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Left ventricular systolic and diastolic performance was examined using Doppler and M-mode echocardiography in 42 patients with chronic renal failure before and after hemodialysis. Twenty patients with left ventricular hypertrophy, 22 without hypertrophy and 30 normal subjects were studied. Chronic renal failure patients showed significantly larger chamber diameters of the left ventricle, left atrium and right ventricle than did normal subjects. This group also exhibited greater fractional shortening, stroke volume and cardiac output. Before hemodialysis, patients with left ventricular hypertrophy had a significantly higher cardiac output and the greater ratio of late to early diastolic peak flow velocities (A/R) than did patients without hypertrophy. After hemodialysis, there were significant reductions in blood pressure, ventricular and atrial dimensions, stroke volume and cardiac output. The velocities of early and late diastolic left ventricular filling and the deceleration rate were also significantly reduced. The heart rate, A/R, deceleration half time, and the ratio of deceleration half time to acceleration half time (DHT/AHT) were significantly increased. The greater the amount of fluid removed, the greater the changes in the above values. Patients with left ventricular hypertrophy exhibited significant reductions in fractional shortening, ejection fraction, stroke volume and cardiac output, compared to those without hypertrophy. However, patients without hypertrophy showed more significant decrease in the acceleration half time and increase in DHT/AHT than did patients with hypertrophy. These findings demonstrated normal systolic function and impaired diastolic properties in patients with chronic renal failure, who had left ventricular hypertrophy unaccompanied by dilatation.

One hundred eighty consecutive male patients, mean age of 64.6 years, who were referred to cardiac catheterization for the evaluation of aortic stenosis (AS), were studied using a noninvasive scoring system. The system is based upon 7 variables including: 1) LVH by ECG, 2) aortic valve calcium by chest x-ray, 3) loudness of A2, 4) Q to peak of murmur, 5) T time of the carotid pulse, 6) LV ejection time and 7) LVH by echocardiography. The scoring system has a range from 0 to 16, and a score greater than or equal to 5 indicates severe AS (valve area less than or equal to 1.0 cm2). Eighteen patients had hemodynamic studies on two occasions. In 3 years progression of stenosis was evident by an increase in the mean aortic valve gradient from 23 +/- 3.4 mmHg to 44 +/- 4.2 mmHg (p less than 0.005). The aortic valve area decreased from 1.4 +/- 0.1 cm2 to 0.76 +/- 0.07 cm2 (p less than 0.005). Noninvasive scores increased in these patients from 2.1 +/- 0.5 to 7.6 +/- 1.0 (p less than 0.005). Fifty-one patients had repeated noninvasive studies. Twenty-two patients, who had mild AS at the initial evaluation, attained a score of greater than or equal to 5 in 3 years, indicating probable progression to severe AS. The mean initial score was 2.3 +/- 0.4, and the score at the end of the mean follow-up period of 3 years was 8.0 +/- 0.6 (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)

Using an in vitro colony forming assay system, cytotoxic effects of anticancer drugs, adriamycin (ADM) and peplomycin (PEP), and the combined effect of hyperthermia and anticancer drugs on cultivated KK-47 cells were investigated. From the response curves obtained at 42 and 43 degrees C hyperthermia, 20% growth inhibition time (IT20) at 42 and 43 degrees C hyperthermia and 50% growth inhibition time (IT50) at 43 degrees C were calculated. The IT20 and IT50 hyperthermia were combined with a 2-hour treatment of each of the anticancer drugs. When the hyperthermia was combined with various concentrations of ADM ranging from 0.005 to 0.1 microgram/ml, enhanced cell killing effects were obtained at the concentrations of less than 0.02 microgram/ml of ADM, whereas, there was no increase in cell killing effect at the concentrations of more than 0.05 microgram/ml of ADM. The combination of hyperthermia with PEP considerably enhanced the cell killing effects with an increase of PEP concentration.

The present study is a retrospective clinicoradiological correlative investigation of subarachnoid hemorrhage associated with ruptured aneurysms. There were 360 patients in whom the source of subarachnoid hemorrhage was shown by angiography to be a ruptured aneurysm, and 302 of them underwent surgery. Arterial vasospasm was demonstrated in 113 of 360 patients (31%). When the time relationship between the subarachnoid hemorrhage and vasospasm was considered, vasospasms were revealed in 35 patients (31%) to ten days after a hemorrhage. In these cases with preoperative vasospasm, 17 patients were operated within 14 days and 43 patients later than two weeks. On the examination, their clinical state was graded according to Hunt and Hess. The surgical results were also grade in five groups (excellent, good, fair, poor and died) according to the functional results at discharge from the hospital. Of 35 patients of grade I and II at operation, 23 patients (66%) were of excellent or good results. However, of 14 patients of grade IV and V at operation, only on patient took good result. Of 12 patient in whom severe vasospasm was demonstrated and surgery was delayed more than two weeks, 8 patients (66%) had good result. Postoperative vasospasm was recognized in 2 patients, who took poor result. Surgery was carried out in 32 patients on the first or second day after subarachnoid hemorrhage, and 7 patients (22%) of them took good result. The overall mortality was 59% (19 patients). In ten patients, surgery was carried out on the third or fourth day after subarachnoid hemorrhage. Five patients had good result (50%) and four (40%) died. Considering the relationship between the timing and result of surgery, the mortality was 35% in patients operated on in the first week, whereas there were only 38 deaths among the 252 patients operated on after that interval. Among the death patients who were in grade IV or V at admission, intracranial hematoma was seen in 73%. It was concluded that in patients classified as grade I or II, the operation should be performed as soon as possible to prevent another rupture. In grade IV and V patients with severe damage by large hematoma, the mortality and morbidity were high even after evacuation of the hematoma. Patients with marked and diffuse vasospasm should be given conservative treatment at first and then operated on when the patients condition becomes good.

To investigate the apparent association of mitral anular calcification (MAC) and electrocardiographic abnormalities, the relation between the location of two-dimensional (2D) echoquantified MAC and conduction disturbances was studied in 140 patients with MAC (MAC group) and 135 age- and sex-matched patients without MAC (control group). The MAC group was subclassified regarding the site and severity of calcium in the mitral anulus. The site of MAC was defined as Type I of MAC near the conduction system and Type II of MAC away from the conduction system. The severity of MAC was graded on 2D echocardiography as mild (localized within 1 segment) and moderate to severe (more than 1 segment). Seven patients with MAC, and only one control subject, had pacemakers in place. Conduction disturbances were present in 44 (31%) of 140 patients with MAC and in 37 (27%) of the 135 control patients (no significant difference). But there were more conduction disturbances in the patients with Type 1 MAC (53%) than in those with Type II MAC (26%) (p less than 0.01). Specifically, complete left bundle branch block and intraventricular conduction delay were more prevalent when MAC was near the conduction system. Intraventricular conduction delay also was more prevalent in the patients with Type I MAC than in the control group (Type I: 12% vs control: 4%; p less than 0.05). These data suggest that moderate to severe degrees of MAC located near the conduction system are associated with conduction disturbances, especially intraventricular conduction delay.

One hundred seventy-one patients with aortic stenosis (AS) who had hemodynamic studies were evaluated by a scoring system of the seven following noninvasive variables which our laboratory had developed to estimate the severity of AS: left ventricular hypertrophy (LVH) by ECG; visible aortic valve calcification by chest x-ray examination; loudness of A2; Q to peak of systolic murmur; T-time of the carotid pulse; LV ejection time; and LVH by M-mode echocardiography. The range of the severity score is 0 to 16, and a score greater than or equal to 5 has been shown correctly to identify 93 percent of patients with severe AS (valve area less than or equal to 1.0 cm2). The present study has applied this method to the detection of progression of AS. Eleven patients (mean age, 60.4 years) were studied who had hemodynamic studies performed two to nine years apart (mean, three years). Progression of stenosis occurred in all, with an increase in mean aortic valve gradient from 23 +/- 4.7 mm Hg to 46 +/- 6.5 mm Hg (p less than 0.005). Aortic valve area decreased from 1.5 +/- 0.18 cm2 to 0.88 +/- 0.10 cm2 (p less than 0.005). Noninvasive scores increased in these patients from 0.7 +/- 0.5 to 7.1 +/- 2.3 (p less than 0.005). Thirty-five patients (mean age, 62.4 years) had repeat noninvasive studies one to six years apart (mean 3 years). Twenty-two (63 percent) had an increase in the noninvasive score of greater than or equal to 3 points, and 20 (57 percent) attained a score of greater than or equal to 5, indicating probable severe AS. The mean initial severity score was 2.2 +/- 0.3, and at the end of a mean follow-up of three years, the score was 8.3 +/- 0.6 (p less than 0.005). It is concluded that in the elderly male, progression of AS over a three-year period occurs in about 60 percent of patients, and progression can be detected by simple, noninvasive methods.

Thirty-six colloid cysts were treated from 1949 to 1983. There were 26 male and 10 female patients, ranging in age from 12 to 65 years old, 60% between 31 and 40 years. Headache or disturbed mental function was the most frequent complaint, papilloedema the most frequent sign. The patients were classified into 3 groups by symptoms and signs; Group I (17 patients): Headache, papilloedema and no neurological signs. Group II (6 patients): Fluctuating or progressive dementia. Group III: Twelve cases with "classical" features, episodic headache and drop attacks. One patient could not be classified in any of these groups. Seventeen of 36 patients were diagnosed by ventriculography, 19 patients were diagnosed by CT scan. CT scan was the most reliable diagnostic study, but was unavailable in the earlier part of the series. All patients have been operated by transventricular exposure of the right foramen of Munro with incision of the middle frontal gyrus in an antero-posterior linear manner. Twenty-five of 36 patients showed an excellent operative result, and nine had a good result, one of the 9 patients dying of an unrelated intracerebral haemorrhage 4 years after operation. Two patients had a poor result, characterized by memory loss and confusion. One of these died of an unknown cause 5 years after operation.

Peripheral blood specimens were obtained from 22 patients with Philadelphia chromosome (Ph1) positive chronic myelogenous leukemia (CML) (16 in chronic phase, 2 in an accelerated phase, and 4 in blast crisis). Studies were performed to determine the frequency of the presence of the Ph1 chromosome in cells of lymphoid lineages. Rosetted (E+) lymphocytes (T lymphocytes) from nine patients in chronic phase and one patient in blast crisis were stimulated with T cell growth factor interleukin 2 (IL-2) and/or phytohemagglutinin (PHA). All ten patients had sufficient T lymphocyte metaphases for analysis and of a total of 461 metaphases examined, only one contained the Ph1 chromosome. Nucleated cells of density less than 1.077 g/mL were infected with Epstein-Barr virus (EBV). Following infection, cell lines were established from individual colonies attached to egg albumin-coated Lab-Tek slide chambers (clonal cell lines) or from suspension culture in 96-well tissue culture cluster dishes (nonclonal cell lines). Cell surface and intracellular marker analysis confirmed the B lymphocyte phenotype of all the cell lines examined. B lymphoblastoid cell lines were established from 16 of the 22 patients. All lines from 12 patients were Ph1-negative. From two chronic phase patients, both Ph1-positive and Ph1-negative lines were established. From one patient in an accelerated phase, only Ph1-positive lines were established. From another patient in blast crisis (of myeloblastic phenotype), only Ph1-positive lines were established initially; however, five months later, after the patient had been treated with mitoxantrone, only Ph1-negative lines were derived from this patient. Based on these results, it appears that most B cells and mature T cells in most CML patients are Ph1-negative, but that about 25% of patients have predominantly Ph1-positive B cells or a mixture of Ph1-positive and Ph1-negative B cells that are capable of growing as established cell lines after transformation with EBV.

A retrospective study of 125 patients with cervical spondylosis with, in the main, myelographic features, and treated by the anterior cervical route (Cloward's operation) is presented. Patients were selected for this type of surgery as opposed to the posterior approach, on clinical and radiological grounds which are described. Results of this treatment have generally been good and this is particularly so in very elderly patients with a single lesion at C 3/4. There is a group of patients in whom the disease process seems to progress despite surgery.

A patient with acute myelofibrosis associated with erythroleukemia is described. The terminal course of the patient was marked by the erythroblast population in the peripheral blood increasing to a level of 21.8 x 10(3)/mm3, 18% of which were PAS-positive. Possible transformation of acute myelofibrosis into the erythroleukemic state is discussed.

A 30 year old man with DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy and deafness) syndrome associated with myocardial disease is reported. Echocardiographic study revealed a marked symmetric left ventricular hypertrophy. Histology of the endomyocardial biopsy specimen from the right ventricle showed severe glycogen deposition in the myocytes. This case may indicate that DIDMOAD syndrome is a hereditary systemic disease affecting multiple organs, including the myocardium.

Proto-oncogenes were studied by Southern blotting in 12 patients with chronic myelogenous leukemia in blast crisis (CML). Cytogenetically, all cases had Philadelphia (Ph1) chromosome and 4 had additional chromosomal abnormalities including +8, +19, i(17q), double Ph1. The bcr gene was rearranged in all cases and the region of breakage points were located in the 5.8 kb Bgl II-Bam HI fragment of bcr. In a case with double Ph1 the breakage points of bcr were thought to be different from each other. We analyzed other proto-oncogenes (N-ras, H-ras, c-myc and myb) by Southern blotting, but did not find any abnormalities.

A case of bilateral testicular seminomas with abdominal huge metastatic tumors is presented. The patient is a 23-year-old male. An abdominal huge mass was found incidentally by a physician. CT scan and ultrasonography revealed the presence of the tumor in the left retroperitoneal space and biopsy specimen of the abdominal tumor was diagnosed as seminoma. On March 7, 1985, he was referred to our clinic. Bilateral testicular tumors were detected on palpation and ultrasonography. Bilateral orchiectomy was performed. Histological diagnosis was pure seminoma. After four sessions of VAB-6 combined chemotherapy, the abdominal tumor, 14.1 x 12.3 cm in size, decreased to 5.7 x 4.4 cm ( a regression rate of 85.5%). Retroperitoneal lymph-node dissection was undertaken, but the abdominal tumor could not be resected completely. Histological examination of the resected tumor revealed complete necrosis of the tumor tissue. After the operation, one session of the chemotherapy and irradiation were added. A total of 109 cases of bilateral testicular germ cell tumors in Japan was reviewed.

A noninvasive point score system for the evaluation of severity of aortic stenosis (AS) was employed in a prospective study of 153 patients (mean age 64.8 +/- 0.8 years) referred from invasive studies or for the evaluation of a systolic murmur. Seven variables were recorded and scored as follows: LVH by ECG (0-2); aortic valve calcium by chest x-ray film (0-2); loudness of A2 (0-2); Q-peak of murmur (0-3); T-time of carotid pulse (0-3); ejection time (0-3); and LVH by echo (0-1). Range of the total score was 0-16. All patients had the aortic valve area (AVA) determined by cardiac catheterization. Data analysis revealed that the relation between the total score and the AVA was curvilinear with a score greater than or equal to 5 correctly identifying 100/107 (93 percent) of patients with a valve area of less than or equal to 1.0 cm2. If the patients with an AVA of less than or equal to 1.0 cm2 were considered severe and patients with a total score less than 5 were considered mild-moderate, the sensitivity, specificity, and predictive accuracy for a score greater than or equal to 5 were 93 percent, 96 percent, and 98 percent, respectively. The relation between the score and aortic valve gradient (AVG) was linear with a score of greater than or equal to 5 correctly identifying 84/88 (95 percent) with an AVG greater than or equal to 40 mm Hg. If the patients with a pressure gradient over 40 mm Hg were considered severe, the sensitivity, specificity, and predictive accuracy for a score greater than or equal to 5 were 95 percent, 72 percent, and 82 percent, respectively. It is concluded that a point score system employing seven noninvasive variables is simple and accurate in identifying patients with severe AS and would be a valuable addition to a Doppler determined gradient.

The consistent cytogenetic translocation of chronic myelogenous leukemia (the Philadelphia chromosome, Ph1) has been observed in cells of multiple hematopoietic lineages. This translocation creates a chimeric gene composed of breakpoint-cluster-region (bcr) sequences from chromosome 22 fused to a portion of the abl oncogene on chromosome 9. The resulting gene product (P210c-abl) resembles the transforming protein of the Abelson murine leukemia virus in its structure and tyrosine kinase activity. P210c-abl is expressed in Ph1-positive cell lines of myeloid lineage and in clinical specimens with myeloid predominance. We show here that Epstein-Barr virus-transformed B-lymphocyte lines that retain Ph1 can express P210c-abl. The level of expression in these B-cell lines is generally lower and more variable than that observed for myeloid lines. Protein expression is not related to amplification of the abl gene but to variation in the level of bcr-abl mRNA produced from a single Ph1 template.

Antitumor activity of marine bacteria, Vibrio anguillarum P-B-1, against Ehrlich carcinoma cells in ddY mice was investigated. Ehrlich carcinoma cells were inoculated intraperitoneally (ip) into mice and V. anguillarum (1.0 mg/mouse) was administered ip twice before and 4 times after the tumor inoculation. Groups of mice administered V. anguillarum survived 80 approximately 90% and their mean survival was 54.0 approximately 56.0 days (range, 24.0 approximately 60 days) at day 60 after inoculation of 10(4) to 10(6) tumor cells against the mean survival of 16.4 approximately 22.3 days (range, 7 approximately 26) in the control group. When 2 x 10(6) tumor cells were inoculated subcutaneously (sc) mixed with 1.0 mg of V. anguillarum, the bacterial cells markedly suppressed the growth of tumor at the injection site; tumor did not grow in 30% of recipient mice and the inhibition rate of grown tumor in the rest of recipients was 69%. The consistently demonstrable antitumor activity of V. anguillarum was reduced by pretreatment of mice with immunosuppressants such as anti-thymocyte serum, hydrocortisone, or irradiation of X-ray. This fact indicates that the antitumor activity of V. anguillarum is mediated by immune response.

A combined therapy of irradiation and 8 MHz radiofrequency hyperthermia using the Thermotron-RF Model 8 was performed on a patient with mediastinal metastasis of renal cancer. The patient was a 74-year-old male, who received left transperitoneal nephrectomy for left renal tumor in December, 1982. Histology report indicated clear cell carcinoma of the kidney. He noticed puffy face and dyspnea in April, 1984. A CT scan showed a mediastinal tumor 57 X 43 X 120 mm in size and right pleural effusion. Aspiration biopsies revealed metastatic adenocarcinoma of the mediastinal lymph nodes. The combined therapy of irradiation and 8 MHz radiofrequency hyperthermia was started in July, 1984. He was irradiated with daily 2.0 Gy, 5 times a week and was heated twice a week within one hour after each irradiation, totally 50 Gy of irradiation and 14 sessions of hyperthermia. After the treatment, 69% tumor regression and disappearance of pleural effusion were obtained. The combined therapy with 28.8 Gy of irradiation and 7 sessions of hyperthermia was added for the regrowth of the tumor in February, 1985. A 30% of tumor regression was achieved, however, there was no improvement of the dyspnea or pleural effusion. He died on April 8, 1985.

Four cases (2 children and 2 adults) of spontaneous occlusion of the circle of Willis were studied using EEG, somatosensory evoked potential (SEP), cerebral angiography and CT scan. The following results were obtained. 1) Among the above described parameters, SEP was the most useful to detect the ischemic change in the thalamus when the obstruction of the posterior part of the circle of Willis extends, even before a low density lesion of the thalamus appears on CT. 2) In child cases, a decrease in the amplitude N3 of SEP was observed after hyperventilation. It was speculated that this finding of SEP might be correlated with the mild cortical ischemia due to vasoconstriction and "rebuild up" phenomenon in EEG after hyperventilation.

Unlabelled: Contrast echocardiographic examinations were performed to evaluate hemodynamic filling profiles in patients with right ventricular overload as well as in normal adults. The subjects were 15 cases of atrial septal defect (ASD) as a representative of right ventricular volume overload, 13 cases of mitral stenosis (MS) as a condition with right ventricular pressure overload and 15 cases of normal adults. M-mode contrast echocardiograms were recorded through the ultrasonic beam direction determined by two-dimensional echocardiograms as shown in Fig. 1., Results: 1) In diastole, continuous rapid linear flow through the tricuspid valve orifice was observed in 11 patients with ASD, while biphasic rapid linear flow was noted in normal adults (control) and in patient with MS. 2) Maximum flow velocity (MFV) in early diastole and flow velocity in atrial contraction phase (AFV) were larger in cases with ASD than that of the control subjects. However, there was no difference in rapid filling time (RFT) between patients with ASD and MS. 3) The characteristic findings of tricuspid valve echoes in cases of ASD included increased valve opening velocity (TOV), decreased diastolic descent rate (TDDR), and high F point. These findings were correlated well with increased MFV and prolonged RFT. 4) MFV was decreased secondarily to the increment of pulmonary artery pressure. 5) Turbulent flow in the right-sided chamber was observed in patients with pulmonary hypertension. These results suggest that linear contrast echoes in the M-mode echocardiograms may be useful for the evaluation of flow velocity and flow profiles across the tricuspid valve orifice in patients with right ventricular volume or pressure overload.

We report a patient with acute nonlymphocytic leukemia (FAB classification: M 2) with trisomy 4, which is the first case in our country. A 42-year-old man was admitted to our hospital because of fever and general fatigue in May, 1988. His WBC count was 8,100/microliters with 90% of leukemic cells and bone marrow smear showed 76.1% leukemic cells. The chromosomal analysis of marrow cells by G-banding revealed 47, XY, +4. In spite of administration of chemotherapy complete remission was not obtained, and he died of septic shock and severe liver damage 4 months after making the diagnosis. Chromosomal abnormality of trisomy 4 has been reported to be associated with predominantly either M 4 or M 2, and to be less than 0.1% of incidence in ANLL, according to the Second MIC Cooperative Study Group. It is suggested that trisomy 4 may be caused by exposure to some environmental factors such as toxic substances, since this chromosomal abnormality has been reported in the last 10 to 20 years.

A survey of 1,950 phonocardiograms recorded over a 6-year period revealed 170 (9%) with a distinct aortic ejection sound. All patients were men with a mean age of 61 years (range 29 to 88). Associated clinical features were: aortic stenosis in 28%, history of systemic hypertension in 10%, history of rheumatic fever in 4% and none of these features in 58% of patients. In 141 (83%) of 170 patients the aortic ejection sound occurred simultaneously with or 0.01 second before or after the onset of the rise of the externally recorded carotid pulse. In 37 (66%) of 56 patients who had simultaneous echocardiograms and phonocardiograms recorded, the aortic ejection sound occurred at 0.01 second before or after the maximal opening point of the aortic valve leaflets. Two-dimensional echocardiography was performed in all patients and a bicuspid aortic valve was identified in 38 patients (22%). In 83 patients (49%) 3 cusps were clearly seen. In 49 patients (29%) an accurate determination was not possible. Anatomic examination of 120 consecutive aortic valves at autopsy was performed to identify possible causes of the aortic ejection sound. In 18 (15%) of autopsies fusion of 2 aortic cusps extending greater than or equal to 5 mm from the attachment to the aorta was observed. This abnormality, aortic commissural fusion, may be congenital or acquired. It is concluded that aortic ejection sounds may occur in patients without bicuspid aortic valves and in a variety of clinical conditions. A moderate degree of cuspal fusion may be the cause of the sound.

Ceftriaxone (CTRX), a new long acting antibiotic in the 3rd generation cephem group, was administered intravenously once or twice a day in daily doses of 1-6 g for at least 3 days to 86 patients with severe infections complicating hematopoietic disorders. Underlying diseases were acute leukemia in 41 cases, chronic leukemia in 3 cases, malignant lymphoma in 19 cases, myeloma in 7 cases and others. Most patients (55 cases) suffered from sepsis or suspected sepsis. As for efficacy rates classified by underlying diseases, the treatment was effective in 61.0% of patients with acute leukemia. As for efficacy rates classified by infections, the treatment was effective in 60.0% of patients with sepsis. No side effects were noted except rash in 2 patients. Abnormal hepatic functions were recognized in 3 patients but were not attributed to the agent in any case. The results indicate that CTRX is a safe and useful antibiotic for the treatment of severe infections accompanied by hematopoietic disorders.

A combined treatment of irradiation and 8 MHz radiofrequency hyperthermia after chemoembolization, using 20 mg of microencapsulated mitomycin C (MMC.mc), was undertaken in a patient with an advanced left renal tumor. The patient, a 70-year-old man, noticed a gross hematuria in February, 1984. CT showed a left renal tumor, 88 X 70 mm in size. Histological examination revealed clear cell carcinoma of the left kidney. The tumor was unresectable because of an invasion into the surrounding tissues. Chemoembolization was performed before the combined treatment of irradiation and hyperthermia. He received 23.2 Gy of irradiation and 10 sessions of hyperthermia. Intratumoral temperature reached 42.6 degrees C during the heating. After treatment, there was a tumor regression rate of 58%, as well as pain relief, and an improvement in his appetite loss. He died 8 months after this treatment. An autopsy specimen revealed bionecrotic tumor cells among the prominent necrotic and fibrotic tissues.

Forty-four male patients (mean age 63.6 years) with aortic stenosis (AS) were evaluated by conventional hemodynamic methods and continuous wave (CW) Doppler echocardiography. The relationship between Doppler mean gradients and direct mean pressure gradients in all patients was significant, with an r value of 0.88. Sixteen of 17 patients with a mean Doppler gradient greater than or equal to 40 mmHg had severe AS (AVA less than or equal to 1.0 cm2). Twenty-seven patients had a Doppler gradient less than 40 mmHg, and 8 of these patients had severe AS (AVA less than or equal to 1.0 cm2). The sensitivity and specificity of a Doppler gradient greater than or equal to 40 mmHg in detecting severe AS were, therefore, 67% and 95%, respectively. Thirty-three percent (8/24) of patients with severe AS and low Doppler gradients (less than 40 mmHg) had evidence of poor left ventricular function, evidenced by a lower cardiac output, a higher heart rate and an abnormal PEP/LVET ratio compared to the other patients. Thus, the presence of a low stroke volume less than or equal to 60 ml/beat and PEP/LVET x HR greater than 26 is of value in identifying patients where the Doppler is likely to significantly underestimate the degree of aortic stenosis.

The effects of whole cells of three different O serotypes of Vibrio anguillarum on the murine immune response were studied. The addition of different doses (1-100 microgram/ml) of V. anguillarum cells, as well as Salmonella typhimurium lipopolysaccharide, markedly increased the incorporation of [3H]thymidine into in vitro cultured spleen cells of C57BL/6 mice. All three serotype strains of V. anguillarum were able to induce the mitogenic effect at 10 microgram /ml and 100 microgram/ml, but serotype I strains were more potent than the others. Since pretreatment of spleen cells with rabbit anti-mouse thymocyte antiserum did not affect the mitogenic activity of V. anguillarum, Vibrio cells may be a B-lymphocyte mitogen. When sheep or horse erythrocytes and Vibrio cells were injected intraperitoneally into ddY mice, Vibrio cells exhibited an enhancing effect on antibody response in vivo, regardless of the different serotypes. Vibrio cells, when injected intraperitoneally into mice before the antigen, markedly suppressed the antibody response. Several days after the injection of Vibrio cells, these mice showed an enhanced carbon clearance activity. Acid phosphatase activity in their peritoneal cells was also augmented, suggesting that Vibrio cells activated macrophages in the mice.