In estimating oxygen consumption and glycolysis of bone marrow by warburg's apparatus, the method of making slices seems to have much influence upon results. When the obstruction imposed on the tissue proves intense, it is hard to obtain a constant results. We, inserting the tissue of bone marrow between two Graefe's messes, and by cutting while smoothly moving these knives on both sides, could succeed in getting thinkness of the slices below 0.5mm. In a normal rabbit these slices, of bone marrow have always proved greater amount of oxygen consumption than in case of minced one; besides, the lowering rate according to the lapse of time was smaller. As for the floating solution, relatively constant results were obtained with saline phosphate solution, but Ringer-bicarbonate solution possesses greater value than those of saline phosphate solution or Tyrode's solution, showing slightest in their lowering rate in the course of time. The optimum pH in the floating solution seems at pH 7.4. Subsequently, as for sternal punctate, clinical application would be made possible by making conditions of both puncture as well as suction more steady. Results may need to be judged from all these figures: Xo2, Xo2/K, Qo2, XMN2, XMN2, /K, QMN2, (K=nucleated cells in 1cmm punctate). If considered as to various kind of diseases in series of microcytic hypochromic anemia, oxygen consumption has indicated approximately normal, or somewhat excessive accompanied with a moderate advance in glycolysis. In case of hypoplastic anemia, the both function lowers remarkably, moreover in the type of blood cell arrest, the lowering ratio proved slight, while proved marked with the type of regeneration disturbance, mixed type or panmyelophtisis. Also, in hypoplastic anemia, Xo2, XMN2, /X show pretty high so that it appears almost antipodinous compared to leukemia. Among various leukemias, the rise in oxygen consumption in case of monocytic leukemia appears remarkably unique. Thus, we could realize that oxygen consumption and glycolsis in the bone marrow possess very close connection with hematopoietic function, playing an important role in the explanation of ethological physiology of bone marrow as well as clinical differential diagnosis.
(I) Experimental method. 1) Viviperfusion: rabbits and dogs were viviperfused for 30-60 minutes. 2) Digestion: samples were wet ashed in Kjeldahl's flasks. 3) Electroplating: Vosburgh's method. 4) Fractionation of non-hemin iron: Yoneyama's method. 5) Extraction of non-hemin iron: Brueckmann's method. 6) Determination of serum iron: Burch's method. 7) Determination of radioactivity: by Geiger Müller counter. 8) Histological iron-staining: by the turnbull-blue reaction method. (II) Conclusions 1) For the studies on the physiological iron-metabolism, amount of intravenously injected iron should be within the limit of the iron-binding capacity of serum. 2) Intravenously administered radioiron is taken most intensively by the bono-marrow and next by the liver; in the bone-marrow it is mainly used for the synthesis of hemoglobin, while in the liver it is deposited as non-hemin iron. 3) When animals are bled the deposited radioiron is mobilized from liver, bone-marrow and other organs for the synthesis of hemoglobin. In such condition hemosiderin seems to be utilizated for the synthesis of hemoglobin. 4) In the hemorrhagic iron deficient anemia the uptake of radioiron by the bone-marrow is increased, but the uptake by the liver is decreased in compaired with normal animals. On the other hand, in the acute inflammation and X-ray irradiated anemia it was decreased in the bone-marrow. 5) The iron deposition following intravenous injection of red cells ragged with radioiron is mainly seen in the spleen. In such experiment radioiron is found in the ferritin, therefore iron of ferritin seems to be drived from hemoglobin iron too.
In considering the prophylaxis of the focal infection, it is essentially required to exclude the causative factors, thereby revealing the disease, and other various factors responsible for the individual resistance to infection. The experimental studies have been undertaken from the above mentioned clinical view in order to attempt the clarification of the various factors which may preventively affect against the carditis due to the focal infection. The carditis due to the focal infection was experimentally produced by repeated injection of β-haemolytic streptococcus, thereby providing subcutaneous aleuronat abszess at the lateral site of abdomen in rats. The following results were experimentally obtained. 1) Removing the aleuronat abszess at the early stage of the disease, the heart of rats has not revealed any appreciable lesion of carditis. 2) The injection of anti-histamine drag was not effective against carditis. 3) The administration of penicillin or small amounts of cortisone arrested the developement of the carditis. 4) The injection of large amounts of cortisone has not arrested the onset of the disease, but incited the bacteriemia. 5) Vitamin B1 defficiency or intermittent exposure to cold effect has not promoted the onset of carditis. 6) The rats exposed to the cold effect for a long term have easily affected from the carditis.
Studying the thyroid activity in essential hypertension, we have measured serum protein bound iodine (PBI) level and basal metabolic rate (BMR) in patients with hypertensive diseases and normal adults. We have also investigated the effects of thyroid extract on essential hypertension. Serum PBI is determined by the slightly modified Barker's alkali incineration method. 1) We can not find any marked difference between the serum average PBI level of 20 patients with essential hypertension and of 10 normal adults. But it is interesting that the PBI level is lower in patients with the essential hypertension of group 1 (according to Keifh Wagener's classification-i.e. early stage) than in normal adults. However, the PBI level in group 2, 3 and 4 is higher than normal adults, and then it tends to rise as the hypertention develops. 2) The average of the basal metabolic rates in 20 cases of essential hypertention is higher than that of 9 normal adults. 3) We can not find any corelation between the PBI level and the BMR in essential hypertention. The increase of the BMR in essential hypertension may not always mean the hyperfunction of the thyroid gland. 4) Nine cases of essential hypertension are administered with thyroid extract (0.05-0.1gr. pro day) for 2 to 13 weeks. Among them in 5 cases of low PBI level at the earlier stage is shown the remarkable response to administration of thyroid extract. It results that serum PBI level rises up and both systolic and diastolic pressure begins to fall. Another 4 cases with high PBI level (1 case of Group 2, 1 case of Group 3 and 1 case of Group 4) do not so clearly respond to administration of thyroid extract as the formers. The PBI level decreases against our expectation. The slight fall of systolic pressuer is observed but diastolic pressure does not fall. 5) The favorable response to thyroid extract in these cases may be ascribed to the existence of the hypofunction of thyroid gland which may be at the early stage of essential hypertension. The reverse response to thyroid extract observed in the late stage of the disease may be the result of the fact that the secretion of thyrotropic hormone may be inhibited by the thyroid extract administered and then the already existing compensative hyperfunction of thyroid gland is diminished. Although it is not able to conclude that the hypertension occurs from the hypo- or hyper-function of thyroid gland, it may be thought that the interrelation between essential hypertention and thyroid activity may be more complicated than it has been considered up to now.
Ninety cross-infected cases were found in bacillary disentery patients admitted in our hospital during 2 years, 1952 to 1954. Development of dysenteric symptoms is observed in a few cases when the cross-infection occurs between the bacillary types belonging to St. flexneri (B group). On the other hand, its morbidity rate is very high on the occasion of such cross-infection between different groups of Shigella genus, as from Sh. sonnei to Sh. flexneri or from Sh. flexneri to Sh. sonner (Table 1). The difference of the morbidity rate will be interpreted as follows: immunity is not formd in the case of cross-infection between different bacillary groups, but it is formed in one between same bacillary group. Whenever the secondary bacilli appear in exchange for the primary, the primary Shigella bacilli by which symptoms are caused disappear rapidly from feces, even though they are discharged continuously. The secondary bacilli already appear into the feces previous to the development of dysenteric symptoms (Fig 1). In the serum of the patients infected crossly, the agglutinin and the protective antibody against primary agent only arise in the stage of first onset, and those antibodies against the secondary one begin to arise after the second infection when the infection is caused by the bacilli of a different group from the primary one (Fig 2, 3). An attempt was made to inject Sh. flexneri 2b vaccine treated with KCN-VK3 by Hosoya's method to dysenteric patients affected with Sh. sonnei, to know whether the antibodies against Sh. flexneri arises or not and whether the cross-infection to Sh. flexneri is prevented or not. We believe the vaccination is effective from the result that the cases of the cross-infection to Sh. fiexneri is less among vaccinated patients than non-vaccinated ones (Fig 4, Table 5).
Details upon the pathological physiology and the exact mechanism of effect of artificial pneumoperitoneum, commonly used as a treatment for pulmonary tuberculosis, remain to been elucidated so far. The results of many investigations concerning this problem have been reported by professor, Dr. Sunao Wada. As my share, I have made clinical studies on the fluctuation in the blood sugar level by pumping gases intraperitoneally. To estimate the blood sugar level, Hagedorn & Jensen's method was employed. Fasting blood sugar levels in healthy individuals and patients of mild pulmonary tuberculosis without any complications were observed for one week. In patients with mild pulmonary tuberculosis the fasting blood sugar levels caused by intraperitoneal pumping were observed for one week. 4 types of gases were used: air, nitrogen, oxygen and carbon dioxide. The results as follows: 1) The results in cases of pulmonary tuberculosis with no intraperitoneal pumping were almost constant and the mean value of them was 86 mg%, almost the same as that of 85 mg% in healthy individuals. 2) 3 hours after the gases were pumped into the peritoneal cavity, the blood sugar level of the tuberculous patients showed a slight reduction. After 24 hours, the blood sugar level reached its maximum value, after surpassing its pre-pumping value. Subsequently, the elevated blood sugar gradually returned to its original value. However, these fluctuations were physiologically within normal limits. 3) The 4 different gases produced no significant difference in the fluctuation of blood sugar level.
The author has attempted to conduct clinical experiments on kidney function in order to clarify the pathological physiology of artificial pneumoperitoneum. The method consisted of urea clearance measurements following intraperitoneal pumping of such gases as air, oxygen, carbon dioxide and nitrogen for one week. The following results were obtained. 1) At the controlling observation there was no difference between tuberculous patients and healthy one. The average value of the former was 49.6cc/min., and that of the latter was 49.8cc/min.. 2) The urea clearance measured before the 3rd intraperitoneal pumping using 4 kinds of gas, especially air and nitrogen, revealed lower value than that of tuberculous control patients. 3) The urea clearance measured after the 3rd intraperitoneal pumping using 4 kinds of gas showed the lowest degree of uaea clearance after 24 hours. Two days after the 3rd pumping the urea clearance gradually increased, and after 7 days rose to a level higher than that before the 3rd pumping.
I. Relationship between RBF and Blood Pressure in Experimental Renal Hypertension: In order to clarify the significance of renal ischemia in experimental renal hypertension, 11 dogs subjected to the Goldblatt's operation were followed for about 6 months, during which blood pressure and RBF were measured simultaneously, and then the following conclusions were obtained: 1. To produce the sustained elevation of blood pressure in dogs subjected to the Goldblatt's operation, it is necessary PBF to be reduced less than at least 80% compared to the preoperative levels. 2. In the course of time, there was a certain tendency for RBF to approach the initial level, but the elevated blood pressure continued approximately its high levels. II. Demonstration of Pressor Substances from Renal Venous Blood in Essential Hypertension. To Know whether or not pressor substances are present in the blood of the patient of essential hypertension is of the utmost importance. A series of experiments was undertaken, therefore, in an attempt to demonstrate their presence, and the following results were obtained: 1. In the extracts from 8 of 19 hypertensive patients, pressor effects were found. Their RBF showed reduction under 50% compared to normal ones. 2. In the extracts from 5 normal individuals these pressor effects were absent. III. In conclusion, although depression of RBF under certain level is necessary, for the production of experimental renal hypertension the way in which essential hypertension is initiated in man may not involve the kidney. It is suggested that some factors other than the kidney probably participate in early essential hypertension and late stage of experimental renal hypertension. Following the reduction of RBF in essential hypertension, however, the ischemic kidneys liberate pressor substances into the circulation, and the kidney may play a role as one mediator of hypertension.
The absorption tests were made on the sera of 7 normal individuals, 30 tuberculous cases, and 7 non-tuberculous cases which showed high γ-globulin contents, by using the tuberculin sensitized red cells as absorbants and then the changes of each fraction the serum protein before and after this procedures were observed by Tiselius's electrophoretic method. The results obtained were as follows: 1) In normal individuals, no significant change was found on the γ-globulin fraction, but the albumin fraction showed 2.4% decrease on the average. According to writer's preliminary experiments, this seemed to be caused by the non-specific absorption by the sensitized red cells. 2) In the tuberculous cases, 2.4% decrease of γ-globulin fraction and 1.8% increase of albumin fraction observed were significant-in the sense that the specific absorption occurred more markedly than the non-specific absorption by the sensitized red cells. And at the same time, the hemagglutination titers also showed a marked decrease after the absorption tests. 3) In the non-tuberculous cases, no significant change was noted in all the fractions of the serum. 4) Absorption tests by usiog heat killed tubercle bacilli of human type were made on the tuberculous cases in parallel with the sensitized red cells, and almost the same findings were obtained. Based on these results, it may be concluded that the some parts of the specifiic antibodies are contained in the γ-globulin fraction of the serum of tuberculous patients.
Studies on the analysis of auricular excitation wave by means of the precordial lead and the esophageal lead have been reported in considerable numbers. It is natually understood from the well known relationship between the theoretical bases of unipolar lead and the anatomy of the thorax that precordial leads CR1 and CR2 may represent the excitation of the right auricle, and the esophageal lead held behind the left auricle may represent that of the left auricle. Furthermore, it is expected that, when we record simultaneously the electrocardiograms of both leads and make a minute analysis of of the phase of P-wave, we can understand pretty exactly the process of conduction of excitations to and between both auricles. Performing the simultaneous leads on thirty healthy persons, we analysed auricular excitation waves and decided the standard values of healthy persons from our measurements. Thereafter various abnormal ECG were analysed compared with them. The result were as followed. 1. 8 patients whose standard limb lead ECG showed the prolongation and slurring of P-wave: We could distingwish left auricular dilatations from disturbances of interauricular excitatory conduction. The former showed widening of esophageal lead P, and the latter prolongation of the interval between both intrinsicoid deflections. Both showed the broadened P on standard limb lead. 2. One patient who suffered from frequent episodes of auricular premature beats: The origin of excitation and the direction of excitatory processes were made clear. 3. One patient with auricular flutter: We understood in considerable detail the state of conduction of excitation. 4. One patient with arrhythmia due to ventricular extrasystole: A small wave after extrasystolic QRS of limb leads were interpreted to be a retrograde P-wave by means of our simultaneous leads. This method can be performed easily in daily clinic and is useful to interprete the condition of auricles.