Citrate is a very important medicament in clinical use. Recently injection of this medicament is becoming very common with the increase of massive blood transfusion. Although the infusion of citrate is very much concerned with liver function, there have been published few studies upon the relation of citrate to liver function. Accordingly, the present writer observed the effect of citrate on the function of liver and R.E.S. in healthy and liver-damaged rabbits. The following liver function tests were performed: hippuric acid test, santosol test, fructose tolerance test, azorubin S test, B.S.P. retention test, prothrombin test and congored test. As citrate solution 10% sodium citrate was used. The following results were obtained. 1) After injection of 50 mg/kg citrate in healthy rabbits, several kinds of liver function, especially the ability of detoxication, were greatly increased. 2) By daily injection of 50 mg/kg citrate in healthy rabbits, the ability of detoxication was increased during the period from the 4th to the 7th day, but it could not be increased further. 3) In the cases of liver-damaged rabbits, the group of citrate injected (daily) showed earlier healing of detoxication ability than the control group. In a word, some kinds of the liver function are accelerated by citrate injection, and the mechanism of this accelerating action is analogous with that of glucose or fructose. Considering that the acceleration and protection of liver function are necessary for most cases of blood transfusion, this action of citrate is clinically very important.
We examined on the cold pressure effect by Hines and Brown's method in hypertensive patients and in apparently healthy persons at several districts in Japan. 1) In benign form of essential hypertension the cold pressure effect is generally more sensitive than in other form of essential hypertension: the patients of malign and form are scarcely reactive to the cold. 2) The unstability of blood pressure (especially systolic pressure) of hypertensive patients has parallel relationship with the rising degree of cold pressure effect. 3) The effect in renal hypertensive patients is not so significant. 4) In the Akita Prefecture the frequency of hypertension and the positive cases of this effect are both more than in the Iwate Prefecture. 5) In the Akita Prefecture many young adults with hereditary disposition of hypertension have the positive effect, but in the Iwate and the Miyagi Prefecture the juvenile hypertension with the positive effect are less than the former. 6) Drinking and Smoking of hypertensive patients have not statistically so intimate relationship with the cold pressure effect.
During the period 1950 to 1954, 145 patients with diabetes mellitus were admitted to the Medical Clinic of Prof. Kurokawa of the Tohoku University Hospital. In this report, the complication of hypertension, albuminuria, retinopathy and cataract was observed statistically. Our diabetic patients were classified in two groups; one group is the patients whose diabetic symptoms could be controlled by our standard therapeutic diet alone (I type diabetes mellitus), and the other the patients controlled by standard diet accompanied with insulin (II type diabetes mellitus). The incidence of hypertension in our diabetic patients was 31.0 per cent. This incidence is far higher than that in 1000 non-diabetic out-patients during the same period. The incidences of hypertension in diabetic patients of 4 and 5 decades were compared with those in non-diabetic patients of the same decades and no difference in incidence of hypertension was found between these two groups. Hence, the difference in incidence of hypertension between diabetic and non-diabetic patients is not an essential one, but an apparent one due to the different age distribution in these two patients groups. No significant difference was found in the sex, the type and the duration of diabetes. With increasing severity of hypertension, there was an increase in the incidence of albuminuria, diabetic retinopathy and cataract in those patients with hypertension. There was no significant difference in incidence of inheritance of apoplexy and diabetes between these two groups. The incidence of albuminuria was 26.8 per cent and twenty per cent of our diabetics showed more than 2 plus albuminuria. With increasing duration of diabetes there was an increase in the incidence of albuminuria. Albuminuria was more frequent in II type diabetes and in high decades. The incidence of diabetic retinopathy was 23.6 per cent and that of diabetic cataract was 16.5 per cent. Both ocular complications were more frequent in females, in II type diabetes and in patients with longer duration of diabetes. Relatively low incidence of retinopathy was found in patients of 4 and 5 decades. Kimmelstiel-Wilson syndrome was observed in 8.6 per cent of our diabetics. This syndrome was more frequent in II type diabetics. The urine 17-ketosteroid excretion was increased in Kimmelstiel-Wilson syndrome, but normal in patients with diabetic retinopathy.
It is a well-known fact that during the antibiotic treatment serious complications such as bronchopulmonary and systemic Candidiasis are not infrequently encountered. To get some informations about the mechanism of the onset of Candidiasis, the locationof Candida albicans in human bodies and the influences of the oral administration of the broad-spectrum antibioties on its appearance are studied. As no studies have been attempted as to the metabolism of C. alb. and the mode of action of fungicidal agents on it, the terminal respiratory pattern of C. alb. and the mechanism of the inhibitory action of the several fungicidal agents are investigated. Clinical Studies. (1) The fecal fungal flora (especially C. alb.) was studies in 16 healthy adults and 28 patients without severe gastrointestinal disturbances. After oral administration of several antibiotics such as TM., AM., CM., and SM., a marked increase in the frequency of appearance and in number of not only Candida group but also of Cryptococcus and Saccharomyces was obtained. (2) To clarify the location of C. alb. in the digestive tracts, Miller-Abbott intubation was performed in 10 patients in order to obtain the intestinal juice which was put into the Littman's isolating media. In one of 5 cases with normoacidity of gastric juice, C. alb. was discovered in only one portion, colon, ascendens, which in two of 5 with anacidity C. alb. was found in duodenum and jejunum accompanied with the ordinary intestinal bacterial flora. (3) Bronchial secretion, sputum and throat secretion of 82 pulmonary tuberculous patients were tested by culture media for C. alb.. The bronchoscopic technique was used to obtaine the bronchial secretion. The results showed that C. alb. was recovered in sputum of II of 82 caces, in throat secretion of 9, and in the bronchial secretion of only one case, who had no sign of the bronchopulmonary candidiasis. (4) For the first time in the literature, terminal chlamydospores of C. alb. were found in the freshly expectorated sputum from a patient who was suspected of the bronchopulmonary candidiasis. Experimental Studies. (1) The (intact) C. alb. was able to oxidize acetate, and glucose, but not citrate, α-ketoglutarate, succinate, fumarate and malate. The inhibitory effect of malonate on the oxygen-uptake was not demonstrated. (2) The C. alb. dried at 37°C for 16 hours, demonstrate the additional ability of oxidizing succinate and fumarate. The inhibitory effect of malonate was also observed. However it lost the ability to oxidize glucose. (3) The C. alb. ground at low temperature oxidized such substrate as pyruvate, acetate, , citrate, α-ketoglutarate, succinate, fumarate, and malate, and the inhibition of oxidation of succinate by malonate was clearly demonstrated. From the date described above, it was considered that the membrane of C. alb. had specific permeability to several substrates and this permeability could be altered partially by drying. The so-called TCA cycle, not demonstrated in the intact cells on account of its specific permeability, could be demonstrated in the ground cells where the cell-membrane was destroyed. (4) The minimal concentrations of Vitamin K3, Aureothricin and Trichomycin to inhibit the growth of C. alb. were 78γ/cc, 25γ/cc and 1.4u/cc respectively. As to Paraben derivatives, Butylparaben was most effective than any other derivatives (methyl, ethyl, propyl paraben) and 78γ/cc was minimal necessary concentration. (5) Butylparaben and Vitamin K3 showed the unspecific inhibitory effect on TCA cycle of C. alb.. (6) It seemed that Aureothricin affected some enzymatic activity of the cell-membrane but not TCA cycle.. (7) Trichomycin affected the oxidation of amino-acid but not TCA cycle. Of those four agents Trichomycin caused the most remarkable morphological changes of C. alb..
Following the research exposed in Report (I) (Vol. 44. No. 4., 1955), the present report deals with the results of the examination how the intracutaneous and subcutaneous injection of some substances will influence the increase or decrease of the eosinophil cells in the local tissue and the peripheral blood. The results are summarized as follows: The ascaris-extract and ankylostoma-extract injected intracutaneously into the body of a human being who is in an eosinophilic condition, increase the number of eosinophil cells in the local tissue in 5 to 10 minutes after the injection. But acetyl-cholin solution and glair have weaker effect: Histamin solution, Phosphatbuffer solution (pH. 5.9 and pH. 7.6.), the serum of an ankyloatomiasis patient and physiological saline have no effect at all. The reinjection of 1.0cc of the glair into the body of guinea pig three weeks after it became sensible with 2.0cc of the glair, will cause a speedy and marked increase in the eosinophil cells contained in the blood, local tissue and bone marrow, resulting in the development of eosinophilom in the lung. The present report, then, gives a description of the condition of the eosinophil cells in the blood, exudate and organ-tissue in the eosinophilic case, 1) eosinophile pleuritis, 2) pulmonary acariasis which has developed Loeffler's syndrome and 3) the pancreas eosinophilom caused by ascaris eggs. Lastly, mainly based on the results of the examination already described in the Reports I and II, a few opinions of my own have been given in the present report about such subjects as the relationship between eosinophilia and allergy or parasite diseases; the mechanism of the development of tissue-eosinophilia; the co-relativity of tissue-eosinophilia, and blood-eosinophilia, and others.
The author carried out serological tests for canine leptospiroses by Schüffner-Mochtar's agglutination-lysis tests and examined by darkfield microscopy the kidneys of dogs caught in Fukuoka City, a sporadic area of human canicola fever, and in Raizan Village (Itoshima District) and Hojo Village and neighborhood (Tagawa District), epidemic areas of the disease. Examination of the sera and the kidneys disclosed that of 458 dogs from Fukuoka City 108, 23.6%, were positive for leptospiral infection, serologically, comprising 16 positive for L. icterohaemorragiae, 81 for L. canicola, and 11 for L. icterohaemorragiae and L. canicola, titer being equal for both, and 30, 6.6%, positive for leptospira, microscopically, the strains isolated from 6 of those 30 being identified as L. canicola; that of 11 dogs from Raizan Village, an area where there had been an epidemic outbreak of 43 cases of canicola fever one year before, 6, 54.5%, were positive for leptospiral infection due to L. canicola, serologically, and 3, 21.3% for leptospira, microscopically; that of 56 dogs from Hojo Village and neighborhood where 114 cases of epidemic canicola fever had broken out one month before, 35, 62.5%, were infected with leptospira, including 1 with L. icterohaemorrhagiae and 34 with L. canicola, serologically, and 12, 21.4%, positive for leptospira, microscopically, the strains isolated from 5 of the 12 dogs being identified as L. canicola. As the figures show, the incidence in percentage was higher among the dogs from the two villages and neighborhood than among those from Fukuoka City. The incidence was approximately the same among males and females. The infected dogs were of any age, but were more numerous among those one to two years old.
Various autonomic nervous symptoms were observed on 45 pulmonary tuberculous patients who subjected to thoracoplasty. At the same time, the effect of tetraethylammonium bromide (TEAB) which was given intravenously to those cases was examined before and two weeks after the operation. Positive Rossolimo reflex was observed in 18 of 45 cases (40%) on the 7th day after the operation. Its frequency was higher on the side of the operation. According to the method of eliciting Rossolimo reflex, the frequency was 42.6%, while 35.6% by the original method of Rossolimo reflex. Positive wartenberg reflex was most frequently noted (77.3% after operation) than any other hand reflexes. The difference between its frequency on the side of operation and that on the other side was not significant. The administration of TEAB depressed these reflexes of hand and foot. Enlargement of pupil on the side of operation was also frequently observed. The administration of TEAB made the latent anisocoria manifest. Total incidence of anisocoria was 47.6%. Hemihydrosis appeared soon after the operation on the oposite side of thoracoplasty, and later on the reverse was observed, i.e. the hydrosis was noted only on the side of the operation. Goose skin reflex was accelerated on the side of operation, after the thoracoplasty, and TEAB depressed this reflex. In addision, a certain hyperaesthetic area was frequently noted on the breast of the side of the operation. According to the effect of TEAB and various autonomic nervous symptoms, this fact was considered due to accelerated autonomic tonus. In order to explain all these findings, participation of the cervical and thoracic sympathetic trunk on the side of the operation and of autonomic centripetal fibers in the lung must be taken into consideration.