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Fullerenes are compelling molecular materials owing to their exceptional robustness toward multi-electron reduction. Although scientists have attempted to address this feature by synthesizing various fragment molecules, the origin of this electron affinity remains unclear. Several structural factors have been suggested, including high symmetry, curved structures, and five-membered ring substructures. To elucidate the role of the five-membered ring substructures without the influence of high symmetry and curved structure, we herein report the synthesis and electron-accepting properties of oligo(biindenylidene)s, a one-dimensional fragment of fullerene C60. Electrochemical studies corroborated that oligo(biindenylidene)s accept electrons equal to the number of five-membered rings in their main chains. Moreover, ultraviolet/visible/near-infrared absorption spectroscopy revealed that oligo(biindenylidene)s exhibit significantly enhanced absorption covering the entire visible region in relation to C60. These results highlight the significance of the pentagonal substructure for attaining stability toward multi-electron reduction and provide a new strategy for the molecular design of electron-accepting -conjugated hydrocarbons.

In this research, thermal desorption characteristics of deuterium retained at trap sites of W created by irradiation of 300 keV hydrogen ions have been studied. With 10 hours of annealing, about 85...

In this paper, we demonstrated the use of a photodiode (PD) packaging technique that employs a catadioptric system. This optical system consisted of two components: a BK7 ball lens with a diameter of 1.5 mm that was soldered with glass on a hermetic cap and a plastic-molded offset parabolic mirror with a radius of 550 mu m and an offset of 550 mu m. The offset parabolic mirror was mounted above a surface-illuminated InGaAs pin PD with a detective area of diameter 20 mum. When an incident pencil of rays were passed through the ball lens and then perpendicularly reflected by the mirror and impinged upon the PD, compact planar assembling became possible for numerous electrical parts on a can-type header for minimizing parasitic impedance due to wire bonds. The optical system provided a high coupling efficiency of 98% between a single-mode fiber and the PD.

The purpose of this study was to clarify which physiological and anatomical factors were involved in the formation of tongue indentations, which are believed to be a clinical sign of clenching. Twenty-four dentulous subjects were investigated. They were divided into two groups, depending on the presence or absence of tongue indentations: (i) a tongue indentation group and (ii) a no tongue indentation group. Intraoral appliances containing a small pressure sensor were placed at the lingual surfaces of the upper and lower right first molars. Lingual pressure on the lingual surfaces of the upper and lower right first molars was then recorded under different conditions. The tasks selected as physiological factors to be recorded were: (i) silent reading at rest for 10 min, (ii) maximum voluntary clenching (MVC) for 5 s, (iii) 10% of MVC for 1 min and (iv) swallowing. The results for all tasks were compared between groups. Tongue width and dental arch width were also measured as anatomical factors. No significant differences were found between groups during silent reading at rest, clenching, swallowing, or in tongue pressure integration during silent reading at rest. However, a significant difference was found in terms of tongue width (P < 0.05). These results indicate that neither volume of lingual pressure exerted on the lingual surface of the teeth during rest, clenching, nor swallowing are related to the formation of tongue indentations. The results do suggest; however, that tongue width at rest plays an important role in the formation of tongue indentations.

The aim of this study was to clarify the factors related to the formation of the buccal mucosa ridging, which has been mentioned to be a clinical sign of clenching. Twenty-one individuals were investigated and divided into three groups: (i) those without buccal mucosa ridging, (ii) the buccal mucosa ridging located in all the posterior teeth region, and (iii) the buccal mucosa ridging corresponding only to the molar teeth region. A pressure sensor was used and placed at two points: first upper premolar and second upper molar. The recording tasks were: (i) silent reading at rest, (ii) light voluntary clenching, (iii) maximum voluntary clenching, (iv) holding the cheeks tightly against the teeth while light voluntary clenching, (v) holding the cheeks tightly against the teeth without tooth contact, (vi) pulling angle of mouth laterally while light voluntary clenching, (vii) pulling angle of mouth laterally without tooth contact and (viii) swallowing. No significant differences were found between groups in all the recording tasks except for the swallowing, at which significant difference (P < 0.05) was found between the groups of individuals having buccal mucosa ridging and without it. Based on these results it became clear that the buccal mucosa pressure exerted on the buccal aspect of teeth during swallowing plays an important role in the formation of buccal mucosa ridging.

W samples were irradiated at 300 and 573 K with 4.8 and 20 MeV W ions to displacement damage levels in the range from 0.022 to 50 displacements per atom at the damage peak. 50 μm thick W samples were exposed to high flux D plasma at 550 K on the side opposite to the damaged one, whereas 2 mm thick W samples were exposed to low flux D plasma at 403 K on the damaged side. Trapping of deuterium at displacement damage was examined by the D(3He, p)4He nuclear reaction with 3He energies between 0.69 and 4.0 MeV allowing determination of the D concentration up to a depth of 6 μm. It was found that (i) at the damage level above 0.1 dpa, the concentration of the W-ion-induced defects responsible for trapping of diffusing D atoms depended very weakly on the numbers of displacements per atom, and (ii) the quasi-saturation concentration of the defects decreased by a factor of two as the W-ion irradiation temperature increased from 300 to 573 K.

Retention of D in neutron-irradiated W and desorption were examined after plasma exposure at 773 K. Deuterium was accumulated at a relatively high concentration up to a large depth of 50–100 μm due to the trapping effects of defects uniformly induced in the bulk. A significant D release in a vacuum continued to temperatures ⩾1173 K because of the small effective diffusion coefficient and the long diffusion distance. Exposure of ion-irradiated W to D2 gas showed a clear correlation between concentrations of trapped and solute D as determined by the trapping–detrapping equilibrium. These observations indicated that the accumulation of tritium in high concentrations is possible even at high temperatures if the concentration of solute tritium is high, and baking at moderate temperatures is ineffective for removal of tritium deeply penetrating into the bulk. Nevertheless, clear enhancement of D release was observed under the presence of solute H.

The center segregation of continuously cast blooms has to be improved, users demands being more and more severe concerning equiaxed crystal proliferation and filling observed in the conventional casting.In order to find a solution of this problem, several trials to prevent suction flow in the final solidification stage have been done recently.A solution to this problem has been developed consisting in a combination of CAE (Computer Aided Engineering) and experiment, and a hard reduction method with large diameter rolls : the flow is squeezed to offset the suction flow, the result being a remarkable improvement of the center segregation without any cracking on the solidification front.

Recently, there have been many papers on skill-based controllers in which human skills are represented by artificial neural networks in the literature. This technique for representing the human skills plays an important role in various industries, for example, in manufacturing systems and process systems. A skill-based PID control scheme is proposed, which represents the skills of human experts as PID gains. This controller is designed using three-layered artificial neural networks. The effectiveness of the proposed skill-based PID control scheme is investigated in an application to a pressure control system. The characteristics of the skill-based PID controller are analysed in the frequency domain.

We consider an agent-based model consisting of a finite number of firms that move stochastically within a discrete bounded domain in order to obtain higher business profits. The desirability in business is expressed by a certain exogenous random variable and a linear integral operator called market potential. If the number of firms is extremely large and the domain is very wide, then it is almost impossible to fully investigate the model by only doing numerical simulations. In order to overcome the difficulty, we employ a deterministic continuous model that is derived from the stochastic agent-based model by taking the scaling limit. By making use of the continuous model thus derived, we can fully observe self-organization exhibited by the original agent-based model.

Hepatocellular carcinoma (HCC) occurs more frequently in patients with hepatitis C virus (HCV)-related chronic liver disease than those with hepatitis B virus-related disease. It is important to assess the factors affecting the development of HCC.A long term follow-up study involving patients with chronic HCV was performed retrospectively. A total of 153 patients diagnosed between June 1981 and November 1990 with chronic HCV with or without cirrhosis by liver biopsy were enrolled in a long term follow-up study (average, 99.4 months) and the cumulative incidence rate of HCC and factors affecting the appearance of HCC were examined.The 5-year cumulative incidence rate was 9%, the 10-year cumulative incidence rate was 23%, and the 15-year cumulative incidence rate was 42%. The annual rate of incidence increased as the follow-up period progressed. The authors selected ten variables and investigated their effect on the incidence rate of HCC, including age, gender, habitual heavy drinking, positivity of antibody against hepatitis B virus surface antigen, treatment with interferon (IFN) during the follow-up period, maximum and minimum serum alanine aminotransferase levels during the follow-up period, histologic staging, grading, and irregular regeneration of hepatocytes. Of the 10 variables, age (50 years), habitual heavy drinking, and histologic staging were determined to be independent risk factors according to multivariate Cox proportional hazards regression analysis. IFN therapy by itself was not found to be an independent factor affecting the appearance of HCC.In patients with chronic HCV, the annual incidence rate of HCC appeared to increase as the follow-up period progressed. According to the results of the current study, the factors that independently affected the development of HCC were age, habitual heavy drinking, and histologic staging.

The Mahalanobis-Taguchi System (MTS), an evaluative technique used in quality engineering, was utilized in a system analysis of medical examinations to determine practicability, to differentiate cost reduction benefits of specific components for increasing efficiency, and to determine possibility of utility on forecasting of future health condition of individuals.1. Medical examination date over a two year period were utilized to differentiate subject into two groups: Group A--Healthy or normal; and Group C--Patient group requiring treatment or currently undergoing treatment. The Mahalanobis distance for Group C from the Mahalanobis space of Group A was calculated for each subject to determine differentiability. 2. Utilizing the MTS method specific components of the examination system were selected and analyzed for effectiveness in diagnosis and screening to enhance efficiency of the examination. 3. Group A subjects (determined from the two year data), were analyzed using the data at the end of 1 year to develop the Mahalanobis space and the Mahalanobis distance at the 2nd year point was calculated and analyzed.1. Subjects who were classified as group A at both 1st and 2nd year points numbered 159. With a cutoff point of 2.0 for Mahalanobis distance 98.1% of the healthy subjects (Group A) were classified as belonging to the healthy group, and 91.9% of C group as belonging to the patient group. 2. Blood pressure, GOT, GPT, gamma-GTP, T Chol, TG, UA, Cr, BS, HbA1c, Hb, and MCH were found to be effective components in the examination. Based on this result the items included in the examination can be reduced by approximately 60%. 3. With cutoff value of 1.5, the results of 90% of subjects 1 year later could be predicted. The prediction that 15% of Group C subjects would improve to join Group A could be made. Overall, the results 1 year later could be predicted at a level of 90% accuracy.These results suggest that the Mahalanobis-Taguchi System technique can accurately assess medical examination quality and can also be used, with reasonable accuracy, to predict the condition of individuals one year later. Therefore, the MTS can be used to help determine which patients should be receiving the examination 1 year later. In addition, components of the examination can be assessed using the MTS for benefits and costs to determine levels of essentiality of components. As a result, it can be used an effective tool for development and improvements in the examination system. With further development in the technique, it may become possible for use as a tool in disease diagnosis and treatment.

Surface and tissue transitional concentration of 3% FOM aerosol for treatment of paranasal sinusitis was examined in 18 patients (21 sides) who underwent the Caldwell-Luc operation. In this operation, patients have a bony window on the sinus; we therefore investigated the difference of compliance of the maxillary sinus between when we closed the bony window with subcutaneous tissue and when we did it with a silicone sheet before the FOM nebulization. No significance was found in the mean concentration of FOM either at the maxillary sinus surface or in the tissue with or without the use of the silicone sheet. We also examined the concentration using a jet-type nebulizer and an ultra-sonic type nebulizer. Using the ultrasonic-type nebulizer resulted in a higher transitional concentration at two sites of the maxillary sinus surface than when using the jet-type nebulizer. The results suggest that the ultrasonic-type nebulizer is more effective in the treatment of paranasal sinusitis than the jet-type, and that there was no change of maxillary sinus compliance with or without a bony window.

To clarify how Epstein-Barr virus (EBV) infection is responsible for Sjögren's syndrome (SjS) we measured both IgG and IgM antibodies to viral capsid antigen (VCA) of EBV in the sera of normal healthy subjects and patients with SjS. Anti-VCA IgG was detectable in all controls and patients however, anti-VCA IgG titers in the sera of SjS patients were significantly higher than those of the controls (p0.01). No anti-VCA IgM was detected in the sera of controls whereas anti-VCA IgM was detected in the sera from 10 out of the 13 patients with SjS. This suggests that SjS might be associated with EBV. The serum levels of sCD23 (IgE-binding factor) were also measured to assess the differential state in patients with SjS. The sCD23 level of normal individuals was 211.26 +/- 12.01 micrograms/L (value is mean +/- SE), and was 443.77 +/- 71.94 micrograms/L in the 13 patients with SjS. The mean sCD23 level in the 9 patients with SjS without any complication was 360.67 +/- 35.63 micrograms/L. In the patients with SjS, sCD23 levels were significantly higher than those in the normal individuals (p0.01).

In type I allergy such as allergic rhinitis, not only immunocytes but also interleukin 4 (IL-4) and other cytokines are significant factors. In the present study we explored the course of change in IL-4 in the sera of allergic rhinitis patients upon immunotherapy. Assays of serum IL-4 were performed by the chemiluminescence sandwich enzyme immunoassay using AMPPD(3-(2'-spirodamantane)-4-methoxy-4-(3'-phophoryloxy+ ++) phenyl-1,2-dioxetane). The results indicated that immunotherapy reduced the IL-4 level from the pre-treatment baseline but not significantly. However, as far as good responses to the therapy are concerned a significant decrease in IL-4 was seen, and s-CD23, assayed at the same time, was also significantly decreased by immunotherapy.

We established an enzyme-linked immunosorbent assay (ELISA) for determining moth-related antigens in house dust. Samples, biotinated anti-moth antibodies, and horseradish peroxidase labeled streptavidin were reacted with the microplate on which anti-moth rat polyclonal antibodies were absorbed. The concentration of moth antigens was correlated with absorbance in the range from 0.1 to 100 micrograms/ml. Cross-reaction with other insect antigens was observed; 10 micrograms of midge antigens and 100 micrograms of mosquito antigens corresponded to 1 microgram of the moth antigens, respectively. With this method, moth-related antigens can be detected in house dust. However, there was no remarkable difference in antigen levels among the three locations examined: a large city, a small town, and a rural area.

Identification of allergens is necessary for proper treatment of allergic diseases. We have so far mainly used two types of allergen identifying tests, one type based on the quantification of specific serum IgE (e.g. radioallergosorbent test (RAST)), the other on allergen challenging (e.g. prick test, provocation test) for an estimation of immediate allergic reaction. However, with the former test, a high level of serum specific IgE does not necessarily indicate evidence of allergy; the latter type causes itching on the challenged focus and may, in some cases, cause anaphylaxis. The histamine release test using the glass-fiber method (HRT) is based on the measurement of an immediate allergic reaction but can be performed safely in vitro. In this investigation, we measured the reaction of samples taken against 10 allergens simultaneously using HRT with a small amount of peripheral whole blood. HRT showed a high correlation and concordance with the CAP-RAST system. HRT also had a significant correlation with the nasal provocation test, and had good specificity and positive predictive value. With these advantages, HRT is considered to be clinically useful and especially suitable for screening of allergens because of its high specificity and positive predictive value, and also because of its safety and ease of performance.

Localization of t-PA, u-PA, PAI-1, PI and TGF-beta within tumors was examined immunohistologically in 31 patients with squamous cell carcinoma (SCC) of the head and neck, and correlations between the localization of these factors and local cancer infiltration, tumor size or cervical lymph node metastasis were investigated. The results revealed that u-PA, PAI-1 and PI tend to stain more intensely in infiltrating tumors than in peripheral connective tissue or normal epithelium, whereas neither t-PA nor TGF-beta showed any such tendency. Not all of these fibrinolytic factors participated in lymph node metastases or influenced tumor size in head and neck SCCs. These results suggest a disorder of fibrinolytic systems in carcinoma cells and that u-PA plays a part in the infiltration of head and neck SCCs by degenerating connective tissue.

Allergic rhinitis is conventionally treated with anti-histamine or immunotherapy, although in many cases the results are unsatisfactory. Using a contact type Nd:YAG laser we have succeeded in relieving the symptoms of rhinitis by thermocoagulating only the inferior turbinate, making this a quick and effective form of treatment. The subjects were 60 patients with severe house-dust induced allergic rhinitis presented to the out-patient clinic of the ENT department of Nagoya City University Hospital. There were 25 men and 35 women ranging in age from 17 to 53 years. Patients were irradiated at an output of 10 W for 0.5 s for a total of about 386 joules for both nasal cavities. Prior to the procedure, surface anesthesia was applied using 10% cocaine. The irradiation was completed in only one out-patients session. The effects of this therapy were evaluated using 4 points to express the degree of subjective symptoms and intranasal findings. From one week before surgery the patient was asked to record symptoms (sneezing, blowing, blockage) every day, and to continue this recording until 4 weeks after surgery. After surgery no drugs were used. The effects were evaluated by adding up the total scores for sneezing, blowing, and blockage at one week intervals, and comparing the total scores between one week pre-operatively and those 1, 2, 3, and 4 weeks post-operatively. Full effect, including disappearance of symptoms, was obtained in 80%, good effect in 10%, fair effect in 5%, and no effect in 5%.

In our clinic we have encountered nasal allergy due to fungi such as Candida, Aspergillus, and Alternaria. We therefore conducted a retrospective study of patients who consulted our Department between 1984 and 1991. A clinical review of patients who showed a positive skin test for Candida, Aspergillus, or Alternaria was performed. Our study revealed that Alternaria showed the highest ratio of strong positivity upon both RAST and skin test among the three fungi examined. These results led us to reconsider Alternaria as an important fungal antigen.

In Japan, pollen of Cryptomeria japonica and Chamaecyparis obtusa are a yearly source of distress for many people suffering seasonally from allergic rhinitis. To study common epitopes shared by the two species, two monoclonal antibodies (moAbs) were raised against Cry j 1, which is the most predominant allergen in C. japonica. One of the moAbs was found to be reactive even to the major allergen of C. obtusa, demonstrating that the moAb (J1B01) can detect an epitope shared by both species J1B01 strongly inhibited the binding of the major allergens of C. japonica and C. obtusa to IgE of patients who are sensitive to C. japonica and C. obtusa. This finding signifies the importance of the epitope recognized by J1B01.

Japanese cedar (Cryptomeria japonica) is the most important pollen causing pollinois during spring. During recent years some patients' nasal symptoms have been getting worse after the Japanese cedar pollen season. Japanese cypress (Chamaecyparis obtusa) pollen is also observed in this period. The purpose of the study was to investigate the effect of Japanese cypress pollen and cross-allergenicity between Japanese cypress and Japanese cedar in patients with allergic rhinitis.A total of 267 patients were enrolled in the study. IgE antibodies to both tree pollens were measured by the CAP RAST method. The results of the CAP RAST test were compared with those of skin tests. In order to compare cross-allergenicity between these two pollens, CAP RAST inhibition assay was carried out.The positive frequencies of Japanese cypress and Japanese cedar in 267 patients were 50.1% and 74.7%, respectively. A significant correlation (r = .765) was observed between the two tree pollens. There was good concordance (75%) between RAST and skin tests to Japanese cypress. The results of RAST inhibition assay indicated cross-allergenicity between these two pollens and species-specific allergens.Measurement of IgE antibody to Japanese cypress is useful for the diagnosis of pollinois during the spring.

We have treated a 58-year-old man with almost complete tracheal occlusion arising as a result of recurrence of esophageal cancer. Although laser photoresection using partial cardiopulmonary bypass was desirable, neither laser nor cardiopulmonary bypass was available in our hospital. It was then decided to resect the tumor by forceps. In order to prevent bleeding from tumor during such emergency procedure, intratumoral injection of ethanol was preceded and tracheal lumen could be opened successfully. He was managed by insertion of a Dumon silicone stent seven days after the emergency. The result was satisfactory for maintaining the patency of the airway where the stent was placed. Unfortunately the patient died 113 days after the insertion of Dumon silicone stent from massive hemoptysis, which might resulted from the rupture of vessel feeding the tumor or the perforation of aorta involved by the tumor.

To determine the importance of silkworm moth allergens, we tested 267 patients with allergic rhinitis with CAP-RAST, a new assay system for detecting specific IgE in sera. We used the following allergen sources: house-dust mite, Candida, Alternaria, cat dander, orchard grass, ragweed, mugwort, Japanese hops, Japanese cedar, Japanese cypress, cotton, silk, larval chironomid midge, adult chironomid midge, and silkworm moth. As expected, the highest positive rate of reaction, as determined by CAP-RAST, was 73.8% for Japanese cedar, followed by 53.2% for mite and 50.6% for Japanese cypress. Although the positive rate for silkworm moth was not as high as for cedar pollen, one-third of patients had specific IgE against silkworm moth. The positive rate of reaction to silkworm moth was much higher than that to chironomid. It was interesting to note that the patients reported had not been documented as having frequent contact with silkworm moth allergen. Correlations between silkworm moth and silk, and silkworm moth and chironomid midge were found to be significant (P < 0.001). Silkworm moth allergen showed the third highest reaction rate in patients with severe symptoms. These results suggest that silkworm moth allergen should be considered to be important in patients with allergic rhinitis in Japan.

We had already made a report on outcome of schizophrenia (1986). The patients, 129 typical schizophrenia, were continuously observed over 30 years in the Kawagoe Dojinkai Hospital. Recently, we again evaluated their prognoses according to the same criteria as adopted in the first report, and divided them into the following five groups. [symbol: see text]: completely remitted group (21 persons, 16.3%), [symbol: see text]: almost remitted cases now holding jobs (23 persons, 17.8%), [symbol: see text]: Slightly remitted group showing good adjustment at home or hospital (41 persons, 31.8%), [symbol: see text]: maladjusted cases always showing an unfavorable condition (25 persons, 19.4%), x : incurable cases (19 persons, 14.7%). 1) In the last 8 years, there were 30 persons (23.3% of the whole patients) who showed prognostic changes (10 persons improved, 20 persons worsen). While the second group ([symbol: see text]) has seen fewer persons (12 persons down) than previous study, the third group ([symbol: see text]) has seen more persons (9 persons up). Each three groups, that is, the first two groups ([symbol: see text] + [symbol: see text], 44 persons, 34.1%), the third group ([symbol: see text], 41 persons, 31.8%), and the forth and fifth groups ([symbol: see text] + x, 44 persons, 34.1%) accounted for a third of the whole patients. It is after 32 years on the average (extending from 21 to 50 years) from the onset of illness that they showed prognostic changes. 2) Generally speaking, catatonic patients had favorable prognoses, hebephrenic patients unfavorable ones, and paranoid patients medium ones. But 4 improved persons in the forth and fifth groups were all hebephrenic type. 3) 17 among the 30 persons who showed prognostic changes were unstable type. They took a wave-like course. 4) 27 of all the 129 patients were dead. 25 were dead from disease mentioned below. Malignancy (8 persons), Cerebral vascular disease, Pneumonia and Diabetes (3 persons), Heart-failure (2 persons), Ileus, Myocardial infarction, Hepato-cirrhosis, Gastric ulcer, Tuberculosis and Natural death (1 person). 2 persons committed suicide. 5) Outcome of 45 patients who discontinued our medical therapy became clear as follows. [symbol: see text] + [symbol: see text]: 18 persons (40.0%), [symbol: see text]: 9 persons (20.0%), [symbol: see text] + x : 18 persons (40.0%). A smaller percentage of the patients belongs to the third group ([symbol: see text]) than that of our patients who were continuously followed by us.

In a multi-center case-control study, we evaluated the risk of esophageal cancer in the Japanese population. All patients and controls were inpatients in the surgical departments of seven hospitals nationwide. Patients eligible for the study were those newly diagnosed as having primary esophageal cancer. One control per case was selected from among patients admitted to the same hospital, and 141 male pairs were analyzed using logistic regression analysis. The results showed dose-response relation between the risk of esophageal cancer and both the quantity (g/week) and frequency (times/week) of alcohol drinking (P value for trend = 0.0001). Although a statistically significant risk increase was shown among moderate to heavy smokers (15or = cigarette/day25) (odds ratio, 4.35:95% confidence interval, 1.81-10.49), the dose-response for cigarette smoking was unclear (P value for trend = 0.07). No combined effect of alcohol drinking and cigarette smoking was found. A frequent intake of fruit was associated with a decreased risk (P value for trend = 0.02). After adjustment for alcohol consumption, cigarette smoking and fruit intake were found not to be associated with the risk, whereas a preference for high-temperature food and drink showed a statistically significant positive association (P value for trend = 0.02). Drinkers who consumed shochu most frequently showed a three-fold increased risk over that for beer consumers, although the association disappeared after adjusting for the amount of alcohol consumed. The present results confirm alcohol intake and a preference for high-temperature food to be associated with an increased risk of esophageal cancer and show the amount of alcohol consumed, rather than the type of alcoholic beverage, to be the main risk determinant.

Patients with decompensated liver cirrhosis have a high risk of bacterial infection and a worse prognosis. They have defects of the humoral defence mechanism; impaired antibody production and depressed serum complement levels. The cellular defence mechanism is also defective. The function of neutrophil and reticuloendothelial system is depressed. The clearance of enteric organisms from the portal circulation is impaired by portosystemic shunt and impaired Kupffer cell function. Patients with massive ascites are prone to spontaneous bacterial peritonitis due to gram negative enteric organisms.

Fourteen patients with chronic renal failure (CRF) were studied by dipyridamole 201Tl myocardial scintigraphy. In this study, patients with coronary heart disease were excluded by clinical findings. 201Tl SPECT was performed at 8 min after injection of dipyridamole (0.56 mg/kg) and at a 3-hr delayed interval, and washout rates (WR) were calculated. Because UCG showed left ventricular hypertrophy (thickness; 13 +/ 2 mm) in CRF, the WR values were compared with those of hypertrophic cardiomyopathy (HCM) (n = 9). In CRF, an average WR was 54.2 +/- 6.8% and was significantly higher than that in normal (46.2 +/- 9.1%, p0.05, n = 9), though WR in HCM was significantly low (26.9 +/- 11.4%, p0.01). Hematocrit value was 24.5 +/- 3.2% in CRF and was significantly lower than that in normal (37.8 +/- 3.6%, p0.001). On the other hands, hemoconcentration was observed in HCM (hematocrit; 44.6 +/- 3.6%, p0.001). WR in CRF, HCM and normal had significant correlation with hematocrit values (r = -0.796, p0.001). These results suggest that anemia or hemoconcentration may affect coronary blood flow and WR, and this should be considered when diagnosing coronary heart disease in CRF or HCM.

Generally, the cases with symptomatic biliary stone are diagnosed as cholelithiasis and asymptomatic cases are not defined as cholelithiasis in the strict sense. However, asymptomatic stones are often diagnosed and treated as cholelithiasis. In the diagnosis and treatment of cholelithiasis, it is important to study the localization and classification of biliary stones relation to clinical symptoms.

Esophageal cancer with endemic distribution of high-risk areas in the world is also known to be more prevalent in the male--and in the aged-populations than in their counterparts. The hormonal characteristics of esophageal cancer patients and the geographical distribution of high and low-risk areas in Japan were comparatively investigated in search of the etiology of this neoplasia. A case-control study of 14 urinary steroids indicated that cancer patients of both sexes were associated with an acceleration of cortisone to hydrocortisone conversion within their bodies. Evidence was presented to suggest that the above state of glucocorticoid excess could be related to the production of hyperplasia as well as malignant transformation in the epithelial cells of the esophagus. The 10 highest risk areas and the 7 lowest risk areas were clearly separated by the 2 fault lines of the Japan Islands, a finding to suggest that some microelements of the soil play a role in conditioning the cancer risk. The possible linkage of the observed hormonal characteristics of Japanese patients to both the geochemistry of the soil and the genesis of this neoplasia is discussed in the light of the competitive relationship between the intake of vitamin C and endogenous nitrosation.

In order to establish a safer and simpler antigen administration method in immunotherapy, we prepared biodegradable microspheres containing antigen and evaluated its safety and efficacy using guinea pigs. Poly (lactic/glycolic acid); (LGA) microspheres containing ovalbumin (OA) were fabricated by solvent evaporation. Over 70% of the OA was released from the microspheres within 3 days, and release was completed within 14 days in vivo. The local tissue reactions to the OA-LGA microspheres were apparently weaker than those to OA-alum. Repeated injections of high dose OA-LGA microspheres to OA-sensitized guinea pigs (high-LGA group) for 8 weeks at intervals of 2 weeks elicited an excellent therapeutic effect, i.e. a significant increase in the threshold value of antigen inhalation test, with a significant increase in IgG2 blocking antibody. The therapeutic efficacy of the high-LGA group was comparable to the conventional immunotherapy model (conventional group) and was superior to the antigen-alum model (alum group). We concluded that administration of antigen-LGA microspheres could become a new immunotherapeutic method for allergic disorders, being safer and requiring a lower frequency of antigen injections than the conventional method.

Thirty-nine patients with advanced measurable squamous cell carcinomas were treated with two or more courses of 70 mg cisplatin/m2 on day 1 and 700 mg infused 5-fluorouracil/m2 on days 1-5 every 21 days. The overall response rate was 35.9 (95% confidence limits, 24.8-55.1%). Responses were seen in primary sites in the esophagus of five patients, in the lung of seven, the liver of one and the mediastinal lymph nodes of one. The average response duration was 3.5 (range 1-12) mo for patients who achieved partial response. The average survival time after the first administration was 9.5 mo for patients who responded to the treatment whereas, for those who did not, it was 5.6 mo. The major form of toxicity was myelosuppression and there were six patients with grade 3 toxicity and one with grade 4. The present study was designed to evaluate the effectiveness of combined cisplatin and 5-fluorouracil for advanced squamous cell carcinoma, and the results showed that it had a reasonable effect and might possibly be used as a postoperative chemotherapy because of its mild side effects.

A 59-year-old woman with Sjögren's syndrome had an anterior mediastinal tumor. The tumor had epithelium-lined thymic cysts. Histologically, centrocyte-like (CCL) cells were present as clusters intermingling with small lymphocytes and plasma cells, invaded the epithelium, and formed characteristic lymphoepithelial lesions; the tumor was identified as malignant lymphoma arising in mucosa-associated lymphoid tissue (MALT). Within the tumor, trapped Hassall's corpuscles were recognized. Immunohistochemical staining demonstrated monotypic cytoplasmic kappa light chains in a small portion of the CCL cells. Furthermore, Southern blot hybridization studies showed rearrangements of immunoglobulin heavy chain, immunoglobulin kappa light chain, and T-cell receptor beta genes. The findings are consistent with thymic low-grade B-cell MALT lymphoma.