In one hundred patients treated with artificial pneumoperitoneum, the present author studied on hepatoptosis and some related problems during the treatment. For the purpose of this study 326 roentgenograms were measured and following results were obtained: 1) In more than half of the films (61.4%) taken in upright position, hepatoptosis was observed and its degree was generally within 5.0 centimeters. 2) In a majority of 35 patients (91.4%), whose roentgenograms were taken both in upright and in supine position, the elevation of the liver was observed by changing position from upright to supine, the degree of the elevation ranging from 5 to 10 centimeters. This fact indicates that the liver of the patients is not ptotic in supine position. 3) Hepatoptosis in itself did not always inhibit the elevation of the diaphragm. 4) In cases having adhesion between liver and diaphragm, the degree of the elevation of the diaphragm was not good in general, of these cases, however, some with string adhesion showed the great elevation of the diaphragm after more than twenty treatments, others showed more greater elevation of the diaphragm in supine position than in upright, as a result of discharge from the weight of the liver. 5) No correlation was found between the degree of hepatoptosis and the intraperitoneal pressure.
For the measurement of sensitivity of Leptospirae (L) for drugs, the medium-sized test-tube method is usually applied, according to which 5 to 10 cc. of medium containing test drugs are necessary. The author applied, however, the small-sized test-tube method in order to spare the amount of materials, and by this method examined leptospirocidal (L-cidal) and leptospirostatic (L-static) action (put together called antileptospiral activity) of seven-membered ring compounds. To 2 cc. of Korthof's medium were added derivatives of hinokitiol (Hi) and tropolone (Trp) in various concentrations and L were cultured in these media, whereby their growth was observed from time to time in the dark-field. The concentration of the compounds in the media in which the number of L remained in less than 80% of the control was regarded as L-static, while the concentration at which L lost their motion or they were dissolved was regarded as L-cidal. Now, Hi-Na had L-cidal action on L. icterohaemorrhagiae at 0.5 γ/cc. and L-static action at 0.062 γ/cc. These compounds, unlike anti-biotics, showed no marked difference in the strength of the antileptospiral action at different stages of the growth of L. As to the various kinds of L., Hi-Na showed L-cidal action on L. autumnalis at 1.0 γ/cc. and on other kinds of L at 2 γ/cc. while L-static action on L. autumnalis and L. australis was seen at 0.062 γ/cc., on L. pyrogenes at 0.5 γ/cc., and on L. canicola at 0.125 γ/cc. Finally, antileptospiral activity of 14 kinds of Trp-derivatives on L. icterohaemorrhagiae was measured, Tween 80 being used as a solvent. Trp and Hi had the L-cidal action at 0.5 γ/cc., Hi-Na at 1.0 γ/cc., mercapto-Tpn at 2.0 γ/cc., and 7-monobromo-Hi, 3-7-dichloro-Hi, 3-monobromo-Trp, 3-7-dibromo-Hi and 3-5-dibromo-Trp at 4.0 γ/cc. On the other hand, Trp and Hi showed L-static action at 0.062 γ/cc., Hi-Na at 0.125 γ/cc., mercapto-tropone at 0.5 γ/cc., 7-monobromo-Hi, 3-7-dichloro Hi, 3-monobromo-Trp and 3-7-dibromo-Hi at 1.0 γ/cc., 3-5-dibromo-Trp at 2.0 γ/cc., and the other derivatives at higher concentrations. From these results we noticed that, among the examined compounds Hi and Trp had the most powerful anti-leptospiral activity and that the activity showed nearly the same strength at any stage of the growth of L.
We examined the hemocytopenic action of the spleen 53 times on the 41 cases of typhoid fever, paratyphus A & B, and obtained following results. Maturity disturbance of the erythroblast and neutrophile leucocyte is one of the causes of anemia and leucopenia seen in these diseases, and the main cause of thrombocytopenia is the decrease in the activity of platelet formation of the megakaliocytes. Moreover, from the finding of the unusual morphological changes of megakaliocytes, it was conjectured that in some occasions the megakaliocytes were damaged directly by certain noxeus substances. We proved a positive case of Coombs test and noticed that there were occasionally hemolysis due to autoantibody. During the febrile state, the colour index showed within normal range in general and some were increased, but excessive decrease were relative rare. During the same state, serum iron content revealed normal range in the most cases and were relatively lower in some cases, but after the reduction of fever, increasing tendency of iron content was observed. Wa made this phenomenon out as following; the serum iron was caught somewhere during febrile stadium, and was released after the reduction of fever, and this cause transient increase of serum iron in this stadium. Even by the time of disappearance of eosinophile leucocytes on the peripheral blood picture, the decrease of eosinophile cell count in the bone marrow was not recognizable and, furthermore, mature eosinophilecytes were not decreased in general. It is impossible to explain completely the rôle of splenomegalia due to infection on the mechanism of the hemocytopenia in these disease only by above mentioned results of our clinical examinations, but it may be said that the splenomegalia is an influential cause of the hemocytopenia.
Studying the thiamine metabolism in blood and urine of pulmonary tuberculosis patients, I got results as Follows: 1) Thiamine is laeking in pulmonary tuberculosis, and the worse is the disease, the less is thiamine in the body. Thiamine increases by dosing thiamine preparations in general, but it is apt to decrease to the previous amount after dosing in serious cases. 2) Many of pulmonary tuberculosis patients have beriberoid-complaints, but none of them could be diagnosed to have evident Beriberi as complication. 3) Composite Vitamine and T. P. D. are more effective to cure the beriberoid-complaints of pulmonary tuberculosis than simple B1 hydrochloride.
Four groups of normal dogs were sensitized in the following manner for this study. The first group was injected with an emulsion of the pancreatic islets of Bonsto, the second with horse serum, the third with an emulsion of horse pituitary glands, and the fourth with ACTH. These groups were reinjected with the same antigens into the following places: First group--pancreatic artery or pancreatic tissue Second group--main pancreatic duct Third group--pancreatic and carotid arteries Fourth group--pancreatic artery Dogs with a chronic abscess formation of the subcutanous tissue or intra-articular cavities caused by Streptococcus hemolyticus or Streptococcus viridans, were injected with a suspension of the above heat-killed bacteria, or their filtrates into the main pancreatic duct or artery. Also, dogs with the same chronic abscess formation sensitized with horse serum, were injected again with the serum into the main pancreatic duct. Conclusion: (1) Through the whole group of experiments, there was a specific serofibrinous inflammation, which was considered a histological indication of phenomenon of Arthus in the pancreas. In addition, the abscess-formed dogs showed either the primary finding of rheumatoid nodules or the picture of fatty necrosis. (2) There were two possible types of allergic pancreatitis, the one was the slow formation of the rheumatoid nodular granulative tissue, and the other was the fatty necrosis, rapidly and diffusely involving the fatty tissue. (3) In general, allergic pancreatitis through the pancreatic duct was of a slighter degree than that through the artery. However, in abscess-formed dogs, there was a remarkable histological change in the pancreatitis through the pancreatic duct. (4) There was a close reiationship between the internal and external secretory portions of the pancreas. Although the emulsion of islets gave a selective reaction to a certain degree for the islet of Langerhans, there was no possibility of developing the specific inflammation localized only in the islet. There was, in addition, considerable parenchymal degeneration accompanied by interstitial reaction. (5) A correlation to a certain degree was observed among the pancreas, the pituitary gland and adrenal glands. (6) The presence of the focal infection gave growth to an allergic pancreatitis due to foreign protein, and also produced histological pictures similar to those of patients with various types of pancreatitis. Experimentally induced allergic pancreatitis. After sensitization of normal dog with the emulsion of Langerhans' islets cells of the Bonito, reinjection of the same emulsion made into the pancreatic artery (5th day). Small necrotic foci in the pancreatic interstitium, formation of the granulation tissue consisting of acidophiles, polymorphonuclear leucocytes intermixed with fibrin, and formation of the partly organized thrombus seen. Also noted vacuole formation and basification of the gland cells. Haematoxylin-eosin stain X100. Experimentally induced allergie pancreatitis. After sensitization with the emulsion of Langherhans' islets of the Bonito, the same emulsion reinjected into the pancreatic artery (5th day). Vacuole formation in Langerhans' islets cells, or destruction of nuclei noted. No sign of regeneration. H. E. stain X900. Normal dog sensitized by the emulsion of Langherhans' islets of the Bonito followed by reinjection of the same emlusion into the pancreatic tissue and ligation of the large pancreatic duct (5th day) X100. Marked proliferation of interstitial connective tissues, remarkable atrophy of the parenchyma. Experimentally induced allergic pancreatitis. After sensitization of normal dog with horse serum, reinjection of the serum made into the large pancreatic duct (after 48 hours). Desqualmation of the pancreatic ductepithelia, serous inflammation and cell infiltration around the duct, mainly by acidophiles and