In this investigation, lymphocytes from the patients with primary macroglobulinemia had been stimulated with phytohemagglutinin (PHA) for 24hrs. and IgM synthesis of lymphocytes were measured by the methods of C¹⁴-leucine incorporation into IgM with radioimmunoassay.
In all cases, lymphocytes from the patients with primary macroglobulinemia stimulated with PHA had synthesized IgM strongly than normal subjects, and also without PHA, lymphocytes from the patients with primary macroglobulinemia had synthesized IgM much more than normal subjects.
But, in some cases, there had been paradoxical phenomenon. Although the production of IgM in lymphocytes had been accelerated markedly, the excretion of IgM from lymphocytes had been suppressed.
It had been indicated the gap between IgM synthesis in lymphocytes and discharge of IgM from lymphocytes.
From these evidences, it had been considerable that lymphocytes from the patients with primary macroglobulinemia indicated, at least, some biochemical abnormalities on immunoglobulin production and membrane permeability.

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In our previous studies on the freeze-dried homologous vein graft implanted to the canine femoral artery as a patch graft, complete patency (22/22) and satisfactory healing of the pseudointima were observed. In these studies, a fine vascular channel communicating directly with the arterial lumen and being lined with the endothelial-like cells was found in the pseudointima microscopically. It was considered that this vascular channel in the pseudointima must be a newly developed vessel to nourish the fibrously thickened pseudointima of the graft.
In this study, the microscopic examination by serial section technique and transluminal Microfil infusion method were carried out in order to make distinct the process of development and extension of these vascular channels in the thickened pseudointima. The freezedried homologous vein grafts were implanted to the canine femoral arteries as a patch graft and ten grafts were examined at various intervals from 3 to 175 days after implantation.
In early stage, that is 10 and 11 days after implantation, some clefts communicating directly with the arterial lumen and containing some red blood cells were found in the mural thrombi near the suture line. They seemed to be an earliest feature of the above mentioned vascular channel. In all specimens 21 days and more later after implantation vascular channels communicating directly with the arterial lumen were found in the fibrously thickened pseudointima near the suture line as well as the central portion of the grafts, these vascular channels were more often observed near the suture line than the central part of the graft. They were lined with endothelial-like cells completely. The vascular channels arose from the arterial lumen near the suture line extended into the deeper layers of the pseudointima branching off in tributaries and some reached to the adventitial layers penetrating through the fibrous tissues proliferated in the suture line. On the other hand, those from the arterial lumen near the central part of the graft were found to develop vertically into the pseudointima and the extension was confined within the pseudointima without penetrating the graft towards the adventitial layer. Same findings as mentioned above were observed in microscopic examination by transluminal infusion of Microfil.
From the findings above mentioned, it seemed reasonable to presume that the vascular channels communicating directly with the arterial lumen were not extension of the vasa vasorum from the adventitial layers but newly developed vessels in order to nourish the pseudointima of the graft, and they were formed through the clefts which was formed in the mural thrombi in the course of their organization in early stage.

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Thrombosis is one of the most important problems in the recent medicine. The mechanism of thrombolysis is not clearly elucidated. Using immunofluorescent technique, we examined the mechanism of thrombolysis in vitro in the present study.
Blood clots were made of 4ml normal human blood at 37°C incubation for 24 hours. They were immersed either in Urokinase (UK) or saline solution. The degree of clot lysis was represented by decrease of each clot weight. Artificial thrombi were made by the method of Chandler. The thrombi were rotated at 37°C for two hours in the loop containing UK or saline solution. The effect of UK on thrombolysis was assessed by decreased weight of the thrombi. Clots and thrombi were observed by immunofluo-rescent technique with anti-human fibrinogen, anti-human plasminogen and anti human-urokinase rabbit serum.
Results obtained were as follows.
(1) Intensive fluorescence of plasminogen was detected generally along the fibrin network in the blood clots and in the red tail of the artificial thrombi. In the white head of the thrombi, on the other hand, faint fluorescence was found along the fibrin nets surrounding the platelet aggregate.
(2) UK solution induced an enhanced lysis of clots and thrombi.
(3) Immunofluorescence of Urokinase was observed along the fibrin network, especially at the margin or slit-like spaces of the thrombi.
It was assumed that both of plasminogen and UK were found along the fibrin network and the activated plasmin in the thrombi played an important role in the thrombolysis, and that the red tail of the artificial thrombi which contained plasminogen more than in the white head was easily lysed.

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The present paper reported a case of female bleeder in a family of hemophilia A with sex-linked recessive inheritance. One of her uncles of maternal side and one of uncles of maternal side of her mother were known as hemophilias. The patient, her mother, all of her siblings and two of her cousins of maternal side were examined. The last two were bleeders and were already diagnosed as hemophilia A in our laboratoay.
The patient is a 15-year-old female. She has had some hemorrhagic episodes since her early infancy. The first examination which was performed in her twelve years old age revealed prolonged partial thromboplastin time, low level of Factor VIII (6.25%), abnormal TGT which was never corrected with samples of hemophilia A, and reduced prothrombin consumption.
The second examination was preformed in an occasion of hematuria in 1974. Normal platelet count, prolonged bleeding time, reduced Factor VIII, and reduced adhesiveness of platelets were observed. Platelet aggregation induced by ADP, collagen and adrenalin was respectively normal. However, the platelet aggregation by ristocetin was always deficient or markedly reduced. This abnormality in ristocetin-aggregation was corrected by adding in vitro normal plasma, as well as hemophilic plasma, while addition of AHG did not correct it. AHG-infusion in this patient did not improve the deficient ristocetin-aggregation nor reduced platelet adhesion. The increase in Factor VIII after the AHG-infusion was as expected mathematically.
Factor VIII level in her mother and in her sisters was normal but in latters reduced platelet adhesiveness was recognized and in one of them ristocetin-aggregation was deficient. In two of her cousins who have been considered as hemophilia A, no other findings were observed except for those corresponding to previous diagnosis.
The patient and all of her family tested had normal level of Factor VIII-related antigen. The number and the mode of the chromosomes in this case were 46 XX.
Although this case resembles to von willebrand's disease, the existence of normal level of Factor VIII-related antigen, and inefficacy of AHG on the reduced adhesiveness and on ristocetin-aggregation faile to this diagnosis. It is considered that this unusual case is deficient in Factor VIII as a carrier of hemophilia A and not as a case of von willebrand's disease, and this hemorrhagic diathesis is rather caused by an associated deficiency in another factor which prolongs the bleeding time, reduces the platelet adhesion and disturbs the ristocetin-aggregation.
Whether and how does this factor relate to von Willebrand's factor? Further investigation has to be made.

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Owren described a patient who had a bleeding tendency due to the lack of clotting factor, namely, Factor V or labile factor in 1947. More than 70 patients with Factor V deficiency have been reported in foreign counties, while 29 cases have been described in Japan until present. A few cases of infants have been appeared in literatures.
Prophylactic substituted treatment by use of fresh plasma or fresh frozen plasma during surgical operation and postoperative period has not been well documented in patients with Factor V deficiency. In most cases, transfusion therapy has been largely empirical.
We present here a patient with congenital Factor V deficiency who has required an operation of eye ball extraction at the age of 9 months. The level of Factor V in our patient was less than 1.5% of normal control, whereas the concentration of other clotting factors were normal. Twelve hours before operation, 50ml of fresh plasma was infused intravenously. During the operation, 190ml of fresh frozen plasma was again infused and subsequently 50ml of same plasma has been given every 12 hours on the first to 7th day after the operation. During the operation and postoperative days, the Factors V level in his plasma was varied in the range of 10 to 63% of normal control value. No complications such as disturbance of healing proceses at the operated wound or severe hemorrhage have been noted throughout the whole postoperative course clinically, the patient appeared to have normal hemostasis.
The half disappearance time of Factor V was 3 hours, determind by graphical results.

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The study was carried out in order to know the influence of two types of meals on fibrinolytic activity in diabetics. The first meal consisted of 200gm heavy cream and the second of carbohydrate of the same calory. Subjects took the heavy cream in the morning after overnight fasting, and the same patients were reexamind by feeding the carbohydrate rich meal after a week interval. Blood samples were collected before intake, 60min. after intake and 180min. after intake. The euglobulin clot lysis time (ELT), plasma fibrinogen, serum total lipids, triglyceride and glucose were measured with each blood samples. As the result, the shortness of the ELT was observed after intakes of both meals. But the degree of the ELT shortness after the heavy cream was less in comparison with the carbohydrate induced ELT shortness. Especially, the diabetics with severe vascular complications were shown as the most poor responder for the ELT shortness effect which induced by the heavy cream.
And significant correlation existed between the triglyceride and the ELT after heavy cream intake. Therefore, it was suggested that serum triglyceride rather than total lipids depress the fibrinolytic activity which could be measured as the result of inhibition of the ELT shortness effect. On the contrary, the ELT after carbohydrate meal accelerated by decreasing of FFA level. Because there was a reverse correlation between FFA and the ELT. It was found that the ELT in diabetics after the different kinds of meals was affected mainly by the increase of postprandial substance such as triglyceride or FFA in blood. And the fatty meal induced depressing action to the fibrinolytic activity, while the carbohydrate meal accelerated it.

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A study of the effect of long-term use of oral contraceptives on various clotting factors and fibrinolytic activity was made.
Blood samples for analysis were taken after 1, 3, 6, 12 months, 2, 3 years and more than 5 years. In 20 cases among them, analysis was performed every month during 1 year. The assay was also performed in 18 normal volunteers with ovulatory cycles.
In the women taking oral contraceptives, the following results were obtained:
1. The partial thromboplastin time was slightly decreased, but other clotting tests were almost in normal limits.
2. The concentration of fibrinogen and plasminogen as well as plasma euglobulin caseinolytic activity was significantly elevated after a month, and then plasminogen appeared to maintain a constant level. The others tend to return to the base line value. However, the fibrinogen levels at the period of 2, 3 years were decreased, and prothrombin time and PPT were prolonged.
3. No significant changes were found in platelet aggregation with ADP.
In normal ovulatory women, no detectable change was obsered in blood coagulation system, but the levels of fibrinogen and plasminogen were increased during postovulatory phasis.

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