Forty-five cases with positive cold-hemagglutination reaction and transient pulmonary infiltration were investigated clinically.
Cold-like symptoms were shown as general symptoms in one third of the cases. Cough and sputum were seen frequently, but the symptoms in the upper respiratory tract were seen infrequently. Eighty percent of the cases suffered from fever, of which body temperature was mostly 38°C-39°C. Physical findings in the chest indicated minimal abnormality. On red cell sedimentation rate 60% of the cases had middle-graded acceleration higher.
The cold-agglutination value was defined positive above 27, most of the cases showed 27 or 28 at their maximum value, most of which appeared in the 2nd-9th week. The pulmonary infiltration was observed in general in the lower lobes, Especially in the right lower lobe the infiltration was seen in the high rate of 44% and disappeared within the 2nd-9th week. But 73% of them disappeared within the 6th week.

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患者は28才の既婚の女子,生来健康であつたが昭和46年10月ころより上口唇の腫脹糜爛をもつて発症し,鼻の悪性肉芽腫と類似した経過をとり,全身の皮膚および臓器に病変が波及し,剖検によつて悪性細網症と診断された稀有な一症例を経験した.発病時の主訴は上口唇の縻爛を伴う高度の腫脹で,某医に6ヶ月間治療をうけていたが軽快せず当科へ入院した.入院時には上口唇は甚だしく腫脹しその表面は潰瘍に陥り,高熱悪感,咽頭痛,全身倦怠態,食欲不振などあり,これらの症状は初めは一進一退していたが次第に増悪した.入院時より上口唇より再三に亘り組織生検を行つたが確定診断が得られず,細綱肉腫がもつとも疑われた.
治療は極めて困難をきたし,局所の軟膏塗布,抗生剤とステロイギ併用療法,放射線療法,多剤併用化学療法(VEMP),輸血等可及的に行つたが,放射線療法(60Co)に少しく反応を示した他は見るべき効果がなかつた.3ヶ月目頃より全身皮膚表面に拇指頭～梅実大の深い潰瘍形成を伴う硬結が多発し,それらの潰瘍及び原発巣からも度々出血した.47年11月全身状態は更に悪化し,肺及び肝への転移も疑われたが,入院後7ヶ月で気管支肺炎を併発し死亡した.
剖検では肺,心,胸腺,全身皮膚に腫瘤がみられ,喉頭蓋,食道,胃に潰瘍がみられた.肝,脾は腫大していた.このように本症例では皮膚,呼吸器,消化器を初め種々臓器に多数の腫瘍状結節及び潰瘍が認められたのであるが,組織学的には転移した腫瘍とみるよりはむしろ上記諸臓器における既存組織の壊死と異常細網細胞の浸潤及び他の間葉性細胞の肉芽腫様増殖とであつた.これら壊死巣の内部及び周辺では血管内膜下に細網細胞が強く増殖し,ために血管内腔が狭くなり,血栓が生じて内腔が完全に閉塞されたものもみられた.

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Enzyme histochemical changes were observed both light and electron microscopically in the thyroid follicular cells of the rats given either TSH or PTU. One enzyme was peroxidase which plays important roles in the synthesis of thyroid hormones and the other was acid phosphatase, one of many lysosomal enzymes.
Light microscopically the follicular cells of normal rat's thyroid were positive by both enzyme stainings. The follicular cells of rats given TSH singly were strongly positive, and the cells of those administrated PTU for 2 weeks were also strongly positive.
Electron microscopically, the localization of thyroid peroxidase activity was found in the following sites :
(a) the perinuclear cisternae (b) the cisternae of the endoplasmic reticulum (c) Golgi complex (d) some apical vesicles. The changes of peroxidase activity in the follicular cells of rats given TSH singly or PTU continuously were as follows : the perinuclear cisternae, the dilated cisternae of r-ER and many apical vesicles were positive after single TSH administration, and the perinuclear cisternae and the dilated cisternae of r-ER were also positive after prolonged PTU administration. From above observations, it was speculated histo-chemically that the endogenous peroxidase activity in the thyroid follicular cells of the rats was elevated after single TSH or prolonged PTU administration.
In order to compare these histochemical changes with biochemical ones of peroxidase activity, peroxidase activity of the rat's thyroids under the same maniplations were determined by guaiacol assay. The peroxidase activity per thyroid lobes from a rat was significantly increased after prolonged administration of TSH and PTU.

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In the present paper, the author attempts to clarify the social situation of civil servants working in Bakufu daikan 代官 (deputy executive) offices in order to link together the research on central Bakufu policy concerning its proprietorships and the work that treats those fiefs from a regional standpoint. To begin with, the author investigates the lowest ranking members of the daikan office staff, the katte-makanai 勝手賄, ashigaru 足軽, and chugen 中間. In many cases, these staff members were hired by the top ranking officials (tetsuke 手付 and tedai 手代) to accompany the latter to their appointed proprietorships. Therefore, these three positions were similar in function and social position to servants (hokonin 奉公人) of samurai families. The author concludes that these three posts were clearly separated in both treatment and social background from the tetsuke and tedai, who actually administered Bakufu fiefs. Next, the author investigates the aspect of succession and inheritance among tetsuke and tedai. There were two kinds of tetsuke : one who had risen from the clerical/law enforcement position of kumi-doshin 組同心, the other who was connected to Bakufu ministers. Because the position of tetsuke could be bought and sold, there were also such persons of tedai and commoner origins who were able to acquire the position of tetsuke. During the latter half of the Tokugawa period, many tedai positions became kinshiporiented, being handed down from father to son, and thus came to be monopolized by certain family lines. The social position of tedai was not very clear, but during the period in question they tended to identify themselves strongly with the samurai class. Both tetsuke and tedai were frequently moved or "lent" (moraiuke 貰い請け) from one daikan office to another, resulting and smooth working relations within offices throughout the realm. It was believed that such lending woud contribute to the improvement of tedai job skills, and specialization was encouraged among those who had inherited the position from a kinsman. It was in this way that tedai developed strong camaraderie among themselves and formed groups. Under the influence of such tedai group formation, tetsuki of both varieties formed bonds with the tedai bureaucrat class and formed what can be called "daikan civil servant groups."Such group formation facilitated the reproduction of tetsuki-tedai relationships and became firmly imbedded within the daikan organization in the form of a very influential group capable of effecting the decisions of the daikan himself.

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