We have experienced 64 Patients complicated with postoperative renal failure for last 14 years and there are only 12 survivers in 44 patients who are treated with the dialysis therapy.
Acute renal failure following any surgical procedure is a severe postoperative complication and a poor prognosis because of life threatening complications of renal failure including sepsis, gastrointestinal hemorrhage, congestive heart failure and others.
Twenty-nine (45%) out of 64 cases were seen in the choledoco-pancreatic surgery and almost of them were surgical hepatorenal syndrome.
Postoperative renal failure has occured highly in a case who has a preoperative renal dysfunction or in elderly patient, so in such a case it is important to have a consideration of possibility of renal failure in the postoperative management.
We should be made an effort to prevent of postoperative renal failure because of poor prognosis but once the renal failure is suspected in early postoperative stage, the messurement of urinary osmotic pressure is valuable to have an early diagnosis.

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To evaluate the myocardial protective effects of various cardioplegic infusates, 104 isolated working rat hearts were studied. Following normothermic (37 C) cardioplegic arrest (30 minutes) and hypothermic (21 C) cardioplegic arrest (60 minutes), the recovery course of cardiac function were observed.
At hypothermic condition, St. Thomas'Hospital solution (ST), glucose insulin potassium solution (GIK), lactate Ringer's potassium solution (LRK) showed significantly better restoration of aortic flow than modified Roe's solution. GK solution and Young's solution. ST added GIK solution exhibited the highest and most lasting functional recovery in mean values. On the other hand, simple external cooling, Kirsch's solution, and lactate Ringer's GK solution resulted in marked deterioration of cardiac function. At normothermic condition, ST was significantly superior than LRK. Groups of simple aortic occlusion, GIK and Young's solution followed by GIK could not recover after the reperfusion.
These results indicate that balanced electrolyte solution contained Mg ^_??_ (ST) may have a superior myocardial preservative action, insulin may present an inotropic effect following global ischemia at hypothermic condition, and excessively hypertonic solution (LRGK, Kirsch) may be damaging to the myocardium. It seems also that perfusion experiment of isolated working rat heart is very useful as a screening test of cardioplegic solutions, because the isolated heart has no extracoronary collateral flow and their net effect on myocardium can be clearly observed.

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Extracellural administration of adenosine triphosphate has been known as potent vasodilator and has been used for the treatment of hemorrhagic shock or intentional hypotensive anesthesia.
But the mechanism of its action on vascular smooth muscle has not been studied sufficiently yet.
On the isolated spiral-cut aortic strip of the rabbit, adenosine triphosphate showed inhihitory action on the phenylephrine dose-response curve of the strip dose-dependently.
The aortic strips, brought to the half-maximal contracted state by phenylephrine or histamine were relaxed by adenosine triphosphate as the same manner as lidocaine and quite different from those of phenoxybenzamine, diphenhydramine and isoproterenol.
These findings suggested that adenosine triphosphate may act as a non-specific vasodilator on the vascular smooth muscle.

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Generally speaking, in patients with bronchial asthma, high incidence of drug hypersensitivities has been reported.
Patients with bronchial asthma (188 males and 261 females) were investigated on drug hypersensitivities in contradistinction to healthy subjects (1978 males and 190 females) that belong to a company in Tokyo. The following results were obtained :
(1) Incidence of drug hypersensitivities in patients was significantly higher (26.1%) than healthy subjects (4.5 %) .
(2) In both groups, in females higher incidence of drug hypersensitivities was proved.
(3) Incidence in mixed type of bronchial asthma was higher than atopic or infectious type.
(4) Incidence of the drug induced asthma in patients was 6.7% (30/449) and incidence so called aspirin asthma was 3.3% (15/449) .
(5) Clinical manifestations and kinds of the drugs induced hypersensitivities were no significant differences between patients and healthy subjects.

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Pyrine allergy is one of the well-known drug hypersensitivities. But, Mechanisms of pyrine allergy are still not well understood. It is generally accepted that pyrines themselves were unable to be antigenecity, but they must combine irreversibly with carrier protein in order to gain antigenecity.
In this study, using pyrine metabolites and their protein complexes as antigen, RAST, leucolytic reaction, hemagglutination test, intracutaneous reaction and precipitation test were carried out to clarify pyrine allergy. The following results were obtained:
A few cases used pyrine metabolites and protein binding compexes as antigen showed positive in leucolytic reaction and intracutaneous reaction, though cases used pyrine (sulpyrine) itself as antigen showed negative.
It is paramount of importance to be metabolized and combine with carrier protein in order to develop pyrine allergy.

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The author studied on the existence of the allergic or bronchial asthmatic characteristics in the patients with so-called cardiac asthma, that is the patients with cardiovascular diseases accompanied with the paroxysms of dyspnea.
1) Among the 84 patients applied to our clinic for the so-called cardiac asthma, 24 were the patients with cardiovascular disease combined with bronchial asthma, and 20 were the patients with cardiovascular diseases who showed no paroxysmal dyspnea in the course of further observation.
Remaining 40 cases were considered to be cardiac asthma having paroxysmal dyspnea related to their cardiovascular diseases.
2) Among 40 patients with cardiac asthma, 34 had not bronchial asthma in their past histories. The average age at the onset was 64.5 years, and 38 (95%) were over 50 years of age at their onset.
3) The basal diseases of these 40 patients were hypertension in 44.4%, coronary disease in 23.8%, myocardial infarction in 17.5 %. Many patients with coronary disease accompaning symptoms of cardiac asthma were shown to have simultaneously hypertension.
4) Allergic histories were found in 40-50%, skin tests were positive in 60%, 17.5% of patients showed eosinophylia, rhonchi were Neared in patients of 72.5%. One and more of these symptoms were found to be positive in 92.5% of 40 patients.
5) Paroxysmal dypnea was found in all patients. This paroxysms occured at night in 67.5 % at rest in 62.5%. Many of typical cardiac asthmatic symptoms were found in most patients.
6) For the conclusion it was suggested that the patients with cardiovascular diseases accompanied with allergy or hypersensitivity of the bronchi were prone to have the symptoms of cardiac asthma.

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Human tendon was observed by scanning electron microscpy and the following conclusion was obtained.
1. Tendon surface presents wave structure and forms an arch and is arranged without adherence one another. At a higher magnification, it is oriented to a certain direction and a part of it is constituted from numberless collagen fibrils without direction.
2. Structure of the surface is different a little morphologically depending upon each tendon site. Comparsion of M. flexor digitorum profundus tendon and M. flexor digitorum superficialis tendon and tendon sheath at Noman's land shows rough structure and degenerated fibrils in collagen fibrils on surface of M. flexor digitoroum superficialis tendon of M. flexor digitorum profundus tendnon and the surface of M. flexor digitorum profundus tendon of M. flexor digitorum superficialis tendon.
In parietal layer of tendon sheath, arch meets at right angle with direction of tendon running. Extensor tendon presents flatter pictures than flexor tendon.
3. The vertical split surface of tendon is covered with endotendon, forming tendon bundles. The vertical split surface of the tendon bundle is composed of collagen fibrils runnig toward the long axis and lengthweise and crossweise fibrils connecting collagen fibrils.
4. At the muscle-tendon junction, tendon fibers and muscle fibers are running toward the direction of axis and muscle fibers and sarcolemma enter and connect into tendon fibers.
5. Tendon fibers running obliquely at the site of bone attachment go through periosteum, and enters into bone and branch finely and entangle with bone collagen fibrils in net state or without direction and transfer. Namely, fibrous connection of bone collagen fibrils and tendon fibers is supposed.
6. There is no formation of tendon bundle at the muscle tendon junction in transverse section of tendon, however, many areas which are considered to form tendon bundles are observed.
Formation of tendon bundles becomes apparent at the intermediate part and the tendon bundles are composed of collected bundle of numberless tendon fibers. The tendon bundle disappears again at the site of bone attachment and connects with bone fibers as each one of tendon fibers.
From above scanning electron microscopic observation, it is apparent that morphology of tendon surface has the structure effective for tendon lubrication by reducing friction surface and retention of synovialfluid as a lubrication and that tendon is the strong connective tissues which transmit contactile power of muscle to periphery.

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Four-week-old mice administered with anti-thymocyte serum (ATS) were infected ip. with five strains (less virulent Nakayama-NIH, moderately virulent G-1, Mie 44-1, JaGAr01 and highly virulent JaTH 160) of Japanese encephalitis virus and mortality, virus multiplication and antibody response were studied.
When 0.2 ml of ATS was injected into mice on 0, 3, and 7 day ip., number of leukocyte in circulating blood was markedly reduced during the first 24 hours and gradually recovered to the normal level by 12 days. Mortality of mice treated with ATS one day before, or one day before and three days after ip. infection with JaTH 160 or Nakayama-NIH strain showed no difference from that of infected mice without ATS treatment. However, apparent increase of mortality and shortening of average incubation period were observed in ATS-treated mice, when infected with Mie 44-1, G-1 and JaGArOl strains.
Time of appearance, duration and heights of viremia were apparently the same in mice infected with Mie 44-1 and JaTH 160 strain regardless of ATS-treatment. However, virus multiplication in brain was markedly enhanced by ATS treatment in mice infected with Mie 44-1. On the other hand, no change of viral growth in brain was observed in mice when infected with JaTH 160. Neutralizing antibody response following JE virus infection was found to be slightly retarded in ATS treated mice as compared with non-treated mice infected with either JaTH 160 or Mie 44-1,
The above findings suggest that cell mediated immunity may be involved in the host-defence against JE virus infection in mice, since ATS treatment mainly impairs T cell function in mice.

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In vitamin E deficient rats, the experiments were performed to test excretion of histidine, its derivatives and histidine dipeptide in urine and the histopathological changes were studied. Vitamin E deficient rats were produced by feeding of vitamin E deficient diet. The following results were obtained :
1) The excretion of histidine, 1-methylhistidine and 3-methylhistidine in the urine was decreased. The result obtained in this experiment was opposed to that in the case of rabbits.
2) Excretion of the metabolites in urine was increased by the subcutaneous injection of 20 mg/animal histidine and its dipeptides (anserine, ophidine or homocarnosine) . It seemed likely that the vitamin E deficiency in rats did not cause any abnormality in the metabolism of histidine and its dipeptides.
3) By histopathological studies, sphacelation of spermatid, spermatogonium and of spermatocyte in testis were observed, but no changes in liver, kidney and muscle were observed.
4) Excretion of histidine and its derivatives in vitamin E deficient rats was different from that in rabbits. One possibility to explain the different results in rats and rabbits could be attributed to the difference of animal muscles used for experiments.

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Feeding of male rats of Fischer strain for 24 weeks with 4-Dimethylaminoazobenzen-4'-Arsonic acid (DABAsO (OH) ₂) mixed in regullar basal diet and lower dose of Aflatoxin B₁ (AfB₁) soluted in olive oil, resulted in various degree of hyperplastic changes of common bile duct including dilatatolic changes, cholangiofibrosis, hepatocellular carcinoma and other changes of liver and atrophic changes of pancreas similar to chronic pancreatitis. The findings observed in liver were very similar to the changes induced by AfB₁. Whereas, the hyper-plastic changes of common bile duct and pancreatic changes are probably induced by AfB₁ supperimposed on DABAsO (OH) ₂, though there was no case acompanied with carcinoma of common bile duct.

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A 55 years old male suffered from persistent cough and sputa for two years. On the admission, creptations were audible on the both lungs and the breathing sounds were weak. Serum gammaglobulin was increased. On the chest X-ray film, many large and samll bulla were recognized at the both lung fields. The irregulation of the bronchial wall were revealed on the bronchography and the peripheral pooling were seen on the aleolarography. Antibody for the lung tissue and the the thyroid gland were negative.
This patient was examined on immunologically, thinking the autoimmune relationship between hypothyroidism and pulmonary multiple bullosis with hypergammaglobulinemia, but these finding detected no singnificance obvious evidence.

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Definite and classical rheumatoid arthritis from II to IV stage in our clinic in 1977 were examined by roentgenography.
Objects were 57 cases, male 6 and female 51, ranged from 21 to 67 years of age, and 110 knees were studied by roentgenography. We observed several roentgenological changes and obtained the following results :
1) In terms of the relationship between the history and the narrowing of joint space, it was clearly demonstrated that joint space narrows with time.
In R. A. cases with the history of less than 5 years, not the single case of remarkable narrowing was observed.
2) In terms of the relationship between the knee joint range of motion and the narrowing of the joint space, the joint space was normal in most cases which stretching was not limited, but none had normal joint space of cases in which limitation of 11 degree or more was recognized.
3) Bone atrophy was frequently recognized in the femoral condyle, tibial plateau, head of the fibula and medial facet of the patella.
Findings indicative of osteosclerosis and bone destruction were frequentry observed in the tibial plateau.

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