Compared with normal mice, the concentration of serum zinc in zinc-deficient mice was significantly increased after oral administration of 1ml of 1000ppm ZnSO₄ solution, while that of zinc-deficient mice treated with Kampo (Pogostemi Folium et Rhizoma, Perilla Herba, Saussureae Radix, Aurantii Nobilis Pericarpium, Anemarrhena Rhizoma, etc.) was not increased. The intestinal mucosa of zinc-deficient mice was also remarkably injured with administration of ZnSO₄ but the Kampo formula inhibited its injury.

A dermatitis of unknown etiology has occurred among the farmers working in paddyfields in some districts of Tokushima Prefecture, such as Anan, Kainan and Komatsujima.
The dermatitis occurs from March to May when rice-planting and weeding are on and is characterized by erythemato-papulo-vesicular eruptions accompanied with severe itching. The chief symptoms are observed on the parts exposed to water, especially on forearms and lower legs. The results of the epidemiologicaland clinical observations indicated that the dermatitis was due to the invasion of cercariae of an avian schistosome.
The investigation for snail intermediate hosts was carried out in the paddy fields where the dermatitis occurred.
Cercariae of apharyngeal furcocercous type were detected from the fresh water snails (Austropeplea ollula) which were collected most abundantly from the paddy fields during the season of occurence of the dermatitis.
The cercaria wasidentified as species belonging to the genus Trichobilharzia and was regarded as the same species as so far described in Saitama Prefecture by Suzuki et al (1973).
An experimental infection with the cercaria was performed. A few drops of watercontaining cercariae was placed on the fore-arm of. a voluntor. The cercariae invaded into the skin and produced a dermatitis quite similar to that prevailing in the endemic areas.
Therefore, it was concluded that theetiological agent was the cercaria of a species of an avian schistosome.

A 52-years-old female farmer has suffered from bronchial asthma during the last 10 years during the lettuce growing season (NOV.-May). Laboratory test findings showed that her sumptoms were due to type I allergy. Namely, she showed eosinophilia, an increased level of Ig E and an immediate positive reaction to intracutaneous lettuce allergen. But, she gave negative reactions in RAST and immediate skin reaction test to 23 common allergens. By provocation tests she showed positive reactions to both the environment (FEV_1.0-26.8%) and allergen inhalation (FEV_1.0-30.0%), and had amoderate attack 15 minutes after inhalation of undiluted lettuce juice. The allergen was extracted from fresh lettuce juice by Coca's method. The protein concentration of the allergen was 8.74 mg/ml and its concentration in crude juice was 0.874 mg/ml.
Inhalation of lettuce juice during the harvest time was concluded to be the cause of this allergy.
A survey of farmers cultivating lettuce by a questionnaire and by mass physical examination revealed dermatitis as the most frequent complaint, with a similar incidence (7.1%) of respiratory symptoms including rhlnitis. However, further detailed questioning showed that the cause of most respiratory symptoms was not allergic, and the intracutaneous reaction of the farmers to the allergen was similar to that of control subjects who were not farm workers. The positive rate of the skin patch test was significantly higher in farmers growing lettuce than in control who were not farm workers.
Allergic disease caused by lettuce might be generated as allergic dermatitis of type IV. Type I allergy caused by lettuce is rare, but here we reported one case of this rare type.

Surgical mortality associated with ruptured abdominal aneurysm remains high, especially in elderly patients, despite recent progress in improved patient management. We present the successful salvage of a 90-year-old woman with ruptured abdominal aortic aneurysm. She was transferred from another hospital because of severe abdominal and back pain and pulsatile abdominal tumor. One hour after admission, shock suddenly developed. We diagnosed her illness as ruptured abdominal aneurysm on enhanced CT scan. Emergency surgery was performed. The hematoma surrounding the aneurysm occupied the retroperitoneal space below the level of the diaphragm (Fitzgerald III). Aortic cross clamp was quickly performed below the level of the diaphragm approaching from the lesser omentum. After controlling bleeding, the site of the aortic cross clamping was changed to the infrarenal aorta. The aneurysm was resected and replaced by a knitted Dacron Y-graft (albumin coated). Duration of surgery was 5 hours and 5 minutes. Blood loss was 6200ml. After surgery, artificial ventilation was required for ten days to avoid hypoxemia. On the 5th postoperative day disseminated intravascular congulation (DIC) developed but she recovered. On the 30th postoperative day, she was discharged. Advanced age may not be an absolute contraindication for surgical treatment even in cases of rupture.

In 13 patients who underwent left ventriculography both before and after operation, we investigated regional wall motion of the left ventricle (LV) with the centerline method in LV aneurysmectomy. There were no significant differences between preoperative predicted and postoperative ejection fraction. No significant differences were observed between preoperative predicted and postoperative regional wall motion of all segments in all cases and cases without significant stenosis who did not undergo revascularization of the right coronary artery. Postoperative regional wall motion of the inferior wall was significantly better than the preoperative predicted one in cases who underwent revascularization of the right coronary artery with significant stenosis. It is considered that revascularization of the right coronary artery with significant stenosis in LV aneurysmectomy was effective for the improvement of regional wall motion of the inferior wall.

We report a 65-year-old man with a mobile thrombus in the distal aortic arch with no previous history of thromboembolic events. There was no evidence of either aneurysmal changes or aortic dissection. Transesophageal echocardiography revealed the presence of a mobile tumor in the distal arch. The patient underwent elective resection. The mobile tumor was attached to the aortic wall, approximately 3cm distal to the left subclavian artery. Histological examination revealed an old thrombus containing calcification. He was discharged on the 22nd postoperative day with no thromboembolic complications. This is the first report of a case of mobile thrombus in the distal aortic arch in Japan.

[Objective] Physical exercises raise more or less body temperature. A body temperature is regulated constantly generally by homeostasis mechanism. Perspiration is only heat radiation mechanism under high temperature environments. And sudoriferous water is supplied from blood. Blood flow is determined by blood fluidity, blood volume and the cardiovascular system. It was reported that strong stress decreased blood fluidity.In this experiment, we investigated the relation between blood fluidity and water supply in rats loaded with forced exercise in high temperature environment.[Methods] SPF male Wistar rats weighing 150 g were used. All animals were put in high temperature environment (Wet Bulb Globe Temperature; WBGT: 28°C) through whole experimental period. In a group of water supply, distilled water was served before and later exercise by sonde forcibly. The rats were divided into five groups randomly; Rest-Non water intake (RN), Rest-Water intake (RW), Exercise-Non water intake (EN), Exercise-Water intake (EW) and Baseline (B). The blood was collected before or later of exercise and blood fluidity or platelet aggregation was measured.[Results] In the EN, platelet aggregation, lactic acid and corticosterone increased while blood fluidity were decreased significantly compared with the RN, RW and EW. In addition, the hematocrit did not increase even if water equivalent to 8 % of body weight lost it.[Conclusion] We speculate that exercise in high temperature environment decreases blood fluidity. However, the water supply that does not completely make up for quantity of depletion in exercise may improve blood fluidity.

We report two cases of an abdominal aortic aneurysm, one with congestive heart failure, and the other with a dissecting aortic aneurysm (type IIIb), who underwent an aorto-bifemoral bypass operation under a temporary external axillofemoral bypass. In one patient (Case 1, a 74-year-old male), who had an abdominal aortic aneurysm with congestive heart failure due to aortic valve insufficiency and stenosis, perioperative transesophageal echocardiography demonstrated that, with a temporary external axillofemoral bypass, the regurgitant doppler signal was unchanged during the cross-clamping period of the abdominal aorta. In the other patient (Case 2, a 71-year-old male), who had a dissecting thoracoabdominal aortic aneurysm with the lower abdominal aorta having a true aneurysm formation, the transesophageal echocardiography demonstrated that, with a temporary external axillofemoral bypass, the false lumen of the dissecting thoracic aneurysm had no change in size during the cross-clamping period of the abdominal aorta. Thus, a temporary external axillofemoral bypass might avoid any unfavorable hemodynamic effect during and after the abdominal aortic clamping in patients suffering from an abdominal aortic aneurysm with cardiovascular complications.

We reviewed 24 cases of patchplasty for true thoracic aortic aneurysm performed in our hospital up to July 2001. The size of the aneurysm in the ascending aorta was 6.0cm (1 case), and the mean size in the aortic arch was 2.5±0.5cm (4 cases), that in the distal arch was 4.7±1.7cm (11 cases), and that in the descending aorta was 3.7±0.5cm (8 cases). The hospital mortality rate was 12.5% (3 patients out of 24). The causes of death were multiple organ failure, cerebral bleeding and sepsis. In the long-term results, 2 patients had recurrence, but there were no late deaths in relation to the aneurysmal recurrence. We performed open stent operations for severe adhesion and pulmonary dysfunction in the aneurysmal recurrence cases. The postoperative course of these cases was uneventful. The open stent was useful for the treatment of the aneurysmal recurrence in the distal arch.