Sogen and Kuwano in our laboratory reported recently on the results of estimation of the protein-bound iodine (PBI) in plasma in various internal diseases. They used then a simple method, modified by Heki and Sogen. The investigation on the improvement of method, however, was continued thenceforth and the report of the new precise one was published as Heki-Ono's method in the Endocrinologia japonica, 2, 99, 1955. The author intended in this report to reinvestigate the results, obtained by Sogen and Kuwano, by this now procedure of PBI estimation. The level of PBI in healthy adults was found to be 5.0-7.5 γ/dl; there was no overlapping of values between hyper-or hypothyroidal state and normal individuals. In beri-beri, pulmonary tuberculosis, diabetes mellitus etc, the level was low, the results which well agreed with those by Sogen and Kuwano. In essential hypertension the level of PBI was found to be rather low, the result which agreeded with that by Kuwano, but not with that by Sogen. In anchylostomiasis normal values were obtained, while Sogen and Kuwano reported low levels in the same disease. The fact of the seasonal variation of PBI in normal adults, previously reported by Kuwano, has been established.
Transient leucocytosis was observed at first in the blood of the rabbits which were irradiated with the tube of Co60, but it was no more stimulated by repeated irradiation. It may be assumed that a leucocytopenia especially lymphocytopenia stimulating factor which was produced in the lymph node and serum of the repeatedly or continuously irradiated animals, controled the leucocytosis in them.
Measurements of cerebral hemodynamics and cerebral oxygen consumption (CMRO2) were made by the nitrous oxide method in 60 patients with essential hypertension. The mean values for cerebral blood flow (CBF) and CMRO2 were significantly lower (P<0.05) than normal values noted for healthy young men. The mean cerebral vascular resistance (CVR) was significantly higher than normal value (P<0.01). In these hypertensive patients the influence of aging on cerebral hemodynamics was studied, and statistically significant correlations was calculated between age and such values as CBF CVR and CMRO2. These findings revealed a decreasing CBF and CMRO2 and an increasing CVR accompanied with advancing age. Comparing these values in hypertensive patients with those in normotensive subjects of the same age, the statistically significant difference was only the significantly increased CVR (P<0.01). The effects of aging on the cerebral hemodynamics in the hypertensive group were more remarkable than that in the normotensive group. These facts were atributed to the more progressive increase of cerebral arteriosclerosis with advancing age in hypertension. The cerebral hemodynamic changes in seven renal hypertensive patients and one patient with coarctation of the aorta were the same with that of essential hypertensive prtients. In five hypertensive arteriosclerotic patients with psychosis CBF and CMRO2 were significantly decreased. There was no relationship between mean arterial blood pressure and CBF and the former and CMRO2. The relation between cerebral hemodynamics and the Keith-Wagener's grade were significant. The proportional increasing cerebral vascular resistance was observed accompanying with advancing in the grade. The cerebral vascular reactivity due to the inhalation of 5 per cent carbon dioxide in essential hypertensive patients was significant. These findings demonstrated that the CVR in hypertension was increased, mostly due to increased cerebral arteriolar tone, but partly due to arteriosclerosis. Finally, clinical implications of these studies were briefly discussed.
Cardiac hyperfunction is regarded as one of the causes inducing subacute bacterial endocarditis (S.B.E.). In the present study, Digitamin (digitalis preparation Shionogi) injection and forced movement were used as the tools to give over-load to the heart. Methods and results are summarized as follows: 1) Six rabbits were injected with Digitamin and Streptococcus sanguis, strain A, which was isolated from a patient, with S.B.E.. Bacterial endocarditis was found in none of these animals. 2) Six rabbits were similarly treated with Digitamin and Streptococcus sanguis, strain B, which was obtained by rabbit passages of strain A. In 2 of 6 cases, bacterial endocarditis with certain pathological changes could be produced. On the other hand, 3 rabbits which were inoculated only with strain B showed no finding of bacterial endocarditis. It is considered that in this experiment the combination of Digitamin and strain B has been necessary to cause bacterial endocarditis, and Digitamin has played an important rôle in causing the disease by its cardiotonic activity. 3) Eight rabbits were put in a round wire cage separately, which was quickly turned for the purpose of making the animals exhausted. All animals were pathologically studied for changes in the heart after being sacrificed. Two of 4 cases which were subsequently inoculated with strain B showed the signs of bacterial endocarditis (Fig. 4), while the other 4 rabbits which were not otherwise treated showed the following abnormalities. 1. Hypertrophy and exfoliation of the endothel cells of valves. 2. Platelet-thrombus on valves (Fig. 1, Fig. 2). 3. Development of fibrocytes and fibroblasts in endocardium. 4. Cell infiltration in endocardium (Fig. 3). These minute changes are supposed to offer a clue to the onset of bacterial endocarditis by subsequent inoculation with bacteria. From the above experiments, it was concluded that Digitamin injection and forced movement are important factors which cause bacterial endocarditis through giving overload to the heart, so far as they are combined with a certain virulent strain of Streptococcus sanguis.
Direct Coombs test was performed on the total of 157 cases with various kinds of hemal disease and allied illness. In consequence of this experiment, 30 out of 157 cases showed positive reaction; 13 out of 62 cases of chronic splenomegalia of unknown origin including so called Banti's syndrome, 1 out of 3 cases of chronic lymphogeneous leukemia, 1 out of 3 of acute myelogeneous leukemia, 2 out of 7 cases of panmyelopathia, a case of chronic erythroblastphthisis, 1 out of 2 of pernicious anemia, 2 cases of constitutional hemolytic anemia, 3 out of 7 cases of Laennec type of liver cirrhosis, 1 out of 6 cases of acute hepatitis, 1 out of 19 cases of typhoid fever (including paratyphoid), 2 out of 13 cases of other infectious disease, 2 out of 6 cases of cancerous disease. But the following cases showed negative reaction. They were 3 cases of chronic myelogeneous leukemia, 3 cases of reticulosarcomatosis, 3 cases of essential thrombccytopenia, 8 cases of Schönlein-Henoch's purpura and 7 miscellaneous diseases. It was suggested that the incomplete antibody is present on the patients who were suffering from various disease. But, the tendency of increasing hemolysis was not always observed, even on the Coombs test positive patients. It was observed with much interest that on the two cases of panmyelopathia and on a case of chronic erythroblastphthisis Coombs test revealed a positive reaction at the start and subsequently it changed to negative, and on a case of pernicious anemia incomplete antibody was not recognized during spontaneous remission. On a case of constitutional hemolytic anemia, antibody was proved 13 years after splenectomy. Furthermore, on a case with incomplete antibody for erythrocytes the presence of incomplete antibody for thrombocytes was also confirmed by the direct method, and on another two cases the presence of it was conceived with sufficient grounds.
As one of the methods in differentiating so-called Koga's “camouflaged tuberculosis” with the so-called neurosis, the influence of so-called emotional stress (emotions such as anxiety, fear, etc, ) upon the living body, especially upon the anterior pituitary-adrenal cortical system has been studied. Furthermore, as a control experiment, the influence of physical fatigue and malignant neoplasm upon the adrenal cortex, and at the same time the influence of environmental change upon the living body have been observed. 1. White rats received ample emotional stress applying Koga's apparatus. 2. Muscle exercise proved to be a strong stressor. 3. Transplantation of Yoshida's sarcoma became a stressor in white rats, and on the contrary, lead to exhaustion. Administration of cortisone gave a poor influence upon the living body. 4. Although laboratory practice may temporarily become a stressor in white rats, it was found that they gradually adapted. 5. Since it can be considered that the handling of animals may influence the living body as a so-called emotional stress, special care must be taken in selecting the control value.