Blood pressure, pulse rate (including ecg graphic observation) and skin temperature were determined in essential hypertension group, miscellaneous disease state group and normal control group who were exposed to the artifical climate room at 35°C or 5°C during 30' respectively. Hemodynamical analysis was made by our own modification of Wezler's method. 1) The blood pressure lowers in the hot environment and rises in the cold; this fluctuation is more remarkable in essential hypertension than in normal control. 2) There are some differences of reaction mode in juvenile, middle-aged and senile hypertension: while the change of diastolic pressure is most distinct in juvenile group, the fluctuation of systolic pressure is more dominant in the last two groups. 3) The response of skin temperature against generalized exposure to hot or cold environment in essential hypertension varies from that in normal control; there can be shown some possibilities of the existense of the generalized temperature dysregulation in hypertensive patients. The response of the skin temperature of extremity ends was more abnormal than that measured in fore-head and abdomen.
In the Ist Report, the author stated that the liver function is expressed as the elimination quotient (E. Q.) of the bile acid, namely by D. E., R. E. and R. E./D. E., and when D. E.>3.0, R. E.<4.0, R. E./D. E.<1.0, the liver function is disturbed, and that the patients with liver disease had high positive results in this test paralleling those of some other liver function tests. In the present study, this test was performed on the other various diseases, viz. 44 cases of pulmonary tuberculosis, 9 cases of gastrointestinal diseases (4 gastric cancer, 4 gastric and duodenal ulcer, 1 chronic gastritis), 6 cases of gallbladder diseases (cholelithiasis, cholecystopathia and cholecystectomized patients, 2 respectively), 9 cases of heart diseases (7 mitral failure, 1 aortic failure, 1 pericarditis), 8 cases of renal diseases (7 chronic nephritis, 1 nephrosclerosis), 7 cases of diabetes mellitus and 15 cases of other diseases. And then, by administration of various hepatotonic preparations such as V. B1, V. B2, V. K, glucuronic acid and methionine to these liver disturbed patients, their effects were observed on the point of this test. The results obtained are as follows: 1) In pulmonary tuberculosis, 70.4% of the total showed positive result in this test, and the more advanced the disease, the higher the positivity of the test and the stronger the disturbance of the liver. 2) In gastric cancer, gastric and duodenal ulcer, the positivity of this test was remarkably high. 3) In heart diseases, particularly with congestive hepatomegalia, this test showed sharply positive results. 4) In renal diseases, the elimination of the R-acid was very little and this test revealed serious disturbance of liver function. 5) In diabetes mellitus, either D. E. or R. E. tended to be high, which suggested particularly a changed metabolism of the bile acid in the liver. 6) In observing the effects of various hepatotonic preparations on the disturbances of the liver function by this test, methionine, glucuronic acid and V. B2 had clear hepatotonic action, but V. B1 and V. K had none.
In these studies, renal functions were estimated in 97 patients with hypertensive diseases (67 patients with essential hypertension and 30 patients with renal hypertension.) by clearance methods, and their values of blood pressure, retinal findings, proteinuria and electrocardiogram were compared with the data of renal clearance tests in these patients. As the results: 1) In the 67 patients with essential hypertension, reduction of RPF under the normal range was observed in about 3/5 of them, and decrease of GFR under the normal range was recognized in about 2/5 of them. It was found that the reduction of RPF in essential hypertension indicates the grade of renal hypofunctions most earliest and exactly. 2) In the patients of essential hypertension, it was found that systolic, diastolic and mean blood pressure indicate the correlation with RPF in statistically. 3) The correlation of RPF and GFR with the blood pressure in essential hypertension is contrary to that of renal hypertensions. (Fig. 28). 4) Between the degree of eyeground findings by Keith-Wagener's classification and GFR, RBF and FF, there are some parallel correlations. 5) Particular attention was given to the correlation between RPF and proteinuria. The 80% cases of proteinuria showed the reduction of RPF. 6) The correlation between E.C.G. and GFR, RPF was not proved.
In performing the so-called Waaler-Rose test in rheumatoid arthritis, humon O erythrocytes sensitized with the rabbit anti-human O cell amboceptor were used and some clinical evaluations of this modified test were investigated. 69% of 39 cases of rheumatoid arthritis, 2.6% of 154 cases of other deseases and none of 11 cases of healthy persons showed positiv results. This modified method is considered to be well available in clinical use, although sheep red cells sensitized with the rabbit anti-sheep cell amboceptor have been almost always used in the Waaler-Rose test.
A routinely applicable method of roentgen visualization of the spleen is described, which is useful to diagnose the enlarged but not parpable spleen. Technique: The patient is given one-half to one effervescent powdor before meal. Then the P. A. and left oblique views are taken in prone position, using a Potter-Bucky diaphragm. The films are exposed at 40 inch distance, one to one-half second, 100-120ma., 65-75kv. The measurements of the spleen shadow are illustrated in Fig. 4. The criteria for determining splenic enlargement are as follows. 1) The spleen is not enlarged if the “T” is less than 5cm and the “W” is less than l0cm. 2) The spleen is doubtfully enlarged if the “T” is from 5 to 6cm or the “W” is from 10 to 12cm. 3) The spleen is probably enlarged if the “T” is more than 6cm or the “W” is more than 12cm or the “D” is more than 1.5cm. 4) The spleen is definitly enlarged if the “T” and the “W” are more than 6cm and 12cm respectively, while the “D” is more than 1.5cm. The other signs of enlarged spleen which can decide the diagnosis in questionable cases are: The upper pole of the spleen reaches to the top of the diaphragm, and the shape of stomach-bubble is cylindrical or oblonged. The following should be added: 1) In the cases of greatly enlarged spleen, its size and shape are recorded by the roentgenogram in spine position with no contrast technique. 2) Tomographic studies of 15 normal subjects show that the angle of normal splenic axis (A. A. in Table 3.) to the transverse plane in prone position is 8 degrees upward to 26 degrees downward, and far less than that of the direction of the 10th. rib (A. R.).