The author obtained the following results concerning the content of urinay 17-KS in various kinds of internal diseases. 1) In diabetes mellitus it is normal or decreases, but some cases show an increased content. 2) In Basedow's disease it is normal or decreases, and in myxodema it decreases, but it returns to normal content as the basal metabolism becomes normal. 3) In addison's disease it decreases, but by no means becomes zero. In addisonism, it decreases too. 4) In various sorts of anemia it decreases, but it is normal in minimal cases of anemia. In leukemia it decreases. 5) In liver diseases it generally decreases. 6) In heart diseases, cases without decompensation show a normal content and cases with decompensation show a decreased content, but the content increases with emeliorated decompensation. 7) In hypertension it is normal or decreases, and some cases with juvenile hypertension and diabetes mellitus show an increased content. 8) In chronic nephritis and nephrosis, it generally decreases: 9) In infectious diseases, cases with fever of long duration show a decreased content, while cases with fever of short duration, a normal content. 10) In tuberculosis, cases with malnutrition show a decreased content. 11) In bronchial asthma it decreases during the attack. 12) In tumor, cases with good general condition show a normal content, but the content decreases as cachexy progresses. 13) In neurotic diseases it is generally normal, some cases with so-called neurosis show a decreased content.
Coronary sinus catheterization was performed in 112 human subjects, including thirty-three normal subjects, forty-six patients with cardiac failure, eleven patients with coronary sclerosis, six patients with hypertension, eight patients with anemia, seven patients with hyperthyroidism, and one patient with beri-beri. In these subjects myocardial gaseous metabolism has been investigated, while left ventricular coronary blood flow has been determined in forty-six of them by means of nitrous oxide methode. 1. In normal subjects the average oxygen extraction of left ventricular myocardium was 10.5 volumes per cent. The left ventricular coronary blood flow per 100 grams per minute and the left ventricular oxygen consumption per 100 grams per minute averaged 68.5cc and 7.1cc., respectively, and left ventricular myocardial efficiency averaged 29 per cent. The average myocardial RQ was 0.89. 2. In patients with cardiac failure due to valvular or hypertensive heart disease, the myocardial oxygen extraction were significantly increased. This was marked when failure was moderate or severe. The coronary blood flow was normal or slightly increased, resulting in the elevated myocardial oxygen consumption and low cardiac efficiency. In moderate or severe failure myocardial RQ was significantly reduced. 3. In patients with coronary sclerosis, most of whom had anginal pain on exertion, myocardial oxygen extraction was slightly but significantly increased, while the coronary blood flow was normal at rest, resulting in elevated myocardial oxygen consumption. Myocardial efficiency was slightly decreased but was within normal range. 4. In patients with essential hypertension both myocardial oxygen extraction and myocardial efficiency were normal. Further study is necessary, however, because only a few subjects were studied, including cases with slight hypertension. 5. In patients with anemia myocardial oxygen extraction was decreased but myocardial oxygen extraction coefficient (Cao2-Cso2)/Cao2 was increased. Coronary blood flow was markedly increased, the ratio of coronary flow/cardiac output being higher than normal value. Myocardial efficiency was normal. 5. In patients with hyperthyroidism myocardial oxygen extraction was normal. Coronary blood flow was increased but the ratio of coronary flow/cardiac output was normal. Myocardial efficiency was normal. 7. After the administration of digitalis preparation (lanatoside-C or digicorin) in three patients with congestive failure coronary blood flow reduced about 10 per cent, resulting in the decreased left ventricular oxygen consumption and the elevation of cardiac efficiency. 8. The effect of exercise, hypoxia and hexamethonium bromide on myocardial gaseous metabolism and coronary hemodynamics were also demonstrated in healthy and diseased heart.
(1) The cathepsin activity of the liver revealed no change in degree in a rabbit treated repeatedly with CCl4 and in a normal one, while that of the spleen was greater in the former than in the latter. (II) Incubation in rabbit serum of a liver slice from a normal rabbit and from a CCl4 treated one showed that the total nitrogen, the non protein nitrogen, and the total protein content of the medium was increased in both cases, and that the albumin content was decreased and the α-globulin content increased in the former case, but not in the latter. Incubation in γ-globulin solution of a liver slice, and incubation in rabbit serum of a spleen slice, either from a normal or from a CCl4 treated rabbit, caused no notable change in the contents of the medium. The fact that a normal liver (and spleen) was not different in cathepsin activity from one in chronic CCl4 intoxication appeared to indicate that protein metabolism in the liver (and spleen) was maintained at normal level even in case the liver (and spleen) was impaired, although a decline in albumin metabolism in an impaired liver might imply a rise in globulin metabolism in such an impaired liver.
I. Using dogs, cats and rabbits, there were examined mainly, the circulatory actions of R.s. and Deserpidine. Results are as follws. 1. The lowering of arterial blood pressure due to R.s. is of mild and slow mode; however it is possible to exist such cases which show the abrupt response by the intravenous use of Alseroxylon solved in propylenglycol. This abrupt reaction does neither depend upon nature of solvents, nor upon so-called yohimbine-liked action of R.s., 2. R.s. suppresses carotid sinus pressor reflex, but does not inhibit its depressor reflex. 3. In cats, R.s. does not ameliorate the elevation of blood pressure due to faradization of peripheral end of splanchnicus, but the stimulation of the central end. 4. R.s. does not inhibit pressor action of epinephrine by means of single intravenous injection nor of droplets-infusion. 5. Reserpine does not influence the contraction of nictating membrane in cats induced by faradization of preganglionic fiber of upper cervical sympathetic ganglion. 6. The miosis can be brought on by the intravenous application of R.s.; in turn, atropine changes this miosis into mydriasis. 7. Blood pressure moderators were cut previously; no striking lowering of arterial pressure can be observed in decerebrated dogs even 15 minutes after the intravenous injection of Reserpine, whereas, 1-Hydrazinophthalazine shows marked lowering of blood pressure within this time course. 8. R.s. is apt to set up bradycardia: slight prolongation of PQ interval and respiratory sedation, although these data can be often attributable to the tranquil state of animals. 9. The circulatory analyzis clarifies that the decreas in W. (peripheral vascular resistance), E′. (elastic resistance), and the increase in S.V. (stroke volume), M.V. (minute volume) can be determined before the lowering of blood pressure does not remarkably stilly appear. 10. The experimental results obtained with the use of Deserpidine are similar to those of Reserpine. II. Effects of lowering of blood pressure and influence on circulatory dynamics were examined in 87 patients suffering from high blood pressure, especially from essential hypertension under the treatment with R.s.. 1. With the parenteral use of large dosis the lowering of blood pressure is so remarkable that shock and severe side effect can appear, though it happens not frequent. At this depression the hemodynamics is characterized with the decrease in both W. and E′ and with the increase in M.V., When B.P. is excessively lowered, the hemodynamics designs to disclose so-called “Anspannungskollaps”. 2. The effect of lowering of B.P. can be ascertained of usual dosage. The earlier is the stage of disorder, classified by Keith-Wagener, the more valid is R.s.. Improvement of subjective claim is not necessary parallel to the degree of lowering of B.P., and the former is generally more striking. The side effect is not so severe that it does not disturb the daily life of patients; but it was, evan if not often, observed that it increases in frequency of anginal attack, or induces cardiac block e.g. partial sinuauricular block. 3. As to Alseroxylon, common dosage is thought to be 6-8mg. pro die, and as Reserpine, it is assumed to be enough only 1/8-1/10 of the dosage in Alseroxylon treatment. In the patients who show no effective lowering of B.P. within this dosage, there cannot be expected more marked lowering even if with madication of larger dosis above this limit. The patients who show refractoriness against R.s., are apt to disclose side effect. 4. The changes of circulatory dynamics in peroral and chronic use are variable from case to case. There can be seen frequently the increase in M.V. though it is of slight extent. In the type of W. or E′., R.s. affects to induce normal state. 5. The influence of R.s. upon R.B.F. (renal blood flow) or T.R.R. (total renal resistance) is not constant, and there
The histological investigation on chronic hepatitis based on biopsy studies has been the subject of previous publication. In this paper, a statistical attempt has been made to compare morphologic phenomena with the results of liver function tests in chronic hepatitis. A tetracholic coefficient of correlation of the histological characteristic with the results of biochemical determination was chosen for statistical correlation. This attempt was believed to be necessary in order to understand the clinical findings of chronic hepatitis. There was a statistically significant correlation between thymol turbidity test and regenerative process; the regenerative process included the following alteration: enlargement of hepatic cells and hepatic nuclei and inflammatory cellularity in portal spaces. The interstitial inflammation and fibrosis revealed a good correlation with Kunkel's reaction and thymol turbidity test. Correlation was also observed between elevation of icteric index and increased Kupffer's cell activities. A significant correlation was found between elevation of iodic acid value of serum, a criteria indicating the grade of oxidation process, and following alteration of hepatic cells such as swelling, acidophilic shrinkage and irregularity in staining of the cytoplasma. However no statistically significant relation was observed between morphologic alteration of hepatic cells and any of the function tests other than the thymol turbidity test and iodic acid value. The results of this investigation is of strong evidence in emphasizing of the value of liver biopsy in the diagnosis of chronic hepatitis.
The histological studies on the characterization of chronic hepatitis and its relation between histological features and routine test of liver function have been the subjects of previous investigation. In this paper the investigation was carried out for the purpose of classifying histologically the type of chronic hepatitis, thereby enabling simplification of diagnosis and treatment of chronic hepatitis. No attempt is made here to discuss the etiology of this disorder. Type I was found to be compatible with so-called “Dubin-Johnson's syndrome”, and Type II was of the cholangiolitic type previously reported by Watson-Hoffbauer. Type III showing the interstitial cellularity chiefly was further classified as follows: A: presenting typical interstitial inflammation of the liver, B: presenting atypical inflammation and scarring which has been reported by Shiff et al., C: cases showing remarkable proliferation of fibroblast, where transition to cirrhosis may be expected., and D: presenting fatty metamorphosis of the liver. A type presenting chiefly degeneration of parenchymal cells was differentiated altogether from the former types and was designated as Type IV. None of these type IV changes were previously considered pathologically to be these of chronic hepatitis. In compliance with the author's opinion of chronic hepatitis so-called posthepatitis neurosis which has been reported by Caravati and Sherlock may fall into the category of Type IV. The clinical and laboratory findings were studied according to this histological classification of chronic hepatitis. The percussion tenderness of the liver was elicited most frequently in Type III. The abnormalities of serum colloidal reactions were found to be prominant in cases with changes of Type II and III. No clearcut of difference in the abnormality of B.S.P. retention and reduced oxidation (for example in Iodic Acid Value, Pyruvate and Citrate concentration of blood etc.) between the Type III and IV could be observed. Further discussion may be necessary in considering cases of Type I to be chronic hepatitis.
In the Fall of 1954 a beauty artist called on one of the author's clinic at the Tagawa Social Insurance Hospital complaining mainly of lassitude. Medical examination showed that she had a disease in the liver. She said to the author that it was generally thought that the beauty artist was inclining to be attacked by liver disease. By careful observation we came to the thought that might be probable. So we began a systematic examination and as a first step of it we examined the liver of 77 beauty artists, who were engaging in their business in Tagawa city of Fukuoka Prefecture, and obtained the following results: 1. Disturbance in the liver function was found in 26%. 2. It was however not clear whether or not age and duration of business had some relation with liver disturbance. 3. Among the patients the liver was palpable in 26%, and among the latter the liver disturbance was recognized in 25%.