It has now widely been assumed that the kidney plays the most important role on pathogenesis of essential hypertension. In the present studies, renal functions were estimated in 120 patients with essential hypertension by clearance methods and other renal function tests, and their retinal findings were compared with the data on clearance tests in these patients. In 15 of them, renal oxygen consumption was also measured by renal venous catheterization method. As the result, reduction of RBF under the normal range was observed in about three fifths of 120 patients, but in the remainder (about two fifths of them), RBF was maintained within the normal range. Similarly, in regard to renal oxygen consumption, it was maintained within the normal range in the early stage of essential hypertension (in seven of fifteen cases), but gradually decreased in parallel with reduction of RBF. Particular attention was given to the correlation between RBF and severity of retinal findings. The eyeground findings were graded I through IV following Keith-Wagener's classification.: It was observed that the higher the grade, the more strong was the reduction of RBF. Its correlation was statistically significant. In all patients with the retinal finding, IV grade RBF was reduced to belower than 40% of normal average value.
As the basis of treatment of anemia by cobalt, experimental anemia in rabbits was used, and compared with the effect of cobalt and that of iron. Cobalt produced excellent effect than iron on the infectious anemia, associated with sterile inflammation induced by the intramuscular injection of turpentine in the rabbits. Also cobalt produced similar effect on the anemia, due to staphylococcal infection by the intramuscular injection. But there is no effect on the phenylhydrazine anemia and less effect on anemia due to bleeding. The daily oral dosage of 30-60 mg of cobaltous chloride administered to 35 patients with various types of anemia produced erythropoetic responses in 10 cases. In 6 of 10 patients with iron deficiency anemia, in 2 of 8 patients with infectious anemia, and 1 patient with inoperable sarcoma of stomach, definite reticulocytic responses and increase in red cells, hemoglobin and hematocrit values were observed. But in cases with refractory anemia, chronic nephritis, thrombocytopenic purpura, and leukemia no effect were observed. Effect of cobalt on the iron refractory anemias, especially on infectious anemia and anemia due to tumor was discussed.
A pressure of 60 mm Hg was applied on the upper arm for the duration of 15 min. to cause blood stagnation and the fluid filtration and the protein loss before and after the pressure application were measured from the hematocrit values and the plasma protein. Next, various drugs were administered and similar measurements effected, to determine the influence of these drugs upon the permeability of blood capillaries. The results may be summarized as follows; 1. Calcium chloride and flavon derivatives caused decrease of permeability by enhancing the density of the interendothelial cement substance of the capillaries. 2. Hyaluronidase acts in increasing the capillary permeability, while chondroitin sulfate caused its decrease. 3. Benzylimidazoline effects increase, but tetraethyl ammonium bromide does not affect in any way the capillary permeability. 4. Kallikrein accentuates the permeability but methyl-androstendiol has little effect. Testosterone, estradiol and progesterone normalize abnormalized capillary permeability. Cortisone and interenin-strong perceptibly depresses an accentuated capillar permeability. 5. Upon administration of thyroxine an accentuation of the capillary permeability is observed. This accentuation is normalized with methylthiouracil.
The alternation of the fecal flora by the administration of several antibiotics, “Aurofac”, lactbacilli and various diet in 102 cases has been studied in this report. The distribution of intestinal flora has also been examined using Miller-Abott' tube in 10 cases. The following results were obtained. (1) Medicamentous doses of several antibiotics were administrated in 66 cases (20 cases of healthy persons and 46 cases of patients). In 58 cases in which were administrated AM, TM, CM and SM orally, coli-aerogenes group in the fecal flora was reduced remarkably in number or disappeared completely during the administration of these antibiotics and the species of proteus and pseudomonas became predominant alternatevily. The alternative increase of proteus and pseudomonas species was especially remarkably by the administration of AM and TM but was not so much by the administration of CM and SM. (2) It has been examined whether or not the causative organisms of the infection in the neighbouring organs of the intestine alternate in parallel with the changes of the intestinal flora. The 8 cases of the infection have been observed in which causative organisms were alternated in the neighbouring organs (Cholecystitis 2 cases, cystitis 6 cases). These infections were caused by the organisms which become predominant in the intestinal flora during the oral administration of antibiotics. (3) Marked change or alternation of the fecal flora was not observed in those who were administered small dose of AM orally. The administration of “Aurofac” or preparation of lactbacilli did not produce marked change in the intestinal flora. (4) Using the Miller-Abott'tube, marked ascending phenomenon of the gram-negative bacilli, mainly E. coli, was observed in the patients with achylia ga trica in compared with those with normal acidity of the gastric juice.
Prof. Kudo has already published a report on his experimental study on the sodium sulfide reaction method for testing kakke cases. The author of this paper has experimentally followed up the relation between the metabolism of vitamin B1 and the urinary sodium sulfide reaction using rabbits suffering from aneurinasis, and obtained the following resultes: 1. The number of drops required for titrating the test solution in the sodium sulfide method was always smaller in testing rabbits with experimental aneurinsis than in normal rabbits. 2. The paralysis appearing in the rabbits due to deficency of vitamin B1 and the above decrease of drop number in urinary tests coincide 3. By administration of vitamin B1 to rabbits suffering from B1 deficiency, the number of drops required in urinary tests increased and the paralysis is cured simultaneously. 4. The above recovery is the more rapid, when vitamin B2 is used in combination with vitain B1. 5. When rabbits were to be made to contract aneurinasis an administration of liquid culture of aneurinasis bacilli in total proved more effective in causing prompt reduction of the drop number and the speedy appearance of the paralytic symptoms than administration of a suspension of aneurinasis bacilli. From the above experiments, the author arrived at the conclusion that the sodium sulfide method is of meaning in clinical diagnosis not only of apparent vitamin B1 deficiency, but also of B1 deficiency cases who are not yet sufficienily consccious of the deficiency subjectively and are barely keeping up their health, their vitamin B1 metabolism having fallen to the lowest level required for maintaining health.
In recent years, it has been reported that the amino-aciduria is not accompanied by any significant elevation in blood alpha-amino-nitrogen level in hepatocerebral degeneration; and, in regard to the abnormality of amino-acid metabolism, different observations of true form of hepatocerebral degeneration has been presented which would offer an interesting study in the peculiar nature of this disease. The use of the Folin's method for the measurement of amino-acid in blood and urine of liver, mental, brain, kidney and circulatory organ diseases has shown that the content of amino-acid in blood and urine of mental, brain and circulatory organ patients was normal; whereas, in tests with kidney patients, there was a tendency toward decrease, in the content of urinary amino-acids. In hepatic patients, often the tests has shown that amino-aciduria was not accompanied with any significant elevation in blood alpha-amino-nitrogen level. The existance of amino-aciduria not accompanied by any significant elevation in blood alpha-amino-nitrogen level is not an observation of a peculiarity of hepatocerebral degeneration. Even in mild cases of liver disease, the duration of the disease would most certainly indicate the presence of amino-aciduria. Therefore, the condition involving liver disease would indicate this to be the most important factor in relation to the presence of amino-aciduria, and the presence of amino-aciduria is an indication tending to show symptoms of poisoning phenomemon that occurring chiefly in liver. Furthermore, 500ml of amino-acid (polytamin) was injected into the vein of patients where amino-aciduria was indicated, according to tolerance test, and no positive results to affirm the theory of decreasing the values of the renal excretion of amino-acid was noted.
No definite theory has yet been advanced regarding the causative factor in Lipoid-nephrosis. It has been pointed out that renal impairment is connected with hypo-thyroidism, and hence under the view that there might exist a relationship between hypothyroidism and development of nephrosis, plasmapheresis was carried out in rabbits in which a state of hypothyroidism had been induced by thyroidectomy or methyl-thiouracil (methiocil) injection. Investigation was directed mainly to plasma-proteins, serumcholesterol and histological changes, and the following results were obtained. 1). Hypothyroidism causes in general decrease in albumin and increase in globulin, especially γ-Globulin. 2). Plasmapheresis alone does not induce hypoproteinemia, but when it is put into operation in the group with hypothyroidism, there results decrease in both total proteins and albumin, and γ-globulin also shows a tendency to diminish again. The above suggests that the thyroid gland has an intimate relationship to formation and regulation of plasma-proteins. 3). Hypothyroidism increases in serum-cholesterol, and when the plasmapheresis is repeated in addition to it, there results a further increase, which is often 2 or 3 times larger than the preoperative normal value. 4). When the thyroidfunction is lowered or when the plasmapheresis is repeated during hypothyroidism, albuminuria is observed in some cases. 5). Histologically, the epithelia of the renal tubules in some cases showed cloudy swelling and fatty degeneration. 6). Experimentally, a condition corresponiding to entirety of nephrosis could not be induced, but pathological changes bearing some resemblance to that of nephrosis were obtained, and it was elucidated that hypothyroidism is intimately related to the development of nephrosis.