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We investigated the effect of polydextrose, one of the water-soluble non-digestible polysaccharides, on the activities of brush-border membrane enzymes of small intestine in rats and on glucose absorption with relation to the thickness of the unstirred water layer in humans. Rats were fed a 5% polydextrose-supplemented elemental diet for 2 or 4 wk. The mucosal alkaline phosphatase, maltase, and sucrase activities were measured in the upper, middle, and lower intestine. There was no significant difference between control and polydextrose groups. The potentiometric tube was inserted orally in the jejunum. Glucose absorption was measured by perfusion with the solutions with or without 5% polydextrose. There was no significant difference in the glucose absorption rate or the thickness of the unstirred water layer between control and polydextrose solutions. The increase in viscosity of the polydextrose solution was negligible. This study indicated that polydextrose had no effect on the thickness of the unstirred water layer and did not inhibit glucose absorption in humans.

Romano-Ward syndrome is an autosomal dominant trait disease, which is characterized by QT prolongation and normal hearings and shows predisposal to sudden death from cardiac arrhythmia. Recently, Keating et al. reported that Harvey ras-1 locus (H-ras-1) was closely linked to long QT syndrome (LQTS), being located on the short arm of chromosome 11. In this study we have examined a three-generation Japanese family whose members had recurrent fainting with prolongation of the QT interval on electrocardiogram. Using the H-ras-1 probe as DNA marker, we could not determine that the H-ras-1 gene was linked to LQTS. LQTS seems to be a genetically heterogeneous disease. Further study is needed to clarify the chromosomal location of the LQTS.

The patient was a 72-year-old man, who was admitted to our hospital because of cough. Chest X-rays showed a mass shadow in the right lower lung field. Amylase activities in serum and urine were extremely high. Amylase isozyme pattern identified salivary type amylase. Cytological examination of the sputum suggested adenocarcinoma. Amylase activities in serum and urine gradually decreased with the administration of chemotherapy. Afterwards, pleural effusion increased, and the amylase activity in pleural fluid was also extremely high. Pleural fluid also showed adenocarcinoma. Enzyme-labeled antibody method (PAP) on this specimen from pleural fluid proved that tumor cells were producing amylase ectopically.

Tc-99m pyrophosphate (PYP) and Tl-201 simultaneous dual energy single photon emission computed tomography (SPECT) were performed for 33 patients with clinically diagnosed unstable angina. Twenty-two patients (76%) showed PYP accumulation in the myocardium (PYP+group). Clinical features, types of unstable angina, electrocardiographic changes during and after the anginal attack, and serial creatine kinase (CK) sampling data were reviewed and compared in the 2 groups. Selective coronary angiography was performed in all patients, and contrast left ventriculography was carried out in 29 patients both in unstable and stable states. In the study of left ventriculograms, the ejection fraction (EF) was calculated by the area-length method and the wall motion abnormality index was calculated by the centerline method. The PYP(+)group differed significantly from the PYP(-)group in several features as follows: 1) the "new angina at rest" type of unstable angina was more frequent in the PYP(+)group than in the PYP(-)group. The ratios of new angina at rest/effort angina (including new angina of effort and angina of effort with changing pattern) were 16/6; 2/9 for the PYP(+) and (-)groups, respectively (p0.05). 2) ST elevation during the heart attack was seen more in the PYP(+)group. The ratios of ST elevation/ST depression were 13/22 (59%); 5/22 (23%) for the PYP(+)group, and 2/11 (18%); 7/11 (64%) for the PYP(-)group, respectively (p0.05). 3) EF was improved in the PYP(+) group to the normal range. EF in the PYP(+)group changed from 57 +/- 12 in the unstable state to 62 +/- 11% in the stable state (p0.02), while that of the PYP(-)group showed no significant difference between the unstable state (59 +/- 9%) and the stable state (59 +/- 11%). 4) Wall motion abnormality index (WMI) in the PYP(+)group was poorer than in the PYP(-)group, but it improved markedly in one month to the same level as that of the PYP(-)group. WMI in the PYP(+)group in the unstable state (21.7 +/- 26.2) was worse than that in the PYP(-)group in unstable state (5.7 +/- 8.2) (p0.001). WMI in the PYP(+)group in the unstable state markedly improved in the stable state (from 21.7 +/- 26.2 to 8.4 +/- 19.8) (p0.025); whereas, WMI of the PYP(-)group showed no significant improvement (from 5.7 +/- 8.2 to 15.5 +/- 19.6). These data suggest that the area showing PYP(+) may represent stunned myocardium.(ABSTRACT TRUNCATED AT 400 WORDS)

The third complement component, C3, is an important factor in the host defense mechanism in which monocytes/macrophages participate as the primary phagocytes. Monocytes/macrophages are the principal extrahepatic producers of C3, and this C3 production is thought to be regulated by several cytokines. In the present study, we demonstrated that human macrophage colony-stimulating factor (M-CSF) enhanced C3 production by human peripheral monocytes in serum-free culture. Analytical immunoblot and ELISA showed that the presence of M-CSF increased the production of intracellular pro-C3 and extracellular C3 for 24 h in a dose-dependent manner. To confirm the rapid effect of M-CSF on C3 production, we performed metabolic labeling of C3 with [35S]methionine. The production of [35S]C3 for the first 6 h in the presence of M-CSF was also increased as compared to that in the absence of M-CSF. In addition to the previously reported effects of M-CSF on monocytes/macrophages, such as the enhancement of C3 receptor expression and C3 receptor-mediated phagocytosis, we consider that the effects of M-CSF demonstrated in this study are of importance in the local immune system organization of C3 and monocytes/macrophages.

A 74-year-old female was diagnosed as having multiple myeloma in August 1989 and was treated with combined vincristine, melphalan and prednisolone. Subsequently, she was followed followed up in the outpatient clinic using interferon-alpha. On August 6, 1990, she had a transvenous demand pacemaker inserted because of severe atrioventricular block. The pulse generator was placed in a subcutaneous pocket in the left pectoral area. On February 3, 1991, she developed a mass overlying the pulse generator. This tumor was diagnosed as plasmacytoma by histological examinations. A myelogram showed 5.1% plasma cells with 5.5 x 10(4) nucleated cells/microliter. The amounts of serum protein and IgA M protein were 6.8 g/dl and 1.8 g/dl, respectively. The tumor responded to combined chemotherapy, but reenlarged to the initial size 3-4 weeks later. On August 6, 1991, this tumor, including the pulse generator was removed. By October 1991, the patient had systemic subcutaneous tumors and a right maxillary tumor suggesting the aggressive phase. On December 19, 1991, she died due to cardiac failure. In this paper the discussion focussed on the etiopathogenesis of plasmacytoma arising in the region of pulse generator pockets.

A 32 year-old female admitted to our hospital with pancytopenia. The hematological data on admission were: RBC: 247 x 10(4)/microliters, Hb: 8.8 g/dl, Plts: 13,000/microliters, WBC: 2,500/microliters. Bone marrow aspirate and biopsied specimen showed marked hypocellularity without infiltration of abnormal cells. A diagnosis of aplastic anemia was made. Neither high-dose methyl-prednisolone pulse therapy nor anti-lymphocyte globulin were effective. With combination of oxymetholone (30 mg/day), recombinant erythropoietin (rHuEpo; 12,000 U/day, three times a week) and recombinant granulocyte-colony simulating factor (rHuG-CSF; 33 micrograms/day) for 3 months, remarkable improvements of hematological data were obtained. Her hemoglobin level reached 11.4 g/dl, and platelets count 49,000/microliters. However, 4 weeks after the withdrawal of erythropoietin and G-CSF administrations, her platelet count fell to 12,000/microliters. It was suggested that combination therapy with erythropoietin and G-CSF were effective for aplastic anemia.

A 63 year old female, who was admitted to a psychiatric hospital for schizophrenia, was referred to our emergency room because of sudden loss of consciousness and convulsions. On arrival, she was drowsy and hypoxemic. Her chest X-ray showed cardiomegaly with pulmonary edema. ECG showed marked ST depression in precordial leads and serum chemistry revealed marked elevation of CPK, GOT and LDH along with hyponatremia and hypochloremia. She was immediately admitted to CCU on suspicion of acute non-transmural myocardial infarction complicated with congestive heart failure. After fluid restriction and intravenous infusion of dopamine she passed large amount of urine, and her consciousness level, electrolyte imbalance and ECG change, improved gradually. Although serum CPK level increased as high as 32,307 IU/ml, there were no signs of left ventricular asynergy on UCG and CPK isozyme analysis performed later revealed more than 99% of serum cCPK was MM-type. We concluded that water intoxication was the cause of the ECG change and the elevated serum CPK, GOT and LDH levels. There are few reports on elevated CPK level in association with water intoxication, in which rhabdomyolysis is speculated as the cause of CPK elevation. But there is no report on ECG change complicated with water intoxication. In our case, electrolyte imbalance caused by water intoxication seemed to play a major role in ST depression and QT prolongation. Although water intoxication is a rare disorder in the general population, it is not infrequent among patients with psychiatric diseases. Care must be taken when such patients present ECG change and serum enzyme elevation mimicking ischemic heart disease.

To clarify the kinetics of cell membrane and intracellular mediators in the process of auranofin (AF)-induced diarrhea, we perfused electrolyte solution containing the oral gold preparation AF, which is a treatment for rheumatoid arthritis, through the rat jejunum, and studied net water and electrolyte transport, Na+, K(+)-ATPase activity, and c-AMP and c-GMP concentrations in the jejunal mucosa. In addition, change in Ca+ concentration in isolated intestinal cells was evaluated using fura-2-acetoxyl-methyl ester. AF significantly suppressed water and electrolyte transport. Mucosal secretion was increased due to elevation of the intracellular Ca+ concentration early in the perfusion period, then due to reduction in the Na+, K(+)-ATPase activity, and increase in the c-AMP concentration late in the perfusion period. Therefore, these cell membranes and intracellular mediators are considered to be involved in the mechanism of AF-induced diarrhea.

1) Myocardial infarction (MI): Aspirin (160-300 mg/day) therapy started immediately after the onset, with or without simultaneous coronary arterial thrombolytic therapy, reduces the mortality rate in vascular diseases, including MI, and prevents reinfarction. Maintenance therapy with the same dosage is also recommended. 2) Angina pectoris: In unstable angina, aspirin in a dose of 300 mg/day for 2 years reduces the mortality and the incidence of MI. Ticlopidine decreases anginal attacks in a few cases of angina at rest. 3) Coronary artery bypass grafting (CABG): Long-term administration of 325 mg aspirin/day should be started on the day of surgery and combined with 200-400 mg dipyridamole/day administered from 2 days before to 1 week after the surgery. 4) Percutaneous transluminal coronary angioplasty (PTCA): Current antiplatelet drugs prevent post-procedural acute coronary occlusion but not late restenosis.

Right ventricular endomyocardial biopsies were performed in patients with ventricular tachycardia (VT: n = 20) and idiopathic premature ventricular contraction (PVC: n = 23). Active myocarditis was found in one case and postmyocarditic change in 9 cases. Significant pathology according to our definition was found in 9 out of the total of 43 cases (20.5%). The pathological features of the 9 cases were interstitial fibrosis in 5, disarrangement of muscle bundles in 6, degeneration of myocytes in one and increase in fatty tissue in 7. Increase in fatty tissue was characteristically observed in 6 out of the 20 cases with VT and it was noteworthy that the VT cases with left bundle branch block configuration showed high incidence of the fatty tissue (5/12 cases, 42%).

Transport of amino acids; glycine, L-alanine, L-leucine, L-proline, L-lysine and dipeptides; gly-gly, gly-L-pro, gly-L-leu, L-leu-gly was investigated by measuring the short-circuit current in control rats and the rats 3 days after intraperitoneal injection of cyclophosphamide (CPM) 300 mg/kg. For determining active transport using the short-circuit current method in injured intestinal epithelia the short-circuit current measured should be corrected for the decrease in the mucosal resistance of CPM group. Jmax values for transport of glycine and L-alanine in ileum are significantly decreased in CPM group than in control group. Contrariwise, there are no differences in Jmax values for peptides transport in ileum between two groups. The results indicate that the glycine transport carrier is more sensitive to CPM injury than the peptide transport carrier for glycine-containing dipeptide, suggesting the clinical usefulness of the peptide nutrition during chemotherapy.

We subcutaneously injected indomethacin (IDM) to rats and evaluated its effects on the unstirred water layer (UWL) of the small intestine. One hour after IDM administration at a dose of 4, 10, 20 and 50 mg/kg, the thickness of UWL decreased dose-dependently. Serial measurement of UWL 1, 3, 6, 12 and 24 hours after the administration showed early thinning of UWL after 1-3 hours. Many IDM-induced ulcers were shown 24 hours after the injection of IDM at a dose of 10 mg/kg. However, in the group given food during the latter 3 hours between 12 and 15 hours after the drug administration, the number of ulcers was significantly decreased compared with those in the group given food ad libitum or in the group given food during the early 3 hours. When pectin, a soluble dietary fiber, was given together with solid stock food, ulcer formation was significantly inhibited. Synthesis of mucus glycoprotein by tissue organ culture was also decreased in the jejunum in the IDM-treated group. These results suggest that the formation of IDM-induced intestinal ulcer is related to the thing of intestinal UWL and the decrease of the synthesis of intestinal mucus glycoprotein.

Specific binding sites for human gastrin I (gastrin) were identified in a crude membrane preparation from the gastric carcinoid tumor of Mastomys (Praomys) natalensis. The binding of 125I-gastrin to the carcinoid tumor membrane was saturable, and Scatchard analysis of the data revealed a single class of binding site with a dissociation constant of 139.2 pM and a maximal binding capacity of 23.5 fmol/mg protein. Gastrin and CCK8 equipotently and dose-dependently displaced the binding of 125I-gastrin to the membrane. GTP but not ATP decreased 125I-gastrin binding to the membrane, and removal of Mg2+ attenuated this inhibitory action of GTP. The GTP-induced reduction of 125I-gastrin binding was found to be due to a decrease in binding affinity without a change in binding capacity. These results clearly indicate the presence of specific binding sites for gastrin, probably coupled to guanine nucleotide-binding protein, in the carcinoid tumor membrane of Mastomys, and suggest that gastrin has possible biological actions on these tumors.

Increase of CD16+ cells in the peripheral blood is not uncommon for sarcoidosis. However, further subclassification of such cells have not been reported yet. Here, we report a case of sarcoidosis developed in 71 year-old female who had abundant CD16+ lymphocytes in the peripheral blood and most of them were revealed to be CD3+ WT31- by analysis using cell sorting. Although exact role of these cells is remained to be solved, they seem to be implicated in the immune disorder of this disease.

During the intensive research of highly potent coronary dilators carried out by Dr. F. Bossert and Dr. W. Vater, nifedipine has been found to be one of the most active drugs in this category, not only for parenteral but also for oral administration. Nifedipine was introduced into Japan by Professor K. Hashimoto, Department of Pharmacology, Tohoku University, in 1968. Professor Hashimoto was very impressed by the extraordinary activity of this drug, as described in the Bayer company leaflet, and started his first experimental study with small doses of this compound. He immediately recommended a clinical application trial, and the clinical study started in the following year. Other experimental studies rapidly developed alongside this clinical one.

A 62-year-old man with pneumonia and left flank pain had a clinical syndrome of hyponatremia, hypotension, dehydration, and high urinary sodium excretion in the presence of a normal glomerular filtration rate. The plasma level of antidiuretic hormone was relatively high despite decreased serum osmolality. Thyroid function and excretion of glucocorticoid and sex steroids were normal. The serum aldosterone level was very low despite elevated plasma renin activity. Angiotensin II failed to stimulate any secretion of aldosterone, despite the occurrence of a progressive rise in blood pressure. On the other hand, rapid ACTH administration increased both serum aldosterone and cortisol. The patient showed no effective response to increased salt intake, but large doses of mineralocorticoid resulted in a normal serum sodium level without dehydration. Subsequently, he suffered cardiac arrest secondary to ventricular tachycardia. Postmortem examination showed well differentiated adenocarcinoma in the left pleura and an intact, histologically normal adrenal zona glomerulosa and kidney. This is the first reported case of a critically ill patient with hyponatremia caused by hyperreninemic hypoaldosteronism possibly due to angiotensin II insensitivity and tubular unresponsiveness to mineralocorticoid.

We analyzed the phagocytic activity of purified human monocytes using fluorescent latex beads sensitized with IgG or IgG.C3 by flow cytometry. To prepare IgG-sensitized latex beads (BA), BSA-coated latex beads (B) were incubated with diluted rabbit IgG anti-BSA. To bind complement components, BA were incubated with whole serum pretreated with K-76 monocarboxylic acid (K-76COOH). K-76COOH inhibits the activity of factor I and C5, resulting in deposition of C1, C4b, C2a, C3b on BA (BAC). Phagocytic activity was assessed by percent phagocytosis and phagocytic index (PI). To eliminate the effects of non-phagocytosed latex beads, subtraction of the data at 4 degrees C from 37 degrees C was performed. Percent phagocytosis for 60 min. was B 5.0%, BA 18.3%, and BAC 57.5%, and PI (ingested latex beads/100 cells) was B 7.9, BA 36.8, and BAC 152.7, respectively. In addition, K-76COOH caused dose dependent inhibition on IgG.C3 mediated phagocytosis. Comparison of inhibition pattern on BAC and BA indicated that K-76COOH directly inhibited C3.C3-receptor binding.

Pancreatico-biliary diversion (PBD) by jejunal transposition in rats caused pronounced hyperplasia of pancreas. The increase of pancreatic trypsinogen contents exceeded the pancreatic growth, while pancreatic lipase and amylase contents relatively reduced. The high level of plasma CCK at the early period of PBD gradually decreased. The plasma secretin levels remained unchanged for 14 days after PBD. The plasma CCK levels were not elevated in fasting, but increased after intrajejunal infusion of 0.1 N HCl or Clinimeal. In acini prepared from PBD rats, the responsiveness to CCK8 was decreased when amylase release was expressed relative to DNA. The dose-response curve for CCK8 was shifted 3 fold toward higher concentrations of CCK8 4 days after PBD, but on 7 and 14 days after PBD returned to the same curve as the transected rats (control).

A 70-year-old woman with active hypereosinophilic myocarditis presented with high fever and heart failure. Repeated right ventricular endomyocardial biopsies and 201-T1 myocardial scans before and after steroid therapy suggested that this treatment reversed the cardiac injury. Patients with hypereosinophilia may die from complications of eosinophilic infiltration and fibrosis in target organs, especially the heart. The findings in this patient suggest that steroids have benefit in this disease, at least in the short term.

The impairment of secretory IgA in human upper and lower intestine was studied. SDS-PAGE and immunoblot demonstrated that IgA peptide was cleaved, to more extent, in colonic fluid than in jejunal fluid, but IgA in mucous layer was almost intact. The level of specific IgA antibody to outer membrane antigen of Bacteroides fragilis was lower in colonic fluid than in jejunal fluid. We suggested that secretory IgA was considerably destroyed in intestinal intraluminal fluid but possibly exercised its power in mucus attaching epithelial surface.

In our series of studies of cardiomyopathy with endomyocardial biopsy in 1500 cases, we have noticed that there were a certain number of patients with arrhythmias and/or conduction disturbance who showed no evidence of hypertrophic or dilated form of caridiomyopathy but showed significant pathology in the biopsy. Significant pathology was determined when the biopsy findings from the right atrium and the right ventricle showed apparent pathology such as interstitial fibrosis, myocyte degeneration, and fragmentation of muscle bundles. Among 226 biopsied patients in whom arrhythmia and/or conduction disturbance were the main clinical feature, 85 patients (38%) demonstrated significant pathology in their biopsy. Familial occurrence was note-worthy among these patients. We propose that these cases should be grouped as nonhypertrophic, nondilated, and nonrestrictive cardiomyopathy, and suggest the term electric disturbance type of cardiomyopathy (ECM).

A case report of patient with cardiac sarcoidosis is presented. Advanced atrioventricular (AV) block and abnormalities of radionuclide imaging were improved by steroid therapy. We stress the effectiveness of steroid therapy together with usefulness of radionuclide techniques.

During the past 15 years, we followed 21 patients with prosthetic heart valves who experienced a total of 24 pregnancies at mean age of 31.3 +/- 3.6 years. The course of these patients and their pregnancies were reviewed to evaluate the problems associated with prosthetic heart valves and anticoagulation. Among the 21 patients, the aortic valve (AV) had been replaced in 10 (12 pregnancies), the mitral valve (MV) in nine (10 pregnancies), AV + MV in one (one pregnancy), and the tricuspid valve (TV) in one (one pregnancy). The implanted prosthetic valves were mechanical type in 16 cases (Björk-Shiley 15, Starr-Edwards 1) and bioprosthetic type in six (Hancock 5, Ionescu-Shiley 1). With the exception of one case of intra-uterine fetal death probably related with warfarin therapy, all the patients with bioprosthetic valves underwent successful deliveries. Anticoagulant therapy was employed for 11 pregnancies; warfarin for 10 and subcutaneous heparin for one. No anticoagulant therapy was performed for 13 pregnancies. Ten of the 21 mothers had atrial fibrillation. Eighteen pregnancies (67%) culminated in uneventful deliveries for both mothers and infants. Three mothers (13%) died of thromboembolic complications; two of cerebrovascular accidents and one of acute heart failure caused by thrombus on the replaced valve. All of them had Björk-Shiley valves. Oral warfarin was administered in one of the three, heparin in one and no anticoagulant in the remaining one. Massive maternal bleeding occurred in two cases (8%). There were three cases (12%) of intra-uterine fetal death which were caused by intracranial hemorrhages.(ABSTRACT TRUNCATED AT 250 WORDS)

To study the pathogenesis of idiopathic ventricular tachycardia with left bundle branch block morphology (LBBB-VT), histopathological findings in 34 patients and adrenergic receptor (AR) density obtained by micro-autoradiography in 11 patients were analyzed, using endomyocardial biopsy samples. According to the ventricular volume, we divided the patients into 3 groups. Group A patients (n = 8) were diagnosed as having arrhythmogenic right ventricular dysplasia (ARVD) showing right ventricular enlargement, group B patients (n = 7) showed decreased left ventricular function and/or enlarged left ventricle, and group C (n = 19) included patients with idiopathic ventricular tachycardia (VT) without enlargement or dysfunction of either ventricle. Histologically, there was a high incidence of significant pathology showing myocardial hypertrophy, degeneration, abnormal branching, and interstitial fibrosis in all groups (group A, 100%; group B, 86%; group C, 56%). There was a higher incidence of fatty tissue infiltration in groups A (100%), B (71%), C (48%) than in the control groups. As for AR, specific grains of alpha 1- and beta-AR were 23.0, and 18.3 (grains/25 x 25 mm square) respectively, in patients with LBBB-VT. The number of alpha 1 grains in patients with LBBB-VT was apparently higher than in the control group, sick sinus syndrome (SSS; 11.2), and the beta-AR density in the LBBB-VT group was the same as in the control group (SSS; 15.4). We concluded that the significant pathology in cases with VT might affect the arrhythmogenic condition. Moreover, these results suggested that the increase in the number of alpha 1-AR might have a great influence in idiopathic VT.

The aim of this study was to elucidate the role of the mitochondria as a store of calcium(Ca) under the condition of pathophysiological Ca overload induced by a rise in extracellular Ca concentration and the administration of isoproterenol.Eight rats were employed, and hearts were perfused as in the Langendorff method with Krebs-Henseleit solution gassed with 95% O2 and 5% CO2. Tow specimens were perfused with 2mM Ca for 30 min, and 2 were perfused with 5.5 mM Ca for 20 min. 4 specimens were perfused with 2 mM Ca for 5 min, and of these 4, 2 were infused with 10-7 mM/kg/min. isoproterenol for 5 min, and 2 were given a bolus injection of 3 x 10-7 mM isoproterenol. After rapid-cryofixation by the metal-mirror contact method with a Reichert-Jung KF80/MM80, and cryosectioning at -160 to -180° C with a Reichert-Jung Ultracut Fc-4E, ultrathin specimens (100nm) were free-ze-dreid for several hours at 10-5 Torr in the JEOL FD 7000, and mitochondrial Ca was determined by quantitative x-ray micranalysis (JEOL 1200EX, LINK AN 10000S).

The cases of rectal carcinoid reported in Japan have shown a significant increase in recent years, and total numbers of cases recorded in the literature until 1976 were 65. Average age of the patients was 48 years, and the overall percentages were 61% in males and 39% in females. The primary tumors were usually found 4 to 6 cm above the anal ring as a single submucosal nodule with yellowish color, but there was no constant laterality in their localization. The majority of the tumors were below 2 cm in diameter, and the simple local excision was performed. The cases reported had nonspecific rectal symptoms of bleeding and pain, and only two cases were accompanied by carcinoid syndrome. The metastasis into local lymph nodes or liver was observed in 11 cases including one with a primary tumor below 2 cm in diameter. The rectal carcinoids regardless of their size proliferated in lamina propria mucosae, and often invaded submucosa beyond muscularis mucosae. The muscular invasion and lymph node metastasis were more pronounced in the cases with the lesion more 2 cm, in whom the radical operation including an abdominoperineal excision of rectum was undertaken as adequate therapy.A primary carcinoid tumor of rectum can be correctly diagnosed by characteristic histologic patterns such as the formation of ribbon or rosette and sclerosing pattern compres-sed by dense connective stroma. It was found that the rectal carcinoid belongs to the family of slightly argyrophilic carcinoid by Grimelius' silver nitrate stain. In all of the cases examined by electron microscope, neoplastic cells contained abundant round secretory granules measuring 200 nm on average in diameter.

前壁中隔心筋梗塞59例,左前下行枝(LAD)に有意狭窄を示す狭心症25例に対し,安静時あるいは運動負荷断層心エコー法を施行した. 1)心筋梗塞例で,安静時の前壁および前方中隔の基部壁運動異常の出現率は, LADの遠位部狭窄例に比較して近位部狭窄例において有意に高値であった. 2)狭心症例でも,運動負荷による前壁および前方中隔基部の新たな壁運動異常あるいは増悪の出現率は, LADの近位部狭窄例において有意に高値であった. 3)狭心症例で,運動負荷中にLAD支配領域に壁運動異常が認められ回復期の過大収縮を欠く例は有意に高度狭窄例が多かった.以上より,運動負荷断層心エコー法は冠動脈病変の部位診断と共に重症度の評価にも有用と考えられた.