α- or β-Adrenergic blockers such as phenoxybenzamine, phentolamine and propranolol were administered subcutaneously or intraperitoneally chronically to intact, adrenal-demedullated (ADMx) and ADMx plus peripherally chemical-sympathectomized rats with intravenous 6-hydroxydopamine. Adrenal and serum corticosterone (B) levels were determined fluorometrically. Basal levels of B were not changed by the chronic administration of the blockers except phentolamine, which elevated significantly the basal levels of B. Diurnal variation of B levels was not changed by the treatment of the blockers. After exposure of the rats to cold stress (4-6℃, 30 min.), serum and adrenal B levels were markedly elevated in all of intact, ADMx and ADMx+peripherally chemical-sympathectomized rats given propranolol in contrast to much smaller elevation with rats given phenoxybenzamine. In the rats given phentolamine, responses of adrenocortical tissue to the stress were slight and not significant. These results will indicate that peripheral α-adrenergic system may be stimulatory and β-adrenergic system may be inhibitory to adrenocortical function via probable changes in ACTH release as the animal was exposed to the stress.

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A 48×10^4IU/day urokinase (UK), which had been estimated by the appearance of fibrinolysis in the preceeding studies, was infused at the velocity of 12×10^4IU/h in 20 patients with various types of thrombosis. Infusion of UK resulted in a marked fibrinolysis characterized by a decrease of α_2-plasmin inhibitor to about 50% of the preinfusion value. Fibrinogen and α_2-macroglobulin also decreased to about 50% of the preinfusion value. PT, APTT and platelet aggregation were hardly changed during UK infusion. This UK therapy resulted in marked systemic fibrinolysis without inducing hypercoagulation.

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We have examined religious delusions in 20 schizophrenic patients who were admitted to the neuropsychiaric clinic of Kyorin university School of Medicine and Sankei Hospital during the years 1975-1980. We classified 20 patients into two groups. One is a group of patients who belong to some religious sect, the other do not belong to any religious sect. We call the former the religious group and the latter the non-religious group. Such phenomenon was seen that patients in the religious group took acute onset and had transient religious delusions, while patients in the non-religious group took chronic onset and had continuous religious delusions. Therefore we classified them into an acute type and a chronic type. Further we classified a chronic type into a single type and a complex type. The single type had only religious delusions while the complex type had not only religious delusions but also other kinds of delusions. Most of the acute type had delusions of possessin. Many objects of worship were expressed by the word god. But the meaning of the word is complex. Modern Japanese religion involves Christianity, Buddhism, Shinto, and so called New religion. Analogous involvement of such varieties of religious sect was seen in the symptomes of the cases studied. In the present stage of study it was concluded that, in most acute type, patients showed some religious delusion more or less concerning to one's own sect from the core of patient's personality whereas committment of religion in the acute type of patient's delusion was mostly superficial.

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Recently mesurement of Systolic Time Intervals (STI) has become one of the useful techniques for non-invasive evaluation of left ventricular function. The STI were mesured by the conventional triple instantanous recording of the electrocardiogram, phonocardiogram, and carotid arterial pulsation. Cardiovascular status was reflected in the change of STI both in health and disease. In case of acute myocardial infarction, two specific changes were observed, i. e. prolonged pre-ejection period (PEP) and shorter ejection time (ET). The STI was influenced by heart rate, load test, and by myocardial contractility. These parameters can limit the usefulness of STI, for the evaluation of cardiac function. For the appropriate use of STI, these limited usefulness of the parameters and many problems involved in the STI measurements should be always kept in mind before the data of mechanocardiography are evaluated.

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Recently immunologic disorders in patients with diabetic nephropathy have been paid much attention in relation to the pathogenesis and progression of diabetic glomerular injury. In order to check the injury of glomerular basement membrane (GBM) in patients with diabetes mellitus (DM), we examined serum anti-GBM antibodies and urinary excretion of GBM antigen in 38 patients with DM (9 cases without proteinuria-non renal DM and 29 cases with proteinuria-renal DM). Trypsin digested ultrasupernatant of human GBM obtained from autopsied kidneys without renal diseases was used as a soluble GBM antigen. Serum anti-GBM antibodies were measured by passive hemagglutination (PHA) and urinary excretion of GBM antigen by reverse PHA (RPHA). Both of these assay systems are as sensitive as RIA and more convenient than RIA. Serum anti-GBM antibodies were positive in 34.5% of patients with renal DM and negative in all patients with non renal DM. In 53 patients with various primary glomerulonephritis serum anti-GBM antibodies were positive in 7.5%. Urinary GBM antigen was excreted in 87.5% in non renal DM and 60% in renal DM with mild proteinuria. These data suggest that in patients with diabetic nephropathy of glomerular injury GBM antigen is excreted from very early stage and possibly this might be the origin of antigenic stimuli to induce anti-GBM antibodies. Further study is needed to analyze more precisely antigenic components which is excreted into urine and to determine whether anti-GBM antibodies we found in this report really play some role for the glomerular injury.

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Ulcerative colitis, Basedow's disease, dermatomyositis and finally multiple mononeuritis appeared, almost successively within less than 1 year, in a previously healthy 61-year-old woman when she was 53 years old. The diagnosis was confirmed by clinical features and biopsies performed on the colon, skin, muscle and sural nerve. Among the four diseases, multiple mononeuritis of the right upper and left lower limbs has continuously been present, showing some progression, for more than 8 years with added damage to the right trigeminal nerve. Although occlusion of vasa nervorum was suspected as the cause of multiple mononeuritis, evidence of angiitis, which also could link multiple mononeuritis to dermatomyositis, was not obtained from the biopsies. The patient has no diabetes mellitus. On this admission, serum immunoglobulins were normal. Serum CPK which previously showed elevated values was in the normal range, while urinary excretion of myoglobin and creatine was abnormal. Autoimmune processes are assumed in the pathogenesis of ulcerative colitis, Basedow's disease and dermatomyositis. Generally there is a tendency for more than one autoimmune disease to occur in the same individual, but when this happens the association is usually between diseases belonging to only one of the three groups classified by Roitt according to the nature of diseases and autoantibodies. The three disorders mentioned above, of this patient belong to the different groups of the autoimmune diseases. In this point this case is unique. The combination of these three disorders and also with multiple mononeuritis has not ever been reported in the literature.

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A case of acute diabetic ketoacidosis due to temporary interruption of insulin injection is described. The patient, 44 year old woman, showed a marked hepatomegaly with liver dysfunction developed after initiation of the treatment with a large amount of insulin. After careful control of insulin, hepatomegaly dissapeared and liver function normalized. Possible pathophophysiologic mechanism for this process is thought to be responsible for, at least in part, initial large amount of insulin given to the patient. Insulin stimulates glycogen synthesis in the liver directly by the activation of glycogen synthetase and indirectly by the suppression of cyclic AMP production. Therefor, any case of diabetic ketoacidosis shoud be treated by continued injection of small doses of insulin from the start of treatment instead of large initial doses of insulin.

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