Nagoya Journal of Medical Science

We found that human bone marrow cells formed mononuclear phagocyte clusters and colonies in liquid culture with or without conditioned medium. In this study, we prepared media from human spleen or bone marrow cells in several different conditions and assessed their colony-stimulating activities as well as the sensitivities of human spleen or bone marrow colony-forming cells to these conditioned media. Conditioned media from human spleen cell cultures showed distinct cluster-stimulating activity to human bone marrow cells but those from human bone marrow cell cultures did not. On the other hand, conditioned media from human spleen cell cultures showed distinct colony-inhibiting rather than -stimulating activity to human spleen cells with high plating efficiency (11-350/4 x10⁶) compared with those from human bone marrow cell cultures. To human spleen cells with low plating efficiency (1-10/4 x10⁶ ), conditioned media from human bone marrow cell cultures showed distinct cluster-stimulating activity compared with those from human spleen cell cultures.

Biliary obstruction often follows advanced cancers of the biliary system, such as pancreas cancer, which requires a resection of the involved portion of the portal vein. To improve the patient's state of obstructive jaundice, bile drainage should be performed before the operation. Temporaryocclusion of the portal vein is inevitable for a resection and reconstruction of the portal vein, and its detrimental influence on the liver remains to be resolved. In this study, the effect of portal vein occlusion on rat liver mitochondria was investigated after releasing biliary obstruction. The common bile duct of the male Donryu rat was ligated and, after a certain duration, was recanalized to allow for external bile drainage. Then the portal blood flow was blocked for either IS or 30-rnin. At the end of the experiment, the following parameters were examined: the respiratory functions and ultrastructures of liver mitochondria, and the serum levels of hepatic enzymes. A significant reduction of the respiratory functions was observed in the 30-min occlusion group regardless of the length of the biliary obstruction period; also the ultrastructures of the liver mitochondria showed severe changes associated with increased s-GPT and m-GOT. These results indicate that IS-min occlusion of the portal vein after releasing biliary obstruction has a negligible effect on the liver functions, but 30-min occlusion induces dysfunction of liver cells. Therefore, additional countermeasures to clear such liver dysfunction should be employed in biliary tract surgery, provided that a prolonged portal vein occlusion is inevitable.

The prognosis of gastric cancer was investigated in relation to histopathological grading and amount of interstitial connective tissue in 42 patients with gastric cancer pervading the muscularis propria but without invading the serosa (pT₂ gastric cancer). The 5- and 10-year survival rates of patients with this type of gastric cancer were 76.3% and 47.3%, respectively.
On examining the relation between the prognosis and the histopathological grading, the 5-year survival rate was 82.4% in cases with low degree of differentiation and 66.5% in cases with high and medium degrees of differentiation. No significant statistical difference was seen. The prognosis in relation to the amount of interstitial connective tissue a 5-year survival rate of 91.3% in cases with rich interstitia (scirrhous type), 76.5% in those with intermediate type, and 43.3% in cases with medullary type, thus revealing a favorable prognosis in the first type and a poor one in the last type (p≒0.03). The prognosis was extremely poor in cases of meduallary type with low degree of differentiation; these cases had a high rate of mortality from recurrence in the liver and a tendency toward early recurrence. In contrast, a favorable prognosis with a high 5-year survival rate was noted in cases with rich interstitia.

In an experimental study in rats, cimetidine, a potent gastric-acid inhibitor (50 mg/kg, .p.o.) reduced the macromolecular glycoprotein level of glandular stomach. The administration of cimetidine at a dose of 50 mg/kg, which inhibited the gastric lesions induced by hypoxia (13% O₂ for 6 hours), reduced the glandular stomach level of high molecular glycoproteins in animals receiving a low oxygen load as well as in those receiving no load. It was assumed that the reduction of macromolecular glycoprotein accelerated the gastric lesion induced by hypoxia load in rats and that cimetidine inhibited the lesions through a process other than that of recovering the glycoprotein level in the glandular stomach.

A new technique for reconstruction of oral mucosa, named reversed dermis graft (RDG), was introduced. In the RDG, dermis freed from the epidermis was transplanted upside down. The graft was then covered by the surrounding mucosal epithelium to form the mucosal tissue, while the implanted tissue inhibited the wound contracture somewhat. The various mucosal defects in 20 patients were repaired with the RDG. Clinical and histological evaluation were conducted to analyze the value of this method.
1) In 20 patients, all parts of the oral cavity were reconstructed with RDG except for the palatal mucosa. The maximum graft size was 9 x 5 cm and the minimum graft size was 2.5 x 1.5 cm.
2) All grafts were reepitheliarized with the surrounding mucosal epithelium within about 5 weeks. Hair growth, keratinization, and formation of dermal cyst were not seen in the reconstructed area.
3) The grafts contracted in all cases to about 55% of their original size.

Incidence of sleep apnea syndromes in the general population in Japan is unknown. To investigate this incidence in Japan, sleep apnea syndromes were carefully diagnosed for all patients who visited a private hospital located in Naka Ward, Nagoya, from November 1, 1983, until April 30, 1985. A total of 9132 patients were examined by four doctors. Insomnia, heavy snoring, daytime hypersomnia, shortthick neck, hypertrophied tonsils, obesity, and micrognathia were considered important clues for diagnosis of sleep apnea syndromes. Patients with signs and symptoms of possible sleep apnea syndromes underwent either an ear-oximeter test or a recording of snoring. Final diagnosis was determined by polysomnography.
Sleep apnea syndromes were diagnosed in 26 (23 males and 3 females) out of 9132 patients, the percentage among general patients being 0.285%. The percentage was specifically high (0.785%) in male patients between the age of 40 and 69; and 19 out of all 26 patients with sleep apnea syndromes were in this age group. Among the 26 sleep apnea patients, 17 had hypertension, 9 had diabetes mellitus, and 5 suffered from depression.
The percentage of patients with sleep apnea syndromes in this study might actually have been higher because there were more than six patients with suspicious symptoms, whose diagnostic work-up could not be completed.

Twofold magnification radiograms of hands and feet in 384 diabetic cases were reviewed to determine the correlation between clinical findings and osseous lesions, especially early changes. A small, well-demarcated, round radiolucent lesion (small lytic lesion) was the most frequent finding in 87.2% of the 384 patients. In particular, a small lytic lesion of less than 1 mm in diameter was encountered in 85.9% of all cases by magnification radiography. A small lytic lesion can be thought of not only as a specific finding but also as one of the prodromic findings of diabetic osteoarthropathy. Localized osteopenia was also specific for diabetes, with a fairly high frequency (39.1%). Multivariate analysis revealed significant correlation between osseous lesions, especially small lytic lesions, and retinopathy. Significant correlation between retinopathy and osseous lesions was also identified by clinical followup cases. These facts suggest that microangiopathy may play an important role in the development of osseous involvements.