The myocardial citrate metabolism was investigated coronary sinus catheterization in 49 human subjects, including 8 healthy individuals, 6 hypertensive patients without ST-T abnormalities in electrocardiogram (Group I), 16 hypertensive patients with abnormal ST-T findings (Grou II), 9 patients with coronary sclerosis with normal blood pressure and abnormal ST-T findings, 5 patients with mild congestive heart failure due to various kinds of valvular diseases, 4 anemic patients and one thyrotoxic case. Studies were performed at resting state and effects of vasoacting drugs were observed. The drugs examined were vasopressors as norepinephrine and epinephrine, antihypertensive drugs as hexamethonium and hydralazne, coronary dilating drugs as nitroglycerine, papaverine and theophylline-ethylendiamine, and high oxygen tension. The results obtaind were as follows. 1. In the healthy individuals, the average arterial citrate concentration (Ca) was 0.87±0.18mg per 100ml, the coronary venous citrate concentration (Cs) 0.65±0.11mg per 100ml. and the coronary arterio-venous citrate difference (ΔC) 0.20±0.13mg per 100ml/ Cs and ΔC tended to vary with arterial lavel and the relationship of the Cs or ΔC to Ca was demonstrated by the following thentative formula. Cs=0.44Ca+0.27; ΔC=0.56Ca-0.27 2. In patients with hypertension, coronary sclerosis, or mild congestive failure, myocardial citrate extraction was decreased or negative, showing a significant fifference from mormals, Similar tendency, theough statistically not significant, wsa seen also in anemia and thyrotoxicosis. 3. When the blood pressure was elevated in healithy cases by intravenous drop infusion of epiephrine, it was noticed that the relationship between Ca and Cs showed a beviation from that of mormals. In contrast, myocardial citrate metabolism of hypertensive hearts tended to be normalized by slow intravenous in jection of antihypertensive durgs such as hexamethonium or hydralazine. 4. As coronary dilating drugs, the effects of nitroglycerine administered sublingually and papaverine and theophyllin-ethylendiamine given intravenously were examined. It was clarified the, as the effects on the myocardial citrate metabolism were concerned, each drug had different action; disturbance of myocardial citrate metabolism was improved by nitroglycerine of papaverine, whereas it was aggravated by theophylline-ethylendiamine. 5. By inhalation of 50 or 100% oxygen, the disturbance in citrate metabolism was improved. 6. In patients with hypertension, sopontaneous blood pressure variation was reflected on the change of myocardial citrate metabolism. 7. From the above described data, it was concluded that the disturbance of citrate metabolism was present in the heart muscle of patients not only with hypertension, coronary sclerosis, & congestive failure, but with anemia and thyrotoxicosis, and that it might be resulted from the sequel of hypoxia in myocardium.
In twenty eight patients with cardiac diseases, seven patients with pulmonary siseases, eight patients with other diseases, changes of vital capacity, maximal breathing capacity, breathing reserve ratio, tidal volume, and expiratory reserve volume were measured in the following body positions: sitting, right lateral, left lateral, supine positions. In all groups, vital capacity, maximal breathing capacity and expiratory reserve volume were less in the lateral position than in the sitting position, and least in the supine position. These changes were most evident in patients with pulmonary diseases, therefore, the increase of ventilatory resistance seemed to be the chief causal element ot orthopnea in pulmonary patients. In comparing vital capacity and maximal breathing capacity in the right lateral position with those in the left, in cardiac patients, values in the former position were larger than in the latter as far as average of the changes was concerned, and in other two groups the reverse situation was observed. Breathing reserve ratio was not so markedly changed by changing body position. In cardiac patients, the influences of circulatory failure upon the pulmonary congestion and the easy fatigabiliyt of respiratory muscles seemed to be the important causal elements of orthopnea and trepopnea.
An attempt to elucidate the roentgenologic findings of the deformity of stomach, duodenum and gallbladder resulting from intra-abdominal adhesion was undertaken on 92 patients in comparison with those on operation. The results may be summarized as follows; No deformity in pars media of stomach could be induced by adhesion with a few exceptions. Deformity in gastric angle could not be caused by adhesion itself, but likely by pathologic changes in mucosa. This fact suggests that there are possible presence of either ulcer or cancer of stomach. Antrum is, in general, predisposing portion of adhesion, being easily deformed by the adhesion. Roentgenologic characteristic features of Antrum due to adhesion are of either lineal or irregular deformity, particularly topical changes of longitudinal axis of antrum. Differentiation between the deformity in duodenal cap easily induced by adhesion are important and difficult. Duodenal cap due to adhesion without ulcer reveals practically an irregular and a fall-like deformity centributable to differentiation. Therefore, deformity of duodenal cap without ulcer is considered to be of adhesional origin. Abnormalities in longitudinal axies of duodenum are significant features of adhesion, also. Cholecystography with simultaneous duodenography is reliable methode in diagnosis of adhesion of gallbladder. Deformity of duodenum with negative finding in cholecystograms suggests the possible presence of adhesion between gallbladder and surrounding tissues.
KIK reaction has been named to a biological diagnostic method of stomach cancer based on the anemiogenic activity of the gastric juice taken from the patients with stomach cancer when injected to a rabbit. The KIK factor, a substance that presents the anemiogenic activity has been presumed to be one of the simple from polypeptide and it has been successfully isolated from cancerous gastric juice and ascitic fluid. This KIK factor was hydrolized with 6N-hydrochloric acid to be placed on two dimensional paper chromatograply for the analysis of its amino acid constituents in this report. Amino acids that were found to constitute the factor were such as glutamic acid, arginine, glycine, serine, lysine, valine, leucine, phnylalanine, tyrosine, proline, alanine, aspartic acid, and those which were apparently increased in the amount were arginine, lysine, leucine, phenylalanie. Tyrosine was present only in cancerous ascitic fluid.
With the insulin assay using hypophysectomized-adrenodemedullated rats the following facts were observed in dogs: 1. The transient increase of the plasma insulin concentration in the cranial pancre-aticoduodenal vein following intravenous glucose administration was abolished after bilateral sections of the splanchnic nerves, of the sympathetic trunks, of the vertebral nerves, or after bilateral stellate and caudal cervical ganglionectomy. The rise of the concentration, however, was observed after transection of the upper thoracic spinal cord, after bilateral sections of the ansae subclaviae, of the directly connected branches of the stellate ganglia with the spinal nerves (C7, C8 and Thl), or after bilateral cranial cervical ganglionectomy. 2. The blood flow in the cran. pancreatico-duodenal vein was not significantly changed after bilateral section of the vertebral nerves or transection of the upper spinal cord. 3. No significant increase of the plasma insulin concentration was found following electric stimulation of the distal ends of the splanchnic nerves. From these results the conclusion is that such sympathetic pathway as the splanchnic nerves, sympathetic trunks, stellate ganglia and vertebral nerves, is indispensable for the elevation of the plasma insulin concentration, and a possibility of the action of the nervous system as a centripetal reflex arc in insulin secretion was discussed. Through all of these experiments no correlation was found between plasma insulin concentrations in the pancreatic vein and glucose tolerance.
The net production of serum albumin and γ-globulin by human liver slices in vitro was studied by means of immunochemical quantitative precipitation reaction. The results were as follows: 1. The average values of net production of albumin and γ-globulin in 5 cases of nonliver diseases was 0.17 and 0.07mg. per g. of the liver per hour, respectively. 2. The correlation between the net production of albumin and that of γ-globulin was found. 3. In cases of liver diseases the net production of albumin decreased correlating with their liver function (Bromsulphalein test, Takata test.). However, the net production of γ-globulin did not decrease in liver diseases except for icteric cases, but rather increased in some cases.
An investigation was made on the changes of the blood elements on the subjects, who climbed Northern Japan Alps. The results are as follows: 1) Erythrocytes show slight fluctuation in number in early stage, but increase in terminal stage. 2) The amount of hemoglobin decreases in early stage, then it recovers. Above results show that color index is hypochromic, compared with that measured before climbing. 3) The value of hematocrit increases in terminal stage and the increased volume of blood cells is recognized. 4) Eosinophiles markedly decrease in initial stage, and recover in terminal stage in most of the examined subjects. 5) In serum protein, total protein fluctuates slightly in initial stage, and decreases in terminal stage, A/G ratio and albumin fraction decreases slightly initially, and distinctly decreases terminally, α-globulin fraction slightly increases in terminal stage, and γ-globulin shows distinct increase. 6) The concentration of blood creatinine shows no marked change. 7) In regard to urine protein, half of the subjects presented slight albuminuria initially, and none observed terminally.
The investigation was performed by electrophoresis on the changes of serum protein of ten normal subjects, who stayed in our research laboratory after the bus-trip to Mt. Norikura, high altitude with 2, 740 meters above the sea-level, without any physical labor. The results are as follows: 1) The amount of total protein decreases slightly in early stage right after the trip then in all cases it recovers to show a certain value one week later. 2) Albumin fraction and A/G ratio tend rather to increase in early stage, and to decrease on the 3rd and 5th day, then return to original value. 3) No marked change appears in α-globulin fraction and β-globulin. 4) γ-globulin fraction distinctly increases on the fifth day after the bus-trip to high altitude.