It is well known that the neutropenia is the most important complication of the anti-thyroid drugs, which are widely used in the treatment of hyperthyroid patients. In order to clarity the relationship between the admistration of anti-thyroid drugs and the hematologic complications,29 patients with hyperthyroidism were serially examined on their peripheral blood counts at the First Dept. of Internal Medicine, Kansai Medical University, from 1973 to 1975.
The results obtaied were as follows:
1) The hemoglobin content (Hb) as well as the red blood cell (RBC) and Lymphocyte counts were not related to the severity of hyperthyroidism. In contrast, the patients with higher levels of ¹³¹I-T₃ RSU had lower counts of neutrophilic granulocytes than those with lower ¹³¹I-T₃ RSU levels.
2) During the therapy with anti-thyroid drugs, RBC, Hb as well as RBC and Lymphocyte counts showed no consistent changes, in spite of the improvement of hyperthyroidism. In contrast, the neutrophil count significanthy decreased in the great majority of the patients following the successful anti-thyroid treatment: In the seven count out of 29 patients (25.9%)neutrophil descended down to less than 2,000/c mm during the therapy. Increase of the cumulative dose of anti-thyroid drugs resulted in significant decrease of the neutrophil count, whereas the RBC count showed no changes related to the dose.
3) Among the anti-thyroid drugs, prophylthiouracil seemed to be less potent in reducing the neutrophil count than methimazole. These results suggest that each of the hyperthyroidism and anti-thyroid drug administration may cause areduction of the neutrophil count by itself, which, according to the patient's conditions, may develop to the clinically manifest “neutropenia induced by anti-thyroid drugs”.

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In this part, the author attempted experimental studies using rabbits for the purpose of investigating the pathogenesis of the blood disorders induced by anti-thyroid drugs: Rabbits were treated with TSH or thyroid powder in order to simulate the hyperthyroid conditions and treated with methimazole (MEZ). Although the TSH administration for 11 days could not cause consistent hyperthyroidism rabbits treated with thyroid powder for two weeks showed TBCindex of less than 0.5, accompanying elevation of RBC count, which was cancelled by MEZ administration. MEZ alone, too, could decrease the RBC count depending on its dosage. The increase of RBC induced by thyroid powder was abolished also by NMO (nitrogen mustard Noxide)administration for two weeks.
In contrast, neutrophil count was decreased by the thyroid powder administration as well as by the MEZ treatment depending on its dosage. Administration of 2mg/kg or 20mg/kg MEZ added after thyroid powder administration intensified the neutrophil depression, while 10mg/kg of MEZ showed no additional effect. Recovery of the neutrophil count was faster in the 10mg/kg group than in the 2 mg/kg or 20 mg/kg group. Addition of NMO did not significantly affect the decrease of neutrophilic granulocyte cells induced by MEZ alone or MEZ after thyroid powder administration.
There sults obtained could be summarized as follows:
1) The RBC count increased in hyperthyroid rabbits, while the neutrophil count decreased.
2) Administration of MEZ alone depressed both RBC and neutrophil counts.
3) Concerning the RBC count, the opposing effects of thyroid hor mone and MEZ were cancelled in their combined administration. On the contrary, the neutrophil count was decreased depending on the MEZ doses or the severity of hyperthyroidism, but I could not demonstrate their synergistic effects.
4) NMO adm inistration, as far as my experimental design is concerned could not intensify the neutrophil depressen.
These experim ental results obtained are consistent with those obtained in hyperthyroid patients receiving anti-thyroid drugs. The reason why most of hyperthyroid patients receiving anti-thyroid drugs do not develop a clinically apparent not show neutropenia should be attributed to the opposing effects of thyroid hormone and MEZ on the thyroid function. It may be speculated that the neutropenia due to anti-thyroid drug occurs in the patients with some hereditary predisposition,1. g. bone marrow dysfunction, although, in these studies, by NMO administration could not prove the significance of such predisposition to the neutropenia.
The pathogenesis of agranulocytosis still remains to be proven. However, this study should have clarified, at least to some extent, hyperthyroidism and that of anti-thyroid drug administration in the pathogenesis of the hematological disorder; in hyperthyroid patients receiving anti-thyroid drugs.

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Several new office closure methods were deviced and carried out on 207 selected ears with central perforation.
The basic technique of these methods was characterized by combining the following three procedures in compliance with the size of the perforation and the condition of its margin: 1)traumatizing of the perforated epitherial margin using a tiny scalpel,2) patching of the perforation margin with several kinds of supporting materials and 3) trichloacetic acid cautery. The following supporting materials were used: ointment-corted gauze (first method), human amniotic membrane which has been exposed to high-voltage cathoderay irradiation (second method) and collagen sheet (third method).
Successful closure was best accomplished using the second method.81.4 % of the cases were successful and the average time required for treatment was six and a half weeks.
The excellent functional and morphological condition of the ear drum that was repaired by these office closure methods was checked by a neuro-otological examination using an audiogram and a tympanogram, human temporal bone study, the histological observation of replaced membrane and an experimental study using cats.
In conclusion, these office closure methods were thought to be very useful clinical procedures because operations were unnecessary and the morphological and functional condition of the repaired drum was excellent.

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Macroscopically there were widespread necrotic changes in hepatoma (Case 1) and metastatic carcinoma (Case 2) both of which occupy a great part of the left lobule (Case 1) and of the right lobule (Case 2) of the liver. The necrotic changes of these tumors surrounded by fibrous tissue associated with massive hyaline-like substances appear to have been caused as a result of the administration of one shot of mitomycin C, an anti-cancer drug, (Case 1) or of a large amount of 5-Fu, an anti-eancer drug, (Case 2).
Microscopical examination of necrotic area of the liver tumor seen in both the two cases revealed numerous yellow-brown pigment scattered in cord-like fibrous tissues surrounding hyaline substances deposited in the necrotic area of the hepatic cancers.
The pigment could be histochemically identified as ceroid, which is assmed to have been formed in macrophages in the tumor as a result of their phagocytosis of the necrotic tissues induced by the administration of the anti-cancer drugs.

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Homologous and heterologous arterial segments were implanted in Fisher rats subcutaneously for the purpose of examining the antibody titer of the recipients' serum after implantation by means of the immune-adherence hemagglutination method. The antibody titer after implantation both of homologous and heterologous grafts decreased to 1/8 by 2.0 million (M) rads irradiation of high voltage cathode rays but the numerical value of irradiated heterologous grafts was still higher than that of non-irradiated homologous grafts. Heterologous implantation showed no significant difference in the antibody titers between 2.0M and 2.5M rads irradiation. These results suggested that high voltage cathode ray irradiation was not enough for heterologous graft to suppress its tissue reaction.
In order to assess whethe r the postmortem change of arterial graft may affect the patency rate of the transplanted grafts, homografts taken from dogs 3 or 6 hours after sacrifice were irradiated with 2.0M rads and transplanted in canine carotid artery using the technic of endtoend anastomosis. Angiograms 6 months after operation revealed excellent patency rate in all the grafts of 28 dogs. On light microscopic examination 6 months after transplantation, the structure of the graft, especially its elastic fiber, was well preserved.
Findings of the grafts from 1 week to 5 years after opera tion on scanning and transmission electron microscopies were as follows; 1) at the early stage after operation, endothelial cell had a number of rough surfaced endoplasmic reticula, free rebosome and poor basement membrane,2) myointimal cell was observed on the subintimal layer near the neoendothelial cell at the early stage,3) neoendothelial cell near the suture line had many pinocytic vesicles and a few rough surfaced endoplasmic reticula 1 month after operation, which suggested maturation of neoendothelial cell,4) subintimal layer of the graft was composed of smooth muscle cells. These findings indicated transformed process of the underlying smooth muscle cell into the endothelial cell. As for the 10cm long arterial graft, neoendothelial cells entirely covered its surface at the stage of 6 months on SEM and TEM. The intimal thickening was mild and not progressive at the stage of 5 years' follow up.
Clinical application of bypass surgery from the main trunk of the superficial temporal artery to M2 portion of the middle cerebral artery, using 20cm long irradiated arterial homograft, was carried out in patients with episodic cerebral ischemia. One of the patients was relieved from the symptoms and his motor function was improved after surgery. Angiogram 4 days after operation showed excellent filling of the middle cerebral circulation through the graft both in the retrograde and antegrade. This bypass procedure provided a good deal of blood flow soon after the operation, resulting in good protection of the ischemic hemisphere. Thus, bypass surgery using irradiated homograft proved to be useful enough for the ischemic cerebrovascular disease.

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An electrophysiological study was made with rabbits on the electrical changes of photopalpebral reflex (PPR) which were cumulatively recorded by computer. In addition, electroretinogram (ERG), visual evoked response (VER) and photo-evoked eyelid microvibrat ion (MV) were simultaneously recorded.
The results o btained were as follows.
1.9 components (PPR₁, PPR₂, PPR₃, PPR₄, PPR₅, PPR₈, PPR₇, PPR₈ and PPR₉) were observed in PPR with monopolar lead. In ERG, there were found a wave and 3 oscillating potentials (O₁,O₂ and O₃) on b wave, and 5 components (VER₁, VER₂, VER₃, VER₄and VER₅) were shown in VER.
2. All components of PPR and ERG disappeared when the intraocular pressure was elevated as high as 120-160 mmHg.
3. The componen ts of PPR_5-9 and VER disappeared after the optic nerve was cut off.
4. The components of PPR_5-9 disappeared after the brain stem reticular formation (RF) was destroyed.
5. All components of PPR showed no appreciable change with 3Hz stimulation on RF, whereas all but PPR₁ increased in amplitude with 100Hz stimulation on RF.
6. The PPR_5-9 increased in amplitude and the PPR₆,₇,₈ de creased after the destruction of the nucleus ventralis anterior (VA).
7. The PPR_5-9 decreased in amplitude with 3Hz stimulation on VA, but they increased with 100Hz stimulation.
8. W hen PPR and MV were recorded simultaneously, MV was found coincidental with the culmination of PPR_5-8.
9. The ampli tude of PPR_5-8 decreased after either the removal of M. orbicularis oculi or the resection of external eye muscles, and they disappeared after the simultaneous resection of both muscles.
10. The amplitude of PPR_5-9 decreased after the amputation of n. facialis and they disappe ared following additional retrobulbar anesthesia.
11. Inhibitory effect was observed on the amplitude of PPR_6-8, following the administration of gallamine.
12. Barbiturate, chlorpromazine, diazepam and tofranil had inhibitory effect predominantly on all the components of PPR. Whereas cardiazol, when properly given, showed facilitatory effect on PPR_5-9. Amphetamine and CDP-choline showed no noticeable effect.
13. ERG was not affected significantly with the administration of such chemicals as barbiturate, chlorpromazine, diazepam, tofranil, cardiazol, amphetamine and CDP-choline.
14. VER was not affected either with the administration as cardiazol, amphetamine or CDPcholine.
15.9 components of PPR were also found in men as well as in rabbits. When a series of photic stimulation was given through one eye and led out of the other shielded eye, the components of PPR_1-4 and ERG disappeared, but the PPR_5-9 and MV were also recorded. On giving mathematical questions, the amplitude of PPR_5-9 and MV increased.
Consequently, it was obvious that the early components of PPR (PPR_1-4) were closely related to ERG, that the late components of PPR (PPR_5-9) had their origin in the central nervous system (especially in RF), that, above all, the components of PPR_5-8 were parallel with MV and that the PPR₉ was a potential different from MV as well as the secondary response of VER and activated by nervous activities higher than consciousness.

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Electrical silence which appeared in bifunctional leg muscles during simultaneous hip and knee extensions under isometric condition was investigated in terms of the neurophysiological and dynamical features in the biarticular movement.
Subjects employed in the experim ents were healthy adult males ranging in age from 19 to 40, and they have no special training experiences for sports activity. Experimental posture was supine with both hip and knee joints kept at 90 degree angles. Electromyograms (EMGs) were recorded by conventional method using surface electrodes.
Part 1. Electrical inhibition in the bifunctional knee extensor during simultaneous extensions of hip and knee joints
Simultaneous hip and kn ee extensions were performed along two distinctly different functional force directions, so that the resultant force output was limited by the hip joint force in one direction, and by the knee joint force in another. EMGs were recorded from the Rectus lemons (Rf), the Vastus medialis (Vm) and the Semimembranosus (Sm), and potentials evok ed by the patella tendon jerk were recorded from the Rf and the Vm. The total leg extension force exerted at the sole and the mechanical impact of the tendon tapping were recorded simultaneously with the EMGs and the evoked potentials.
When the total leg extension force was limited by the hip extension force, the amplitude of the evoked potential from the Rf decreased while the leg extension force gradually increased. The Sm showed a marked discharge in this case. The results obtained in the experiment suggested that there was an inhibitory input to the a-motoneurone pool innervating the Rf, and this was probably due to an antagonistic inhibition induced by the increased activity in the hamstring muscles like the Sm. When the total leg extension force was limited by the knee extension force, the evoked potential from the Rf remained unchanged, and no discharge was observed in the Sm. The amplitude of the evoked potential from the Vm tended to increase with the increases in the resultant leg extension forces exerted along both functional force directions. Thus, the appearance of the electrical inhibition in the Rf was depending on whether or not the hip joint force was limiting the resultant leg extension force.
Part 2. Electrical inhibition in bifunctional muscles and its effects on recruitment of monofunctional muscles during voluntary biarticular leg movement
Discharges of the hip extensors, the Gluteus maximus (Gm), the Adductor magnus (Am), the Biceps femoris (Bf), the Semitendinosus (St) and the Sm, and those of the knee extensors, the Vm, the Vastus lateralis (Vl), the Rf and the Tensor fasciae latae (Tfl) were integrated through the Miller Circuit and recorded with their raw EMGs. A constant load (60 max.)was applied isometrically at the distal end of the thigh against the hip extension during application of graded load (10∼60% max. ) at the ankle joint against the knee extension (Exper.1). A constant load (60% max. ) was applied against the knee extension, and graded loads (10∼60% max.) were applied against the hip extension (Exper.2). Individual hip extension (Exper.3-A) and knee extension (Exper.3-B) were performed against constant loads (60%max.) as references to the Expers.1 and 2.
Although the constant load was applied against the hip extension, the integrated EMGs (IEMGs) of the bifunctional hip extensors of the Bf, the St and the Sm decreased with the increasing load against the knee extension in the Exper.1. Also in the Exper.2, the IEMGs of the bifunctional knee extensors of the Rf and the Tfl decreased with the increasing load against the hip extension. These decreases in the IEMGs of the bifunctional muscles might be due to an antagonistic inhibition induced by the increase in activities of the antagonistic muscles.
While the constant load was applied, the monofunctional agonistic extensors of the Vm and the Vi increased their activities.

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The health condition, family structure, daily life and needs of the aged over 65 years old were researched in Moriguch, an urban district in Osaka, Mio, a fishery district in Wakayama and Kibi, a rural district in Wakayama, from April 1978 to March 1980.
1. The result of the research shows that the family structure, daily life and housing condition of the aged have the own characteristics due to the locality.95% of the aged live with their families in the rural district, though half of the aged live in couple or alone in both the urban and fishery districts.60-70% of the female old people are widows and 70-90% of the aged living alone are female. So “the problem of the aged” might be said to be “the problem of the female”.
2. The old people in the urban district have rather more leisure time, smaller sitting rooms and more medical facilities, on the other hand, the old people in the rural districts have rather more agricultural or domestic work, larger sitting rooms and the aged in Mio district have rather more agricultural, fishing or domestic work time, smaller sitting rooms and fewer medical facilities.
3. Mio distrct, which is famous for “the longivity” of its inhabitants, has the larger population of the elder people, nearly half of whom had been abroad, especially to Canada, in their younger age, engaging mainly in the fishery, and returned home in old age.
4. As the result of the health examination of old people, in Moriguchi and Mio districts more than 90% of the examined have some kinds of health disorders, especially heart and vascural disorders in 60%.
5. Old people need continual health inspection and guidance by family doctors or nurses together with curative service. Home nursing and assistance service in daily life should be provided to the aged sick in bed.
The comprehensive health service for old people should be provided by family doctors, nurses, public health nurses, helpers and social workers with the encouragement by the public administration, local authorities and volunteer organizations.

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A visiting survey was held on the health condition and daily life of the elder people sick in bed and living alone in Moriguchi City, Osaka and Miyo district, Wakayama.
The elder people sick in bed and living alone should be provided with home nursing and assistance service, including mobile meal and bath service.
It's recommended that family doctors, nurses an d helpers should cooperate together on the health service for these elder people and their service activities should be encouraged by the public administration, especially local authorities, and volunteer organizations in community.

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The inactivation of antibiotics in tissue homogenate is an important problem in the field of chemotherapy. Serial estimation of the in vitro recovery rates of antibiotic activities in rat kidney homogenate kept at 0°C were made by bioassay (OKUBO's band culture method). And some examinations were made to explain the inactivation mechanism in the rat kidney homogenate, comparing these studies with the same studies on rat liver homogenate reported by GO.
The results obtained were as follows:
(1) The changes in antibacterial activity of the various antibiotics in the rat kidney homogenate could be divided into four groups:
1) CER, CEZ: No significant decrease in activity through 24 hours preservation.
2) PCG, ABPC, CBPC, MCIPC, CET, JM: Gradual decrease; no recurrence.
3) MINO, DOXY: Immediate decrease; no activity change to 24 ho urs.
4) TC: Gradual decrease followed by recurrence of activity after 24 hours. The recurrence phenomenon that GO called the change of PCG and TC in rat liver homogenate could only be found in the TC measurement.
(2) The rat kidney homogenate was centrifuged at 9,000 × G and divided into supernate and pellet suspension. As time passed, the supernate showed a change similar to that of the homogenate presenting a slightly higher recovery rate, but the pellet suspension did not.
(3) Similar results to those obtained by the supernate in
(2) were obtained by the centrifugal ultrafiltration, contradicting the interaction between the antibiotics and the tissue c omponents during the bioassay procedure. TLC/bioautography d enied the production of metabolites.
(4) The Kidney homogenate supernate was fractionated by gel-filtration with a Sephadex G-200 to yield three fractions. The activities of both TC and PCG were neither inactivatedn or changed in any of the fractions.
(5) No inactivations or changes in PCG and TC were found in the supernate obtained by ultracentrifugation (105,000 × G ) of the kidney homogenate.

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