Okayama Igakkai Zasshi (Journal of Okayama Medical Association)

STUDIES ON THE EPIDEMIC OF JAPANESE B ENCEPHALITIS OF 1958 OCCURRING IN OKAYAMA PREFECTURE AND ON NEWLY ISOLATED STRAINS, “OKAYAMA 58 H” “OKAYAMA 58 I”

K. OHTAHARA, M. OGATA, M. OKAZAKI, M. SIDAO

1959 Volume 71 Issue 3supplement-1 Pages 1-10
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_1

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In their epidemiological studies on the epidemic of Japanese B encephalitis in 1958 that broke out in Okayama Prefecture, the authors obtained the following results.
1) The Patients numbered 148, the dead 41, and the morbidity incidence rate of 8.8 was situated to the 6th in all prefectures. These are accepted as the average prevalence for Okayama Prefecture.
2) The peak of prevalence in the southern district was seen a week earlier than in the northern district and this indicates what is called “tendency towards north”.
3) The morbidity incidence rate was higher in the southern district, on the contrary the lethality rate was higher in the northern district.
4) With distinction of sex, the former was higher at the side of male and the latter was so at the side of female.
5) The patients who died 6 days after suffering from this disease were most in all patients.
6) The morbidity in the persons vaccinated for the Japanese B encephalitis has been found markedly lower than that in the untreated persons, proving the favorable effect the vaccination.
7) Okayama 58 H and Okayama 58 I strains virus were isolated from the brains of the encephalitis patients and these strains have been identified serologically with Japanese B encephalitis Nakayama strain.

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THE METABOLISM OF ELECTROLYTES IN JAPANESE B ENCEPHALITIS

PART 1. QUANTITATIVE STUDY OF THE SERUM ELECTROLYTES IN MICE WITH EXPERIMENTAL JAPANESE B ENCEPHALITIS AND IN PATIENTS WITH THIS DISEASE

Toshiyuki Kuwajima

1959 Volume 71 Issue 3supplement-1 Pages 11-18
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_11

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In the quantitative study on the fluctuations of serum electrolytes in the mice experimentally infected with Japanese B encephalitis virus and in the patients with Japanese B encephalitis, the author obtained the following results:
At the onset of symptoms of Japanese B encephalitis in the test mice and during the period from the progressive stage to the peak of the disease in the patients with Japanese B encephalitis, the quantities of Ca, K, Na, and Cl in the sera are dereased while the contents of inorganic phosphorus are increased. In addition, of the changes in the quantities of these serum electrolytes, inorganic phosphorus alone have increased already in the latent period.
These changes in the serum electrolyte contents seem to be induced by many complex factors nevertheless at least the changes in the functions of the vegetative nervous system and in the nucleic acid metabolisms of various organs, constituting a portion of pathophysiology in this disease, appear to be the important causative factors.

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THE METABOLISM OF ELECTROLYTES IN JAPANESE B ENCEPHALITIS

PART 2. INFLUENCES OF PITUITARY AND ADRENOCORTICAL HORMONES ON THE SERUM ELECTROHYTE CONTENTS IN MICE WITH EXPERIMENTAL JAPANESE B ENCEPHALITIS AND IN PATIENTS WITH THIS DISEASE

Toshiyuki Kuwajima

1959 Volume 71 Issue 3supplement-1 Pages 19-26
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_19

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Continuous administrations of ACTH tend to restore the contents of serum Ca and Cl as well as of inorganic phosphorus at the onset of symptoms in the mice with experimental Japanese B encephalitis to the normal level, while the same treatment with cortisone and prednisolone tends, in addition to the above effects, to restore the Na content back to the normal level as well. Furthermore, in the patients with Japanese B encephalitis, the contents of Ca, K, Na, Cl, as well as inorganic phosphorus in the serum are all brought back to the normal level after the treatment with ACTH.
As for the mechanism of the changes elicited in these mice and in the patients with Japanese B encephalitis by the administraitons of pituitary and adrenocortical hormones, it appears to be the mechanism mainly responsible for the curative effects of these hormones.

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THE METABOLISM OF ELECTROLYTES IN JAPANESE B ENCEPHALITIS

PART 3. INFLUENCES OF PANS 610- TW AND P³² ON THE SERUM ELECTROLYTES IN THE MICE WITH EXPERIMENTAL JAPANESE B ENCEPHALITIS

Toshiyuki Kuwaijma

1959 Volume 71 Issue 3supplement-1 Pages 27-33
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_27

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Continuous administrations of PANS 610- TW to the mice inoculated with the Japanese B encephalitis virus help to increase the serum K content at the onset of symptoms; but this seems to be due to the hemolytic action of PANS independent of the pathophysiology of the encephalitis.
When P³² is administered in place of PANS, the contents of serum inorganic phosphorus are increased, but the rate of such an increase is lower than in the control. This increase of the inorganic phosphorus seems to be mediated by the mechnism of the curative effect of P³².

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STUDIES ON THE EFFECT OF ACTH ON JAPANESE B ENCEPHALITIS

PART 1. A STUDY ON THE BASIS OF CLINICAL EXPERIENCES

Kiyoshi HIRAKI, Yoshikatsu DEMIYA, Toshiyuki KUWASHIMA, Tetsuo NI-IYA, ...

1959 Volume 71 Issue 3supplement-1 Pages 35-42
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_35

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In the application of ACTH on seven human cases of Japanese B encephlitis the authors obtained excellent results in all the cases.
The effects of ACTH and cortisone on acute infectious diseases or on diseases of the nervous system have been discussed in connection with the application of these drugs on Japanese encephalitis.

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STUDIES ON THE EFFECT OF ACTH ON JAPANESE B ENCEPHALITIS

PART 2. A STUDY BASED ON ANIMAL EXPERIMENTS

Kiyoshi HIRAKI, Yoshikatsu DEMIYA, Toshiyuki KUWASHIMA, Tetsuo NI-IYA, ...

1959 Volume 71 Issue 3supplement-1 Pages 43-55
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_43

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1. By applying ACTH in various concentrations by different routes of administration and also by inoculating virus at different concentrations for the experimental Japanese B encephalitis with the use of mice, the preventive and curative experiments with ACTH were performed but no effect of this drug could be recognized.
The reason for this ineffectiveness seems to lie in the fact that mice will not develop fever even when afflicted with Japanese B encephalitis and that the metabolism of steroid hormones and the susceptibility to the encephalitis virus differ from those of human.
2. Likewise in the treatment of mice with experimental encephalitis predonisolone and DOCA in the same manner as above, no effect could at all be observed.
3. In the ACTH treatment of six monkeys given inoculation of Japanese B encephalitis virus via the nasal cavity, three were saved from death, Even in the monkeys infected with Japanese B encephalitis virus the rise in the body temperature is less than that in man, and therefore, not much antipyretic effect of ACTH can be expected. However, in view of the fact that the monkeys afflicted with Japanese B encephalitis are generally believed to die 100 per cent, our excellent result with monkeys as afore-mentioned seems to support the efficacy of the ACTH treatment on human Japanese B encephalitis, what we have been advocating as the therapeutic method.

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CLINICAL AND CHEMICAL STUDIES OF JAPANESE B ENCEPHALITIS

PART 1. SERUM PROTEIN IN JAPANESE B ENCEPHALITIS

Shiro TOYOTA

1959 Volume 71 Issue 3supplement-1 Pages 57-66
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_57

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In the study on the changes of the serum protein ocurring in Japanese B encephalitis the author carried out investigations on 34 cases of the patients with this disease and also on 60 mice inoculated with the virus of Japanese B encephalitis. The total protein were estimated by the refractometer, while their fractions were determined by paper electrophoresis.
As the results it has been found that the total protein in the acute stage decreases in amount and it requires quite a long period of time to recever to the normal level. The albumin decreases while α-globulin increases, but this condition returns to normal quickly when the acute stage is past.
On the other hand, β-globulin in the case of mice increases and that in the patients decreases. The contents of γ-globulin likewise show different results, namely a decrease in the case of mice while no change in the patients. It can be assumed that the different behaviors of β-and γ-globulins between mice and patients are due to the different reactions against the disease.
These changes of the serum Protein in Japanese B encephalitis, namely, the decrease in the total proteins and albumin and the increase in α-globulin, are common changes observable in general acute inflammatory diseases, and it is believed that the same thing can also apply in the present instance.

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CLINICAL AND CHEMICAL STUDIES OF JAPANESE B ENCEPHALITIS

PART 2. INFLUENCES OF ACTH, PREDNISOLONE, DOCA, AND PANS ON SERUM PROTEIN PATTERNS

Shiro TOYOTA

1959 Volume 71 Issue 3supplement-1 Pages 67-76
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_67

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1. By administering such drugs as ACTH (10 mg/kg, intramnscular), prednisolone (5 mg/kg, i. m.), DOCA (1.0 mg/kg, i. m.), and PANS (200 mg/kg, intraperitoneal) to mice for consecutive days, the author observed the changes in serum protein.
As the results it has been found that an increase in α-globulin and adecrease in β-globulin can be recognized in the ACTH administration; an increase in the serum protein and α-globulin and a decrease in β-globulin in the case given prednisolone; a decrease in γ-globulin in the case of the DOCA administration; and an decrease in serum protein and γ-globulin and an increase in α-globulin in the case of the PANS administration. Of these the changes in α-globulin due to ACTH and prednisolone seem to be induced as the adaptation action of these hormones; while the changes due to PANS seem to be due to the peritoneal stimulation by PANS.
2. When ACTH and prednisolone are administered in the similar manner as mentioned above to the mice previously inoculated with the virus of Japanese B encephalitis, the changes occurring in the ACTH adminstration resemble closely to those observed in encephalitis while in the latter the changes are similar to those observed in the adminstration of prednisolone alone. Since encephalitis in mice is not cured by any of these drugs, it seems that the results will be different from those of human cases. In other words, in the twenty-two patients cured by the ACTH treatment all the fractions such as β-globulin tend to recover the normal level.
Although differences of the changes in the cases administered with DOCA are fairly great in each individual case, they all move more or less within the normal range.
In the PANS administration there occur a decrease in serum protein and albumin and an increase in α-globulin. This seems to be due to the inflammatory changes of encephalitis coupled with the stimulation in the abdominal cavity induced by PANS.

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CLINICAL AND CHEMICAL STUDIES OF JAPANESE B ENCEPHALITIS

PART 3. STUDIES ON SERUM PHOSPHATASE, TRANSAMINASE, AND CHOLESTEROL

Shiro TOYOTA

1959 Volume 71 Issue 3supplement-1 Pages 77-85
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_77

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The author estimated the contents of phosphatase, transaminase and cholesterol in the serum in mice and patients with Japanese B encephalitis, and also studied the influences of administrations of ACTH, prednisolone, DOCA, and PANS on normal mice and mice infected with the virus of Japanese B encephalitis.
1. The serum phophatase in encephalitis decreases, especially alkaline phosphatase. Moreover, when the above-mentioned drugs are given to normal mice, phosphase decreases in amount, but no marked change occurs when these drugs are given to mice with encephalitis.
2. The serum transaminase, especially GOT, decreases in encephalitis, but it recovers to the normal level after passing the acute stage. Although GOT decreases in normal mice administered with the above drugs, in the cases with encephalitis no effect can be recognized by the similar treatment. In addition, the fluctuation in GPT is trivial.
3. As for the serum cholesterol, the ratio of cholesterol ester to toal cholesterol decreases in encephalitis, but it recovers to normal after passing the acute stage.

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TEN AUTOPSY CASES OF JAPANESE ENCEPHALITIS THAT OCCURRED IN THE OKAYAMA AREA DURING THE PERIOD OF SIX YEARS FROM 1953 TO 1958

Junichi KOBAYASHI, Takuzo ODA

1959 Volume 71 Issue 3supplement-1 Pages 87-98
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_87

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In our histopathological studies on the ten autopsy cases of Japanese encephalitis that occurred in the Okayama area during the period from 1953-1958, it has been found that the characteristics and distribution pattern of encncephalitis pathologic changes approximately coincide with the findings on those Japanese encephalitis autopsy cases that prevailed in 1924 and frequently every summer thereafter. In addition, the septal interstitial pneumonia (interalveolar pneumonia) is cardiogenic pathologic changes presenting a viral inflammatory picture, and the Japanese encephalitis virus has been confirmed again to be the virus to possess neurotropic and viscerotropic traits. Also in other organs such as kidneys, digestive. canals, spleen and adrenal glands certain pathologic changes have been commonly recognized.
In the brains of an foetus and a premature infant autopsy cases from two mothers died of Japanese encephalitis it has been clarified that the pathologic changes specific to Japanese encephalitis were lacking. Moreover, in one of these two cases the use of ACTH to this disease has suggested a possibility of alleviating pathologic changes in the organs other than the brain, shedding a light on the future treatmet of this disease.

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RELATIONSHIP BETWEEN THE OUTBREAK OF JAPANESE ENCEPHALITIS AND WEATHER FACTORS FOR THE PAST 12 YEARS IN OKAYAMA PREFECTURE

Hisanori Okuda

1959 Volume 71 Issue 3supplement-1 Pages 99-106
Published: March 20, 1959
Released on J-STAGE: March 30, 2009

DOIhttps://doi.org/10.4044/joma1947.71.3supplement-1_99

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By studying relationship between the outbreak of Japanese encephalitis and various weather factors for the period from 1946 to 1957 in Okayama Prefecture, the author arrived at the following conclusions:
In the southern part of Okayama Prefecture, by selecting days in which average temperature exceeded 28°C, and adding the values in excess of 28°C, the sum total of these differences has been found to be correlated with numbers of Japanese encephalitis patients. And the amount of rainfall during august, has been correlated with numbers of patients. However, no correlation has been recognized between other weather factors and numbers of patients.
In the northern part of Okayama Prefecture, there seems to be no correlation at all between any weather factor and numbers of Japanese encephalitis patients.

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