Regarding to the pathogenesis of renal arteriolar hyalinosis in diabetic nephropathy, although neumerous morphological studies have been documented, its true nature is still unknown. From this reason, observations were made in consecutive 65 autopsy kidneys of clinical diabetes upon light and electron microscopical studies for morphological characteristics of arteriolar hyalionsis and glomerular lesions.
Results were following, the renal arteriolar hyalinosis tended to increase by ageing and very high incidencies were found in hypertensive personals. There existed good correlations between diabetic glomerular lesions and arteriolar hyalinosis. The latter was frequently found in vasa aff. and occasionally their successive intraglomerular branches and further in vasa eff. However, it was rarely found in intralobular arteries and arcuate arteries. If it was found in intralobular arteries, the parts of branching to vasa aff. were usually affected. Early signs of arteriolar hyalinosis were often found at the parts of branching of intraglomerular capillary tufts from vasa aff. These early lesions consisted of edematous swelling of arteriolar channels and imbibition of plasma substance into subendothelial spaces which showed variable electron densities. On progrressive stage, medial smooth muscle cells disclosed depressive atrophy of variable grade by subendothelial hyaline material deposits. At the same time, dougnuts like lesions of mesangium which was described by Yajima were frequently found in glomeruli of moderrately diabetic cases. These changes were commonly found at peripheral parts of intraglomerular capillary tufts.
Hitherto described morphological characteristics and localization of arteriolar hyalinosis stronglysuggest that hemodynamic disturbances of intraglomerular circulation play an important role for occurence of arteriolar hyalinosis and further of glomerular lesions. Physicochemical specificities of circulating blood in diabetic patients, such as hyper lipemia, hyper viscosity and hyper coagulability may contribute to the development of this disturbed state of hemodynamics.

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Cerebral apoplexie ranks the top of the nation's mortality statistics at present. The patients surviving after the apoplectic attacks often find it difficult to return to normal life routine due to the post-apoplectic paralysis. Consequently, it is important to grasp its life and paralytic prognoses in the early stage following the attacks in order to provide appropriate treatments and to give the diagnosis and also to give necessary guidance to the diseased. For this reason, the author has studied the life and paralytic prognoses of such patients through their clinical conditions and laboratory findings during the earlier stage.
1) Life prognosis: The prognosis of cerebral hemorrhage is poorer than that of cerebral infarction. The prognoses of both cerebral hemorrhage and infarction are poor among the older patients than the younger ones. However, their clinical conditions proved that those with more intense disturbance of consciousness had poorer prognosis. Those with vomiting have revealed poorer prognosis than those without the symptom. The cerebral hemorrhage patients with headache or nuchal rigidity revealed poorer prognosis. Their laboratory findings showed that cerebral hemorrhage patients with higher systolic blood pressure than 200mm Hg, those with higher diastolic pressure than 120mm Hg, those with spinal fluid pressure higher than 200mm H₂O, and especially those with that of 300mm H₂O revealed much poorer prognosis. However, the patients with cerebral infarction did not reveal any significant differences. Both types(hemorrhage and infarction)of patients proved to have poorer prognoses with the increase of leukocytes, positive proteinuria, and increased erythrocyte sedimentation level. The increase of total cholesterol rate was recognized only among the patients with cerebral infarction, and itsprognosis was poor. Certain scorepoints were designated to those with significant statistical differences, and we tried to make judgements for their life prognosis based upon the points.
2) Paralytic prognosis: Cerebral hemorrhage patients have showed better recovery from the paralysis than those with cerebral infarction. Those with more intense disturbance of consciousness revealed worse recovery than those with less sensory impairment. Those with spastic paralysis have recovered better than those with flaccid paralysis. Those with normal and hyperactive patella reflex also revealed better recovery. However, their sensory impairment has prevented them from having better recovery.
The above is a report on the results of the case studies accompanied by the literature discussion.

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(1) The role of the carotid sinus in regulation of the blood flow of the internal carotid artery was studied in rabbits anesthetized with Nembutal and immobilized with D-tubocurarine. The blood flow and the blood pressure of the internal carotid artery were measured with a heated thermocouple and pressure transducer, respectively.
(2) Despite a reduction in the blood pressure which was induced by a gradual clipping of the common carotid artery, a fairly constant blood flow was maintained, provided that the blood pressure did not fall below a certain value. The value was termed Cr. B. P.(critical blood pressure) for convenience and ranged from 46 to 96mm Hg.
(3) Section of the ipsilateral sinus nerve resulted in an elevation of Cr. B. P. from 46-96 to 75-110mm Hg. This indicates that the capacity for keeping the constant blood flow was considerably reduced by the nerve section. From these results it was inferred that some informations detected by the sinus contributed for the maintenance of a constant blood flow in the internal carotid artery. If this is accepted, it follows that the sinus plays a role as the flow monitor in regulation of the blood flow.

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The effects of artificial bleeding upon the systemic blood pressure, as measured with a cannula inserted into the femoral artery, and the blood flow of the internal carotid artery, as measured with the heated thermocouple, were studied in rabbits anesthetized with Nembutal and immobilized with D-tubocurarine. It was revealed that as long as the amount of the blood removed was within a certain limit, not only the blood pressure, but also the blood flow remained fairly constant. It was especially noteworthy that the tendency to maintain a constant blood flow was far more powerful than that to keep a stable blood pressure. These phenomena were abolished by sectioning the sinus nerve on both sides. From these results it was inferred that the informations conveyed in the sinus nerve served two purposes, that is, to keep the systemic blood pressure as well as the blood flow of the internal carotid constant.

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The author noted that the endogenous peroxidase (TPO) is related closely with the hormone biosynthesis and the thyroglobulin (T) is mainly constituted of the glycoprotein. The TPO is most sensitively demonstrated by Karnovsky method and the T is most likely demonstrable with the Periodic Acid Methenamine Silver (PAM) stain procedure. In this connection, the author developed efficient and accurate method (peroxidase-PAM-double-staining-method) (PPDS) which is able to demonstrate the both constitutions simultaneously. In this report, the author has made a correlative study from functional and morphological aspects of the various thyroid diseases. Moreover, a semi-quantitative investigation of the TPO has been performed.
The following thyroid diseases have been investigated. Hyperthyroidism: 40 cases, adenoma: 20 cases, adenomatous goiters: 11 cases, carcinoma: 10 cases, Hashimoto's thyroiditis: 5 cases, then summing up to 86 cases. The PPDS reaction was performed on the identical sections both in light and electron microscopy. The electron microscopic semi-quantitative study was attempted to visualize the TPO positive deposits in a single cell. The light microscopic TPO positive deposits and T reactive patterns and thier localization were scored.
The results were as follows:
(i) The PPDS score point system indicates the full points (10 points) in normal autopsied thyroid gland. Hyperthyroidism, 9.8±6.25 (papillary) type: 11.0±4.26, non-papillary type: 8.0±2.77), adenoma (colloid adenoma: 9.2±3.41, follicular adenoma: 14.0±3.95, functioning adenoma: 18.0±2.09, non-funct. adenoma, 8.0±1.71). Adenomatous goiter, 6.5±2.11 (carcinoma) (papillary type), 5.4±1.07, follicular type: 8.3±2.45), Hashimoto's thyroiditis: 4.2±1.28.
(ii) Based on the observation of the semi-quantitative study of the electron microscopically demonstrable TPO, the normal thyroid: 13.4±6.08, adenoma (functioning type: 43.9±5.05, non-functioning type: 13.1±6.78), hyperthyroidism: 22.9±11.0, adenomatous goiter: 6.9±2.81, carcinoma: 1.64±1.62.
(iii) In accordance with ¹³¹I-uptake rate, the TPO was increased on quantitative basis.
(iv) The localization of the TPO was in a full agreement with the observation of the other authors. The mitochondrial cristae also showed the positive reaction to the TPO procedure.
(v) The vesicles which were transmitted through the Golgiassociated ER disclosed similar reaction to it.
Conclusively, the author revealed significant increase of the TPO in functioning adenoma and papillary variety of the hyperthyroidism which is demonstrated in virtue of the PAM technique. The observation may indicate a possibility that the localization and quantitative increase of the PPDS reaction may reflect activated hormonal biosynthesis.

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Ventilatory function and pulmonary hemodynamics changes were comparatively studied on 52 cases of congenital and acquired heart diseases associated with pulmonary hypertention before and 6 months to 4 years after operation, on 32 cases which has been practiced postoperative examinations.
Pulmonary hypertension was applied over 30mmHg of mean pulmonary artery pressure. The following results were obtained.
1) Ventilatory disturbances were noted in almost cases with over 50mmHg mean pulmonary artery pressure., in cases with over 0.45 in P_p/P_s and 2.0 in Q_p/Q_s, in isolated ASD and VSD, in cases with over 450dyne/sec/cm^-5 in PVR and below 0.84 in Q_p/Q_s, in mitral and aortic vulve diseases.
2) It was showed tendency to increase ventilatory disturbance in patients with over 30 years old and to decrease % MBC and FEV 1.0% in patiants with over 50 years old after operation.
3) It needs a careful consideration to have operations in following cases with below 45%in % MBC, over 42% in % RV and in cases of valvular diseases which show over 560dyne/sec/cm^-5 in PVR, below 0.84 in Q_p/Q_s.

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A eighteen-year-old boy clinically and roentgenographically examined, has striking abnormalities in feet. The distal interphalangeal joints of middle, ring and little toes of both feet are stiffened in the extended position. The skin over the affected joints is smooth and tense and has no volar creases and dorsal transverse wrinkles. X-ray examination has revealed that the boy has synostosis between the phalanx media and phalanx tertia.

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