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The diagnosis, sex ratio and age-distribution were investigated in 1, 301 patients, who visited the Neuro-otological Clinic and the Laboratory of Equilibrium Function in Kitasato University Hospital, Sagamihara City, in a 3 year period from January 1996 to December 1998. The percentage of people aged over 60 years old was 14.8% of the total population in Sagamihara city, but patients aged over 60 years old represented 37.4% of the total patients in Kitasato University Hosipital and 33.6% of the total patients in the Neuro-otological Clinic. The patients in the Neuro-otological Clinic were classified into 4 groups by diagnosis; peripheral vestibular disorders (19.1%), diseases of the CNS (8.3%), generalized disorders (3.9%), and others (68.8%). However, the percentage of peripheral vestibular disorders decreased from 19.1 to 11.7% and the percentage of CNS diseases increased from 8.3 to 16.9% in patients aged over 60 years old. Peripheral vestibular disorders included Meniere's disease, benign paroxismal positional vertigo, vestibular neuritis, sudden deafness and delayed hydrops in the 4th and 5th decades. The increase in the percentage of diseases of the CNS in elderly patients was accompanied by increases in cerebrovascular disease and vertebrobasilar insufficiency in the 6th decade.

In circular smooth muscle tissues of the guinea pig gastric fundus, transmural nerve stimulation (TNS) evoked an atropine-sensitive cholinergic excitatory junction potential (e.j.p.) and, after inhibiting the e.j.p. with atropine, an apamin-sensitive nonadrenergic noncholinergic (NANC) inhibitory junction potential (i.j.p.). The amplitude of e.j.p.s was similar when the frequency of TNS was low (0.5 Hz), but it decreased successively (depression phenomenon) when the frequency was high (1 Hz). The depression phenomenon was attenuated after inhibiting the production of nitric oxide (NO) with N(omega)-nitro-L-arginine (NOLA), but was not altered by inhibiting the i.j.p. with apamin. The e.j.p.s were increased in amplitude by the inhibition of cholinesterase activity, but they were decreased by NO produced from SNP with no alteration of their depression phenomenon. Isometric twitch contractions were depressed during high-frequency TNS. NOLA caused an increase in the amplitude of twitch contractions and the attenuation of their depression that changed the transient contraction produced by high-frequency TNS (1 Hz) to a tetanic one. SNP reduced the amplitude of twitch contractions, with no alteration of the depression phenomena. Contractions produced by low concentrations of acetylcholine, but not by high concentrations, were attenuated by SNP, with no alteration of the membrane depolarization. The results suggest that NO produced during TNS has inhibitory actions on cholinergic transmission; the depression of e.j.p.s is mainly prejunctional events, and the depression of mechanical responses is mainly postjunctional events.

C-kit immunoreactive cells are known to be interstitial cells of Cajal (ICCs), and they generate pacemaker activity of the gastrointestinal tract. Recently a large number of special smooth muscle cells corresponding to c-kit immunoreactive cells were found in the proximal colon of the guinea pig. We learned that the rat proximal colon showed tetrodotoxin-insensitive regular rhythmic spontaneous contractions (RSCs) and hypothesized that RSCs are generated and/or regulated by ICCs. To prove our hypothesis, we investigated whether RSCs are absent in homozygous Ws/Ws mutant rats, since c-kit positive ICCs along the submucosal surface of the circular muscle (ICC(SM)) and myenteric plexus (ICC(MY)) are lacking. In contrast to our hypothesis, we found that RSCs were still present in the proximal colon of the Ws/Ws mutant rats. A recent study has reported that c-kit negative ICC(SM) remains in Ws/Ws mutant rats. Taken together, RSCs may be generated by c-kit negative ICC(SM) in the rat proximal colon. The blockade of sarcoplasmic reticulum Ca(2+)-ATPase by cyclopiazonic acid (CPA) (10(-6)M) or by thapsigargin (10(-6)M) increased the frequency of RSCs. The increasing effects of CPA on the frequency of RSCs were more prominent in Ws/Ws mutant rats than in +/+ rats. We concluded that the functional coordination between c-kit negative ICC(SM) and other mutationally impaired c-kit positive ICC(MY) and ICC(SM) may be required for moderate regulation in the frequency of spontaneous activity.

We investigated the clinicopathological correlations among 49 surgically resected thymic epithelial tumors (TET), which were subclassified according to the six subtypes estab- lished by the Marino, Kirchner, and Muller-Hermelink system, which were renamed as follows: spindle cell type (medullary thymoma), mixed spindle and polygonal cell type (mixed medullary and cortical thymoma), small polygonal cell type (predominantly cortical thymoma), large polygonal cell type (cortical thymoma), atypical type (well differentiated thymic carcinoma), and cytologically malignant type (high- grade thymic carcinoma). The related categories were grouped for statistical analysis as follows: group 1, spindle cell type and mixed type; group 2, small polygonal cell type and large polygonal cell type; group 3, atypical type; group 4, cytologically malignant type. The association of each group with the presence of myasthenia gravis, tumor stage, and the length of survival was studied. Myasthenia gravis was signifi- cantly present in patients with small polygonal type, large polygonal type, and atypical type tumors (groups 2 and 3) (P 5 0.003). The tumors in group 1 showed the lowest tumor stage while those of group 4 had the most advanced tumor stage (P 5 0.002). The patients in group 4 had the worst prognosis, followed by those in group 3, 2, and 1, in that order. The differences among these groups were statistically signifi- cant (P 5 0.0003). From our results, we determined that TET can be separated into an extremely low-grade malignancy group (group 1), a low-grade malignancy group (group 2), an intermediate malignancy group (group 3), and a high-grade malignancy group (group 4).

[目的] 肺癌手術例における術死症例 (術後30日以内)・術後長期入院症例 (術後30日以上) を抽出し, これに関与する患者背景因子・手術関連因子を多変量解析を用い検討した.[対象] 過去6年間に原発性肺癌に対し肺部分切除以上の肺切除手術を受けた534例.[結果] 術死は12例 (2.3%), 長期入院は60例 (1L6%) であった.多変量解析の結果, 術死要因は中枢気道再建, 主肺動脈再建, T因子, 術後長期入院要因は胸壁再建, 慢性閉塞性肺疾患の合併, 肺全摘, 気管支形成が指摘された.[考察] 多変量解析の結果, 患者自身の背景因子として意味を持つものは長期入院に対する閉塞性肺障害のみで, 他の併発症に関しては術前に良好に管理されている限り重大な問題とはならない可能性が示された.術式上問題となる因子は, 胸壁合併切除, 気道再建, 肺動脈再建, 肺全摘等であった.しかし, 手術侵襲を左右する因子として通常考えられているリンパ節郭清の程度は, 術死・長期入院双方に関してその因子とは認められなかった.

Using a “hybrid logistic function,” we attempted to develop a new approach for a quantitative and comprehensive evaluation of the force–time curve of guinea pig gut contractions. We recorded ileum twitch and proximal colon spontaneous isometric longitudinal contractions because of their high regularities. We digitized the force–time curves of both contractions and performed curve fitting to them by hybrid logistic functions with a personal computer. We found that the fitness of these functions to both contractions was excellent. The respective best-fit parameters of these functions were closely correlated with the observed mechanical indexes, all of which are physiologically meaningful. This result suggests the possibility that these parameters can characterize the magnitudes and time courses of F(t) curves of the intestinal contractions. Furthermore, it might be able to show an effect of a pharmacological agent specifically either on the contraction phase, the relaxation phase, or other parameters of each. Therefore, we insisted that the present new approach for evaluating gut motility is promising for clinical application.

From April 1994 to March 1998, we managed twenty-eight patients with tracheobronchial obstructive disease (27 cases of malignant disease and 1 benign stricture). Cylindrical resection of the trachea and end-to-end anastomosis were performed in 6 patients; resection of the membranous portion of the trachea and patch repair using the latissimus dorsi muscle in 1, and carinal resection and primary reconstruction in 9 (right pneumonectomy in 3, left pneumonectomy in 1, upper right lobectomy in 4). Twelve patients with unresectable disease underwent airway stenting. Four patients who underwent carinal resection and upper right lobectomy or pneumonectomy with a combined resection of the superior vena cava for lung cancer, died of myocardial infarction, respiratory failure, airway bleeding or brain edema within 30 days after the surgery. There was no anastomotic leakage or anastomotic stricture in any of the patients.After stenting, the dyspnea remarkably improved in 11 of the 12 patients with unresectable disease.

Primary pulmonary lymphoproliferative disorders (PLDs) are histologically divided into a neoplastic state of high and low grade malignant lymphoma (ML), and a reactive state of follicular bronchitis/bronchiolitis (FB) and lymphoid interstitial pneumonia (LIP). We reviewed 19 cases with PLDs, including 4 cases each of high and low grade B cell ML, 6 FB cases, and 5 cases of LIP. To clarify the clonality of the proliferating cells, we performed an immunohistochemical examination (IHC), in situ hybridization (ISH) for the immunoglobulin light chain and a polymerase chain reaction (PCR) analysis of the immunoglobulin heavy chain gene using DNA obtained from paraffin sections. In addition, a Southern blot analysis was also performed in 6 cases using fresh materials. In IHC, all ML were positive for L26 (CD20), while the monoclonality of the kappa light chain was observed in only one high grade case. However, using ISH we could detect the clonality in three of four high grade ML cases and in one of four low grade ML cases. In FB and LIP, no clonality of immunoglobulin by ISH was observed. In a PCR analysis for the immunoglobulin heavy chain gene, we could detect one or two prominent bands in all 8 cases of high and low grade ML. On the other hand, in all cases of FB and LIP, we could only detect either an oligoclonal or polyclonal population. In summary, the presence of monoclonality of ISH and/or PCR for the immunoglobulin heavy chain gene were limited in the neoplastic state, but not in the reactive state.

We studied the effects of the hydroxylation patterns and the degrees of polymerization of condensed tannins on their metal-chelating capacity. These effects were evaluated by the relative stability of aluminium complexes with proanthocyanidin. The relative stability of aluminium complexes was determined qualitatively in methanol solution by the competition with the metallochromic reagent (chrome azurol S). A comparison of these capacities indicates the following results: 1) phenolic hydroxy groups in tannins are essential sites for the chelation with metal. 2) the sites of tannins interacting with metal ions are mainly o-dihydroxyphenyl groups in B-ring. 3) increasing degrees of polymerization of tannins tends to increase the relative stability of condensed tannin-aluminium chelate.

A Y-shaped tracheo-bronchial tube was designed and used for two patients with carinal stenosis following a lower tracheal resection in one case and a malignant tracheal fistula in the other. The tube consisted of three parts including a Y-shaped, thin-walled, soft silicone stent; a spiral-wire-reinforced main tube; and a curved tracheostomy tube. The stent was inserted easily and comfortably through the tracheostomy under fiberoptic bronchoscopic guidance with minimal local anesthesia. The positioning stability of the tube was excellent because of the carina-shaped structure of the tube end. Resistance to compression was satisfactory due to the embedded spiral wire. The insertion procedure through the tracheostomy was smooth, even in patients whose respiratory condition was severe or critical. Satisfactory phonational activity was also provided by breathing through the hole on the tube back up to the vocal cord. Bronchoscopic inspection was uncomplicated, and the patients themselves could easily clean the stent. Since palliation of the airway obstruction is the main purpose of such a stent for patients with either severe lower tracheal or carinal stenosis, and because of the difficulty of ordinary stent insertion in this part of the airway, this device appears to offer excellent stability and easy insertion of the stent. In addition, the ease of maintenance and suctioning through the tracheostomal end allows for an excellent quality of life in which the patients are able to return to their homes.

Background and Objectives: Lymph node involvement adversely affects the survival of patients with esophageal cancer. We retrospectively investigated whether the number of involved lymph nodes and the degree of lymph node dissection affect survival. Patients and Methods Eighty-eight patients underwent surgical resection and reconstruction for T1–T3 thoracic esophageal squamous cell carcinoma. Patients were classified into three groups: group 1, 32 patients without lymph node involvement; group 2, 26 patients with 1 to 3 positive nodes; and group 3, 30 patients with ≧4 involved lymph nodes. Results The 3-year and 5-year survival rates were 34.8% and 30.0% in group 1, 30.0% and 22.7% in group 2, and 14.8% and 0% in group 3, respectively. The mean survival time (MST) X ±SD of the patients in group 3 (453.06 ± 74.5 days) was significantly shorter than in group 1 (450.1 ± 450.5, P = 0.0005) and group 2 (937.3 ± 1317.9, P = 0.0295). For patients in groups 1 and 2, the MST for three-field lymph node dissection (1136.9 ± 1476.4 days) was longer than for two-field lymph node dissection (1007.4 ± 1476.4 days, P = 0.0355). However, in group 3, there was no survival advantage to three-field lymph node dissection. Conclusion We conclude that the survival in patients with thoracic esophageal cancer involving four or more nodes, is poorer than in patients with lesser involvement. Three-field lymph node dissection does contribute to prolonged survival in patients with node-negative disease or fewer than four positive nodes. J. Surg. Oncol. 1998;67:160–163. © 1998 Wiley-Liss, Inc.

癌肉腫は上皮性, 非上皮性組織が混在した非常に稀な悪性腫瘍であり, その病理学的特異性が注目されている.我々が手術をおこなった6例ではpure carcinosarcoma が1例, so-called carcinosarcomaが5例存在した.気管支内腔発育形式をとるものは1例, 末梢発生局所進展は5例であった.なかでも巨大肺嚢胞壁に発生する稀な症例も1例含まれた.予後はpureの癌肉腫では5か月と不良であった.これらの症例に対し各種免疫組織染色に加え癌抑制遺伝子p53蛋白の発現を検討した.その結果socalled carcinosaocoma 症例ではp53蛋白は上皮性, 非上皮性の両組織成分に発現が認められたことより肺原発癌肉腫では両成分はmonoclonalな部分より発生している可能性が示唆された.しかしpuoecarcinosarcomaではいずれの組織にも発現は認められず異なった様相を呈していた.carcinosarcomaの組織学的特異性をp53蛋白発現の違いにて明らかにした.

A new synthetic method for the preparation of high molecular mass (the highest ; 10 200) condensed tannin has been developed. Polymerization of 3′,4′,5,7-tetrabenzyloxyflavan 3,4-carbonate 2 and subsequent debenzylation gives a condensed tannin having high molecular mass. Molecular mass of the synthetic tannin increases up to a degree of polymerization () of ∼35 with an increase in the reaction time. This high molecular mass condensed tannin, synthesized for the first time, is useful as a model compound for natural condensed tannins with high molecular mass, such as that from Japanese persimmon (Diospyros kaki L.) fruit.

Diagnosis and age at on set were investigated in 18, 246 vertiginous patients who had visited the neuro-otological clinic in Kitasato University Hospital between August 1971 and December 1995. There was a high incidence of the patients in the 4th decade, but the age distribution showed a recent tendency to shift toward older patients. The proportion of patients with peripheral vestibular disorders, diseases of the central nervous system, generalized diseases and others were 30.1%, 17.7%, 6.6% and 45.6%, respectively. Meniere's disease was diagnosed in 6.67% and BPPV in 4.72% of all patients.

The aim of this study was to investigate the relationship between prognosis and the changes in serum-ionized calcium concentration in neonates with hypoxic-ischemic encephalopathy (HIE) before and during brain hypothermia (BHT).Serum samples were obtained from 16 HIE neonates who underwent BHT. All patients underwent developmental testing at 18 months of age.Mean serum-ionized calcium concentration in the poor outcome group (developmental quotient [DQ],80; nine infants) was significantly lower than in the good outcome group (DQ80; seven infants), both immediately before and after 6 h of BHT. Mean serum-ionized calcium concentration significantly decreased in both groups for 6 h, and the lowest adjusted serum-ionized calcium during 6 h of BHT was1.05 mmol/L, known as the cut-off value for poor outcome, in 57.1% of the good outcome group.The influx of calcium into cells continues regardless of neurological prognosis during the early phase of BHT, but BHT might protect some high-risk patients against neurological damage at low adjusted serum-ionized calcium concentration.

Malignant histiocytosis has been described as a proliferation of morphologically atypical histiocytes, but it is difficult to determine whether or not malignant proliferation is present based on morphology alone. Recently the disorder has been thought to be heterogeneous, and therefore a true histiocytic origin is considered to be rare. The Epstein-Barr virus (EBV) is thought to have the ability to transform human cells. Therefore, eight cases of malignant histiocytic (MH) syndrome and five cases of virus-associated hemophagocytic syndrome (VAHS) were analyzed using a polymerase chain reaction (PCR) and the in situ hybridization (ISH) method in order to determine their relationship to EBV infection. At the same time, the cellular origin of these syndromes was also studied. The results indicated that three of the MH cases were derived from T cells while four the MH cases were from histiocytes. The amplification of the EBV-LYDMA region, which was used to determine the monoclonality, was detected in two MH cases and one VAHS case, and all these cases showed only one band. An ISH study also demonstrated the presence of an EBV in these three cases. One of the EBV-positive cases revealed an amplification of the EBV-LYDMA region by the PCR method before showing any sign of MH clinically. In the VAHS cases, the EBV genome was detected in hemophagocytic cells. The EBV-positive cases all demonstrated a rapid clinical course. Based on these results it is possible that EBV infection causes similar rapid clinical features in some cases of both MH and VAHS by the same mechanism.

Some previous investigators have reported controversial results in the stomach movement in response to labyrinthine stimulation (1). The purpose of the present study was to investigate the influence of vestibular stimulation on the stomach movement and respiration in anesthetized cats, and to investigate the differences between increased and decreased responses of the stomach movement. This study used an electrophysiological technique: a bipolar stainless-steel stimulating electrode with a tip diameter of 20 microns introduced chronically into the anterior and/or lateral semicircular canal (2). The intragastric pressure was recorded by using a balloon-transducer system. Respiration was recorded by measurement of the thorax. When the peripheral labyrinth was stimulated, we found conflicting results in that the pressure in the stomach increased several times and sometimes decreased. Respiration usually became irregular or intensified. It seems that forced respiration may be involved in vestibular vomiting but we were unable to induce vomiting.

術中の気道合併症を減らすためNd-YAGレーザーで焼灼した後に, 気管環状切除を施行した原発性気管腫瘍の2例を報告した.症例1は65歳の女性.血痰と軽度の呼吸困難を主訴とし, 気管支鏡検査で気管内腔を約75%閉塞する腫瘤を認め, 生検で気管腺様嚢胞癌と診断した.腫瘍のNd-YAGレーザー焼灼術を行った後に病巣部気管を約3.2cm環状に切除し, 気管は逆テレスコープ型に端々吻合した.術後放射線療法を追加した.症例2は51歳の男性.約6ヵ月前より気管支喘息として加療されていたが, 気管支鏡検査で気管内腔を約80%狭窄する気管腫瘍を発見され, 術前にレーザー焼灼術を受けた後, 約2.5cmの気管環状切除が行われた.病理組織診断は多形腺腫であった.いずれの症例も胸骨縦切開でアプローチし, 術後は気管吻合部の緊張を緩和するため1週間の頚部前屈位固定を行った.

Our patient was a 71-year-old man who presented with lower abdominal pain, and bloody and white mucosal stools. He purchased by mail-order an electrical muscle stimulation (EMS) device, which he strapped onto his lower abdomen, and for 2 consecutive days he underwent muscle stimulation comprising 600 contractions at 2.40 mA and 1.20 V over a 10 minute period. He experienced the onset of lower abdominal pain immediately following muscle stimulation on the second day, and then passed stools containing blood and white mucus. The cause was thought to be electrical and mechanical stimulation of the lower abdomen by the EMS equipment, either inducing colonic or vascular spasm, or dislodging thrombi associated with atrial fibrillation or atherosclerosis. This is the first known report of ischemic colitis associated with the use of EMS exercise equipment. We report this case in the belief that this condition is likely to become more common with increasing use of such devices.

A microfiber spectroscopic method was developed to reveal the photonic crystalline characteristics of a cylindrical frustule of the diatom Melosira variance. The spectroscopy apparatus used was composed of two quartz fibers with fine ends, approximately 10 µm in diameter, set on micromanipulators to control the position of the fine ends of each fiber, which were focused at the edge of a frustule. The method had fine space resolution and sensitivity toward the propagation direction of incident light, which is suitable for analyzing photonic crystallinity. A typical absorption was observed at wavelengths of 400–500 nm, which corresponded to a quasi-stop band calculated by a finite-difference time-domain (FDTD) method for a three-dimensional (3D) slab model constructed based on an SEM image of the frustule. These results suggest that the photonic crystalline characteristics of the frustule can assist the absorption of incident light near 420 nm, which is crucial for the efficient photosynthesis of the diatom.

Summary We used the polymerase chain reaction (PCR) in situ hybridization (ISH) (PCR-ISH) on sections of malignant lymphoma and nonspecific lymphadenitis to detect small amounts of Epstein-Barr virus (EBV), a DNA virus of the herpes virus family. We first surveyed the EBV DNA by Southern blot analysis and PCR, and then compared results of the two PCR/ISH methodologies with the results of simplified/sensitive ISH for the positive cases. The target of the simplified in situ (DNA-ISH) was a few copies of EBV DNA per cell, and the target of the sensitive in situ (RNA-ISH) was as many as 107 copies of EBV RNA per cell. When EBV DNA was detected by Southern blot, DNA-ISH, RNA-ISH and PCR-ISH all revealed EBV genomes. When PCR revealed only amplified EBV DNA, DNA-ISH showed no EBV genomes, but PCR-ISH and RNA-ISH showed EBV genomes in a few cells. When PCR showed no detectable amplified EBV DNA, all of DNA-ISH, RNA-ISH and PCR-ISH showed no genomes. These findings indicate that PCR-ISH consistently detected a few copies of the EBV virions. The PCR-ISH was as sensitive as RNA-ISH. The RNA-ISH could not detect virus if RNA was not expressed, but the PCR-ISH could detect virus without such expression. The ability to detect a single copy of a specific gene in situ has many advantages and multiple applications in molecular biology, pathology, and cell biology.

Preparation of Pb(Ni1/3Nb2/3)O3 (abbreviated as PNN) perovskite powder and thin film by sol-gel method was studied. The precursor of PNN was synthesized in 2-methoxyethanol using Pb(OAc)2, Ni(OEt)2 and Nb(OEt)5. It was hydrolyzed, dried at 120°C and calcined at 900°C for 3h in air to obtain the perovskite powder. The films were deposited on various substrates by spin coating from the precursor solution, dried at 350°C for 5min and then calcined at temperatures between 400 and 1000°C for 3h to yield PNN thin films. Using BaPbO3 ceramics substrate, which has a high electric conductivity, perovskite PNN films were produced by calcining at 700°C for 3h, which is rather low compared to the conventional method of powder synthesis.

Previously diagnosed cases of hepatosinusoidal T-cell lymphoma and malignant histiocytosis (MH) may include lymphoid neoplasms of natural killer (NK) cell lineage associated with Epstein-Barr virus (EBV). Such hepatosinusoidal neoplasms were found to demonstrate hepatomegaly but not lymphadenopathy, and all were diagnosed by a liver biopsy. Sixteen adult patients diagnosed with hepatosinusoidal leukaemia/lymphoma (six NK-cell leukaemia/lymphomas [NKLLs], five instances of MH, three T-cell malignant lymphomas [T-MLs], and two adult T-cell leukaemia/lymphomas [ATLLs] were examined for EBV by in situ hybridization, then were studied immunohistochemically and subjected to a DNA analysis. Among our five patients with MH, neoplastic cells showed T-cells, but no histiocytic markers, and they were considered to have either a T-cell or NK-cell lineage. All NKLLs, MHs and T-MLs, except for ATLLs accompanied by reactive hemophagocytic histiocytes, varied in number in each case. In situ hybridization revealed the presence of EBV in the nuclei of atypical cells in all of the six lymphoid neoplasms of NK-cell lineage. Each case of MH and each T-ML which represented EBV demonstrated no definite T-cell or histiocytic markers. Patients with ATLL did not reveal EBV. In all patients with hemophagocytosis, EBV was present in the nuclei of the neoplastic lymphocytes, but not in the hemophagocytic cells. Finally, the 16 cases were reclassified into eight cases with EBV-containing NKLLs, six T-MLs, and two ATLLs. In addition, no true histiocytic neoplasms were observed. The mechanism of hemophagocytosis may be therefore the production of lymphokines (macrophage-activating factors) by neoplastic lymphocytes. EBV-associated hepatosinusoidal leukaemia/lymphoma may thus contain a lymphoid neoplasm of NK-cell lineage, which made it difficult to be distinguished from the previously designated malignant histiocytosis.

The purpose of this study was to investigate the neural pathway from the vestibular labyrinth to the medullary vomiting center in the cat, using electrophysiological techniques. During electrical stimulation of the canal nerve, we found conflicting results: the pressure in the stomach sometimes increased, and sometimes decreased. There might be several neural structures between the semicircular canal nerve and the vomiting center in the dorsolateral portion of the reticular formation of medulla oblongata. Retching or vomiting-like behavior during both respiration and movement of the stomach was recorded during stimulation at several sites in the lateral medullary reticular formation. However, the evoked unit activities were not always induced by stimulation of the canal nerve.

当科で経験した胸腺癌7例について, 臨床病理学的検討を加え, さらにこれらのパラフィン包埋切片を用いて, flowcytometry (FCR) にごよる, Ploidy patternを解析した.また, 癌抑制遺伝子P53蛋白の発現について, 免疫組織染色を行なって検討した.年齢は, 47～71歳 (平均年齢56.3歳), 男性3例, 女性4例, 組織型は扁平上皮癌5例, 大細胞癌1例, 小細胞癌1例で, 病期はII期1例, III期3例, IVa期, IVb期がそれぞれ1例であった.胸腺癌の平均生在期間を当科で経験した浸潤型胸腺腫10例と比較すると前者は27.2ヵ月, 後者は75.2ヵ月で, 有意に前者が予後不良であった (p=0.016). Ploidy pattern, p53蛋白発現は, diploidy が2例, p53陰性が2例, aneuploidyが5例, p53陽性が5例であった.胸腺癌は高増殖能で進行例が多く, その進展, 増殖には p53 遺伝子の不活化が関与している可能性が示唆された.

症例は70歳, 男性.左前胸部痛を主訴に入院し, 胸部X線写真で左第3肋骨前方上縁に骨融解像が認められた.胸部CT・MRI検査で, 骨融解の部位に一致した胸壁内に腫瘍が認められ, また, 腫瘍直下には肺嚢胞が認められた.胸壁腫瘍の診断で手術を施行したところ, 腫瘍と肺嚢胞の一部が一塊となっており, 術中病理検査で悪性所見が認められた.胸壁原発の悪性腫瘍と考えて胸壁と肺の一部を一塊に切除したが, 術後の病理診断は肺嚢胞壁原発の扁平上皮癌であった.本症例は胸壁へ強く浸潤していたにもかかわらず, 肺内への浸潤は認められず, 臨床的にも骨破壊を来たした時点でようやく発見されている.気腫性嚢胞の肺癌合併はよく経験されるところであるが, 本症例のように胸壁進展肺癌の形態をとるタイプもあることを強調したい.気腫性肺嚢胞症は, 嚢胞壁や胸壁の変化も観察することが重要であると考えられた.

原発性非小細胞肺癌におけるBcl-2 (B cell lymphoma/leukemia2) 遺伝子蛋白の発現について免疫組織学的に検討した.Bcl-2の発現は, 腺癌7/107例 (6.5%), 扁平上皮癌17/58例 (29.3%), 腺扁平上皮癌0/23例 (0%), 大細胞癌1/11例 (9.1%), 腺様嚢胞癌1/1例 (100%) に認められ, 扁平上皮癌は腺癌, 腺扁平上皮癌に比べ有意に高発現を示した (P

A novel collimated microfiber spectroscopy technique using an optical fiber probe with microball lens was developed to observe the photonic crystalline characteristics of porous anodized alumina (PAA) slabs with disordered arrays of holes. Transmittance spectra of the PAA slab observed by the microfiber probe with ball lens showed a broad valley at ∼410 nm; conversely, no significant valley was observed by an ordinary microfiber spectroscope without ball lens. The broad valley was comparable with that observed in a spectrum simulated for a model based on a scanning electron microscopy image of the PAA slab by using the finite-difference time-domain method.

There are very few reports regarding the outcome of lung cancer surgery in patients with schizophrenia, and the clinical features of such patients are still unclear. From 2004 to 2012, 11 lung cancer patients (six male, five female; mean age, 62.7 years) with schizophrenia underwent lung resections at our institutions. All patients had been institutionalized because they were unable to live independently at home. We retrospectively evaluated their postoperative clinical outcomes and long-term results. Ten of the 11 patients had comorbidities, such as diabetes mellitus and chronic obstructive pulmonary disease. Preoperatively, two patients had a history of treatment for other primary cancers in other organs, and one was on hemodialysis. A lobectomy was performed in nine patients, a segmentectomy in one, and a partial resection in one. There were no hospital deaths. The postoperative morbidity included two cases of pneumonia, one of atelectasis, and one of prolonged air leakage lasting more than 7 days. Wandering was postoperatively observed in two patients; one of these fell and fractured the left femur. At the time of our investigation, two patients were deceased, and the overall 5-year survival rate was 74.1 %. The postoperative morbidity and long-term results of schizophrenic patients with lung cancer were acceptable. Therefore, even in patients with schizophrenia, surgical treatment for lung cancer should be recommended when deemed to be necessary.

To examine the relationship between preterm birth and socioeconomic factors, past history, cervical length, cervical interleukin-8, bacterial vaginosis, underlying diseases, use of medication, employment status, sex of the fetus and multiple pregnancy.In a multicenter, prospective, observational study, 1810 Japanese women registering their future delivery were enrolled at 8⁺⁰ to 12⁺⁶ weeks of gestation. Data on cervical length and delivery were obtained from 1365 pregnant women. Multivariate logistic regression analysis was performed.Short cervical length, steroid use, multiple pregnancy and male fetus were risk factors for preterm birth before 34 weeks of gestation. Multiple pregnancy, low educational level, short cervical length and part-timer were risk factors for preterm birth before 37 weeks of gestation.Multiple pregnancy and cervical shortening at 20-24 weeks of gestation was a stronger risk factor for preterm birth. Any pregnant woman being part-time employee or low educational level, having a male fetus and requiring steroid treatment should be watched for the development of preterm birth.

The incidence of Meniere's disease was investigated in patients with vertigo or dizziness who visited Kitasato University Hospital from 1985 to 1991. Of a total of 3, 222, Meniere's disease was diagnosed in 251 patients (7.8%). The male female ration was 1 : 1.73.Seventy patients with Meniere's disease were classified into 5 groups, depending on the duration of the disease. Both ears were affected in 12 (17.1 %) of the 70, but in 4 (33.3%) of the 12 patients with more than 15 years of disease.Of the 70 patients 67 were treated conservatively, and 3 surgically. The frequency of vertigo attacks and the degree of hearing impairment during the past year in each group were compared. No vertigo attack was experienced in 13 (24.1 %) of the 70. In 49 patients the average number of vertigo attack was 4.5 in the past year.Adequate therapy is most desirable within one year after the onset of Meniere's disease, because the frequency of vertigo attacks and the hearing level can be best controlled when therapy is started less than one year after the onset.

Immunophenotyping of lymphoma using paraffin-embedded lymphoid tissue is useful in identifying the large neoplastic B cells in T-cell-rich B-cell lymphoma (TRBL), but does not succeed in deciding clonality. We studied six cases to determine the clonal population of B and T cells of TRBL. Immunohistochemistry on frozen and paraffin-embedded material showed that the cellular population in all six cases consisted mainly of T cells; fewer than ten percent of the cells stained as B cells. However, in all cases, monoclonality of the immunoglobulin was helpful for diagnosing the B-cell neoplasia. Southern blot-yielded genetic analysis showed monoclonality of B cells in three cases, but no evidence of clonality in the T cells. Moreover, gene monoclonality has been detected in all cases examined by polymerase chain reaction, using the primers for the V and J regions of the immunoglobulin heavy chain gene. For T cells, the D and J regions of the T-cell receptor (TCR) beta chain showed the same patterns of oligoclonal bands in all cells, and the V and J regions of the TCR gamma chain showed the same bands in all. The expression of TCR V beta families was polyclonal but restricted.

縦隔奇形腫のうち若年者に多く, 予後が比較的不良とされる悪性奇形腫4例について Flow Cytometry を用いた核DNA量解析をおこなった.コントロールである良性奇形腫では, diploidy を示したが悪性奇形腫では全て aneuploidy を示した. aneuploidy を示した症例の中では30%と高い比率を示した症例は治療にもかかわらず予後は5ヵ月であり, 18%の症例は20ヵ月生存した.悪性奇形腫においては病態の把握や予後を推測するうえで組織像や腫瘍マーカーだけでなくDNAの解析を加えることが有意義と考えられた.

The cervical lymph nodes of 27 patients with histiocytic necrotizing lymphadenitis (HNL) were examined, as were those of 9 patients with tuberculous lymphadenitis (Tb), 10 with reactive paracortical hyperplasia (RPH), and 10 with nonspecific lymphadenitis (NSL). Southern blot analysis, the polymerase chain reaction (PCR), and in situ hybridization were use to locate the human herpesvirus-6 (HHV-6) genome. Southern blot analysis showed that all cases were negative for HHV-6 genomes, although all but one HNL case expressed HHV-6 genome using PCR. On in situ hybridization all 10 HNL cases, 6 of the 10 RPH cases, 6 of the 10 NSL cases, and 2 of the 9 Tb cases showed HHV-6 DNA. These results indicate that the presence of HHV-6 genome is not specifically related to HNL, and that this virus could hibernate in a latent form in the cervical lymph nodes. In addition, we examined three different primers (A, B, and C) for PCR amplification of HHV-6 genomes.

We compared the effectiveness of 2 different therapies in elderly patients with benign paroxysmal positional vertigo.Eighteen patients were treated with an anti-vertigo drug and 18 with vestibular training (VT) and the same drug. They were classified into Group "B" and "VT + B", respectively.The background factors, such as age, severity in symptoms, degree of disturbance in examinations, et, were similar in the 2 groups.Vertigo, dizziness, unsteadiness in Mann's test and positional nystagmus improved significantly more in Group "VT+B" than in Group "B". The global judgment in each group revealed that both marked and moderate improvement was significantly higher in Group "VT+B" than in Group "B" (P

Meso-2,3-butanediol dehydrogenase (meso-BDH) has been crystallized and preliminary X-ray crystallographic characterization of meso-BDH crystals has been performed. Single crystals of meso-BDH were prepared in two forms by the hanging-drop vapour-diffusion method using polyethylene glycol as a precipitant. Form I crystals belong to space group C2, with unit-cell parameters a = 215.5, b = 79.4, c = 134.8 A, beta = 98.22 degrees, and form II crystals belong to space group P2(1), with unit-cell parameters a = 69.16, b = 109.78, c = 127.28 A, beta = 102.29 degrees. The crystals diffracted to 2.0 and 1.7 A resolutions, respectively, using synchrotron radiation.

The purpose of this study was to determine whether the proportion of galectin-1-expressing peripheral blood T and NK cells is altered in normal pregnancy and preeclampsia (PE). We also examined whether circulating levels of galectin-1 and anti-galectin-1 autoantibodies are affected in PE. Seventy preeclamptic patients, 75 healthy pregnant and 21 healthy non-pregnant women were involved in this study. Serum galectin-1 and anti-galectin-1 autoantibody levels were measured by ELISA. Intracellular galectin-1 expression of lymphocytes was determined with flow cytometry. Serum galectin-1 and anti-galectin-1 IgG levels did not differ significantly between the healthy pregnant and the PE group. In healthy pregnant women, significantly higher percentage of T and NK cells expressed gal-1 in their cytoplasma than in healthy non-pregnant women. However, the proportion of galectin-1-expressing peripheral blood T and NK cells was markedly decreased in PE compared to normal pregnancy, which might contribute to the activation of innate and acquired immune cells.

To evaluate (18)F-fluorodeoxyglucose (FDG) uptake to predict the malignant nature and analyze the correlation between FDG uptake and expression of glucose transporter 1 (Glut-1) and hexokinase II (HK-II) in thymic epithelial tumors.Eleven patients with a thymic epithelial tumor who underwent FDG PET/CT before therapy were reviewed. The thymic tumors were classified by the WHO histological classification and Masaoka clinical staging. Comparison of maximum standardized uptake value (SUV(max)) of the lesion was made between the low-risk (Type A, AB and B1) and high-risk {Type B2, B3 and C (thymic cancer)} groups and among clinical stages. Expression of Glut-1 and HK-II was analyzed immunohistochemically.All 11 tumors showed FDG uptake visually. SUV(max) was significantly higher in the high-risk group (n=5, 5.24 ± 2.44) than the low-risk group (n=6, 3.05 ± 0.55) (P=0.008). Staining scores of both Glut-1 and HK-II were significantly higher in the high-risk group than in the low-risk group (Glut1: P=0.034 and HK-II: P=0.036). There were no significant differences in SUV(max) (P=0.11), Glut-1 (P=0.35) and HK-II scores (P=0.29) among clinical stages. SUV(max) was significantly correlated to each of the staining scores of Glut-1 (ρ=0.68, P=0.031) and HK-II (ρ=0.72, P=0.024).These preliminary results support the previously published view that SUV(max) may be useful to predict the malignant nature of thymic epitherial tumors and suggest that the degree of FDG uptake in the thymic epitherial tumors is closely related to the amount of Glut-1 and HK-II in the tumor.

The Th1/Th2 paradigm has recently been reconstituted to include a third population, Th17 cells. It has been reported that Th2 type immunity is predominantly present in normal pregnancy. However, the level of Th17 cells during pregnancy is still unclear. We investigated the level of peripheral Th17 cells in healthy pregnancy subjects.of study To evaluate the levels of Th17 cells, we investigated the proportion of peripheral blood mononuclear cells that produced IL-17 in the first, second, and third trimester pregnancy subjects using flow cytometry. We further studied the proportion of decidual lymphocytes that produced IL-17 in early pregnant subjects.Most of the IL-17-producing cells were CD4(+) T cells. The number of circulating Th17 cells did not change during pregnancy. In a paired t-test of early normal pregnant subjects, the proportion of IL-17(+) decidual lymphocytes was significantly higher than that of peripheral blood lymphocytes.Th17 levels in peripheral blood lymphocytes do not change during normal pregnancy.

A new low profile waveguide band-rejection filter (BRF) is proposed. In the waveguide BRF, substrate integrated waveguide (SIW) cavities are employed as resonators, and they are simply inserted in a hollow waveguide. For this simple configuration, this waveguide BRF is low-profile and easy to fabricate compared with a conventional waveguide BRF, which employs resonant waveguide cavities outside the waveguide and needs costly machining processes to fabricate. A Q-band prototype waveguide BRF is fabricated using alumina substrates and the measured results showed high attenuation more than 50 dB at 47 GHz in 2% fractional bandwidth.

Background Intra-amniotic infection has long been recognized as the leading cause of preterm delivery. Microbial culture is the gold standard for the detection of intra-amniotic infection, but several days are required, and many bacterial species in the amniotic fluid are difficult to cultivate. Methods We developed a novel nested-PCR-based assay for detecting Mycoplasma, Ureaplasma, other bacteria and fungi in amniotic fluid samples within three hours of sample collection. To detect prokaryotes, eukaryote-made thermostable DNA polymerase, which is free from bacterial DNA contamination, is used in combination with bacterial universal primers. In contrast, to detect eukaryotes, conventional bacterially-made thermostable DNA polymerase is used in combination with fungal universal primers. To assess the validity of the PCR assay, we compared the PCR and conventional culture results using 300 amniotic fluid samples. Results Based on the detection level (positive and negative), 93.3% (280/300) of Mycoplasma, 94.3% (283/300) of Ureaplasma, 89.3% (268/300) of other bacteria and 99.7% (299/300) of fungi matched the culture results. Meanwhile, concerning the detection of bacteria other than Mycoplasma and Ureaplasma, 228 samples were negative according to the PCR method, 98.2% (224/228) of which were also negative based on the culture method. Employing the devised primer sets, mixed amniotic fluid infections of Mycoplasma, Ureaplasma and/or other bacteria could be clearly distinguished. In addition, we also attempted to compare the relative abundance in 28 amniotic fluid samples with mixed infection, and judged dominance by comparing the Ct values of quantitative real-time PCR. Conclusions We developed a novel PCR assay for the rapid detection of Mycoplasma, Ureaplasma, other bacteria and fungi in amniotic fluid samples. This assay can also be applied to accurately diagnose the absence of bacteria in samples. We believe that this assay will positively contribute to the treatment of intra-amniotic infection and the prevention of preterm delivery.