緒言一般的にみて, わが国でのインフルエンザの流行は毎年10月後半からその兆しがみられる。すなわち, 小・ 中学校での集団かぜによる学級閉鎖や休校などの動きによって流行が認知されると同時に, 児童, 生徒のいわゆるかぜ様疾患群からのウイルス分離によって確認される。
一方, インフルエンザの場合も, 他の多くのウイルス性疾患と同様にみるべき化学療法剤のない現状では, その予防対策の唯一の手段として従来からのワクチン接種による免疫付与に頼らなければならない訳である。そのためわが国での予防接種は, 過去の流行例の疫学的結果から小・ 中学校の児童, 生徒を中心とする学校集団に対する集団予防i接種方式で実施されているのが現状である。そのため現行法でのワクチン接種時期は初回接種が10月に入ると開始され, 1-4週間隔で第2回目の接種が行われている。すなわち, 接種対象集団の多くが11月中に予防接種が完了するように実施されている訳である。
一般に, 各種感染症の発生あるいは流行の確認は臨床診断のみで行うことは困難で, 最も的確な方法は病原学的検索による病原体の分離同定による確認である。さらに, 血清学的, 臨床的診断を加味すればほとんど誤ることはないであろう。しかし, ある種の感染症では病原体検索の手技が繁雑で時間を要したり, あるいは手技の確立していないものでは血清学的, 臨床的診断に頼らなければならない。
かぜ様疾患群からのインフルエンザウイルス分離のための術式は比較的容易な方法で確立されているが, ウイルス分離用検体の採取時期が適切であることも重要である。
1982-1983年にかけてのわが国の流行はウイルス分離状況からみるとまだ主流行株はA香港型で, Aソ連型に完全に移っていない。また, B型ウイルスは全く分離されていない状況でA型の流行が繰り返していたとされている。しかしながら, 著者はこの流行期を利用して1982年度の市販ワクチンの効果を検討中, 血清学的反応でB型インフルエンザの流行のあったことを示唆する集団流行例に遭遇したのでその成績について報告する。

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The changes which occurred in the bladder urothelium were observed with the use of a SEM after 1 ml of saline solution of Adriamycin (2 mg/ml) was kept in the bladder of a Wistar rat for 30 minutes. The normal superficial cells of the bladder urothelium were large, flattened surface cells and had a mature surface pattern. They were damaged by Adriamycin and desquamated.
The cells of the intermediate layer, which were forced to line the luminal surface of the bladder due to loss of the superficial cells, were smaller in size and had an immature surface pattern. This immature surface pattern of the cells changed and took on an aspect remniscent of the normal superficial cells within 6 hours afterinstillation of Adriamycin, though the size of the cells remained small. Within 12 hours, the mitotic figures were observed in the cells of the basal layer in the light microscopic sections. Four weeks after instillation of Adriamycin, there were differences neither in the surface pattern nor in cell-size between the renewed superficial cells and the normal superficial cells. From these findings, it was suggested that the damaged bladder urothelium repaired firstly its urine-tissue fluidbarrier function and then replenished itself with the urothelial cells. The cell replacement mechanisms in the urothelium were also discussed.

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The iron status of 1198 high school students, aged 16-18 years, was evaluated by measuring hemoglobin (Hb), hematocrit (Ht), red blood cells (RBC), serum iron (SI), total iron binding capacity (TIBC) and transferrin saturation (TS) from peripheral blood.
The average value of Hb concentration was 14.7±0.9g/dl in males and 12.7±1.0 g/dl in females. The frequency of anemia in adolescents who had Hb levels less than 13 g/dl in males and 12 g/dl in females was 3.5% and 15.9%, respectively.
In addition, a concentration of serum ferritin (SF) and free erythrocyte porphyrins (FEP) was measured in 28 anemic males, 62 anemic females, 90 nonanemic males and 150 nonanemic females. The geometric mean of SF was 62.1 ng/ml (arithmetic mean : 73.6±40 ng/ml) in nonanemic males and 18.1 ng/ml (arithmetic mean : 30.6 27ng/ml) in nonanemic females. The percentage of subjects with a low SF concentration below 10 ng/ml in nonanemic females was 26.0% in contrast to 1.1% in nonanemic males.
In order to standardize the diagnostic parameters of screening for latent iron deficiency, individual parameters indicating iron deficiency were defined by the author as follows: SF below 10 ng/ml, TS below 15%, and FEP above 70μgl di RBC. In each of these three parameters, the incidence indicating iron deficiency was the highest with SF. Accordingly SF was supposed to be the most sensitive parameter for iron deficiency within these three. A low rate of latent iron deficiency was present in nonanemic males with Hb level above 13 g/dl, and on the other hand, the incidence of latent iron deficiency was 34.9% and 28% in two groups of nonanemic females who had Hb values of 12.12.9 and 13.13.9g/dl in the same order. Distinct differences were observed in the values of the parameters for evaluating iron status between male and female subjects.
These findings suggest that the combination of these parameters make the diagnosis of iron deficiency more reliable than the information derived from a single parameter.

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Nicotinic acid (NA) loading test was evaluated among patients with various liver diseases. Serum total bilirubin (TB) and indirect bilirubin (IDB) reached a peak 90min after an intravenous injection of 50 mg NA and they gradually declined among healthy subjects (HS). The patterns of elevations of serum TB and IBD were generally similar to those observed among patients with acute hepatitis or chronic hepatitis. However, among patients with liver cirrhosis (LC), elevations of serum TB and IDB were sustained up to 120 min after NA administration. Maximum increments of TB and IDB (IDBmax) were significantly larger among patients with LC as compared to those observed among patients with HS or CH. Among 7 patients with Gilbert's syndrome and 3 patients with posthepatitic hyperbilirubinemia, elevations of serum TB or IDB were sustained and IDBmax was significantly augmented as compared to those observed among HS. The patterns of elevations of serum TB and IDB, and IDBmax among 2 patients with Dubin-Johnson syndrome were similar to those in HS.
IDBmax among patients with LC was significantly larger in those with splenomegaly as compared to those without it. Further, there existed a positive correlation between IDBmax and the size of the spleen calculated on scintigram.
In a patient with idiopathic portal hypertension (IPH) and 2 patients with congenital spherocytosis, elevations of serum TB and IDB after the administration of NA significantly reduced after splenectomy. However, NA-induced elevations of serum TB and IDB among patients with spherocytosis persisted after splenectomy. In contrast elevations of serum TB and IDB after NA were not observed among 3 patients who had splenectomy because of abdominal trauma or gastric cancer. NA provocation test was performed in 3 patients with CS and 4 cases of IPH during splenectomy. IDB concentration was the highest in blood obtained by splenic puncture, followed by splenic vein and artery, respectively.
Serum haptoglobin levels did not decrease among subjects who received the measurement. It was also ascertained that the existence of the expected concentration of NA in blood did not induce hemolysis in vitro.
Results suggest that hyperbilirubinemia after NA loading shows different curves in various liver diseases. In addition, results indicate that the spleen plays important roles in hyperbilirubinernia after NA administration.

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The ferritin molecule has 24 subunits, which are composed of two kinds (H and L) of similar molecular weight polypeptides. Accordingly, the molecule may contain many isomers depending on the composition of the subunits in a molecule, and these isomers can be a cause in the heteroge -neity of iron/protein ratio or isoferritin pattern detected by isoelectric focussing.
The author planned to investigate the heterogeneity in biochemical characteristics within human liver and spleen ferritins by measuring individually the purified materials from the liver (n=57) and the spleen (n=51). The following results were obtained:
1) There was no statistical difference in average values of ferritin concentration either between the two organs in the same sex or between the same organ in different sexes. The average concentration of liver ferritin was 0.98±0.69 mg/g tissue and that of spleen ferritin was 1.04 0.86 rng/g tissue. However, a significantly positive relation was observed within concentra. tions of liver and spleen ferritins derived from the identical specimen (n=39, p<0.001).
2) There was no statistical difference in the iron/protein ratio within ferritins of the same organ from different sexes. But the values showed a statistical difference between the two organs (p<0.0025), which were 0.16 0.08 and 0.22±0.10μg Fe/μg protein in the liver (n=57) and the spleen (n=51) respectively.
3) Isoferritin patterns were transformed to histograms of the density versus 0.05 pH distances, and average isoferritin patterns were drawn by peak frequency and peak height methods for every group of different sexes. All histograms showed normal distribution by a statistical method. The average values with standard deviation were for the male liver pH 5.50±0.34 (n=31), the male spleen 5.45+0.40 (n=28), for the female liver 5.42±0.38 (n=26) and the female spleen 5.39+0.44 (n=21).
These results suggest the presence of functional and chemical heterogeneity between liver and spleen ferritins.

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Preventive inoculation with influenza vaccine is contraindicated for patients under treatment by hemodialysis. A total of 164 such patients were divided into two groups, A and B, of 113 and 51 patients, respectively. The patients of group A were inoculated with commercial HA vaccine, produced in 1981, in the same manner as healthy normal adults. Then they were examined serologically for the ability to produce humoral immunity and to protect themselves from infection by developing acquired immunity. The patients of group B were not inoculated with the vaccine. The results obtained are summarized as follows:
1) Antibody of humoral immunity (HI antibody in the blood) against each vaccine strain was found to have been produced significantly in the patients of group A 4 weeks after inoculation.
2) The rate of significant rise of antibody titer to exceed 1 : 4 was the highest, or about 6796, for the antibody against the Hong Kong A type. It was about 40% and about 30% for the antibody against the Russian A and B types, respectively.
3) The rate of infected patients to the total number of patients of each group was 3.2% for group A and 11.1% for group B. It was significantly lower (x²=12.2, p<0.001) in group A than in group B.
4) When the leukocyte count and general biochemical properties of serum were examined in both groups one week after inoculation, there was little difference between the two groups.
5) Neither local reaction (redness, pain, or swelling at the site of inoculation) nor systemic reaction (fever or headache) was seen in any of the patients.
From the above results it was concluded that the present vaccine could be applied effectively to patients under treatment by hemodialysis for the prevention of influenza virus infection.

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Olfactory nerves were observed in nasal mucosae in relation to their direction and distribution in 11 adults (54-86 years) and 5 fetuses (7-10 months). The following results were observed:
1) Features of the distribution of the olfactory nerves in olfactory mucosae.
(i) Rod-shaped olfactory nerves were surrounded with connective tissue which was linked. with cerebral meninges. The bundles of olfactorynerves were various and approximately measured 0.4 mm to 1.5 mm in diameter. In their downward course from the cribriform plate to olfactory mucosa, the olfactory nerves spread stratified and joined together or branched off to form a complex nerve plexus. The nerve plexus on the ethmoidal sinus (lateral wall) side of the nasal cavity was more complex than on the septal (medial wall) side.
(ii) The conformation of the olfactory nerves of the fetuses was the same as that of the adults, but the nerve plexus was simpler.
2) Distribution area of the mean olfactory nerves.
(i) Adult
Ethmoidal sinus side (lateral) right 3.20 cm²
left 2. 84 cm²
Nasal septum side (median) right 1.10 cm²
left 1.15 cm²
(ii) Fetus
Ethmoidal sinus side (lateral) right 0.38 cm²
left 0.39 cm²
Nasal septum side (median) right 0.34cm²
left 0.35 cm²
3) Features of the distribution of the olfactory nerves in anteroposterior directions.
(i) Adult
The posterior part in the nasal mucosa was larger than the anterior part. At the same time the dominant in the posterior part was the most numerous.
(ii) Fetus
The distribution pattern was the same as that of the adults, but its predominance was small.
4) Features of the distribution of the olfactory nerves insuperoinferior directions (the mean distance from the cribriform plate to the point of the nerve penetrating the mucosa).
i) Adult
From 0.6cm up to 1.2cm in the lateral side.
From 0.2 cm up to 0.6 cm in the median side.
(ii) Fetus
From 0.2 cm up to 0.7 cm both in the lateral and median sides.
5) Relation of the middle nasal concha and the olfactory nerves.
(i) Adult
The olfactory nerves crossed the criteria line of the middle nasal concha forward and downward in the lateral side, but did not reach that line in the median side.
(ii) Fetus
The olfactory nerves crossed the criteria line of the middle nasal concha forward, but did not cross that line downward either in the lateral or median sides.

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