The Intrahepatic circulation of the blood in urethan-anaesthetized mice has been observed by means of the transillumination technique with the long length condensor type apparatus, on the case of acute carbon-tetrachloride poisoning. It seems that this procedure will result in the necrosis and degeneration due to the ischemic hypoxia in the centrallobule. Because, the swelling and fatty degeneration of the liver cell and the narrow sinusoid are noted. While, the blood stream is obstructed around the above focus. These observation may be suggest there is the close relationship between the necrosis and the intrahepatic blood-flow.
Hyperglycemia which was induced by subcutaneous injection of adrenalin (0.01mg per kg) were observed on normal persons and patients of various hepatic and endocrine diseases. It was proved that on hepatic patients, especially with decompensate cirrhosis, the blood sugar elevation by adrenalin injection was lower and prolonged compared with that on control cases without hepatic damage. This fact was so charateristic as to permit the diagnosis of hepatic insufficiency, in which endocrine disturbances were excluded. Using hepatic venous catheterization, the increase of hepatic sugar output induced by adrenalin injection in all cases was found to precede arterial blood sugar elevation. And when glucose solution was previously injected intravenously this effect was in-tensified. The increase of hepatic sugar output on hepatic patients was smaller than that on normal persons. The blood sugar elevation in systemic artery were not always proportional with the grade of increase of hepatic sugar output.
Initial hyperglycemia and serial hypoglycemia after intravenous injection of insulin which contained H-G-F i.e. “Glucagon” were observed with normal and patients of various hepatic and endocrine diseases. It was proved that in hepatic patients the initial elevating effect and serial lowering effect of regular insulin upon arterial blood sugar level was not marked compared with that on control cases without hepatic damage. Using hepatic venous catheterization, the increase of hepatic sugar output in these cases was found to precede the initial elevation of arterial blood sugar, and its sub-sequent change was found to decrease parallel to arterial blood sugar level. The return to the initial blood sugar level from hypoglycemia was prolonged in hepatic patients. Blood sugar curve after insulin injection reflects carbohydrate metabolism of the liver but also may be influenced by extrahepatic hormonal regulation. From the above observations it was concluded that examination of the blood sugar changes after insulin injection have diagnostic value to estimate the severity of hepatic damage when endocrine disturbances were excluded.
The inhalation tests of the gas mixture of low oxygen content and of high carbon dioxide content were made in man whose carotid bodies had been extirpated bilateraly. The results obtained are as follows: 1) About three weeks after the extirpation of bilateral carotid bodies, the respiration volume of the normal air was diminished than before. 2) About three weeks after the extirpation, the respiration volume of the low oxygen gas mixture tended to be less than that of the normal air, and it was the more marked, the poorer the oxygen content of the inhalating gas mixture. 3) More than four months after the extirpation, the respiration volume was not increased when the arterial oxygen content reached about 15.6 vols per cent, but was increased instantly when the content showed 12.1 vols per cent being less than normal. 4) After the extirpation of bilateral carotid bodies, the respiration volume of the high carbon dioxide gas mixture also tended to be less than before, but it became normal relatively soon.
Clinical and laboratory studies on three cases of constrictive pericarditis were carried out in the period of time between pre- and postpericardiectomy. Two of them were restored and one died 27 days after the operation and was autopsied. In all cases the past history supported the probable diagnosis of pericarditis of tuberculous origin. The major signs in these cases were ascites, peripheral edema, hepatosplenomegaly and engorgement of the jugulal veins. Some manifestations like hypoproteinemia, increased sedimentation rate, elevated venous and spinal fluid pressure, low arterial blood pressure, small pulse pressure, and prolonged circulation time were in accord with those observed by many other authors. The X-ray findings; the cardiac pulsation were definitely decreased or almost completely absent and a few plaques of calcification were found by tomography. The electrocardiogram; flat and/or comparatively sharply or deeply inverted T weves in all cases and auricular fibrillation in one case were seen but low voltage of QRS complexes was not seen in any case. The angiocardiogram; dilatation of the superior vena cava and the small aortic arch were shown. The regurgitation of the contrast material into the inferior vena cava was also demonstrated and this is considered as a prominent sign in the diagnosis. The liver biopsy; marked congestion was found without any change suspected of being hepatic cirrhosis. The hemodynamic studies in the usual way by means of right heart catheterization revealed a rise of the blood pressure at any site in the range between the systemic vein and the “pulmonary capillary”, and the so-called “early diastolic dip” was recorded in the right ventricle. The cardiac output was low and its level was not affected by the reduction of the venous return induced by the tourniquets applied on both thighs. Dye-dilution curves obtained at the brachial arteries indicated a curve similar to normal but not a alow one as is usually seen in congestive heart failure. The decortication of the heart improved the morbid conditions of the hemodynamics but such symptoms as peripheral edema, ascites, and hepatosplenomegaly remained unchanged, or were slightly improved. From above studies we would like to draw the conclusion that the surgical treatment for constrictive pericarditis should be performed as soon as possible after the diagnosis has been made.