With a view of making clear the causes and the mechanisms of anemias seen in various diseases, the life spans of transfused red cells were studied by using Ashby method. That is, 300-500 c. c. of O-type blood was transfused into human subjects having another blood types A, B and AB during three to five days. The red cell count on the day succeeding the transfusion was estimated as 100 per cent, and the days required for the decrease of the transfused erythrocytes to 10 per cent were counted and compared. In six cases of normal subjects (male 5, female 1) that had received the transfusion from the normal persons, the periods for the decrease were from 83 to 102 days. Fourteen patients of aplastic anemia received the blood from normal persons. In about one-third of these patients the life spans of red cells were equal to those in the normal persons, and in another patients with gìngival bleeding, epistaxis, subcutaneous hemorrhage, such were from 50 to 60 days. Especially, in cases with severe hemorrhagic diathesis among the latter, the count of transfused red cells have decreased under 10 per cent during from thirteen to seventeen days and in these example wear and tear of the erythrocytes was two to seven times more than in normal subjects. On the other hand, in seven cases of normal persons received the blood from the patients of aplastic anemia, the life spans of transfused erythrocytes were normal. Then, in all seven cases of acute myeloid leukemia was seen moderate shortening of life spans combined with hemorrhagic diathesis. Among four cases of chronic myeloid leukemia, two patients showed normal values on life span of transfused erythrocytes and another two patients showed shortening. In one case of the latter, “nitromine” (a derivative of Nitrogen mustard) was used. Shrinkage of spleen, temporal increase of transfused red cells in the cirulating blood were observed and their life spans remained normal. In cases of iron defficiency anemia, chronic nephritis and subacute bacterial endocarditis, any sign which indicates the increase of erythrocytic destruction was not observed. In 5 cases of patients wirh Banti's syndrome the life spans of transfused erythrocytes had been remarkably shortened before splenctomy, but returned to normal values after the splenectomy. Red blood cells of normal person transfused into a patient with anemia due to lead-poisoning survived for normal length and vice verva. In one acquired hemolytic anemia, transfused red blood cells decreased to below 10 per cent in 19 days; in a case of pernicious anemia 59 days, and in a patient of Hodgikins disease 50 days.
Of 64 hypertensive patients treated with Rauwolfia serpentina there were observed 66% whose blood pressures were decreased by 20 mmHg in systolic and by 15 mmHg in diastolic; 38% whose dynamical mean pressures were lowered by 20 mmHg; 30% whose systolic and diastolic pressures were reduced to normal range (150/90mmHg). Of 15 cases medicated with R. s. above 60 years old there were ascertained 67, 40, 7% and of 46 patients administered with R. s. under 59 years old 65, 37, 35% correspondently. It is possibly due to the high incidence of systolic hypertension in advanced aging group that both systolic and diasnolic pressure were reduced at large percentage in cases above 60 years old. In order to further elucidate this point, the elasticity moduli were calculated by means of Dexter's formula, and following results were obtained. Of 15 patients there were observed 14 cases (93%) with diminished elasticity moduli, and 87% after the medication with Rauwolfia. This suggests that the majority of patients above 60 years old observed here is sure to be arteriosclerotic (systolic) hypertensive cases, whereas of total 65 patients there were 52 cases (80%) with elastivity hypertension in the sense of Dexter. Circulatory dynamics were analysed by means of Wezler-Böger's method in 19 cases with hypertension above 60 years old of which 13 patients (69%) showed larger E' than normal range. Dexter's classification agrees with that of Wezler-Böger's in 14 cases of 19, therefore it appears that Dexter's classification is of considerable clinical value. The above mentioned can be summerized as follows:- 1. Pros & Cons upon the medication with Rauwolfia serpentina in the hypertensive patients of aged above 60 years old are discussed from the hemodynamic analytical standpoints. 2. In the hypertensive cases of aged it is sometimes difficult to estimate the hemod-ynsmics by means of Wezler-Böger's method. In such a case, taking care to avoid danger, we are compelled to make shift with Fick-Cournand's method. 3. The percentage of hypertensive potency of Rauwolfia is proved larger in the senil group than in the young. 4. The vascular elasticity calculated from Dexter's formula roughly agrees with volume elasticity and elasticity modulus obtained from Wezler Böger's method 5. The hypertensive cases of aged are frequently subject to the senil arteriosclerotic high blood pressure. Classifying them according to Wezler Böger's interpretation, most of them can be placed under the category of W+E', M+E' or M+E'+W type. While the circulatory dynamics of M+E' type can be scarcely improved by administration with Rauwolfia, W+E' type can be ameliorated fairly well. In the M form the treatment by the use of Rauwolfia is very often superflous (Authors' Referate).
1. Basic experiments on the manufacture and examination of clinical hemometers are here described. 2. Hemoglobin was determined by analysis for total iron, the concentration being calculated from the iron content of 0.34 per cent. In parallel with the iron method cyanmethemoglobin of the same blood samples was determined in the photoelectric spectrop-hotometer at 540mμ with a wave width of 0.5mμ and adsorption cell of 1.0cm in thickness. Then the constant with which one can calculate the hemoglobin concentration from the optical dencity of cyanmethemoglobin was determined as 0.146. 3. The constant for the optical dencity of acid hematin in the spectrophotometer at 520mμ with a wave width of 0.5mμ and absorption cell of 1.0cm in thickness was calculated to be 0.143 by reference to the mean values of hemoglobin concentration obtained from the cyanmethemoglobin method. The hemoglobin concentration of standard blood was determined to be 16g/dl=100 per cent, from which standard solution of acid hematin was prepared. 4. The colorimetric properties of the acid hematin solution were studied, and optimal conditions for optical colorimetry were demonstrated as follows: Brightness=18° (or 45 per cent), Saturation=56 per cent, Dominant wave length=581.5mμ, Hue; x'. 0.435, y.' 0.400. 5. Salicylic acid added to the acid hematin solution to the extent of 0.01 per cent did not change the color of the solution, and prevented the decoloration of the solution for over one month. 6. The light of 1000-5000 Lux from a north window was suitable for optical colori-matry of the acid hematin solution.
Amino-acids in urine were analyzed by means of paper partition chromatograph, both clinically and experimentally. Usually two-dimension method is performed, but it is also of some clinical value to detect amino-acids with large Rf by the use of one dimension method. Alanine, Glycine and Taurine always appear in urine, no matter whether it be normal or pathological. As a rule, amino-acids detected in urine of hepatic patients increase in number; especially in the jaundice-stage of acute hepatitis there can be ascertained several sorts of amino-acids, while in the reconvalescence they decrease in number showing tendency to become normal. In cases with liver cirrhosis, detected amino-acids are of various number, only the appearance of amino-acids with large Rf is more remarkable than in those who suffer from hepatitis. This occurrence is neither concerned in existence of icterus nor ascites. In cases with hepatic coma, some increase in number very much, others not so markedly. That is to say, patients suffering from hepatic coma do not always excrete high-degree amino-aciduria. Number of amino-acids proved in hepatic cancer is relatively few, and there is no great difference between in cancer and innormal. Number of amino-acids detected in cholecystitis and cholecystopathy fluctuates instablely. In above mentioned cases there can not be proved any special amino-acid appearing without fail. Attitude of amino-acids in urine of rats which livers were damaged with various kinds of toxins, is similar to that of clinical cases. High protein diet after administration of hepatic toxins is admitted as effective to prevent the appearance of a certain amino-acids in urine.
Heretofore, in Japan only 4 lineages with authentic Osler's disease have been reported. The following case also is thought to be Osler's disease with supervention of vascular purpura. The patient is a 28 years old divorcee. A younger brother of a different mother died at 15 from hemoptysis of unknown cause and his younger sister consulted us at 19 on account of continual epistaxes. The patient often noticed gingival hemorrhages since the grade school period. Menarche was at 13. Epistaxes appeared repeatedly for one year since the age of 17, and from the age of 19 the sputum began to be streaked with blood but there was no evidence of pulmonary tuberculosis. At the age of 20 sugillations were recognized at times. From about the age of 23 a dull pain was felt in the renal region and hematuria was recognized at 25. At 26 she was discovered to have gastroptosis and wandering kidney. As hematemeses and hemoptyses appeared repeatedly from about May, 1952, she was admitted to our hospital on June 12. Linear form telangiectases were observed in the alae of the nose, both shoulders, interscapular spaces and femoral regions, and Kiesselbach's area. In the right lateral chest was recognized a single spot consisting of grouped telangiectases. An occult blood test of the feces was positive. Bleeding time was 9 minutes. Tourniquet test was positive. Coagulation time, prothrombin time, and clot retraction were normal. Liver function tests positive. The hemorrhages after admission are illustrated in figure 1 in the mani text. VitaminC, rutin, and ethinylestradiol had little effect but vitamin E had some good effect. In this case the fact that vesicles appeared in the skin and lips by rubbing suggests that there was an abnormality of the general connective tissue in addition to the vascular system. Together with the instability of the autonomic nervous system this is an interesting fact.