In the previous several references it has been asserted that the patient with pulmonary tuberculosis has in general a ststemic hypotension. But according to the progress of the chemotherapy and chirurgic treatment during the last ten years, this assertion may have to be revised. Therefore, in this point of view, our statistic studies about the distribution of systemic blood pressure in pulmonary tuberculosis were made in 1.000 patients who were chosen at random, the results were as follows. 1. The normal ranging systolic pressure were presented in 40.5 to 79.0 per cent of men and 36.3 to 84.0 per cent of women. In jounger male than twenty-nine years of age, the hypertensive tendency was observed and the hypotensive tendency manifested in the thirties, but in the female the latter tendency was recognized earlier in the twenties. 2. Through all generetions of age, without regard to sex, diastolic pressure indicated the tendency to have low values. 3. The pulse- pressure tended to have a large magnitude under thirty-nine years of age and a small magnitude above the fourties, in both sexes. 4. The increase and decrease of the systolic and diastolic pressure after the various chemotherapies showed the same rate and then could not be concluded as a celtain tendency to one or another.
Fluothane, Azeotrope and Chloroform were administered to 94 dogs with a copper kettle vaporizer in a non-rebreathing system. 1) Intravenous administration of epinephrine and nor-epinephrine produced fatal ventricular fibrillation in dogs anesthetized with Fluothane, Azeotrope and Chloroform. 2) Arrhythmia induced by epinephrine during Fluothane, Azeotrope and Chloroform anesthesia was prevented by Trilafon (Perphenazine) injection prior to epinephrine injection. Dibenamine also prevented arrhythmia induced by epinephrine during Fluothane and Azeotrope anesthesia. 3) There were significant differences between the preanesthetic level of respiratory minute volume, blood pH, Pco2, HCO3, and those observed during Fluothane, Azeotrope and Chloroform anesthesia in various concentration. Anesthesia under Azeotrope showed least alteration in acid-base balance compared with anesthesia under Fluothane and Chloroform. 4) Blood pressure lowered in proportion to increased concentration of Fluothane, Azeotrope and Chloroform inhalation. Extrasystole in EKG was observed in a single dog anesthetized wiht Chloroform although no significant changes in EKG were observed in dogs anesthetized with Fluothane and Chloroform. 5) Diffuse fat degeneration of liver cells was seen in all dogs administered Chloroform, but minimum alteration in the composition of liver was seen in dogs administered Fluothane and Azeotrope.
The acute toxic actions of tofranil, chlorpromazine, dimethylaminoethanol and GABA injected intraperitoneally were examined on behaviour of mouse and the influences of the subtoxic doses of these psychotropic drugs on pentobarbital anesthesia were studied with mice. 1) The LD50 of tofranil was 1.025mg per 10g body weight of mouse. After large doses of the drug, central excitatory symptoms occured and walking movement was observed as one of the severe toxic symptoms. But dimethylaminoethanol produced little change in behaviour when administered in doses of 5 to 20mg per 10g of body weight and the excitatory symptom was seen after 30mg of the drug which was near the lethal dose in mice. The effect of GABA on behaviour of mouse was scarcely observed even after 30mg of the drug. 2) Pentobarbital anesthesia was influenced by the small dose of tofranil, dimethylaminoethanol as well as GABA and the duration of pentobarbital anesthesia was shortened after the administration of each drug. In contrast with the effects of these drugs, chlorpromazine acted to prolong the duration of pentobarbital anesthesia. 3) The potentiation of pentobarbital anesthesia by chlorpromazine was completely depressed by the administration of small dose of tofranil. The above described suppression of pentobarbital anesthesia by dimethylaminoethanol or by GABA was diminished by the administration of small dose of tofranil. 4) On mechanism of central action of tofranil, dimethylaminoethanol as well as GABA, some discussions were done in reference to the effects of drugs on central limbic system and thalamic nuclei.
The actions of cardiazol and megimide injected intravenously on pentobarbital anesthesia were investigated by righting reflex test and by electroencephalographic technique with rabbits. 1) Megimide exerted remarkable antagonistic action in subconvulsive as well as convulsive dose to pentobarbital anesthesia in rabbit. Cardiazol had similar action in convulsive dose to that of megimide. If the subconvulsive dose of cardiazol was administered to pentobarbital anesthetized rabbit, the depth of anesthesia was increased and no antagonistic action was seen after cardiazol in this case. 2) In light pentobarbital anesthetized rabbit, cardiazol caused characteristic EEG pattern with high voltage slow wave component simultaneously developed in cortex, hippocampus and centre median nucleus of thalamus. 3) The accelerating action of the small dose of cardiazol on pentobarbital anesthesia might be related to the slow wave component in cardiazol EEG pattern picked up from hippocampus as well as centre median nucleus.
Studies were made on isolation of pseudomonas enteritis(pathogenic halophilic bacteria), a species to cause food poisoning discovered by Takigawa, and a method to examine this species in food poisoning. The results were as follows. 1. The optimum NaCl concentration for the growth of pathogenic halophilic bacteria was 2-3%. 2. This species grew in Chapmann-Stone agar among the culture media used for examination of food poisoning. 3. The culture media to isolate intestinal flora in which this species grew well with 2-3% of NaCl were BTB lactose agar, Endo's agar, desoxycholate agar, Mac Conkey's agar, Brilliant green Bile agar, and Violet red Bile agar. This species had a special affinity for pigmentary preparations. 4. Enriched and plate culture media with advantage of chitin-decomposing activity were proved to be suitable for isolation of this species from the causal food, fishery products and sea water. 5. Egg yolk agar was also a suitable selective culture medium because Pseudomonas enteritis had lecithinase. 6. A quick and accurate method to detect and identify this species was devised on the basis of the shapes of pathogenic halophilic bacteria and the other biological characters. The identification was possible within 48 hours by this method.
Electromyographic studies were made of effects of Spa and procaine on fibrillation voltage produced in chronically denervated tibialis anterior muscle of rabbit and on nociceptively as well as proprioceptively induced reflex discharges in tibialis anterior muscle of spinal and intact rabbit under non-anesthesia, to examine central or muscular actions of these drugs. 1) In small doses, Spa caused slight facilitation followed depression of spinal reflex discharges. The depressive effect was progressively pronounced until the discharges were completely eliminated. Spa affected the spinal reflex activities more remarkably in intact rabbit by producing the excitatory action on brainstem reticular formation, than in spinal rabbit. In large doses, Spa caused depression of spinal reflex discharges soon after the administration of the drug in spinal as well as in intact rabbit. Procaine had a somewhat similar action to Spa but differed from Spa in regard to the extent of excitative or depressive action. Spa was more potent than procaine in the effects on the spinal reflex discharges and the excitatory effect was revealed after the administration of procaine in the case of intact rabbit. 2) The fibrillation voltage in chronically denervated muscle increased following the administration of the small doses of Spa and in the lesser degree also following procaine. In large doses, both drugs caused depression of the fibrillation voltage. Spa may influence upon acetylcholine-potassium metabolism in degenerated muscle and also in the regulatory structure of the central nervous system.
Experiments are performed in order to investigate the limit of cellular passage through diaphragmatic macula cribriformis. The first experiment is to ascertain the limit of the cellular size of the frog erythrocyte, which has been intraabdominally inoculated to a rabbit, can penetrable through macula cribriformis. The next experiment is to determine the limit of the size of a tumour cell which can pass through the macula cribriformis of the diaphragm. A suspension of Brown-Pearce cancer cells was injected into the abdominal cavity of a rabbit. One hour after the intraabdominal administration, a drop of lymph was obtaine from the internal mammary lymphatics and simultaneously from the thoracic duct. Each the size of tumour cells contained in these lymph was then measured under a phase contrast microscope with micrometer. The results are shown in tables 1,2,3,4, and 5. It is considered from the literature that the cellular size up to 22.5μ is a possible size of passage through the diaphragm of a rabbit. But the present results strongly suggest the penetrable limit size up to 28μ(long diameter)×24μ(short diameter)of frog erythrocytes, and up to 30μ (long diameter)×26μ(short diameter)of Brown-Pearce cencer cells. It is suggested that even a greater size than 26μ can pass diaphragmatic macula cribriformis by modifying its contour.
The following results were obtained in the treatment of leprosy, including 12 lepromatous and 2 nervosa, with promin and other sulf one drugs, investigating the histopathological findings of eyeball.15 eyeballs, the clinical findings of which had been known, were enucleated from four hours to twenty-one hours after death. 1) Lepra bacilli in eyeball were degenerated and reduced markedly. But, on a few cases the bacilli were latent in the cornea and sclera for a long time in spite of continual treatment. 2) Lepra cells were reduced in number to parallel in accordance with lesion absorption. In the iris, ciliary body, chorioidea and retina vacuole degeneration were seen markedly. 3) The leprous infiltration were observed atrophic, arround vessels of the subconjunctiva, episclera, iris and ciliary body. On a few cases, numerous lymphocytic infiltration were seen in the episclera, iris and ciliary body, 4) These processes were not specific only with the treatment of sulfones, but were seen with natural heeling or Chaulmoogra oil treatment, and there may be no essential difference between them. 5) The state of lepra bacillus and lepra cell on the eyeball is generally similar to those on the peripheral nerve and skin of the same individual.
Recently, long acting sulfonamides plus INH has been recommended for pulmonary tuberculosis therapy. This Study comprised 32 cases of serious pulmonary tuberculosis. Patients were treated daily with 1 gm. of IHMS and 0.5 gm. of sulfadimetoxine for 6 months. The results were as follows: 1) Body temperature, body weight, blood-sedimentation rate, cough, sputum and appetite were slightly improved by this chemotherapy. 2) We did not fine remarkaple change of tubercle bacille. 3) The breast roentgenogram showed improvement of 24% about infiltration and of 15% about cavity. 4) Blood picture: a) Anemia recovered in 6 months. b) In the cases with leucocyte count below 5,000 and neutrophil count below 3,000, the former rose to above 5,000 and the latter to above 3,000 in 6 months. The leucocyte count or the neutrophil count did not fall. 5) The abnormalities in the liver function tests recovered in 6 months. 6) Side action found very little and lesser compared with sulfisomidin: INH therapy.
The author report the results of bacteriological and pathological study on 220 cases of pulmonary tuberculosis undergone the lung resection after chemotherapy and included 446lesions, that is,136 cavities,12 inspissated cavities,10 open healed cavities,285 caseous lesions and 3 cicatrical lesions. Materials obtained from these cases (sputum and lesion) were smeared by the ordinary acid-fast staining and malachitegreen-fuchsin staining, and cultured by the standard technique. Secondly the connection with the bacteriological examination from the lesion was studied in the duration of chemotherapy and the existence of tubercle bacilli from the sputum before operation. Finally the existence of drug resistant tubercle bacilli from the lesion or the sputum was considered in the some sorts of chemotherapy and lesion. The conclusion was as follows. 1) In cavity group positive smear were 79.4%, positive cultures 46.3%, positive smears with nepative cultures 33.1% and both negative only 9.6%. In inspissated cavity group the result was approximately similar in the former. In caseous lesion group the positive percent to smear and culture was less than in cavity group. In open healed cavities only a case showed the positive culture. There was the close relation between the positive percent to smear by the malachitgreenfuchsin staining and the positive percent to culture from the cavities, open heald cavities and cicatricial lesions, but no close relation in the inspissated cavities and caseous lesions. 2) The significant correlation could not be found between the the duration of chemotherapy and the increase of the negative percent to smear and culture from the cavities and the caseous lesions. The negative percent to culture from lesion increased in proportional to the negative duration of tubercle bacilli during a year or less before operation, while those during more than a year decreased again. In the cavity group that was negative to smear and culture from the sputum overall the period before operation the positive smears were 83.3%, but the positive cultures only 8.3% from the lession. On the other hand, in some cavity cases that were positive to both test from the sputum. over all the period before operation, the positive percent to both from the lesion was higher than in the former. 3) The resistant population of tubercle bacilli from the lesion to SM-PAS was higher than to those in addition of INH. In cavity group the resistant grade to the drugs and the resistant population from the lesion was higher than from the sputum, and in the inspissated cavity group these were much higher. In caseous lesion group the resistant population was lower than in cavity group and inspissated cavity group, but the relation between the resistant grade and the resistant population obtained from the sputum and the lesion was similar in cavity group.
1) It is demonstrated that the aqueous humor of a bull-frog which has developed a pupillary constriction due to stimuli on the trigeminal pupilloconstricting nerve (“trigeminus aqueous humor”) possesses a pupilloconstricting action on another medullary frog. 2) A pupilloconstricting action of “trigeminus aqueous humor” is increased by eserine and abolished by atropine. It is demonstrated that the aqueous humor subject to stimulation of efferent trigeminal pupilloconstricting nerve contains an Ach-like substance. 3) The pupilloconstricting effect of “trigeminus aqueous humor” is similar to the effect of “oculomotorius aqueous humor”. 4) The eserinized “trigeminus aqueous humor” has a contracting action on eserinized leech dorsal muscles. 5) The contracting effect of “trigeminus aqueous humor” corresponds with the contracting effect of a 10-6 to 10-8 Ach-Ringer's solution on leech dorsal muscles. 6) A neuro-effector transmission of the trigeminal pupilloconstricting nerve seems to have been ascertained by Ach-mechanism.
In an attempt to investigate the mode of cancer spread through extravascular fluid pathways, a histological study was made on 8 fatal cases of tumor including intraabdominal tumors. In these cases the entire anterior portion of the chest wall including internal mammary lymphatics, the thoracic duct, parasternal nodes, and the diaphragm was removed and dissected. The peritoneal diaphragm which had been peeled at the level of the submesothelial connective layer and stained with May-Giemsa's method, Bielschowsky-Maresch's impregnation method clearly showed a typical pattern between cancer cells and macula cribriformis. The most prominent feature of human autopsy materials was that macula cribriformis was densely packed with cancer cells. Another prominent feature was that the fat tissues around internal mammary lymphatics were permeated with many cancer cells, occasio-nally with many cancer cells infiltrated into interstitial tissues of intercostal muscles and transversus thoracis muscles. It was conceivable that the involvement might result in a leakage through the wall of retrosternal lymphatics, disclosing physiologically their special function, i. e., leakage phenomenon. Evidence from human autopsy materials supports a conclusion that cancer cells may pass through the pre-lymphovascular fluid path, but partly may deposit in macula cribriformis and that cancer cells dicharged into internal mamary lymphatics may have leaked from lymphatics leading to a proliferation of cancer cells.
One strain of Proteus vulgaris isolated from the feces of healthy young pupils showed agglutination by Shigella antisera. This agglutinability of the strain has been preserved during these 3 years. Absorption tests of the immune sera were performed with this proteus strain and Shigella flexneri. These antigens related with the Shigella are very complex, and its analysis is still incomplete. Further investigation of this field is now in progress. In this paver. it was confirmed that the common antigens in this strain is partially thermolabile and partially thermostable. Some of the antigens are identical with the characteristic antigens of Shigella group; but as H. Mizuno mentioned, specific antigens contained in the strain, not identical with the Shigella, may have a role on common agglutination. Of course, Mizuno's strain (Proteus mirabilis) and the strain in this report (Proteus vulgaris) are not identical each other, but they have common factors which agglutinate the Shigella group B. The agglutinability of the strain has been preserved well when the bacilli were kept under low temparature (about 4°C), and tends to decrease when they are kept in room temperature.
The adjustment of the pitch of the singing voice has been studied by many authors, but the part played by the extrinsic muscles in the function of the vocal cords has not esearched so actively, except the muscles taken some parts in the so-called “frame function”. A. A. Sonninen (1956) noted that in addition to the sternohyoids, sternothyroids, thyrohyoids and omohyoids, a great number of other muscles in the external laryngeal musculature might be included. But he recognized to consider only a few signification of those muscles for the function of vocal cords. Y. Amenomori (1960), however, maintained the importance of suprahyoids in the pitch regulation of the vocale cords with some experiments of animal (dog) and human body. He dissected the hyoid muscles, and stimulated each of them in the midst of the same pitch singing, and observed some regular changes of the singing pitch, that is, stimulation of the suprahyoids caused the pitch to raise, and infrahyoids to lower. With many other experiments he considered that the extrinsic muscles in phonation participated in the pitch regulatory mechnism were not merely infrahyoids and sternothyroids but the suprahyoids, and stated that in addition to these muscles, hyoid bone, sternum, mandible, styroid processes and etc. which were let the above-mentioned whole musculature tighten, related to the pitch regulation in a regular manner, and then asserted to give a name whole of them, that is, “SUSPENDING MECHANISM OF THE LARYNX”(“KOTO SIJI KIKO” in the Japanese). We made an experiment of a 42 aged man who was attacked by a tumour of epiglottis, and get the following results to support the Amenomori's opinion. 1). The pitch of singing voice raised when the hyoid bone was drawn upwards. 2). The pitch lowered by drawing downwards.
The present authors came across a typical case of anencephaly where an erroneous breech presentation was made during pregnancy. It has found as the result of autopsy that this was a case accompanied by the lack of pituitary gland and the endocrinal disorders such as the swelling of thymus and an extremely unsatisfactory growth of adrenal gland. Inquries were made into the causes of anencephaly based on available literature on anencephaly, and a review was made on the abovementioned diagnosis of the case.
The present case was previously treated by another doctor with operation for left ovarian cyst. At the time of the operation, severe accretion was seen, making it difficult to treat Douglas' pouch. When the case was examined on the 10th day after operation, a hard resistance of th size of egg was felt in Douglas' pouch. The present authors consider that the case followed the course of endometriosis since that time. This was confirmed by the fact that the showed reactions when hormone treatment was given against the symptoms of menorrhagia and irregular bleeding. As described above, a case of radical cure of vaginal endometriosis is reported in this paper. It existed as a tumor in Douglas' pouch for a long period of time, developing into polyps at the cervical part and the rectovaginal pouch. These polyps, even if removed, were again generated one after another, and it was not possible for the case to be cured in spite of the treatment for a long period of time. However, this case of vaginal endometriosis has been completely cured by operation in this hospital.
The management of pheochromocytoma is difficult and operative mortality is considered quite high. I employed an endotracheal anesthesia with nitrous oxide-oxygen and ravonal intravenous injection and took a great caution to control blood pressure using regitine and noradrenaline, respectively. Patient had an uneventful operative course and made satisfactory postoperative recovery.
Hypothermia was applied for ligation of intracranial arterio-venous fistula. Twenty-one years old male patient was immersed in ice water bath for cooling and the lowest temperature reached to 28°C, then electric blanket warmed up the body to prevent further drop of temperature. Fluothane-nitrous oxide anesthesia obtained satisfactory maintenance of anesthesia.