Continuing the investigation of the previous report, the author reported on the electron microscopical changes in the kidney caused by the active immunization of auto-renal extract, and these investigation is a part of the studies on the antigen-antibody reaction in the kidney. On the experimental method, normal rabbits were immunized intraperitoneally with auto-renal suspension prepared by the unilateral nephrectomy. A total of ten times immune injections was executed once weekly, and one or six weeks after the last injection, these rabbits were sacrificed and the electron microscopical changes of the remaining kidney were observed. In seven of these ten rabbits, remarkable glomerular changes were observed as follows: 1) Major findings were degenerative or proliferative changes of the epithelial cells of glomerulus and Bowan's capsels, namely mitochondrial swelling, enlargement of endoplasmic reticulum and deposition of homogenous granules within cytoplasma of the epithelial cells. 2) Glomerular tufts showed remarkable dilatation and basement membranes were slight swelling or thining with decrease of density, and on Bowman's capsels, remarkable fibrous thickening of the basement membranes were observed. 3) Rarely, mesangial cells showed swelling with filamentous structural matrix. 4) But no significant changes were observed on the glomerular endothelial cells except slight swell ing of the endothelial layers. On the author's three experimental renal shocks caused by different antigen or antibodies, three different types of glomerulitis were observed, namely mesangial glomerulitis by anti-kidney serum, endothelial glomerulitis by anti-thymic serum and epithelial glomerulitis by auto-renal extract. Similar glomerular changes to these glomerulitis are observed on the other experiments by Hamamoto and his co-workers using various antigens or antibodies and autopsy cases of various diseases too, for example, mesangial glomerulitis are found in cases of acute glomerulonephritis and Schonlein-Henoch purpura, endothelial glomerulitis are in cases of thrombotic thrombocytopenic purpura and epithelial glomerulitis are in pyelonephritis and tuberculosis of the kidney. The results of the author's three experiments suggest that these different types of glomerulitis occur by the kinds of sites on which antigen-antibody reactions are caused.

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Several studies were carried out concerning threshold of tuberculin reaction. Recently attention has been paid to the threshold of immediate type of skin reaction (end point of antigen dilution) and its clinical significance. In this paper following points were studied and discussed: cause of individual difference in the threshold of skin test, advantage of the use of threshold dilution as a method of skin test in asthmatic patients, and change of the threshold values following hyposensitization. As concerned flare of the immediate skin reaction, either reaction by standard antigen dilution or threshold measurement showed skin sensitivity to antigen. There was no difference in skin sensitivity to histamin between in house dust-positive subjects and house dust-negative ones, and there was no significant correlation between sensitivity (threshold values) to histamin and that to house dust in asthmatic patients. Prausnitz-Kustner titers proved to be variable even with the serum from a single patient. It was concluded statisically that comparison of Prausnitz-Kustner titers of different sera should be carried out on a same reccipient, and it was demonstrated by P-K test that threshold of skin reactions in asthmatic patient was significantly correlated to the amount of reagin in the serum. Blocking antibody was tested during hyposensitization in ten asthmatic patients. The relationship between changes in threshold and blocking antibody titer suggested a possibility that hyposensitization caused production of blocking antibody, consumption and production of reagin. As the consequence of these possible reactions, threshold values and intensity of the standard skin reaction would change, however the former showed more sensitive change than the latter.

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The antibody globulins are classified into three immunoglobulin types on the basis of their antigenically differing heavy chains and all three immunoglobulin classes have similar light chains in common. The present studies demonstrate that the antinuclear factors (ANF) of γ-G, γ-A, and γ-M immunoglobulin classes are found in the sera of patients with systemic lupus erythematosus (SLE) and other diseases, and that these immunoglobulins with the ANF activity include molecules of both L chain types. Twenty-seven sera from patients with SLE (20 cases), rheumatoid arthritis (3 cases), and other diseases were examined by immunofluorescence test with mouse liver cell nuclei. Rabbit antisera against human γ-G, γ-A, and γ-M globulin and against human type I and type II Bence Jones protein were used determine the heterogeniety of the ANF. In sera of patients with SLE, the ANF of γ-G class was found in all cases, the ANF of γ-A class in only two, and ten ANF of γ-M class in twelve, respectively. Therefore, the ANF in the four sera contained all three immunoglobulin classes, and the ANF in the eight sera contained γ-G and γ-M classes. Quantitative and qualitative studies on the ANF in SLE demonstrated that there were no significant correlations between clinical findings or course of illness and titer or classes of the ANF. In sera of patients with the other disease, the ANF of γ-M class was found in all cases, the ANF of γ-G class in three, and the ANF of γ-A class in only one. The author suggeted that the ANF of γ-M class was demonstrated dominantly in SLE, while the ANF of γ-M class was demonstrated in the heighest rate in the other diseases. The ANF in all sera binded complement unrelated to immunoglobulin classes.

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Antibody-holding cells against antigens of tubercle bacilli of guinea pigs sensitized with heat-killed tubercle bacilli were investigated by fluorescent antibody technique. 1) Large and small mononuclear cells in the peritoneal exudate of sensitized guinea pigs reacted on antigens of tubercle bacilli and were well stained specifically. 2) Lymphocytes and plasma cells in lymphnodes and spleen of sensitized guinea pigs were specifically by fluorescent antibody technique. 3) Cells in liver, kidney, adrenal, thyroid and salivary glands were not stained specificially by fluo-rescent antibody technique. 4) Eosinophilic leucocytes in the peritoneal exudate, lymphnodes and spleen were stained rather markedly, but it was considered to be non-specific as compared with controls. The above results suggested that, by the sensitization with tubercle bacilli, intraperitoneal mono-nuclear cells, lymphocytes and plasma cells in lymphnodes and spleens of sensitized guinea pigs came to hold specific antibodies against antigens of tubercle bacilli. It was discussed that these antibodies might take part either in immediate type- or in delayed type-hypersensitivity of tuberculosis.

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The authors studied of the optimal condition of the BDB-treated formalinized red cell harmaggluti-nation technique and the following results were obtained: 1) The optimal sensitizing concentration and pH of antigen are different following to the kinds of antigens, but the optimal incubation time was usually 15-30 minutes at 37℃. 2) The formalinized red cell treated with BDB is very stable and the frozen and dried cells were demonstrated to be stored for a long time. 3) BDB-treated cells was superior to the tanned cells as the sensitizing cells in some cases. 4) The optimal pH was usually alkaline in BDB-treated cells than in the tanned cells and the optimal sensitizing concentration of antigen was rather higher in the former.

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The authors studied immunoserologically on the cause of death in the intestinal obstruction and the following results were obtained: 1) E. coli group of bacilli were found to be increased in the closed loop of the intestine and ascites of the patients and dogs of the intestinal obstruction. However, in the dogs administered Furamycetin, the increasing number of E. coli was inhibited the histopahological changes was also slightened and the survival time was remarkably prolonged. 2) Macromolecular substances such as endotoxin and DNA-fraction of E. coli were demostrated in the blood and ascites following to the process of the patients and dogs of intestinal obstruction. How-ever, in the cases administered Furamycetin the appearance of macro-molecular substances of E. coli was clearly inhibited. 3) Acetylcholine and catecholeamine was demonstrated to be increased in the blood of intestinal obstruction, however in the cases administered Furamycetin the increase of actylcholine and catecholaemine content in the blood was also inhibited. 5) Protective effect of antihistamine (Pyribenzamine), anti-serotonin (Cyproheptadine), anti-plasmin (Transamine) and anti-acetylcholine (Atropin) drugs againt the challenge of lethal endotoxin to mice were investigated and the most protective effect was demonstrated in the atropin treated mice. These results suggest that the remarkable increase of acetylcholine in the blood of the intestinal obstruction may be closely related to the appearance of macro-molecular substances of E. coli.

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Sixteen patients, from 9 months to 4 years old, with papular urticaria, were investigated clinically and serologically from view point of food allergy. Firstly, food allergen responsible for the disease was suspected from food diary and history of the patient. Secondly, elimination and provocation test on the suspected food allergens were carried out. Thirdly, antibodies in patients' sera to hen's egg and cow's milk were determined by Bis-diazotized benzidine hemagglutnation test (BDB test). 1) In all sisteen cases improvement of the symptom was observed after elimination of the food allergen that is the appearance of new eruption was prevented almost completely after twenty-four hours and the symptoms were disappeared thereafter. 2) Following ingestion of the food allergen the symptoms began to appear within twenty-four hours in most cases. Erythema or Urticaria accompanied by itching was induced within twenty-four hours and followed by solid papule thereafter. By further administration of food allergen, the papule developed to vesicle and increased in number. 3) Fourteen cases showed other allergic manifestations than papular urticaria in their history or as present complication. These manifestations were consisted of eczema, urticaria, mucocutaneo-ocular syndrome, diarrhea, vomiting, wheezing, nasal and ocular discharge. Their course ran almost parallel with papular urticaria by elimination or administration of the food allergen. 4) The allergen responsible for the disease were determined to be hen's egg in 8 cases, cow's milk in 5 cases and the both in 3 cases. 5) BDB test of the patients' sera showed in all the cases of hen's egg allergy markedly high titers, ranging from 1:1, 280 to 1:5, 120, to either egg white or egg yolk, while on the other hand, in all the cases of cow's milk allergy similar high titers, ranging from 1:640 to 1:2, 560 to only lactoalbumin and not so high titers to lacto-globulin or casein. In 2 cases with both allergy, rather high titers were observed to lactoalbumin, ranging from 1:320 to 1:2, 560 and to egg yolk, ranging from 1:160 to 1:2, 560. Conclusion: From the results it became clear that papular urticaria was caused etiologically by food allergy, mainly to hen's egg or cow's milk, and that BDB hemagglutinaion test was helpful in detecting food allergen responsible for this disease.

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