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Endometriosis involving the perineum is rare. We have collected total 110 cases of perineal endometriosis from the literature which included only 5 cases in Japan. The cases reported have steadily increased in recent years. Based on the fact that four new cases have been found in our Hospital in a relatively shorter period, we postulate much higher incidence of this disease in Japan than that would appear from the literature. Almost all of cases were managed by episiotomy associated with parturition, and the resultant endometriosis developed in previous episiotomy scar or at its adjacent site. The patients commonly complained of painful paeineal swelling during menstruation. The period of latency between episiotomy and manifestation of symptoms varied 45 days to 14 years, showing a peak between 1 to 3 years. The average age of patients was reported to be between 28 and 38 years from different institutions, being somewhat lower than the usual age group for patients with endometriosis. The perineal lumps were recognized as a single dark reddish or bluish nodule which varied 1 to 2 cm in diameter. On palpation, the mass was less movable, often tender due to periodic bleeding into cystic space. It increased in size and became painful during menstrual period ; after menses, the nodule became almost painless and decreased in size. When the patients fulfilled these clinical features, the preoperative diagnosis of perineal endometriosis is possible. The treatment of choice is simple local excision. Complementary hormonal therapy has been suggested in several cases with large or recurrent mass. Definite histologic diagnosis can be made by demonstrating endometrial glands and stroma, accom-panying hemorrhage, and granulation tissues characteristically containing large amounts of hemosiderin and lipid debris. The specimens obtained from Gase 3 and 4 of our series were subjected to ultrastructural analysis.Electron microscopic examination showed that the epithelial cells in specimen of Case 3 retained the fine structure of endometrial cells during proliferative phase, and those in specimen of Case 4did that of the cells during early secretory phase. As to histogenesis of perineal endometriosis, the most cases reported including our cases can reasonably be explained by direct wound implantation of shed endometrial tissues during delivery. On the basis of this implantation theory, we proposed some measures to eliminate the occurrence of this disease.

Three bacterial strains of Bifidobacterium and Clostridium sp. from patients with inflammatory bowel disease (I.B.D.) and Streptococcus pneumoniae from a patient with pneumonia were identified to produce extracellular proteases cleaving IgA into Fab and Fc fragments. Although the proteases from the Bifidobacterium and the Streptococcus pneumoniae showed the characteristics of typical IgA1 proteases, cleaving the IgA of only the IgA1 subclass, the protease from Clostridium sp. revealed a dual substrate specificity, in that it cleaved both IgA1 and IgA2 of the A2m(1) allotype. The latter protease, however, did not show any activity with respect to the IgA2 of the A2m(2) allotype. Fc fragments isolated from the IgA1 and the IgA2 A2m(1) by digestion with the Clostridium sp. protease were identified to have an identical amino terminal residue of valine. The site of cleavage in both the alpha 1 and the alpha 2 of A2m(1) by the protease was assumed to be an identical peptide bond at Pro(221)-Val(222), which is a common one present just before the hinge of both the alpha 1 and the alpha 2 of the A2m(1) but not of the alpha 2 of the A2m(2). The protease was sensitive to ethylene-diamino tetraacetic acid, a chelating agent, similar to other already reported IgA1 proteases.

In four patients with essential hypertension and one patient with renovascular hypertension, decreases in blood pressure and plasma angiotensin II levels, and increases in plasma renin activity and plasma kinin levels were observed during eight days of alacepril treatment. Significant correlations between the changes in mean arterial pressure and those in plasma angiotensin II or kinin levels were observed positively or negatively, respectively, in the essential hypertensives. These findings suggest that the hypotensive effect of alacepril might be caused mainly by a decrease in plasma angiotensin II levels and, at least in part, by an increase in plasma kinin levels.

The effect of diltiazem pretreatment on the pharmacokinetics of nifedipine were determined in six healthy male volunteers. Placebo or diltiazem (30 mg and 90 mg) was given orally three times daily for 3 days in a double-blind, Latin square method. On the fourth day, a 20-mg nifedipine was given orally 1 hour after the last dose of placebo or diltiazem. The mean elimination half-life of nifedipine prolonged significantly following diltiazem (2.54 hours on placebo vs 3.40 hours on 30 mg diltiazem and 3.47 on 90 mg diltiazem, both P less than .01). The mean AUC of nifedipine increased during diltiazem (1726.6 nmol X hr/ml on placebo vs 3838.0 on 30 mg diltiazem, and 5370.0 on 90 mg diltiazem, both P less than .05, 30 mg vs 90 mg, 0.1 less than P less than .05). The ratio of the AUC of primary metabolite (nitropyridine form) to the AUC of nifedipine was reduced by diltiazem pretreatment in a dose-dependent manner. ICG clearance was not influenced following diltiazem. These results indicate that diltiazem dose-dependently alters the pharmacokinetic profiles of nifedipine. The ICG clearance test showed that the liver blood flow did not decrease during diltiazem therapy, therefore, the reduction in the metabolic clearance of nifedipine might be caused by inhibiting effect of diltiazem on the activity of drug oxidizing enzymes.

The Hayabusa2 spacecraft investigated the C-type (carbonaceous) asteroid (162173) Ryugu. The mission performed two landing operations to collect samples of surface and subsurface material, the latter exposed by an artificial impact. We present images of the second touchdown site, finding that ejecta from the impact crater was present at the sample location. Surface pebbles at both landing sites show morphological variations ranging from rugged to smooth, similar to Ryugu’s boulders, and shapes from quasi-spherical to flattened. The samples were returned to Earth on 6 December 2020. We describe the morphology of >5 grams of returned pebbles and sand. Their diverse color, shape, and structure are consistent with the observed materials of Ryugu; we conclude that they are a representative sample of the asteroid.

To elucidate the localization of the subunit C of aldolase (aldolase C) in peripheral neuroendocrine cells, we made an immunohistochemical study with monospecific antibodies against human aldolase C. Aldolase C was found to be localized in various types of neuroendocrine cells; in the pituitary gland, thyroid, pancreas, adrenal gland, bronchus, and gastrointestinal tract.

Tissue fibrinolytic activity, mainly due to activator of tissue plasminogen was increased in the biopsied gastric mucosa of patients with protein-losing gastropathy. Antiplasmin therapy with trans-AMCHA (trans -4-aminomethyl cyclohexane carboxylic acid) was dramatically effective, except in the case of a patient with intestinal lymphangiectasia. These findings suggest that increased fibrinolysis in the gastrointestinal mucosa may play an important role in enhancing mucosal permeability to plasma proteins.

We used two-dimensional echocardiography (2-D echo) for the mass screening of 2,673 subjects for cardiovascular disorders (1,032 men, 1,641 women, aged 23-95 years with a mean age of 59), who lived in 12 rural areas in Japan. In 1,665 of the 2,673 subjects (62.3%), cardiac abnormalities were recognized. Three major abnormalities included sclerotic aortic (33.0%) and mitral valves (21.8%), and left ventricular (LV) hypertrophy (15.9%). Apparent pericardial effusion (54 cases), mitral valve prolapse (44 cases), and dilated cardiomyopathy (4 cases) were incidentally found in this study. Prevalence of the abnormalities insidiously increased with age (below 49 years: 39%, and above 80 years: 97%), and this was apparently higher in men than in women. The abnormal findings which were significantly higher in men were the sclerotic aortic valves, LV hypertrophy and dysfunction, the prevalence of which was particularly high in ages 40-79, but it became nearly equal beyond 80 years of age. These results may indicate a sexual difference in the influence of age on the cardiovascular system. It was concluded that 2-D echo is helpful for primary screening and prevention of cardiovascular disorders.

We have found that neuroendocrine tumors (including neuroblastoma, ganglioneuroma, gut carcinoid, pheochromocytoma, medullary thyroid carcinoma, insulinoma, glucagonoma, prolactinoma, carotid body tumor, and small cell lung carcinoma) produce considerable amounts (about 1000-80,000 ng/g tissue) of the alpha subunit of guanine nucleotide-binding protein, GO (GO alpha), whereas nonneuroendocrine tumors contain less than 300 ng of GO alpha/g tissue. GO alpha in the neuroendocrine tumors was present both in the soluble fraction, and cholate-extractable membrane-bound fraction of tissues. Immunoblots of membrane fractions of neuroblastoma and carcinoid tissues confirmed that the immunoreactive substance in the tumor tissues was GO alpha. Immunohistochemically, GO alpha was localized consistently in the cell membrane and occasionally in the cytoplasm of neuroendocrine tumors. GO alpha was also detected in sera of 73% patients with neuroblastoma at diagnosis, whereas serum GO alpha concentrations in control children, or patients with nonneuroendocrine tumors were lower than the detection limit of the immunoassay method employed. Serum GO alpha concentrations in patients with neuroblastoma changed with the clinical course; they fell in patients responding to treatment and increased in patients who relapsed. Since GO alpha, a specific protein in the neural and neuroendocrine cells, was found to be produced in considerable amounts by all types of neuroendocrine tumors but not in nonneuroendocrine tumors, GO alpha might be a useful biomarker for neuroendocrine tumors.

To investigate the basic mechanisms of granuloma formation, in vitro granulomas were induced by culturing murine spleen cells in the presence of artificial microparticles. Large granulomas developed around dextran beads. The lesions were inducible by spleen cells from either normal mice or athymic nude mice. Minimal inflammation was produced around latex beads. The histologic features and time kinetics of granulomas in vitro. Culture supernatants of dextran induced granulomas contained high levels of interleukin-1 (IL-1) activity but not interleukin-2 (IL-2) or interleukin-4 (IL-4) activity. IL-1 activity was correlated with granuloma size. Additionally, granulomas were produced by culturing spleen cells in the presence of agarose beads coupled to recombinant IL-1 or recombinant tumor necrosis factor-alpha (TNF-alpha). Granulomatous lesions also were induced by macrophage-enriched populations in the presence of monokine-coupled beads. Adherent macrophages, but not nonadherent cells, were required for induction of granulomas in vitro. In contrast, very small lesions were seen when spleen cells or adherent cells were cultured in the presence of beads coupled to recombinant IL-2 or recombinant interferon-gamma (IFN-gamma). These results suggest that macrophages and monokines such as IL-1 and TNF-alpha play an essential role in granuloma formation in vitro.

The growth of the C3H mouse mammary tumor (MMT) is considered to be hormone independent. Medroxyprogesterone acetate (MPA) had no effect on the growth of transplanted autochthonous MMT or the colony-formation of MMT cells. The tumor angiogenesis factor (TAF) activity of tumor-extract prepared from C3H mouse with transplanted autochthonous MMT and injected with 0.67 mg of MPA (in vivo MPA group) and that prepared from the colony of MMT cells treated with 10(-6) M MPA (in vitro MPA group) was lower (100.0% and 9.8%) than those of the in vivo and in vitro cortisol groups (325.5% and 44.3%), and the in vivo and in vitro groups without treatment (393.5% and 46.8%), respectively. The fibroblast growth factor (FGF) activity of the in vivo and in vitro MPA groups was lower (23.7% and 2.7%) than those of the in vivo and in vitro cortisol groups (54.7% and 11.3%), and the in vivo and in vitro groups without treatment (49.6% and 11.3%), respectively. Therefore, MPA may reduce neovascularization induced by TAF and FGF, although it had no effect on the growth of this MMT, and it had a glucocorticoid action similar to that of cortisol.

The uptake of D-glucose, L-leucine and L-leucylglycine into intestinal brush border membrane vesicles isolated from rats was investigated. They were fed either oligopeptide (SP group) or amino acid (AA group) elemental diets for four weeks. The results are as follows. As for L-leucine uptake, there was no significant difference in Km value between SP group and AA group. But Jmax value of SP group is significantly 1.7 times as large as that of AA group. As for L-leucylglycine uptake, there was no difference in Km value between the two groups, but Jmax value of SP group is significantly about twice as large as that of AA group. There is however, no difference in Km value and Jmax value between the both groups. These results indicate that L-leucine and L-leucylglycine transport carriers in the brush border membrane significantly increased in SP group compared with that in AA group, and that these carriers might be induced by oligopeptides as intraintestinal substrate.

The cardiovascular effects of three single intravenous doses of a beta 1-adrenoceptor partial agonist, xamoterol (0.025, 0.05 and 0.1 mg kg-1) and placebo were studied in six healthy volunteers at rest using a single-blind design. In addition to heart rate and blood pressure measurements, cardiac contractility was measured by means of M-mode echocardiography and systolic time intervals. Ambulatory 24 h Holter-monitoring of the electrocardiogram was performed. Plasma concentrations of xamoterol were measured. Compared to baseline, xamoterol (0.025 mg kg-1) increased heart rate (61 +/- 3-68 +/- 3 beats min-1, means and SEM) and systolic blood pressure (119 +/- 3-138 +/- 5 mm Hg) but decreased pre-ejection period (100 +/- 4-76 +/- 5 msec). Stroke volume (88 +/- 6-104 +/- 10 ml), cardiac output (4.8 +/- 0.4-6.6 +/- 0.61 min-1), velocity of circumferential fibre shortening (1.15 +/- 0.06-1.50 +/- 0.06 circ s-1) were increased by xamoterol. No significant changes were produced by placebo. No dose-dependent effects were seen and maximum effects were produced by 0.025 mg kg-1 xamoterol. Significant effects were observed for 2 h. The areas under the plasma concentration curves (AUC0-12) showed a linear dose response. No adverse effects attributable to xamoterol were seen in haematological, biochemical, urinalysis or electrocardiographic tests. Four volunteers were aware of a more forceful heart beat after xamoterol, but this was mild and transient. It is concluded that xamoterol has a positive inotropic action.

As a new method for regional wall motion analysis, the tomographic functional images, including "coronal", "sagittal" and "four-chamber" sections, were produced by applying the fundamental Fourier analysis using gated cardiac pool emission computed tomography (POOL-SPECT). Segmental wall motion was qualitatively assessed from the functional images in 10 normal subjects and in 48 patients with myocardial infarction. The results were compared with those assessed by gated blood pool planar images (modified LAO 45), two-dimensional echocardiography (2DE) or contrast left ventriculography (LVG). The following results were obtained. 1. POOL-SPECT imaging could separate the ventricle in three dimensions from the neighboring cardiovascular system by avoiding the overlapping blood pool to make accurate recognition of regional wall motion. 2. The functional tomograms had greater clinical efficacy in the diagnosis of infarcted segments than did the conventional equilibrium method, with high sensitivity (93/99, 93.9%), specificity (128/141, 90.8%) and accuracy (221/240, 92.1%), especially in the apical and inferoposterior portions. 3. Tomographic functional imaging facilitated estimating segmental cardiac performance from spatial and temporal aspects. The amplitude image which expresses regional stroke volume was readily available to detect hypokinesis and akinesis. The phase image of the initial cardiac movement was very useful for diagnosing dyskinesis. 4. In comparing the qualitative analysis with 2DE or LVG, complete agreement was observed in 80% (128/160) and 85.1% (149/175) of segments, though POOL-SPECT imaging showed underestimations in 11% of the segments. In conclusion, POOL-SPECT can be performed repeatedly without potential risks and the tomographic functional images derived from application of Fourier analysis to POOL-SPECT images are very useful for qualitative and three-dimensional analysis of regional wall motion. Thus, this technique may be a promising procedure in clinical investigations, obviating the disadvantages of conventional methods.

The hypotensive effect of 4-(2'-nitrophenyl)-2,6-dimethyl-1,4-dihydropyridine-3,5-dicarboxydimethylester (nifedipine, Adalat) was studied in 15 hypertensive patients with chronic renal failure. The decrease of blood pressure lasted for approximately 3 h and maximum decrement was achieved in 1 h after oral administration of nifedipine (10 mg). Hypotensive action of the drug was associated with a constant decrease in total peripheral resistance and an increase in cardiac output, plasma renin activity (PRA), and plasma norepinephrine (noradrenaline). Initial PRA was apparently the major determinant of the rise in PRA since a close correlation was present between the initial value and the increase induced by nifedipine (r = 0.93, p less than 0.05). Marked reduction of blood pressure without noticeable side effects was observed in two cases who had not responded to previous antihypertensive treatment. These data suggest that nifedipine exerts its hypotensive action through peripheral vasodilation and may be an effective drug for treatment of hypertension during chronic renal failure.

Pancreatic injury was induced to rats with intraperitoneal injection of ethionine 60 mg per 100 g BW twice or three times weekly for 6 weeks. These rats were given 100 mg/kg of Camostate mesilate (CM) via a gastric tube daily for 14 days. CM administration resulted in an increase of pancreatic wet weight, hypertrophy and hyperplasia of acinar cells, and an increase of exocrine pancreatic function. Acini prepared from CM and ethionine-treated rats exhibited increased response to caerulein, but decreased sensitivity to caerulein. The plasma CCK level in rats with CM administration 24 hours later was higher than that without CM administration. However, there were no significant changes in plasma CCK and secretin level thereafter. We concluded that CM had a trophic effect on the pancrease with ethionine-induced pancreatic injury, and CCK was considered playing the same role in injured pancreas as the normal rat pancreas. Studies using CCK receptor antagonist are needed for further clarification.

The present study was aimed to evaluate the acute and chronic hypotensive effects of nifedipine (Bay a 1040, Adalat) and niludipine (Bay a 7168) in hypertensive patients with chronic renal failure. 1. The decrease of blood pressure lasted for at least 3 h and maximum decrement was achieved in 60 min (26% decrement, p less than 0.05) after oral administration of nifedipine (10 mg). On the other hand, niludipine (20 mg) caused decrease of blood pressure for at least 4 h and attained maximum decrement in 90 min (13% decrement, p less than 0.05) after oral administration. 2. In chronic studies of both drugs, the maximum decrease of blood pressure (p less than 0.05) was attained after one week and lasted at least 4 weeks. There were no significant changes of pulse rate, body weight and urine volume in both nifedipine and niludipine groups. 3. Nifedipine caused great diurnal or day-to-day fluctuations of blood pressures after chronic administrations. On the other hand niludipine did not cause any significant fluctuations. Any serious complications could not be seen during these studies. In conclusion, these results provide clinical evidence that niludipine could be usefused great diurnal or day-to-day fluctuations of blood pressures after chronic administrations. On the other hand niludipine did not cause any significant fluctuations. Any serious complications could not be seen during these studies. In conclusion, these results provide clinical evidence that niludipine could be useful for treatment of hypertension associated with chronic renal failure. Results also suggest that the optimal efficacy of nifedipine and niludipine in part depends on the specific clinical situation at hand. For example, nifedipine seems to be the drug of choice in hypertensive emergencies when there is a need for rapid lowering of blood pressure.

Serial changes in cardiac function after surgery were studied in 84 patients with various valvular heart diseases using M-mode and two-dimensional echocardiography (2-DE). The results were as follows: 1. Serial postoperative changes in cardiac dimensions and left ventricular functions were well documented by M-mode and 2-DE. 2. The change in left ventricular function became most pronounced one month after surgery, and remained unchanged in many patients during the subsequent observation periods. 3. Open mitral commissurotomy (OMC) and mitral valve replacement (MVR) were compared as to their benefits for patients with isolated mitral stenosis (MS) accompanied by left ventricular dysfunction, and MVR proved superior to OMC in terms of magnitude of functional improvement. 4. (a) Ejection fraction (EF) in patients with left ventricular volume overload was overestimated due to the influence of increased preload. Accordingly, EF which tended to be depressed one month after surgery was judged to reflect altered loading conditions; it did not represent myocardial damage caused by valve replacement. (b) In patients who had MVR or aortic valve replacement (AVR) without postoperative heart failure, EF remained unchanged in the MVR group after a lapse of one month postoperatively, while it tended to improve in the AVR group. This difference was thought to be caused by changes in left ventricular systolic overload resulting from correction of regurgitation. (c) In patients with MR and postoperative heart failure, there was a tendency for EF to decrease after a lapse of one month postoperatively.(ABSTRACT TRUNCATED AT 250 WORDS)

A new antiarrhythmic agent, 1-(2,6- dimethylphenoxy )-2-aminopropane (mexiletine), was investigated in 10 patients with chronic premature ventricular contractions (PVCs) to evaluate the antiarrhythmic efficacy and the pharmacokinetics after single intravenous, single oral and repeated oral dosings of mexiletine 150 mg. Mexiletine was well absorbed from the intestinal tract. The relative bioavailability was 83.2 +/- 8.9% (mean +/- S.E.). The time-concentration curve of mexiletine fitted in well with two-compartment open model. Elimination half-life, volume of distribution and plasma clearance were 10.54 +/- 0.26 h, 2.10 +/- 0.49 l/kg, 6.01 +/- 0.63 ml/min/kg, respectively. The computer-simulated time-concentration curves of multiple oral dosings , which were based on the kinetic parameters from single oral dosing, conformed well with measured concentrations. This might be applied to predict the plasma level of mexiletine. The steady state of plasma mexiletine level was reached 4-5 days after 450 mg/day dosings and ranged 0.75-2.18 micrograms/ml. In 6 of 10 patients, the frequency of PVCs was suppressed more than 75% as compared with the pre-medication value. Mexiletine was well tolerated at a dose of 450 mg/day. However, of 4 patients with the dose increased to 600 mg/day, the administration was ceased in three patients due to gastrointestinal symptoms and tremor. All of these adverse reactions disappeared when the administration was stopped. These results suggest that mexiletine is effective against ventricular arrhythmias and the dosage should be carefully adjusted. The prediction of plasma level would be applied to the dosage regimen of mexiletine.

18 patients with ventricular tachycardia (VT) underwent direct arrhythmia surgery between 1984 and 1988. There were 8 patients with ischemic VT, and 10 with nonischemic VT. Operative technique consisted of ablative procedures of the arrhythmogenic area determined by pre- and intraoperative mapping. Induced VT was usually unstable and transient during operation, so that instantaneous multi-point mapping was necessary in almost cases. For VT originated in the left ventricle or interventricular septum, the earliest excitation point determined by the epicardial mapping did not always predict the endocardial arrhythmogenic focus. Pre- and/or intraoperative endocardial mapping was important in this regard. Cryocoagulation (-150 degrees C, 120 sec) was mainly used as an ablative procedure; for ischemic VT, endocardial resection was added, and in nonischemic VT originated in the right ventricular outflow tract, transmural resection was combined with the cryoablation. In performing surgery for nonischemic VT, care must have been taken to make transmural cryocoagulation because the arrhythmogenic focus could exist intramurally. There were no operative deaths. In one patient with nonischemic VT, reoperation was required. After a mean follow-up of 17 month, all the patients are free from sustained VT.

The simultaneous occurrence of carcinoma and carcinoid in the stomach is rare. Only 5 cases have been reported in the literature so far. Our patient developed double primary neoplasms adjoining the gastric antrum. One was an early ulcerated adenocarcinoma limited to the submucosa, the other a minute carcinoid also within the submucosa. A large amount of 5-HIAA, but a normal amount of histamine, was excreted in the urine. The carcinoid syndrome, however, was absent through clinical course. The patient died of liver metastasis 3.5 months after gastrectomy. Microscopic examination after autopsy disclosed that the metastases consisted of only carcinoid cells.

To predict pulmonary arterial pressure non-invasively, systolic motion of the pulmonic valve was evaluated in relation to flow velocity at the pulmonic valve measured by the electromagnetic catheter-tip flow velocity probe or by linear contrast echo. Seventy-five cases including 45 cases with pulmonary hypertension (PH) of mean pulmonary arterial pressure (PAP) above 25 mmHg were studied. On the basis of the presence and velocity of mid-systolic semi-closure, the reopening and fluttering of the PV, the systolic motion of the pulmonic valve was classified into the following 5 types: 1) rapid semi-closure followed by reopening, 2) rapid semi-closure without reopening, 3) slow semi-closure followed by slow reopening, 4) rough fluttering during whole systole, and 5) rapid opening without semi-closure. Results were as follows: (1) In all cases in which mean PAP was normal, PV motion could be classified as type 5, (2) In 45 PH cases, mean PAP was 50.2 +/- 8.3 mmHg in type 1, 38.4 +/- 5.5 mmHg type 5, mean PAP was 16.3 +/- 11.7 mmHg when 30 normal cases were added. Flow velocity at the PV orifice was maximum in type I and decreased in type 2, 3 and 4 in this order. In type 4, cardiac indices were minimum in all groups of pulmonary hypertension. In conclusion, 1) systolic pulmonic valve motion is of value to predict PAP, and 2) it was suggested that mid-systolic semi-closure of the PV is related to increase in flow velocity at the PV orifice.

In order to investigate the relationship between the kallikrein-kinin (K-K) system and renin-angiotensin (R-A) system, plasma kinin (pKIN), plasma angiotensin II (pAII), plasma renin activity (PRA) and angiotensin converting enzyme activity (ACEA) were determined in 19 essential hypertensives (EHT). pKIN and pATII measurements were performed by highly sensitive radioimmunoassay (RIA), both of which were established in our laboratory. The assay sensitivity of pKIN and pAII were 0.5 pg/tube and 0.1 pg/tube, respectively. In pKIN RIA, pKIN was extracted by ethanol from 0.8 ml of plasma obtained with a syringe containing kinin generating and destroying enzyme inhibitors. In pAII RIA, pAII was measured directly in small amounts of 50-100 microliter, unextracted plasma samples. The level in pAII was significantly higher (p less than 0.05) in the normal renin group (NRH: n = 13) as compared with low renin group of EHT (LRH: n = 6). However, no significant difference was found in pKIN and ACEA between these two groups. Although a significantly positive correlation was observed between pAII and PRA (p less than 0.001) in EHT, the ratio of pAII/PRA tended to be higher in LHR than in NRH. ACEA correlated positively with pAII (p less than 0.01) or PRA (p less than 0.02), respectively. On the other hand, a significant negative correlation was also found between pKIN and pAII (p less than 0.05). From these findings, it was assumed that there was a closed relationship between R-A and K-K systems, and that angiotensin converting enzyme (kininase II) might play some role in the interrelation between both systems.

Regional left ventricular wall motion abnormalities were assessed by two-dimensional echocardiography (2-DE) in 66 patients with healed myocardial infarction (MI) and the results were compared with those of coronary angiography which was performed at nearly the same time as 2-DE. The left ventricular wall was divided into 14 segments and asynergy was assessed in each segment. To compare the severity of segmental asynergy with coronary artery lesions, relation between segments and coronary artery perfusion was assumed as follows: the anterior wall, anterior septum and apex corresponded to the anterior descending artery (LAD); the lateral and inferior walls corresponded to the left circumflex artery (LCX); and the posterior septum and inferior wall corresponded to the right coronary artery (RCA). One vessel disease: In all 24 patients with MI induced by LAD lesions, regional asynergy was identified in the anterior wall, anterior septum and apex. All patients had advanced asynergy (severe hypokinesis, akinesis or dyskinesis) except one with subendocardial infarction. Advanced asynergy was identified in the other segments including the lateral wall (one patient) and the posterior septum (11 patients), but such asynergy was not associated with that of the inferior wall. In four patients with MI induced by RCA lesions, regional asynergy appeared in localized segments of the posterior septum and inferior wall, and the asynergy was severe in all patients except one in whom collaterals were well-developed. In four patients with MI induced by LCX lesions, asynergy was observed in both the lateral and inferior walls. In only one patient, mild asynergy was identified in the apex. Multi-vessel disease: In both groups with double vessel (16 patients) and triple vessel (16 patients) disease, asynergy was recognized in the affected areas of the major coronary artery which was considered responsible for the infarction, irrespective of the severity of the coronary stenosis. Also, there was no significant correlation between the severity of coronary artery stenosis and segmental wall motion abnormalities in non-infarcted areas. No significant correlation was observed between the severity of regional wall motion abnormalities in the infarcted areas and the degree of development of collaterals. In patients with MI induced by LAD lesions, more extensive asynergy in the anterior wall and anterior septum at the basal portion was observed in the patient group with proximal stenosis than in the group with distal stenosis.(ABSTRACT TRUNCATED AT 400 WORDS)

The transplantable argyrophilic gastric carcinoids producing histamine found in Praomys (Mastomys) natalensis contained no significant amount of vitamin B12-binding proteins. It was also demonstrated that the concentration of vitamin B12-binding proteins in glandular stomach of mastomys was much lower than those in the same tissues of the rat or mouse.

Two biochemically distinguishable transplantable tumor strains (A and B) were established from a primary gastric carcinoid of Mastomys secreting histamine alone. Strain A in the third generation acquired a new ability to produce serotonin [5-hydroxytryptamine (5-HT)] and retained endocrine activities to produce both histamine and 5-HT through the following subpassages, whereas strain B (like the primary tumor) continued to produce histamine alone. The findings were further supported by the immunohistochemical demonstration of 5-HT-containing tumor cells in strain A after generation 3 and the absence of such cells in strain B and also by the ultrastructural demonstration of tumor cells containing pleomorphic secretory granules in strain A after the third generation but not in strain B. Sixteen samples of Formalin-fixed, paraffin-embedded primary gastric carcinoids of Mastomys were stained by the same immunohistochemical method for 5-HT detection. The positively stained tumor cells were demonstrated in 4 tumor samples, though they were scantily distributed in tumor parenchyma except for 1 metastasizing tumor. 5-HT-producing tumor cells appeared through many proliferative cycles of the deranged histamine-producing cells. The endocrinologic similarity was noted between this transplantable tumor strain and a specific type of gastric carcinoid in humans, and the possible histogenesis of the latter tumor was discussed on the basis of data obtained from the present transplantation experiments.