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The trajectory of glomerular filtration rate (GFR) in relation to glomerular hyperfiltration (GHF) has been unknown. It was evaluated retrospectively in 23,982 GHF-free health examinees who were followed for 2−10 yr (mean: 5.1 yr). GFR was estimated by the serum creatinine concentration, and GHF was defined as age- and sex-specific estimated GFR (eGFR) ≥ 95% of the Japanese general population. The temporal profile of eGFR was plotted in a GHF-centered way, which was fitted to a random coefficient linear mixed model. Of the 23,982 subjects, 797 and 23,185 subjects developed or did not develop GHF, respectively, so that they were termed as the GHF(+)and GHF(−)groups. At baseline, median eGFR was significantly elevated in the GHF(+)group compared with in the GHF(−)group: 94.1 versus 77.3 mL/min/1.73 m2( P < 0.001). Elevation of basal eGFR lasted for a mean (SD) of 3.3 (1.9) yr in the GHF(+)group; mean eGFR then rose to the GHF range, which was 108.5 mL/min/1.73 m2. The eGFR decline after the peak was steeper in the GHF(+)group than in the GHF(−)group: −0.984 versus −0.497 mL/min/1.73 m2/yr ( P < 0.001). Baseline eGFR, but no other variable, well predicted incident GHF, with an area under the receiver operating characteristic curve of 0.87 (95% confidence interval: 0.86–0.88). In conclusion, GHF occurs as a chronic, multiphasic phenomenon: initially with a sustained GFR elevation for years, followed by a GFR surge to the GHF range, which was accompanied by accelerated GFR declining.

Aims To compare impact of elevated HbA1c and fasting plasma glucose (FPG) on incident chronic kidney disease (CKD) in a non-diabetic cohort. Methods Data from diabetes- and CKD-free 25,109 health examinees were retrospectively analysed with a mean observation period of 5.3 years. Prediabetes was diagnosed by the ADA and WHO criteria, and CKD by estimated glomerular filtration rate (eGFR) Results For incident CKD (n = 2483), high HbA1c but not FPG was an independent risk: adjusted hazard ratio (AHR, 95%CI) for HbA1c 1% and FPG 1 mmol/L, 1.91 (1.70–2.16) and 0.85 (0.60–1.20), respectively. Prediabetes by the ADA and WHO criteria were both risk for CKD with AHR (95%CI), 1.21 (1.12–1.32) and 1.31 (1.16–1.48), respectively. Prediabetes diagnosed by ‘elevated HbA1c irrespective of FPG’, either by the ADA and the WHO definition, was a risk with AHR (95%CI), 1.48 (1.36–1.61) and 1.51 (1.31–1.74), respectively. In contrast, prediabetes diagnosed by ‘raised FPG irrespective of HbA1c’ was not a CKD risk. Conclusions Elevated HbA1c, but not FPG, identified CKD risk in non-diabetic individuals.

Objective We aimed to clarify the onset of diabetes. Design Data from 27,392 nondiabetic health examinees were retrospectively analyzed for a mean of 5.3 years. Trajectories of fasting plasma glucose (FPG), body mass index (BMI), and the single point insulin sensitivity (Si) estimator (SPISE), an index of Si, 10 years before diagnosis of prediabetes (PDM; n = 4781) or diabetes (n = 1061) were separately assessed by a mixed effects model. Diabetes and PDM were diagnosed by the American Diabetes Association definition on the basis of FPG and glycosylated hemoglobin A1c values. Results In individuals who developed diabetes, mean FPG and BMI were significantly higher (P < 0.01 each) and SPISE lower than those who did not at −10 years: FPG 101.5 mg/dL vs 94.5 mg/dL, BMI 24.0 kg/m2 vs 22.7 kg/m2, and SPISE 7.32 vs 8.34, P < 0.01 each. These measurements, in subjects who developed prediabetes, were slightly but definitely different from those who did not, already at −10 years: FPG 91.8 mg/dL vs 89.6 mg/dL, BMI 22.6 kg/m2 vs 22.1 kg/m2, and SPISE 8.44 vs 8.82, P < 0.01 each. In both cases, the differences were progressively greater toward year 0, the time of diabetes, or PDM diagnosis. Conclusions FPG was significantly elevated in those who developed diabetes at least 10 years before diagnosis of diabetes, and this was also the case in those who developed PDM. Glucose dysregulation precedes diagnosis of diabetes at least for 20 years., FPG already increased at 10 years before diagnosis of diabetes and also at 10 years before diagnosis of prediabetes. Diabetes may begin at least >20 years before its diagnosis.

A hypothesis that postchallenge hyperglycemia in subjects with low body weight (BW) may be due, in part, to small glucose volume (GV) was tested. We studied 11,411 nondiabetic subjects with a mean BW of 63.3 kg; 5,282 of them were followed for a mean of 5.3 yr. In another group of 1,537 nondiabetic subjects, insulin sensitivity, secretion, and a product of the two (index of whole body insulin action) were determined. Corrected 2 h-plasma glucose (2hPGcorr) during a 75-g oral glucose tolerance test in subjects with BW ≤ 59 kg was calculated as 2hPGcorr = δPG2h · ECW/[16.1 (males) or 15.3 (females)] + fasting PG (FPG), where δPG2h is plasma glucose increment in 2 h; ECW is extracellular water (surrogate of GV); FPG is fasting plasma glucose; and 16.1 and 15.3 are ECW of men and women, respectively, with BW = 59 kg. Multivariate analyses for BW with adjustment for age, sex, and percent body fat were undertaken. BW was, across its entire range, positively correlated with FPG ( P < 0.01). Whereas BW was correlated with 2hPG and δPG in a skewed J-shape, with inflections at around 60 kg ( P for nonlinearity < 0.01 for each). Nonetheless, in those with BW ≤ 59 kg, insulin sensitivity, secretion, and action were unattenuated, and incident diabetes was less compared with heavier counterparts. BW was linearly correlated with 2hPGcorr, i.e., the J-shape correlation was mitigated by the correction. In conclusion, postchallenge hyperglycemia in low BW subjects is in part due to small GV rather than impaired glucose metabolism.

Aim Risk profile for incident chronic kidney disease (CKD) in Japanese subjects has not been established. Our aim was to identify risk factors for CKD in Japanese. Methods Consecutive 171 536 health examinees (median age 49 years and estimated glomerular filtration rate (eGFR) 78.2 mL/min per 1.73 m2) without CKD were re-examined after a median period of 6.2 years. Results of Cox proportional hazards models in randomly assigned two thirds (Derivation cohort) were verified in the rest (Validation cohort). CKD was defined as eGFR

The quantitative impact of weight gain on prediabetic glucose dysregulation remains unknown; only one study quantitated the impact of weight loss. We quantified the impact of weight gain on the evolution and regression of prediabetes (PDM).In 4234 subjects without diabetes, using logistic regression analysis with a 4.8-year follow-up period, we analyzed the relationship between (1) δBMI (BMIMean (±s.d.) δBMI was 0.17 (±1.3) kg/mIn Japanese adults, an increase in the BMI by even 1 kg/m

To clarify if prediabetes defined by the International Expert Committee (PrediabetesIEC) and/or the American Diabetes Society (PrediabetesADA) is a risk for incident glomerular hyperfiltration (GH). 24,524 health examinees without diabetes, chronic kidney disease (CKD), GH and antihypertensive treatment at baseline, and repeated examinations at least twice during a mean of 5.3 years were retrospectively analysed. Diabetes was defined as fasting plasma glucose (FPG) ≥ 7.0 mmol/L and/or HbA1c ≥ 47 mmol/mol, CKD by estimated glomerular filtration rate (eGFR)

It has been unknown if attenuated insulin sensitivity (Si) in non-alcoholic fatty liver disease (NAFLD) is a cause or a result. We examined the impact of attenuated Si on NAFLD evolution. We observed 4856 NAFLD- and diabetes-free participants for a mean 2.9 years. Si was indexed by single point insulin sensitivity estimator (SPISE = [600 × HDL-c0.185]/[TG0.2 × BMI1.338]), correlating with 1/HOMA-IR in an independent cohort (n = 1537, Spearman rho = 0.519, P 10.06) as the reference, tertile 1 (

To develop diabetes risk score (RS) based on the current definition of diabetes, we retrospectively analyzed consecutive 4,159 health examinees who were non-diabetic at baseline. Diabetes, diagnosed by fasting plasma glucose (FPG) ≥7.0 mmol/L, 2hPG ≥11.1 mmol/L and/or HbA1c ≥6.5% (48 mmol/mol), developed in 279 of them during the mean period of 4.9 years. A full RS (RSFull), a RS without 2hPG (RS-2hPG) and a non-invasive RS (RSNI) were created on the basis of multivariate Cox proportional model by weighted grading based on hazard ratio in half the persons assigned. The RSs were verified in the remaining half of the participants. Positive family history (FH), male sex, smoking and higher age, systolic blood pressure (SBP), FPG, 2hPG and HbA1c were independent predictors for RSFull. For RS-2hPG, 7 independent predictors, exclusive of 2hPG and smoking but inclusive of elevated triglycerides (TG) comparing to RSFull, were selected. FH, male sex, and higher age, SBP and HbA1c were independent predictors in RSNI. In the validation cohort, C-statistic (95%CI) of RSFull, RS-2hPG and RSNI were 0.80 (0.76-0.84), 0.75 (0.70-0.78) and 0.68 (0.63-0.72), respectively, which were significantly different from each other (P

Risk profile for incident chronic kidney disease (CKD) in Japanese subjects has not been established. Our aim was to identify risk factors for CKD in Japanese.Consecutive 171 536 health examinees (median age 49 years and estimated glomerular filtration rate (eGFR) 78.2 mL/min per 1.73 mIn the Derivation cohort, CKD developed in 1002 (5.8%) subjects. Seven variables such as lower eGFR, male gender, higher uric acid concentration, lower red cell count and higher age and systolic blood pressure were identified as significant risks for CKD, with lowered eGFR being an overwhelmingly strong risk: adjusted hazard ratio for those with the baseline eGFR70 mL/min per 1.73 mSeven risk factors for incident CKD were identified in Japanese health examinees. However, lowered baseline eGFR outweighed other risks to the degree that eGFR alone was suffice for CKD prediction.

目的:急性虫垂炎の診断におけるCTを重視したプロトコールの正確性と虫垂径の測定の有用性の評価．対象と方法:2002年1月から2004年6月の間に急性虫垂炎と診断した連続した239人を検討した．CTでの診断基準は6mm以上の虫垂径または2次性の炎症変化とした．病理学的な診断基準は筋層以上の炎症細胞浸潤とした．結果:239人のうち235人がCTを受けていた．222人が虫垂切除術を受け，205人が病理学的に急性虫垂炎と診断された．CTで虫垂径が6mm以上あった200人中193人が病理学的に急性虫垂炎と診断された．手術症例の陽性的中率は92.3％（205/222）で，CTで虫垂径が6mm以上あった手術症例の陽性的中率は96.5％（193/200）であった．また保存的治療症例の35.3％（6/17）が再発し，10mm以上で再発率が50％（5/10）と高かった．結論:CTは急性虫垂炎の診断に有用である．

coq7/clk-1 was isolated from a long-lived mutant of Caenorhabditis elegans, and shows sluggish behaviours and an extended lifespan. In C. elegans and Saccharomyces cerevisiae, coq7/clk-1 is required for the biosynthesis of coenzyme Q (CoQ), an essential co-factor in mitochondrial respiration. The clk-1 mutant contains dietary CoQ(8) from Escherichia coli and demethoxyubiquinone 9 (DMQ9) instead of CoQ(9). In a previous study, we generated COQ7-deficient mice by targeted disruption of the coq7 gene and reported that mouse coq7/clk-1 is also essential for CoQ synthesis, maintenance of mitochondrial integrity and neurogenesis. In the present study, we rescued COQ7-deficient mice from embryonic lethality and established a mouse model with decreased CoQ level by transgene expression of COQ7/CLK-1. A biochemical analysis showed a concomitant decrease in CoQ(9), mitochondrial respiratory enzyme activity and the generation of reactive oxygen species (ROS) in the mitochondria of CoQ-insufficient mice. This implied that the depressed activity of respiratory enzymes and the depressed production of ROS may play a physiological role in the control of lifespan in mammalian species and of C. elegans.

We report a case of a primary abscess of the omentum without any obvious etiology. A 62-year-old man was referred to our clinic with lower abdominal pain, and computed tomography showed an intra-abdominal abscess in the left pelvic area. Laparotomy revealed that the abscess adhered to the urinary bladder and abdominal wall, but no perforation of the alimentary tract was identified and there was no foreign body in the abscess cavity. A culture of the abscess fluid grew Clostridium perfringens. The patient was discharged on the 16th hospital day after an uneventful postoperative course without any complications.

症例は56歳の女性. 2002年12月に左乳腺腫瘤に気づき急激に増大したため受診.左EAB領域に6×6 cmの分葉状で境界明瞭な固い腫瘤を触知した.マンモグラフィでは分葉状で一部境界不明瞭,内下部に粗大で不整形な石灰化を伴う高濃度腫瘤を認めた.超音波検査では内部に無エコーやacoustic shadowを伴う高輝度エコーが混在する不整形腫瘤が存在し腫瘤に接して境界明瞭な円形小腫瘤を認めた.吸引細胞診では悪性を疑い,術中迅速病理診断で軟骨化生を伴う化生癌とされ乳腺全摘術とリンパ節郭清を施行した.病理診断は乳腺原発性骨肉腫で辺縁に線維腺腫を伴っていた.術後1年経過するが現在も再発所見はみられず,極めて稀な原発性乳腺骨肉腫の1例を経験したので報告する.

当院では医療の標準化・業務の効率化・医療の質の向上・入院日数の短縮を目的として全科的にクリニカルパスを導入し,その有効性について検討したので報告する.対象は乳癌症例で, 2000年4月から2001年3月までの導入前14症例と2001年4月から2002年3月までの導入後25症例とした.医療の標準化を徹底するため,従来の漫然とした医療行為は削除され,早期離床・早期退院を促すことが可能になった.入院オーダーを疾患毎に統一してオーダリングシステムからパス表を作成し,必要な医療行為をもれなく確実に行い,患者に対してはパス表を用いて入院後の治療内容と経過の説明を行いインフォームドコンセントの充実を計った.パス導入後は在院日数は短縮し,総医療費は減少したが1日あたり医療費は増加した.更に病床利用率は一時的に下がったものの回転率は上昇し全身麻酔手術件数も増加し収益にも有効であった.現在の厳しい医療業界においてパス導入は有効と考えられた.

症例は32歳の男性.腹痛,嘔吐,腹部膨満感を主訴として来院し,腹部X線検査でニボー像を認めたため腸閉塞の診断で入院となった.右下腹部に圧痛があり腹部超音波とCT検査所見で回腸末端炎と判断し,保存的治療を施行した.症状は一旦改善するも経口摂取再開にて症状の再燃を繰り返した.注腸造影と大腸内視鏡検査を施行し終末回腸に明らかな異常はみられなかったが,保存的治療によっても症状改善しないため開腹術を施行した.肉眼的には漿膜粘膜面から異常はみられず,漿膜下に径3～4mmの肉芽腫を複数個触知したためこの部分を含めて回盲部切除術を施行した.病理組織所見では,血管壁に好酸球を主体とした炎症細胞の浸潤とフィブリノイド壊死を伴う壊死性血管炎が認められ.アレルギー性肉芽腫性血管炎と診断された.腸管に限局する非定型的Churg-Strauss症候群の1症例と思われた.

症例は56歳の女性. 3年前から時に右下腹部痛あるが放置し, 1998年6月に右下腹部痛・発熱・下痢が続き症状悪化したため当院紹介となった.右下腹部に圧痛と強い腹膜刺激症状があり,腹部CT検査所見で回腸末端部の壁肥厚像を認め,回腸潰瘍による腹膜炎を疑い同日開腹した.虫垂に炎症所見は無く,回腸末端から口側10cmにかけて壁は固く肥厚し充血していたため回盲部切除術を施行した.切除標本では全周性に粘膜面の粗造と浅いびらんを形成し,病理組織所見では粘膜から粘膜下組織にかけて異型リンパ球の増加を認め,免疫組織化学検査で小腸MALTリンパ腫と診断された.治癒切除の判断が困難で術後化学療法を施行し退院,現在再発所見は認められていない.小腸原発MALTリンパ腫は比較的稀とされており,文献的考察を含め報告する.

1998;114;25S-28S Chest Hideo Koike, Dara Brodsky, Victoria Arthur and S. Alex Mitsial Stella Kourembanas, Toshisuke Morita, Helen Christou, Yuxiang Liu, Hypoxic Responses of Vascular Cells ation http://chestjournal.chestpubs.org/content/114/1_Supplement/25S.1.cit services can be found online on the World Wide Web at: The online version of this article, along with updated information and ISSN:0012-3692 ) http://chestjournal.chestpubs.org/site/misc/reprints.xhtml ( prior written permission of the copyright holder. this article or PDF may be reproduced or distributed without the Dundee Road, Northbrook, IL 60062. All rights reserved. No part of Copyright1998by the American College of Chest Physicians, 3300 Physicians. It has been published monthly since 1935. is the official journal of the American College of Chest Chest

Excess vascular smooth muscle cell (VSMC) proliferation and contractility are key events in the pathophysiology of vascular disorders induced by hypoxia. We have recently reported that carbon monoxide (CO), produced by VSMC under conditions of hypoxia, can be a modulator of cGMP levels in both endothelial and smooth muscle cells. In this respect, some of the physiologic effects of CO in the vasculature parallel those of nitric oxide (NO), a well characterized regulator of vascular tone. We report here that under hypoxia, VSMC-derived CO is an important regulator of VSMC proliferation. Inhibiting CO formation or scavenging CO with hemoglobin increased VSMC proliferation in response to serum or to mitogens such as endothelin, whereas increasing CO production or exposing cells to exogenous CO lead to a markedly attenuated growth response. The effects of CO on VSMC proliferation correlated with changes in E2F-1 expression, the prototype member of a family of transcription factors that participate in the control of cell cycle progression. CO significantly suppressed E2F-1 expression, whereas, removal of CO from the cultures with hemoglobin lead to increased E2F-1 gene transcription, mRNA, and protein production as well as mRNA levels of c-myc, a target gene of E2F-1. Moreover, the actions of CO were mediated by the second messenger molecule, cGMP. Limiting VSMC growth by increasing the release of CO may represent a key event in the body's compensatory responses to hypoxia.

Atheroprotective effects of estrogen (E2) are well documented and are due in part to direct effects of E2 on vascular cells. We recently demonstrated that human vascular smooth muscle cells (VSMCs) express a functional E2 receptor capable of activatine gene expression. This study was designed to identify E2-regulated genes in human VSMCs.VSMC mRNA was screened by differential-display polymerase chain reaction (ddPCR) to identify E2-regulated genes. Quiescent human VSMCs were stimulated with 10% fetal bovine serum in the absence or presence of 10(-8) mol/L E2, and total cellular RNA was harvested. ddPCR was performed in triplicate on each RNA sample and differentially expressed candidate genes were isolated. Differential expression of candidate genes were confirmed by dot blotting and positive bands were identified by sequence analysis. E2-mediated regulation at the protein level was investigated by immunoblotting.ddPCR of RNA harvested from aortic VSMCs identified a 462 bp gene product, EAo8, as a candidate E2- regulated gene. Dot blotting with probes derived from four independent VSMC cultures demonstrated a 5.8 +/- 3.9-fold increase in EAo8 expression in response to E2 treatment (p0.05 vs control). Sequence analysis identified EAo8 as nucleophosmin, a nucleolar phosphprotein implicated in the regulation of cell growth and protein synthesis. E2-induced expression of nucleophosmin protein was demonstrated by immunoblotting in both saphenous vein and mammary artery VSMCs.E2 induces nucleophosmin expression in human VSMCs, and ddPCR is a useful approach for studying estrogen-regulated gene expression in VSMCs.

Right ventricular (RV) systolic time intervals (STIs) have been shown to accurately reflect RV function in patients with acute respiratory distress syndrome (ARDS). The measurement of RVSTIs requires phonocardiography to define the time of RV end systole. If RV end-systolic pressure (RVESP) can be derived from peak pulmonary artery (PA) systolic pressure, then the time of RV end systole, and hence, RVSTIs can be deduced without phonocardiography. We tested this possibility. In 34 patients with ARDS, RVESP was determined on the PAP curve at RV end systole, which was defined by phonocardiography. The ratios of RVESP/peak PA systolic pressure were obtained in each patient, the mean of which was 0.90 +/- 0.006. With an application of this value, the estimated RVSTIs were determined in other groups of patients. Right ventricular end-systolic pressure was estimated from the peak PA systolic pressure by multiplying 0.9. Then the point of RV end systole was determined on the electrocardiographic tracing that coincided with the point of RVESP on the PAP curve by simultaneous display of electrocardiograph and PAP curve. Total electromechanical systole was measured from the onset of the QRS complex to the point of RV end systole on the electrocardiograph. The onset of RV ejection was defined by PAP curve. The validity of this estimated RVSTIs was tested by comparing with the measured RVSTIs. By Bland-Altman analysis, the mean difference in RVSTIs between the two methods was 0.007, and bias was 0.0036, suggesting close agreement. The estimated RVSTIs can be used to accurately assess RV function.

Epithelioid leiomyomas of the gastrointestinal tract are difficult to diagnose before surgery and their malignancy is not readily evaluated. The tumor is of smooth muscle origin, arising from the muscularis propria, and frequently develops in the gastrium, occasionally extending into the gastrocolic ligament or greater omentum. Malignancy is evaluated from the numbers of mitotic cells per 50 high power fields. However, even a tumor with few mitoses may metastatize. Thus, we propose that the malignancy of the tumor should be decided in terms of location, size, pattern of growth, invasion of the mucosa, cellularity, mitotic rate, and anaplasia. We reported a case of epithelioid leiomyoma that was pedunculated, with exogastric expansion. The literature is reviewed.

coq7/clk-1 was isolated from a long-lived mutant of Caenorhabditis elegans, and shows sluggish behaviours and an extended lifespan. In C. elegans and Saccharomyces cerevisiae, coq7/clk-1 is required for the biosynthesis of coenzyme Q (CoQ), an essential co-factor in mitochondrial respiration. The clk-1 mutant contains dietary CoQ(8) from Escherichia coli and demethoxyubiquinone 9 (DMQ9) instead of CoQ(9). In a previous study, we generated COQ7-deficient mice by targeted disruption of the coq7 gene and reported that mouse coq7/clk-1 is also essential for CoQ synthesis, maintenance of mitochondrial integrity and neurogenesis. In the present study, we rescued COQ7-deficient mice from embryonic lethality and established a mouse model with decreased CoQ level by transgene expression of COQ7/CLK-1. A biochemical analysis showed a concomitant decrease in CoQ(9), mitochondrial respiratory enzyme activity and the generation of reactive oxygen species (ROS) in the mitochondria of CoQ-insufficient mice. This implied that the depressed activity of respiratory enzymes and the depressed production of ROS may play a physiological role in the control of lifespan in mammalian species and of C. elegans.

Abstract —We investigated the role of heme oxygenase (HO)–1 in the development of hypoxia-induced pulmonary hypertension. HO catalyzes the breakdown of heme to the antioxidant bilirubin and the vasodilator carbon monoxide. Hypoxia is a potent but transient inducer of HO-1 in vascular smooth muscle cells in vitro and in the lung in vivo. By using agonists of HO-1, we sustained a high expression of HO-1 in the lungs of rats for 1 week. We report that this in vivo enhancement of HO-1 in the lung prevented the development of hypoxic pulmonary hypertension and inhibited the structural remodeling of the pulmonary vessels. The mechanism(s) underlying this effect may involve a direct vasodilating and antiproliferative action of endogenous carbon monoxide, as well as an indirect effect of carbon monoxide on the production of vasoconstrictors. These results provide evidence that enhancement of endogenous adaptive responses may be used to prevent hypoxia-induced pulmonary hypertension.

BACKGROUND It is important to identify risk factors for liver metastasis in patients with colorectal carcinoma because the liver is the most common site of recurrence. Alcohol consumption reportedly is associated with hematogenous metastasis in certain animal models. Furthermore, some studies have shown that carmofur, a derivative of 5-fluorouracil, is particularly effective as adjuvant chemotherapy for colorectal carcinoma, and may even suppress liver metastasis, although the mechanism by which this occurs remains unknown. In addition, carmofur is known to inhibit alcohol metabolism. To the authors' knowledge, the relation between liver metastasis in colorectal carcinoma and alcohol consumption has not been examined previously. Therefore, the authors studied the relations between liver metastasis in colorectal carcinoma and various clinicopathologic factors including alcohol consumption status. METHODS This study was comprised of 133 colorectal carcinoma patients with invasion beyond the submucosal layer who had undergone surgical resection. The subjects were examined and divided into two groups according to the occurrence or absence of liver metastasis. The relations between liver metastasis and other clinicopathologic factors were analyzed by univariate and multivariate statistical methods. RESULTS Univariate analysis showed alcohol consumption (P = 0.0021) and blood vessel invasion (P = 0.0045) were correlated with liver metastasis. Multivariate analysis showed both to be independent risk factors for liver metastasis. CONCLUSIONS Alcohol consumption is an independent risk factor for liver metastasis in colorectal carcinoma patients. Therefore, patients with colorectal carcinoma who drink alcohol require intensive examination and follow-up with respect to liver metastasis. Further study is necessary to confirm the effect of adjuvant chemotherapy using carmofur in colorectal carcinoma patients. Cancer 1998;83:1483-1488. © 1998 American Cancer Society.

Prevention of Hypoxia-Induced Pulmonary Hypertension by Enhancement of Endogenous Heme Oxygenase-1 in the Rat. • 238

Sugarcane (Saccharum officinarumL.) was planted in the fall; the seed cane was healthy or infected either with sugarcane mosaic virus (strain H) or with ratoon stunting disease (RSD) (Clavibacter xyli). Herbicide treatments were applied the following spring and each subsequent spring during the 3-yr crop cycle. Hexazinone [3-cyclohexyl-6-(dimethylamino)-1-methyl-1,3,5-triazine-2,4(1H,3H)-dione] at 1.1 kg ai/ha was applied as a soil foliage treatment when sugarcane was about 30 cm tall. The methyl ester of diclofop {(±)-2-[4-(2,4-dichlorophenoxy)phenoxy] propanoic acid} at 1.1 kg ai/ha and the sodium salt of asulam {methyl [(4-aminophenyl)sulfonyl] carbamate} at 3.4 or 3.8 kg ai/ha were applied as foliage treatments when sugarcane was about 90 cm tall. Both mosaic and RSD reduced yield of sugar/ha by 16% for the 3-yr crop, primarily by causing a decrease in stalk population. Hexazinone reduced yield of sugar/ha by 24% primarily by causing a decrease in both stalk population and sugar content of stalks. Diclofop reduced yield by 7% and asulam caused no significant yield loss. Combinations of disease and herbicide treatment reduced yields in an additive manner, with the combination of hexazinone and either mosaic or RSD causing a 38% reduction.

十二指腸潰瘍の成因として, 酸分泌亢進が第一にあげられるのに対して, 胃潰瘍の場合にはこの酸分泌の亢進が顕著でなく, 低酸, 無酸状態下でも発生しているために, いろいろな発生要因があげられてきた.ことにF, Hollanderが強調した2層からなる粘液による粘膜関門の障害と潰瘍発生との関係は胃潰瘍の発生をかなり解明させる, 興味深い見解であり, この考えに立ち, 胃粘液分泌に焦点を向けた研究成果も少なからず発表されてきたが, なお解明を要する点が数多く残されている.筆者らは胃潰瘍病巣組織内のムコ物質の消長, 胃液検査上, 酸量と粘液成分量との相関, 各種病態下におけるこの相関の変化, 手例前後における胃液中の粘液成分の消長, 実験的胃粘膜創部, および急性潰瘍病巣における胃壁組織内および胃液内のムコ物質の態度などを検討し, 十二指腸潰瘍例におけるような顕者な機能異常ではないが, 胃潰瘍の成因あるいは慢性化の要因として, 他の局所性因子とともに粘液による粘膜防禦機構の弱体化をも考慮すべきことを述べた.

A case of intestinal evisceration through the anus due to spontaneous rupture of the rectosigmoid is reported. The patient was a 76-year-old widow with habitual constipation. The episode of eviscerati

Recent progress inthestudy ofantigen-antibodyreactions ofbiologicals inagargel demands improvement ofexisting gel-cutting devices. For anideal comparison oftwoormoreantigenic preparations against anantiserum, itisnecessarytoobtain a critical distance between the ( antigen andantibody cupsandtoobtain apartial orcomplete identity ofprecipitinogen inadjacentcups. However, noneoftheavailable gel cutters (Feinberg, Intern. Arch. Allergy 11:129, _~~~~~~~~~~~~~~~~~~~~ _-r