For the pathogenecity of the intestinal flora, particularly E. coli group as the one of the cardinal lethal factors induced by ileus, the author has made the following histopathological study, using ICR strain germfree mouse. The experimental groups are divided into two ones. The first group is served as control and received no treatment. The second group is experimental one which is monocontamined with the E. coli derived from fecal material. Both groups were placed in the isolater and them strangulated ileus was installed at the upper portion of the small intestine. The survival time, bacterial count in intestinal content and histopathologic findings of the cardinal visceral organs were studied with the light and electron microscopes. The results obtained were as follows: 1) The survival time of the control group is estimated at 72 hours in average, while in the experimental group time is estimated at 19 hours in average and remarkable shortening of the survival time is confirmed. 2) The intestinal content of the control group remained essentially aseptic, while numerous E. coil colonies are detected in the experimental group. 3) The histopathological changes of the liver, kidney, adrenal glands and intestinal wall remained to be a lesser extent, however, in the experimental group, striking cellular damages being manifested by degeneration necrosis and hemorrhage are observed. The ultrastructural study also disclosed the degeneration and loss of intracellular organellae as well as the disintegration of the cellular structures. Thus the importance of the E. coli as one of the cardinal initiators of the lethal outcome in ileus is histopathologically substantiated.
For clarifying the pathogenesis of the acute renal failure which is regarded as one of the most important complications in the patients who died in the ICU and CCU, the histopathological study of the renal lesions has been performed in this communication and the results obtained were as follows: 1) There was no typical case of classifical lower nephron nephrosis (LNN) type I in this study. However, a few cases of LNN type II revealed interstitial focal edema-fibrosis variant were obserbed. Incidentally in both group striking anemia in intra-renal vasculature constitutes the common features. 2) Approximately 8% of the LNN type I group associated with shock kidney (SK) type III which suggested the alteration, of renal change resulted from incorporation of intensive care medical units. 3) The author failed to observe the osmotic nephrosis which was anticipated by the massive infusional therapy and majority of them disclosed focal nephrotic type. Moreover, no case of renal hemosiderosis is encountered. This fast also may support a view that the changes of the renal lesions have been alterated remarkably after incorporation of infusional therapy based on theoretical back ground. 4) In the entity of specific varities, intra-glomerular stasis, intra-glomerular micro-thrombosis formation, acute renal infarction, renal cortical necrosis, renal vascular paralysis, acute tubular necrosis and renal, or pen-pelvic hemorrhages are frequently observed. Majority of them manifested clinical symptomes of acute renal failure. Moreover, it is of noteworthy that the marked increase of the intra-glomerular micro-thrombosis is observed recently, which also supports the view of alteration of renal lesions after installation of critical care units. 5) In the entity of renal cortical necrosis, renal pre-infarction or renal pre-cortical necrosis which may reflect the extremely acute cases of renal impairment. 6) The renal or pen-pelvic hemorrhages are frequently observed in various underlying disease conditions. This fact is justified as one of the most noteworthy pathological changes which suggest the causation of severe shock conditions.
The effect of the internal tococardiography (TCG) on the mother and the newborn were studied. When the internal TCG was employed, the number of total bacterial colonies in the amniotic fluid tended to increase, as compared with controls. However, there were no essential differences between those in whom the internal TCG was employed and controls, as far as following items were concerned. Items : Maternal fever incidence in puerperium, fever incidence in newborns, Apgar score, CRP and IgM in umbilical blood, duration of labor, rupture of membranes and delivery internal, relationship between the duration of TCG and the fever incidence in the mother or the newborn. It is therefore concluded that the employment of the internal TCG does not increase the risk either in the mother or in the newborn.
Chromatin is composed of DNA, RNA, histones and non-histone chromosomal proteins NHCP. Although there are several methods for the extraction of NHCP, it is difficult to isolate each of NHCP in its native form. The author devised a simple electrophoretic method for the analysis of NHCP and used it to study the chromatin of the tadpole and bullfrog, Rana catesbeiana. The method was better in the reproduction and yield of proteins than previously used methods. Histones and NHCP were extracted from the chromatines of various tissues of the bullfrog and tadpole, and were analyzed by the electrophoretic method. No qualitative but quantitative variations were found in the composition of NHCP among the tissues examined. The tissues of the tadpole and frog were classified into three groups according to their electrophoretic patterns of NHCP; brain, heart muscle and spleen showing almost the same pattern, liver and kidney showing a slightly different pattern, and erythrocytes showing a markedly different pattern. Component D 3 oocurs in the frog liver, but not in the tadpole. An increase in the tadpole liver was found during natural and thyroxine-induced metamorphosis.
Histopathological changes of the conduction system of the heart were studied with special reference to the aging process in 31 autopsy cases, which were not accompanied by circulatory diseases. Particular attention was paid to the correlation between the histopathology of the sinus node, atrioventricular node, His bundle and both bundle branches, and designated perfusing arteries and their branches. A significant correlation was demonstrated between age and the sclerotic changes of the sinus node artery. Similar significant correlations were also observed between age and the sclerotic changes of the arteries and their branches which perfuse AV node and more distal portions, indicating that sclerotic changes became more marked as aging progressed. As these findings, however, were not so striking, the changes were not identifiable as indisputable “arteriosclerosis”. Accordingly, certain factors must be considered to contribute to the development of arteriosclerosis in addition to aging. It was noted that the arteriosclerosis was observed even in newborn infants having marked abnormalities in the circulatory system, such as congenital cardiac malformations, indicating that the circulatory derangement might beone of its causes. There were positive correlations between age and the histopathological changes of SA and AV nodes, His bundle and both branches. However, the decrease of the number of the conduction cells to less than 50%, which is regarded as the significant pathological change, was not confirmed in the cases studied. Positive correlation was also confirmed between the extent of the histological injury of SA and AV nodes and the changes of their perfusing arteries. The histological changes of the His bundle were similarly correlated with the changes of the ramus septi fibrosi and ramus septi ventriculorum superior, which perfuse this portion, but the correlation with the right coronary artery was not significant. There were two types of histological changes associated with the decrease of conduction cells: one is the replacement by the adiposal tissue and the other by the increase of collagenous fibers. Both types of changes increased with age in SA node, while the His bundle and AV node showed the aging preponderance of the fibro-collagenous type. In conclusion, the histological changes of the conduction system and sclerotic changes of perfusing arteries were observed to progress with age, but the degree of changes was rather minimal or slight. It is suggested that additional factors, such ascirculatory derangement, should be considered to contribute to the development of indisputable arteriosclerosis.
An experimental brain edema was produced by the cold injury method. Three kinds of rats were used ; that is, stroke-prone spontaneously hypertensive rats (SHRSP, Blood Pressure 194±16 mmHg), stroke-resistant spontaneously hypertensive rats (SHRSR, B.P. 168±14 mmHg) and normotensive Wistar rats (WR, B.P. 119±8 mmHg). Brain edema was assessed by measuring the brain water content. Blood-brain barrier permeability was studied by estimation of the transfer of 181 I-RISA from blood to brain tissue. Regional cerebral blood flow (rCBF) was measured by the hydrogen clearance method. The experiment was carried out without anesthesia in order to exclude the effects of anesthesia. The following results were obtained: 1) Three to six hours after the cold injury the water content in SHRSR andWR gradually began to increase in the damaged hemisphere. In the undamaged hemisphere the changes of the water content were slight. There was no significant difference between SHRSR and WR. However, in SHRSP the increase of the water content after the cold injury was remarkable compared to the other two groups. 2) The uptake of 181I-RISA to the brain tissue rapidly increased among thethree groups in the damaged hemisphere. But in the undamaged hemisphere these changes were slight. These changes suggest that the damage of the blood-brain barrier was induced after the cold injury. In SHRSP these changes were remarkable compared to SHRSR and WR. In the three groups rCBF decreased rapidly immediately after the cold injury not only in the damaged hemisphere but also in the undamaged hemisphere. Disturbance of the brain metabolism caused by hypoxia was considered. 3) These results suggest that the presence of severe hypertension (B.P. over 190-200 mmHg) emphasizes the occurrence of brain edema.
Cervical ripening score in three factors of consistency, length and dilatation has been evaluated by bimanual examination, and furthermore, factors of fetal and cervical positions have been also taken into consideration as are in Bishop's pelvic score. The following results have been obtained. 1) The error rate of measurement is about 10% and is not affected by parity and the elapse of time. 2) Both in a primiparous and a multiparous patient, the cervix is ripened towards the end of the pregnancy, and the improvement is especially pronounced from the 8th to the 9th gestational month. 3) The cervical ripening score in primiparae just before the onset of labor has the coefficient correlation with the duration of the 1st stage of labor (r=-0. 23*), (1st and 2nd) stage: (-0.33**), interval between onset of labor and onset of fetal descent (-0.30**), but an insignificant relation is found in multiparae (**...significant on 1% level, *...significant, 5% level). 4) As for the score of the fetal descent, that is, the fetal position before labor, significant relation is found in multiparous patients, --such as with the duration of the 1st stage of labor, (r=-0.33**), (1st and 2nd) stage: (-0.26*), interval between onset of labor and onset (of fetal descent: (-0.24*), but no significance is obtained in primiparae. 5) Bishop's pelvic score has a significant relations with the duration of the 1st stage of labor (r=-0.28**) in primiparae, but no in multiparae. 6) The cervical ripening score directly before onset of labor has no significant relation to the incidence of a vacuum extraction delivery and fetal distress. Bleeding amount during labor increases in primiparae when the cervix is unripe, but not in multiparae. Conclusion: The cervical ripeness score is connected with the prediction of the labor process in primiparae, that is, the stages of labor are shortened when the cervix is ripe, while the position of fetal part before labor is connected with the prognosis in multiparae. Therefore, in the cervical ripening scoring system, fetal element and cervical one should be separately considered.
A quantitative method has been already established for differential diagnosis between cerebral hemorrhage and infarction. The method is based on evaluating frequency of occurrence for each of the 15 items (age, history of strokes, stroke status, how strokes occur, respiration, blood pressure, clouding of consciousness, headache, vomiting, conjugate deviation, light reflex, stiffness of the neck, dyskinesia, Babinski reflex, and cerebrospinal fluid), regardless of whether consciousness was seriously affected or not. In the present study, first, the presence of hemorrhage or infarction was ascertained by means of Computed Tomography. Then the patients were classified into two groups: consciousness seriously affected and that slightly affected. In the case of consciousness seriously affected, frequency of occurrence was assessed for each of the 11 items (age, history of strokes, stroke status, respiration, blood pressure, clouding of consciousness, vomiting, light reflex, stiffness of the neck, dyskinesia, and cerebrospinal fluid) whereas in the case of consciousness slightly affected for each of the 7 items (age, history of strokes, how strokes occur, blood pressure, headache, stiffness of the neck, and cerebrospinal fluid). By the revised quantitative method, the differential diagnosis between cerebral hemorrhage and infarction was improved by about 10%.
The distribution and characterization of 59Fe in the maternal liver, maternal blood, placenta, and fetal liver were examined in rats of late gestation 3 and 24 hours after intravenous 59Fe-iron administration. The following results were obtained bythe comparison of 59Fe incorporation 3 and 24 hours later. 1) The incorporation into the maternal liver was reduced from 29.5% to 14.1%, that into maternal blood was increased from 5% to 12%, that into placenta was increased from 3.3% to 7.4%, and that into fetal liver was increased from 9.3% to 13.4%, respectively. But the change of 59Fe incorporation into the liver and blood in non-pregnant rats at these intervals was not so strong, when compared with pregnant rats. 2) The identification of 59Fe-containing compounds from the livers and placenta was achieved by gel-filtration on Sephadex G-75 and qualitative immunoreactions. On the maternal liver, 59Fe was mainly incorporated into ferritin and transferrin fractions, but on the placenta and fetal liver, a considerable amount of 59Fe was recognized in the small molecular (M. W. 18, 000) and rather heat labile protein, in addition to those of the already detected proteins. 3) The distribution of 59Fe incorporated into isoferritins of the livers and placenta was investigated by ampholyte-gel isoelectric focusing. 59Fe was largely incorporated into rather acidic isoferritins 3 hours after the injection, but the incorporation was shifted to basic isoferritin after 24 hours. However, protein detections showed no significant difference in the livers and placenta either 3 or 24 hours after the injection, compared with those of the control.
The spinal rami of the lumbar artery were observed in two hundreds lumbar ganglion areas corresponding to the first to the fourth lumbar nerves in 25 Japanese in relation to their origin, divergence, direction and distribution. Following results were obtained: 1) By observing ramus spinalis in relation to the origin and distribution, four branches were identified: (1) The basivertebral artery was found in 199 out of 200 (99.5%), (2) The superior branch in 200 out of 200 (100%), (3) The middle branch in 63 out of 200 (31.5%), (4) The inferior branch in 164 out of 200 (82.0%). 2) The superior branch was the chief artery reaching the lumbar ganglion, anterior root, posterior root and spinal cord. In 146 cases out of 200, it formed the common stem with the basivertebral artery. Its origin was classified into the following five types according to its relationship with the basivertebral artery: Type I: Both the superior branch and the basivertebral artery originate from the lumbar. artery as an independent branches (25.5%). This type is subclassified as follows; Type A: The superior branch originates from a point more central than that of the basivertebral artery (13.7%). Type B: Both the superior branch and the basivertebral artery originate from a point at the same level (31.4%) Type C: The superior branch originates from a point more peripheral than that of the basivertebral artery (54.9%). Type II: The superior branch forms the common stem with the basivertebral artery and both branches diverge almost equally (28.5%). Type III: The superior branch forms the common stem with the basivertebral artery. Thereafter, the basivertebral artery becomes the main stem, from which the superior branch emerges (42.5%). Type IV: The superior branch forms the common stem with the basivertebral artery. Thereafter, the superior branch becomes the main stem, from which the basivertebral artery emerges (2.0%). Type V: anomalous type (1.5%) 3) The distribution of the superior branch to the lumbar ganglion was classified into the following three types: Type I: At the region of the ganglionic ampulla, the superior branch penetrates deeply into the confluent area of the anterior and posterior roots (70.3%). Type II: The superior branch tends to run a long way on the surface of the lumbar ganglion, then along the confluent area of the anterior and posterior roots finally perforating the dura mater (18.5%). Type III: At the region of the ganglionic ampulla, the periphery of the superior branch subdivides arborescently and reaches the surface of the lumbar ganglion (11.2%). 4) The middle branch originates in most cases directly from the lumbar arterial trunk as an independent branch and proceeds directly toward the lumbar ganglionic surface (7-3.2%). 5) The inferior branch originates mostly from the dorsal branch of the lumbar artery and proceeds directly to the lumbar ganglionic surface (64.7%). 6) Among the superior, middle and inferior branches, 51 cases out of 200, or 25.5%, showed anastomosis at the lumbar ganglionic surface. As modes of anastomosis, the following two types were observed: (1) One is the mode where the two branches are connected to each other by a communicating branch. (2) T he other is the mode where the two branches from a V-shaped anastomosis.