[in Japanese]

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Light and electron microscopic studies were made on the cut ends and the distal portion of the rat sciatic nerves at intervals from 1 day to 56 weeks after nerve section.
Degenerative changes were evident both in myelin sheaths and axons 24 hours postoperatively at the bilateral stumps, and these changes were able to observe mainly from the 4th day towards the end of the second week in the distal portion. Almost all the Schwann cells appear to survive during this stage of degeneration, undergo hypertrophy with fine filaments and increased numbers of cell organelles, and even multiply themselves. They contained various forms of myelin fragments in their cytoplasms. It is considered that the myelin sheaths are degraded in Schwann cells during Wallerian degeneration.
Three days after the nerve section, cells identified as macrophages were observed in the endoneurium of both cut ends and thereafter they became widely distributed along the distal portion of the nerve showing Wallerian degeneration. The cytoplasms of the cells appeared darkly staining and contained numerous vacuoles and various forms of lamellar debris. They had many finger-like processes at their periphery. In contrast with Schwann cells, the macrophages didn't possess cytoplasmic filaments and basal lamina. Occasional cells were found also inside the basal lamina of the Schwann cells and some were observed crossing the disrupted basal lamina. Injections of horseradish peroxidase around the devided nerves disclosed an uptake of the tracer by these debris-laden macrophages. It seems likely that macrophages play an active part in the breakdown and removal of the degraded myelin and axon in addition to Schwann cells.
The earlier signs of regeneration were found in sections of the proximal cut end and the junctional zone between the cut ends on the 7th day after nerve section. Smaller axons containing distinctive neurofilaments reappeared in relation to Schwann cells with beginning remyelinization. Groups of Schwann cells and their included axons became separated each other by cells with elongated processes. They displayed ultrastructural features of fibroblasts and gradually assumed an appearance of perineurial cells which were evidenced by the presence of basement membrane envelope and of multiple pinocytic vesicles in their elongated extensions. It seems that these cells play an important role in isolating the environment of the regenerating nerve fibers from the surrounding tissues.
Solitary cilia were observed in fibroblasts and Schwann cells degrading the myelin. Those observed in Schwann cells had a fibrillar configuration of 9 + 0, having nine peripheral doublets of microtubules with no axial complex.

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In a study on proliferation kinetics of erythroblasts in myeloid leukemia, the following results were obtained :
1) In the untreated, acute type, the activity of erythropoietin responsive cells (ERC) in the bone marrow was markedly decreased. There was a significant, positive correlation between ERC activity and relative erythroblast counts in the bone marrow. In these cases, the labeling index (LI) with ³H-thymidine of the total erythroblasts was significantly decreased. The decreased in LI was more striking in the cases where the erythroblasts resembling megaloblasts (PAS negative) were found in the bone marrow smears. LI in the basophilic erythroblasts remained within normal range, while the decrease in LI was conspicuous and statistically significant in polychromatic erythroblasts. In remission, ERC activity was raised to normal or above normal. LI was also normalized. The DNA synthesis time of erythroblasts in the untreated acute type was 12.9 + 0.4 hours, which did not differ from that of normal erythroblasts. The decreased LI was, therefore, considered to indicate that the polychromatic erythroblasts had a long G₁ phase or that those which got into the G₀ phase increased. In these cases, it was revealed that increase in number of erythroblasts with nuclei of small diameter resulted in a decreased labeling index.
2) In chronic myeloid leukemia, ERC activity and LI of erythroblasts showed no particular changes.
3) There occurred no striking changes in the LI of erythroblasts of cancer patients.
4) From the results presented above, it was concluded that there were not only quantitative but also qualitative changes in the erythropoiesis in acute myeloid leukemia.

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The present report describes two anomalous cases of the right subclavian artery as the last branch of the aortic arch, which were encountered in the female Japanese cadaver of 74 years old (case 1) and in the male one of 71 years old (case 2).
In both cases the following branches arise in turn from the aortic arch with normal course. They are 1. the bicarotid artery, 2. the left subclavian artery and 3. the right subclavian artery as the last branch. The short bicarotid artery is soon divided into the right and left common carotid arteries which takes a normal course respectively. The left subclavian artery courses normally with the left vertebral artery leaving at its superior wall. The right subclavian artery arises from the postero-superior wall of the aortic arch with the so-called “diverticulum” at its origin. The artery runs backwards shortly at first. Then it bends sharply to the right and runs transversally behind the esophagus, thereby causing depression of the esophagus on its posterior wall. The right vertebral artery arises from the right subclavian artery.
These two anomalous cases belongs to type G of Adachi's classification (1928) of the aortic arch variations, and also to type H of Williams-Nakagawa's classification (1932) for having the bicarotid artery. Suzuki (1894) has reported the first case of type G in Japan, and these two are the 67th and 68th cases as far as we know.

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A case of manic-depressive illness with sever lithium carbonate poisoning taking a long time to recovery, is reported.
In this case, symptoms consisted of lethargy, fever, vomiting, tremor, lateral rotation of the head, upward gaze, conjugate lateral deviation of the eyes, anisocoria, nystagmus, muscle fasciculation, clonic contractions of large muscle groups, hyperactive tendon reflexes, Babinski sign positive, ataxia, and snout and grasp reflexes.
Laboratory studies showed the following, leucocytosis and the elevated levels of serum GOT, GPT, LDH, BUN. Electroencephalograms showed generalized slowing. Cerebrospinal fluid examinations were normal.
Within one month period, these acute toxic symptoms disappeared. EEG became normal after five months. The maximum serum level of lithium ion reached to 5.03 mEq / L. Twenty one days later, serum level of lithium ion was no longer presented. Six months later, a pneumoencephalogram showed slight dilatation of the lateral ventricles and widened cortical sulci in the frontal area.
We also recognized mask-like facies, dysarthric, monotonous and low pitches speech, limb ataxia, dementia and change in personality. These clinical symptoms are gradually improving.
In this case, in spite of lowere dosages as 400 mg/day lithium carbonate, it showed high serum lithium ion level as 5.08 mEq/L, when clinical toxic symptoms appeared.
We thought, during the transition from mania to depression, the total body water was decreased, moreover the diet and liquid intake was reduced, in consequence serum lithium ion level increased and severe intoxication appeared.
Prevention of intoxication required administration of proper dosage and maintaining laboratory and clinical control during treatment.

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A biopsy specimen of granular cell tumor which had been obtained from the breast of a 20-year old female was studies by light and electron microscopy.
The tumor was composed of sheets of large, round or oval cells lacking any particular arrengements. The most characteristic feature was the presence in the cytoplasm of a great abundance of small eosinophilic granules. Those granules were faintly stained with Oil red O and showed a positive reaction with periodic acid-Schiff which was unaffected by diastase digestion.
Electron microscopically, tumor cells were aggregated in compartments which were separated from the abundunt connective tissue spaces by basement membrane. The granular cells comprising these cell aggregates revealed close approximation of cell borders with occational desmosome-like structures. The cytoplasmic granules were constituted by dense bodies, vacuoles and vesicles of various sizes and shapes.
It seems that the nature of the tumor examined is that of a benign tumor-like lesion, but on the basis of this work the cellular origin of this granular cell tumor remaines unclear.

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