The author researched on isolating of leptospiras from human blood, cerebrospinal fluid, urine and canine kidneys in the period from 1950 to 1953. Cultures, which were found positive, were subcultured and identified with cross agglutination-lysis tests and absorption tests. Attempts to isolate leptospiras from the blood and verebrospinal fluid of patients with leptospirosis were made through both the direct cultural method and the animal inoculation method followed by culture of the animals' blood which were obtained four to ten days after the inoculation, irrespective as to whether or not they showed signs. In his experience, the two methods were equally effective in yielding positive results. Both Korthof's medium and Ono's medium have been employed for direct cultural recovery of leptospiras, and the two mediums were equally effective in case of positive cultures. From the standpoints of the simplicity of technique and expenses, the research method to isolate leptospiras from patient's blood and cerebrospinal fluid with direct cultural method are better than the inoculation to animals. In order to detect leptospiral existing only in small number, it was found to repeat the culture. Both guinea pigs weighing about 150gm and syrian golden hamsters weighing about 15gm have been employed for animal inoculation. Both animals were efficacious in yielding positive culture. There, moreover, was seen no significant difference in the number of successful cultural experiments. 23 strains were isolated from hunan cases and 11 strains from canine cases. The author carried out the serological tests of leptospiras isolated with the methods of Schüffner-Mochtar's agglutination-lysis test and Schüffner-Bohlander's absorption test. Agglutination-lysis tests were performed by employing as antigens the six leptospiral strains known to exist in Japan-L. icterohaemorrhagiae, L. pyrogenes, L. canicola, L. hebdomadis, L. autumnalis and L. australis A, and the other six strains-L. grippotyphosa, L. bataviae, L. pomona, L. javanica, L. mochtarii and L. andaman A. Of the human strains, 4 were identified as L. icterohaemorrhagiae, and 19 were identified as L. canicola. 11 canine strains were all identified as L. canicola. Moreover, of these canicola strains isolated, 13 strains were compared with strain Roesel by cross absorption tests. Strain Roesel absorbed all antibodies from the immune serums of strains isolated, and the strains isolated absorbed all antibodies from Roesel immune serum. It can be concluded from that L. canicola is the most important causative organism of various leptospiroses. Canicola fever should never be forgotton when not only suspected leptospirosis, but acute febrile disease will be encountered.
In the pleural-fluid, obtained from the pleuritis-patients, the eosinophil cells are scarecely found; but often abundant in the fluid, obtained from the pleuralsinus in the course the artificial pneumothorax. The eosinophilia in the fluid comes into existence within 3 days after the first pneumothorax-therapy. When sinus-fluid is found, the percentage of eosinophil cells in peripheral blood of the artificial pneumothorax patients are higher, as compared with that in other times. The lung and bone marrow of guinea pigs, which underwent the artificial pneumothorax, showed marked eosinophilia, but the eosinophil cells percentage decreased in the peripheral blood. In the sputum of the patients, who underwent artificial pneumothorax, the eosinophil cells slightly increased in number. From these results, I conclude that the eosinophilia of the fluid, found in the pleurasinus, comes into existence in close connection with the eosinophilia of the lung and the bone marrow. The confidence limit and the rejection limit to which the eosinophil cells percentage of the average Japanese adult may safely be regarded as appropriate are 2.8-1.9% and 6.7-0.3%. The peritoneal fluid of the non-managed guinea pigs often showed marked eosinophilia.
In the preliminary paper it has been reported that the change of blood sugar certain period following the intravenous administration of glucose could be expressed as follows: y=c1e-λ1t+c2e-λ2t y: Concentration of blood sugar. t: Time after the administration. e: Basis of natural logarithm. C1, C2, λ1, λ2: Constant based on the experiment. Since c1e-λt decreases very rapidly within few minutes following the administration, the formula could be simplified as y=ce-λt C and e-λ may be easily obtained by plotting the blood sugar values on semi-logarithmic graph. e-λ especially indicates the ability of glucose assimilation in an individual, namely, the higher the value the lower the assimilating function and the lower the value the higher the function. This was also proved to be valid in single intravenous tolerance test performed in 20 human subjects, 9 normal and 11 rabbits with electrolytic lesion of hypothalamus. Fairly marked rebound hypoglycemia following the hyperglycemic response produced intravenous glucose injection was observed in several cases. The values of e-λ following triple intravenous glucose tolerance test in 58 healthy subjects and cases with various diseases, 15 normal and 12 rabbits with electrolytic lesion of hypothalamus indicated the ability of glucose assimilation was accelerated by the initial injection in most of the healthy human and all of the rabbits. In diabetic cases, however, there were two types, i. e., the one which showed progressive increase in glucose assimilation ability and the other progressive decrease in glucose assimilation ability following the repeated glucose injection.
1) URINARY EXCRETION OF THE PREFORMED GLUCURONIC ACID, AND THE INFLUENCE OF GLUCURONIC ACID UPON THE URINARY EXCRETION OF MEN-THYLGLUCURONIDE IN RABBITS. The preformed glucuronic acid injected to rabbit was excreted into the urine rapidly, and 75 to 90% of the injected dose was excreted within six hours. The excretion was particularly rapid in case of intravenous injection. (Fig. 3). The administration of menthol had no significant influence upon the excretion of the injected preformed glucuronic acid in rabbit. (Tab. 4, Fig. 4). 500 mg. of preformed glucuronic acid administered to rabbit orally was hardly excreted into the urine. When the preformed glucuronic acid was administered to menthol treated rabbit, the increase in the excretion of menthylglucuronide was obserbed. (Tab. 2, 3, Fig. 2) However, the dosage and the way of administration of glucuronic acid had little influence upon this effect. Judging from the above results, it appears that the most of the menthylglucuronide excreted in case of the concomitant administration of menthol and preformed glucuronic acid is derived from endogenous source, and that the exogenous glucuronic acid itself is scarecely utilized for the synthesis of menthylglucuronide. 100 mg. of glucuronic acid injected together with asorubin-S scarecely influenced the excretion of asorubin-S into the urine. (Tab. 5) 2) THE RELATIONSHIP BETWEEN THE SYNTHESIS OF MENTHYLGLUCURONIDE AND THE LIVER GLYCOGEN. The administration of menthol to rabbits resulted in the significant decrease in the liver glycogen contents (Tab. 7, Fig. 6). This procedure, however, hardly produced the histological changes in the liver. No definite correlation was found between the amount of menthylglucuronide excreted into the urine and the pretreatment contents or decrease of the liver glycogen. (Fig. 8, 9, ) Intravenous injection of 10 c. c. of 5% glycogen saline solution increased the excretion of menthylglucuronide in rabbit treated by menthol. (Tab. 10) The preformed glucuronic acid, glycogen or glucose could not prevent the decrease of the liver glycogen caused by the administration of menthol. (Tab. 8, Fig. 7) Furthermore, the preformed glucuronic acid and glycogen themselves did not increase the liver glycogen. (Tab. 9)
Cases reported here are 18 cases hospitalized in our Clinic from 1952 to date, of which 15 persons received transfusion of whole blood, 2 cases of plasma and 1 both of blood and plasma. The occurrence of jaundice was seen 26 to 198 days after the first transfusion and 34 to 219 days after the last. Anorexia and fatigue were observed in most cases as symptoms in the preicteric stage, and the average duration was 4 days which is shorter than that in infectious hepatitis observed in our Clinic. One case with a complication of bronchiectasis died 46 days after the onset of jaundice. Duration of jaundice ranged from 20 to 90 days, the average being 34 days, which is not so different from that of infectious hepatitis. The following chief characteristics were found in the function tests performed in its course. Among serum reactions, thymol turbidity test showed a tendency to give positive results of long duration as compared with other reactions; cephalin cholesterol flocculation test had a tendency to show positive results in the early stage; Takata's reaction showed a tendency to give negative results earlier than other reactions. Santsol and hippuric acid tests had a tendency to show positive results while serum reactions were negative. It is also desirable to test urobilinogenuria, especially to perform its quantitative determination, and excretory function test by hepatosulphalein which gave a positive result for a long time. Disturbances in the liver function by many tests were testified in all cases, and it is clinically noteworthy that some cases showed disturbances of the liver function even after the disappearance of jaundice, shifting to non-icteric chronic hepatitis.
After surveying various internal diseases, especially blood diseases, the following results were obtained concerning Vitamin B12 concentration in 1 ml of the whole blood and serum observed during the process of these diseases. (1) The Vitamin B12 concentration in 1 ml of the whole blood shows higher value than that in 1 ml of the serum. (2) The average value of Vitamin B12 concentration in the whole blood of patients with aplastic anemia is about twice the normal. The administration of folic acid or cortisone, in this disease, has no effect on Vitamin B12 concentration in the whole blood. (3) Vitamin B12 concentration is somewhat increased in case of acute type of myeloic leukemia, but the concentration is markedly increased in case of its chronic type. In case of chronic myeloic leukemia, it seems that there is correlation to some extent between the white blood cell count and Vitamin B12 concentration in the whole blood, though not absolute. The Vitamin B12 concentration in the whole blood of erythremia patient is also increased. (4) In liver diseases, specifically in cirrhosis of the liver, infectious hepatitis, serum hepatitis and in tumor of the liver there are an increase of Vitamin B12 concentration of the whole blood, though the number of cases were relatively few. Contrary, in each case of liver abscess and cholecystitis, Vitamin B12 concentration in the whole blood was within normal limit. (5) In case of iron deficiency anemia, Vitamin B12 concentration in the whole blood was within normal limit. (6) In case of thrombocytopenic purpura, Banti's syndrome, benzol-poisoning, hemolytic anemia, cancer of the stomach and in chronic nephritis, Vitamin B12 concentration in the whole blood was within normal limit.
P. KrÖll's modification (1951) was electrophotometrically reexamined and found more sensitive than original Manoiloff's colour-reaction which is thought as being a test to indicate the various state of the neurovegetative tonus. The reaction is ruled by Lambert-Beer's law and the filter 610μ is most suitable for its estimation. While pH of reagents exeats a far-reaching influence upon this colouration, both storage of blood sample within 20° and temperature from 4 to 37°C have no significant effect upon T% in modified Manoiloff's reaction. Observing the mode of discolouration, it is found that the proper time for the estimation is from 30' to 60' after the administeration of reagents. Although it can not be yet concluded decidedly to which serum fraction the water-blue has affinity, the protective action of the serum on proteine (globuline) is taken into account, agreeing with Kröll, concerning the chemism of this reaction which can not be much related to pH of the test serum itself. T% of the blood of 30 normal cases examined under the same condition shows froms 67 to 83 (mean value %73.9; 77.95≥m≥69.85). Simultaneous observations of other autonomic function tests including the effects of serveral drugs on the authonomic nervous system were studied on patients suffering from various kinds of vegetative disorders and proved that Manoiloff-Kröll's reaction corresponds to much extent to the autonomic nervous state despite of some exception; details were discussed in each case.
In 45 cases of chronic pulmonary emphysema treated with artificial pneumoperitoneum, the observations were made as to the lung volume, ventilatory function, circulatory hemodinamics, ventilation-perfusion relationships and diffusing capacity before and after the treatment. The ventilatory insufficiency, in many cases, was observed to be improved as a result of the increase of diaphragmatic movement or the decrease of pulmonary over-distension. However the circulatory disturbances were observed to be inclined to increase due to the impairment of blood distribution and to the increase of pulmonary vascular resistance, which is mainly attributable to the decrease of pulmonary vascular beds. In all patients, except one, residual volume and total lung capacity reduced substan-cially after pneumoperitoneum and the ratio of residual volume to total lung capacity (VR/TLC×100) also decreased. In many cases, were observed the considerable increase in maximal breathing capacity, intra pulmonary gas mixing, arterial blood oxgen saturation and the decrease in pulmonary arterial pressure, pulmonary blood flow and work of right ventricle against pressure. However in several cases, the arterial blood oxygen saturation failed to increase, the pulmonary arterial pressure and the work of right ventricle were increased slightly. The ratio of dead space ventilation (VD/VE×100) was considerably reduced in general following the pneumoperitoneum. But in one case, this ratio increased slightly, and the arterial carbon dioxide pressure rose relatively. The evidence of disturbances in pulmonary circulation after pneumoperitoneum, as shown on one hand, by the increase in such factors as the venous admixture quotient, total pulmonary vascular resistance, right cardiac work and on the other hand, by the decrease in arterial blood oxygen saturation, suggests the difficulty to determine the indication of pneumoperitoneum for the treatment chronic pulmonary emphysema.