuloma in rats. Furthermore, effects of these steroids on liver glycogen deposition in mice, thymolysis, and decrease of serum corticosterone level in rats were examined. Systemically administered HBP was less potent than betamethasone 17-valerate (BV), but was almost equal to hydrocortisone 17-butyrate (HB) in anti-inflammatory activity, and its effects on liver glycogen deposition, thymolysis, and the decrease of serum corticosterone level. However, the topical anti-inflammatory activity of HBP was more potent than that of BV and HB, although in the same experiment, thymolytic activity of HBP was less potent than that of BV, but was almost equal to HB. The inhibitory effect of HBP on hypotonic induced hemolysis was weaker than that of BV, but was stronger than that of HB in vitro. The affinity of HBP was higher than that of BV and HB to polymorphonuclear leucocytes used as the inflammatory cells in vitro. On the other hand no marked difference was observed in the affinity to erythrocytes used as the non-inflammatory cells in vitro. These results suggest that HBP is a useful drug which has superior topical anti-inflammatory activity, but has a weak systemic effect.

A rare anesthetic experience of a 30-year-old woman with acromegaly complicated with Basedow's disease is reported. After the thyroid function was successfully controlled by drug therapy, resection of pituitary adenoma was performed under general anesthesia. Anesthesia was induced and maintained with NLA. No problem was observed during the operation and postoperative period. Careful attention should be paid to the management of circulation, respiration, metabolism and endocrinium through the perioperative period.

It was considered that nonresponsiveness to hepatitis B surface antigen was in part due to a failure in the antigen recognition (i.e., antigens' phagocytosis, processing and presentation by accessory cells). In order to enhance the capture of antigens, we investigated the effect of simultaneous administration of HBs antigen and anti-HBs IgG on antibody responses in vitro and in vivo. As a result, in vitro sensitization of mononuclear cells from anti-HBs-positive subjects with HBs antigen and anti-HBs IgG induced significant amounts of anti-HBs IgG production in 5 of 6 cases, whereas sensitization with HBs antigen alone failed to induce the antibody production in most cases. In vivo administration of HBs vaccine and anti-HBs immunoglobulin to non-responders to the vaccine triggered active anti-HBs antibody responses in 3 of 7 cases in vivo and in 5 of 7 cases in vitro.