Stereotaxic thalamic lesions by electrocoagulation have been produced on sixty four cases of extrapyramidal disorders by means of newly deviced simple electrocoagulation probe, which is made of 300mm of straight steel wire with one millimeter in diameter covered loosely by 293mm of hard teflon pipe as insulation to electricity and the local heat. The probe, therefore, has retractable 7mm bare tip, so it can be safely withdrawn without any, danger from hemorrhage of destructed tissue after coagulation. As a preliminary experiment, stereotaxic thalamic lesions by the probe have been produced in the dog brain as well as the formalin suspended human brains under observation with ultrasonic A-scope apparatus by reflection method. The transducer provided with barium titanate (2.25Mc, 10mm diameter) was used. It was clearly identified that the echoes were corresponded to size and location of the lesions in the dog brain as well as human brain specimen. During the surgery, echo was noted from the tip of probe which was in the target area of the thalamus of the patients. In every case, the lesion echoes showed high fluctuating amplitude and width during coagulation procedure. Lesion echoes were observed up to 45 days after the surgery. They maintained stable duplicate echoes during the period. It is our suggestion that the ultrasonic examination of the stereotaxic lesion is useful to note accidental hemorrhage in the lesion of a reconvalescent patient. It is also a great aid for this purpose to check the midline echo at the same time. Recently further investigations with ultrasonic compound sector scope, Aloka SSD-10, were done. The ultrasonic scanning was performed on the operative side vertically. During and after the coagulation of the target, twenty three cases were examined with compound sector scope. The reflextion from the lesion with compound scope was noted in 91.3% of the cases while 82.9% with A-scope. The lesionecho was obtained about 1.4cm lateral from the midline echo in case of destruction of V. L. nucleous of the thalamus. In case of the centre median the lesionecho was located adjacent to the midline echo. These lesionechoes were located correctly in their anatomical coordinates of the targets. But the size and shape of the lesionechoes were identified rather larger than the destructed lesions. This deflexion would be due to the width of the ultrasonic reflected wave. As confirmative experiments, stereotaxic thalamic destructive lesions have been produced in the specimen of the formalin suspended human brains under observation with ultrasonic compound sector scope. It is our impression that echo-encephalgraphy with the ultrasonic compound scope has a potential usefulness to observe location, shape and size of the lesion as well as to detect the accidental hemorrhage of a reconvalescent patient.
The high request of the preoperative diagnosis for liver metastasis of cancer is the claimed factor in the surgical field. Many kinds of examinations; i.e, physical examination, liver function test of serum, liver biopsy, laparoscopy, roentogenological diagnosis and others were using for this purpose, but the diagnosis was unliable yet. Recently, the clinical application of radioisotope is remarkably advanced, and the scintiscanning is used as a standard tool for clinician. The advances of the ultrasonic diagnostic apparatus and techniques is also evident. In this paper the investigations were carried out by combinating method of ultrasonic diagnosis with hepatoscintigram. The excellent point of this method is to improve the weak points each other of the hepatoscintigram and ultrasonic diagnosis. By means of hepatoscintigram every large space occupying lesion (more than 2-3cm in diameter) in liver can be seen but the depth and structure of the lesion can not be recognized, however the ultrasonic A-scope method is able to clarify the laters. Ultrasonic method is able to diagnose the character of the aimed occupying lesion, respectively. Generally, the continuous multiplying echo indicate the cancer tissue, the boundary wall echo is the cyst or abscess, and the gall stone is easily diagnosed at the same time. But the risk for over diagnosis is respective in two methods, the diagnosis by this combinating method must be carefull in considerations. Combinating method of ultrasonic A-scope with hepatoscintigram gave a good result for liver disease. But the nature of the echoes obtained various kind of livers tend to over-lap. Therefore it is difficult to remark the distinguished accuracy in all cases. The suitable frequency was 2.25MC and a barium titanate of 10mm in diameter was used. Now we are using the ultrasonic contact compound scope, Aloka SSD-10. In this paper some results and problems of this method were presented. The examination is carried out at the lower right chest wall or through the abdominal wall. Several normal human livers were examined first. Some echograms of them were shown. Details of the deep structure are shown when STC (Sensitivity Time Control) is on. But concerning intrahepatic structure, it demonstrates more clearly than when STC off. Some echo patterns of the metastatic liver cancers were shown. A patient who had alarge tumor at his upper right abdomen was examined. His echogram of liver is shown. There is a large tumor (4cm in diameter) at the deep region in liver and the back surface of liver is pressured backwards. But no malignant echo pattern is seen. In some cases of our examinations malignant tissues showed only the surface and bottom echoes. The result of operation actually showed the metastatic cancer of liver, corresponding with the echogram. This fact suggests there are various degrees of absorption of ultrasound among cancers.
90Y is a high-energy radioisotope and emite β-ray with 2.6 days half life. 90YCl3 colloid has been used for malignant tumor therapeutically, as 198Au colloid. In the present experiment, the purification of 90Y, and the detection of the contaminated 90Sr was studied. Amberlite XE-100 column was suitable for this prupose. The colloidal size of 90YCl3 was transformed by pH, and the features of 90YCl3 colloids were observed on electrone microscope. 1) 90Y and 90Sr mixture adsorbed on Amberlite XE-100 column (100-200 mesh, 2.5 column volume), and eluted by 0.5N HCl. 90Sr is eluted out at 10-60ml, and 90Y is eluted out from 170ml. 2) A mixture of 20mC of citrate-90Y complex and 1μC of 90Sr fixed on this column, and then eluted by 0.5N HCl. One drop of eluate at 10ml was detectable by GM counter. The detectable lower limit of contaminated 90Sr is 0.1μC by re-counting on GM counter 24hrs after the elution. 3) Amberlite XE-100 column is suitable for the second column on the milking system, for the purpose of separating the contaminated 90Sr and 90Y. This procedure is complete in 1hr process. 4) 90YCl3 colloid is aggregated and formed clamp in high pH solution, Electrone microscopic observations showed that the colloidal size was 40-50mμ at pH 5, and 20mμ at pH 7.
It is an expectation on radiocolloid therapy from the standpoint of prevention of side efects, that the administered radiocolloid is not removing in blood stream or in some organs. Old 90YCl3 colloid at pH 7.0 (20mμ diameter) and new type of a mixture of YCl3 and 90YCl3 colloid at pH 7.0 (3-15μ diameter) were administered into peritoneal cavity of mice and rabbits. The distributions of administered 90Y in serum and organs were compared. Also, these two colloids were examined by intralymphatic administration for clinical use, and the distributions were observed in serum and the excretion of urine. 1) 90Y in peripheral blood by peritoneal administration of mice were higher in old 90YCl3 colloid than that of new type of YCl3 and 90YCl3 mixture. The c. p. m. in peripheral blood were generally decreased by addition of YCl3. Minimum distribution in peripheral blood was obtained by addition of 1mg/ml of YCl3. 2) The same results were obtained from rabbit experiment. Old 90YCl3 colloid was 2 times of c. p. m. than that of new type mixture colloid at 7th day. 90Y excretion in urine of old 90Y colloid was 51 times than that of new type colloid after 3 hrs colloid administration. The distributions of old 90YCl3 colloid were spleen, kidney, liver, marrow, lung, heart muscle, and thigh, in the orders, 7 days after administration, and that of new type colloid were spleen, liver, marrow, lung, kidney, heart muscle, and thigh. 90Yc. p. m. of old colloid was 4 times than that of new colloid in kidney, heart muscle and thigh. New colloid was 5 times than old colloid in spleen, liver, marrow and lung. 3) 90Yc. p. m. in peripheral blood of intralymphatic administration was observed in both colloid, below 1% excretion in urine of administered dose after 3 days. In clinical use, one case was visible reduction of metastatic lymphnode, but clinical effects were not clear, for control patients were end stadium of malignant tumor.
It is a complicating and also urgent problem to educate and rehabilitate the speech handicapped, esp. school-children. And now a trend to teach such handicapped children as a group is increasing in Japan. In May, 1968, two classes for speech correction were established at Izushi Primary School, Okayama City. They consisted of two teachers specially educated and sixteen children with various speech disorders.
A clinical name of “Borderline Case” is generally used for such a case which is very difficult to diagnose as schizophrenia or neurosis. It is inevitable that the various cases with different genesis and symptomatology are classified in the borderline case, as the concept and the diagnostic standpoint of schizophrenia or neurosis are not uniform. Although there are many papers on the psychodynamic structure of the borderline case, the clinical pictures of this case are not the same. The author feels that the further clinical observation and the classification are also necessary as well as the psychodynamics of the borderline case. 17 cases are observed and classified into 3 types, who had been the in-patient during two years, from Jan. 1961 to Jan. 1963, at the Dep. of Neuro-Psychiatry, Okayama University Hospital. 1. Pseudoneurotic Type Various neurotic symptoms such as anxiety, phobia, obsession and neurasthenic symptom are flourish. Thought disorder or the superficial emotional contact are prominent in most cases, but autism, the primary schizophrenic disorder is not remarkable in some of these cases, although Hoch, P. insisted that pseudoneurotic schizophrenia is not the borderline case, but a sub-type of schizophrenia. 2. Type of Character Deviation Symptoms are vague and transient, and the disorders of the social life due to the various abnormal behavior and the distortion of the inter-personal relationship are characteristic. Severe disorder of the personality which is difficult to differentiate from psychopath or simple schizophrenia is cardinal in this type. 3. Mono-symptomatic Type Delusional interpretation about his shape, expression or smell persists for a long period. The appearance of the symptom is closely related with the special situation, the presence of other peoples, and the disorder of the personality is minimum. In these cases, the neurotic picture is more evident than in the other types.
The particles of measles and distemper viruses have been examined in the electron microscope and the technique of negative staining was used. The diameter of virus particles varies from 120mμ to 600mμ and the structures of the viruses are very similar for each other. The particles have an internal herical component about 18-20mμ diameter, enclosed in the outer membranes with the spikes. The virus particles are pleomorphic.
Morphology and movement of splenic reticulum cells of the normal adult mouse were observed in the growth zone of tissue culture by phase contrast microscopy and 16 mm microcinematography. 1) For the vital observation of these cells, rectangular cover slip method proved satisfactory. 2) In tissue culture of normal mouse spleen, lymphocytes appeared initially untill 24 hours, follwed by some types of reticulum cells which increased after 24 to 48 hours of culture, and finally fibroblasts increased in the growth zone. 3) According to the morphology, function and degree of maturation, these reticulum cells could be classified into three groups; I, IIa, IIb, IIIa and IIIb. There were intermediate types between these cells and type I reticulum cells matured into type II and III reticulum cells. 4) Type IIa reticulum cells possessed multiple pseudopods and showed active migratory movement, their nucleus locating in the forwarding part of the cytoplasm.
Janus green B and neutral red were used for vital staining of mouse splenic reticulum cells that have been described in the chapter I and phagocytic activities were observed by carbon particle feeding. 1) With my estabished method, observation of vital staining of splenic reticulum cells were possible under condition avoiding deletrious effects of stain after various time intervals of culture. 2) Each type of reticulum cells which were classified in the chapter I was characteristically separated by vital staining method. i) Neutral red granules and vacuoles increased in size and number. On the other hand, janus green B granules decreased and/or vanished, in the stage of I, II and III type of reticulum cells. These findings showed that type I reticuum cells matured into type II and then type III reticulum cells in this order. ii) In the cytoplasm of type III reticulum cells, markedly enlarged red vaculoes and phagocytized stainable materials were observed. 3) Some of the neutral red stainable materials were vaculoes induced by toxic effects of neutral red and janus green B stain. 4) Reticulum cells cultured over 120 hours were stained immediately and faded sooner, in contrast to reticulum cells in the relatively early stage. This phenomenon was thought to be related to the declining function of the cell. 5) By addition of carbon particles to medium, most of type I and II reticulum cells showed little phagocytic ability, but type III reticulum cells manifested active phagocytosis so that their cytoplasm was filled with carbon particles. That was considered to be specific function to type III reticulum cells.
1) Fluorochrominized tissue culture of spleen was established by the similar method used for bone marrow culture devised in our clinic. And vital observation of splenic reticulum cells was done by fluorochrominized tissue culture method by the use of rectangular cover slip method which has been mentioned in the chapter I. 2) Each type of reticulum cells showed characteristic fluorochrominized findings when stained with acridine orange. Granules and vaculoles stained with acridine orange showed nearly similar findings to neutral red granules and vacuoles as described in the chapter II. 3) By this method the existence of transitional forms between each type of reticulum cells and maturation process were confirmed in the series of types I, II and III reticulum cells, as have been already described by other methods in the chapter I and II. 4) Part of acridine orange stainable vacuoles were thought to be secondary to toxic effects of acridine orange stain. 5) Changes of fluorochrominized granules and vacuoles were observed successively in the degenaration of type III reticulum cells.
It is well established that there are two types of lymphocytes. One of these is rapidly dividing and short-lived. The thymic lymphocytes and germinal-center cells of the lymphatic tissues belong to this type. The other is produced at a slow rate and has a long life span. With respect to the incorporation of 3H-thymidine into DNA, the former type is characterized by weak labeling autoradiographically, in contrast to intense labeling in the latter type. Experiments in mice have demonstrated that the lymphocytes of the thymus are capable of synthesizing DNA-thymine endogeneously from deoxycytidine which is circulating in a considerable amount and hence to be weakly labeled with injected 3H-thymidine. In contrast, the majority of lymphocytes of the lymph nodes were found to be incapable of synthesizing DNA-thymine endogeneously from deoxycytidine and hence to be intensely labeled with injected 3H-thymidine. When the pathway of synthesis of DNA-thymine endogeneously from deoxycytidine was blocked by the administration of 5-fluoro-2'-deoxycytidine, the labeling intensity of the lymphocytes of the thymus with 3H-thymidine was greatly increased. Experiments in vitro with or without adding cold deoxycytidine to the medium provided further evidence for the utilization of deoxycytidine for the synthesis of DNA-thymine in the lymphocytes of the thymus.
The difference of the effect of cornins extracted from various kinds of living tissues was examined by employing several cell lines in vitro. And the inhibitory effect on tumor growth of the cornins was tested on the mice transplanted with Ehrlich ascites carcinoma. The results are as follows: 1) The antimitotic effect of canine intestine cornin (CIC) was more effective on Ehrlich ascites carcinoma cells in vitro (JTC-11) than that of bovine intestine cornin (BIC) and that of porcine intestine cornin (PIC). 2) Dialysable fraction, undialysable fraction and crude of CIC showed similar activities on the JTC-11 cell line. 3) The antigenicity of CIC was not proved by the hemagglutination test and no mice injected intraperitoneally with large doses of CIC showed any intoxication and disturbance. 4) The inhibitory effect of CIC on tumor growth was the strongest in the three kinds of the intestine cornins with Ehrlich ascites carcinoma and some of tumor-bearing mice were cured completly by the intraperitoneal injections of CIC. 5) The cornin extracted from liver of normal rats (RLC) had marked inhibitory effect on the cell growth of the short-term cultured cell line (RLM-1) and the long-term cultured cell line (RLN-10) originated from normal rat liver, but no effect was observed on the cell line in culture which came from the DAB ascites hepatoma of the same line rat.
At the beginning of the 20th century, the cytoplasmic bodies which appear in the lymphoid tissues of mammals had received much attention of haematologists, in the relation to the origin of the blood platelets. However, since Wright described and figured in 1910 the process of cytoplasmic budding of megakaryocytes by the use of his own technics, the biological significance of the cytoplasmic bodies in the lymphoid tissues has been ignored until now. Recent works on the formation of antibodies in the lymphoid tissue seem to suggest, on the other hand, that these bodies would play an important role in the immune response. Consequently, we attended a renewed study of these bodies. In this paper we described the results of histochemical observations on these bodies in the mesenteric lymph node and thymus of adult mice. The chief findings are as follows: 1. Cytoplasmic bodies are found in large number in the mesenteric lymph node of adult mice. They also occur in the thymus, though in much smaller numbers. 2. Cytoplasmic bodies in the thymo lymphatic tissues vary greatly in size, from the size of blood platelets to that of small lymphocytes, and are commonly round in shape. They often contain pyroninophilic granules. 3. Staining of these bodies with methyl green-pyronin and acridine orange revealed that they contain abundant RNA. However, no evidence was obtained for the presence of DNA in these bodies. 4. After digestion of the samples with RNase, the pyroninophilia of these bodies disappeared completely. This suggests that the pyroninophilic granules of these bodies might be regarded as ribosomes.
187 cases of glomerulonephritis hospitalized in the 2nd Department of Internal Medicine, Okayama University Medical School in the period from 1953 to 1965 were statistically analysed with respect to pathogenetic and etiological aspects. 1) In acute glomerulonephritis 17.6% of patients showed progression to the chronic state. Subacute glomerulonephritis amounded to 8% of all the cases and occurred at the rate of one patient per year. 2) Acute glomerulonephritis was observed more frequently among young people and 83.3% of the affected were under 34 years of age. The prognosis tended to be better as the patient age became younger. 3) Many cases of acute glomerulonephritis which was preceded by obvious infection occurred in winter. 4) The occupation of patients had no relation to the occurrence of glomerulonephritis. 5) Glomerulonephritis which had no subjective complaints and was found accidentally by physical examination was either mild nephritis or latent type of chronic glomerulonephritis. In order to prevent progression to a chronic form, it is most important to detect the early stage of glomerulonephritis by frequent urinalysis. The prognosis of patients whose initial symptoms included headache was poor. 6) In 34.8% of total cases an upper respiratory infection was considered to have played a trigger. 7) The prognosis of glomerulonephritis which had a clear-cut previous infection tented to be good. But in acute glomerulonephritis without known previous infections the curability was higher than in other types. 8) The prognosis of infant glomerulonephritis was almost equal to that of adult one. Those who had a history of infant glomerulonephritis were more liable to suffer from glomerulonephritis in adults.
The prognosis of glomerulonephritis was evaluated from the laboratory data and therapeutic effect of 178 cases of glomerulonephritis hospitalized in the 2nd Department of Internal Medicine Okayama University Medical School in the period from 1953 to 1965. 1) In chronic glomerulonephritis except the nephrotic type, the degree of proteinuria was strongly related with prognosis. 2) In glomerulonephritis except the initial stage of acute glomeluronephritis, hypertention with little response to therapy was a sign of poor prognosis. 3) In the late stage of glomerulonephritis, hyperchromic anemia was often observed. 4) In the late stage of glomerulonephritis, B. S. G. was closely related with prognosis. In the nephrotic type, serum cholesterol was characteristically increased. 5) The youngest patients with retinopathia alubuminurica was 19 years old. Those showing funduscopic abnormalities died from 1 to 7 months with an average of 3 months since the occular diagnosis was noted. 6) In the long range prognosis not much of the therapeutic effects of ACTH and steroid hormones was obtained. 7) Tonsillectomy did not appear to affect the prognosis of glomerulonephritis. 8) The intervals from onset to death ranged from 1 month to 35 years with an average of 5 years survival rate was 76.2% for all the cases and 84.8% for patients with chronic glomerulonephritis. 9) The life span of patients with glomerulonephritis does not seem to be significantly prolonged by the internal measures currently employed.
The authors succeeded in isolating and purifying cardiolipin that we found in Escherichia coli and checked the chemical properties. Furthermore, with this E. coli cardiolipin a study was carried out its reactivity in VDRL slide microflocculation test and the following results was obtained. 1. The purity of cardiolipin prepared from E. coli has been found to be satisfactory by its various chemical analyses. 2. The composition of fatty acids of E. coli cardiolipin differed considerably from that of beef heart cardiolipin in the point that unsaturated fatty acids occupied only about 50% in the former, while the later contained 94% of unsaturated fatty acids. Therefore, in the preparation of antigen, EtOH containing 10% tetrahydrofuran was used as E. coli cardiolipin did not dissolve completely in EtOH. 3. The antigen prepared with E. coli cardiolipin gave almost the same reactivity to the commercial antigen for the syphilitic sera in the VDRL test (both in the qualitative and quantitative test). This antigen gave negative results against the normal sera with the exception of one case. Furthermore, this antigen gave positive reactivity on a liquor of syphilitic patient in VDRL test.
In order to clearfy the mechanism of intrahepatic shunt formation occurred in chronic hepatitis, precirrhotic stage and cirrhosis of the liver, a study was undertaken to compare ratio of the area of connective tissue to that of parenchym measured on liver specimens with wedged hepatic venous pressure and effective hepatic blood flow obtained by means of hepatic venous catheterization, peritoneoscopical findings of the liver, liver function tests, plasma disappearance rate of Indocyanine Green, and liver accumulation coefficient of radioactive gold colloid. 1) Ratios of the area of connective tissue to that of parenchym measured on liver biopsy specimens were 0.38-9.8% (mean: 3.5%) in chronic hepatitis, 1.1-13.1% (mean: 7.3%) in precirrhotic stage and 1.7-24.8% (mean: 13.2%) in cirrhosis of the liver. The ratio increased in the transforming process from chronic hepatitis to the cirrhotic stage of the liver. 2) Ratio of the area of connective tissue to that of parenchym was correlated to the each factor of hemodynamics such as excretion rate of galactose, wedged hepatic venous pressure, effective hepatic blood flow, plasma disappearance rate of Indocyanine Green (KICG), and liver accumulation coefficient of radioactive gold colloid (KAu198). There was a significant relationship between an increase in the ratio of the area of connective tissue to that of parenchym and the intrahepatic shunt formation. The ratio was also correlated to liver function tests such as serum total bilirubin value, ZnTT, CCF, BSP, and γ-Globulin value. 3) In the cases showed the findings of smooth liver surface and no nodular or scar building peritoneoscopically and no increase of connective tissue histologically, intrahepatic shunt flow was recognized in only 2 out of 15 cases which showed the intrasplenic pressure below 250 mm H2O, in 4 out of 6 cases which showed that above 250 mm H2O, and in 3 out of 4 cases which showed that above 300 mm H2O. 4) There was a significant relationship between plasma disappearance rate of Indocyanine Green (KICG) and the excretion rate of galactose or the effective hepatic blood flow, while liver accumulation coefficient of radioactive gold colloid (AAu198) was correlated to the excretion rate of galactose only. It was considerable that plasma disappearance rate of Indocyanine Green (KICG) represented the excretion rate of galactose and the effective hepatic blood flow more sharply than liver accumulation coefficient of radioactive gold colloid (KAu198).
Using the technic of column chromatography, free and conjugated forms of BSP in serum were separated and studied on thirty-five cases of various liver diseases. Following results were obtained. 1) As a cause of BSP retention in patients with chronic hepatitis and cirrhosis of the liver, it is due to the defects in hepatic uptake or conjugation or both. 2) In case of obstructive jaundice, the conjugation of BSP is relatively intact, however, the secretory mechanism or excretory pathway for BSP is impaired. 3) Patients with Dubin-Johnson's syndrome, increasing of BSP retention fourty-five minutes after intravenous administration and conjugated form of BSP in serum were recognized. As a result, it is reconfirmed that BSP retention in this syndrome is due to the regurgitation of conjugated BSP via microvilli to the blood. 4) In two cases of Rotor's disease, BSP retention was considerably in high degree, however, increasing of BSP retention fourty-five minutes after intravenous administration could not be observed and conjugated BSP was only 1.0 to 1.2% in serum. Also, plasma disappearance rate of Indocyanine green (KICG) was remarkably low. With these findings, it is still difficult to explain or conclude the excretory mechanism of BSP in this disease at present. 5) It is estimated as significant and helpful for clinical diagnosis as an aid to differentiate the dysfunction of liver parenchymal cell and obstructive jaundice by studying both percentage retention of BSP and ratio of free and conjugated BSP.
Screening tests for acatalasemic gene carriers were carried out in Formosa during the year of 1966. Fifty-nine hypocatalasemias were found out among 20, 439 racial Chinese, and only one hypocatalasemic individual was detected among 1, 350 Formosan aboriginals. Then, the incidence of hypocatalasemia in Formosa was 0.29% among Chinese and 0.07% among aborigines.