The availability of afternoon glucose tolerance test for the diagnosis of diabetes mellitus was investigated. Fifty grams glucose tolerance test was performed twice in 52 patients of various diseases, i.e., one test was made in the morning and another was done in the afternoon after taking an ordinary breakfast alone. No significant difference was seen between the two tests. Hence, we can use the glucose tolerance test for the diagnosis of mild diabetes in the afternoon instead of the test in the early morning without any change of criteria. There was also no significant difference in the plasma insulin response to glucose ingestion when it was given in the morning or in the afternoon.
With the histochemical method of Häusler, activity of carbonic anhydrase (CAH) in normal mouse kidney was found most concentrated in proximal tubules, while distal tubules showed less intense activity of CAH. Specificity of the reaction was confirmed by complete block of the reaction with either in vivo or in vitro application of Diamox. After in vivo administration of Diamox, even in a large dose, complete block of CAH in sections was detectable for about half an hour. Duration of this blocking effect could be sustained longer by simultaneous administration of sodium bicarbonate, but not when the alkali and Diamox had been given successively. Reduction of the effect of Diamox by acidosis was also confirmed in the mice in a state of artificial acidosis which had been induced by oral administration of ammonium chloride.
It is of importance to detect split products derived from fibrinogen or fibrin for the diagnosis and therapy of intravascular proteolysis (digestion of fibrinogen, fibrin, factors V and VIII). A simplified method of detecting the split products was presented by using a tanned red cell hemagglutination inhibition immune assay as in pregnancy test of Pregnosticon or Serotest. The method was easily performed within 2 hours. A minimum sensitivity of fibrinogen concentration to be detected was approximately 5μg per ml. By the application of this test system to gynecological and obstetrical materials, a large amount of the split products was detected in defibrinated plasma or serum samples from the umbilical cord, the uterine cavity during menstruation and patients with obstetrical hypofibrinogenemia.
The clinical effects of combination chemotherapy with five or six anticancer drugs were investigated on the patients with the advanced cancer which originated mainly from the gastrointestinal tract. The five-drug regimen was found effective in 15 of 21 patients (71%) and the six-drug regimen in 29 of 43 patients (67%). The incidence of the cases which showed favorable clinical responses was higher in the five- and six-drug regimens than in the one-, two- and three-drug regimens. Leukopenia, which occurred in almost half of the patients, was observed more frequently in cases of the six-drug regimen than in cases of the five-drug regimen. Gastrointestinal disturbances were found frequently during and after treatment, and seemed to be aggravated mainly by 5-FU and SP-G in these regimens. The main reasons for the discontinuation of these therapies were firstly leukopenia and secondly gastrointestinal upsets. The cases treated with the five- or six-drug regimen survived only slightly longer than the non-treated. However, there were few remarkable differences in the survival period between the cases of the five- or six-drug regimen and the cases of other regimens.
In order to find out the sensitive tests to differentiate intravascular coagulation from intravascular proteolysis, the changes in factors of coagulation-fibrinolysis were studied on experimentally produced fibrinolysis, fibrinogenolysis and intravascular coagulation. Fibrinogen, and factors V and VIII were decreased; the prothrombin time, thrombin time and partial thromboplastin time were prolonged in both intravascular proteolysis and coagulation. The reliable factors to be tested for the differentiation were the prothrombin determined by the two stage method or by employing prothromb in- free plasma, plasminogen, platelets and the split products derived from either fibrinogen or fibrin. Namely, the platelets and prothrombin were decreased in intravascular coagulation, whereas these factors were normal in proteolytic stage. Plasminogen was low in both fibrinolytic and fibrinogenolytic states, but normal in intravascular coagulation. Basing on the facts that the split products from fibrinogenolysis were heatlabile at 56°C for 15 minutes, while those from fibrinolysis were heat-stable, the differentiation between the split products from fibrinogen and fibrin was possible by measuring the thrombin clotting on a mixture of control plasma and heated or non-heated test sample, and by employing the simple radial immune diffusion technique.
Histopathological characteristics of ectopic ACTH-secreting tumors were confirmed by detailed examinations on 8 undoubtful cases with bio- and/or radioimmunoassay for ACTH in the tumor tissue. They were unexceptionally composed of carcinoma cells of poor differentiation, and basically adenocarcinoma took more advantage of ACTH-elaboration by the tumor tissue than epidermoid carcinoma. There was no relation between carcinoma cell patterns and degrees of ACTH activities. Electron microscopic studies revealed serotonin-like granules in cells of colon carcinoma but failed to demonstrate them in thymic carcinoma. Additional 4 cases with atypical Cushing's syndrome without assay for ACTH activities by the tumor tissue included a case of bronchial carcinoma with clinical signs of gonadotropic activities and an exceptional pattern of histology as colloid carcinoma. Appearance of Crooke cells in the pituitary gland was remarkable. The ratio of Crooke cells to beta 1 cell (R cell) in number had a close relation to adrenocortical hyperplasia rather than to the value of ACTH activities in the tumor tissue.
Morphological changes of the metallophil Kupffer cells, stained by the silver impregnation, have been investigated on autopsy eases with malignancy and on rats with Yoshida sarcoma. Yoshida sarcoma cells were injected into the subcutis, liver, portal vein and spleen of the rats. In the autopsy cases with malignancy, Kupffer cells were numerically increased and hypertrophic. These changes were always observed, even if the malignancy existed in any other organs except the liver. In the rats, Kupffer cells were increased in number and became hypertrophic after transplantation or in accordance with growth of the tumor. The acid and the alkaline phosphatases and the non-specific esterase became more active. The PAS reaction was also rather intensive. The most marked changes of Kupffer cells were seen in cases of the intrasplenic transplantation of tumor cells. The vital staining showed a depressed phagocytic activity in contrast with enzymatic and PAS reactivities. It has been suggested through the present study that Kupffer cells of the reticuloendothelial system act against the growth of malignant tumors.
The response of plasma renin activity (PRA) to various renin stimulating procedures was determined in 108 hypertensive patients. PRA was suppressed in all of the patients with primary aldosteronism and in a patient with adrenal 17a-hydroxylase deficiency. In benign essential hypertension low response of PRA was observed in 11 of 72 patients. Aldosterone secretion rate was determined in these 11 patients and raised values were found in 7, of whom 3 patients received adrenal exploration. A small adrenocortical adenoma was detected in one patient but not in the other two. The suppression of PRA was also found in patients with Cushing's syndrome and in patients with chronic renal parenchymatous diseases. These results raised some doubt about the reliability of the diagnostic criterion postulated by Conn for primary aldosteronism.
The perfusion of the sinus node artery in dogs in situ was performed. The selective administration of nicotine and DMPP into the sinus node artery induced a biphasic response, i.e., a negative chronotropic response followed by a positive one. Both compounds produced similar negative chronotropic responses, but positive responses were more markedly induced by DMPP than by nicotine. These negative chronotropic responses were blocked by atropine, hexamethonium and tetrodotoxin. The positive response to nicotine was blocked by propranolol and tetrodotoxin. DMPP-induced positive chronotropic effect was blocked by propranolol but never by tetrodotoxin. It is suggested that the positive chronotropic action of DMPP is different from that of nicotine on the sino-atrial node and is similar to that of tyramine.