The frozen shoulder or painful stiff shoulder is called as“Gojukata” (Shoulder of fifty years old) in Japan.
This report discusses on the arthrogram-findings of seventy-seven shoulders of seventy cases, which were diagnosed as“Gojukata”in our clinic for past four years. Ages of these cases are ranging from over forty years to seventy-four years of ages, of those males are thirty-seven, females are thirty-three and right shoulder thirty-six, left forty-one.
The posterior approch was employed for arthrogram at first, and anterior recently, and as the dye, seventy-six per cent Urografin and one per cent Hostacain at ratio of 1 to 2 was administered. The capacity of the shoulder joint in Japanese varied normally 12-15 cc.
Arthrograms are classified as following types.
A. Normal types.………………………48 joints
B. Pathologic types.…………………29 joints
1. Leakage at supraspinatus area of rotator cuff.………………9
2. Leakage at inf raspinatus area of rotator cuff.………………1
3. Leakage at subscapular area of rotator cuff.…………………1
4. Decrease of axillary fold.…………………20
5. Abnormal findings of intertuberal groove. (Leakage, defect and irregularity) .………………8
6. Miscellaneous (failure or decrease of contrast dye in subscapular bursa) ………………4

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The metastatic growths in the ovaries were studied using 361 autopsy cases of carcinoma (except the primary ovarian carcinoma) . The results obtained were as follows.
1) The so-called Krukenberg tumor was defined conveniently as the grossly bulky ovarian tumor with apparent metastasis (metastatic ovarian tumor), irrespective of colloid differentiation. That is, the Krukenkerg tumor is used in a broad sense. Judging from the mode of spread and its biological behavior, the term“metastatic ovarian tumor”should be preferable to the Krukenberg tumor.
2) The Krukenberg tumors were observed in 75 cases (20.7 %) of the 361 female autopsy cases of carcinoma. In 53 cases (36.1 %) of the grossly normal 147 ovaries, microscopic metastases were observed. A number of microscopic metastasis in the ovaries were unilateral, although most of the Krukenberg tumors were bilateral. In cases of unilateral metastasis, metastatic foci were frequently observed in right ovaries both in cases of macroscopic and microscopic metastasis.
3) The Krukenberg tumors were observed in 54 cases (36.7 %) of 147 cases of gastric cancer. Furthermore, microscopic foci in the ovary were revealed in 22 cases (47.8 %) among 46 cases of gastric carcinoma which showed no macroscopic metastasis in the ovaries. In 54 cases (72.0 %) of the 75 cases of Krukenberg tumor, conversely, the primary sites were stomach. So it may well be said that the gastric carcinoma is liable to metastasize in the ovary.
4) Histological features of the stomach which spreads to the ovary, were mostly scirrhous carcinoma or carcinoma simplex. In most of cases (ca. 90 cancer cell infiltration into the gastric serosa and dissemination into the Douglas' cul-de-sac were observed.
5) The Krukenberg tumors occur from 16 to 82 years old (average, 44.7 years old) . The average age of the Krukenberg tumor in cases of the gastric cancer was 41.7 years old and that of the other cancers was 52.4 years old. There was 10 years gap between them. The three fourths of the Krukenberg tumors were found before the climacterium. These findings suggest that there are some important relationship between the tumor metastasis in the ovary and the function of the ovary.
6) It has been said that ovarian hormone has some tendency to promote the growth of the cancer, especially that of the breast cancer. It is possible that the cancer metastasized in the ovary may spread to other organs and tissues more widely. Oophorectomy should be done actively in the female cancer cases before the climacterium.
7) The ovary with metastases are apt to fall into the gelatinous degeneration more frequently and intensely than the primary lesion.
The milieu interieur of the ovary seems to give some influences to the cancer cells in the ovary.
8) About the mode of spread, dissemination seems to be the most commonest metastatic path-way to the ovary as far as the primary lesion is concernd in the intraperitoneal organs. In most of 40 cases of microscopic metastasis in the ovary (primary intraperitoneal cancers including gastric cancer), cancer cell infiltration, invasion and adherence to the ovarian surface were observed like mashroom or mooth.
In other cases, cancer cell infiltration was only limited in the stroma just beneath the surface of the ovary.
These findings strongly suggest that almost all of the Krukenberg tumors of the primary intraperitoneal cancers are formed by dissemination from the primary lesion.

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[in Japanese]

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Effects of AOAA on free amino acids in rat brain and glutamate-oxaloacetate transaminase (GOT) activities in rabbit muscle were investigated. The following results were obtained.
1) γ-aminobutyric acid (GABA) level in rat brain was increased following the intraperitoneal administration of 20-60 mg/kg of AOAA. Namely, it showed about 3 times as much as control level 1 hour after the administration. Then gradually it decreased with the time elapsed. However, even 48 hours after the administration it showed about 1.5 times as much as the control level.
Except GABA, free amino acids in rat brain, such as glutamic acid, aspartic acid, glutamine were induced marked reductions in contrast with the elevation of GABA level.
2) AOAA and hydroxylamine inhibited GOT activity in rabbit skeletal muscle. AOAA showed more potent inhibition than hydroxylamine to the GOT activity. PI50 at the final concentration of AOAA and hydroxylamine were 1.6×10^-5 M and 8.0×10^-4 M respectively.
Against L-aspartate, one of the substrates of GOT, both of the compounds showed competitive inhibition to GOT activity, but against α-ketoglutarate, another substrate of GOT, both of them showed mixed type inhibition.

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The several action of extract from“INUTADA”was investigated pharmacologically and the following observations were noticed;
1. The earthworms (Eisenia foetida) and the round worm (Ascaris Lumbricoides) aoaked in to the liquid of the extract showed remarkablly vigorous movements at the beging and then they died following complate paralysis of their movement.
2. Furthermore, the extract showed hypotensive effect kymographically in the rabbit's blood pressure at the dosage of 24 mg/kg and the depressant action on the isolated frog's heart, the isolated intestine and the uterus of rabbits.
3. The above effects of extract may be attributed to the direct paralysis of the muscles.

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A 27-year-old male, with chief complaints of lumbago and hemoglobinuria, was admitted to our hospital on Feb. 28th, 1966.
His peripheral blood showed no abnomalities except a slight leucopenia. Appearent half survival time of erythrocytes, determined by Cr⁵¹-method, shortened to 10.5 days.
The osmotic resistence of erythrocytes, before and after incubation at 37°C for 24 hours, was within normal range.
Ham's, Crosby's, and Hegglin's tests were all positive.
On the other hand, Wassermann's Donath-Landsteiner's, Coomb's (direct and indirect) and Rosenbach's tests were all negative.
From these clinical and laboratory examination, he was diagnosed as a typical case of paroxysmal nocturnal heamoglobinuria.

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