A study on alpha-fetoprotein and endodermal sinus tumor.

The phenomenon of alpha-fetoprotein production by testicular, ovarian, or sacrococcygeal teratocarcinomas is frequently observed but has not been well explained. This paper includes clinicopathologic studies of 19 cases of teratocarcinoma with positive AFP reactions. Sixteen of the 19 showed typical histologic features of endodermal sinus tumor (yolk sac tumor) of Teilum and one other was compatible with this diagnosis.^6,7 The occurrence of AFP in these tumors is best explained by the concept of endodermal sinus tumor; because it is known that large amounts of AFP are synthesized not only by the fetal liver but also by the yolk sac during early embryonic life, and because the diagnosis of endodermal sinus tumor itself implies that the tumor is of yolk sac origin morphologically.¹³More direct evidence of AFP synthesis was demonstrated by immunofluorescent technique in one of our cases. Immunofluorescence was seen only in that cell layer long defined as of yolk sac origin morphologically.Alpha-fetoprotein studies are valuable in following such patients, unless they are 1 mo of age or younger.     

Eye position and electromyographic observation of squint eyes under general anesthesia.

The position of eyes under general anesthesia was measured in different groups of nonparalytic strabismus. Almost all patients with esotropia or hyperactive inferior oblique muscle showed divergent eye positions while patients with exotropia showed no consistent trend. The eye position of patients with lid ptosis without squint, which served as a control group, were divergent in all cases. Electromyographic observation of the medial rectus muscle under the same condition of anesthesia revealed that muscle discharge disappeared almost completely at the stage at which the eyes were in a well-stabilized position.     

Heading judgments during active and passive self-motion

Previous studies have generally considered heading perception to be a visual task. However, since judgments of heading direction are required only during self-motion, there are several other relevant senses which could provide supplementary and, in some cases, necessary information to make accurate and precise judgments of the direction of self-motion. We assessed the contributions of several of these senses using tasks chosen to reflect the reference system used by each sensory modality. Head-pointing and rod-pointing tasks were performed in which subjects aligned either the head or an unseen pointer with the direction of motion during whole body linear motion. Passive visual and vestibular stimulation was generated by accelerating subjects at sub- or supravestibular thresholds down a linear track. The motor-kinesthetic system was stimulated by having subjects actively walk along the track. A helmet-mounted optical system, fixed either on the cart used to provide passive visual or vestibular information or on the walker used in the active walking conditions, provided a stereoscopic display of an optical flow field. Subjects could be positioned at any orientation relative to the heading, and heading judgments were obtained using unimodal visual, vestibular, or walking cues, or combined visual-vestibular and visual-walking cues. Vision alone resulted in reasonably precise and accurate head-pointing judgments (0.3° constant errors, 2.9° variable errors), but not rod-pointing judgments (3.5° constant errors, 5.9° variable errors). Concordant visual-walking stimulation slightly decreased the variable errors and reduced constant pointing errors to close to zero, while head-pointing errors were unaffected. Concordant visual-vestibular stimulation did not facilitate either response. Stimulation of the vestibular system in the absence of vision produced imprecise rod-pointing responses, while variable and constant pointing errors in the active walking condition were comparable to those obtained in the visual condition. During active self-motion, subjects made large headpointing undershoots when visual information was not available. These results suggest that while vision provides sufficient information to identify the heading direction, it cannot, in isolation, be used to guide the motor response required to point toward or move in the direction of self-motion.     

The efficiency of the central and peripheral retina in driving human optokinetic nystagmus

Previous experiments to decide whether the gain of optokinetic nystagmus (OKN) is increased or decreased by occlusion of the central retina involved the use of stationary edges on the occluder and unmatched contrasts. With these factors controlled, it was confirmed that OKN gain is severely reduced by occlusion of the central retina but only at stimulus velocities above about 30°/sec. The gain of horizontal OKN was found not to increase with increasing width of the display if the lateral edges are blurred. The high gain of centrally driven OKN may be related to the ability of higher mammals to stabilize the images of objects at a given distance in a complex parallactic visual field.     

Prediction of Postdialysis Serum Sodium Concentration and Transcellular Fluid Shift Without Measuring Body Fluid Volumes

Abstract: The postdialysis levels of serum sodium concentration, urea concentration, and osmolality, as well as the magnitude of both transcellular fluid shifts and sodium removal, were predicted based on computer modeling without measuring body fluid volumes. A 4-h hemodialysis was performed in five patients at a constant ultrafiltration rate of 0.5 L/h using dialysate with normal (141 mEq/L) or high (150 mEq/L) Na+ concentration. The serum sodium concentration, urea concentration, and osmolality, as well as intracellular and extracellular fluid volumes, were determined before and after hemodialysis. The model predictions without measurement of body fluid volumes were in excellent agreement with measured values, suggesting clinical validity. The model may be useful in clinical practice to control the postdialysis levels of sodium and water content by computerized hemodialysis.     

Experience with cefmetazole in the urological fields

Recently, a new antibiotic of cephamycins, cefmetazole (CMZ) has been developed. In our clinic, CMZ was used to examine its clinical effect and adverse reactions, and the results were herein reported. The CMZ was administered to 8 patients for the prevention of postoperative infections, 7 with genitourinary infections and 1 with maxillitis complicated with uremia. For these patients, a daily dose of 1 to 6 g of CMZ was intravenously given for a period of 4 to 12 days. Among the 8 patients who received CMZ for the prevention of postoperative infections, there were 1 case with urinary tract infection, 1 with wound infection and 2 with fever of over 38 degrees C, but they had no serious infections. In the clinical observations on 3 cases with pyelonephritis, the CMZ showed marked effectiveness in 2 cases and effectiveness in 1 case. It must be noted that CMZ was proved to be markedly effective for pyelonephritis caused by Serratia marcescens. In the cases with acute epididymitis and prostatitis, a good effect of CMZ was obtained. Similarly in the case with maxillitis complicated with uremia, the maxillitis was improved by the effect of CMZ and hemodialysis. No cases with hepatic or renal dysfunction were observed after using CMZ. It is concluded that satisfactory effect of CMZ was obtained clinically.     

Presence and distribution of fibronectin on the surface of implanted intraocular lenses in rabbits

An immunohistochemical study was performed to observe cellular proliferation on the surface of implanted intraocular lenses (IOLs) in rabbit eyes. Rabbits were killed at intervals of 3 days and 1, 2, and 4 weeks after the operation. The IOLs were removed and examined by an immunoperoxidase staining method using antifibronectin (anti-FN) antibodies. The FN immunoreactivity was detected in macrophages and giant cells attached to the IOL surface. Prominent staining was observed in these cells 1 week after the operation, and staining for FN was less intense in the specimens obtained 2 and 4 weeks after implantation. These findings suggest that FN is produced by macrophages and giant cells on the IOL surface and may play an important role in cellular adhesion and motility. FN immunoreactivity decreased with time, which might be related to cellular activity.     

Treatment of Adult T Cell Leukaemia by Extracorporeal Photochemotherapy

Four patients with chronic or smouldering type adult T cell leukaemia (ATL) were treated by extracorporeal photochemotherapy (photopheresis). From 4 to 8 months after starting photo-pheresis, skin lesions with ATL cell infiltration began to disappear. Cell surface markers in three patients showed improvement. In one patient, a serial decrease of soluble interleukin-2 receptor levels (950 U/ml to 620) in the serum was observed after 4 months. This pilot study suggests that photopheresis may be successfully applied in ATL. It is still necessary to continue follow-up observations in these patients and to treat a larger number of cases, before definite conclusions can be drawn in the future