Acta Medica Okayama volume13 issue2

Der Verfasser schildert auf Grund eigener Untersuchungen, bzw. Erfahrungen die Verwertungsmoglichkeit seines Myotonometer genannten Apparates fur die Registrierung von Krankheitsprozessen der Bauchregionen und der Schmerzempfindung.

Judging from our vital observation conducted mainly by tissue culture, it was firmly demonstrated that ascitic phagocytes are not histiocytes but they are the cells closely related to monocytes and that the sites of the genesis are the milky spots of the greater omentum. The milky spots are most possibly the remnants of the mesenchymal hematopoiesis of the embryonic stage.

Effects of stimulation of the small intestine upon the gastric, small intestinal and colonic motility have been studied in dogs. The results are summarized as follows. 1. The movements of the stomach, small intestine, and proximal colon are always inhibited by the distension or the contracture of the muscular coats of the small intestine but no responses are produced by a mechanical or chemical stimulation of the mucosa; and those of the distal colon are in most cases also inhibited, whereas in rare instances are they augmented. 2. The afferent impulses are transmitted through the great and small splanchnic nerves and the lumbar sympathetic nerves to the inhibitory as well as the excitatory (pelvic nuclei) centers of the intestinal movements located within the spinal cord, whereas the vagal nuclei remain unaffected. The efferent impulses are transmitted through the thoraco-lumbar sympathetic nerves as well as through the pelvic nerves. The latter are involved in the augmentative effect produced in the distal colon. 3. The threshold producing the extrinsic muscular reflex is higher than that eliciting the intrinsic muscular reflex.

In our studies on the hypotensive effect of Diamox by intravenous injection, we have arrived at the following conclusions. 1. Ocular tension falls and the flow of aqueous humor becomes sluggish. 2. Diamox inhibits the activity of carbonic anhydrase, and the concentrations of HCO3-, K+, Cl- and glucose are markedly altered. 3. Protein increases both in blood and aqueous humor, but no change in protein fraction can be observed in blood. 4. Diamox in no way affects the metabolism. 5. It seems that Diamox brings about the change in the specific gravity of blood, making the latter either more diluted or more concentrated. From these, we conclude that the mechanism of the loweing of ocular tension by Diamox seems to lie in the fact that it inhibits the activity of carbonic anhydrase, and that consequent alteration in the concentrations of HCO3- and other ions accompanied by the change in osmotic pressure as well as a slight decrease of water in tissue all bring about the fall in the ocular tension. However, Diamox seems to have nothing to do with aqueous humor in so far as active transport or permeability are concerned.

Papanicolaou's smear test is a method based upon the morphological study of the cancer cells exfoliated from the epithelium, whereas T.P.T. is a method for examining the intracellular metabolism, the glycolysis, by a supravital staining of the cancer cells. The latter, therefore, can be called as a cytochemical diagnosis. Since, by the T.P.T. method, even a beginner can obtain the result of approximately 80% in correct and the skilled ones as high as 95%, the clinical diagnosis can be made all the more accurate by using Papanicolaou's test in combination with T.P.T. method. As for the entity of these granular cells, there remains a room for discussion, but Misonou feels that Cell Type A arises from necrobiosis of the carcinomatous tissues while Type B would be a certain wandering cell. This reaction, however, should not be employed to the cases in the puerperium, because the similar cells are exfoliated from the puerperal uterus. Thus, I can say that the T.P.T. is not a specific reaction to cancer. From this study, I wuld recommend T.P.T. as a method that is quite simple and is servicable for saving a great deal of effort and time on the part of clinicians, and I would like to encourage you to use it as one of tools for the diagnosis of carcinoma of the uterus, especially for an early diagnosis.

In our department we have been placing a special emphasis on the treatment and study of rheumatoid arthritis, and during the last four years we have handled about 1,600 cases visiting our outpatient clinic and approximately 100 hospitalized cases. Our experiences with these patients are only what might be called an introductory phase in the study and treatment of rheumatoid arthritis when compared with those in Europe and America. In estimating the incidence of rheumatoid arthritis in Japan from various available data, although it would not reach the level of England and U.S.A., it will be about 100 cases per 100,000 population, matching more or less the incidence in the northern Europe. As regards sex and the predisposing age we find no great difference from those in Europe and America. One striking difference that we find is the fact that patients in our country have very little resistance against salicylic acid drug used in treatment. Therefore, it is unreasonable to expect a good anti-inflammatory action by administering a large dosage of 5-10g of such a drug as aspirin per day. It must be limited within a comparatively small dosage of 1.0 to 2.0 g or with concomitant administration of prednisolone and aspirin in the hope of utilizing its analgesic effect. Furthermore, it is not feasible to introduce the results of studies made in Europe and America on the salicylic drug and its prescription all of them showing the concentration in blood 35 mg%, which is on the borderline of intoxicating dosage. This is only one example, and with some more experiences we shall undoubtedly encounter many dissimilar points. Therefore, it is essential that rheumatology specific to Japan needs to be established.