Angiographic demonstration of intrahepatic arterio-portal anastomoses in hepatocellular carcinoma

Hepatic angiograms of 114 patients with hepatocellular carcinoma (HCC) were studied, particularly changes in the portal vein branches. Arterio-portal shunts of varying sizes, evidenced by opacification of intrahepatic portal branches, were seen in 72 cases (63.2%), with retrograde opacification of the portal vein trunk in 29 (25.4%). At least four types of shunts were found: (a) through a tumor thrombus in the portal branch, (b) in a retrograde direction via a peripheral tumor nodule, (c) through a small tumor invading or amputating an artery, and (d) through a tumor located near a major portal vein branch and supplied by a large, coiling artery. Postmortem angiography of the liver in 50 patients with HCC suggests that arterio-portal shunts are the result of the special vasculature in HCC and are highly diagnostic when accompanied by other angiographic changes.

Cortically induced masticatory rhythm and its modification by tonic peripheral inputs in immolbilized cats

Repetitive cortical stimulation induced rhythmical masticatory jaw movement and masseteric nerve activity in cats with the spinal cord sectioned at the C2 level. Jaw depression alone did not induce any rhythmical jaw movement, but it turned the irregular jaw movement evoked by subthreshold cortical stimulation into the regular jaw movement as evoked by suprathreshold cortical stimulation. The cortically induced rhythmical masseseteric nerve activity could be induced even in immobilized condition and after cerebellectomy, although the rhythmical nerve activity was depressed in amplitude and the rhythm became slower than before immobilization. Tonic jaw depression after immobilization facilitated the tonic activity in the masseteric nerve and also induced a remarkable increase in the amplitude of the cortically evoked rhythmical nerve activity and a slight acceleration of the rhythm, leading to the same masticatory rhythm as before immobilization. It was concluded (1) that the cortically induced masticatory rhythm in cats is basically generated centrally and (2) that the tonic inputs from the muscle spindle in the jaw-closing muscles participate in the rhythm formation by supplying tonic excitatory inputs mainly to the jaw-closer motoneuron and also to the central rhythm generator.

[Clinical study of amoxicillin used for treatment of infections of the lower urinary tracts (author's transl)]

The following results were obtained from treatment of 29 cases of lower urinary tract infections with amoxicillin. 1. Amoxicillin was remarkably effective in 13 cases of acute cystitis, in terms of effect according to dose and bacterial species. 2. The effective rate of amoxicillin in 10 cases of chronic cystitis amounted only to 30% due to complications and resistant bacteria. (The group given 1,500 mg/day was a little higher in the effective rate than the 750 mg/day group.) 3. Amoxicillin was low in effect against infections with Pseudomonas aeruginosa and hardly effective against bacteria resistant to amoxicillin. 4. So far as this study is concerned, amoxicillin produced good clinical results at a half dose of ampicillin, as in the fundamental experiment. 5. Any severe side effect was observed in no case.

Primary liver cancer coincident with Schistosomiasis japonica. A study of 24 necropsies

The etiologic relationship of parasitic liver disease to primary liver cancer has long been debated. For this reason, a review of 4611 necropsies was carried out to determine the frequency with which hepatocellular carcinoma occurred in association with schistosomiasis. Of 227 cases of hepatocellular carcinoma, 24 (10.6%) were associated with schistosomiasis japonica. This was significantly higher than the incidence of this carcinoma without schistosomiasis (2.78%). The majority of the 24 cases exhibited the features of a mixed macronodular and micronodular cirrhosis (Gall's posthepatitic cirrhosis); this was super-imposed upon and caused a masking of schistosomiasis fibrosis. By radioimmunoassay hepatitis B antigen was positive in 27% of these cases. A review of the literature indicated that chronic schistosomiasis, on its own, is unlikely to be the cause of primary liver cell carcinoma. Histologic features resembling post-hepatitic cirrhosis combined with a high frequency of hepatitis B antigen suggest that viral hepatitis rather than S. japonicum is the more likely etiologic factor involved, or has a synergistic effect on carcinogenesis.