Okayama University Medical School

In the present study, tryptamine produced a slow hyperpolarization in a few neurons other than a slow depolarization in myenteric neurons of the isolated guinea-pig ileum. Neither the adrenergic neuron blocker, guanethidine nor the 5-hydroxytryptamine uptake inhibitor, zimelidine, which can inhibit the release of 5-hydroxytryptamine from enteric neurites induced by tryptamine (M. Takaki et al. (1985) Neuroscience 16, 223-240), affected this slow hyperpolarization. Therefore, it was concluded that the slow hyperpolarization induced by tryptamine in myenteric neurons was not mediated via the release of 5-hydroxytryptamine or noradrenaline. It might be possible that the hyperpolarization was induced by a direct action of tryptamine on myenteric neurons per se.

In this prospective cohort study for Japanese patients with established ischemic heart disease (IHD), the authors investigated the rate of success of smoking cessation 3 months after hospital discharge and its related factors. The subjects included 90 current smokers admitted for IHD. A total of 58 subjects (64%) had quit smoking for 3 months after being discharged. In comparison with subjects with acute myocardial infarction, those with stable angina (SA) showed a significantly lower frequency of smoking cessation (relative risk of resuming smoking (95% confidence interval):2.06 (1.09, 3.92), p=0.036). This relationship remained significant even after controlling for sex, age, and scores of the Fagerstrom Test for Nicotine Dependence (adjusted odds ratio:3.39 (1.01, 11.37), p=0.048). However, it became insignificant when hospital admission followed by emergency medical service (EMS) care was additionally adjusted (adjusted odds ratio:2.48 (0.36, 16.97), p=0.356). The smoking cessation rate in this study was identical to that observed in studies conducted in Japan prior to the recent social changes with regard to tobacco use. SA still appears to be a risk factor for smoking resumption after discharge. Experiencing EMS care would be an intermediate variable in this relationship.

Sneddon's syndrome is characterized by livedo reticularis and cerebrovascular lesions. We report the cases of women (mean age, 36.2 +/- 8.1 years) diagnosed with Sneddon's syndrome based on the presence of livedo reticularis and characteristic cerebrovascular findings. Seven of these patients had cerebral infarcts on cranial computed tomography scan. Antiphospholipid antibodies were positive in 6 of these cases. Three cases had abnormal levels of antithrombin III. Analyses of chromosome 6 revealed no abnormalities. In 3 of the cases, investigation of the pedigrees revealed autosomal dominant traits. Two cases had epilepsy, and 3 had migraine. One case with migraine also had myasthenia gravis. In addition, we detected inferior altudinal hemianopia in 2 cases, cognitive functional disorder in 3 and depression in 2. Based on these findings, the entire vascular, haematologic, neurologic, and dermatologic systems should be evaluated in patients diagnosed with Sneddon's syndrome.

A rare case of resectable solitary pancreatic metastasis from a renal cell carcinoma is reported. The patient was a 57-year-old man who presented with epigastralgia. He had undergone a radical nephrectomy of the right side 30 months previously. The diagnosis of pancreatic metastasis was based on the patient's past history and angiographic demonstration of typical hypervascular tumor staining. Histological examination was confirmatory. The patient was successfully treated by pancreaticoduodenectomy followed by alpha-interferon administration. As of 6 months after surgery, he remains well.

In order to examine how long diploid cells can be maintained in vitro cultivation without any chromosomal aberrations and to evaluate the mechanism of chromosomal heteroploid transformation, changes of chromosomes were studied in the course of serial in vitro transfers in four normal rat liver cell lines. As a result the diploid cells decreased in number gradually at early culture stage and disappeared completely in the periods between 350 and 500 days. The culture shifted to heteroploid as follow: diploidy---tpseudodiploidy---thypodiploidy---thypertriploidy or hypotetraploidy. This proces to heteroploid transformation is divided into five stages according to ploidy: 1- and II-stages show diploidy, III-stage, pseudodiploidy, IVstage, hypodiploidy and V-stage, hypertriploidy or hypotetraploidy. Chromosomal heteroploid transformation and neoploastic conversion occurred in IV-stage of the cultures. A possible mechanism involved in the process of chromosomal transformation was discussed.

In our department we have been placing a special emphasis on the treatment and study of rheumatoid arthritis, and during the last four years we have handled about 1,600 cases visiting our outpatient clinic and approximately 100 hospitalized cases. Our experiences with these patients are only what might be called an introductory phase in the study and treatment of rheumatoid arthritis when compared with those in Europe and America. In estimating the incidence of rheumatoid arthritis in Japan from various available data, although it would not reach the level of England and U.S.A., it will be about 100 cases per 100,000 population, matching more or less the incidence in the northern Europe. As regards sex and the predisposing age we find no great difference from those in Europe and America. One striking difference that we find is the fact that patients in our country have very little resistance against salicylic acid drug used in treatment. Therefore, it is unreasonable to expect a good anti-inflammatory action by administering a large dosage of 5-10g of such a drug as aspirin per day. It must be limited within a comparatively small dosage of 1.0 to 2.0 g or with concomitant administration of prednisolone and aspirin in the hope of utilizing its analgesic effect. Furthermore, it is not feasible to introduce the results of studies made in Europe and America on the salicylic drug and its prescription all of them showing the concentration in blood 35 mg%, which is on the borderline of intoxicating dosage. This is only one example, and with some more experiences we shall undoubtedly encounter many dissimilar points. Therefore, it is essential that rheumatology specific to Japan needs to be established.

An abnormal glucose tolerance is often found in patients with psychiatric or neurologic diseases, and the problem is then, what does this abnormal glucose tolerance mean and what is the relation between this and the patient's psychic state.

An outbreak of encephalomeningomyelitis in Ehime·Syuso area from April to June 1956 was clinico-virologically investigated with the materials obtained from 28 hospitalized cases and their healthy visiting relatives. The major rise in polio type I antibody titer and the positive isolation of 4 strains of type I indicate the epidemy in this area to be the polio type 1. Three undeterminable cytopathogenic agents were concomitantly obtained in the HeLa cultures. The style of this episode was duly compared with the documents already reported.

Serum levels of total IgE, specific IgE, IgG and IgG4 against house dust mite were measured in mite-sensitive asthma patients receiving immunotherapy with house dust. Serum levels of total IgE, mite specific IgE and IgG did not significantly change during the course of hyposensitization. Increased levels of mite specific IgG4 were observed in patients during immunotherapy. The increase in specific IgG4 was dependent on the total dose of house dust administered in both children (r = 0.636, p less than 0.001) and adults (r = 0.629, p less than 0.01). However, the increase of specific IgG4 in adults was not as apparent as in children. These results might suggest that mite specific IgG4 is a useful immunological marker in the immunotherapy for allergic asthma, and that IgG4 antibody acts as a blocking antibody in atopic bronchial asthma.