Studies of the causes of bronchial asthma always point to the common charactaristic of air way hypersensitivity.
In order to test the effectiveness of Sch 1000 in reducing air way hypersensitivity in the patients, three groups of asthmatics and nonasthmatics were divided up for clinical treatment in the following way.
One group was administered only Sch 1000 as cholinergic blocker, second group was administered acetylcholine only, and third group was administered acetylcholine after Sch 1000 inhalated.
The results were as follows :
1) Among both asthmatics and nonasthmatics in the group which inhalated only Sch 1000, cyclic AMP levels rose considerably after inhalation, however the ammount of increase was higher among nonasthmatics cyclic GMP levels were decreased in nonasthmatics with Sch 1000 inhalation. The lung function was improved in asthmatics. There were no significant differences in pulse and blood eosinophils before and after inhalation among both asthmatics and nonasthmatics.
2) In the group which inhalated acetylcholine only, cyclic AMP and cyclic GMP levels were much increased and lung function grew worse in asthmatics.
3) In the group which inhalated acetylcholine after Sch 1000 was administered, cyclic GMP levels didn't increase due to the suppression effect of Sch 1000 inhalated. Lung function tests showed no significant changes, thus indicating the beneficial effect of Sch 1000.
4) These preliminary tests indicate that the etiology of air way hypersensitivity in asthmatics is derived from not only β-blockade but also cholinergic hypersensitivity, and cyclic nucleotides are closly related with the causes of the hypersensitivity.

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Forty-four patients, including 15 astmatics (5 atopic, 5 infectious and 5 mixed type), 13 lung cancer, 4 chronic bronchitis, 4 other pulmonary diseases and 8 non-pulmonary diseoses, were performed transtracheal bronchial mucosal biopsy.
The specimens were observed to distinguish the histological abnormality between asthmatics and non-asthmatics by using light-microscopical and immunopathological procedures.
By light-microscopy, 14 cases of asthmatics showed the thickening of mucous basement membrane (MBM) and infiltration of eosinophils in submucosal area and within or on the mucous lining cell, accompanied with submucosal edema, The pulmonary diseases other than bronchial asthma showed only infiltration of polymorphonuclear leucocytes in submucosal area.
By immunofluorescence, IgA and IgG deposits along MBM were observed in homogeneous pattern in many cases of atopic or mixed type asthmatics and chronic bronchitis. However, they were not found in the cases of infectious type asthmatics, and other pulmonary or non-pulmonary diseaes. IgE was found in three cases of the atopic type. but never found in any other types. Fibrin deposits along MBM were occasionary found in infectious type of asthmatics and the patients with chronic bronchitis. An attack occured in only one case of atopic type during the biopsy, and this case revealed the deposition of all immunoglobulins, C₁q, C3 and fibrin.
In addition of the biopsy, serial-biopsy were performed on the mucosa were antigen (house dust) was dropped on the MBM to observe time-related histological changes. In asthmatics, IgG and IgA increased with time after the dropping, but not in non-asthmatics.
Thus, immunological findings of mucous tissue in a variety of diseases were studied. In asthmatics, IgA and IgG deposits were found along the MBM in the atopic and mixed type, but no immunoglobulins were found in the infectious type.
On the ther hand, IgA, IgG and fibrin deposits were discovered in majority of the cases with chronic bronchitis. Therefore, it is suggested that the deposition of IgA and/or fibrin in MBM resulted due to the chronicity of the illness or bacterial stimulation to the mucosa.

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Masugi Nephritis induced in rats was employed as experimental model to investigate the possible effects of rheumatoid factor on in-vivo antigen-antibody reactions. Rats injected simultaneously with rheumatoid arthritis serum or Hodgkin's serum (containing high titer of Rheumatoid factor) and rabbit nephrotoxic serum showed a three or four-fold increase with time compared with rats injected with nephrotoxic serum alone. Normal human serum had no effect on the proteinuria produced by a standard dose of nephrotoxic serum. IgM (presumably rheumatoid factor) in glomerular of rat injected the RF serum was detected by immunofluorescence along the glomerular basement membrane with the nephrotoxic serum and rat complement (C3 and C₁q) . Rheumatoid factor activity was also recovered by elution from glomeruli isolated from rat kidneys 48 hrs. after the injection of rheumatoid arthritis serum or Hodgkin's disease serum and nephrotoxic serum. Histological changes of kidneys of rat 48 hrs, after injection with rheumatoid arthritis serum (particularly malignant rheumatoid arthritis serum) and nephrotoxic serum showed cortical necrosis (4/6) and severe glomerular changes, compared with the other groups.
Thus, the deposition of RF in the glomeruli seemed to closely relates to chronicity and sererity of the Masugi nephritis.

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It is well known that majority of the cases with glomerulonephritis are mediated by immunological events. Among the various types of glomerulonephritis, Goodpasture syndrome is typical model which mimick with Masugi nephritis (antiglomerular basement membrean (GBM) disease) . Recent numerous studies of Masugi nephritis using electron microscopy gave us various informations. However precise mechanism of the glomerular injuries are still unknown. On this points of view, precise glomerular injury of Masugi nephritis was investigated by using immunofluorescence, peroxidase staining and electron microscopical immunoautoradiography. GBM antibody which was obtained from rabbits immunized with rat GBM was used for induction of the Masugi nephritis. Masugi nephritis was studied by light-microscopy and electron-microscopy. For the detection of anti-GBM antibody in the tissue specimen, procedures of the immunofluorescent and peroxidase staining and also electron microscopical immunoautoradiography were performed. These three techniques were compared from the points of sensitivity and identifying power of localization of the antibody.
By light-microscopy, glomeruli of rats received anti-GBM antibody showed accumulation of the polymorphonuclear leucocytes (PMN), hyalin thrombi and crescent formation. By electron-microscopy, the mild thickening of GBM, infiltration of PMN and platelet frequently seen in the glomeruli. By immunofluorescent study, rabbit IgG, rat C3 and rat C₁q were found along GBM in linear fashion. On the other hand, rat fibrin was occasionally found in the lumen of glomerular capillary. By peroxidase staining, the staining was seen in the both side of the glomerular capillary walls and the mesangial basement membrane.
By electron microscopycal immunoautoradiography, a number of the grains were found along GBM, but the precise localization of the grains were not clearified whether they were in the lamina rara interna, lamina densa, or lamina rara externa, because spur of the grains was fairly long. The grains were also found in the mesangial area, surface of the epithelial cells and endothelial cells. In addition of these glomerular findings, the grains were found in the tubular basement membrane and also lumen of the tubules.
These three immunological techniques, particularly electron microscopycal immunoautoradiography, seemed to be valuable methods for studying the mechanisms of the immunological glomerular injury.

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It was reported that tetraethylammonium (TEA) ion caused twitch in skeltal muscle and its mechanism was explained by the enhancement of transmitter release from nerve endings due to TEA action on it.
Whether such TEA action is observed in nerve terminals of smooth muscle was investigated by recording the inner pressure of isolated guinea pig bladder.
When bladder was immersed in TEA Krebs' solution in which Na ions were replaced by TEA ions, large rapidly developing phasic, gradual declining contraction was induced.
After treatment of bladder with atropine, initial phasic contraction disappeared and low amplitude sustained contraction remained, while contraction induced by acetylcholine was completely abolished by atropine.In the treatment of 10^-5 g/ml tetrodotoxin, TEA contraction still remained, rather augmented. After immersion of bladder in sucrose Krebs' solution in which Na ions were replaced by sucrose, TEA contraction unchanged and atropine abolished initial phasic contraction in smillar manner as normal TEA contraction.
On the other hand, when bladder was immersed in Ca free adding 1.3 mM EDTA solution or in CdCl₂ containing Krebs' solution, TEA and ACh contractions disappeared almost completely. In latter, abolishment of contraction was restored by cysteine.
Bladder contraction induced by direct stimulation or indirect stimulation also unchangec in Na lack medium, while these were abolished in Ca lack adding EDTA medium.
These dataes indicate that 1) TEA acting on bladder liberates transmitter from nerve endings and cause contraction as observed in skeltal muscle, 2) Tetrodotoxin did not influence on transmitter releasing like in motor nerve terminal, 3) Na ions did not influenced on either bladder contraction or release of transmitter from nerve endings, while lack of Ca strongly depressed bladder contraction.

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As one of the aims to clarify the mechanism of depression during animal hypnosis induced by inversion, the changes of flexor reflex during inversion were investigated in Rana pipiens.
Flexor reflex was induced by repetitive electric stimulation applied on the skin of lower extremities and was recorded electromyographically from anterior tibial muscle.
Flexor reflex was markedly inhibited by inversion. Such inhibition was not influenced by the grade of stimulus strength causing flexor reflex. The destruction of vestibular organ did not influence on inhibition of flexor reflex during inversion. Among of the transections in rostral end, medial and caudal end midbrain, the transection in caudal end abolished inhibition of flexor reflex during inversion.
These results indicate that the inhibitory center of flexor reflex during inversion is located in the caudal part of the midbrain in amphibians.

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Blood viscosity and hematocrit were measured on 113 newborn infants during the first 6 days of life including 3 cases of neonatal hyperviscosity syndrome. Viscosity examinations were carried out at 37°C with a Epprecht Viscometer Low-shear-100, Contravas Company.
Blood viscosity of normal term infants with late cord clamping was significantly higher at 2 hours of age than the cord blood (p<0.001), and then decreased gradually until 6 days of age when the value was still higher than that of the cord blood.
Viscosity of the infants born after cesarean section showed no increase at 2 and 4 days after birth compared with the cord blood, but the value at 6 days of age was significantly higher than that of the cord blood (p<0.05) .
Viscosity of normal term infants was higher than that of infants born after cesarean section, A F D low birth weight infants and S F D low birth weight infants (p<0.05), the difference was statistically significant. There was no significant difference between the latter 3 groups.
The relation between viscosity and hematocrit calculated the correlation coefficient to be more than 0.9 with hematcrit (p<0.001) . Therefore, it should be possible to use hematocrit instead of viscosity measurement for simple clinical purposes.
Three cases of neonatal hyperviscosity syndrome showed significantly high blood viscosity and hematocrit over 65 %. Viscosity and hematocrit decreased after partial exchange transfusion with clinical improvement.

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Recently, endoscopic retrograde cholangiopancreatography (ERCP) is a necessary examination in morphological diagnosis of bile and pancreas ducts systems. We have experienced 183 successful cases of ERCP from March, 1972 to September, 1976.
The endoscopic figure of papilla of vater and the regional reflection rates and diamater of bile and pancreas duct systems were investigated in relation with the diseases of the systems.
1) The characteristics of the endoscopic figure of the papilla of vater in cholelithiasis. Most of cholecystolithiasis group cases were hemispherical type and slit-like type and choledocholithiasis group cases were homiellipsoid type and slit-like type. Particularly plica longi-tudinalis duodeni was often elevated higherly in choledocholithiasis group.
2) The regional reflection rates of bileduct system by ERCP. In cholecystolitiasis group, the reflection rates of cystic duct and gall bladder were low, and in choledocholithiasis group, reflection rates were low in duodenal portion and its side along the liver.
The regional reflection rates of the pancreatic duct system, in benign group of pancreatic diseases, the reflection rates were generally lower except in the head part of pancreas in comparing to the control group. In cholelitiasis group, the reflection rate of the pancreatic duct was somewhat high.
3) Every part of common bile duct and head part of pancreatic duct were enlarged remarkably in choledocholithiasis (P<0.001) . In benign pancreatic disease group, head part of pancreatic duct was also enlarged obviously (P<0.05) .
4) In benign bile duct disease group, significant corrlation was recognized between the maximum diameter of the common bile duct and that of the pancreatic duct (P<0.001) . A positive correlation was also observed in cholecystolithiasis (P<0.02) and choledocholithiasis (P<0.05) .

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Serum level of monoamine oxidase (MAO) was determined in 92 patients with digestive diseases (gastric and duodenal ulcers, gastric cancer, colon cancer and hepato-bileduct disorder) . Significant change in serum MAO level was not observed in patients with these digestive diseases. Marked elevated serum MAO level was found in patients with early gastric cancer, while no change was observed in patients with scirrhous gastric cancer. No difference in serum MAO level was observed between in patients with advanced gastric cancer and with early gastric cancer. Marked elevated MAO level was observed in patients with scar stage of gastric and duodenal ulcers, while not found in patients with ulcer stage of them. No marked change in serum MAO level was observed between in patients with scar stage of gastric and duodenal ulcers and with ulcer stage of them. Serum MAO levels in patients with advanced cancer, early gastric cancer, gastric and duodenal ulcers, gallbladder disorder and colon cancer were determined from the period of preoperation to 14 days after operation and found no marked change in serum MAO level throughout these periods. Regression analysis demonstrated that serum MAO level was not correlated to serum GOT level, value of thymol turbidity test and number of platelet. From these results, it is suggesting that measurement of serum MAO level is not useful tools for the diagnosis of these digestive diseases.

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In these days of highly-spread medical care, it is comparatively rare to encounter giant ovarian cystoma. The authors have recently experienced three cases of pseudomuciloginous cystadenoma in patients of middle and advanced ages. The weights of tumor are from 6.2 to 13.6 kg and their abdominal cavities are filled with the adenoma. The authors take this opportunity to investigate the giant ovarian cystoma clinically.

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The effect of perfusion therapy of intractable ascites was investigated in the patients with liver cirrhosis and peritoneal carcinoma.
In this procedure the ascitic fluid was reinfused into the cubital vein after being filtrated through cellulose acetate hollow fiber and concentrated by polyacrylnitril hollow fiber. With this treatment, the improvement of symptoms and general conditions of the patients, the protection against the reaccumulation of ascites and the increase of the reactivity to diuretics were observed. This procedure was easily performed without any complainments. No severe side effects were seen.
From these results, this treatment seemed valuable as the practical therapy for ascites which was difficult to be contrabled.

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The patient, a 39-year-old man, was admitted on August 23, 1976, because of anemia and general fatigue. Peripheral blood examination revealed leukocytosis of 110, 600/cmm. with 86 per cent of peroxidase positive myeloblasts. A diagnosis of AML was made.
On the 10 th hospital day, he was clinically improved following the treatment with daunorubicin, methotrexate and prednisolone. On the 15 th hospital day, leukocyte count rose to 10, 000/cmm. with 35% myeloblasts and 12% promyelocytes. Platelet count decreased to 30, 000/ cmm.. Coagulation studies revealed marked decrease of fibrinogen (20mg/dl), increase of FDP (50μg/ml), prolongation of prothrombin time (15sec., 45%) and the extraordinary reduction of euglobulin lysis time (30min.) . Those were suggestive of the presence of disseminated intravascular coagulation. He was treated again with DCP without clinical responses. On the 25 th hospital day, he had a sudden onset of chest pain, fever and bloody expectoration. A chest film showed diffuse infiltration in the left lower field. An electrocardiogram disclosed no findings of pulmonary infarction. He was expired on September 17, 1976.
On postmortem examination, pulmonary embolus and thrombus adhering to tricuspid valve were found.
Pulmonary embolus might be originated from the thrombus adhering to tricuspid valve caused by disseminated intravascular coagulation.

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