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Summary: Background & Aims: The prevalence of artificially administered nutrition and hydration (AANH) in different age groups among patients with advanced cancer remains unknown. The present study investigated the current utilization of AANH according to age groups in palliative care units. Methods: This was a secondary analysis of a prospective cohort study. We obtained information on primary nutritional administration routes during the first week of admission and data on the averaged calorie sufficiency rate or total calorie intake on the 7th day of admission. Patients were divided into five age groups (18–39, 40–59, 60–74, 75–89, and 90- years). Among patients receiving AANH, the proportions of higher-calorie AANH were compared between the five age groups. Results: A total of 1453 patients were included. The proportion of patients categorized as receiving nutrition and hydration via the parenteral route was the highest in the 18–39 and 40–59 groups (52.4 and 41.1%, respectively). Among patients receiving AANH (n = 534), the proportions of patients categorized into the

Background The prognosis of high-risk osteosarcoma, defined by the presence of chemo-resistance, metastatic disease at diagnosis, and relapse, remains poor. The efficacy of high-dose chemotherapy (HDC) and autologous stem-cell transplantation (ASCT) for high-risk osteosarcoma is still unclear. Methods We retrospectively reviewed pediatric patients with high-risk osteosarcoma who underwent HDC and ASCT at our institution between 2002 and 2018 and performed a review of the literature regarding the efficacy of HDC and ASCT for high-risk osteosarcoma. Results Six patients with high-risk osteosarcoma underwent high-dose melphalan (180 mg/m2)-based chemotherapy followed by ASCT. Two patients received HDC consisting of ifosfamide and melphalan. Three patients received HDC consisting of etoposide, carboplatin, and melphalan. One patient underwent tandem HDC consisting of thiotepa and etoposide followed by melphalan, thiotepa, and etoposide. Non-hematological toxicities presented mainly as mucositis and diarrhea. Two patients developed grade 3 mucositis. No life-threatening toxicities were observed in any of the six patients. One patient with disease progression before HDC died of multiple metastases, while five patients, with no evidence of disease in the peri-transplant periods, were alive at the time of publication; there was no disease recurrence at a median follow-up period of 144 months (range, 24–215 months). Our review of the literature supports the use of HDC with a higher dose of melphalan (180–280 mg/m2) for high-risk osteosarcoma. Conclusions Melphalan-based HDC and ASCT can be a promising treatment for high-risk osteosarcoma. Additionally, surgical removal of macroscopic residual lesions may be essential in peri-transplant periods.

Parenteral morphine is widely used for dyspnea of imminently dying cancer patients (terminal dyspnea). However, the efficacy of other opioids such as oxycodone remains largely unknown.To explore the efficacy of parenteral oxycodone vs. morphine by continuous infusion over 24 hours in cancer patients with terminal dyspnea.This was a pre-planned subgroup analysis of a multicenter prospective observational study. Inclusion criteria were advanced cancer patients admitted to palliative care units, Eastern Cooperative Oncology Group performance status = 3-4, and a dyspnea intensity ≥2 on the Integrated Palliative care Outcome Scale (IPOS) for which oxycodone or morphine was initiated by continuous infusion. We measured dyspnea IPOS scores over 24 hours.We analyzed 164 patients who received oxycodone (n = 26) and morphine (n = 138) for dyspnea (median survival = 5 days). The mean age was 70 years, 58 patients (35%) had lung cancer, and 97 (59%) had lung metastases. Complete case analysis revealed that mean dyspnea IPOS scores decreased from 3.0 (standard deviation = 0.7) to 1.5 (0.7) in the oxycodone group (difference in means = 1.5; P 0.001), and from 2.9 (0.7) to 1.6 (1.0) in the morphine group (difference in means = 1.3; P 0.001). No significant between-group differences existed in the IPOS scores at 24 hours (P = 0.753). Adverse events were seen in no and 5 patients in the oxycodone and morphine groups, respectively.Parenteral oxycodone may be equally effective and safe as morphine in the treatment of terminal dyspnea in cancer patients. Future randomized controlled trials should confirm the efficacy and safety of opioids other than morphine for terminal dyspnea.

Decompensated liver cirrhosis is often complicated by refractory ascites, and intractable ascites are a predictor of poor prognosis in patients with liver cirrhosis. The treatment of ascites in patients with cirrhosis is based on the use of aldosterone blockers and loop diuretics, and occasionally vasopressin receptor antagonists are also used. Recent reports suggest that sodium–glucose cotransporter 2 (SGLT2) inhibitors may be a new treatment for refractory ascites with a different mechanism with respect to conventional agents. The main mechanisms of ascites reduction with SGLT2 inhibitors appear to be natriuresis and osmotic diuresis. However, other mechanisms, including improvements in glucose metabolism and nutritional status, hepatoprotection by ketone bodies and adiponectin, amelioration of the sympathetic nervous system, and inhibition of the renin–angiotensin–aldosterone system, may also contribute to the reduction of ascites. This literature review describes previously reported cases in which SGLT2 inhibitors were used to effectively treat ascites caused by liver cirrhosis. The discussion of the mechanisms involved is expected to contribute to establishing SGLT2 therapy for ascites in the future.

Poor graft function (PGF) is a major obstacle to successful allogeneic stem cell transplantation after achieving normal bone marrow function. We report a successful treatment of domino DLI for poor graft function in younger brother with hyper IgM syndrome from HLA-identical elder brother with the same disorder with a history of HLA-mismatched unrelated bone marrow transplantation using same donor. Immunological profiling revealed that DLI-induced T-regulatory cells could correct skewed immune responses in the BM microenvironment due to secondary PGF pathogenesis. Immunological tolerized domino DLI can be a new therapeutic option for secondary PGF in HLA-identical sibling pairs with congenital immunodeficiency.

Poor graft function (PGF) is a major obstacle to successful allogeneic stem cell transplantation after achieving normal bone marrow function. We report a successful treatment of domino DLI for poor graft function in younger brother with hyper IgM syndrome from HLA-identical elder brother with the same disorder with a history of HLA-mismatched unrelated bone marrow transplantation using same donor. Immunological profiling revealed that DLI-induced T-regulatory cells could correct skewed immune responses in the BM microenvironment due to secondary PGF pathogenesis. Immunological tolerized domino DLI can be a new therapeutic option for secondary PGF in HLA-identical sibling pairs with congenital immunodeficiency.

The benefits of artificial nutrition and hydration in patients with advanced cancer remain unknown. Therefore, we conducted a prospective study to evaluate effects of enteral nutrition (EN) and parenteral nutrition and hydration (PNH) on survival in palliative care units.This study involved a secondary analysis of a multicenter cohort study. Data of primary nutritional administration routes during the first week after admission (oral intake, enteral tube feeding, parenteral nutrition, parenteral hydration, poor oral intake) were obtained. Data of averaged calorie sufficiency rate/total calorie intake [high (75% ≤ or 750 kcal/day ≤), moderate (50-75% or 500-750 kcal/day), low (25-50% or 250-500 kcal/day), very low (25% or250 kcal/day)] were also obtained. After investigating the implementation of artificial nutrition and hydration, participants were divided into three groups according to the nutritional administration route and calorie sufficiency rate/total calorie intake: EN, PNH, and control. We conducted time-to-event analyses using the Kaplan-Meier method, log-rank test, and univariate and multivariate Cox regression analyses.Patients were divided into the EN group (n = 730), PNH group (n = 190), and control group (n = 533). Differences in survival rates among the three groups were significant (Log-rank P 0.001). Median survival times were 43.0 (95% CI 40-46), 33.0 (95% CI 29-37), and 15.0 (95% CI 14-16) days, respectively (P 0.001). In the multivariate-adjusted model, a significantly lower risk of mortality was observed in Cox's proportional hazard model in the EN group and PNH groups (HR 0.43 [95% CI 0.37-0.49], P 0.001; and HR 0.52 [95% CI 0.44-0.62], P 0.001, respectively) than in the control group.This study indicated the clinical benefits of EN and PNH for patients with advanced cancer. Nevertheless, managing symptoms to improve oral intake is essential before initiation of PNH, because EN was superior to PNH.

Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings. Therefore, we conducted a questionnaire to examine the relationship between the perception of need for nutritional support and cancer cachexia and the prevalence of specific needs, perceptions, and beliefs in nutritional support. We conducted a questionnaire in palliative care settings. Patients were classified into two groups: (1) non-cachexia/pre-cachexia and (2) cachexia/refractory cachexia. A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: non-cachexia/pre-cachexia (32.7%) and cachexia/refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were “when anorexia, weight loss, and muscle weakness become apparent” (48.6%) and “nutritional support team” (67.3%), respectively. The top three beliefs of nutritional treatments were “I do not wish to receive tube feeding” (78.6%), “parenteral nutrition and hydration are essential” (60.7%), and “parenteral hydration is essential” (59.6%). Patients with cancer cachexia expressed a greater need for nutritional support. They wished to receive nutritional support from medical staff when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Most patients wished to receive parenteral nutrition and hydration.

Carnitine is a vitamin-like compound that plays important roles in fatty acid β-oxidation and the control of the mitochondrial coenzyme A/acetyl-CoA ratio. However, carnitine is not added to ordinary enteral nutrition or total parenteral nutrition. In this study, we determined the serum carnitine concentrations in subjects receiving ordinary enteral nutrition (EN) or total parenteral nutrition (TPN) and in patients with inflammatory bowel diseases to compare its levels with those of other nutritional markers. Serum samples obtained from 11 EN and 11 TPN patients and 82 healthy controls were examined. In addition, 10 Crohn's disease and 10 ulcerative colitis patients with malnutrition who were barely able to ingest an ordinary diet were also evaluated. Carnitine and its derivatives were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). The carnitine concentrations in EN and TPN subjects were significantly lower compared with those of the control subjects. Neither the serum albumin nor the total cholesterol level was correlated with the carnitine concentration, although a significant positive correlation was found between the serum albumin and total cholesterol levels. Indeed, patients with CD and UC showed significantly reduced serum albumin and/or total cholesterol levels, but their carnitine concentrations remained normal. In conclusion, only a complete blockade of an ordinary diet, such as EN or TPN, caused a reduction in the serum carnitine concentration. Serum carnitine may be an independent biomarker of malnutrition, and its supplementation is needed in EN and TPN subjects even if their serum albumin and total cholesterol levels are normal.

Purpose Pericardial effusion (PE) is a potentially life-threatening complication following hematopoietic stem cell transplantation (HCT). A higher incidence of early-onset PE, unrelated to graft-versus-host disease, before day 100 after HCT has been reported in pediatric patients, but the pathogenic mechanism is poorly understood. Aiming to determine the pathogenesis of early-onset PE in pediatric patients, we analyzed the cytokine concentration and cell population in the pericardial fluid of four pediatric patients with PE. Methods Between January 2009 and December 2015, four patients requiring pericardiocentesis for clinically significant PE were identified in 60 patients. We evaluated the interleukin-6 (IL-6), interferon-γ, IL-1β, and tumor necrosis factor-α levels in PE. Two patients were available for analysis with intracellular cytokine flow cytometry and a chimerism assay. Results All patients showed the accumulation of pericardial macrophages and high concentrations of IL-6 in PE. Notably, the accumulated pericardial macrophages were CD163+ CD15+ CD14+ cells of host origin that produced IL-6. Conclusion These IL-6-producing tissue-resident macrophages may be key players in the pathogenesis of early-onset PE.

100 Background: Few studies have investigated the need for nutritional support in advanced cancer patients in palliative care settings.The aim of this survey is to examine the relationship between the need for nutritional support and cancer cachexia, specific needs, perceptions, and beliefs. Methods: We conducted a questionnaire in outpatient service/palliative care teams/palliative care units. Patients were classified into two groups: 1) Non-cachexia/Pre-cachexia and 2) Cachexia/Refractory cachexia. Results: A total of 117 out of 121 patients responded (96.7%). A significant difference was observed in the need for nutritional support between the groups: Non-cachexia/Pre-cachexia (32.7%) and Cachexia/Refractory cachexia (53.6%) (p = 0.031). The specific needs of patients requiring nutritional support were nutritional counseling (93.8%), ideas to improve food intake (87.5%), oral nutritional supplements (83.0%), parenteral nutrition and hydration (77.1%), and tube feeding (22.9%). The top perceptions regarding the best time to receive nutritional support and the best medical staff to provide nutritional support were “when anorexia, weight loss, and muscle weakness become apparent” (48.6%) and “nutritional support team” (67.3%), respectively. The top three beliefs of nutritional treatments were “I do not wish to receive tube feeding” (78.6%), “parenteral nutrition and hydration are essential” (60.7%), and “parenteral hydration is essential” (59.6%). Conclusions: Patients with cancer cachexia had a greater need for nutritional support. Advanced cancer patients wished to receive nutritional support from medical staff with specific knowledge when they become unable to take sufficient nourishment orally and the negative impact of cachexia becomes apparent. Additionally, most patients wished to receive parenteral nutrition and hydration.

A 57-year-old man was referred to our outpatient clinic after interferon-beta (IFN-beta) treatment for 7 weeks. While IFN-beta therapy was continued in our outpatient clinic, his blood glucose level increased gradually, and he was admitted to our hospital for hyperglycemia. The patient was prescribed a 1,600-kcal diet and intensive insulin therapy was performed. GAD antibody became positive 15 months after the start of IFN therapy, and disappeared 27 months after the start of IFN therapy. Insulin secretion was depleted and the patient had HLA-DR4, B54, and DRB1*0405. This appears to be a case of type 1 diabetes mellitus induced by administration of IFN-beta alone.

Objective: To study the interaction between salicylate and class 1 antiarrhythmic agents. Methods: The effects of salicylate on class 1 antiarrhythmic agent-induced tonic and phasic block of the Na+ current (INa) of ventricular myocytes and the upstroke velocity of the action potential (Vmax) of papillary muscles were examined by both the patch clamp technique and conventional microelectrode techniques. Results: Salicylate enhanced quinidine-induced tonic and phasic block of INa at a holding potential of −100 mV but not at a holding potential of −140 mV; this enhancement was accompanied by a shift of the h∞ curve in the presence of quinidine in a further hyperpolarized direction, although salicylate alone did not affect INa. Salicylate enhanced the tonic and phasic block of Vmax induced by quinidine, aprindine and disopyramide but had little effect on that induced by procainamide or mexiletine; the enhancing effects were related to the liposolubility of the drugs. Conclusions: Salicylate enhanced tonic and phasic block of Na+ channels induced by class 1 highly liposoluble antiarrhythmic agents. Based on the modulated receptor hypothesis, it is probable that this enhancement was mediated by an increase in the affinity of Na+ channel blockers with high lipid solubility to the inactivated state channels.

Under whole cell patch conditions, 1389-S blocked the I Na in guinea-pig ventricular myocytes under steady state conditions (K d rest = 30 μ M, K d i = 2.4 μ M) with a shift of the inactivation curve to the hyperpolarizing direction. Both brief and long conditioning pulses could produce a use-dependent block of 1389-S. These results suggest that 1389-S had a higher affinity to the inactivated than to the rested state under steady state conditions and had a higher affinity to the activated state during train pulses as well as to the inactivated state, making channels unavailable for conduction upon activation.

Summary: A simple and sensitive method for the quantitation of theophylline (TP) in tears and plasma developed using gas chromatography/electron-impact ionization/mass spectrometry. Tears were collected by non-invasive Schirmer method. Plasma was pipetted on a Schirmer tear test strip (cutting to 5 mm × 5 mm). Then, TP was converted directly into its pentafluorobenzoyl amide derivative without the need to perform any extraction from the biological fluid absorbed on Schiemer test paper and was quantified by gas chromatography-selected ion recordings with electron ionization mode. The concentrations in tears [C]t correlated very well with those of the free form in the plasma [Cf]p and those of the total form in the plasma [Cb + f]p. The ratios between TP concentrations in tears and plasma (free and total form) were as follows: [C]t/[Cb + f]p = 0.53 ± 0.20; [C]t/[Cf]p = 1.21 ± 0.19; [Cf]p/[Cb + f]p = 0.44 ± 0.14. The ratios of [C]t/[Cb + f]p, [C]t/[Cf]p and [Cf]p/[Cb + f]p were in good agreement with the previously published data.

A rapid and sensitive method for the quantitation of valproic acid in tears has been developed using gas chromatography/electron capture negative chemical ionization/mass spectrometry. Valproic acid was converted directly into its pentafluorobenzyl ester derivative without the need to perform any extraction from the biologic fluid. The concentrations in tears [C]t correlated very well with those of the free form in the plasma [Cf]p and those of the total form in the plasma [Cb+f]p. The ratios between valproic acid concentrations in tears and plasma were as follows: [C]t/[Cb+f]p = 0.10 +/- 0.02; [C]t/[Cf]p = 0.57 +/- 0.11. Ratios of [C]t/[Cb+f]p were in good agreement with previously published data.

The effect of TYB-3823 on Ca2+ current (ICa) of guinea pig ventricular myocytes was investigated by means of whole-cell patch-clamp technique. TYB-3823 (100–1,000 μM) caused a concentration-dependent decrease in ICa. Furthermore, a reduction of ICa induced by TYB-3823 (1,000 μM) was progressively accentuated by repetitive membrane depolarization, indicating a rate-dependent block of ICa. However, the inhibitory potency on ICa was approximately 1 1000 of a Ca2+ antagonistic agent, verapamil hydrochloride. Considering evidence that 3–30 μM TYB-3823 decreased the maximum upstroke velocity of the action potential of guinea pig ventricular muscles, it is indicated that the drug does not show its Ca2+ antagonistic property in the usual concentration range as a class I antiarrhythmic agent.

1. Sodium current (INa) blockade by TYB-3823, a newly synthesized antiarrhythmic agent, was investigated in isolated single ventricular myocytes by use of the whole cell patch-clamp technique. 2. TYB-3823 blocked INa under steady-state conditions (Kd,rest = 500 microM, Kd,i = 4.9 microM), findings consistent with a shift in the steady state INa availability curve to more negative potentials. 3. TYB-3823 produced use-dependent block at 2 Hz in conjunction with increase in pulse duration (5-300 ms), that was markedly enhanced at less negative holding potentials. 4. The time course of the onset of block was accelerated and the degree of use-dependent block was decreased at more negative holding potential. The time course of the onset of block was accentuated with enhancing block at more positive holding potentials. 5. The time course of recovery from use-dependent block was accelerated at more negative holding potentials but was accentuated at more positive holding potentials. 6. These results suggest that both tonic block and use-dependent block of sodium channels in cardiac tissue might result from an interaction of TYB-3832 with sodium channels mainly in the inactivated channel states and the kinetics of the interaction between drug and receptor may be modulated by the inactivation gate.

1. 1. Cibenzoline, a class 1 antiarrhythmic drug, was studied on the effects upon the myocardial slow inward Ca2+ current (ICa) and the contractile force, and was compared with verapamil. 2. 2. In voltage-clamp experiments with guinea-pig ventricular myocytes, cibenzoline caused a concentration-related inhibition of ICa (IC50 = 30 μM), whereas verapamil exerts a stronger effect (IC50 = 0.6 μM). 3. 3. Cibenzoline also produced a concentration-related decrease in contractile force of isolated papillary muscle preparation (IC50 = 30 μM), while IC50 of verapamil was 0.8 μM. 4. 4. Although the myocardial Ca2+ channel blocking effect of cibenzoline is about 1 50 compared to verapamil, cibenzoline possesses an inhibitory action on Ca2+ channel as well as on Na+ channel.

The concentrations of sodium valproate (VPA) in tear and plasma by a quadrapole ion trap type GC/MS (GCQ) in a negative ion/chemical ionization/electroncapture mode. VPA was converted into the pentafluorobenzyl ester and was quantified by monitoring the ion of m/z 143. The VPA concentrations [C]Ts in the tear obtained from patients by non-invasive Schirmer method correlated very well with those of the unbound form in the plasma, indicating that the [C]TS will be used as a convenient index for monitoring the unbound VPA level in the patients.

There are a number of permanent magnets in the market. Quality improvement of ferrite magnets has been done steadily and it is possible to obtain materials with a remanence of 3600 G coupled with an intrinsic coercivity of 5000 Oe for automobile starter motors.In 1983 permanent magnet manufacturers in USA and Japan announced their intention to produce Nd-Fe-B magnet. It can be produced both by the technique used for rapid quenching and by conventional powder metallurgy. The powder produced by rapid quenching is applied for isotropic plastic bonded magnets which are used for small motors.

症例は65才,主婦.鼻出血,心窩部痛を主訴に入院した.父に鼻出血,娘に鼻出血および毛細血管拡張病変を認めた. 14才頃より鼻出血が時々あり, 57才頃より毛細血管拡張と口腔内出血が著しくなつた.入院時,皮膚,口腔・鼻腔粘膜の著しい毛細血管拡張,眼瞼結膜に強度の貧血を認めた.肺には異常血管雑音を聴取せず,肝は約4cm触知したが,脾腫は認めなかつた.検査所見では便潜血陽性,ヘモグロビン6.5g/dl,血清鉄, UIBCは鉄欠乏型であつた.肝機能障害を認め,超音波検査は肝硬変に一致した.凝固系検査は正常であつた.胃・十二指腸造影検査,内視鏡検査にて胃および十二指腸潰瘍を認め,潰瘍底部とその周辺部に毛細血管拡張病変を認めたこと,胃液検査にて胃酸が分泌過多であつたことから,本症における消化性潰瘍の発生機序について考察を加えた.

The polymerization of N-methylmethacrylamide (NMMAm) with azobisisobutyronitrile (AIBN) was investigated kinetically in benzene. This polymerization proceeded heterogeously with formation of the very stable poly(NMMAm) radicals. The overall activation energy of this polymerization was calculated to be 23 kcal/mol. The polymerization rate (Rp) was expressed by: Rp = k[AIBN]0.63-0.68[NMMAm]1−2.5. Dependence of Rp on the monomer concentration increased with increasing NMMAm concentration. From an ESR study, cyanopropyl radicals escaping the solvent cage were found to be converted to the living propagating radicals of NMMAm in very high yields (ca. 90%). Formation mechanism of the living polymer radicals was discussed on the basis of kinetic, ESR spectroscopic, and electron microscopic results.

The depression of Vmax of the action potential in guinea-pig ventricular muscle by aprindine and quanidine was compared. Aprindine caused a more pronounced rate-dependent block (Kd = 10(-6) M at 3.3 Hz) than did quinidine (Kd = 1.6 X 10(-5) M at 3.3 Hz). Aprindine shifted the relationship between Vmax and resting potential to a more negative potential (mean 9.2 mV: 10 microM) than did quinidine (mean 5.7 mV: 10 microM). In addition, aprindine caused a more pronounced resting block (Kd = 1.3 X 10(-5) M) than quinidine (Kd = 8.6 X 10(-5) M). It is concluded that aprindine has a higher affinity for activated and/or inactivated and resting state channels than quinidine, making channels unavailable for conduction upon activation.

Es wurden Losungen von 10 verschiedenen Chemikalien und Arzneimitteln in die Kaninchenharnblase instilliert und in ihr 2 Stunden lang belassen. Die Veranderungen der Bindegewebszellen der Schleimhaut wurden hauptsachlich an mit Eisenhamateinlack gefarbten Schnitten untersucht.1. Trypanblau wird von den Epithelzellen aufgenommen. Es kann auch durch das Epithel ins subepitheliale Gewebe eingehen und von den Histiocyten gespeichert werden.2. Die Starke der Veranderungen der Bindegewebszellen der Blasenschleimhaut ist bei: 1%iges Hexamethylentetramin>0.1%iges Rivanol> 0.1%iges Silbernitrat>0.5%iges Proteinsilber>2%iges Penicillin>6.6%-iges Streptomycin>1%iges Sarol>2%ige Borsaure>0.1%iges Permanganat >0.5%iges Trypanblau.3. Bei der Anwendung vom am starksten reizenden Hexamethylentetramin sieht man alle Ubergangsformen von Retikulumzellen und Fibrocyten zu Mono- und Histiocyten und viele Mono- und Histiocyten, daneben pseudoeosinophile Leukocyten aus den Blutgefasen.4. Bei Silberpraparaten und Rivanol vermehren sich die Monocyten stark, Fibrohistiocyten und Histiocyten werden aber auch zahlreich gesehen. Pseudoeosinophile Leukocyten kommen nicht viel vor.5. Penicillin und Streptomycin verursachen auch eine Vermehrung der Monocyten. Pseudoeosinophile Leukocyten kommen in geringem Grade vor.6. Der. Reiz von Sarol, Borsaure, Permanganat und Trypanblau ist schwach. Sarol lockert den submikroskopischen Bau der Epithelzellen auf.

Der Harnweg des mannlichen Kaninchens wurde in HELLYscher Flussigkeit fixiert. Die Schleimhaut wurde mit Eisenhamateinlack und Hamatoxylin-Azur-Eosin gefarbt und beobachtet.Das Epithel des Nierenbeckens des Ureters und der Harnblase ist ein Ubergangsepithel. Stellenweise dringen in das Epithel Blutkapillaren ein. Das Epithel der Urethra ist ein mehrschichtiges Zylinderepithel, in das die Blutkapillaren nicht eintreten.In der oberflachlichen Schicht der Lamina propria der Schleimhaut des Nierenbeckens, des Ureters und der Harnblase um die Ausmundung des Ureters bilden Retikulumzellen den Mutterboden verschiedener freien Zellen. In der tieferen Schicht sind aber Fibrocyten die wesentlichsten Zellarten. Man sieht neben den Retikulumzellen und Fibrocyten mehr oder weniger zahlreiche Monocyten, Fibrocyten und Histiocyten. In der ganzen Schicht der Lamina propria der Schleimhaut des Corpus vasicae sind Retikulumzellen zahlreich zu sehen, aber im Halsteil der Blase sind mehr Fibrocyten und in der Urethra wieder mehr Retikulumzellen.In der subepithelialen Schicht des Blasenhalses, in welcher viele Bindegewebsfasern vorhanden sind, befinden sich ziemlich zahlreiche, aus den Fibrocyten entstandene Fibrohistiocyten. In der faserarmen subepithelialen Schicht des Corpus vasicae sieht man dagegen ziemlich zahlreiche Monocyten und Lymphocyten.In der oberflachlichen Schicht der Tunica propria mucosae der Urethra sind nicht wenige, aus den Retikulumzellen gelieferte Monocyten vorhanden, in der Tiefe aber ebenso viele Fibrohistiocyten und Histiocyten aus Fibrocyten.Lymphocyten sind in kleiner Zahl in allen Teilen der Harnwege zu treffen. Es sind aber keine Lymphknoten ausgebildet.

1. In leerem Zustand des Harnweges ist das Epithel von den Nierenpapillen der Niere ab allmahlich dicker, und erreicht am Ureter das Maximum 58.2μ, wird aber am distalen Ende des Ureters wieder dunner, seine Dicke betragt etwa 60% des proximalen Teils des Ureters. Das Epithel im Blasenkorper ist fast so dick wie am Nierenhilus. Am Blasenhals wird das Epithel auffallend dunner. Das Epithel wird in der Urethra am dunnsten, namlich 22.9μ. An dem Nierenhilus, dem Ureter und der Harnblase bildet die Schleimhaut Falten, auf deren Gipfel das Epithel dicker ist als im Tal zwischen ihnen.2. Die Langsachse der obersten Zellen des Epithels des Harnwegs steht, wenn dies leer ist, bis zum distalen Ende des Harnleiters senkrecht zur freien Epitheloberflache. Am Blasenkorper sind aber die Zellen kuboid. Die Wand der Urethra wird bekanntlich von einem geschichteten Zylinderepithel ausgekleidet.3. Das Volumen der obersten Epithelzellen des Harnwegs nimmt in zusammengezogenem Zustand mit der Dicke des Epithels zu. Es ist am Blasenkorper am grosten, 6380μ3, und an der Urethra am kleinsten, 1160μ3. Das Volumen der basalen Zellen hangt wie das der obersten Zellen von der Dicke des Epithels ab. Dies ist am grosten am Blasenkorper, 4330μ3, und am kleinsten an der Urethra, 1220μ3.4. Wenn die Harnblase stark erweitert wird, wird die Dicke des Epithels ein Viertel. Der Horizontaldiameter der obersten und basalen Zellen wird dabei fast 1.3mal groser, dagegen wird ihr Vertikaldiameter 2.6mal kleiner. Die starke Ausdehnung des Ureters verursacht auch das Dunnerwerden des Epithels auf etwa die Halfte. Dabei wird der Vertikaldiameter der obersten Zellen 1.5mal kleiner, dagegen wird der Horizontaldiameter 1.2mal groser. Der Vertikaldiameter der basalen Zellen wird ubrigens 1.8mal kleiner, dementsprechend wird ihr Horizontaldiameter ein wenig groser.

A 22-year-old man was found to have low serum urate concentration (1.1-1.7 mg/dl). His urate clearance was markedly increased (26.9-35.5 ml/min) and was not decreased after administration of pyrazinamide, but was even more increased after administration of benzbromarone. No other renal tubular abnormalities were detected. The young man has one sister and two brothers. His sister also has hypouricemia and hyperuricosuria. We suggest that the present case had a genetically determined renal abnormality affecting tubular presecretory reabsorption of urate.

We studied the effects of mianserin on the action potentials of papillary muscle from the guinea-pig. Mianserin (above 10μM) reduced the maximum rate of the rise (⊢otV max ) of the action potential, and shifted the ⊢otV max E m relationship to more negative potentials. The compound also depressed the slow action potentials of K + -depolarized papillary muscles. It is concluded that relatively high concentrations of mianserin had an inhibitory action on the electrophysiological properties of both the fast- and slow-response fibers of the heart.

A 22 year old man with two extra-adrenal pheochromocytomas located in the media stinum and in the pelvis is presented. We believe this is the first report in Japan of extra-adrenal multiple pheochromocytomas in adult located in the two distant places.

The effects of aprindine (1 X 10(-7) to 4 X 10(-6) M) were examined on membrane potential and current of rabbit sinoatrial node by means of conventional microelectrode and double microelectrode voltage clamp methods. Aprindine decreased, in a dose-dependent manner, the spontaneously firing frequency, the maximum rate of depolarization and the action potential amplitude, and prolonged the action potential duration at half-amplitude. The slope of the diastolic depolarization was also reduced by the drug. In the voltage clamp experiment, aprindine reduced the slow inward current (Isi), the time-dependent potassium current (Ik) and the hyperpolarization activated current (Ih). The recovery time constant of Isi was prolonged by aprindine, while the kinetics of Ik was not altered. It is indicated that aprindine does not have an effect on a specific conductance or a single current system, but that the drug exerts an inhibitory effect on the electrical activity of sinoatrial node.