Ectopic pregnancy is not an uncommon ailment, but at times its abnormal development leads the condition into erroneous diagnosis, resulting in the delay of the proper treatment. The diagnosis of the case is not difficult if the condition of genital bleeding develops after a certain period of amenorrhea, or if there are typical symptoms such as stomach ache or shock symptoms. However, the rupture of ectopic pregnancy is one of the fatal ailments which results in acute intra-abdominal hemorrhage, and therefore its early diagnosis is most important. The medical examiners of Metropolitan Tokyo conducted administrative necropsies of 6 2 cases of sudden deaths due to the rupture of the ectopic pregnancy which had occurred in the past 16 years (1949-64) in Tokyo proper (23 wards) . A statistical study of these 62 cases has been compiled, taking into consideration of age, time until death, rupture section, period of pregnancy and rupture section, amount of intra-abdominal bleeding, marital or single status, occupation, and erroneous diagnosis, as follows : 1) Of the cases, 53.2 % were between the ages of 20-29. 2) Thirty-seven per cent died within 12 hours after subjective symptom of the rupture ; further, 90.8 % died within 24 hours. 3) Rupture had occurred in the isthmic part of tubal pregnancy in the ampulla, and in the interstitial part and infundibulum, 51.6 %, 29.0 % and 9.7 %, respectively. 4) The majority, 66.1 %, had bleeding due to intra-abdominal hemorrhage to the amount of 1500-2000 cc. The minimum amount of bleeding was 530 cc, the maximum 4000 cc. 5) Thirty-nine per cent of the women were unmarried. 6) As to the occupation of these women, 9 (14.5 %) were business women while 30 (46.8 %) were housewives. 7) Erroneous diagnosis was observed in 26 cases of 40 women who had consulted doctors. Of these, 6 cases were diagnosed as normal pregnancy and died from bleeding due to abortion. 8) When a matured female visits a doctor and complains of stomach pain, first of all one must think of rupture of the ectopic pregnancy. Even though she is not married, be wary. If she is not married, she may hesitate to disclose the fact that her menstration has stopped and may not want to admit pregnancy.
A histopathological study was performed on the 36 autopsy cases of myeloid leukemia (30 acute cases, 6 chronic ones) with aplastic bone marrow due to the administration of the so-called antileukemic agents (steroid hormone, 6 MP, Busulphan etc. ) . The following results were obtained. 1) The findings of the bone marrows are classified into 4 types; Type A : Bone marrow with severe desolation. 13 acute cases and 2 chronic ones. Type B : Bone marrow substituted by fat tissue. 7 acute cases and 2 chronic ones. Type C : Bone marrow with regeneration of normal hemopoiesis. 7 acute cases and 1 chronic one. Type D : Bone marrow with marked fibrosis. 3 acute cases and 1 chronic one. Their histogenesis is discussed briefly in each type. 2) Bone marrows of type B and C are much simillar to that of aplastic anemia and especially the marrow substituted by fat tissue is very much simillar to the so-called fundamental type of aplastic anemia, therefore the painstaking detection of the leukemic infiltration in the other organs and the remain of the leukemic cells in bone marrow is urgently needed for the sake of the differential diagnosis. Furthermore, it goes without saying that clinical course, blood pictures and marrow smears play an important role in making final diagnosis. 3) Except few cases, there are no histological differences in the different site of bone marrow. Even in such few cases, only slight discrepancy is noted about hemopoietic cell content among the various sites of bone marrow. 4) In 21 cases of 30 acute one and in 5 cases of 6 chronic ones, some rest of leukemic cells is discernible in the aplastic bone marrow induced by antileukemic agents. In those cases which show some rest of leukemic cells in bone marrow, the frequency of the leukemic infiltration to other organs is higher than that in the cases which show no leukemic infiltration in bone marrow. 5) Even in cases with leukemic infiltration to other organs, its degree is not so marked except testis. 6) Any apparent relationship can not be clarified between the kinds of antileukemic agents and its histopathological influence to bone marrow structure. 7) The average survival periods of acute 30 cases are 5.9 months. There seems to be some effect of lif e-extention by the antileukemic agents. In acute cases the average survival in each type is 8.1 months in type B, 6.8 months in Type C, 4.6 months in Type A and 3.3 months in Type D. But the decisive conclusion remains obscure and further studies on this problem are necessary.
A new method of the microbiological determination of galactose and lactose in the urine of newborn babies was projected by the use of galactose-se. var, and lactose-se. var., the Mutabile-type Var. Murase of enteric bacteria. Galactose or lactose itself was believed to be contained in the baby urine as the normal composition. For the determination of galactose, the urine was used directly. In the case of lactose, the urine was used after treating with Salm. typhi-murium for one night to ferment and to exclude galactose. Seedlayer of each galactose-se. and lactose-se. var. as well as the cups were prepared for determination. The urine was diluted in two-fold with distilled water. Each dilution was dispensed into a cup in a dose of 0.1 ml and incubated for one night. Diameter of the growth inhibition zone around the cup was measured by vernier on the following day. Concentration of galactose or lactose was calculated from the endpoint titre, by comparing with that of known controls. Influence upon the titre which might be derived directly from the urine was negligible. This procedure is very simple to run and does not require any special reagents or instruments. Sensitivity of the galactose-se. var. or lactose-se. var. was tested occasionally and the strains of constant sensitivity were used. The test can be completed ordinarily within 24 hours from the start. Two mcg of galactose and 16 mcg of lactose in 0.1 ml of the urine seem to be the minimum detectable concentration. The sensitivity of the detection of lactose can be enhanced up to 2 mcg in 0.1 ml by the so-called medium apply method of Fukutome et al. From the above experiments, it was found that in most cases the concentration of galactose in the urine lies between 40 mcg/m1-160 mcg/ml and lactose between 160 mcg/ml-3 20 mcg/ml. Galactose was positive in 51 of 52 cases and lactose in 52 of 52 cases. Therefore, these dose seemed to show the physiologic concentrations in the urine of newborn babies in Japan. In the authors experiments, urinary samples were collected only once per baby, but the percentage of sugar positive cases was much higher than that of European works performed by paperchromatographic technic.
The electrogram of the uterus and vagina of rats have been recorded by the implanted electrodes. The speculations have been done on the amplitude, number of spikes, length of train discharge and the interval of train discharge of the electrical activity under the administration of various hormones as well as in each phases of pregnancy, parturition and post partum rat's uterus. At estrogen dominated rat, train discharge tends to be formed, its amplitude being 0.5-1mV, whereas at progesterone dominaied and early stage in pregnancy, the action potentials appeared irregularly and sporadically, its amplitude being 0.1-0.5 mV. At estrogen-progesterone dominated, train discharge was formed and the amplitude increased slightly as estrogen dominated rat. At the middle stage of pregnancy, the action potentials have been grouped, amplitude being increased and train discharge became shorter. At parturition stage, the electrical activity was quite regular and the amplitude being sometimes 1-2 mV. Till 3 days post partum, one group of train discharges contained much number of spikes and the amplitude being 0.5-1.0 mV. Since 7 days post partum, number of spikes decreased and the amplitude became smaller. The electrical activity of the vaginal muscle, also has been changed under the influence of hormones like the uterine muscle does. But in the vaginal muscle burst formation of the spike discharge were poor. By the castration or the domination with hormones the water contents of the uterine muscle were remarkably changed, but the sodium contents of the muscle were decreased by castration and by the domination with estrogen it decreased further. Potassium comtents of the uterine muscle was also decreased by castration, but the estrogen dominated muscle restored its potassium content. The myometrium was more greatly influenced by these treatment than endometrium.
The electrical activity of rabbit uterus and vagina has been recorded by the small calomel or implanted platinum electrodes. Estrogen dominated uterus showed very active contractions and the configulation of action potentials were very spiky. The effective concentration of drugs were 50μU/kg in Oxytocin, 1μg/kg in Methergin and 0.5 mg/kg in Spatym. The corpus portion produced the maximum tension and the cervical portion showed repetitive contractions by the application of drugs but the activity was decreasedby progesteron. The pace-maker region of vagina has not been determined but usually contraction waves initiated at the cervical end and traveles down to the olificed end, but the visible contraction rings became strongest at the middle portion. The conduction velocity of the impulse was about 2.1-3.9 mm/sec at the cervical and 1.3-3.0 mm/sec at the middle portion. The action potential consists fast RQ waves which were superimposed by spike train and a slow T wave. Automatic contractions were easily evoked by distention of vaginal muscle. Usually the ovariectomized rabbit vagina did not contracts spontaneously, but when the inner pressure of vagina was increased to about 5-10 mmHg, the contraction was elicited frequently and the impulses were conducted down to the olifice. When the muscle was distended about 10-15 mmHg inner pressure, the train discharge were recorded and the initiation of automatic contraction became more frequently and more stronger. But when the pressure was increased to 20-30 mmHg, the muscle distended so strong that the muscle could not contracts, evenso the brief train of spike discharge could be observed. The rhythmic contractions were also observed from the isolated vaginal muscle and the activity of muscle was increased by drugs such as Methergin. When adrenaline was given -0.03 mg/kg- a conduction was blocked and asynchronized electrical activity was generated at different vaginal portion. The same action of acetylcholine was weaker than that of adrenaline. As uterine muscle, the activity of vaginal muscle was strongly controled by hormonal status.