Lysosomes are subcellular organelles containing various acid hydrolases and isolated from the surrounding cytoplasm by a single lipoprotein membranes. Hypoxia and acidosis are main factors known to increase the fragility of the lysosomal membrane. Splanchnic ischemia during circulatory shock provides the ideal circumstances for the activation and extra-lysosomal release of these enzymes.
Intracellular redistribution of hydrolases causes mitochondrial dysfunction in the reversible stage and cellular death in the terminal stage. Enzymes released extracellularly induce injury to tissues distant from their site of origin, and produce MDF and other vasoactive polypeptides through proteolysis. Leucocytes trapped in the pulmonary capillary beds in shock cause capillary damage and increase the permeability by the disruption of lysosomes.
Clinical and laboratory studies have demonstrated a salutary effect of steroids on shock state through the stabilization of lysosomal membrane. Aprotinin known as effective inhibitor of acid proteases is effective for the prevention and reversal of shock.
These results show that lysosomal acid hydrolases play an important role in the pathogenesis of refractory shock.

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Human plasma estrogens with breast cancer were mesured by radioimmunoassay and compared with normal.
Plasma were collected from 76 patients at luteal phase.
The plasma samples were applied to a column of Sephadex LH-20 following extraction with 15 ml ether. The column was washed and eluted with benzen methanol (85:15) and the dried elutes after being added tritiated assay steroids were incubated at room temperature for 20 minutes with the antiserum in a dilution of the borate buffer (pH 8.0) containing 0.06% BSA and 0.05% bovine gamma globulin.
The free steroids were removed by dextran-coated-charcoal and the tritium activities in the supernatant were counted.
Results :
1) Plasma estrogens (E₁, E₂, E₃, total estrogen) in 2-nd, 3-rd, 4-th decades and premenopausal of 5-th decades with breast cancer could not be differentiated from normal females.
2) Estrone, Estradiol and total estrogen in plasma of postmenopausal females passed within 5-years were higher than normal, but estriol could not be differentiated.
3) Plasma estrogens (E₁, E₂, E₃, total estrogen) in postmenopausal passed over 5-years could not be differentiated from normal.
4) Estriol ratio did not varied in both of patients with breast cancer and normal females.
5) In histological classification, there were no differences between patients of scirrhous carcinoma, medullary-tubullary ca, and papillary-tub ca.

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This report deals with an autopsy case of “INFECTIOUS MONONUCLEOSIS.” A 23-year old woman was admitted to the hospital, with complaints of slight fever, vomiting, abdominal pain and dyspnea. Soon after, high fever and cyanosis developed. After three days, she died of the respiratory disturbance. On section, there were marked enlargement of the general lymphoid tissues. Bronchitis and peribronchitis were remarkable. And hemorrhagic diathesis in wide spread organs such as lungs, bronchi, rectum, uterus, tonsils, heart and skin. Histologically, there was marked infiltration of atypical mononuclear cells in following organs- lymph nodes, tonsils, thymus gland, spleen, lungs, kidneys, liver, pharynx, stomach, small bowel, heart, salivary glands, adrenal glands, meninges and bone marrow. Their own structures were not destroyed by the mononuclear cell infiltration. In the liver, the mononuclear cells were seen in the Glisson's sheath, and liver cell necrosis was not recognized. The immediate cause of the death was the mononuclear cell infiltration to the lungs, followed by bronchitis and peribronchitis with hemorrage.

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There are numerous causes of respiratory difficulty in the newborn, but congenital lobar emphysema, a kind of pulmonary tension disorders, is rare.
The patient was a 2-month-old boy who exhibited respiratory distress and cyanosis since 20th day of life. Physical examination on admission revealed labored respiration, tachycardia and intermittent cyanosis when the infant cried or was being fed.
Roentgenologic examination disclosed marked radiolucency of the right lung field with shift of mediastinum to the left. The right leave of the diaphragm was depressed and in lateral view, the retrosternal clear space was markedly increased (Fig. 1 and 2).
At operation on Feburary 1, 1967, the right upper lobe was hugely enlarged and could not be collapsed. During upper lobectomy the middle and lower lobes were atelectatic but expanded completely at the end of the operation. An anomalous, narrow branching of upper lobe bronchus was thought to be a cause of progressive emphysema (Fig. 3).
The postoperative course was smooth and the infant was discharged on the 22nd day. He was well upon clinic visit one and half years later.

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Two thousands and twenty-three patients were treated at the Dapartment of Pediatrics, the Maebashi Red Cross Hospital, at night or on holiday under emergency basis during three years beginning from 1971. This figure matched approximately 24 % of all emergencies in the Hospital during the same period of time. Eighty-four per cent of patients were under 5 years of age and a fifth was treated in the early morning (0-8 A.M.). Two-thirds of patients received medical care only once or twice at the Department solely as emergency. Chief-complaints were classified as fever (47.5%), abdominal pain (9.2%), nausea and vomiting (9.0%), and convulsions (6.2%) in the order of frequency. Classifying them by disease, they were constituted by common cold (48%), respiratory tract disease other than common cold (9.6%), alimentary tract disease (15.2%) including acute infantile diarrhea, gastroenterocolitis and cyclic vomiting, nervous system disease (9.7%) including febrile convulsions, night-cry and epilepsy, and infectious disease (6.7%) including measles, exanthema subitum, mumps and chickenpox. Incidences of respiratory tract disease excluding common cold, gastroenterocolitis, constipation, febrile convulsions, night-cry and urticaria were significantly higher in the early morning than other overtime. Admissions were needed only 8.5%.
From the foregoing statistics, we can draw following inferences, the most of these patients were brought to the hospital from apprehensions of their parents and we must continue to instruct the parents to reduce their unnecessary anxiety and what they should do first at the time of emergency.

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This paper describes a technique for recording the His bundle activity from the body surface in man. Standard electrocardiogram and highly amplified bipolar or unipolar lead across the chest filterd between 80 and 300 Hz were recorded simultaneously in 16 cases. In 9 of these, the His bundle electrogram was simultaneously recorded by routine technique using catheter electrodes. In order to extract the small electrical activity of His-Purkinje system from random electrical noise, the signal averaging was applied. The R wave in the standard electrocardiogram was used for triggering the signal averaging.
There were obvious deflections (G complex) between the atrial and ventricular deflections in the surface lead. This G complex appeared simultaneously with the His bundle activity recorded by routine invasive technique. The G complex was clearly seen in the presence of atrial fibrillation. The G-V interval was exactly identical to the H-V interval in 5 cases, while the G-V was 1-2 msec shorter than H-V in 4 cases. There was a intimate correration between the G-V and H-V intervals (r=+0.995).
From the above results, it was concluded that the recording of the His bundle activity in man from the body surface was possible by using the signal averaging technique.

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